The stigma of digital amputation: a survey of amputees with analysis of risk factors

The purpose of this study was to quantify the stigma associated with digital amputation and examine factors associated with it. One hundred and sixty-four digital amputees completed the Neurological Quality of Life-Stigma questionnaire and a battery of Patient-Reported Outcome Measurement Information System instruments. Multivariable analysis examined factors associated with stigma experience. The mean observed stigma score of 47 (SD 8, range 36–64) was similar to the mean value of the normal population. Younger age, a worker’s compensation claim and depression were each independently associated with a more severe experience of stigma after digital amputation. Socioeconomic variables, anatomical details and mechanism of injury were not independently associated with stigma. Digital amputation is not highly stigmatizing overall. Surgeons should consider referring at-risk patients to a mental health provider for support during the coping and adjustment process after amputation. Level of evidence: III

Clinical presentations and long term prognosis of childhood onset polyarteritis nodosa in single centre of Korea

Childhood-onset polyarteritis nodosa (PAN) is a rare and systemic necrotising vasculitis in children affecting small- to medium-sized arteries. To date, there have been only a few reports because of its rarity. Thus, we aimed to investigate the clinical manifestations, laboratory findings, treatment, and long-term outcomes in patients with childhood-onset PAN and to evaluate the usefulness of the paediatric vasculitis activity score (PVAS). We retrospectively analysed the data of nine patients with childhood-onset PAN from March 2003 to February 2020. The median ages at symptom onset, diagnosis, and follow-up duration were 7.6 (3–17.5), 7.7 (3.5–17.6), and 7.0 (1.6–16.3) years, respectively. All patients had constitutional symptoms and skin manifestations, while five exhibited Raynaud’s phenomenon. Organ involvement was observed in one patient. The median PVAS at diagnosis was 7 (range: 2–32). Prednisolone was initially used for induction in all patients, and other drugs were added in cases refractory to prednisolone. All patients survived, but three patients with high PVAS at diagnosis experienced irreversible sequelae, including intracranial haemorrhage and digital amputation. In conclusion, early diagnosis and treatment may minimise sequelae in patients with childhood-onset PAN. This study suggests that high PVAS score at diagnosis may be associated with poor prognosis.

The Stigma of Digital Amputation: A Survey of Amputees with Analysis of Risk Factors

Purpose: We aimed to quantify the stigma associated with digital amputation using the Neuro-QOL Stigma patient-reported outcomes instrument and examine the patient and injury factors associated with a more severe amputation stigma experience. Methods: This descriptive retrospective cohort study analyzed 164 patients who underwent digital amputation. Records were reviewed for age at amputation, sex, indication, laterality, level, number of amputated digits, and a diagnosis of depression that preceded amputation. Enrolled patients remotely completed the Neuro-QOL stigma computer adaptive test, a battery of PROMIS instruments, and a questionnaire clarifying personal/injury details. Multivariable analysis was used to identity factors associated with a more severe stigma experience.Results: Among 164 digital amputees enrolled, the observed mean Neuro-QOL Stigma score of 47.2 +/- 8 is slightly below the population mean of 50. Younger age, a worker’s compensation claim, and a diagnosis of depression at the time of amputation are each independently associated with a more severe stigma experience after digital amputation. Neither socioeconomic variables, anatomic details of the injury, nor mechanism were independently associated with Neuro-QOL Stigma. Conclusions: While we have previously targeted patients with more severe injuries for discussion of coping with physical stigma, our findings suggest that attention should perhaps instead be focused on digital amputees who are young, depressed, and/or involved with worker’s compensation. A surgeon may be of service to the at-risk patient by offering referral to a mental health provider who can offer depression treatment and/or support the patient’s process of coping and adjustment.

CHONDROSARCOMAS OF THE HAND: A REPORT OF THREE CASES

Chondrosarcoma of the hand is very rare. We report three observations of chondrosarcoma of the hand, which enable us to make a review of its pathology. The follow-up was up to 2 years.There were two women and one man with an average age of 48 years old (30, 85 and 31). The localisation was phalangeal in two cases and metacarpal in one case, one case followed for chondroma. The three cases were central. X-rays were characterized by the presence of lytic areas with calcifications and in one case, we showed a calcification in the peripheral tissue. Histological diagnosis was made by biopsy (grade 2 in two cases and grade 1 in one case). Treatment consisted of amputation of the finger in two cases. In the case of metacarpal localization, wide resection of concerned ray. The patients showed no local recurrence and no metastatic spread after 2 years.The chondrosarcoma in the hand may due to malignant change in a pre-existing chondroma. He is the most common malignant bone tumor of the hand. This shows that the diagnosis of a chondrosarcoma can only be made in the synopsis of the radiological, histological and clinical findings.The metastasis of hand chondrosarcomas is very rare but has been described. With regard to the local recurrence rate, the data in the literature varies between 11% and 50%. Conservative treatment is difficult due to the small size of the hand, which allows easy spread of the tumor from compartment to compartment.Despite the low metastatic potential of chondrosarcomas of the hand in comparison with other sites, ray resection or digital amputation is recommended to avoid local recurrence. In cases with only local excision, close follow-up is recommended.

Analysis on Making of Finger Prosthesis using Amputation Surgery Method

India is a vast country with a large number of individuals in the community with various disabilities. It had been estimated that there are roughly 0.62 amputees in India per thousand population. This translates to close to more than one million individuals with amputations. Digital amputation is a common injury. This very often results in extensive functional disability and a substantial psychological impact. More importantly, the outcome of digital dysfunction is detrimental to the patient's daily activities, such as buttoning a shirt or unlocking a door. Therefore, the overall goal for these patients is to rebuild a finger with the restoration of normal function, stability, length, and sensation. Prosthetic rehabilitation of amputated fingers is an attempt to rehabilitate aesthetics and limitedly function. A prosthesis will be a counterfeit body part that replaces a few of the work and presence of the absent a major aspect. The kind of your prosthetic hand, finger alternately arm will rely on upon the area Furthermore period for your remaining finger or hand Also your practical Also lifestyle necessities. It is critical with impart those exercises that you feel need aid. The separable die allowed the silicone to flow into narrow spaces. Once the mould is filled with silicone, the flask is closed and pressure is applied slowly.

Analysis of Outcomes of Tamai Zone I Digital Replantation in Cases of Severe Crushing Injury

Purpose: Digital replantation has dramatically changed the fate of mutilated injuries of hand. But in case of severe crushing injury in Tamai zone I, it is a contraindication of replantation. This study aims to determine the replantation survival rate in cases with crushing injury.Methods: We retrospectively evaluated patients’ charts and photos from January 2015 to December 2019. There were 294 patients (331 fingers) with digital amputation who underwent surgery. Cases with crushing were divided into petechiae-in-skin group and red-line-sign group and compared with the group without crushing. The relationship of survival rate with factors was evaluated using chi-square analysis.Results: Of these, 199 fingers were defined as severe crushed, and 140 cases with petechiae in skin and 59 cases with red line sign. There was no statistically significant difference in survival rate compared with the group without crushing (p=0.227). Additional surgery was performed more in crushed injury. However, necrotized soft tissue was mainly on margin of amputation, not on crushed area.Conclusion: The presence of crushing did not affect survival rate in Tamai zone I replantation. However, as the degree of crushing was severe, the need for additional surgery increased. We found that the number of anastomosed arteries and veins influences the survival rate. According to our analysis, even if it’s difficult, finding and doing anastomosis as many vessels as possible can make good results.