Mohamed Ibrahim B K, P Umar Farooq Baba, Veena Singh, Ankur Karanjkar, Latha Madhavan, Raheeb Ahmad Shah, Ansarul Haq, Manoj Pawar, Anupama Kumari, Nikhil Panse, Vishnubabu G, Shyamnath Krishna Pandian, Anirudha Sharma, Rajagopalan Krishnamoorthy, Mukund Thatte, Anil Bhat, Sridhar Krishnamoorthy
Background The normative data for finger range of motion (ROM) are not available for the Indian population. The aim of our study was to measure the active ROM of finger joints in normal healthy volunteers in a sample of 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 (ISSH). The study included one participating center from four geographical regions of the country. Certified goniometers were used to measure the ROM of fingers in all centers. A standardized methodology was devised. A pilot study was done to assess the interobserver and intraobserver reliability, following which data were collected by one measurement. Results This pilot study was performed in 20 hands that showed good interobserver and intraobserver reliability correlation. A total of 390 hands were measured in four participating centers. Active flexion of metacarpophalangeal (MCP) joint was the highest in the middle finger (86.6 ± 10.4 degrees) followed by the index finger (86.0 ± 9.2 degrees), little finger (85.0 ± 8.4 degrees), and ring finger (84.2 ± 8.6 degrees). The index finger (97.2 ± 16.9 degrees) showed maximum proximal interphalangeal (PIP) joint flexion followed by the middle finger (96.2 ± 15.8 degrees), ring finger (96.0 ± 15.9 degrees), and little finger (91.8 ± 12.7 degrees). Distal interphalangeal (DIP) joint flexion increased from the index finger (81.6 ± 13.9 degrees) to the little finger (84.6 ± 12.9 degrees). The little finger MCP joint (26.3 ± 6.2 degrees) showed maximum extension followed by the index finger (25.7 ± 6.8 degrees), middle finger (24.7 ± 6.7 degrees) and ring finger (22.3 ± 7.1 degrees). The middle finger (15.6 ± 8.1 degrees) and ring finger (16.2 ± 8 degrees) had more PIP joint extension when compared to the index (13.7 ± 7.8 degrees) and little finger (13.2 ± 8.4 degrees). The ring finger (8.1 ± 6.8 degrees) and the middle finger (8.4 ± 6.9 degrees) had more DIP joint extension when compared with the index finger (6.0 ± 6.0 degrees) and the little finger (6.8 ± 6.7 degrees). Total active motion (TAM) of the middle finger (315.9 ± 31.0 degrees) was the maximum followed by the index finger (310.2 ± 27.3 degrees), ring finger (308.8 ± 29.1 degrees), and little finger (307.8 ± 25.2 degrees). Gender, body mass index (BMI), mother tongue, geographical location, and occupation were factors that had significant correlation, while no significant differences based on side, hand dominance, and age were noted. Conclusion We have reported normative data of finger ROM and TAM for the index, middle, ring, and little fingers in the Indian population. Finger ROM in the Indian population is highly variable. The observed TAM in the Indian population is higher than what is reported earlier.
{"title":"The Normal Active Range of Motion of the Index, Middle, Ring, and Little Fingers in a Sample of Indian Population.","authors":"Mohamed Ibrahim B K, P Umar Farooq Baba, Veena Singh, Ankur Karanjkar, Latha Madhavan, Raheeb Ahmad Shah, Ansarul Haq, Manoj Pawar, Anupama Kumari, Nikhil Panse, Vishnubabu G, Shyamnath Krishna Pandian, Anirudha Sharma, Rajagopalan Krishnamoorthy, Mukund Thatte, Anil Bhat, Sridhar Krishnamoorthy","doi":"10.1055/s-0044-1788593","DOIUrl":"https://doi.org/10.1055/s-0044-1788593","url":null,"abstract":"<p><p><b>Background</b> The normative data for finger range of motion (ROM) are not available for the Indian population. The aim of our study was to measure the active ROM of finger joints in normal healthy volunteers in a sample of Indian population. <b>Materials and Methods</b> 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 (ISSH). The study included one participating center from four geographical regions of the country. Certified goniometers were used to measure the ROM of fingers in all centers. A standardized methodology was devised. A pilot study was done to assess the interobserver and intraobserver reliability, following which data were collected by one measurement. <b>Results</b> This pilot study was performed in 20 hands that showed good interobserver and intraobserver reliability correlation. A total of 390 hands were measured in four participating centers. Active flexion of metacarpophalangeal (MCP) joint was the highest in the middle finger (86.6 ± 10.4 degrees) followed by the index finger (86.0 ± 9.2 degrees), little finger (85.0 ± 8.4 degrees), and ring finger (84.2 ± 8.6 degrees). The index finger (97.2 ± 16.9 degrees) showed maximum proximal interphalangeal (PIP) joint flexion followed by the middle finger (96.2 ± 15.8 degrees), ring finger (96.0 ± 15.9 degrees), and little finger (91.8 ± 12.7 degrees). Distal interphalangeal (DIP) joint flexion increased from the index finger (81.6 ± 13.9 degrees) to the little finger (84.6 ± 12.9 degrees). The little finger MCP joint (26.3 ± 6.2 degrees) showed maximum extension followed by the index finger (25.7 ± 6.8 degrees), middle finger (24.7 ± 6.7 degrees) and ring finger (22.3 ± 7.1 degrees). The middle finger (15.6 ± 8.1 degrees) and ring finger (16.2 ± 8 degrees) had more PIP joint extension when compared to the index (13.7 ± 7.8 degrees) and little finger (13.2 ± 8.4 degrees). The ring finger (8.1 ± 6.8 degrees) and the middle finger (8.4 ± 6.9 degrees) had more DIP joint extension when compared with the index finger (6.0 ± 6.0 degrees) and the little finger (6.8 ± 6.7 degrees). Total active motion (TAM) of the middle finger (315.9 ± 31.0 degrees) was the maximum followed by the index finger (310.2 ± 27.3 degrees), ring finger (308.8 ± 29.1 degrees), and little finger (307.8 ± 25.2 degrees). Gender, body mass index (BMI), mother tongue, geographical location, and occupation were factors that had significant correlation, while no significant differences based on side, hand dominance, and age were noted. <b>Conclusion</b> We have reported normative data of finger ROM and TAM for the index, middle, ring, and little fingers in the Indian population. Finger ROM in the Indian population is highly variable. The observed TAM in the Indian population is higher than what is reported earlier.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Nehete, Anita R Nehete, Amol Ghalme, Abhishek Kulkarni, Al-Iqyan Juzar Fidvi
Introduction Hand amputation at the wrist level is severely disabling, especially when bilateral. It is paramount to restore the hand function to the best possible level for the patient's daily living activities, as well as optimal social and occupational rehabilitation. There are various options for restoration of function after amputation at wrist and distal forearm levels including Krukenberg's operation, variations of toe transfers, hand allotransplantation, and prosthesis. Krukenberg's procedure and the reconstruction using toe transfer like Vilkki's procedure or two-toe transfers, restore only the pinch. Hand allotransplantation, although it gives excellent function, has limitations due to the complications of immunosuppression. Functional hand prosthesis, though superior in cosmetic appearance, have again limitations in function, and the cost is prohibitive for most patients in our country. Materials and Methods We present the unique case of a bilateral hand amputation at the wrist level reconstructed with three toes and free anterolateral thigh (ALT) flap in a single-stage surgery for each hand. In two stages, the patient had six toes transferred to both hands. Result All transferred toes and all three free (two ALT and one thoracodorsal artery perforator) flaps survived completely. Three-finger grip (tripod pinch) was thus restored in each hand. The hook grip was also restored well by the reconstructed two fingers. Within 3 months after surgery, the patient could perform all activities of daily living. He resumed his original job with some modification of his work within 6 months postinjury. Conclusion Hand reconstruction using three toes and a free flap is an excellent option for functional restoration for amputation at the wrist and distal forearm level. It allows an early return to function and good social and professional integration of the patient. This procedure is a potential alternative to expensive prosthesis and allotransplantation for a bilateral hand amputation.
{"title":"Functional Restoration of Bilateral Wrist Level Hand Amputee with Six-Toe Transfers and Three Free Flaps: An Alternative to Hand Allotransplantation or Prosthesis","authors":"R. Nehete, Anita R Nehete, Amol Ghalme, Abhishek Kulkarni, Al-Iqyan Juzar Fidvi","doi":"10.1055/s-0044-1787870","DOIUrl":"https://doi.org/10.1055/s-0044-1787870","url":null,"abstract":"\u0000 Introduction Hand amputation at the wrist level is severely disabling, especially when bilateral. It is paramount to restore the hand function to the best possible level for the patient's daily living activities, as well as optimal social and occupational rehabilitation. There are various options for restoration of function after amputation at wrist and distal forearm levels including Krukenberg's operation, variations of toe transfers, hand allotransplantation, and prosthesis. Krukenberg's procedure and the reconstruction using toe transfer like Vilkki's procedure or two-toe transfers, restore only the pinch. Hand allotransplantation, although it gives excellent function, has limitations due to the complications of immunosuppression. Functional hand prosthesis, though superior in cosmetic appearance, have again limitations in function, and the cost is prohibitive for most patients in our country.\u0000 Materials and Methods We present the unique case of a bilateral hand amputation at the wrist level reconstructed with three toes and free anterolateral thigh (ALT) flap in a single-stage surgery for each hand. In two stages, the patient had six toes transferred to both hands.\u0000 Result All transferred toes and all three free (two ALT and one thoracodorsal artery perforator) flaps survived completely. Three-finger grip (tripod pinch) was thus restored in each hand. The hook grip was also restored well by the reconstructed two fingers. Within 3 months after surgery, the patient could perform all activities of daily living. He resumed his original job with some modification of his work within 6 months postinjury.\u0000 Conclusion Hand reconstruction using three toes and a free flap is an excellent option for functional restoration for amputation at the wrist and distal forearm level. It allows an early return to function and good social and professional integration of the patient. This procedure is a potential alternative to expensive prosthesis and allotransplantation for a bilateral hand amputation.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Korambayil, Hemang Arvind Sanghvi, V. Dilliraj, P. Ambookan
Background Dermal substitutes offer a valuable tool in soft-tissue reconstruction, reducing the need for donor site tissue and its associated complications. However, conventional approaches often require multiple surgeries. This study aimed to compare the effectiveness of a single-stage procedure combining dermal substitute and skin grafting with hyperbaric oxygen (HBO) therapy to the standard multistage protocol. Materials and Methods A comparative study was conducted from January 2022 to December 2023. The medical records of 24 patients who underwent soft-tissue reconstruction were reviewed. Patients were categorized into two groups based on whether they received HBO therapy (HBO group) or followed the standard multistage protocol (control group). Outcomes were compared between the groups. Results The study included 18 males and 6 females with an average age of 43 years (range: 5–91 years). Underlying medical conditions included diabetes mellitus (n = 11) and peripheral vascular disease (n = 2). Wounds were due to various causes, including necrotizing fasciitis (n = 2), trauma (n = 10), diabetic ulcers (n = 6), postburn hypertrophic scars/contractures (n = 3), chronic ulcers (n = 1), and sternal wound dehiscence (n = 1). All the patients achieved successful wound closure with dermal substitute application, eliminating the need for additional surgery. Notably, the group receiving HBO therapy experienced a shorter overall hospital stay compared with the standard multistage group. Conclusion This study demonstrates the effectiveness of dermal substitutes in soft-tissue reconstruction. Furthermore, the addition of HBO therapy in a single-stage procedure appears beneficial for successful outcomes, potentially reducing hospital stay compared with the traditional multistage approach.
{"title":"Evaluating Hyperbaric Oxygen Therapy to Improve Single-Stage Dermal Substitute and Skin Grafting: A Comparative Study","authors":"P. Korambayil, Hemang Arvind Sanghvi, V. Dilliraj, P. Ambookan","doi":"10.1055/s-0044-1788592","DOIUrl":"https://doi.org/10.1055/s-0044-1788592","url":null,"abstract":"\u0000 Background Dermal substitutes offer a valuable tool in soft-tissue reconstruction, reducing the need for donor site tissue and its associated complications. However, conventional approaches often require multiple surgeries. This study aimed to compare the effectiveness of a single-stage procedure combining dermal substitute and skin grafting with hyperbaric oxygen (HBO) therapy to the standard multistage protocol.\u0000 Materials and Methods A comparative study was conducted from January 2022 to December 2023. The medical records of 24 patients who underwent soft-tissue reconstruction were reviewed. Patients were categorized into two groups based on whether they received HBO therapy (HBO group) or followed the standard multistage protocol (control group). Outcomes were compared between the groups.\u0000 Results The study included 18 males and 6 females with an average age of 43 years (range: 5–91 years). Underlying medical conditions included diabetes mellitus (n = 11) and peripheral vascular disease (n = 2). Wounds were due to various causes, including necrotizing fasciitis (n = 2), trauma (n = 10), diabetic ulcers (n = 6), postburn hypertrophic scars/contractures (n = 3), chronic ulcers (n = 1), and sternal wound dehiscence (n = 1). All the patients achieved successful wound closure with dermal substitute application, eliminating the need for additional surgery. Notably, the group receiving HBO therapy experienced a shorter overall hospital stay compared with the standard multistage group.\u0000 Conclusion This study demonstrates the effectiveness of dermal substitutes in soft-tissue reconstruction. Furthermore, the addition of HBO therapy in a single-stage procedure appears beneficial for successful outcomes, potentially reducing hospital stay compared with the traditional multistage approach.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction Speech, one of the main functions affected by cleft palate, involves a complex orchestra of sound deformation by various organs including the larynx, pharynx, epiglottis, palate, tongue, lip, and other structures complementing them. Although the effects of palatoplasty are traditionally evaluated subjectively, objective parameters have seldom been described to compare the pre- and postrepair functions. The study tries to extract the palatal and pharyngeal muscles while uttering various Hindi syllables and tries to find the percentage contraction of these structures as an objective assessment. Materials and Methods Digital Imaging and Communications in Medicine (DICOM) images while uttering each syllable of the Hindi syllable are obtained by subjecting a healthy volunteer to a dynamic magnetic resonance imaging (MRI). Using freeform geomagic software, 3D models of the structure of the pharynx and palate were created, which were then used to create a finite element model. Different anatomical constraints were applied to the muscles obtained. The finite element model was tested for convergence and a suitably fine mesh was used to obtain the results. The percentage of contraction of the palate and pharynx for uttering different syllables was thus evaluated. Results The palate and the posterior pharyngeal walls yielded different contractions for different syllables independent of each other. The highest contraction for the palate and posterior pharyngeal wall was for the syllable /k/ and the lowest regarding the palate was for /h/ and /eː/ for the pharyngeal wall. Conclusion Using computational modeling, quantification of speech in terms of percentage contraction of the palate and pharynx has been attempted for the Hindi language. Once validated with a larger population, the database may be used to quantify speech deformities due to structural pathologies in terms of palatal and pharyngeal contractions and help us assess the effectiveness of corrective surgeries for them.
{"title":"Estimating Palatal and Pharyngeal Muscle Contraction in Hindi Syllable Pronunciation using Computational Modeling","authors":"Madhubari Vathulya, Subrato Sarkar, Indra Vir Singh, Tripta Prajapati, Pankaj Sharma","doi":"10.1055/s-0044-1788591","DOIUrl":"https://doi.org/10.1055/s-0044-1788591","url":null,"abstract":"\u0000 Introduction Speech, one of the main functions affected by cleft palate, involves a complex orchestra of sound deformation by various organs including the larynx, pharynx, epiglottis, palate, tongue, lip, and other structures complementing them. Although the effects of palatoplasty are traditionally evaluated subjectively, objective parameters have seldom been described to compare the pre- and postrepair functions. The study tries to extract the palatal and pharyngeal muscles while uttering various Hindi syllables and tries to find the percentage contraction of these structures as an objective assessment.\u0000 Materials and Methods Digital Imaging and Communications in Medicine (DICOM) images while uttering each syllable of the Hindi syllable are obtained by subjecting a healthy volunteer to a dynamic magnetic resonance imaging (MRI). Using freeform geomagic software, 3D models of the structure of the pharynx and palate were created, which were then used to create a finite element model. Different anatomical constraints were applied to the muscles obtained. The finite element model was tested for convergence and a suitably fine mesh was used to obtain the results. The percentage of contraction of the palate and pharynx for uttering different syllables was thus evaluated.\u0000 Results The palate and the posterior pharyngeal walls yielded different contractions for different syllables independent of each other. The highest contraction for the palate and posterior pharyngeal wall was for the syllable /k/ and the lowest regarding the palate was for /h/ and /eː/ for the pharyngeal wall.\u0000 Conclusion Using computational modeling, quantification of speech in terms of percentage contraction of the palate and pharynx has been attempted for the Hindi language. Once validated with a larger population, the database may be used to quantify speech deformities due to structural pathologies in terms of palatal and pharyngeal contractions and help us assess the effectiveness of corrective surgeries for them.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141826884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pedro Alvedro-Ruiz, A. Sánchez-García, Iván Heredia-Alcalde, Belén Andresen-Lorca, Ana Trapero-Ovejero, Miriam Alonso-Carpio, P. García-Pastor, S. Pous-Serrano, A. Pérez-García
Abstract Abdominal wall repair in adults with bladder exstrophy is challenging. We present a case of a 46-year-old woman with bladder exstrophy presenting with a large midline incisional hernia associated with a 13-cm hypoplasia of both pubic rami that precluded fixation of any abdominal mesh. A two-stage approach was adopted. First, a free vascularized osteocutaneous fibula flap was used to reconstruct the pelvic ring. After complete bone union 18 months later, a mesh was anchored to the fibula flap to restore the abdominal wall competence. After 2 years of follow-up, no hernia recurrence was observed, and the patient reported improved quality of life and self-esteem. This novel technique may provide long-term stability and good functional outcomes for reconstruction of the abdominal wall in selected adults with bladder exstrophy.
{"title":"Pelvic Ring Reconstruction with an Osteocutaneous Fibula Flap for Abdominal Wall Repair in Adults with Bladder Exstrophy","authors":"Pedro Alvedro-Ruiz, A. Sánchez-García, Iván Heredia-Alcalde, Belén Andresen-Lorca, Ana Trapero-Ovejero, Miriam Alonso-Carpio, P. García-Pastor, S. Pous-Serrano, A. Pérez-García","doi":"10.1055/s-0044-1788049","DOIUrl":"https://doi.org/10.1055/s-0044-1788049","url":null,"abstract":"Abstract Abdominal wall repair in adults with bladder exstrophy is challenging. We present a case of a 46-year-old woman with bladder exstrophy presenting with a large midline incisional hernia associated with a 13-cm hypoplasia of both pubic rami that precluded fixation of any abdominal mesh. A two-stage approach was adopted. First, a free vascularized osteocutaneous fibula flap was used to reconstruct the pelvic ring. After complete bone union 18 months later, a mesh was anchored to the fibula flap to restore the abdominal wall competence. After 2 years of follow-up, no hernia recurrence was observed, and the patient reported improved quality of life and self-esteem. This novel technique may provide long-term stability and good functional outcomes for reconstruction of the abdominal wall in selected adults with bladder exstrophy.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Vp, Raghuram Menon, Sebin V. Thomas, Prajwal M., Saju Narayanan
Cyanoacrylate is an organic monomer. Cyanoacrylate compounds are highly unstable and they undergo hydroxylation reaction by an exothermic reaction in the presence of hydroxyl (-OH) group like water or a weak base. 1,2 This reaction is catalyzed by cotton and wool. It is advised not to use cotton gloves while handling these compounds. 3 Kelemen et al in their study showed that, on an average, theheat produced during this exothermic reaction is 68°C for 12.2seconds, which is suf fi cient to cause a full-thickness burn. 4 Even though the use of these compounds are ubiquitous, the awareness regarding the burns caused by these compounds is poor
{"title":"A Case of Cyanoacrylate Glue Burns in a Two-Year-Old Child","authors":"B. Vp, Raghuram Menon, Sebin V. Thomas, Prajwal M., Saju Narayanan","doi":"10.1055/s-0044-1787889","DOIUrl":"https://doi.org/10.1055/s-0044-1787889","url":null,"abstract":"Cyanoacrylate is an organic monomer. Cyanoacrylate compounds are highly unstable and they undergo hydroxylation reaction by an exothermic reaction in the presence of hydroxyl (-OH) group like water or a weak base. 1,2 This reaction is catalyzed by cotton and wool. It is advised not to use cotton gloves while handling these compounds. 3 Kelemen et al in their study showed that, on an average, theheat produced during this exothermic reaction is 68°C for 12.2seconds, which is suf fi cient to cause a full-thickness burn. 4 Even though the use of these compounds are ubiquitous, the awareness regarding the burns caused by these compounds is poor","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashwini Varadha Rajan, Vigneswaran Varadharajan, Praveen Bhardwaj, S. Sabapathy
Abstract While proximal phalangeal joint injuries with comminution of the base of the middle phalanx are common injuries, proximal interphalangeal (PIP) joint fracture dislocations with an intact base of middle phalanx and a comminuted head of proximal phalanx are rare. Volar plate arthroplasty and other described techniques prevail for the former injury, while the latter does not have any supportive literature on the exact method of management. We herein present a 20-year-old male with a severely comminuted head of proximal phalanx fracture with dislocation of the PIP joint, which was not reconstructable but was managed successfully with a novel technique of volar plate draping that resurfaced the raw phalangeal head. A 3-year follow-up of the patient, whose finger has full, painless, and complete functional range of movement, gives us the belief that this procedure can provide a fully functional finger where other methods fail to do so.
{"title":"Volar Plate Draping (VPD) for Severely Comminuted Proximal Phalanx Head Fractures","authors":"Ashwini Varadha Rajan, Vigneswaran Varadharajan, Praveen Bhardwaj, S. Sabapathy","doi":"10.1055/s-0044-1787849","DOIUrl":"https://doi.org/10.1055/s-0044-1787849","url":null,"abstract":"Abstract While proximal phalangeal joint injuries with comminution of the base of the middle phalanx are common injuries, proximal interphalangeal (PIP) joint fracture dislocations with an intact base of middle phalanx and a comminuted head of proximal phalanx are rare. Volar plate arthroplasty and other described techniques prevail for the former injury, while the latter does not have any supportive literature on the exact method of management. We herein present a 20-year-old male with a severely comminuted head of proximal phalanx fracture with dislocation of the PIP joint, which was not reconstructable but was managed successfully with a novel technique of volar plate draping that resurfaced the raw phalangeal head. A 3-year follow-up of the patient, whose finger has full, painless, and complete functional range of movement, gives us the belief that this procedure can provide a fully functional finger where other methods fail to do so.","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141687544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25eCollection Date: 2024-08-01DOI: 10.1055/s-0044-1787871
Pawan Agarwal, M R Thatte, Mansi Saraf, Rajesh Bobba, Dhananjaya Sharma, Jagmoah Singh Dhakar
Introduction This article aims to establish the relative thumb length in comparison to the index finger in central Indian adults. Materials and Methods Five hundred normal adult hands (1,000 thumbs), 316 men and 184 women, mean age 30 years, were included in the study. The relative length of the thumb was measured using the length of the proximal phalanx of the index finger (thumb-proximal phalanx index) and the distance between the proximal digital crease and proximal interphalangeal crease of the index finger (thumb-digital crease index). Results The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. The tip of a normal adducted thumb extends to 68% for male and 69% for female of the length of the proximal phalanx of the index finger. For the dominant hand the tip of a normal adducted thumb extends to 68%, while for nondominant hand it reaches 71% of the length of the proximal phalanx of the index finger. The difference between the laterality, gender, and hand dominance was not statistically significant. Conclusion The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. Relative normal thumb length is independent of gender, laterality, or hand dominance.
{"title":"Normative Values for Thumb Length in Central Indian Adult Population.","authors":"Pawan Agarwal, M R Thatte, Mansi Saraf, Rajesh Bobba, Dhananjaya Sharma, Jagmoah Singh Dhakar","doi":"10.1055/s-0044-1787871","DOIUrl":"https://doi.org/10.1055/s-0044-1787871","url":null,"abstract":"<p><p><b>Introduction</b> This article aims to establish the relative thumb length in comparison to the index finger in central Indian adults. <b>Materials and Methods</b> Five hundred normal adult hands (1,000 thumbs), 316 men and 184 women, mean age 30 years, were included in the study. The relative length of the thumb was measured using the length of the proximal phalanx of the index finger (thumb-proximal phalanx index) and the distance between the proximal digital crease and proximal interphalangeal crease of the index finger (thumb-digital crease index). <b>Results</b> The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. The tip of a normal adducted thumb extends to 68% for male and 69% for female of the length of the proximal phalanx of the index finger. For the dominant hand the tip of a normal adducted thumb extends to 68%, while for nondominant hand it reaches 71% of the length of the proximal phalanx of the index finger. The difference between the laterality, gender, and hand dominance was not statistically significant. <b>Conclusion</b> The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. Relative normal thumb length is independent of gender, laterality, or hand dominance.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25eCollection Date: 2024-08-01DOI: 10.1055/s-0044-1787850
Anil K Bhat, Arvind Kumar Pandey, Mithun Pai G, Raghavendra Ms, Chethan Kumar M, Shaurya Vikram Singh
Introduction Radiography is the most often accessible and affordable imaging modality. Accurate assessments of wrist X-rays can aid in the diagnosis and prognostic evaluation of various wrist problems. This study aims to identify normal radiographic anthropometry reference values and variations of carpal bones and joints by gender and age in sample Indian population, with the potential to be clinically applicable. Materials and Methods Two investigators conducted a prospective analysis of normal wrist radiographs in a single center. Radiology Information Systems and Picture Archiving and Communication Systems were used to collect standard digitized normal X-rays without significant osseous pathology over a year. We conducted measurements of length, angles, and indices in a standard posteroanterior and lateral wrist X-rays in order to establish the standard dimensions and variances based on age and gender. Results A total of 18 measurements which included eight linear measurements, eight angles, and two ratios were documented. A total of 500 X-rays of 250 males and 250 females with 125 of each in two age groups of 20 and 40 years and 41 and 60 years were evaluated. Conclusion This work is a comprehensive database of the Indian population measuring parameters in normal wrist radiographs of posteroanterior and lateral views. The results of our study indicate that men and younger individuals had a significantly higher carpal height ratio. The width of distal radial ulnar joint space was significantly lesser in older subjects. Additionally, males showed a significantly higher lunate uncovered ratio and radial height. When compared to the literature, the study revealed a significant positive ulnar variance in elderly people and women. However, we noted an overall increase in the percentage of positive ulnar variance individuals in our study. We also recorded a marginal increase in radial inclination with no variations across gender and age.
{"title":"Normative Data of Carpal Bone Measurements in the Sample Adult Indian Population.","authors":"Anil K Bhat, Arvind Kumar Pandey, Mithun Pai G, Raghavendra Ms, Chethan Kumar M, Shaurya Vikram Singh","doi":"10.1055/s-0044-1787850","DOIUrl":"https://doi.org/10.1055/s-0044-1787850","url":null,"abstract":"<p><p><b>Introduction</b> Radiography is the most often accessible and affordable imaging modality. Accurate assessments of wrist X-rays can aid in the diagnosis and prognostic evaluation of various wrist problems. This study aims to identify normal radiographic anthropometry reference values and variations of carpal bones and joints by gender and age in sample Indian population, with the potential to be clinically applicable. <b>Materials and Methods</b> Two investigators conducted a prospective analysis of normal wrist radiographs in a single center. Radiology Information Systems and Picture Archiving and Communication Systems were used to collect standard digitized normal X-rays without significant osseous pathology over a year. We conducted measurements of length, angles, and indices in a standard posteroanterior and lateral wrist X-rays in order to establish the standard dimensions and variances based on age and gender. <b>Results</b> A total of 18 measurements which included eight linear measurements, eight angles, and two ratios were documented. A total of 500 X-rays of 250 males and 250 females with 125 of each in two age groups of 20 and 40 years and 41 and 60 years were evaluated. <b>Conclusion</b> This work is a comprehensive database of the Indian population measuring parameters in normal wrist radiographs of posteroanterior and lateral views. The results of our study indicate that men and younger individuals had a significantly higher carpal height ratio. The width of distal radial ulnar joint space was significantly lesser in older subjects. Additionally, males showed a significantly higher lunate uncovered ratio and radial height. When compared to the literature, the study revealed a significant positive ulnar variance in elderly people and women. However, we noted an overall increase in the percentage of positive ulnar variance individuals in our study. We also recorded a marginal increase in radial inclination with no variations across gender and age.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11436329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21eCollection Date: 2024-06-01DOI: 10.1055/s-0044-1787279
P Umar Farooq Baba, Raheeb Ahmad Shah, Mir Yasir, Eknath J, Sheikh Adil Bashir, Adil Hafeez Wani
Fishing as a hobby is fairly popular among youth in hilly and mountainous areas of the world. Hence, injuries to extremities are also common by fishing equipment, especially in untrained people using indigenous equipment. The mechanism of injury is that of penetrating trauma. There is a paucity of literature regarding fishing equipment injury to extremities. In this article, we have presented a case series of fishing arrow injuries presented to us in the Department of Plastic and Reconstructive Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, India. Most of these injuries were treated under the wide-awake local anesthesia no tourniquet technique which has revolutionized the management of extremity injuries. Also, special precautions regarding the prevention of further tissue injury by arrow hooks while retrieving the arrows have been highlighted.
{"title":"Fish Arrow Injuries to the Extremities: A Case Series.","authors":"P Umar Farooq Baba, Raheeb Ahmad Shah, Mir Yasir, Eknath J, Sheikh Adil Bashir, Adil Hafeez Wani","doi":"10.1055/s-0044-1787279","DOIUrl":"10.1055/s-0044-1787279","url":null,"abstract":"<p><p>Fishing as a hobby is fairly popular among youth in hilly and mountainous areas of the world. Hence, injuries to extremities are also common by fishing equipment, especially in untrained people using indigenous equipment. The mechanism of injury is that of penetrating trauma. There is a paucity of literature regarding fishing equipment injury to extremities. In this article, we have presented a case series of fishing arrow injuries presented to us in the Department of Plastic and Reconstructive Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, India. Most of these injuries were treated under the wide-awake local anesthesia no tourniquet technique which has revolutionized the management of extremity injuries. Also, special precautions regarding the prevention of further tissue injury by arrow hooks while retrieving the arrows have been highlighted.</p>","PeriodicalId":47204,"journal":{"name":"Indian Journal of Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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