Management of Intolerance to Casting the Upper Extremities in Claustrophobic Patients

Introduction. Some patients showed unusual responses to the immobilization without any objective findings with casts in upper extremities. We hypothesized their that intolerance with excessive anxiety to casts is due to claustrophobia triggered by cast immobilization. The aim of this study is to analyze the relevance of cast immobilization to the feeling of claustrophobia and discover how to handle them. Methods. There were nine patients who showed the caustrophobic symptoms with their casts. They were assesed whether they were aware of their claustrophobis themselves. Further we investigated the alternative immobilization to casts. Results. Seven out of nine cases that were aware of their claustrophobic tendencies either were given removable splints initially or had the casts converted to removable splints when they exhibited symptoms. The two patients who were unaware of their latent claustrophobic tendencies were identified when they showed similar claustrophobic symptoms to the previous patients soon after short arm cast application. We replaced the casts with removable splints. This resolved the issue in all cases. Conclusions. We should be aware of the claustrophobia if patients showed unusual responses to the immobilization without any objective findings with casts in upper extremities, where removal splint is practical alternative to cast to continue the treatment successfully

Mesophase structure discovered through in-situ X-ray measurement in drawing process of poly(ethylene 2,6-naphthalene dicarboxylate) fiber

The structure development in the continuous laser-heated drawing process of poly(ethylene 2,6-naphthalene dicarboxylate) (PEN) fiber was analyzed by in-situ X-ray diffraction measurement. Because of the rapid and uniform laser heating, and the resultant steady-state nature of the necking-drawing, the structure development after the on-set of necking could be measured in the time resolution of several hundred microseconds. We found for the first time the temporal appearance of meridional (001') diffraction at several milliseconds after the on-set of necking indicating that the mesophase structure similar to the one reported for poly(ethylene terephthalate) was also formed in the initial stage of fiber structure development of PEN. The d-spacing of the (001') diffraction 1.230 +/- 0.003 nm was shorter than the c-axis lengths of both alpha and beta crystals.ArticlePOLYMER. 50(19):4429-4431 (2009)journal articl

In-situ analysis of fiber structure development for isotactic polypropylene

Structural development of isotactic polypropylene (iPP) fibers was analyzed in real time through in-situ WAXD/SAXS and fiber temperature measurements during CO(2) laser-heated drawing because the CO(2) laser irradiation can nearly fix the necking position on the running fiber. The in-situ WAXD/SAXS measurements were carried out with a high time-resolution of 0.4 ms. The as-spun iPP fibers of two different initial structures were laser-heat-drawn to a draw ratio of 6.5. For the drawing of PP fiber containing mesophase structure, diffraction from the oriented mesophase remained until an elapsed time of 1.0 ms, when oriented alpha-phase crystal started to form. Meanwhile, for the drawing of PP fiber containing both an alpha-phase and a mesophase structure, fragmented microcrystals were reorganized by orientation-induced crystallization before an elapsed time of 1.0 ms. The long period increased drastically with fragmentation, and decreased with reorganization. The long period was about 16 nm for both drawn fibers.ArticlePOLYMER. 52(9):2044-2050 (2011)journal articl

Development of a fiber structure in poly(vinylidene fluoride) by a CO(2) laser-heated drawing process

Rapid and uniform heating by CO(2) laser radiation can fix the position where necking occurs. Therefore, this study investigated the development of a fiber structure in poly(vinylidene fluoride) in continuous drawing by in situ measurement using synchrotron X-ray radiation with a time resolution of several hundred microseconds. Two neck-deformation behaviors were observed in the laser drawing: a moderate neck deformation under low drawing stress and a steep neck deformation under high drawing stress. The low drawing stress resulted in a mixture of alpha- and beta-crystals in which the beta-crystal was formed within 1ms after the necking, earlier than the alpha-crystal. The development of the fiber structure under high drawing stress was almost complete in less than 1 ms, and the developed structure contained only beta-crystals. Small-angle X-ray scattering images showed meridional streaks at low drawing stress, whereas a four-pointed pattern occurred under high drawing stress. Low drawing stress generated a long periodic structure that was defective in the periodic regularity of crystalline and amorphous regions, although the molecular chains were nearly oriented along the fiber axis. The high drawing stress resulted in a well-packed structure of adjacent fibrils with alternating amorphous and crystalline regions. Polymer Journal (2010) 42, 657-662; doi: 10.1038/pj.2010.53; published online 23 June 2010ArticlePOLYMER JOURNAL. 42(8):657-662 (2010)journal articl

Arthroscopic Bony Bankart Repair Using Double-Threaded Headless Screw: A Case Report

We present a case of arthroscopic fixation for bony Bankart lesion using a double-threaded cannulated screw. A 39-year-old man sustained a left shoulder injury from a motorcycle accident. Radiographs showed bony Bankart lesion and CT revealed 40% defect of glenoid articular surface. Arthroscopic fixation was performed using double-threaded cannulated screw after the bony fragment was reduced by suturing the labrum at the edge with a suture anchor. Arthroscopic bony Bankart repair using double-threaded cannulated screw fixation is effective because compression force could be applied between bony fragments and the screw head is not exposed in the glenohumeral joint

A Coincidental Anterior Interosseous Nerve Palsy after Volar Plate Fixation of a Distal Radius Fracture Diagnosed by 3D-CT

A case presented dysfunctional flexion of the thumb and index fingers after volar plate fixation for of distal radius fractures was diagnosed anterior interosseous nerve palsy and confirmed by 3D-CT. 3D-CT was useful to confirm the continuities of tendons, which excluded the most common complication of tendon ruptures after volar plate fixation. Also, it was superior to needle electromyography which is unreliable due to the accompanying damage of the pronator quadratus following volar plate fixation

Severe Laceration of Flexor Tendons after Locking Palmar Plate Fixation of Distal Radius Fracture: A Case Report

We report a case of flexor pollicis longus and flexor digitorum profundus(II) laceration as a result of the severe tenosynovitis after volar locking plate fixation of distal radius fractur

A Coincidental Anterior Interosseous Nerve Palsy after Volar Plate Fixation of a Distal Radius Fracture Diagnosed by 3D-CT

A case presented dysfunctional flexion of the thumb and index fingers after volar plate fixation for of distal radius fractures was diagnosed anterior interosseous nerve palsy and confirmed by 3D-CT. 3D-CT was useful to confirm the continuities of tendons, which excluded the most common complication of tendon ruptures after volar plate fixation. Also, it was superior to needle electromyography which is unreliable due to the accompanying damage of the pronator quadratus following volar plate fixation