One-stage repair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps / 中国骨伤

OBJECTIVE@#To explore clinical effects of the stageⅠrepair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps.@*METHODS@#From January 2019 to May 2020, 21 patients(27 middle phalanx fingers)with full-thickness skin defect were repaired at stageⅠusing artificial dermis combing with digital artery perforator fascial flaps. All patients were emergency cases, and were accompanied by the exposure of bone tendon and the defects of periosteum and tendon membrane. Among patients, including 11 males and 10 females aged from 18 to 66 years old with an average age of (39.00±8.01) years old;9 index fingers, 10 middle fingers and 8 ring fingers;range of skin defect area ranged from (2.5 to 3.5) cm×(1.5 to 3.0) cm;range of exposed bone tendon area was (1.5 to 2.0) cm×(1.0 to 2.0) cm. The time from admission to hospital ranged from 1 to 6 h, operation time started from 3 to 8 h after injury.@*RESULTS@#All patients were followed up from 6 to12 months with an average of (9.66±1.05) months. The wounds in 26 cases were completely healed at 4 to 6 weeks after operation. One finger has changed into wound infection with incompletely epithelialized dermis, and achieved wound healing at 8 weeks after dressing change. All fingers were plump with less scars. The healed wound surface was similar to the color and texture of the surrounding skin. These fingers have excellent wearability and flexibility. According to the upper limb function trial evaluation standard of Hand Surgery Society of Chinese Medical Association, the total score ranged from 72 to 100. 26 fingers got excellent result and 1 good.@*CONCLUSION@#StageⅠrepair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps is easy to operate with less trauma. It has made satisfactory recovery of appearance and function of fingers. It could provide an effective surgical method for clinical treatment of full-thickness skin loss of fingers with tendon and bone exposure.

Middle phalanx epidermoid cyst, an unusual site: A case report

Background: Epidermoid cysts are cutaneous cysts frequently observed among farmers, factory workers, carpenters, and tailors due to their occupations’ predilection for repetitive minor hand trauma. Case Presentation: A 66-year-old male laborer presented to our hospital with a swelling on the palmar aspect of his right middle finger. The swelling was accompanied by pain and an inability to work over the previous four months. A 2.5 cm × 2.5 cm smooth, tender, immobile, non-compressible hard swelling was detected just above the middle phalanx during the clinical examination on the volar aspect of the right middle finger. The diagnosis was confirmed by histopathology after excision. The patient’s range of motion improved significantly following surgery, and his pain subsided. Conclusion: We present a novel location for an epidermal inclusion cyst and the importance of histopathologic evaluation in this case. Additionally, we emphasize the significance of extensively checking the cyst’s epithelium to guarantee complete capsule removal and rule out any additional pathology.

Skeletal Age Assessment of SMI and MP3 Stages to Predict the Pubertal Growth Spurt / 대한소아치과학회지

This study aimed to assess the skeletal age of skeletal maturational indicator (SMI) and middle phalanx of the middle finger (MP3) stages and to predict the SMI and MP3 stages corresponding to pubertal growth spurt in boys and girls respectively.The skeletal age was assessed from hand-wrist radiographs of 363 children (182 boys, 181 girls) aged 7 to 16 years by radiologists using the Korean standard bone age chart. Also, SMI and MP3 stages were evaluated from the radiographs. From these records, the mean skeletal age of SMI and MP3 stages was calculated.The stages including pubertal growth spurt were SMI 4 – 5, MP3 FG – G stages in boys and SMI 3 – 4, MP3 F – FG stages in girls.

Measuring Agreement of Modified MP3 and CVMS according to BMI Percentile / 대한소아치과학회지

The objective of this study was to examine measuring agreement between middle phalanx of the third finger and cervical vertebrae analysis for assessing skeletal maturity according to body mass index percentile. A retrospective chart view was used to select patients with body mass index data, hand - wrist radiographs and lateral cephalograms of same day. The patients were divided into 4 groups by body mass index percentile. The hand - wrist radiographs were analyzed using modified middle phalanx of the third finger method and the lateral cephalograms were categorized according to cervical vertebral maturation stage. The degree of agreement between the 2 methods of analyzing skeletal maturation was measured by calculating weighted kappa statistic according to body mass index percentile group. There was a good agreement between the 2 methods in the entire body mass index percentile group. According to the body mass index percentile group, the agreement was found to be different, and the pattern was different between boys and girls. Pediatric dentist should consider sex and weight status when evaluating growing children and adolescents because it can affect the agreement of 2 method of analyzing skeletal maturation.

Reliability of the frontal sinus index as a maturity indicator.

Aim: The aim of this study was to compare the reliability of frontal sinus as a skeletal maturity indicator in males and females. Setting and Sample Population: Lateral cephalograms of 75 males and 75 females, both in preand post-pubertal stages of development as determined by Middle phalanx of the third finger (MP3) radiographs. Materials and Methods: Lateral cephalograms were analyzed for frontal sinus maturity. Maximum height, maximum width and height to width ratio of the sinus were calculated. The mean height to width ratio of the sinus at respective MP3 stages were tabulated and subjected to statistical analysis to determine the correlation. Correlation at different MP3 stages between males and females was also determined. Results: Statistically significant differences were observed between the mean values of F and FG along with F and I stage in males, significant difference between the values of FG stage among males and females were also observed. Conclusion: Based on statistical and direct comparison of raw data, study concludes that frontal sinus is not reliable as a sole criterion for prediction of skeletal maturity.

Método simplificado para determinar el potencial de crecimiento en pacientes de Ortodoncia / A simplified method to determine the potential growth in Orthodontics patients

Se realizó una investigación de innovación tecnológica, de corte transversal, con el objetivo de presentar un método simplificado para determinar el potencial de crecimiento en pacientes tributarios de tratamiento ortodóncico, en una muestra de 150 pacientes entre 8 y 16 años, que ingresaron en la Clínica de Ortodoncia de la Facultad de Estomatología de la Habana, entre los años 2004 y 2006. A cada paciente se le realizó una radiografía de la mano izquierda y por primera vez en Cuba se estudiaron en la misma muestra, tres métodos de evaluación del potencial de crecimiento (métodos TW2, Grave y Brown, y determinación de los estadios de maduración de la falange media del tercer dedo). Una vez determinados éstos, se calcularon la correlación y la concordancia entre los mismos. Hubo altos coeficientes de correlación (hembras rho= 0,888 y varones rho= 0,921) y de concordancia (hembras Kappa= 1,000 y varones Kappa= 0,964). Se concluyó que la evaluación del potencial de crecimiento que presentaron los pacientes de Ortodoncia puede ser efectuada mediante la realización de una radiografía de la falange media del tercer dedo de la mano izquierda, lo cual constituye un útil método simplificado de evaluación(AU)

A cross-sectional technological innovation research was conducted to tender a simplified method to determine the potential growth of 150 Orthodontics patients aged between 8 and 16 admitted in the Orthodontics Clinic from the Stomatology of Ciudad de La Habana in 2004 and 2006. Each patient underwent left hand X-ray and for the first time in Cuba and in the same sample it was possible to study three assessment methods of potential growth (TW2 Method, Grave and Brown and stage determination of maturation of middle phalanx of third finger). After determination, we estimated the correlation and concordance among them, noting high correlation coefficients (rho females= 0,888 and rho= males 0,921) and of concordance (Kappa females= 1,000 and Kappa males= 0,964). We conclude that the assessment of potential growth in Orthodontics patients may be conducted by X-ray of middle phalanx of third finger of left hand being a simplified method to this end(AU)

Bizarre Parosteal Osteochondromatous Proliferation of Middle Phalanx: A Case Report

Although bizarre parosteal osteochondromatous proliferation does not frequently occur, this calcified, osteal, chondromatous tumor has relatively high recurrence rates and presents clinical, radiological, histological features that can be classified with other lesions. And it is a benign disease that until now, there were no death or metastasis reports because of this tumor. This proliferation is hard to distinguish between other benign tumors and non-neoplastic lesions if it is occurred in small bone of hand or foot. We experienced bizarre parosteal osteochondromatous proliferation of middle phalanx of the little finger, and report this case and the review of relevant literature.

Volarly Displaced Epiphyseal Fracture of the Middle Phalanx: A Case Report / 대한정형외과학회잡지

A 12-year old boy sustained a volarly displaced fracture of the middle phalanx after sustaining a hyperextension injury to the fifth finger. The alignment of the proximal interphalangeal (PIP) joint was maintained and the articular surface of the displaced epiphysis faced the proximal phalangeal head. This is different from case reported elsewhere, which described volarly displaced epiphyseal fractures during the reduction of a volar PIP dislocation. This means that the pathomechanism in the present case is different from the previously reported cases. The closed reduction was successful and the hand function of the patient was satisfactory at the 6 month follow-up.

Operative Treatment for Dorsal Lip Fracture of the Base of the Middle Phalanx / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical and radiological results of operative treatment for dorsal lip fracture of the base of the middle phalanx. MATERIALS AND METHODS: From 1992 to 2003 we experienced 9 cases of dorsal lip fracture of the middle phalangeal base that were treated surgically. Spinal needle fixation was used in cases with comminution. iniscrew fixation was performed in cases with a fragment larger than half of the articular surface. The pull-out technique was performed only in the cases with a fragment without comminution smaller than half of the articular surface. Bone union was evaluated using roentgenograms and clinical evaluations were done using Steel's scoring method. RESULTS: The average follow up after operation was 12.3 months. Cases showed union at an average of 7 weeks postoperatively. Two cases achieved excellent results, six cases good, and one case achieved a fair result; mean proximal interphalangeal joint flexion was 100 degrees (range 90-106). Extension deficit of 5 degrees was noted in 2 fingers. CONCLUSION: The pull-out technique, miniscrew fixation, and spinal needle fixation can produce a good clinical and radiological outcome in the treatment of dorsal lip fracture of the base of the middle phalanx.