Indian Journal of Plastic Surgery最新文献

Background  The normal ability to distinguish two points from one is known as the two-point discriminative (2PD) sense. This forms an extremely important assessment in patient with injuries to the nerves distributed to the upper extremity. Objective  The aim of this study was to estimate the normal reference values of static 2PD in healthy adults and children. Materials and Methods  A total of 624 normal adults comprising 380 men and 244 women were recruited randomly for the study at three different centers. Additionally, 172 healthy children, comprising 110 boys and 62 girls, were studied. Eight sensory areas in the palmar surface of the hand were delineated. The ability to distinguish the static 2PD was estimated in millimeters by using disk discriminator. The results were tabulated and statistically analyzed. Results  The mean static 2PD in the adult population ranged from 2.78 to 3.5 mm in the fingertips and 5.39 to 7.13 mm in the mid-palm. There was a statistically significant difference between men and women in zones 6, 7, and 8. In children, the observed 2PD values were 2.15 to 3.63 mm in the fingertips and 4.10 to 5.77 mm in the palm. Children have a significantly better 2PD sense when compared with adults. Conclusion  The normal value of static 2PD in the palmar surface of the hand among the Indian pediatric and adult populations was established in the study.

Background:  India, with a large population working in industries, has a considerable amount of nail bed injuries day to day as well as infections and other issues with nails. However, there are no normative data for nail growth in our population. This study aims to measure and analyze the rate of nail growth in the Indian population, which will be a valuable tool for clinical assessment and treatment. Objective: The aim of the study was to estimate the average rate of nail growth of all fingers in the Indian population between the age group of 18 to 40 years. Materials and Methods: Fifty young adults whose 500 fingernails were painted with three coats of nail polish following a standardized protocol, and the rate of the growth of the nails was recorded with a digital Vernier caliper from the nail fold every 10 days for 1 month. Results: The average fingernail growth is 0.103 mm/d. There is no correlation of nail growth with sex or hand dominance. Nail growth is more in the left index finger (0.13 mm/d) and the left thumb, while it is the least in little fingers (0.101 mm/d). Initial fingernail growth was higher in older individuals, however. At the end of the study period, nail growth was equal. The nail growth rate reduces as the days progress. Conclusion: We have reported the normative data of nail growth as 0.103 mm per day. In the majority of the healthy population, this rate would hold true.

Background  The first web space of the hand plays a crucial role in determining the hand's span. Our study aims to examine and quantify the first web space angle in both hands of adult individuals within the Indian population with no upper limb pathologies. The primary objective of this study is to establish normative data. These data will be useful in surgical correction for the first web release, recommending corrective splints, and calculating the percentage of disability in hand function. Materials and Methods  Data from 800 individuals from various regions across India, ranging in age from 20 to 50 years who had no pathology in both upper limbs were collected. A goniometer was used to measure the first web space angle of both hands by keeping the forearm pronated, elbow flexed, and arms adducted. The subjects from different states were divided into various zones. Results  In 800 subjects, the average measurement in the right hand was 97.28 degrees, and in the left hand, 99.76 degrees. In males, the average measurement in the right hand was 97.54 degrees, and in the left hand, it was 99.61 degrees. In females, in the right hand, it was 96.93 degrees, and in the left hand 100 degrees. The result was recorded in subjects from each zone in the country. Conclusion  The large sample size from various parts of the country makes the study more reliable. The technique of measuring the angles was easily reproducible. Our findings provide crucial normative data for clinicians and therapists.

Background  There is no normative study of transregional grip strength data available from India. Hence, a multicenter study is designed to obtain reference value. Materials and Methods  This is a prospective observational study conducted as a part of the Indian normative data project of the Indian Society for Surgery of the Hand. The study included three participating centers: one from the northern part and two from the southern part. Certified calibrated Jamar dynamometer and Jamar pinch gauge were used to measure the grip strength, key pinch strength, tip pinch strength, and tripod pinch strength as per the guidelines of the American Society of Hand Therapists. Results  A total of 1,019 volunteers in the age group of 18 to 60 years were studied. The mean grip strength in males and females was 38.18 and 24.06 kg, respectively. The mean key pinch strength was 8.52 kg in males and 5.97 kg in females. The mean tip pinch strength was 4.86 kg in males and 3.59 kg in females. The mean tripod pinch strength was 5.41 kg in males and 4.16 kg in females. Conclusions  All four strengths were lower in value when compared with American and other populations. The men had more strength than women. There was no relation to hand dominance. There was a correlation for age and height but no correlation with body mass index (BMI).

Background  The absence of the palmaris longus (PL) varies with race. The presence of a functional flexor digitorum superficialis (FDS) of the little finger also varies widely. The aim of this study is to determine the prevalence of the absence of the PL and functional FDS of the little finger in the Indian population. Materials and Methods  This is a prospective observational study conducted as a part of the Indian normative data project of the Indian Society for Surgery of the Hand. The presence of the PL was assessed by Schaeffer's test. The function of the FDS was assessed by the standard test and modified test and its function designated as absent, present independently, or present combinedly with the ring finger FDS. Results  A total of 200 volunteers including 84 males and 116 females in the 21- to 60-year age group were examined. Of the 400 hands examined, the PL was absent in 26 upper limbs (6.5%). The PL was absent unilaterally in 12 individuals (6%) and bilaterally in 7 individuals (3.5%). Of the 400 little fingers examined, FDS function was absent in 72 fingers (18%), while 67 fingers (16.75%) had a common function and 261 fingers (65.25%) had an independent function. Only 2% had a bilateral absence of both the PL and functional FDS tendons and 5% had a unilateral absence of both tendons. Conclusion  The PL and FDS of the little finger were more absent in the right side than in the left side, but the difference was not statistically significant. There was no significant association between the absence of the PL and the absence of the functional FDS of the little finger.

Objective  The aim of this study is to create clinical normative data for ulnar length in the pediatric population and to demonstrate the usefulness of such data. Materials and Methods  A nationally representative sample of healthy children aged 1 day to 18 years from five centers across India was collected. The percutaneous length of the ulna was measured by using a certified calibrated measuring tape across all centers. Other variables such as geographical domicile, dominance of the hand, age, body mass index (BMI), and sex of the child were also recorded. Results  In total, 1,300 children (883 males and 417 females) with age ranging from 1 day to 18 years were included in the study. Gradual lengthening of the ulna was seen in both male and female children with increasing age without a significant difference; however, at 8, 9, and 14 years, there was significant lengthening of the ulna in males compared with females although the difference was statistically insignificant at 17 years. Apropos BMI at 16 years of age, a longer ulna was observed in obese children. Later on, at 18 years, the difference in ulnar length was insignificant. South Indian children had a significantly longer ulna up to the age of 11 years, but after the age of 11 years there was no difference in ulnar length in all zones. The length of the ulna was not affected by hand dominance. There was good inter-observer agreement and reliability between different centres. Age, zone, and gender, had statistically significant effect on the length of ulna but BMI and hand dominance was not significant. Conclusion  This multicentric study provides normative data on the percutaneous length of the ulna in the Indian pediatric population. Gradual lengthening of the ulna was seen in all children with increasing age. The length of the ulna was significantly more in male, obese, and in South Indian children. However, except for age, other factors become insignificant at maturity.