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Threat perception of COVID-19 among sub-Sahara Africans: a new web-based comparative study associated with community along with diaspora inhabitants.
The lunate preserving operations basically are either decreasing the load on the lunate to possibly permit its revascularization or are the procedures which are aimed at augmenting the vascularity of the lunate. Radius shortening osteotomy is the most popular treatment in the early stages especially in the patients' with negative ulnar variance and the proximal row carpectomy is most popular in the advanced stages of the disease. Authors present their algorithm of management of Kienbock's disease and discuss the various treatment options described in the literature in an attempt to find the apt in 2020.Background Primary treatment of trigger digits is conservative including stretching, night splinting and combination of heat and ice. When these methods fail, invasive methods such as corticosteroid injection, percutaneous release and open surgery are used. The purpose of this study is to compare the efficacy of two outpatient methods of percutaneous trigger finger release (PTFR) and corticosteroid injection (CI). Methods This study is a randomized clinical trial that was performed with 6-month follow up. A total of 83 patients with trigger finger treated either with corticosteroid injection (n40) or percutaneous release of the A1 pulley (n43) were enrolled in this study. Demographic data were recorded before intervention. Pain score (VAS criterion), disease stage (Quinnell criteria), patient satisfaction and complications such as paresthesia, scarring, and stiffness (decrease in the range of motion) were recorded after the intervention. We used SPSS program (statistical package for the social science SPSS version 16) to perform the analysis. Results There were 18 male (21.7%) and 65 female (78.3%) patients, whose mean age was 52.54 ± 11.45 (28-85) years. There was a significant difference between the degree of pain at the time of the third, sixth weeks and sixth months in two groups. The degree of pain was lower in the CI group in the third and sixth weeks but it was lower in the PTFR group in the sixth month. Satisfaction of the patients in the sixth month was significantly higher in the PTFR group. The incidence of stiffness was also significantly lower in the PTFR group in the sixth month. Conclusions Patients in PTFR group had greater recovery and satisfaction level and lower recurrence rate and pain. Therefore PTFR may be used as a substitute for CI in the treatment of trigger finger from the beginning especially in patients who do not want to have open surgery.Upper extremity trauma is one of the most common types of injuries, accounting for 20 to 40 percent of injured patients presenting to the emergency department. In severe upper extremity injury, the likelihood of secondary procedures to improve function and resolve outstanding clinical problems is high. Secondary procedures are performed later than initial primary surgery, usually after wound healing and with a discernible time gap of days, weeks or occasionally longer. They should be considered as separate procedures from the primary surgery, with due diligence given to planning for it. When approaching secondary procedures, the key principles are anchored in early preparation, patient engagement, optimal timing and sequencing, reviewing and considering alternatives, and finally knowing when to stop. Although secondary procedures after upper extremity injuries can be a complex undertaking, the careful application of these principles and considerations will optimise outcomes.Background Hemi-hamate arthroplasty is one of the treatment options for dorsal proximal interphalangeal joint fracture dislocation. Many studies reported favorable outcomes. However, some long term studies demonstrated the degenerative change of PIP joint. The articular mismatch of the hemi-hamate autograft might play an important role of this complication. Methods We studied the anatomy of distal articular surface of the hamate bone in embalmed hamate bones. The anatomy of distal articular surface and dimensions of the hamate bone were measured and recorded. Results Seventy hamate bones were dissected out from embalmed cadavers and included in this study. The mean angle of the 4th metacarpal articulation was 85.54 degrees (SD = 3.53) and mean angle of the 5th metacarpal articulation was 95.51 degrees (SD = 3.57). The inter-articular ridge was approximately 5 degrees radial inclination. Conclusions The inter-articular ridge of distal articular surface was approximately 5 degrees radial inclination. In order to minimize the graft mismatch, we recommend making the bone cut with the saw blade tilted to radial side 5 degrees to achieve better alignment of inter-articular ridge of the graft.Background The Kapandji scale has 10 levels and includes abduction, rotation and flexion movements. Assessing children with thumb hypoplasia, this scale is poorly understood and confusing. The objective of the study is to evaluate an opposition scale simpler and understandable for children. Methods It is a validation study of a simplified scale to qualify the opposition of the thumb, in order to asses only the abduction - rotation but not the flexion of the metacarpo-phalangeal (MP) or interphalangeal (IF) joint. The proposed classification goes from 0 to 3 degrees, where 0 No opposition, 1 The thumb touches the middle phalanx of the 2nd finger, 2 the thumb touches the pulp of the 2nd finger and 3 the thumb touches the pulp of the 5th finger. 10 patients with thumb hypoplasia were analyzed by 9 hand surgeons and 9 orthopedic surgeons. Results The intraclass correlation coefficient shows a very good inter-observer reliability with a kappa of 0.991 (p = 0.000). DX600 order When correlated by groups, the finding were very good between the hand surgeons group k = 0.980 (p = 0.000) and the orthopedic surgeons group 0.974 (p = 0.000). At 6 weeks a new evaluation was made, the intra-observer reliability was excellent k = 0.995 (p = 0.000). Conclusions The proposed scale for the evaluation of the abductionrotation of the thumb is validated and useful in the evaluation of the results of a thumb opposition transfer with a good inter-observer and intra-observer reliability between orthopedic and hand surgeons.
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