ABSTRACT
Background Ulnar-sided wrist pain (UWP) and lateral epicondylitis (LE) are common disorders that can be difficult to treat. Depression and anxiety have been shown to modify patient symptoms, disability and pain. Questions/Purposes The purpose of our study was to quantify the prevalence of depression and anxiety among patients with LE or UWP. A secondary aim was to determine if these patients report higher levels of pain upon presentation and if they are more likely to require occupational therapy. Patients and Methods A retrospective chart review was conducted, and patients included those with LE or UWP, atraumatic in origin, ages 18 and over, and ongoing use of noninvasive treatment of LE or UWP. Results Our final analysis included 97 patients of which 57 had LE, 34 had UWP, and 6 had both. The prevalence of a mood disorder was 34.0%. Anxiety and/or depression was more prevalent in patients with LE compared to UWP. The most common medication was alprazolam. Pain scores averaged 1.2 points higher in subjects with a history of a mental health disorder. After adjusting for age and sex, there was no significant association between prevalence of depression and/or anxiety and utilization of physical or occupational therapy. Conclusions Patients with either LE, UWP or both along with depression and/or anxiety may be less likely to improve with traditional treatments. Future investigations are warranted focusing on the value of a multidisciplinary team consisting of a hand surgeon, behavioral therapist, or psychologist to optimize treatment response. Level of Evidence This is a Level IV, case series study.
ABSTRACT
OBJECTIVE: To describe rates and patterns of rock climbing rescue incidents, morbidity and mortality in Boulder County, CO. METHODS: Rocky Mountain Rescue Group incident reports from 1998 to 2011 were reviewed to provide a 14-year statistical account of rock climbing incidents. RESULTS: Rock climbing rescues in Boulder accounted for 428 of a total of 2198 (19.5%) mountain and wilderness rescue victims. Most rock climbing victims were male (78%), and 46% of victims were between the ages of 20 and 29 years; most rock climbing incidents occurred on weekend days (median time of 3:30 pm) during the spring, summer, and autumn. Technical roped climbers accounted for 58% of climbing victims, whereas unroped climbers accounted for 34%. Belay incidents accounted for 12% of climbing victims, whereas rock fall incidents accounted for 4.5% of victims. Most victims were uninjured (43% stranded or lost), whereas lower extremity injuries were the most common injury (29.5% of injured victims). A total of 5.5% of climbing victims were fatally injured (23 victims: 5 from lead falls and 9 from unroped falls). CONCLUSIONS: The occurrence of rock climbing-related rescue victims comprised one fifth of all rescue victims in Boulder County. A large fraction of incidents and fatalities resulted from unroped climbing. Incidents of lost or uninjured stranded climbers and belay incidents account for more than half of victims, which can likely be prevented by gaining appropriate experience, seeking local information, and applying some simple safety measures for control of rope belays.
