OBJECTIVE: To observe the clinical efficacy of wrist-ankle acupuncture in the treatment of functional frequent premature ventricular contractions (PVCs). METHODS: A total of 64 patients with functional frequent PVCs were randomly divided into an observation group and a control group, 32 cases in each group. The observation group was treated with wrist-ankle acupuncture at bilateral upper 1 and upper 2 on the wrist. The control group received sham acupuncture at the same points as the observation group. Both groups were treated once every day from Monday to Friday, with the needles retained for 60 min each time, for a total of 4 weeks. The TCM syndrome score, the 24-hour PVC count, and MOS 36-item short form health survey (SF-36) score were compared between the two groups before and after treatment, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the TCM syndrome scores and the 24-hour PVC counts in both groups were reduced compared with those before treatment (P<0.01), and the above indexes in the observation group were lower than those in the control group (P<0.01). After treatment，scores of all SF-36 items in the observation group were increased compared with those before treatment (P<0.01); in the control group, the scores of general health (GH), social function (SF) and role-emotional (RE) were increased compared with those before treatment (P<0.05). After treatment, scores of all SF-36 items in the observation group were higher than those in the control group (P<0.01). The total effective rate in the observation group was 90.6% (29/32), which was higher than 46.9% (15/32) in the control group (P<0.01). CONCLUSION Wrist-ankle acupuncture has a significant clinical efficacy in the treatment of functional frequent PVCs. It can effectively improve symptoms such as chest tightness and palpitations, reduce 24-hour PVC count, and improve patients' quality of life.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Adult ; Ventricular Premature Complexes/physiopathology* ; Ankle/physiopathology* ; Wrist/physiopathology* ; Acupuncture Points ; Treatment Outcome ; Aged ; Young Adult

OBJECTIVE: To investigate the effectivess of arthroscopic Wafer surgery combined with triangular fibrocartilage complex (TFCC) insertion point reconstruction in the treatment of Palmer type ⅡC combined with typeⅠB ulnar impingement syndrome. METHODS: The clinical data of 14 patients with Parlmer type ⅡC combined with type ⅠB ulnar impingement syndrome who met the selection criteria between July 2021 and April 2024 were retrospectively analyzed. There were 7 males and 7 females with an average age of 43 years ranging from 16 to 59 years. The causes of injury were fall in 8 cases and sprain in 6 cases. The time from injury to operation ranged from 1 to 6 months, with an average of 2.3 months. Distal radioulnar joint instability was found in all cases. Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction was used. The effectiveness was evaluated by comparing the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, visual analogue scale (VAS) score, and modified Mayo wrist score before and after operation. RESULTS: All patients were followed up 6-12 months, with an average of 9.1 months. The positive variation of ulna was (3.2±0.7) mm before operation, and the negative variation of ulna was (2.2±0.6) mm after operation. There was a significant difference in ulna variation between pre- and post-operation ( t=23.851, P<0.001). The pain symptoms and forearm rotation function of the patients after operation significantly improved. At last follow-up, the wrist flexion-dorsiflexion range of motion, wrist ulnar deviation-radial deflection range of motion, forearm pronation-supination range of motion, VAS score, and modified Mayo wrist score significantly improved when compared with those before operation ( P<0.05). CONCLUSION Arthroscopic Wafer surgery combined with TFCC insertion point reconstruction can effectively relieve wrist pain, enhance the stability of the distal radioulnar joint, and restore the function of the wrist in patients with Palmer type ⅡC combined with type ⅠB ulnar impingement syndrome.
Humans ; Male ; Adult ; Arthroscopy/methods* ; Female ; Triangular Fibrocartilage/surgery* ; Middle Aged ; Range of Motion, Articular ; Retrospective Studies ; Wrist Joint/physiopathology* ; Adolescent ; Young Adult ; Ulna/surgery* ; Treatment Outcome ; Wrist Injuries/surgery* ; Plastic Surgery Procedures/methods* ; Joint Instability/surgery*

OBJECTIVE: To report the clinical experience of using Ilizarov wrist joint distraction technique in the treatment of a case of rheumatoid arthritis of the wrist. METHODS: In January 2019, a 49-year-old female patient with rheumatoid arthritis of the left wrist, complicated by ulnar impaction syndrome, was admitted for treatment. Preoperatively, the active range of motion of the left wrist was as follows: extension 0°-flexion 0°, pronation 65°-supination 35°, and grip strength of 4.0 kg. The visual analogue scale (VAS) score was 9, and the Cooney wrist function score was 15, indicating poor function. As conservative treatment failed to achieve symptom relief, Ilizarov wrist joint distraction surgery was performed. Postoperatively, joint distraction was applied at 2 mm increments on postoperative days 2 and 7, in 4 separate sessions. RESULTS: Postoperative X-ray film examination at 7 days revealed a distraction of 3.6 mm in the affected wrist joint compared to the contralateral side. The external fixator was removed 2.5 months postoperatively. At 22 months postoperatively, X-ray film and MRI examinations revealed that the joint space of the left wrist had returned to near-normal, with significant reduction in joint effusion and synovial proliferation. The active range of motion of the left wrist improved to extension 15°- flexion 30°, pronation 90°-supination 90°, with a grip strength of 18.0 kg. The wrist pain VAS score decreased to 0, and the Cooney wrist function score improved to 90, indicating excellent function. At 50 months postoperatively, follow-up X-ray film, MRI, and functional assessments showed the results similar to those at 22 months. CONCLUSION Ilizarov wrist joint distraction may be a viable treatment option for rheumatoid arthritis of the wrist.
Humans ; Female ; Middle Aged ; Wrist Joint/physiopathology* ; Arthritis, Rheumatoid/physiopathology* ; Range of Motion, Articular ; Ilizarov Technique ; Treatment Outcome ; Osteogenesis, Distraction/methods*

OBJECTIVE: To evaluate the short-term clinical efficacy of external fixation and internal fixation with steel plate in the treatment of unstable distal radius fractures (AO-23C type), based on the principles of Chinese osteosynthesis (CO). METHODS: Forty-eight patients with unstable distal radius fractures between January 2022 and February 2023 were retrospectively analyzed and divided into the CO external fixation group and internal fixation group. CO external fixation group consisted of 25 patients, including 7 males and 18 females, aged from 37 to 56 years old with an average of ( 52.6±11.3) years old. Among them, there were 7 patients of traffic accidents and 18 patients of falls, resulting in a total of 25 patients of closed fractures and no open fractures, the treatment was conducted using closed reduction and CO external fixation. The internal fixation group consisted of 23 patients, comprising 8 males and 15 females, age ranged from 41 to 59 years old, with an average age of(53.3±13.7) years old. Among them, 8 patients resulted from car accidents while the remaining 15 patients were caused by falls. All 23 patients were closed fractures without any open fractures observed. The technique of open reduction and internal fixation with steel plate was employed. The perioperative data, including injury-operation time, operation duration, blood loss, and length of hospital stay, were assessed in both groups. Additionally, the QuickDASH score and visual analogue scale (VAS) were evaluated. Range of motion and grip strength assessment, imaging findings such as palmar inclination angle, ulnar declination angle, radius length, articular surface step, intra-articular space measurements were also examined along with any complications. RESULTS: The follow-up duration ranged from 0 to 24 months, with an average duration of (16.0±3.8) months. The CO external fixation exhibited significantly shorter time from injury to operation (2.4±3.3) d vs (7.4±3.7) d, shorter operation duration (56.27±15.23) min vs (74.10±5.26) min, lower blood loss (14.52±6.54) ml vs (32.32±10.03) ml, and reduced hospitalization days (14.04±3.24 )d vs (16.45±3.05) d compared to the internal fixation group (P<0.05). The QuickDASH score at 12 months post-operation was (8.21±1.64) in the CO external fixation group, while no significant difference was observed in the internal fixation group (7.04±3.64), P>0.05. There were no statistically significant differences in VAS between two groups at 6 weeks, as well as 1 and 3 months post-surgery (P>0.05). Additionally, there were no significant disparities observed in terms of range of motion and grip strength between two groups at the 2-year follow-up after the operation (P>0.05). After 12 months of surgery, the CO external fixation group exhibited a significantly smaller palmar inclination angle (17.90±2.18) ° vs (19.87±3.21) °, reduced articular surface step (0.11±0.03) mm vs (0.17±0.02) mm, and shorter radius length (8.16±1.11) mm compared to the internal fixation group (9.59±1.02) mm, P<0.05. The ulnar deviation angle and intra-articular space did not show any significant difference between two groups (P>0.05). The reduced fell within the allowable range between the CO external fixation group (23 out of 25 cases) and the internal fixation group (21 out of 23 cases) was not statistically significant (P=0.29). There was no significant difference in complications between the two groups(P>0.05). CONCLUSION Both the CO external fixation and open reduction with plate internal fixation demonstrate clinical efficacy in managing unstable distal radius fractures. The CO external fixation offers advantages in shorter injury-to-operation times, reduced intraoperative blood loss, and decreased surgical durations, while radial shortening is more effectively controlled by internal fixation.
Humans ; Male ; Female ; Middle Aged ; Radius Fractures/physiopathology* ; Adult ; Bone Plates ; Fracture Fixation, Internal/methods* ; External Fixators ; Retrospective Studies ; Fracture Fixation/methods* ; Wrist Fractures

BACKGROUNDPulse wave analysis (PWA) quantifies the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis (PIA) is a subjective examination in traditional Chinese medicine.

OBJECTIVEThis study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSThis observational, cross-sectional study enrolled 45 patients (26 men, (55.2 ± 10.3) years, systolic blood pressure (155 ± 28) mmHg, diastolic blood pressure (93 ± 17) mmHg) for assessment of clinical and laboratorial data.

MAIN OUTCOME MEASURESPrimary outcomes comprised: pattern differentiation based on an automated method; PIA at the radial artery using the 'simultaneous pressing' method for identification of factors such as strength (strong/weak), depth (superficial/deep), and speed (fast/moderate/slow); and PWA at the same artery using a noninvasive system.

RESULTSSignificant multivariate main effects were observed for depth (λ=0.648, F5,29 =3.149, P=0.022, η(2) =0.352), strength (λ=0.608, F5,29 =3.736, P=0.010, η(2) =0.392), and speed (λ=0.535, F5,29 =5.302, P=0.002, η(2) =0.465). General effects comprised high values of PWA and blood pressure for superficial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mmHg and systolic blood pressure ≥ 149.5 mmHg, whereas a superficial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s.

CONCLUSIONAssociations were explained by LaPlace's law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.

Adult ; Aged ; Cross-Sectional Studies ; Female ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; physiopathology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Pulse Wave Analysis ; Wrist

BACKGROUND: The aim of this study was to investigate the relationship between clinical symptoms and cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet before and after open carpal tunnel release (CTR). METHODS: Thirty-two patients (53 hands) that underwent open CTR for idiopathic carpal tunnel syndrome were prospectively enrolled. Median nerve CSA at the carpal tunnel inlet was measured preoperatively and at 2 and 12 weeks after CTR by high resolution ultrasonography. The Boston carpal tunnel questionnaire (BCTQ) was also completed at these times. RESULTS: BCTQ symptom (BCTQ-S) score was significantly improved at 2 weeks postoperatively, but BCTQ function (BCTQ-F) score and CSA were significantly improved at 12 weeks postoperatively. Preoperative CSA was significantly correlated with preoperative BCTQ-S and BCTQ-F scores but was not significantly correlated with postoperative BCTQ scores or postoperative changes in BCTQ scores. Postoperative median nerve CSA was not significantly correlated with postoperative BCTQ-S or BCTQ-F scores, and postoperative changes in median nerve CSA were not significantly correlated with postoperative changes in BCTQ-S or BCTQ-F scores. CONCLUSIONS: The study shows clinical symptoms resolve rapidly after open CTR, but median nerve swelling and clinical function take several months to recover. In addition, preoperative median nerve swelling might predict preoperative severities of clinical symptoms and functional disabilities. However, postoperative reductions in median nerve swelling were not found to reflect postoperative reductions in clinical symptoms or functional disabilities.
Anatomy, Cross-Sectional ; Carpal Tunnel Syndrome/diagnostic imaging/epidemiology/*physiopathology/*surgery ; Female ; Humans ; Male ; Median Nerve/anatomy & histology/physiopathology/*surgery ; Middle Aged ; Orthopedic Procedures/*statistics & numerical data ; Prospective Studies ; Surveys and Questionnaires ; Ultrasonography ; Wrist/surgery

Acupuncture Points ; Acupuncture Therapy ; Adult ; Ankle ; Cognitive Therapy ; Female ; Humans ; Intestine, Large ; physiopathology ; Middle Aged ; Rectal Diseases ; physiopathology ; psychology ; therapy ; Treatment Outcome ; Wrist

Trigger wrist is a relatively rare disease compared to trigger finger, which is the most common disorder found in hands. Patients with trigger wrist usually complain about the following symptoms: snapping and clicking or triggering around carpal tunnel with or without mild to moderate median neuropathy. There are a total of five cases of trigger wrist: three cases of anomalous muscle belly of flexor digitorum superficialis and two cases of fibroma around flexor tendon sheath within carpal tunnel. This study reports on two of those cases: one with anomalous muscle and the other with fibroma of flexor tendon sheath. Accurate examination and proper diagnosis are mandatory to obviate improper and time-wasting treatment for patients with trigger wrist.
Adult ; Female ; Fibroma ; Humans ; Male ; *Tenosynovitis/physiopathology/radiography/surgery ; *Wrist/physiopathology/radiography/surgery

Synovial chondromatosis is a rare lesion in the wrist, but some cases in the distal radioulnar joint have been reported and previous case reports emphasize joint calcifications, shown on preoperative plain radiographs. We report an extremely uncommon case of synovial chondromatosis in the pisotriquetral joint, in which radiographs and magnetic resonance imaging did not demonstrate apparent calcified bodies. In our case, for the accurate diagnosis and treatment, surgical exploration of the joint and synovectomy with removal of loose bodies was performed.
*Chondromatosis, Synovial/diagnosis/physiopathology/surgery ; Female ; Humans ; Middle Aged ; *Wrist Joint/physiopathology/surgery

An automatic control system was designed to suppress pathological tremor on wrist joint with two degrees of freedom (DoF) using functional electrical stimulation (FES). The tremor occurring in the wrist flexion-extension and adduction-abduction was expected to be suppressed. A musculoskeletal model of wrist joint was developed to serve as the control plant, which covered four main muscles (extensor carpi radialis longus, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris). A second-order mechanical impedance model was used to describe the wrist skeletal dynamics. The core work was to design the controller and a hybrid control strategy was proposed, which combined inverse model based on feed forward control and linear quadratic regulator (LQR) optimal control. Performance of the system was tested under different input conditions (step signal, sinusoidal signal, and real data of a patient)., The results indicated that the proposed hybrid controller could attenuate over 94% of the tremor amplitude on multi-DoF wrist joint.
Electric Stimulation ; Humans ; Muscle, Skeletal ; physiopathology ; Tremor ; prevention & control ; therapy ; Wrist ; Wrist Joint ; physiopathology