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Fulltext Free non-vascularized fibular graft for treatment of pediatric traumatic radial bone loss: a case report

Thevarajan K, Teo P

Malays Orthop J, 2013 Jul;7(2):37-40.
PMID: 25722825 MyJurnal DOI: 10.5704/MOJ.1307.003

Various methods, such as vascularized bone transfers, Illizarov bone transport, allogenic bone grafts, bone graft substitutes, are available in treating traumatic bone loss. Free non-vascularised fibular graft is an autografting method that only requires minimal facilities or expertise. However, this method is not popularized due to its avascular property and there is not many reports regarding its use in treating a large traumatic bone loss. We reported a case in our center to demonstrate its possibility of successfully treating the traumatic radial bone loss in pediatric patient. Patient had good recovery with the regain of good range of movement of forearm and there is no harvest site morbidity after two years of follow up.

Matched MeSH terms: Forearm
Fulltext A Rare Case of Supinator Intramuscular Myxoma with Encasement of the Posterior Interosseous Nerve

Lim CY, Duski S, Chye PC

Case Rep Orthop, 2019;2019:5156032.
PMID: 31485364 DOI: 10.1155/2019/5156032

Intramuscular myxomas are rare, benign mesenchymal tumors. Tumor location in the forearm is very rare among all the intramuscular myxomas. To the best of our knowledge, there were two cases of supinator intramuscular myxoma reported in the literature, and we intend to report the third case of supinator myxoma with encasement of the posterior interosseous nerve (PIN). A 67-year-old lady presented with history of left proximal forearm swelling for the past 5 years. Magnetic resonance imaging showed a lobulated multiseptated lesion seen within left supinator muscle, which was hyperintense on T2-weighted images (T2WI) and hypointense on T1-weighted images (T1WI), with peripheral enhancement post contrast. The tissue diagnosis of myxoma was confirmed via an open biopsy. She underwent en bloc resection of the tumor. The PIN was encased by the tumor; it was preserved and carefully released from the tumor. The nerve sheath served as an excision margin. In conclusion, we present a rare case of an intramuscular myxoma in the supinator muscle. In view of the location, extra attention should be paid during excision surgery to locate the PIN and to avoid damaging the surrounding structures.

Matched MeSH terms: Forearm
Fulltext Single-Bone Forearm Salvage Procedure for a Child with Acquired Radial Clubhand in a Resource Limited Centre: A Case Report

Sahdi H, Chan WH, Dollah NB, Entri A

Malays Orthop J, 2018 Nov;12(3):43-46.
PMID: 30555646 MyJurnal DOI: 10.5704/MOJ.1811.011

Acquired radial clubhand deformity can be a consequence of large bone gap left by premature extensive radius osteomyelitis sequestrectomy. Single-bone forearm reconstruction is a salvage procedure when other motion-preserving techniques are not feasible. Here we present a child who developed radial clubhand deformity after an untimely sequestrectomy of radius diaphysis. In view of limited microsurgical expertise in our centre, single-bone forearm procedure was done utilising simple Kirshner wires to achieve radio-ulnar fusion. The procedure resulted in pain-free stable wrist, restoration of hand function and improved cosmesis.

Matched MeSH terms: Forearm
The carrying angle: racial differences and relevance to inter-epicondylar distance of the humerus

Allouh MZ, Abu Ghaida JH, Jarrar AA, Khasawneh RR, Mustafa AG, Bashaireh KM

Folia Morphol (Warsz), 2016 02 26;75(3):388-392.
PMID: 26916201 DOI: 10.5603/FM.a2016.0007

The human carrying angle (CA) is a measure of the lateral deflection of the forearm from the arm. The importance of this angle emerges from its functional and clinical relevance. Previous studies have correlated this angle with different parameters including age, gender, and handedness. However, no reports have focused on race-dependent variations in CA or its relation to various components of the elbow joint. This study aimed to investigate the variations in CA with respect to race and inter-epicondylar distance (IED) of the humerus. The study included 457 Jordanian and 345 Malaysian volunteers with an age range of 18-21 years. All participants were right-hand dominant with no previous medical history in their upper limbs. Both CA and IED were measured by well-trained medical practitioners according to a well-established protocol. Regardless of race, CA was greater on the dominant side and in females. Furthermore, CA was significantly greater in Malaysian males compared to Jordanian males, and significantly smaller in Malaysian females compared to their Jordanian counterparts. Finally, CA significantly decreased with increasing IED in both races. This study supports effects of gender and handedness on the CA independent of race. However, CA also varies with race, and this variation is independent of age, gender, and handedness. The evaluation also revealed an inverse relationship between CA and IED. These findings indicate that multiple factors including race and IED should be considered during the examination and management of elbow fractures and epicondylar diseases.

Matched MeSH terms: Forearm
Fulltext Non-Traumatic Snapping Tendon on the Dorsal Aspect of the Thumb: A Diagnostic Challenge

Kesu Belani L, Abdullah S, Soh EZF, Abd Jabar F, Nasseri Z

Cureus, 2021 Apr 11;13(4):e14417.
PMID: 33987066 DOI: 10.7759/cureus.14417

A snapping tendon on the dorsal aspect of the thumb is a rare condition as opposed to the common triggering on the volar aspect of the thumb. This condition is known as triggering of the extensor pollicis longus (EPL). A 21-year-old female presented with a clicking or snapping sensation that was felt on the dorsum of her thumb when it is extended. There was no history of trauma. She worked in an ice-cream parlor with repetitive scooping ice-cream motions. Her triggering immediately resolved on releasing the EPL fascia ulnar to Lister's tubercle. Upon wake-up surgery, we could immediately confirm this. We recommend dynamic ultrasound as an investigation and do not recommend MRI. The surgical method of choice is either wake-up surgery or wide-awake local anesthesia no tourniquet (WALANT) surgery.

Matched MeSH terms: Forearm
Fulltext Giant Solitary Forearm Exostosis in A Child

Faisham W.I., Zulmi, W.

Malays Orthop J, 2009;3(1):81-84.
MyJurnal

Forearm deformity secondary to giant solitary ulna exostosis is rare. We describe a rare presentation of symptomatic solitary giant exostosis involving the entire distal ulna resulting in ulnar bowing of the forearm in a five-year-old boy. The tumour was completely resected and the defect was reconstructed with an allograft wrapped with a free autogenous periosteal tubular sleeve to deliver fresh pluripotential cells for better incorporation and integration. The distal ulna physes was preserved. An osteotomy was performed on the radius to correct the deformity. One year after surgery, the deformity remains corrected with normal bone length and excellent hand function. There is no evidence of local recurrence and the allograft has fully incorporated.

Matched MeSH terms: Forearm
Fulltext The effects of forearm position on handgrip strength

Ali Md Nadzalan

Jurnal Sains Sukan & Pendidikan Jasmani, 2013;2(1):2-9.
MyJurnal

This study was conducted to investigate i) while the shoulder was in 180° of flexion and the elbow extended, which of the forearm position (supination, pronation and neutral) can generate the greatest handgrip strength, ii) is there any correlation of the handgrip strength between the dominant hand (right hand) and non-dominant hand (left hand) in each forearm position, and iii) will the dominant hand possessed 10% higher handgrip strength than the non-dominant hand. 100 right handed sedentary active students age 22.20 years old (± 1.03), height 172.83 cm (± 6.37), body mass 68.87 (± 11.52) and grip position 3.77 (± 0.77) were recruited in this study. The result indicated that for both the dominant and non-dominant hand, when the shoulder is in 180˚ flexion of the body with the elbow extended, the greatest grip strength was obtained when the forearm was in neutral position followed by pronation and supination position. Post Hoc analysis showed that for both dominant hand and non-dominant hand, pronation and supination forearm position produced greater strength score compared to supination forearm position (p0.05). In all forearm position, participants were shown to produced significantly greater strength in their dominant hand and all the scores were more than 10% greater compared to when using non-dominant hand. Positive relationships were also found for the strength score between dominant hand and non-dominant hand. As the conclusion, different shoulder, elbow and forearm position can affect handgrip strength.

Matched MeSH terms: Forearm
Fulltext Free radial forearm flap after partial glossectomy for squamous cell carcinoma of the tongue

Chuah, U.C., Kamarul, T., Sara, T.

JUMMEC, 2006;9(2):28-31.
MyJurnal

Squamous cell carcinoma of the tongue is a highly malignant condition and results in high mortality and morbidity in patients despite its early detection (1). Early surgical interventions have been found to reduce mortality but in many reports, tongue reconstructions using live grafts have been found to reduce normal tongue function of speech, swallow and taste. In contrast, our report using free radial forearm flap (FRFF) to reconstruct the defect left over after a radical tongue resection in a 38-year-old gentleman with oral cancer has shown promising results. This type of reconstruction has left the patient with a functional and cosmetically acceptable tongue with minimal alteration in recognizable speech.

Matched MeSH terms: Forearm
Median nerve compression by gouty tophi: a case report

Raffael, I., Rajesh, S.

International Medical Journal Malaysia, 2015;14(1):87-91.
MyJurnal

We describe a case of median nerve compression by gouty tophi. This is a rare condition and presented with loss of function with paraesthesia of both hands in addition to multiple tophis. Surgery was chosen for immediate relief, where a debulking of left flexor digitorum superficialis with decompression of carpal tunnel was done and resulted in improvement of symptoms but became complicated due to inadequate physiotherapy.

Matched MeSH terms: Forearm
Fulltext Factitious dermatitis: a non infective cause of subcutaneous emphysema

Manohar, A., Azhar, M.Z.

Malaysian Journal of Medicine and Health Sciences, 2012;8(1):69-72.
MyJurnal

We report a case of factitious dermatitis in a 17 year female student who presented with recurrent pain .swelling and subcutaneous crepitations of the forearm. A thorough investigation was done. Full blood count, erythrocyte sedimentation rate was normal. Plain radiographs revealed the presence of subcutaneous emphysema. MRI showed similar findings and revealed normal muscles. Colonoscopy and OGDS were normal. except for a small polyp at the gastro-esophageal junction. Based on the clinical findings and lack of correlation with the investigations a diagnosis of factitious subcutaneous emphysema was made.

Matched MeSH terms: Forearm
Fulltext Anterolateral thigh free flap in reconstruction of oral cavity malignancy: UMMC experience

Ahmad, N.A., Margaret, L.

JUMMEC, 2008;11(1):33-36.
MyJurnal

Oral cavity malignancy reconstructive surgery has advanced from pedicle flaps to microvascular free tissue transfer. Previously, reconstruction of these defects were done using radial forearm free flaps in this centre. We report our experience using anterolateral thigh free flap in a 49 year old lady with squamous cell carcinoma of the tongue. Excision of tumour left a defect which was later reconstructed using microvascular free tissue transfer using the right anterolateral thigh free flap. The flap was well taken up at the recepient site and no evidence of flap failure noted post operatively and on completion of radiotherapy. She was able to maintain comprehensible speech and swallowing ability.

Matched MeSH terms: Forearm
Fulltext Bats data from fragmented forests in Terengganu State, Malaysia

Zakaria N, Tarmizi AA, Zuki MAM, Ahmad AB, Mamat MA, Abdullah MT

Data Brief, 2020 Jun;30:105567.
PMID: 32382599 DOI: 10.1016/j.dib.2020.105567

This data article is about bats observed from fragmented forest understories interspaced by agricultural plantations, utility corridors, and man-made structures within rural areas of Setiu (Bukit Kesing Forest Reserve and Ladang Tayor TDM) and Hulu Terengganu (Pengkalan Utama and Sungai Buweh, Kenyir) that are situated in Terengganu state, Peninsular Malaysia. Surveys were conducted from October 2018 until January 2019. These bats were captured using harp traps and mist nets that were set 30 m apart across flyways, streams, rivers and less cluttered trees in the 50 m transect zones (identified at each site). All animals captured were distinguished by morphology and released at the same location it was caught. The data comprise of 15 species of bats from four family groups, namely Hipposideridae, Pteropodidae, Rhinolophidae and Vespertilionidae. The data were interpreted into weight-forearm length (W-FA) to inform about bats Body Condition Index (-0.25 to 0.25).

Matched MeSH terms: Forearm
Fulltext Cross-talk in mechanomyographic signals from the forearm muscles during sub-maximal to maximal isometric grip force

Islam MA, Sundaraj K, Ahmad RB, Sundaraj S, Ahamed NU, Ali MA

PLoS One, 2014;9(5):e96628.
PMID: 24802858 DOI: 10.1371/journal.pone.0096628

This study aimed: i) to examine the relationship between the magnitude of cross-talk in mechanomyographic (MMG) signals generated by the extensor digitorum (ED), extensor carpi ulnaris (ECU), and flexor carpi ulnaris (FCU) muscles with the sub-maximal to maximal isometric grip force, and with the anthropometric parameters of the forearm, and ii) to quantify the distribution of the cross-talk in the MMG signal to determine if it appears due to the signal component of intramuscular pressure waves produced by the muscle fibers geometrical changes or due to the limb tremor.

Matched MeSH terms: Forearm/physiology*
Fulltext The comparison of discomfort level between upper arm and forearm tourniquet

Ng ES, Ting JR, Foo SL, Akram SA, Fadzlina AA, Alywiah JS, et al.

Med J Malaysia, 2006 Dec;61 Suppl B:23-6.
PMID: 17600989

The conventional upper arm tourniquet used for hand and wrist operations may cause significant discomfort to patient when the procedure is performed under local anaesthesia. Forearm tourniquet causes less muscle ischeamia and pain. The discomfort experienced while using a forearm and upper arm tourniquet was assessed in 96 healthy subjects. Tourniquet placed on both sides was inflated sequentially to 250mmhg for five minutes on different hand. The discomfort level was assessed using a small visual analogue scale and complications were recorded. In the upper arm tourniquet, 24.9% had mild, 60.5% had moderate and 14.6% had severe pain whereas with forearm tourniquet, 99% had mild pain and only 1% had moderate pain. Seventy-nine percent of the subjects tested with forearm tourniquet had no discomfort at all. The average discomfort level for upper arm and forearm tourniquet was 4.72 and 0.39 respectively, which is statistically significant. Complications that were observed only in upper arm tourniquet included prolonged tingling, burning sensation and discomfort and stiffness of the upper limb. We concluded that forearm tourniquet was safe and well tolerated and should be used more often when indicated.

Matched MeSH terms: Forearm/surgery*
Fulltext Peripheral Intravenous Catheterisation in Obstetric Patients in the Hand or Forearm Vein: A Randomised Trial

Tan PC, Mackeen A, Khong SY, Omar SZ, Noor Azmi MA

Sci Rep, 2016 Mar 18;6:23223.
PMID: 26987593 DOI: 10.1038/srep23223

A peripheral intravenous catheter is often inserted as part of care during labour. The catheter is inserted into the back of the hand or lower forearm vein in usual practice. There is no trial data to guide the care provider on which is the better insertion site in any clinical setting. 307 women admitted to the labour ward who required insertion of intravenous catheter were randomised to back of hand or lower forearm vein catheter insertion. Catheter insertion is by junior to mid-grade providers. We evaluated insertion success at the first attempt, pain during insertion and catheter replacement due to malfunction as main outcomes. After catheter removal, we recorded patient satisfaction with site, future site preference and insertion site swelling, bruising, tenderness, vein thrombosis and pain. Insertion of a catheter into back of hand vein is more likely to be successful at the first attempt. Insertion pain score, catheter replacement rate, patient satisfaction, patient fidelity to site in a future insertion and insertion site complications rate are not different between trial arms. In conclusion, both insertion sites are suitable; the back of the hand vein maybe easier to cannulate and seems to be preferred by our frontline providers.

Matched MeSH terms: Forearm/blood supply*
Hypoglossia congenita with anterior maxillo-mandibular fusion

Arshad AR, Goh CS

Br J Plast Surg, 1994 Mar;47(2):139-41.
PMID: 8149059

Two cases of hypoglossia congenita with anterior maxillo-mandibular fusion are reported. One is a case of hypoglossia with anterior maxillo-mandibular fusion and the other is a case of hypoglossia-hypodactylia with anterior maxillo-mandibular fusion. This condition presents the anaesthetist with the problem of airway management during the surgery. A simple technique using a nasopharyngeal tube was used for these two cases, with satisfactory results.

Matched MeSH terms: Forearm/abnormalities
Dependence of human forearm skin postocclusive reactive hyperemia on occlusion time

Tee GB, Rasool AH, Halim AS, Rahman AR

J Pharmacol Toxicol Methods, 2004 Jul-Aug;50(1):73-8.
PMID: 15233971 DOI: 10.1016/j.vascn.2004.02.002

Human postocclusive forearm skin reactive hyperemia is not only a potential means of identifying early signs of cardiovascular diseases, it can also be used in the assessment of local microvascular response to topically applied compounds on skin. The method is not fully characterized. In this study, we investigated the influence of occlusion time on postocclusive forearm skin reactive hyperemia using laser Doppler fluximetry (LDF).

Matched MeSH terms: Forearm/blood supply
Fulltext Association of anthropometric parameters with amplitude and crosstalk of mechanomyographic signals during forearm flexion, pronation and supination torque tasks

Talib I, Sundaraj K, Lam CK

Sci Rep, 2019 11 07;9(1):16166.
PMID: 31700129 DOI: 10.1038/s41598-019-52536-4

This study aimed to quantify the association of four anthropometric parameters of the human arm, namely, the arm circumference (CA), arm length (LA), skinfold thickness (ST) and inter-sensor distance (ISD), with amplitude (RMS) and crosstalk (CT) of mechanomyography (MMG) signals. Twenty-five young, healthy, male participants were recruited to perform forearm flexion, pronation and supination torque tasks. Three accelerometers were employed to record the MMG signals from the biceps brachii (BB), brachialis (BRA) and brachioradialis (BRD) at 80% maximal voluntary contraction (MVC). Signal RMS was used to quantify the amplitude of the MMG signals from a muscle, and cross-correlation coefficients were used to quantify the magnitude of the CT among muscle pairs (BB & BRA, BRA & BRD, and BB & BRD). For all investigated muscles and pairs, RMS and CT showed negligible to low negative correlations with CA, LA and ISD (r = -0.0001--0.4611), and negligible to moderate positive correlations with ST (r = 0.004-0.511). However, almost all of these correlations were statistically insignificant (p > 0.05). These findings suggest that RMS and CT values for the elbow flexor muscles recorded and quantified using accelerometers appear invariant to anthropometric parameters.

Matched MeSH terms: Forearm/physiology*
Analysis of the crosstalk in mechanomyographic signals along the longitudinal, lateral and transverse axes of elbow flexor muscles during sustained isometric forearm flexion, supination and pronation exercises

Talib I, Sundaraj K, Lam CK

J Musculoskelet Neuronal Interact, 2020 06 01;20(2):194-205.
PMID: 32481235

OBJECTIVE: To analyse the influence of muscle fibre axis on the degree of crosstalk in mechanomyographic (MMG) signals during sustained isometric forearm flexion, pronation and supination exercises performed at 80% maximum voluntary contraction (MVC) at an elbow joint angle of 90°.
METHODS: MMG signals in longitudinal, lateral and transverse directions of muscle fibres were recorded from the elbow flexors of twenty-five male subjects using triaxial accelerometers. Cross-correlation coefficients were used to quantify the degree of crosstalk in all nine possible pairs of fibre axes, all muscle pairs and all exercises.
RESULTS: MMG root mean square (RMS) was statistically significant among the fibre axes (p<0.05, η2=0.17- 0.34) except for biceps brachii and brachioradialis in supination and brachialis in flexion. Overall mean crosstalk values in the three muscle pairs (biceps brachii & brachialis, brachialis & brachioradialis and brachioradialis & biceps brachii) were found to be 6.09-52.17%, 4.01-61.42% and 2.16-51.85%, respectively. Crosstalk values showed statistical significance among all nine axes pairs (p<0.05, η2=0.16-0.51) except for biceps brachii & brachialis during pronation. The transverse axes pair generated the lowest mean crosstalk values (2.16-9.14%).
CONCLUSION: MMG signals recorded using accelerometers from the transverse axes of muscle fibres in the elbow flexors are unique and yield the least amount of crosstalk.

Matched MeSH terms: Forearm/physiology
Assessment of macrovascular endothelial function using pulse wave analysis and its association with microvascular reactivity in healthy subjects

Ibrahim NNIN, Rasool AHG

Skin Res Technol, 2017 Aug;23(3):321-325.
PMID: 27868242 DOI: 10.1111/srt.12338

BACKGROUND: Pulse wave analysis (PWA) and laser Doppler fluximetry (LDF) are non-invasive methods of assessing macrovascular endothelial function and microvascular reactivity respectively. The aim of this study was to assess the correlation between macrovascular endothelial function assessed by PWA and microvascular reactivity assessed by LDF.
METHOD: 297 healthy and non-smoking subjects (159 females, mean age (±SD) 23.56 ± 4.54 years) underwent microvascular reactivity assessment using LDF followed by macrovascular endothelial function assessments using PWA.
RESULTS: Pearson's correlation showed no correlation between macrovascular endothelial function and microvascular reactivity (r = -0.10, P = 0.12).
CONCLUSION: There was no significant correlation between macrovascular endothelial function assessed by PWA and microvascular reactivity assessed by LDF in healthy subjects.

Matched MeSH terms: Forearm/blood supply*; Forearm/physiopathology

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