• Title/Summary/Keyword: Hand deformities

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Effects of Psychological Stress and Living Environments on Perceived Hand Deformities: a Community-Based Cohort Study

  • Sunmi Song
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.72-79
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    • 2023
  • Objective: Despite known associations between negative body image and health declines in chronic pain patients, few studies have examined longitudinal associations between psychological stress and perceived hand deformities. This study examined whether psychological distress was associated with hand deformities 4 years later and if rural and urban adults differed in the association. Design: A community-based cohort study. Methods: Community dwelling adults (mean age=51.97, 52.3% women) in a rural (n=2968) and urban area (n=2784) provided demographic data at baseline and, in the 4-year follow-up, responded to questionnaires about psychological distress. Perceived hand deformities were assessed at the 8-year follow-up. Linear regression was conducted to examine the effects of psychological distress on hand deformities and moderation by residential areas. Results: The perceived hand deformities were more likely among those with severe psychological stress, hand osteoarthritis, or any chronic disease condition (p<0.01) but less likely among those with younger age, higher education, or income (p<0.01). The regression results showed that psychological distress predicted more perceived hand deformities 4 years later even after adjusting for demographic and health covariates (p<0.01). The residential areas did not significantly moderate the association between distress and hand deformities. Conclusions: This study suggected that psychological distress may trigger later perception of hand deformities in both urband and rural adults. The findings indicate that stress management interventions that are customizable to regional contexts may be effective at preventing negative body image related health problems of community-dewelling adults.

Epidemiological survey on the relationship between Agent Orange / Dioxin exposure and reproductive anomalies and congenital deformities of inhabitants living in A Luoi valley, Thua thien hue province

  • Hung, Tran-Manh
    • Proceedings of the Korean Environmental Health Society Conference
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    • 2003.06a
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    • pp.26-26
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    • 2003
  • During the Viet Nam war, A Luoi located in Thua Thien Hue Province was heavily sprayed herbicides by the Ranch Hand Operation of U.S.A force (549.274 gallons). After 30 years of knocking the operation off, Dioxin has still contaminated on environment and human body in A Luoi valley. The results of the study show that there is an epidemiological relationship between AO/Dioxin exposure and increasing rate of reproductive anomalies and birth defects (the rate of reproductive anomalies including congenital deformities after the war during 10-year and 25-year is higher than that before the war from 1.5 to 4 times). The study found that the highest rate of reproductive anomalies is spontaneous abortion. The average is premature death and congenital deformities, and the lowest rate is dead foetus and hydratidiform mole. The results of the primary assessment suggested that Dioxin transport from environment to human body through the food chain exposed by Dioxin such as fish, chicken, duck. A mitigation plan for residual dioxin contamination from Agent Orange Hervicides is requeste indispensable to inhabitants in Aluoi District.

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A rare approach? Microsurgical breast reconstruction after severe burns

  • Weitgasser, Laurenz;Bahsoun, Ali;Amr, Amro;Brandstetter, Michael;Knam, Friedrich;Schoeller, Thomas
    • Archives of Plastic Surgery
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    • v.45 no.2
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    • pp.180-184
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    • 2018
  • Breast deformity, in post-burn patients, is a common problem leading to lower self-esteem and reclusive behavior that impairs quality of life. The authors present the course of treatment of an 18-year-old immigrant girl who suffered second- to third-degree burns over approximately 20% of her total body surface area in her early childhood. The second- to third-degree burns were located on her right trunk and abdomen, as well as her right shoulder, neck, and right groin area. Since it was not offered in her home country, reconstructive surgery, including microsurgical breast reconstruction, was sought abroad. Due to the lack of available skin and soft tissue, a bilateral breast reconstruction with free transverse myocutaneous gracilis flaps was offered. This case illustrates one method of using microsurgery to address post-burn breast deformities in order to alleviate psychological suffering and improve quality of life.

Poland`s Syndrome (Poland 증후군 1례 보고)

  • 박병순
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.423-427
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    • 1985
  • The Poland`s syndrome is very rare anomaly, which consists of congenital unilateral absence of the sternocostal part of the pectoralis major muscle, with ipsilateral hand deformities. The clinical features are variable but all patients have absence of at least the sternal head of the pectoralis major muscle. The syndrome is not hereditary and is of unknown origin. Early recognition of Poland`s syndrome may give the provision of psychologic and genetic counseling for anxious parents. We have encountered two patients with this entity, and one of them underwent successful surgical correction.

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Tardy Ulnar Nerve Palsy Caused by Bilateral Cubitus Varus Deformities - A Case Report - (양측성 내반주 변형에 동반된 지연성 척골 신경 마비(1례 보고))

  • Lee Sang Yup;Kim Jeong Hwan;Lee Sang Gug;Chung Chae Ik;Kim Young Hwan;Hwang Sik
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.209-213
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    • 1999
  • It is well known that tardy ulnar nerve palsy occurs with cubitus valgus deformity as a late complication after a nonunion of lateral condyle fracture of the humerus in childhood. On the other hand, cubitus varus deformity often results from malunion of supracondylar fractures of the humerus. However, reports of tardy ulnar nerve palsy in cubitus varus deformity are few. We report a patient with bilateral cubitus varus deformities with bilateral tardy ulnar nerve palsy which was confirmed with EMG. She was treated by step cut osteotomy(DeRosa and Graziano) with sub­cutaneous anterior transposition of ulnar nerve.

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Free Hand Pedicle Screw Placement in the Thoracic Spine without Any Radiographic Guidance : Technical Note, a Cadaveric Study

  • Hyun, Seung-Jae;Kim, Yong-Jung J.;Cheh, Gene;Yoon, Seung-Hwan;Rhim, Seung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.66-70
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    • 2012
  • Thoracic pedicle screw fixation techniques are still controversial for thoracic deformities because of possible complications including neurologic deficit. Methods to aid the surgeon in appropriate screw placement have included the use of intraoperative fluoroscopy and/or radiography as well as image-guided techniques. We describe our technique for free hand pedicle screw placement in the thoracic spine without any radiographic guidance and present the results of pedicle screw placement analyzed by computed tomographic scan in two human cadavers. This free hand technique of thoracic pedicle screw placement performed in a step-wise, consistent, and compulsive manner is an accurate, reliable, and safe method of insertion to treat a variety of spinal disorders, including spinal deformity.

Lateral Arm Free Flap Reconstruction in a Patient with Severe Burn Scar Contracture of the Bilateral First Web Space (외측 상완 유리 피판을 이용한 양측 제1수지간 중증 화상 반흔 구축의 재건)

  • Yoon, Taekeun;Eun, Seokchan
    • Journal of the Korean Burn Society
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    • v.24 no.2
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    • pp.46-49
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    • 2021
  • An anatomically normal first web space is essential for optimal prehensile movements of the thumb and hand. A 28-year-old woman presented with severe scarring and contractures of the first web space of both hands, following a flame burn injury sustained 25 years prior to presentation. First web space contracture may occur secondary to severe injuries, burns (as observed in our patient), or congenital hand anomalies. A significant amount of additional skin is required to release a severe first web space contracture. Reconstruction of wide areas of contractures using only local flaps is challenging. Among other free flaps used in clinical practice, the thinned lateral arm free flap provides flexible vascularized tissue for reconstruction of the skin after severe first web space contracture release. Reconstruction using lateral arm free flaps facilitated thumb abduction and opposition (which were initially difficult) and improved hand function in our patient.

A clinical case study of Acupuncture treatment for burned hand (수부(手部)의 표재성 2도(度) 화상(火傷)의 침치료(針治療) 1례에 관한 임상적(臨床的) 고찰(考察))

  • Won, Seung-hwan;Owi, Jong-sung;Choi, Eun-ju;Kwon, Ki-rok
    • Journal of Acupuncture Research
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    • v.22 no.1
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    • pp.13-17
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    • 2005
  • In general, the function limitation of the burned hand is determined by the thermal injury; however, infection, pressure necrosis, inactivity, poor positioning, subsequent scarring and contractures are intimately related to functional disability. The goal of treatment of the burned hand is the prevention of deformities and maintainance of function. Objective : This study of the Acupuncture therapeutic effect on the burned hand will suggest another treatment plan for the more effective therapy. Methods : To heal the burned hand, we used Acupuncture therapy as Banja-technic(半刺法) Moja-technic(毛刺法). Results & Conclusions : Authors reviewed 1 patient who had received only Acupuncture treatment for the burned hand. The burned hand of the patient was healed in about 11 days by only Acupuncture treatment.

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Algorithm for Primary Full-thickness Skin Grafting in Pediatric Hand Burns

  • Park, Yang Seo;Lee, Jong Wook;Huh, Gi Yeun;Koh, Jang Hyu;Seo, Dong Kook;Choi, Jai Koo;Jang, Young Chul
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.483-488
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    • 2012
  • Background Pediatric hand burns are a difficult problem because they lead to serious hand deformities with functional impairment due to rapid growth during childhood. Therefore, adequate management is required beginning in the acute stage. Our study aims to establish surgical guidelines for a primary full-thickness skin graft (FTSG) in pediatric hand burns, based on long-term observation periods and existing studies. Methods From January 2000 to May 2011, 210 patients underwent primary FTSG. We retrospectively studied the clinical course and treatment outcomes based on the patients' medical records. The patients' demographics, age, sex, injury site of the fingers, presence of web space involvement, the incidence of postoperative late deformities, and the duration of revision were critically analyzed. Results The mean age of the patients was 24.4 months (range, 8 to 94 months), consisting of 141 males and 69 females. The overall observation period was 6.9 years (range, 1 to 11 years) on average. At the time of the burn, 56 cases were to a single finger, 73 to two fingers, 45 to three fingers, and 22 to more than three. Among these cases, 70 were burns that included a web space (33.3%). During the observation, 25 cases underwent corrective operations with an average period of 40.6 months. Conclusions In the volar area, primary full-thickness skin grafting can be a good indication for an isolated injured finger, excluding the web spaces, and injuries of less than three fingers including the web spaces. Also, in the dorsal area, full-thickness skin grafting can be a good indication. However, if the donor site is insufficient and the wound is large, split-thickness skin grafting can be considered.

Retrospective Analysis of the One-per-Million Tumescent Technique in Post-Burn Hand Deformity Surgeries

  • Prasetyono, Theddeus O.H.;Koswara, Astrid Felicia
    • Archives of Plastic Surgery
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    • v.42 no.2
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    • pp.164-172
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    • 2015
  • Background The use of a tourniquet in hand surgery is generally accepted as necessary to create a clear visualization of the operative field. This study aims to determine the effectiveness of one-per-million tumescent solution (1:1,000,000 epinephrine concentration) in creating a bloodless operative field in post-burn hand deformity surgeries performed without a tourniquet. Methods This retrospective observational study was conducted on a series of 12 patients with post-burn hand deformities who underwent surgery between February 2013 and January 2014. A total of 29 operative fields were recorded. The one-per-million tumescent solution was used for hemostatis instead of a tourniquet. The clarity of the operative field, volume of solution injected, duration of surgery, scar thickness and density, and functional outcomes at least three months after the surgery were observed. The relationship of scar thickness and density with the clarity of the operative field was analyzed with the chi-square test. Results Of the 29 operative fields in which the one-per-million tumescent technique was used, 48.2% were totally bloodless, 44.8% had minimal bleeding, and 6.9% had an acceptable level of bleeding. Both scar thickness and density were shown to have a significant relationship with operative field clarity (P<0.05). Conclusions The one-per-million tumescent technique is effective in facilitating post-burn hand deformity surgeries involving meticulous, multiple, and lengthy procedures by creating a relatively clear operative field without the use of a tourniquet. Although scar thickness and density are associated with the clarity of the operative field, this technique can be considered safe and effective in creating a clear operative field.