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The most frequent skeletal injuries are hand fractures, which constitute around 20% of all fractures. Fractures of the phalanx are usual, comprising 6% of all fractures. Proximal phalanx fractures arise more often. The main goals of the care are to repair the anatomy, reduce the damage to soft tissue, and mobilize the damaged fingers as soon as stabilization of the fracture allows it. The present report is intended to examine the clinical and radiation effects of proximal phalanx fractures in patients treated with intramedullary screw fixation who underwent closed reduction. We report three consecutive cases of proximal phalanx fracture: two basal fractures and one simple shaft fracture. They were treated surgically with closed reduction with intramedullary headless compression screws. The preoperative magnitude of the angulation of the proximal phalanx averaged 30.3° (range: 13° to 42°). Two patients presented rotational deformity. The clinical findings were measured using the abbreviated version of the Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire, and the range of motion and functional results were assessed. Complications were observed over a span of at least 3 months. The patients displayed complete active flexion-extension proximal interphalangeal joint and flexion-extension metacarpophalangeal joint without rotative deformity. The scores on the QuickDASH were satisfactory (mean: 2.3; range: 0 to 4.5). No secondary surgeries were performed, and complications were not observed. Intramedullary fixation of proximal phalanx fractures with cannulated tension screws has been shown to be a safe operation, resulting in outstanding functional performance and an early recovery. The fracture is minimized and properly consolidated by the patients.
RESUMO
INTRODUCTION: Delayed union is a problem that can occur after fracture healing. Many studies were conducted based on the diamond concept approach to solve the problem of delayed union. Granulocyte-colony stimulating factor (G-CSF) is one of the various substances known to have a positive role in healing skeletal tissue or adjuvant regeneration. This study was conducted to see the effect of G-CSF in affecting delayed union fracture healing. MATERIALS AND METHOD: The experimental study was conducted by randomized posttest only control group design on 24 experimental animals Sprague-Dawley white rats that had experienced delayed union models. The study compared the treatment group injected with subcutaneous G-CSF with a control group and was divided into four groups (n = 6). Harvest and follow-up histomorphometry and immunohistochemistry were performed in the second week and in the fourth week the histomorphometry analysis consisted of the percentage of immature bone area, cartilage, and fibrous area. The semiquantitative evaluation of immunohistochemistry with the expression of BMP-2 through the immunoreactive score (IRS). RESULT: In the evaluation of histomorphometry and immunohistochemical parameters, there were significantly more woven bone area (p = 0,015), less fibrosis area (p = 0,002) and higher BMP 2 expression (p = 0,004) in treatment group week four compared to control. . CONCLUSION: G-CSF was shown to increase the speed of healing in Sprague-Dawley rats on delayed union models evaluated from histomorphometry and immunohistochemical aspects.
RESUMO
PURPOSE: To evaluate the effect of education and literacy status on completion of the Visual Prostate Symptom Score (VPSS) and the International Prostate Symptom Score (IPSS) in males aged over 40 years in a rural Indonesian area. METHODS: We enrolled 103 men who had visited Tc-Hillers Maumere Hospital. Four questions related to frequency, nocturia, weak stream, and quality of life (QoL) were presented by pictogram in the VPSS. Data on age, educational level, and literacy status were analyzed to determine associations with the capability to complete the IPSS and the VPSS questionnaires. Correlation test was used to identify correlation between the VPSS and the IPSS. RESULTS: The median age of the 103 respondents was 60 years. A total of 69 patients (67.0%) were able to read, 99 patients (96.1%) understood the Indonesian language, and 52 patients (50.5%) had an education grade>9. The IPSS was completed without assistance by 55 patients (53.4%) and the VPSS by 82 patients (79.6%). None of the patients who could not read could complete the IPSS without assistance, whereas 15 patients (44.1%) who could not read could complete the VPSS without assistance (P<0.001). In the analysis of education level, 40 of 51 patients (78.4%) with an education grade≤9 required assistance to complete the IPSS compared with 8 of 52 patients (15.4%) with an education grade>9 (P>0.001). In the same groups, 19 of 51 patients (37.3%) compared with 2 of 52 patients (3.8%) required assistance to complete the VPSS (P<0.001). Total VPSS, VPSS obstructive symptoms, VPSS irritative symptoms, and VPSS QoL scores significantly correlated with the total IPSS, IPSS obstructive symptoms, IPSS irritative symptoms, and IPSS QoL, respectively (correlation coefficient, P-value: 0.675, <0.001; 0.503, <0.001; 0.731, <0.001; and 0.823, <0.001, respectively). CONCLUSIONS: The VPSS correlated significantly with the IPSS and could be completed without assistance by a greater proportion of men with low levels of education. The VPSS might be useful in evaluating men with lower urinary tract symptoms in rural Indonesian areas with a high level of illiteracy and low level of education.
