BACKGROUND: Free fat graft has been used for the treatment of congenital hand differences. However, there have been a few reports about the outcome of that treatment. In this study, the outcome of free fat grafts for congenital hand and foot differences was investigated. METHODS: Fourteen bones with longitudinal epiphyseal bracket, 3 wrists with Madelung deformity, and 5 cases of osseous syndactyly were treated with free fat graft with osteotomy, physiolysis, or separation of osseous syndactyly. Of the fourteen bones with longitudinal epiphyseal bracket, 9 were treated with open wedge osteotomy with free fat graft and 5 with physiolysis and free fat graft. The Madelung deformity was treated with physiolysis with free fat graft. For osseous syndactyly, syndactyly release with free fat graft was performed five times on four hands. RESULTS: In the fourteen cases with longitudinal epiphyseal bracket, lateral deviation improved in all except two cases after surgery. The average lateral deviation angle changed from 32.5 degrees before surgery to 15.2 degrees after surgery. The average improvement of the lateral deviation angle was 12.2 degrees in the osteotomy group and 20.6 degrees in the physiolysis group. The mean ratio of improvement of the lateral deviation angle to the lateral deviation angle before surgery was 39.4% in the osteotomy group and 51.2% in the physiolysis group. The Madelung deformity improved after surgery in two cases but there was no improvement in one case. For these conditions, the results were not good enough when surgery was done after age 13 or at age four for severely hypoplastic brachymesophalangy. Of the 5 cases of osseous syndactyly, reunion of the separated bones occurred in one case. The grafted free fat should be deep enough to cover the osteotomy site of the bones to prevent reunion of the separated bones. CONCLUSIONS: Physiolysis and free fat graft performed during the growth period can correct the deviation due to longitudinal epiphyseal bracket and Madelung deformity. Free fat graft is also useful to prevent reunion of the bones after separation of osseous syndcatyly, if the grafted fat is securely filled into the space between the separated bones.
Adipose Tissue/*transplantation ; Adolescent ; Child ; Child, Preschool ; Female ; Fingers/*abnormalities/surgery ; Foot Deformities, Congenital/surgery ; Hallux Varus/surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Male ; Osteotomy ; Statistics, Nonparametric ; Syndactyly/*surgery ; Treatment Outcome

BACKGROUND: Free fat graft has been used for the treatment of congenital hand differences. However, there have been a few reports about the outcome of that treatment. In this study, the outcome of free fat grafts for congenital hand and foot differences was investigated. METHODS: Fourteen bones with longitudinal epiphyseal bracket, 3 wrists with Madelung deformity, and 5 cases of osseous syndactyly were treated with free fat graft with osteotomy, physiolysis, or separation of osseous syndactyly. Of the fourteen bones with longitudinal epiphyseal bracket, 9 were treated with open wedge osteotomy with free fat graft and 5 with physiolysis and free fat graft. The Madelung deformity was treated with physiolysis with free fat graft. For osseous syndactyly, syndactyly release with free fat graft was performed five times on four hands. RESULTS: In the fourteen cases with longitudinal epiphyseal bracket, lateral deviation improved in all except two cases after surgery. The average lateral deviation angle changed from 32.5 degrees before surgery to 15.2 degrees after surgery. The average improvement of the lateral deviation angle was 12.2 degrees in the osteotomy group and 20.6 degrees in the physiolysis group. The mean ratio of improvement of the lateral deviation angle to the lateral deviation angle before surgery was 39.4% in the osteotomy group and 51.2% in the physiolysis group. The Madelung deformity improved after surgery in two cases but there was no improvement in one case. For these conditions, the results were not good enough when surgery was done after age 13 or at age four for severely hypoplastic brachymesophalangy. Of the 5 cases of osseous syndactyly, reunion of the separated bones occurred in one case. The grafted free fat should be deep enough to cover the osteotomy site of the bones to prevent reunion of the separated bones. CONCLUSIONS: Physiolysis and free fat graft performed during the growth period can correct the deviation due to longitudinal epiphyseal bracket and Madelung deformity. Free fat graft is also useful to prevent reunion of the bones after separation of osseous syndcatyly, if the grafted fat is securely filled into the space between the separated bones.
Adipose Tissue/*transplantation ; Adolescent ; Child ; Child, Preschool ; Female ; Fingers/*abnormalities/surgery ; Foot Deformities, Congenital/surgery ; Hallux Varus/surgery ; Hand Deformities, Congenital/*surgery ; Humans ; Male ; Osteotomy ; Statistics, Nonparametric ; Syndactyly/*surgery ; Treatment Outcome

BACKGROUND: Airborne particulate pollution is more critical in the developing world than in the developed countries in which industrialization and urbanization are rapidly increased. Yangon, a second capital of Myanmar, is a highly congested and densely populated city. Yet, there is limited study which assesses particulate matter (PM) in Yangon currently. Few previous local studies were performed to assess particulate air pollution but most results were concerned PM alone using fixed monitoring. Therefore, the present study aimed to assess distribution of PM in different townships of Yangon, Myanmar. This is the first study to quantify the regional distribution of PM in Yangon City. METHODS: The concentration of PM was measured using Pocket PM Sensor (Yaguchi Electric Co., Ltd., Miyagi, Japan) three times (7:00 h, 13:00 h, 19:00 h) for 15 min per day for 5 days from January 25 to 29 in seven townships. Detailed information of eight tracks for PM pollution status in different areas with different conditions within Kamayut Township were also collected. RESULTS: The results showed that in all townships, the highest PM concentrations in the morning followed by the evening and the lowest concentrations in the afternoon were observed. Among the seven townships, Hlaingtharyar Township had the highest concentrations (164 ± 52 μg/m) in the morning and (100 ± 35 μg/m) in the evening. Data from eight tracks in Kamayut Township also indicated that PM concentrations varied between different areas and conditions of the same township at the same time. CONCLUSION Myanmar is one of the few countries that still have to establish national air quality standards. The results obtained from this study are useful for the better understanding of the nature of air pollution linked to PM. Moreover, the sensor which was used in this study can provide real-time exposure, and this could give more accurate exposure data of the population especially those subpopulations that are highly exposed than fixed station monitoring.
Air Pollutants ; analysis ; Cities ; Environmental Monitoring ; Myanmar ; Particulate Matter ; analysis

BACKGROUND: Particulate matter (PM) is recognized as the most harmful air pollutant to the human health. The Yangon city indeed suffers much from PM-related air pollution. Recent research has interestingly been focused on the novel subject of changes in the air quality associated with the restrictive measures in place during the current coronavirus disease-2019 (COVID-19) pandemic. The first case of COVID-19 in Myanmar was diagnosed on March 23, 2020. In this article, we report on our attempt to evaluate any effects of the COVID-19-restrictive measures on the ambient PM pollution in Yangon. METHODS: We measured the PM concentrations every second for 1 week on four occasions at three study sites with different characteristics; the first occasion was before the start of the COVID-19 pandemic and the remaining three occasions were while the COVID-19-restrictive measures were in place, including Stay-At-Home and Work-From-Home orders. The Pocket PM RESULTS: The results showed that there was a significant reduction (P < 0.001) in both the PM CONCLUSIONS We concluded that the restrictive measures which were in effect to combat the COVID-19 pandemic had a positive impact on the ambient PM concentrations. The changes in the PM concentrations are considered to be largely attributable to reduction in anthropogenic emissions as a result of the restrictive measures, although seasonal influences could also have contributed in part. Thus, frequent, once- or twice-weekly Stay-At-Home or Telework campaigns, may be feasible measures to reduce PM-related air pollution. When devising such an action plan, it would be essential to raise the awareness of public about the health risks associated with air pollution and create a social environment in which Telework can be carried out, in order to ensure active compliance by the citizens.
Air Pollution/analysis* ; COVID-19/epidemiology* ; Humans ; Myanmar/epidemiology* ; Pandemics ; Particulate Matter/analysis* ; SARS-CoV-2