No abstract available.
Carpal Bones/*injuries ; Female ; Fractures, Bone/*complications ; Hand Injuries/*complications ; Humans ; Male ; Radius Fractures/*complications

Compartment Syndromes ; etiology ; Crush Syndrome ; complications ; Fascia ; Hand Injuries ; complications ; Humans ; Infant, Newborn

Child ; Cold Temperature ; adverse effects ; Female ; Hand Injuries ; etiology ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Syringomyelia ; complications

OBJECTIVETo survey the curative effects of kinesitherapy in combination with self-made simple orthosis (SO) in treatment of scar contracture of burned hand in children.

METHODSFifty-eight children with burns of unilateral hand and received treatment in our rehabilitation center from January 2012 to January 2014 were divided into common rehabilitation (CR) and SO groups according to the random number table, with 29 cases in each group. After the wounds were healed, patients in group CR were treated with kinesitherapy combined with hand game exercises and pressure gloves, while patients in group SO were treated with kinesitherapy combined with hand game exercises and self-made SO, which was composed of finger web dividing belt, self-adhesive bandage, and infusion set fixing plate. Before treatment and 16 weeks after treatment, scar condition was assessed with the Vancouver Scar Scale (VSS); hand function was evaluated by the Jebsen Test of Hand Function, and the completion time was recorded; and the activities of daily life (ADL) was measured by the modified Barthel Index. Sixteen weeks after treatment, the range of motion was measured with the Total Active Movement (TAM) method. Data were processed with t test and chi-square test.

RESULTSThe score of VSS in group SO was (12.2 ± 1.3) points before treatment and (6.7 ± 2.2) points 16 weeks after treatment, and the improvement score was (5.6 ± 1.8) points. The score of VSS in group CR was (12.0 ± 1.4) points before treatment and (7.0 ± 1.8) points 16 weeks after treatment, and the improvement score was (5.0 ± 1.0) points. There was no obvious difference in improvement score of VSS between the two groups (t = 1.452, P = 0.152). The ratio of excellent and good results according to TAM method in group SO was 75.9% (22/29) , while it was 37.9% (11/29) in group CR (t = 8.507, P = 0.004). The completion time for the Jebsen Test of group OS was (8.2 ± 1.6) min before treatment and (7.1 ± 1.4) min after treatment, and the improvement time was (1.2 ± 1.5) min. The completion time for the Jebsen Test of group CR was (9.0 ± 1.9) min before treatment and (6.3 ± 1.4) min 16 weeks after treatment, and the improvement time was (2.7 ± 2.7) min. There was a significant difference in improvement time for the Jebsen Test between the two groups (t = 2.618, P = 0.012). The score of ADL in group CR was (7.7 ± 1.4) points before treatment and (10.4 ± 1.4) points 16 weeks after treatment, and the improvement score was (2.7 ± 1.7) points. The score of ADL in group CR was (7.8 ± 1.4) points before treatment and (9.5 ± 1.4) points 16 weeks after treatment, and the improvement score was (1.7 ± 1.6) points. There was a significant difference in improvement score of ADL between the two groups (t = 2.246, P = 0.029).

CONCLUSIONSKinesitherapy in combination with self-made SO can improve the functional recovery of burned hand in children and prevent contractures in hand, and it is worth applying generally.

Burns ; complications ; Child ; Cicatrix ; therapy ; Compression Bandages ; Contracture ; Hand Injuries ; therapy ; Humans ; Orthotic Devices ; Physical Therapy Modalities ; Time ; Wrist Injuries

BACKGROUND: The management of the pulseless perfused hand in association with a supracondylar humerus fracture following operative stabilisation remains controversial. Previous authors have suggested the use of color-flow duplex monitoring, magnetic resonance angiography and segmental pressure monitoring as objective steps to ascertain blood flow following adequate internal fixation. We examine the use of the waveform of the pulse oximeter in objectively determining a perfused limb and in predicting the need for surgical exploration in patients who present with a pulseless perfused hand after operative stabilisation for supracondylar fracture of the humerus. METHODS: A retrospective review of all supracondylar fractures over a 60 month duration (2005-2009) in our instituition was performed. Each electronic record was reviewed and limbs which had absent radial pulse following admission were identified. X-ray films of each of the patients were reviewed. A search using the Pubmed database was performed with the following keywords, supracondylar humerus fracture, pediatric, pulseless, vascular injury, arterial repair. RESULTS: In this series of pulseless perfused hands following operative fixation of supracondylar fracture, a total of 26 patients were reviewed. All were Gartland grade III extension type fractures. Postoperative pulse oximeter waveforms were present in all but 4 patients. These patients subsequently had exploration of the brachial artery with significant findings. In the remaining 22 patients, waveforms were present and the child had return of the radial pulse soon after operative fixation without any further need for surgical exploration. At 24 months follow-up, all children were well with no neurovascular compromise. CONCLUSIONS: The presence of a waveform on a pulse oximeter is a sensitive and easily available modality in determining vascular perfusion as compared to other more complex investigations. The high sensitivity of this test will allow surgeons to objectively determine the requirement for surgical exploration of the brachial artery.
Brachial Artery/*injuries/surgery ; Child ; Child, Preschool ; Female ; Hand/*blood supply ; Humans ; Humeral Fractures/complications/*surgery ; Male ; *Oximetry ; Pulse ; Retrospective Studies ; Vascular System Injuries/*diagnosis/surgery

Objective: To explore the family rehabilitation model for children with scar contracture after hand burns and observe its efficacy. Methods: A retrospective non-randomized controlled study was conducted. From March 2020 to March 2021, 30 children with scar contracture after deep partial-thickness to full-thickness burns of hands, who met the inclusion criteria, were hospitalized in the Burn Center of PLA of the First Affiliated Hospital of Air Force Medical University. According to the rehabilitation model adopted, 18 children (23 affected hands) were included in a group mainly treated by family rehabilitation (hereinafter referred to as family rehabilitation group), and 12 children (15 affected hands) were included in another group mainly treated by hospital rehabilitation (hereinafter referred to as hospital rehabilitation group). In the former group, there were 11 males and 7 females, aged (4.8±2.1) years, who began rehabilitation treatment (3.1±0.8) d after wound healing; in the latter group, there were 7 males and 5 females, aged (4.6±2.1) years, who began rehabilitation treatment (2.8±0.7) d after wound healing. The children in hospital rehabilitation group mainly received active and passive rehabilitation training in the hospital, supplemented by independent rehabilitation training after returning home; after 1-2 weeks of active and passive rehabilitation training in the hospital, the children in family rehabilitation group received active and passive rehabilitation training at home under the guidance of rehabilitation therapists through WeChat platform. Both groups of children were treated for 6 months. During the treatment, they wore pressure gloves and used hand flexion training belts and finger splitting braces. Before treatment and after 6 months of treatment, the modified Vancouver scar scale, the total active movement of the hand method, and Carroll quantitative test of upper extremity function were used to score/rate the scar of the affected hand (with the difference of scar score between before treatment and after treatment being calculated), the joint range of motion (with excellent and good ratio being calculated), and the function of the affected limb, respectively. Data were statistically analyzed with independent sample t test, equivalence test, Fisher's exact probability test, and Mann-Whitney U test. Results: The differences of scar scores of the affected hands of children in family rehabilitation group and hospital rehabilitation group between after 6 months of treatment and those before treatment were 3.0 (2.0, 7.0) and 3.0 (2.0, 8.0) respectively (with 95% confidence interval of 2.37-5.38 and 1.95-5.91). The 95% confidence interval of the difference between the differences of the two groups was -2.43-2.21, which was within the equivalent boundary value of -3-3 (P<0.05). The excellent and good ratios of joint range of motion of the affected hand of children in family rehabilitation group and hospital rehabilitation group were 3/23 and 2/15 respectively before treatment, and 15/23 and 12/15 respectively after 6 months of treatment. The ratings of joint range of motion of the affected hand of children in family rehabilitation group and hospital rehabilitation group after 6 months of treatment were significantly higher than those before treatment (with Z values of 3.58 and 2.30, respectively, P<0.05), but the ratings of joint range of motion of the affected hand between the two groups were similar before treatment and after 6 months of treatment (with Z values of 0.39 and 0.55, respectively, P>0.05). The functional ratings of the affected limbs of children in family rehabilitation group and hospital rehabilitation group after 6 months of treatment were significantly higher than those before treatment (with Z values of 3.98 and 3.51, respectively, P<0.05), but the functional ratings of the affected limbs between the two groups were similar before treatment and after 6 months of treatment (with Z values of 1.27 and 0.38, respectively, P>0.05). Conclusions: The WeChat platform assisted rehabilitation treatment with mainly family rehabilitation, combined with hand flexion and extension brace can effectively reduce the scarring after children's hand burns, improve the joint range of motion of the affected hands, and promote the recovery of affected limb function. The effect is similar to that of hospital-based rehabilitation providing an optional rehabilitation, treatment method for children who cannot continue to receive treatment in hospital.
Male ; Female ; Humans ; Child ; Cicatrix/therapy* ; Retrospective Studies ; Treatment Outcome ; Wound Healing ; Hand Injuries/rehabilitation* ; Wrist Injuries ; Contracture/etiology* ; Burns/complications*

BACKGROUND: The purpose of this study was to investigate the frequency and distribution of associated carpal bone fractures (CBFs) in distal radial fractures (DRFs). METHODS: Three hundred and thirteen patients who underwent surgical treatment for DRFs between March 2007 and January 2010 were reviewed retrospectively. In this study, 223 patients who had preoperative computed tomography (CT) were included. We investigated the frequency and distribution of associated CBFs on CT scans. The relationship between the frequency of associated CBFs and patient factors such as age, gender, body mass index, and the mechanism of injury was assessed. RESULTS: CBFs were complicated in 46 of 223 DRFs (20.9%). The distribution of CBFs was 23 cases in the triquetrum, 16 in the lunate, 12 in the scaphoid, five in the hamate, and four in the pisiform. Among the 46 cases, a fracture of one carpal bone occurred in 36 cases, two in seven cases, three in two cases, and four in one case. In 10 of the 46 cases, associated CBFs occurred in more than two carpal bones. No significant differences were observed for age, sex, body mass index, or the mechanism of injury between patients with DRFs and CBFs and those without CBFs. CONCLUSIONS: Because CBFs that mainly occur in the proximal carpal row are complicated in DRFs at a relatively high frequency, assessment of carpal bones using CT scans is beneficial.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carpal Bones/*injuries/radiography ; Female ; Fractures, Bone/*complications/radiography ; Hand Injuries/*complications/radiography ; Humans ; Male ; Middle Aged ; Radius Fractures/*complications/radiography ; Retrospective Studies ; Tomography, X-Ray Computed

Currently there are more than 10 types of penile prosthesis available today, ranging from the very simple to the very sophisticated. We review our experience with various penile prosthesis, with particular regard to the complication rate. From December. 1983 to July. 1993, we have implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisciplinary diagnostic approaches.The etiologies of impotence were vasculogenic 29%, diabetogenic 22%, spinal cord injury 16%, pelvic bone injury 11%, etc. The types of implanted prosthesis were AMS malleable 143, Jonas 42, Dynaflex 36, Hydroflex 8, Uni-Flate 1000 2, AMS 700 CXM 58, Ultrex 3, Mentor alpha-1 3 and the mean follow-up period was 34 months. The diameters of implanted prosthesis were from 9. 5mm to l3mm, mostly 9.5mm(52.9%) range. The length of implanted prosthesis were from 10cm to 20cm, mostly 16-l8cm( 68.8%). Cases with uneven diameters or lengths were 20(6.8 %). The intraoperative complications were 1 corporeal rupture and 1 bladder rupture, and the postoperative complications were 2 prosthesis infections, 2 mechanical failures, and 1 prosthesis infection with mechanical failure. In 4 patients reimplantations were successful. More than 99% ( 290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and also disadvantages. Factors to be analysed in the selection of proper prosthesis should include patients economic status, education, personality, social activity, hand dexterity, and penile size. So far by our 10 years experience, we believe that 3-piece inflatable prosthesis especially AMS 700 CXM, which is designed to fit the orienta1 penile size, is excellent in quality and reliability.
Education ; Erectile Dysfunction ; Follow-Up Studies ; Hand ; Humans ; Intraoperative Complications ; Male ; Mentors ; Pelvic Bones ; Penile Prosthesis* ; Postoperative Complications ; Prostheses and Implants ; Replantation ; Rupture ; Spinal Cord Injuries ; Urinary Bladder

BACKGROUNDThumb web contracture is a common complication after hand injury, and can markedly affect whole hand function. Therefore, surgery involving thumb web reconstruction is often necessary to restore normal function of the involved hand. In this study, we present the application of the lateral tarsal artery (LTA) flap in first web reconstruction.

METHODSFrom November 1, 2005 to October 31, 2007, seven patients with severe post trauma or burn contractures around the first web space were treated with a LTA flap. All the patients were followed up.

RESULTSAll flaps survived, with an average size of 6.7 cm x 4.8 cm. There were no complications or recurrent contractures during follow-up. All patients were satisfied with the esthetic appearance and functional outcome of the reconstruction.

CONCLUSIONThe LTA flap could be an excellent option for covering various defects in the thumb web space, serving as an excellent alternative for the thumb web space reconstruction.

Adult ; Contracture ; physiopathology ; surgery ; Female ; Hand Injuries ; complications ; surgery ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Thumb ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

BACKGROUND: Nonabsorbable sutures are favorable for repairing flexor tendons. However, absorbable sutures have performed favorably in an animal model. METHODS: Two-strand sutures using the interlocking modified Kessler method with polydioxanone absorbable sutures 4-0 were used to repair completely ruptured flexor tendons in 55 fingers from 41 consecutive patients. The medical records of average 42 follow up weeks were analyzed retrospectively. The data analyzed using the chi-squared test, and Fisher's exact test was used for postoperative complications. The results were compared with those of other studies. RESULTS: Among the index, middle, ring, and little fingers were injured in 9, 17, 16, and 13 fingers, respectively. The injury levels varied from zone 1 to 5. Of the 55 digits in our study, there were 26 (47%) isolated flexor digitorum profundus (FDP) injuries and 29 (53%) combined FDP and with flexor digitorum superficialis injuries. Pulley repair was also conducted. Concomitant injuries of blood vessels and nerves were found in 17 patients (23 fingers); nerve injuries occurred in 5 patients (10 fingers). Two patients had ruptures (3.6%), and one patient had two adhesions (3.6%). Using the original Strickland criteria, all the patients were assessed to be excellent or good. Also, fibrosis and long-term foreign body tissue reactions such as stitch granuloma were less likely occurred in our study. Compared to the Cullen's report that used nonabsorbable sutures, there was no significant difference in the rupture or adhesion rates. CONCLUSIONS: Therefore, this study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repairs.
Animals ; Blood Vessels ; Fibrosis ; Fingers ; Follow-Up Studies ; Foreign Bodies ; Formycins ; Granuloma ; Hand ; Humans ; Medical Records ; Polydioxanone ; Postoperative Complications ; Retrospective Studies ; Ribonucleotides ; Rupture ; Sutures ; Tendon Injuries ; Tendons