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[PMID]:28282745
[Au] Autor:Kox LS; Kuijer PPFM; Opperman J; Kerkhoffs GMMJ; Maas M; Frings-Dresen MHW
[Ad] Endereço:a Department of Radiology, Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands.
[Ti] Título:Overuse wrist injuries in young athletes: What do sports physicians consider important signals and functional limitations?
[So] Source:J Sports Sci;36(1):86-96, 2018 Jan.
[Is] ISSN:1466-447X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This study's objective was to collect items from experienced sports physicians, relating to the presence and severity of overuse wrist injuries in young athletes, for developing a measurement instrument for signals of overuse wrist injury. Seven Dutch elite sports physicians involved in guidance and treatment of young athletes in wrist-loading sports (gymnastics, tennis, judo, field hockey, volleyball and rowing) participated in a focus group. They discussed signals and limitations related to overuse wrist injuries in young athletes. Data were coded and categorised into signals and limitations with subcategories, using an inductive approach. Of the resulting 61 signals and limitations in nineteen (sub)categories, 20 were considered important, forming a comprehensive item set for identifying overuse wrist injury in young athletes. Signals such as pain, "click", crepitations, swelling and limited range of motion were marked useful for early identification of overuse wrist injury. Limitations in movement and performance were considered indicative of severe overuse injury but less relevant for initial injury identification. The focus group provided 17 important signals and 3 important limitations indicative of overuse wrist injury. These provide the basis for a valid measurement instrument for identifying overuse wrist injury in young athletes, with equal emphasis on pain and on other symptoms.
[Mh] Termos MeSH primário: Traumatismos em Atletas/diagnóstico
Transtornos Traumáticos Cumulativos/diagnóstico
Traumatismos do Punho/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Diagnóstico Precoce
Feminino
Grupos Focais
Seres Humanos
Masculino
Meia-Idade
Índice de Gravidade de Doença
Medicina Esportiva
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170312
[St] Status:MEDLINE
[do] DOI:10.1080/02640414.2017.1282620


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[PMID]:29252635
[Au] Autor:Phan KH; Azimi HJ; Franko OI; Abrams RA
[Ad] Endereço:School of Medicine, University of California, San Diego, San Diego, California.
[Ti] Título:Scaphoid and Lunate Dislocation with Complete Soft-Tissue Avulsion: A Case Report.
[So] Source:JBJS Case Connect;6(3):e58, 2016 Jul-Sep.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: We describe an intercarpal dislocation with proximal and rotatory displacement of the lunate and with volar and radial dislocation of the scaphoid; both bones were stripped of soft tissue. Treatment involved ORIF (open reduction and internal fixation). Three years postoperatively, the patient had a DASH (Disabilities of the Arm, Shoulder and Hand) score of 10, equivalent grip strength and 50% wrist palmar flexion and 98% wrist dorsiflexion compared with the uninjured side, and radiographic evidence of posttraumatic arthritis. CONCLUSION: Treatment of simultaneous divergent lunate and scaphoid dislocation with loss of nearly all soft-tissue attachments and vascular supply by means of ORIF and repair of soft-tissue structures can result in a favorable intermediate-term functional outcome and may be superior to other salvage procedures such as proximal row carpectomy.
[Mh] Termos MeSH primário: Osso Semilunar/lesões
Osso Escafoide/lesões
Traumatismos do Punho/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Osso Semilunar/diagnóstico por imagem
Masculino
Meia-Idade
Osso Escafoide/diagnóstico por imagem
Traumatismos do Punho/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.15.00112


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[PMID]:29275614
[Au] Autor:Shen YM; Ma CX; Qin FJ; Zhang C; Wang C; Hu XH
[Ad] Endereço:Department of Burns, Beijing Jishuitan Hospital, Beijing 100035, China.
[Ti] Título:[Wound repair and functional reconstruction of high-voltage electrical burns in wrists].
[So] Source:Zhonghua Shao Shang Za Zhi;33(12):738-743, 2017 Dec 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the methods and effects of wound repair and functional reconstruction of high-voltage electrical burns in wrists. From January 2009 to June 2016, 71 patients with high-voltage electrical burns in wrists were hospitalized, with 118 wrist wounds including 21 of type â… , 69 of type â…¡, 9 of type â…¢, and 19 of type â…£. According to the wrist injuries, different surgical operations were performed. Forearm amputation was conducted in 20 wrists with necrosis in the distal end. On the basis of fasciotomy for decompression, early debridement was performed on the other 98 wrist wounds. After debridement, wounds with area ranging from 10 cm×7 cm to 30 cm×18 cm were repaired with tissue flaps with abundant blood supply. Thirty-two wounds were repaired with pedicled groin flaps, 11 wounds with pedicled paraumbilical flaps, 3 wounds with pedicled anterolateral thigh island flaps, 9 wounds with combined abdominal axial pattern flaps, 37 wounds with free skin flaps or myocutaneous flaps, and 6 wounds with flow-through descending branch of lateral femoral circumflex artery flaps, with tissue flap area ranging from 12 cm×8 cm to 34 cm×20 cm. Ulnar artery or radial artery vascular reconstruction was performed in 20 wrist wounds. Forty-one donor sites were sutured directly, while 14 were closed by thin split-thickness skin grafts from same-side thighs, and 43 were closed by thin split-thickness skin grafts from opposite-side thighs. Fifty-three wrist wounds were performed with tendon and nerve repair surgery, of which 20 were performed with simple tendon and nerve release surgery. Flexor digitorum profundus tendons and (or) flexor pollicis longus tendons were reconstructed with autologous or allogeneic tendon transplantation in 33 wrist wounds, and the median nerve was repaired with sural nerve graft in 21 wrist wounds. In 6 to 24 months after the last operation, tendon function of 53 wrist wounds which had tendon repair was evaluated with finger total active motion (TAM) method, while median nerve function of 21 wrist wounds which had median nerve repair was evaluated with integrate estimation method. (1) After forearm amputation, the incisions of 20 wrists with necrosis in the distal end were healed. (2) Among the 98 tissue flaps, 90 had good blood flow, while 8 had distal necrosis, of which 6 were healed after necrotic tissue removal and skin grafting, and two were sutured directly after debridement. Infection occurred under 7 flaps, of which 3 were healed by dressing change, and 4 were healed after second debridement. Twenty wrist wounds which had radial artery or ulnar artery repair had good blood supply of hand and amputation was avoided. During follow-up of 1 to 3 years, the incisions and flaps of patients who had tissue flap repair surgery healed well. (3) The excellent and good rate of TAM in each finger of the corresponding affected limbs of 53 wrist wounds which had tendon and nerve repair surgery was 51%. (4) Twenty wrists which had simple tendon and nerve release surgery were followed up for 1 to 2 years. The strength of muscle dominated by the median nerve was restored to grade â…¤ in 1 wrist, grade â…£ in 3 wrists, and grade â…¢ in 2 wrists. The strength of muscle dominated by the ulnar nerve was restored to grade â…£ in 3 wrists, with no recovery in other wrists. Sensory function examination showed grade S0 in 4 wrists, grade S1 in 2 wrists, grade S2 in 3 wrists, grade S3 in 8 wrists, and grade S4 in 3 wrists. Twenty-one wrists which had median nerve repair were followed up for 1 to 2 years. There was no recovery in muscle strength dominated by the median nerve. Sensory function examination showed grade S0 in 3 wrists, grade S1 in 5 wrists, grade S2 in 8 wrists, and grade S3 in 5 wrists. It is a good method to sequentially conduct early fasciotomy for decompression, early debridement, vascular reconstruction, transplant of tissue flap with abundant blood supply, tendon and nerve repair in repairing electrical burn wounds of wrists, avoiding amputation, and reconstructing hand function according to the condition of electrical burns of wrists.
[Mh] Termos MeSH primário: Queimaduras por Corrente Elétrica/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Cicatrização
Traumatismos do Punho/cirurgia
[Mh] Termos MeSH secundário: Adulto
Desbridamento
Feminino
Seres Humanos
Masculino
Meia-Idade
Retalho Miocutâneo
Higiene da Pele
Transplante de Pele
Lesões dos Tecidos Moles/terapia
Retalhos Cirúrgicos
Traumatismos do Punho/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171226
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2017.12.004


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[PMID]:29212691
[Au] Autor:Stinton SB; Graham PL; Moloney NA; Maclachlan LR; Edgar DW; Pappas E
[Ad] Endereço:Arthritis and Musculoskeletal Research Group, The University of Sydney, 75 East St, O204, Lidcombe NSW 2141, Australia, and Westmead Private Physiotherapy Services, 16 Mons Rd, Westmead NSW 2145, Australia.
[Ti] Título:Longitudinal recovery following distal radial fractures managed with volar plate fixation.
[So] Source:Bone Joint J;99-B(12):1665-1676, 2017 Dec.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To synthesise the literature and perform a meta-analysis detailing the longitudinal recovery in the first two years following a distal radius fracture (DRF) managed with volar plate fixation. MATERIALS AND METHODS: Three databases were searched to identify relevant articles. Following eligibility screening and quality assessment, data were extracted and outcomes were assimilated at the post-operative time points of interest. A state-of-the-art longitudinal mixed-effects meta-analysis model was employed to analyse the data. RESULTS: The search identified 5698 articles, of which 46 study reports met the selection criteria. High levels of disability and impairment were reported in the immediate post-operative period with subsequently a rapid initial improvement followed by more gradual improvement for up to one year. The results highlight that the period associated with the greatest physical recovery is in the first three months and suggest that the endpoint of treatment outcomes is best measured at one year post-surgery. CONCLUSION: Clinically meaningful improvements in outcomes can be expected for 12 months, after which progress plateaus and reaches normal values. This paper adopted a novel approach to meta-analyses in that the research question was of a longitudinal nature, which required a unique method of statistical analysis. Cite this article: 2017;99-B:1665-76.
[Mh] Termos MeSH primário: Placas Ósseas
Fixação Interna de Fraturas/instrumentação
Fraturas do Rádio/cirurgia
Traumatismos do Punho/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Estudos Longitudinais
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B12.BJJ-2017-0348.R1


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[PMID]:28456057
[Au] Autor:Taylor KW; Moore MM; Brian J; Methratta S; Bernard S
[Ad] Endereço:Department of Radiology, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, United States. Electronic address: 1kevtaylor@gmail.com.
[Ti] Título:Wrist MR imaging in children: Effect on clinical diagnosis and management.
[So] Source:Clin Imaging;44:61-65, 2017 Jul - Aug.
[Is] ISSN:1873-4499
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Evaluate the impact of wrist MRI in children on clinical diagnosis and management. MATERIALS AND METHODS: Four year retrospective analysis including demographics, MRI diagnoses, and effect on diagnoses and management were determined. RESULTS: 101 patients were included. Wrist MRI altered management in 86% (95% CI: 77-92%) and diagnosis in 46% (36-56%) of patients. MRI changed both diagnosis and management in 41% (31-51%), changed management only in 46% (35-56%), changed diagnosis only in 5% (2-12%), and had no change in diagnosis or management in 9% (95% CI: 4-17%). CONCLUSION: Wrist MRI in children changes clinical diagnosis and management in a substantial proportion of cases.
[Mh] Termos MeSH primário: Imagem por Ressonância Magnética/métodos
Punho/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Cistos Glanglionares/diagnóstico
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
Punho/patologia
Traumatismos do Punho/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29068932
[Au] Autor:Saito T; Malay S; Chung KC
[Ad] Endereço:Ann Arbor, Mich.; and Okayama, Japan From the Section of Plastic Surgery, Department of Surgery, University of Michigan Health System; the Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Density, and Pharmaceutical Sciences; and the Department of Surgery, University of Michigan Medical School.
[Ti] Título:A Systematic Review of Outcomes after Arthroscopic Débridement for Triangular Fibrocartilage Complex Tear.
[So] Source:Plast Reconstr Surg;140(5):697e-708e, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Evidence regarding the effectiveness of arthroscopic débridement for a triangular fibrocartilage complex tear is uncertain. The purpose of this study was to conduct a systematic review of outcomes to evaluate the effectiveness of débridement for triangular fibrocartilage complex tears. METHODS: The authors searched all available literature in the PubMed, Embase, and MEDLINE (Ovid) databases for articles reporting on triangular fibrocartilage complex tear débridement. Data collection included arc of motion, grip strength, patient-reported outcomes, and complications. RESULTS: A total of 1723 unique studies were identified, of which 18 studies met the authors' criteria. The mean before and after arc of wrist extension/flexion motion values were 120 and 146 degrees (six studies). The mean before and after grip strength values were 65 percent and 91 percent of the contralateral side (10 studies). Disabilities of the Arm, Shoulder, and Hand scores (six studies) and pain visual analogue scale scores (seven studies) improved from 39 to 18, and from 7 to 3, respectively. The mean pain visual analogue scale score after débridement was 1.9 in the ulnar-positive group and 2.4 in the ulnar-neutral and ulnar-negative groups. Eighty-seven percent of patients returned to their original work. CONCLUSIONS: Patients reported reduced pain and improved functional and patient-reported outcomes after débridement of triangular fibrocartilage complex tears. Most patients after débridement returned to previous work, with few complications. Although some of these cases may require secondary procedures, simple débridement can be performed with suitable satisfactory outcomes for cases with any type of ulnar variance.
[Mh] Termos MeSH primário: Artroscopia/métodos
Desbridamento/métodos
Fibrocartilagem Triangular/lesões
Traumatismos do Punho/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Medidas de Resultados Relatados pelo Paciente
Retorno ao Trabalho
Resultado do Tratamento
Fibrocartilagem Triangular/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003750


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[PMID]:28829171
[Au] Autor:Chang AL; Yu HJ; von Borstel D; Nozaki T; Horiuchi S; Terada Y; Yoshioka H
[Ad] Endereço:1 Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Rte 140, Orange, CA 92868.
[Ti] Título:Advanced Imaging Techniques of the Wrist.
[So] Source:AJR Am J Roentgenol;209(3):497-510, 2017 Sep.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This article covers the technical aspects and clinical applications of recent advancements in wrist MRI techniques, including T2 and T1rho mapping, compressed sensing, and isotropic 3D imaging using driven equilibrium sequences, variable-flip-angle refocusing pulse sequences, and parallel imaging. The clinical applications of these techniques include the quantitative analysis of cartilage and triangular fibrocartilaginous complex (TFCC) degeneration, faster scanning times, and improved resolution of complex wrist anatomy, allowing differentiation of degenerative from traumatic TFCC tears and improved morphologic evaluation of chondromalacia. CONCLUSION: MRI of the wrist and of the musculoskeletal system has had multiple novel and exciting advancements in recent years. Several of these advancements, such as parallel imaging, are already in clinical use, and others will be entering the clinical realm in the near future. An understanding of these techniques allows one to use their advantages to greatest effect.
[Mh] Termos MeSH primário: Diagnóstico por Imagem/métodos
Artropatias/diagnóstico por imagem
Traumatismos do Punho/diagnóstico por imagem
Articulação do Punho/diagnóstico por imagem
[Mh] Termos MeSH secundário: Meios de Contraste
Seres Humanos
Aumento da Imagem/métodos
Interpretação de Imagem Assistida por Computador/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.17.18012


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[PMID]:28781212
[Au] Autor:Cui S; Yang G; Li Q; Wu G; Wang Z; Zhang J; Yu W
[Ad] Endereço:Department of Hand Surgery, China-Japan Union Hospital, Jilin University, Xiantai Street 126, Changchun 130033, PR China.
[Ti] Título:Tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis: A long-term follow-up.
[So] Source:J Plast Reconstr Aesthet Surg;70(11):1577-1581, 2017 Nov.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The present study aimed to investigate the long-term functional and clinical outcomes of a tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis. METHODS AND MATERIALS: From June 2005 to September 2012, eight patients (six males; two females) with a mean age of 30 years (range, 16-52 years) who suffered rupture or division of extensor pollicis longus underwent a tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis. The range of motion, pinch, and grip strength of thumb were compared with the nonoperated hand and evaluated for all the study patients using the Geldmacher scoring system. RESULTS: At an average follow-up of 56 months, all eight patients could extend their thumbs fully and were assessed as good or excellent according to the Geldmacher scoring system. Average grip and tip pinch strengths of the operated hand were 95% (34.9 kg ± 14.0 kg vs. 36.6 kg ± 14.6 kg) and 92% (9.2 kg ± 4.8 kg vs. 9.9 kg ± 4.7 kg) of the nonoperative side, respectively. There was no marked loss of extension motion or strength of the wrist nor any other postoperative complications. CONCLUSIONS: The procedure of transferring the extensor carpi radialis brevis tendon to the extensor pollicis longus provides excellent long-term clinical results for restoring the extension of the thumb. The procedure is safe, with few complications, and it can be an alternate procedure of restoring the extension of the thumb.
[Mh] Termos MeSH primário: Traumatismos dos Tendões/cirurgia
Transferência Tendinosa/métodos
Polegar/cirurgia
Traumatismos do Punho/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Polegar/lesões
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170808
[St] Status:MEDLINE


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[PMID]:28763908
[Au] Autor:Shen YM; Chen X; Zhang C; Wang C; Qin FJ; Ma CX; Hu XH
[Ad] Endereço:Department of Burns, Beijing Jishuitan Hospital, Beijing 100035, China.
[Ti] Título:[Effects of flow-through descending branch of lateral circumflex femoral artery flap on repairing high-voltage electrical burn wounds of wrist of patients].
[So] Source:Zhonghua Shao Shang Za Zhi;33(7):422-425, 2017 Jul 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the effects of flow-through descending branch of lateral circumflex femoral artery flap on repairing high-voltage electrical burn wounds of wrist of patients. From January 2014 to June 2016, 5 patients with high-voltage electrical burn of unilateral wrist were hospitalized in our burn ward, with extensive necrosis of skin soft tissue of burn wrist. Five patients were transferred to our burn ward 6 to 12 days post injury after undergoing emergency dermotomy of wrist to reduce tension in other hospitals. In 2 to 3 days after admission, operation was performed by two surgeon group at the same time, when patients' general condition were stable. One group underwent debridement and the other group designed and dissected flap according to the range of skin soft tissue defect of wrist. Wrist wounds after debridement ranged from 15 cm×10 cm to 24 cm×15 cm. Three patients were treated with flow-through descending branch of lateral circumflex femoral artery flap and great saphenous vein for repairing wounds of wrist and reconstruction of ulnar and radial artery. Two patients were treated with flow-through descending branch of lateral circumflex femoral artery flap for repairing wounds of wrist and reconstruction of ulnar artery. The dissected flaps ranged from 16 cm×12 cm to 26 cm×16 cm and the length of bridging vessel ranged from 15 to 21 cm. The flow-through descending branch of lateral circumflex femoral artery flaps of five patients survived well. Wounds of 4 patients healed and wounds of 1 patient with infection under the flap on 3 days after operation healed after changing wound dressing and undergoing debridement for 2 weeks. After the operation, wrists and hands of 5 patients had adequate blood supply and ulnar and radial artery recovered patency. Follow-up of patients for 6 months to 1 year showed good flap appearance and adequate blood supply of burn hands. The flow-through descending branch of lateral circumflex femoral artery flap can repair wrist wounds and recover blood supply of hands and it is a good method for repairing high-voltage electrical burns of wrist.
[Mh] Termos MeSH primário: Queimaduras por Corrente Elétrica/terapia
Artéria Femoral/cirurgia
Transplante de Pele
Lesões dos Tecidos Moles/cirurgia
Coxa da Perna
Traumatismos do Punho/cirurgia
[Mh] Termos MeSH secundário: Adulto
Queimaduras por Corrente Elétrica/complicações
Desbridamento
Feminino
Artéria Femoral/fisiopatologia
Mãos/irrigação sanguínea
Seres Humanos
Masculino
Meia-Idade
Retalhos Cirúrgicos/irrigação sanguínea
Coxa da Perna/irrigação sanguínea
Artéria Ulnar
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2017.07.006


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[PMID]:28651417
[Au] Autor:Peng H; Liang PF; Wang A; Yue LQ
[Ad] Endereço:Department of Burns and Reconstructive Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
[Ti] Título:[Influences of different rehabilitative methods on function of hands and psychological anxiety of patients with deeply burned hands retaining denatured dermis and grafting large autologous skin].
[So] Source:Zhonghua Shao Shang Za Zhi;33(5):272-276, 2017 May 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate influences of different rehabilitative methods on function of hands and psychological anxiety of patients with deeply burned hands retaining denatured dermis and grafting large autologous skin. Forty-four patients with deeply burned hands, conforming to the study criteria were admitted to Department of Burns and Reconstructive Surgery of Xiangya Hospital of Central South University from January 2014 to June 2015. Patients were divided into propaganda education rehabilitation group (PER, =23) and specially-assigned person rehabilitation group (SAPR, =21) according to the random number table and patients' willingness. On post injury day 3 to 7, 36 burned hands in group PER and 33 burned hands in group SAPR underwent operation of retaining denatured dermis and grafting large autologous skin. Patients in 2 groups received anti-scar treatment of hands with silicone gel from postoperative day 10. Besides, patients in group PER underwent active functional exercise under guidance of duty nurse and received psychological guidance from duty nurse with grade two psychological consultant certificate. Patients in group SAPR underwent active and passive functional exercise under guidance of rehabilitation therapist and received psychological guidance from psychotherapist with intermediate title. In postoperative month (POM) 1, 3 and 6, ranges of active motion of burned finger joints of patients in 2 groups were measured with joint goniometer to calculate excellent and good ratio of total active motion (TAM) range. Values of grip strength of burned hands of patients were measured with electronic hand dynamometer, and psychological anxiety was scored with Self-rating Anxiety Scale (SAS). Data were processed with chi-square test, independent sample test, McNemar test, analysis of variance of repeated measurement, SNK test and Bonferroni correction. (1) Ratio of excellent and good of TAM range of burned finger joints of patients in group SAPR in POM 6 was obviously higher than that in group PER ( (2)=10.745, <0.0167 ). Ratio of excellent and good of TAM range of burned finger joints of patients in 2 groups in POM 3 were obviously higher than that in POM 1 of the same group, respectively (with values below 0.0167). (2) Values of grip strength of burned hands of patients in group SAPR in POM 1, 3, and 6 were respectively (8.2±2.6), (21.6±2.6) and (30.1±2.3) kg, obviously higher than those in group PER [ (5.3±1.3), (12.8±2.7), (20.0±1.8) kg, respectively, with values from 5.934 to 20.403, values below 0.01]. Values of grip strength of burned hands of patients in 2 groups in POM 3 and 6 were obviously higher than those at the previous time point of the same group (with values below 0.05). (3) SAS scores of patients in group SAPR in POM 1, 3 and 6 were significantly lower than those in group PER (with values from 2.944 to 4.758, values below 0.01). SAS scores of patients in 2 groups in POM 3 and 6 were significantly lower than those at the previous time point of the same group (with values below 0.05). Compared with rehabilitation of propaganda and education, rehabilitation under specially-assigned person can improve TAM range of burned finger joints, value of grip strength, and psychological anxiety of patients with deeply burned hands retaining the denatured dermis and grafting large autologous skin.
[Mh] Termos MeSH primário: Ansiedade/psicologia
Queimaduras/reabilitação
Traumatismos da Mão/psicologia
Traumatismos da Mão/reabilitação
[Mh] Termos MeSH secundário: Queimaduras/cirurgia
Queimaduras/terapia
Cicatriz
Derme/cirurgia
Derme/transplante
Traumatismos da Mão/cirurgia
Seres Humanos
Modalidades de Fisioterapia
Procedimentos Cirúrgicos Reconstrutivos
Transplante de Pele
Retalhos Cirúrgicos
Traumatismos do Punho/psicologia
Traumatismos do Punho/reabilitação
Traumatismos do Punho/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2017.05.004



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