ABSTRACT
BACKGROUND: Passive stiffness describes how easily a joint may move passively. To accurately measure wrist stiffness, an electro-oscillation device was developed. The objectives were to 1) ensuring that the measurement are free from intentional or reflex contraction, 2) analyzing how forearm anatomy affects the passive stiffness of the wrist and 3) determining the clinical practical relevance of the device. METHODS: In this prospective study, the device generated low amplitude sinusoidal motions in flexion and extension on the wrist to quantify elastic and viscous passive stiffness in voluntary orthopaedic patients. The first series of measurements was carried out in the state of voluntary relaxation, the second series of measurements was carried out after an axillary plexus anesthetic block. A matched group of healthy subjects were use for control. FINDINGS: The Electromechanical Oscillation methods effectively enable the measurement of passive joint stiffness since the stiffness values obtained show no statistically significant difference pre-post the anesthesia. The stiffness values are comparable to those of healthy subjects. The effect of forearm passive structure, estimated by the perimeter of the forearm, influences the passive stiffness of the wrist, mainly the viscous component. INTERPRETATION: The use of sinusoidal oscillation was well accepted by the participants, demonstrating its usefulness and applicability in a clinical setting. This work serves as a foundation for future investigations of orthopaedic and/or neurological pathological conditions characterized by abnormal passive joint stiffness of the wrist. It paves the way for its use as a diagnostic, prognostic, and monitoring tool in these pathologies.
Subject(s)
Wrist Joint , Wrist , Humans , Prospective Studies , Forearm , Range of Motion, Articular , Muscle, SkeletalABSTRACT
Given the appearance of a good number of cover flaps in recent decades, the Mac Gregor flap in its free form is used less and less but still finds its place today in certain complex cases with extensive loss of substance. This report describes an unusual case of wide tissue coverage by «all around¼ flap by Mac Gregor technique in a victim of an extensive burn of the left upper limb which occurred on 08/08/1997 and was responsible for a progressive flessum of the wrist and a hyperextension of the fingers with a complete loss of their mobility. The intervention is done in one step with a wide release of the scarred areas of the wrist and hand and the realization of the free inguinal flap in «all around¼. Here we discuss the type of flap, the surgical approach, the different advantages and disadvantages compared to other known flaps and the possible complications of the Mac Gregor free inguinal flap.
Suite à l'apparition de nombreux lambeaux de couverture au cours des dernières décennies, le lambeau de Mac Gregor sous sa forme libre est de moins en moins utilisé mais trouve encore sa place aujourd'hui dans certains cas complexes avec des pertes de substance étendues. Ce rapport décrit un cas inhabituel de large couverture tissulaire par un lambeau libre de type Mac Gregor en «all around flap¼ chez une victime d'une brûlure étendue du membre supérieur gauche survenue le 08/08/1997 et responsable d'un flessum progressif du poignet et d'une hyperextension des doigts avec une perte complète de leur mobilité. L'intervention se fait en un temps avec une large libération des zones cicatricielles du poignet et de la main et la réalisation du lambeau inguinal libre en «all around flap¼. Nous discutons ici du type de lambeau, de l'approche chirurgicale, des différents avantages et inconvénients par rapport à d'autres lambeaux connus et des possibles complications du lambeau inguinal libre de Mac Gregor.
Subject(s)
Burns , Free Tissue Flaps , Humans , Fingers , Cicatrix , Postoperative Complications/etiology , Treatment OutcomeABSTRACT
Various plating systems are available to fix distal radius fractures, each with a specific design. The purpose of this study was to compare radiological outcome and complications of the Variable Angle LCP Plate 2.4-mm (DePuy Synthes) with the VariAx volar locking plate (Stryker). One hundred patients (103 wrists) operated on for a distal radius fracture were retrospectively reviewed with a mean follow-up of 3.5 years. Seventy-three wrists were treated with a DePuy Synthes plate and 30 with a VariAx plate. The overall complication rate was 32%. Nineteen cases underwent revision surgery, 18 had malunion and 3 complex regional pain syndrome. Complicaton rate was 43% with DePuy Synthes plates and 27% with Variax plates, but the difference was not significant.
