1.Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea
Maria Florencia DESLIVIA ; Hyun-Joo LEE ; In-Ho JEON ; Hemanshu KOCHHAR ; Hyo-Jin KIM ; Poong-Taek KIM
The Ewha Medical Journal 2025;48(1):e77-
Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.
2.Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea
Maria Florencia DESLIVIA ; Hyun-Joo LEE ; In-Ho JEON ; Hemanshu KOCHHAR ; Hyo-Jin KIM ; Poong-Taek KIM
The Ewha Medical Journal 2025;48(1):e77-
Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.
3.Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea
Maria Florencia DESLIVIA ; Hyun-Joo LEE ; In-Ho JEON ; Hemanshu KOCHHAR ; Hyo-Jin KIM ; Poong-Taek KIM
The Ewha Medical Journal 2025;48(1):e77-
Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.
4.Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea
Maria Florencia DESLIVIA ; Hyun-Joo LEE ; In-Ho JEON ; Hemanshu KOCHHAR ; Hyo-Jin KIM ; Poong-Taek KIM
The Ewha Medical Journal 2025;48(1):e77-
Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.
5.Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea
Maria Florencia DESLIVIA ; Hyun-Joo LEE ; In-Ho JEON ; Hemanshu KOCHHAR ; Hyo-Jin KIM ; Poong-Taek KIM
The Ewha Medical Journal 2025;48(1):e77-
Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.
6.Comparison of the long-term outcomes of cast immobilization methods in distal radius fractures:a systematic review of randomized controlled trials
Maria Florencia DESLIVIA ; Claudia SANTOSA ; Sherly Desnita SAVIO ; Erica KHOLINNE ; Made Bramantya KARNA ; Anak Agung Gde Yuda ASMARA
The Ewha Medical Journal 2024;47(4):e51-
Objectives:
Conservative treatment for distal radius fractures typically involves closed reduction and immobilization with a plaster cast. However, no consensus exists regarding the best method and duration for immobilization. This study investigated the functional outcomes associated with different plaster cast application techniques in the treatment of stable distal radius fractures.
Methods:
A systematic search was performed in accordance with PRISMA guidelines for studies in the last 5 years. The inclusion criteria were randomized controlled trials that investigated non-operative treatments for distal radius fractures. We excluded studies with short-term follow-up (less than 3 months), ongoing trials, those that did not directly address fractures, and studies involving the use of sugar-tong splints or non-circular immobilization. The outcomes evaluated included subjective measures (Disabilities of the Arm, Shoulder and Hand score; Patient-Rated Wrist Evaluation score; Mayo Wrist Score; and visual analog scale) and objective outcomes (complication rate and radiological parameters).
Results:
We included seven articles from 2017 to 2022. These studies reported a total of 542 fractures, predominantly in women, with a mean age of over 50 years. Both short and long arm casts demonstrated similar functional and radiological outcomes. A longer immobilization period (>3 weeks) should be considered to prevent re-displacement.
Conclusion
In stable fractures treated conservatively, the use of both short and long arm casts resulted in comparable functional outcomes in older patients. Immobilization for at least 3 weeks is recommended, as it provided similar clinical and radiological outcomes compared to longer periods of immobilization (level of evidence: 2A).
7.Comparison of the long-term outcomes of cast immobilization methods in distal radius fractures:a systematic review of randomized controlled trials
Maria Florencia DESLIVIA ; Claudia SANTOSA ; Sherly Desnita SAVIO ; Erica KHOLINNE ; Made Bramantya KARNA ; Anak Agung Gde Yuda ASMARA
The Ewha Medical Journal 2024;47(4):e51-
Objectives:
Conservative treatment for distal radius fractures typically involves closed reduction and immobilization with a plaster cast. However, no consensus exists regarding the best method and duration for immobilization. This study investigated the functional outcomes associated with different plaster cast application techniques in the treatment of stable distal radius fractures.
Methods:
A systematic search was performed in accordance with PRISMA guidelines for studies in the last 5 years. The inclusion criteria were randomized controlled trials that investigated non-operative treatments for distal radius fractures. We excluded studies with short-term follow-up (less than 3 months), ongoing trials, those that did not directly address fractures, and studies involving the use of sugar-tong splints or non-circular immobilization. The outcomes evaluated included subjective measures (Disabilities of the Arm, Shoulder and Hand score; Patient-Rated Wrist Evaluation score; Mayo Wrist Score; and visual analog scale) and objective outcomes (complication rate and radiological parameters).
Results:
We included seven articles from 2017 to 2022. These studies reported a total of 542 fractures, predominantly in women, with a mean age of over 50 years. Both short and long arm casts demonstrated similar functional and radiological outcomes. A longer immobilization period (>3 weeks) should be considered to prevent re-displacement.
Conclusion
In stable fractures treated conservatively, the use of both short and long arm casts resulted in comparable functional outcomes in older patients. Immobilization for at least 3 weeks is recommended, as it provided similar clinical and radiological outcomes compared to longer periods of immobilization (level of evidence: 2A).
8.Comparison of the long-term outcomes of cast immobilization methods in distal radius fractures:a systematic review of randomized controlled trials
Maria Florencia DESLIVIA ; Claudia SANTOSA ; Sherly Desnita SAVIO ; Erica KHOLINNE ; Made Bramantya KARNA ; Anak Agung Gde Yuda ASMARA
The Ewha Medical Journal 2024;47(4):e51-
Objectives:
Conservative treatment for distal radius fractures typically involves closed reduction and immobilization with a plaster cast. However, no consensus exists regarding the best method and duration for immobilization. This study investigated the functional outcomes associated with different plaster cast application techniques in the treatment of stable distal radius fractures.
Methods:
A systematic search was performed in accordance with PRISMA guidelines for studies in the last 5 years. The inclusion criteria were randomized controlled trials that investigated non-operative treatments for distal radius fractures. We excluded studies with short-term follow-up (less than 3 months), ongoing trials, those that did not directly address fractures, and studies involving the use of sugar-tong splints or non-circular immobilization. The outcomes evaluated included subjective measures (Disabilities of the Arm, Shoulder and Hand score; Patient-Rated Wrist Evaluation score; Mayo Wrist Score; and visual analog scale) and objective outcomes (complication rate and radiological parameters).
Results:
We included seven articles from 2017 to 2022. These studies reported a total of 542 fractures, predominantly in women, with a mean age of over 50 years. Both short and long arm casts demonstrated similar functional and radiological outcomes. A longer immobilization period (>3 weeks) should be considered to prevent re-displacement.
Conclusion
In stable fractures treated conservatively, the use of both short and long arm casts resulted in comparable functional outcomes in older patients. Immobilization for at least 3 weeks is recommended, as it provided similar clinical and radiological outcomes compared to longer periods of immobilization (level of evidence: 2A).
9.Comparison of the long-term outcomes of cast immobilization methods in distal radius fractures:a systematic review of randomized controlled trials
Maria Florencia DESLIVIA ; Claudia SANTOSA ; Sherly Desnita SAVIO ; Erica KHOLINNE ; Made Bramantya KARNA ; Anak Agung Gde Yuda ASMARA
The Ewha Medical Journal 2024;47(4):e51-
Objectives:
Conservative treatment for distal radius fractures typically involves closed reduction and immobilization with a plaster cast. However, no consensus exists regarding the best method and duration for immobilization. This study investigated the functional outcomes associated with different plaster cast application techniques in the treatment of stable distal radius fractures.
Methods:
A systematic search was performed in accordance with PRISMA guidelines for studies in the last 5 years. The inclusion criteria were randomized controlled trials that investigated non-operative treatments for distal radius fractures. We excluded studies with short-term follow-up (less than 3 months), ongoing trials, those that did not directly address fractures, and studies involving the use of sugar-tong splints or non-circular immobilization. The outcomes evaluated included subjective measures (Disabilities of the Arm, Shoulder and Hand score; Patient-Rated Wrist Evaluation score; Mayo Wrist Score; and visual analog scale) and objective outcomes (complication rate and radiological parameters).
Results:
We included seven articles from 2017 to 2022. These studies reported a total of 542 fractures, predominantly in women, with a mean age of over 50 years. Both short and long arm casts demonstrated similar functional and radiological outcomes. A longer immobilization period (>3 weeks) should be considered to prevent re-displacement.
Conclusion
In stable fractures treated conservatively, the use of both short and long arm casts resulted in comparable functional outcomes in older patients. Immobilization for at least 3 weeks is recommended, as it provided similar clinical and radiological outcomes compared to longer periods of immobilization (level of evidence: 2A).
10.Comparison of the long-term outcomes of cast immobilization methods in distal radius fractures:a systematic review of randomized controlled trials
Maria Florencia DESLIVIA ; Claudia SANTOSA ; Sherly Desnita SAVIO ; Erica KHOLINNE ; Made Bramantya KARNA ; Anak Agung Gde Yuda ASMARA
The Ewha Medical Journal 2024;47(4):e51-
Objectives:
Conservative treatment for distal radius fractures typically involves closed reduction and immobilization with a plaster cast. However, no consensus exists regarding the best method and duration for immobilization. This study investigated the functional outcomes associated with different plaster cast application techniques in the treatment of stable distal radius fractures.
Methods:
A systematic search was performed in accordance with PRISMA guidelines for studies in the last 5 years. The inclusion criteria were randomized controlled trials that investigated non-operative treatments for distal radius fractures. We excluded studies with short-term follow-up (less than 3 months), ongoing trials, those that did not directly address fractures, and studies involving the use of sugar-tong splints or non-circular immobilization. The outcomes evaluated included subjective measures (Disabilities of the Arm, Shoulder and Hand score; Patient-Rated Wrist Evaluation score; Mayo Wrist Score; and visual analog scale) and objective outcomes (complication rate and radiological parameters).
Results:
We included seven articles from 2017 to 2022. These studies reported a total of 542 fractures, predominantly in women, with a mean age of over 50 years. Both short and long arm casts demonstrated similar functional and radiological outcomes. A longer immobilization period (>3 weeks) should be considered to prevent re-displacement.
Conclusion
In stable fractures treated conservatively, the use of both short and long arm casts resulted in comparable functional outcomes in older patients. Immobilization for at least 3 weeks is recommended, as it provided similar clinical and radiological outcomes compared to longer periods of immobilization (level of evidence: 2A).

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