INTRODUCTIONEthnic variations in the prevalence of absence of the palmaris longus (PL) are well known. Many techniques for clinically determining the presence of the PL have been described. Studies have also attempted to correlate its absence with other anatomical anomalies. However, most studies have been done in Caucasian populations.

MATERIALS AND METHODSThe presence of the PL was clinically determined in 329 normal Chinese men and women using the standard technique. In subjects with an absent PL, 4 other tests were performed to confirm absence and an Allen's test was done to assess the palmar arches. All subjects were examined for the presence of the flexor digitorum superficialis (FDS) to the little finger.

RESULTSThe overall prevalence of absence of the PL was 4.6%. All techniques were equally effective in determining the absence of the PL. There was no significant difference in its absence with regard to the body side or sex. Absolute deficiency of FDS to the little finger was seen in 6.4%. No correlation could be detected between the absence of the PL and FDS of the little finger.

CONCLUSIONSThe prevalence of absence of the PL and absence of FDS to the little finger in a Chinese population is much lower compared to previous reports in the literature. There is no association between absence of the PL and absence of the FDS to the little finger. Although all techniques of examining for the absence of the PL are equally effective, the method suggested by Mishra seems the best as it was easily understood by subjects and can be used even when thumb abduction is not possible.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; Child ; China ; ethnology ; Female ; Fingers ; abnormalities ; Hand Deformities, Congenital ; complications ; epidemiology ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; abnormalities ; Prevalence ; Range of Motion, Articular ; genetics ; Singapore ; epidemiology ; Tendons ; abnormalities

INTRODUCTIONEarly debridement and coverage has long been regarded as the standard of care for open fractures of the lower limb, as infection is a serious complication. However, the best time for wound closure remains controversial. Negative-pressure wound therapy (NPWT) is thought to result in reduced flap infection and failure. To determine the effect of NPWT, we reviewed patients with open fractures of the lower limb and compared the rates of infection and flap failure in two time-based cohorts.

METHODSTwo cohorts of patients (periods 2003-2004 and 2008-2009) with Gustilo type IIIB open tibial fractures were recruited and their outcomes were compared. In the 2003-2004 cohort, wounds were dressed with occlusive dressing. In the 2008-2009 cohort, all patients underwent NPWT. Data was retrospectively analysed with regard to infection, failure, age, type of flap, comorbidities and defect size. The incidences of infection and flap failure were further analysed for any statistical difference between the different treatment protocols.

RESULTSIn the 2003-2004 cohort, 33% of patients developed infection and 11% had flap failure. However, in the 2008-2009 cohort, 10% of patients developed infection and 6% had flap failure. The difference in the incidence of infection was statistically significant between the two cohorts (p = 0.029).

CONCLUSIONPatients in the 2008-2009 cohort had better outcomes, and we are of the opinion that performing NPWT may have contributed to this result.

Adult ; Aged ; Cohort Studies ; Debridement ; methods ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Open ; diagnosis ; surgery ; Graft Rejection ; Humans ; Injury Severity Score ; Leg Injuries ; diagnosis ; surgery ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Radiography ; Retrospective Studies ; Surgical Flaps ; blood supply ; Surgical Wound Infection ; diagnosis ; surgery ; Tibial Fractures ; diagnostic imaging ; surgery ; Treatment Outcome ; Wound Healing ; physiology ; Young Adult

Acute Disease ; Arthroplasty, Replacement, Knee ; adverse effects ; Diagnosis, Differential ; Humans ; Knee Joint ; pathology ; surgery ; Male ; Middle Aged ; Pyoderma Gangrenosum ; diagnosis ; Skin ; pathology ; Surgical Wound Infection ; diagnosis