Do Better Postoperative Radiological Findings Predict Better Long-Term Functional Outcomes in Adults with a Displaced Distal Radius Fracture?

Purpose: The purpose of this study was to analyze the relationship of early radiological outcomes and longterm function in postoperative distal radius fracture patients. Methods: This was prospective cohort research, with information including sex, age, patient satisfaction, Gartland and Werley Score, and radiographic score. The statistics, including correlation analysis, ROC Curve, and multivariable binary Logistic Regression, were analyzed in SPSS. Results: In the entire 135 patients, 48 were male, 87 were female. ROC curve showed longterm Gartland and Werley Score, and early radiographic scores have an association to a certain extent with a Spearman correlation coefficient of 0.196 (p = 0.023) and an AUC of 0.639 (ROC Curve, p = 0.017). Patient satisfaction was mainly determined by the statistical modeling of 4.096×(palmar flexion−dorsiflexion)−4.378× (pronation−supination)−5.754 (Multivariable Binary Logistic Regression). Conclusion: Long-terms functional outcomes of postoperative distal radius fracture patients are not only influenced by radiographic score. Patient satisfaction is mainly concerning palmar flexion and pronation–supination of the wrist.

Effect of Wrist Joint Angle on the Examination of Hoffmann's Sign

Objective To study the effect of different wrist flexion and extension angles on the results of Hoffmann’s sign.Methods Thirty-seven patients with cervical spondylotic myelopathy and fifty objectives as control group were examinated at 15° palmar flexion, 0° neutral, 30° back extension, and 60° back extension of the wrist joint to observe Hoffmann's sign.ResultsThe patients with cervical spondylotic myelopathy did not present significantly different results of Hoffmann’s sign at 0° neutral, 30° back extension, and 60° back extension, but significantly different at 15° palmar flexion (P<0.05). In control group, there is no significant difference at 15° palmar flexion, 0° neutral, 30° back extension, but significantly different at 60° back extension (p<0.05).ConclusionThe different angles of wrist flexion and extension present a significant impact on the results of Hoffmann’s sign examination. For the patients with cervical spondylotic myelopathy, it is reliable to test Hoffmann’s sign at 30° wrist back extension.

Comparative study of cast immobilization of wrist in functional position versus conventional palmar flexion in Colles’ fracture

Background: Colles’ fracture is a common injury in the elderly population. Although it can be easily reduced, it is difficult to maintain the reduction in the conventional position of the wrist in palmar flexion with a poor functional outcome. Thus our study aimed to compare the radiological and functional outcome of such fractures with the wrist in two different posi­tions of dorsiflexion and palmar flexion. Methods: A prospective, observational study was conducted from April 2019 to March 2020 in the Orthopedics and Emergency department of KIST Medical College Teaching Hospital, Lalitpur, Ne­pal. Sixty-two patients, 31 in each group, all above 45 years with Colles’ fracture underwent close reduction and below elbow cast immobilization under hematoma block. Maintaining palmar flex­ion and ulnar deviation at the fracture site, the wrist was immobilized in dorsiflexion and palmar flexion attitude alternatively. During the respective follow-ups, the Demerit Scoring System of Saito was evaluated. Data collection and entry was done using the statistical package for social science version 16 and analyzed by using descriptive and inferential statistics. Results: All fractures were united. At the end of twelve weeks, Saito Scoring System of good to ex­cellent was markedly better in dorsiflexed group 29(93.5%) patients as compared to palmar flexed group 22(71.0%) patients, similarly grip power was also superior in dorsiflexed group 19(61.3%) patients than in palmar flexed group 11(35.5%) patients. Conclusions: Cast immobilization of Colles’ fracture with the wrist in dorsiflexion prevents re-dis­placement of the fragments resulting in significantly better radiological and functional outcomes.

Pengaruh kelelahan terhadap perubahan kinematika gerak pada saat overhead jumping smash dalam permainan bulutangkis

Tujuan penelitian ini adalah untuk mengetahui pengaruh kelelahan kardiovaskular terhadap perubahan kinematika gerak pada tubuh bagian atas saat pukulan overhead jumping smash dalam permainan bulutangkis. Metode yang digunakan adalah deskriptif kuantitatif dengan pendekatan pre test and post test design. Sampel yang digunakan adalah pemain bulutangkis putra yang mempunyai keterampilan teknik overhead jumping smash dengan rata-rata usianya 19.4 ± 1.6 tahun, tinggi badan 1.73 ± 0.12m dan berat badan 60.8 ± 3.7kg dengan jumlah keseluruhan 12 orang. Penelitian ini menggunakan satu buah 3D force platform device, 3 buah Panasonic handycam, Frame DIAZ IV 3D motion software analysis, cosmed direct gas analyzer dan radar speed gun. Hasilnya menunjukkan bahwa pada fase maximum angular velocity terdapat perbedaan signifikan pada empat variabel saat kondisi fatigue dan non fatigue antara lain shoulder internal rotation (P=0.042), elbow extension (P=0.035), forearm supination (P=0.024) dan wrist dorsi flexion (P=0.040). Selanjutnya pada fase instant of maximal shoulder external rotation terdapat tiga variabel perbedaan yang signifikan antara lain shuttlecock velocity (P=0.035), shoulder external rotation (P=0.048), dan wrist palmar flexion (P=0.037). Kesimpulan bahwa internal shoulder rotation, wrist palmar flexion dan forearm supination memberikan kontribusi yang sangat signfikan terhadap kecepatan shuttlecock pada saat melakukan overhead jumping smash dalam permainan bulutangkis.

Metacarpal Arc Motion: Comparison of Different Measurement Methods

Introduction The range of motion of the carpometacarpal (CMC) joints is difficult to assess in clinical practice. Materials and Methods The purpose of this study was to measure a precise range of motion measurement of the metacarpal arc during maximum palmar flexion of the fifth CMC joint in healthy persons with three different methods: optical, electrogoniometrical, and sonographical. Results The metacarpal arc motion measured with the optical technique was 24.9 degrees (standard deviation [SD]: 6.2 degrees), with the electrogoniometric technique was 24.3 degrees (SD: 3.6 degrees) and with sonography was 25.1 degrees (SD: 3.5 degrees), with no differences between left and right hand for all methods. Conclusion This study shows that different techniques can be used for the measurement of the metacarpal arc motion. With these techniques, it is possible to assess the metacarpal arc in patients with fractures to the CMC joints to evaluate posttraumatic function und rehabilitation progress. This study shows level of evidence as III.

Dermatoglyphic appraisal of multiple births women in Igbo-Ora and Ogbomosho, South west, Nigeria

The scientific study of epidermal ridges on the palms and toes is termed dermatoglyphics. Multiple births occur when more than one fetus results from a single pregnancy. This study is aimed at determining the relationship if any between multiple births and palmar flexion creases. Two hundred Igbo-Ora and one hundred Ogbomosho healthy and consenting adult female indigenes aged between 25-50 years were recruited and grouped into 4; group I consisted of multiple births women in Igbo-Ora; group II consisted of single births women in Igbo-Ora; group III consisted of multiple births women in Ogbomosho; and group IV consisted of single births women in Ogbomosho. A total of 600 palms (Igbo-Ora n=400; Ogbomosho n=200) comprising of both hands were used in the study. Palm prints samples were obtained by asking the participants to wash their hands, towel dry them, after which they were stained with stamp ink pad and prints made on A4 paper in duplicates. Palm print patterns of 105 (Igbo-Ora) and 50 (Ogbomosho) women with multiple births were compared with 95 (Igbo-Ora) and 50 (Ogbomosho) women with single births. The percentage number of primary, P and intersection, I of palmar creases with complete transverse creases, C (PIC) 300 bilaterally was significantly greater (p < 0.005) in the hands of Igbo-Ora multiple births women (52.4 %) than their single births women (37.4%) while same trend was observed for Ogbomosho women although difference was statistically insignificant,(p > 0.005). In both Igbo-Ora and Ogbomosho women, PIC 310 bilaterally was found to be significantly higher (p < 0.05) in both hands of single births women than the multiple births women. Hence, dermatoglyphics can be said to have relationship with a woman’s tendency to giving birth to multiples. Keywords: Multiple births, dermatoglyphics, palmar flexion creases, Ogbomosho, Igbo-Ora

An isolated pisiform fracture: a case report

<p class="abstract"><span lang="EN-IN">With overall prevalence between 2% to 3%, carpal bone fractures are not encountered frequently in clinical practice. Amongst these, pisiform fractures have very low incidence of &lt;0.2%, in which, more than half are associated with other carpal injuries, and sometimes ulnar styloid and ligamentous injuries. Thus, diagnosis of isolated pisiform fracture requires a very high index of suspicion. Hereby, authors report an isolated pisiform fracture in a 27 year old dentist who sustained an injury due to fall on outstretched hand. After radiographic confirmation in multiple views and CT scan, isolated-minimally displaced pisiform fracture was found. A below-elbow cast with slight palmar flexion was given for 4 weeks. He returned to normal pre-injury activities at 12 weeks.</span></p>

Arthroscopic Reduction-Association of the Scapholunate with an Absorbable Screw

Background The treatment of chronic scapholunate instability is yet a controversial topic. Arthroscopic reduction-association scapholunate technique is a minimally invasive option in which a stable pseudoarthrosis at the scapholunate joint is obtained, allowing some degree of movement while maintaining the normal alignment of the wrist. The purpose of this study was to review the results of arthroscopic reduction-association scapholunate with an absorbable screw. Methods We retrospectively evaluated patients with dynamic or static, but reducible, chronic scapholunate instability who underwent arthroscopic reduction-association scapholunate between 2012 and 2015. An absorbable headless compression screw was used in the technique. Results A total of 33 patients (21 males, 12 females) were included. Average follow-up time was 17 months. At final follow-up, the average postoperative Disabilities of the Arm, Shoulder and Hand (DASH) score was 18 (range, 8–46). The average postoperative grip strength was 30 kg, 73% of the uninjured side. The average extension-palmar flexion arc was 112 degrees, 79% of the uninjured side. The scapholunate angle decreased from 70 degrees preoperatively to 52 degrees postoperatively. In the cases of static lesion, the scapholunate interval decreased from 4.1 mm preoperatively to 2.8 mm at final follow-up. One patient had a breakage of the screw at 4 months, four developed a complex regional pain syndrome, one had a prominence of the screw at the waist of the scaphoid, and four maintained symptoms of instability. From these 10 patients, 5 were submitted to revision surgery. Conclusion The arthroscopic reduction-association technique is capable of maintaining the reduction of the scapholunate joint and of improving symptoms, while preserving range-of-motion. The use of an absorbable screw is an option in this technique, and may diminish screw-related complications.