RESUMO
In the face of challenges ushered in by globalization and technological advancements, financial flexibility has emerged as a pivotal strategy for attaining sustainable development in China's manufacturing sector. Financial flexibility allows firms to manage internal cash flows, alleviate external financing constraints, and augment their capability to absorb risks. Using the framework of Financial Flexibility Theory and Institutional Theory, this study examines data from A-share listed manufacturing firms on the Shanghai and Shenzhen Stock Exchanges from 2011 to 2021. The research aims to investigate the nexus between financial flexibility and sustainable performance, while also probing the moderating roles of environmental uncertainty and governmental grants. The key findings of the study unveil an inverted U-shaped relationship between financial flexibility and sustainable performance. Moreover, environmental uncertainty exerts a significant negative influence on sustainable performance. When both environmental uncertainty and governmental grants are substantial, the inverted U-shaped correlation between financial flexibility and sustainable performance intensifies. The innovation of this study lies in revealing the optimal zone of financial flexibility for enterprises under the influence of environmental uncertainty and government grants. Amidst an increasingly intricate macro-environment, this research furnishes pragmatic insights for optimizing sustainable performance in manufacturing enterprises and offers a series of empirically grounded suggestions for enterprise managers, government departments, and investors, guiding them to enhance sustainable performance through judicious calibration of financial flexibility levels.
RESUMO
Objective: To report the clinical characteristics and treatment analysis of 3 cases of congenital ulnar collateral flexor contracture of the forearm and take a reference for clinic. Methods: A total of 3 patients with congenital ulnar collateral flexor contracture of the forearm were admitted between February 2019 and August 2021. Two patients were male and 1 was female, and their ages were 16, 20, and 16 years, respectively. The disease durations were 8, 20, and 15 years, respectively. They all presented with flexion deformity of the proximal and distal interphalangeal joints of the middle, ring, and little fingers in the neutral or extended wrist position, and the deformity worsened in the extended wrist position. The total action motion (TAM) scores of 3 patients were 1 and the gradings were poor. The Carroll's hand function evaluation scores were 48, 55, and 57, and the grip strength indexes were 72.8, 78.4, and 30.5. Preoperative CT of case 2 showed a bony protrusion of the flexor digitorum profundus tendon at the proximal end of the ulna; and MRI of case 3 showed that the ulnar flexor digitorum profundus presented as a uniform cord. After diagnosis, all patients were treated with operation to release the denatured tendon, and functional exercise was started early after operation. Results: The incisions of 3 patients healed by first intention. Three patients were followed up for 12, 35, and 12 months, respectively. The hand function and the movement range of the joints significantly improved, but the grip strength did not significantly improve. At last follow-up, TAM scores were 3, 4, and 4, respectively, among which 2 cases were excellent and 1 case was good. Carroll's hand function evaluation scores were 95, 90, and 94, and the grip strength indexes were 73.5, 81.3, and 34.2, respectively. Conclusion: Congenital ulnar collateral flexor contracture is a rare clinical disease that should be distinguished from ischemic muscle contracture. The location of the contracture should be identified and appropriate surgical timing should be selected for surgical release. Active postoperative rehabilitation and functional exercise can achieve good hand function.