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

Wrist pain is a common presentation to the general practitioner and emergency department. Most cases are simple to treat, and pain frequently resolves with conservative treatment. However, there are certain conditions, such as scaphoid nonunion and Kienböck's disease, where delayed diagnosis and treatment can result in long-term deformity or disability. This article covers the various causes of wrist pain, recommendations on how wrist pain should be assessed, as well as details some of the common conditions that warrant specialist referral.
Acute Pain ; diagnosis ; etiology ; rehabilitation ; Arthralgia ; diagnosis ; etiology ; rehabilitation ; Chronic Pain ; diagnosis ; etiology ; rehabilitation ; Disability Evaluation ; Fractures, Ununited ; complications ; diagnosis ; Humans ; Orthopedic Procedures ; methods ; Osteonecrosis ; complications ; diagnosis ; Pain Measurement ; Scaphoid Bone ; injuries ; Wrist Injuries ; complications ; diagnosis ; rehabilitation ; Wrist Joint

Laparoscopic adrenalectomy (LA) has become the standard for the management of benign adrenal tumors since Gagner reported a successful surgery in 1992. Conventional open adrenalectomies have been replaced by LA because of significant advantages such as reduced wound pain and hospital stays, decreased transfusion requirements, and postoperative complications. In addition to the development of laparoscopic surgery, robot-assisted adrenalectomies are gaining popularity worldwide. The robotic system offers several advantages: it magnifies a surgeon's view with 3D optics, offers excellent resolution and depth perception, and the robotic wrists offer 7 degrees of freedom, allowing for precise movements. Another new technique of laparoscopic adrenal surgery is single-port surgery, which is an effort to reduce the number of trocars and their related wound complications. Although this is technically more difficult compared to conventional laparoscopic surgeries, patients are satisfied with a single-site scar and reduced pain. In this paper, the recent development of new techniques in adrenal surgery are introduced and their specific advantages and disadvantages are discussed. Also, this article reviews the clinical results of a partial adrenalectomy for small benign adrenal tumors and adrenalectomies for single adrenal metastasis from extra-adrenal malignancy.
Adrenalectomy ; Cicatrix ; Depth Perception ; Freedom ; Humans ; Laparoscopy ; Length of Stay ; Neoplasm Metastasis ; Postoperative Complications ; Surgical Instruments ; Wounds and Injuries ; Wrist

Adolescent ; Adult ; Carpal Tunnel Syndrome ; etiology ; surgery ; Female ; Fractures, Bone ; complications ; surgery ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Wrist Injuries ; complications ; 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*

OBJECTIVE: To evaluate the operative method and the clinical efficacy of volar Barton's fracture treated by internal fixation with T type titanium plate. METHODS: We performed the operation of the open reduction and internal fixation with T type titanium plate in 18 patients with volar Barton's fracture. RESULTS: The 18 patients were followed up after the operation at the average time of 13 months (6 to 31 months). X radiographs showed that all patients achieved solid bone union. Mehara's evaluation for volar Barton's fracture revealed excellent outcome in 12 patients, good in 5 patients, and fair in 1 patients. The excellent and good rate of clinical results was 94.4%. X-radiographs showed that the volar tilting angle was 8-18 (mean=11.0) degree, and the ulnar inclining angle was 16-26 (mean=22.4) degree. There was no shortening of the radius. CONCLUSION The operative treatment with titanium T type plate fixation for volar Barton's fracture is in favor of fracture anatomic reduction, solid internal fixation, and catagmatic concrescence. It is beneficial for functional recovery of the wrist at the utmost. The outcome in the near future is satisfactory. It is an ideal method for volar Barton's fracture.
Adolescent ; Adult ; Bone Plates ; Child ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Radius Fractures ; complications ; surgery ; Recovery of Function ; Titanium ; Wrist Injuries ; surgery ; Wrist Joint ; physiology

Scaphoid dislocation is a rare injury. Traditionally it has been classified into isolated dislocation and dislocation associated with axial carpal disruption. We present a unique case of scaphoid dislocation associated with proximal migration of the entire distal carpal row as a single unit and hamate fracture with no axial carpal disruption. This injury complex has not been previously described in the literature. The purpose of this case report is to emphasize that in absence of axial carpal dissociation with scaphoid dislocation, a careful evaluation of injury to other bones should be done and treated accordingly to maximize the chances of favourable outcome with reconstructive surgery.
Fractures, Bone ; complications ; surgery ; Hamate Bone ; diagnostic imaging ; injuries ; Humans ; Male ; Reconstructive Surgical Procedures ; Scaphoid Bone ; diagnostic imaging ; injuries ; Tomography, X-Ray Computed ; Wrist Injuries ; complications ; diagnostic imaging ; surgery ; Young Adult

A 28-year-old man presented with a palmar divergent dislocation of the scaphoid and lunate. He was treated with an open reduction and an internal fixation with two Kirschner's wires after the 25th day of trauma due to a neurological injury. The results were satisfactory after 18 months follow up without any evidence of avascular necrosis and traumatic arthritis of the scaphoid and lunate. The patient had no limitation in motion or intermittent wrist pain. We reported this case with a brief review of relevant literatures.
Adult ; Arthrography ; Bone Wires ; Dislocations/*etiology/radiography/*surgery ; *Fracture Fixation, Internal ; Human ; Male ; *Scaphoid Bone ; *Semilunar Bone ; Tomography, X-Ray Computed ; Wrist Injuries/*complications

OBJECTIVETo study the diagnosis and treatment of Colles fracture with dorsally dislocated ulna.

METHODSFrom July 2004 to November 2004, 20 cases of Colles fracture with dorsally dislocated ulna treated with supination-cast were evaluated.

RESULTSFractures were healed in all cases, and no recurrent dislocation was found in duration of 6 - 10 months follow up. Evaluation with Gartland and Werley score system showed that 100% of patient restored excellent function of wrist and forearm.

CONCLUSIONSSupination-cast is an effective option for the acute cases. Well understanding of this injury and early diagnosis are critical.

Adolescent ; Adult ; Aged ; Casts, Surgical ; Colles' Fracture ; complications ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation ; instrumentation ; methods ; Humans ; Joint Dislocations ; complications ; surgery ; Male ; Middle Aged ; Wrist Injuries ; complications ; surgery