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1.
Int. j. morphol ; 42(1): 82-85, feb. 2024. ilus, tab
Article in English | LILACS | ID: biblio-1528837

ABSTRACT

SUMMARY: Hand size is part of the anthropometric parameters that are assessed in swimmers to select elite athletes, as certain anthropometric relationships involving hand measurements are significantly correlated with sports performance in various swimming disciplines. The authors present the results of the anthropometric study carried out on the hands of 15 elite male Italian swimmers from to the Italian national open water swimming team. All swimmers participated at least once in World Cup and Absolute Italian Championships, winning at least one medal in their sporting career. In particular, the sample includes a medallist at the World Championships, a winner of the World Cup ultra swim marathon circuit and medallists at the European Championships. The sample consisted of 15 elite male swimmers with a mean age of 28.93 years. The following anthropometric measurements were taken on each athlete: Stature; weight; seven dimensions on each hand: hand length; hand breadth metacarpal; palm length; middle finger length; index finger length; thumb distance; and the distance from the thumb root to first flexure line of the index finger - trigger length. The size of the hands is an important factor in the swimmer's propulsion and push as a larger hand allows for greater support in the water and consequently generates more resistance. The anthropometric characteristics of the hands of Italian swimmers are missing from the anthropometric data already reported in the literature and can be used to make comparisons with elite athletes from other nations. Furthermore, anthropometric measurements could be used as predictors to estimate the swimmers' chance of success.


El tamaño de la mano es uno de los parámetros antropométricos que se evalúan en los nadadores para seleccionar a los deportistas de élite. Los autores presentan los resultados de un estudio antropométrico realizado en las manos de 15 nadadores italianos masculinos de élite pertenecientes al equipo nacional de natación en aguas abiertas. Todos los nadadores participaron al menos una vez en Copas del Mundo y Campeonatos de Italia, ganando al menos una medalla en su carrera deportiva. En concreto, la muestra incluye un medallista en los Campeonatos del Mundo, un ganador de la Copa del Mundo del circuito de ultra maratón de natación y medallistas en los Campeonatos de Europa. La muestra consta de 15 nadadores masculinos de élite con una edad media de 28,93 años. Se tomaron las siguientes medidas antropométricas a cada atleta: estatura; peso; siete dimensiones en cada mano: longitud de la mano, anchura de la mano en el metacarpiano, longitud de la palma, longitud del primer, segundo y tercer dedo, distancia entre la raíz del primer dedo y la primera línea de flexión del segundo dedo. El tamaño de las manos es un factor importante para la propulsión y el empuje del nadador, ya que una mano más grande permite un mayor apoyo en el agua y, en consecuencia, genera más resistencia. Las características antropométricas de las manos de los nadadores italianos faltan en los datos antropométricos recolectados en la literatura y pueden utilizarse para hacer comparaciones con los atletas de élite de otras naciones. Además, las medidas antropométricas podrían utilizarse como predictores para estimar las posibilidades de éxito de los nadadores.


Subject(s)
Humans , Male , Adult , Swimming , Anthropometry , Hand/anatomy & histology , Italy
2.
Bénin Médical ; 69: 35-39, 2024. figures, tables
Article in French | AIM | ID: biblio-1554709

ABSTRACT

L'eczéma des mains est fréquent. Son étiologie est souvent multifactorielle comprenant les facteurs environnementaux et des facteurs individuels prédisposants. Il pose des problèmes de diagnostic étiologique en particulier dans un contexte de poly sensibilisation. Observation Il s'est agi d'une employée de maison âgée de 17 ans sans antécédents allergiques connus. Elle a développé un eczéma bilatéral des mains six mois après embauche. Le patch test avec la batterie standard européenne a montré une poly sensibilisation à plusieurs allergènes contenus dans les détergents et désinfectants. Le patch test aux gants est revenu négatif mais n'exclut pas son implication dans la survenue des lésions devant le caractère bilatéral et symétrique des lésions. Une réorientation professionnelle a été proposée devant le jeune âge de la travailleuse Conclusion La connaissance des allergènes en cause au cours d'un eczéma est un atout pour une meilleure prise en charge du patient mais leur identification n'est pas toujours aisée. La réorientation professionnelle lorsqu'elle est possible assure la guérison.


Introduction: Hand eczema is common. Its etiology is often multifactorial, including environmental factors and individual predisposing factors. It poses problems of etiological diagnosis, particularly in the context of poly sensitization. Observation: This case involved a 17-year-old domestic worker with no known allergic history. She developed bilateral hand eczema six months after hiring. The patch test with the standard European battery showed poly-sensitization to several allergens contained in detergents and disinfectants. The glove patch test came back negative, but did not rule out its involvement in the lesions, given the bilateral and symmetrical nature of the lesions. In view of the young age of the worker, a vocational reorientation was carried out. Conclusion: Knowledge of the allergens involved in eczema is an asset for better patient management, but identifying them is not always easy. When possible, professional reorientation ensures recovery


Subject(s)
Wounds and Injuries , Patient Care Management , Eczema , Hand Dermatoses , Antiviral Agents , Quality of Life , Hand
3.
Int. j. morphol ; 41(6): 1603-1609, dic. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1528770

ABSTRACT

SUMMARY: Despite attempts to develop the plastination technique in Bolivia, standardized results have not yet been achieved that could be communicated via scientific publications. There is a great deal of misunderstanding around the technique, confusing it with classic techniques of inclusion in different types of resin, such as polyester and epoxy, but these protocols are not plastination. The aim of this work was to communicate the first standardized room-temperature plastination protocol with silicone in Bolivia, with the unique feature of doing so at the altitude of the city of La Paz, thus constituting the first communication of a plastination technique at 4,150 m.a.s.l. sub sede La Paz, La Paz, Bolivia.


En Bolivia, a pesar de los intentos en el desarrollo de la técnica de Plastinación, aún no se han alcanzado resultados estandarizados que pudieran ser comunicados por medio de publicaciones científicas. Existe una gran confusión al momento de desarrollar la técnica, confundiéndola con técnicas clásicas de inclusión en distintos tipos de reina, como poliéster y epoxy, pero no correspondiendo estos protocolos desarrollados a la técnica de plastinación. En este sentido, el objetivo de esta trabajo consistió en comunicar el primer protocolo estandarizado de plastinación a temperatura ambiente con silicona de Bolivia, con la particularidad de desarrollarlo en la altura de la ciudad de La Paz, constituyéndose, de esta manera, en la primera comunicación de una técnica de plastinación a 4.150 metros sobre el nivel del mar.


Subject(s)
Humans , Altitude , Forearm/anatomy & histology , Plastination , Hand/anatomy & histology , Silicones , Temperature , Bolivia
4.
Rev. Odontol. Araçatuba (Impr.) ; 44(1): 22-27, jan.-abr. 2023. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1427850

ABSTRACT

Os indivíduos canhotos necessitam de utensílios para concretização de suas atividades diárias, bem como, para o exercício da prática odontológica onde a escassez de equipamentos específicos pode refletir em desgaste corporal, com isso, o presente trabalho tem por objetivo identificar os estudantes canhotos do curso de Odontologia da Universidade Federal de Uberlândia além de identificar suas dificuldades, queixas e locais de dores osteomusculares nas atividades laboratoriais e clínicas. Métodos: Foram incluídos todos os alunos canhotos matriculados no ano de 2021. Foram aplicados questionários on line para coletar os dados dos alunos. Resultados: Foram tabulados e como resultados, encontrou-se que os canhotos representam 5,6% do total de alunos do curso de Odontologia, a maioria são mulheres (66,7%), com média de idade de 21 anos. O segundo período foi o que apresentou maior número de canhotos (25%). As atividades práticas do curso, estas foram cursadas por 91,7% dos entrevistados, que relataram com maior frequência usar a mão esquerda (62,5%), sentar na posição de 1 hora (20,8%) e ter maior dificuldade ao tratar o quadrante superior direito (45,8%). Os locais mais citados de dores osteomusculares após realizar essas atividades, foram: punhos e mãos (62,5%), parte inferior das costas (62,5%) e pescoço (58,3%). Conclusão: Os canhotos representam a minoria dos alunos e suas dificuldades são, a falta de estrutura física adequada e a incompreensão das pessoas ao redor. Em relação a queixa de dor ou desconforto, mãos, punhos, parte inferior das costas e pescoço foram os membros mais citados no estudo(AU)


Left-handed individuals need tools to carry out their daily activities, as well as for the exercise of dental practice where the scarcity of specific equipment can reflect on body wear, with this, the present work aims to identify left-handed students of the course of Dentistry at the Federal University of Uberlândia, in addition to identifying their difficulties, complaints and sites of musculoskeletal pain in laboratory and clinical activities. Methods: All left-handed students enrolled in the year 2021 were included, and three questionnaires were applied online to identify the profile of students and the difficulties encountered in laboratory and clinical practice. Results: They were tabulated and as a result, it was found that left-handers represent 5.6% of the total number of students in the Dentistry course, most of them are women (66.7%), with a mean age of 21 years. The second period was the one with the highest number of left-handers (25%). The practical activities of the course were carried out by 91.7% of the interviewees, who reported more frequently using their left hand (62.5%), sitting in the 1 o'clock position (20.8%) and having greater difficulty when treat the upper right quadrant (45.8%). The most cited sites of musculoskeletal pain after performing these activities were: wrists and hands (62.5%), lower back (62.5%) and neck (58.3%). Conclusion: Lefthanded people represent the minority of students, and their difficulties are the lack of adequate physical structure and the misunderstanding of the people around them. In relation to complaints of pain or discomfort, hands, wrists, lower back and neck were the most cited members in the study(AU)


Subject(s)
Humans , Male , Female , Adult , Dentists , Musculoskeletal Pain , Functional Laterality , Students , Wrist , Cumulative Trauma Disorders , Sitting Position , Hand , Ergonomics , Neck , Occupational Diseases
5.
Chinese Acupuncture & Moxibustion ; (12): 1076-1080, 2023.
Article in Chinese | WPRIM | ID: wpr-1007445

ABSTRACT

Renying and Cunkou pulse diagnostic method is one of the important parts of the pulse diagnosis in Huangdi Neijing (Inner Canon of Yellow Emperor) and has been controversial since its proposal. This article takes WANG Shu-he's diagnostic operation as the evidence, and is in reference of the statement, "Cun region (the region ahead of Guan region of Cunkou) determines the human life, that on the left hand refers to Renying, while on the right hand is Qikou". The pulse conditions on the left and right hands represent yin and yang. If Renying pulse on the left is greater, the diseases are in yang meridians, while if Cunkou pulse on the right is bustling, the diseases are in yin meridians. By comparing the pulse condition and strength, as well as the pulse beating (rapid and urgent) between Guan region and region ahead of Guan on the same side, the conditions of three yang and three yin meridians are detected. In treatment, based on the records of Renying and Cunkou pulse diagnosis in Huangdi Neijing, the principles are proposed for reinforcing and reducing methods on hand and foot meridians of yin and yang. Five-shu points and yuan-source points are taken as the main acupoints in acupuncture treatment. During treatment, the changes in pulse conditions should be emphasized specifically and those at Renying and Cunkou regions are the criteria for judging qi arrival and qi regulation.


Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Foot , Hand , Heart Rate
6.
Chinese Acupuncture & Moxibustion ; (12): 990-992, 2023.
Article in Chinese | WPRIM | ID: wpr-1007431

ABSTRACT

The paper summarizes the academic thought and clinical experience of professor LI De-hua in treatment of facial nerve injury after total parotidectomy with blade needle based on jingjin (muscle region of meridian, sinew/fascia) theory. This disease is located at muscle regions of hand-/foot-three yang meridians; and the sinew/fascia adhesion is its basic pathogenesis, manifested by "transversely-distributed collaterals" and "knotted tendons". In treatment, the knotted tendons are taken as the points. Using the relaxation technique of blade needle, the lesions of sinews/fascia are dissected and removed to release the stimulation or compression to the nerves and vessels so that the normal function of sinews/fascia can be restored.


Subject(s)
Humans , Facial Nerve Injuries/surgery , Fascia , Foot , Hand , Lower Extremity
7.
Journal of Biomedical Engineering ; (6): 320-326, 2023.
Article in Chinese | WPRIM | ID: wpr-981545

ABSTRACT

In clinical practice, radiopharmaceutical dynamic imaging technology requires the bolus injection method to complete injection. Due to the failure rate and radiation damage of manual injection, even experienced technicians still bear a lot of psychological burden. This study combined the advantages and disadvantages of various manual injection modes to develop the radiopharmaceutical bolus injector, and explored the application of automatic injection in the field of bolus injection from four aspects: radiation protection, occlusion response, sterility of injection process and effect of bolus injection. Compared with the current mainstream manual injection method, the bolus manufactured by the radiopharmaceutical bolus injector based on the automatic hemostasis method had a narrower full width at half maximum and better repeatability. At the same time, radiopharmaceutical bolus injector had reduced the radiation dose of the technician's palm by 98.8%, and ensured more efficient vein occlusion recognition performance and sterility of the entire injection process. The radiopharmaceutical bolus injector based on automatic hemostasis has application potential in improving the effect and repeatability of bolus injection.


Subject(s)
Radiopharmaceuticals , Injections , Hand
8.
Journal of Southern Medical University ; (12): 145-152, 2023.
Article in Chinese | WPRIM | ID: wpr-971508

ABSTRACT

OBJECTIVE@#To evaluate the clinical features, laboratory and imaging results, treatment and outcomes of eosinophilic fasciitis (EF) and assess the value of ultrasound in the diagnosis of EF.@*METHODS@#We retrospectively analyzed the clinical data of 45 patients with EF treated in our center from January 1, 2006 to February 28, 2022. The consistency between the diagnoses of EF based on ultrasound and MRI findings was assessed.@*RESULTS@#In the 45 EF patients (male/female ratio 3.5:1), the age of onset ranged from 16 to 64 years with a mean disease course of 22.6 months. The average time from symptom onset to diagnosis was 16 months. The most common possible trigger of the disease was vigorous exercise (10/45), causing symmetrical lesions in the limbs, most commonly in the forearms (86.7%) and lower legs (80%). Clinical features of EF included subcutaneous swelling and induration (95.6%), arthralgia and arthritis (55.6%), groove sign (42.2%), hand joint contractures (42.2%), skin pigmentation (37.8%), and peau d'orange appearance (13.3%). Eosinophilia was found in 31 patients (68.9%). Hypergammaglobulinemia was seen in 23/44 (52.3%) and positive antinuclear antibodies in 9 (20%) of the patients. Twentyone of the patients were treated with high-dose methylprednisolone (≥200 mg daily for 3 to 5 consecutive days), and compared with the patients who did not receive this treatment, these patients more frequently experienced relapse before admission, had more extensive involvement, and had a higher rate of hypergammaglobulinemia without fever, but these differences were not statistically significant. Of the 31 patients (68.9%) with follow-up data (for a median of 3.2 years [range 0.2-15.9]), complete remission was achieved in 12 (38.7%) patients, and the accumulative complete remission rate was 44.1% at 5.5 years. No specific baseline characteristics or immunosuppressants were found to correlate with the treatment response. A total of 26 patients underwent both ultrasound and MRI examination, and the Kappa value of the diagnostic results between ultrasound and MRI was 0.91.@*CONCLUSION@#EF is characterized by symmetrical subcutaneous swelling and induration in the limbs, accompanied by eosinophilia and hypergammaglobulinemia. Glucocorticoid is effective for treating EF. Ultrasound examination can identify thickening of subcutaneous fascia for an early diagnosis of EF.


Subject(s)
Humans , Female , Male , Infant , Child, Preschool , Retrospective Studies , Hypergammaglobulinemia , Eosinophilia , Ultrasonography , Hand , Contracture , Treatment Outcome
9.
Journal of Integrative Medicine ; (12): 254-267, 2023.
Article in English | WPRIM | ID: wpr-982680

ABSTRACT

OBJECTIVE@#This study aims to clarify how the stimulation of acupuncture points is achieved by needles with different surface texture during acupuncture; it also seeks to lessen injury at the insertion site and increase the therapeutic efficacy of acupuncture, by simulating the mechanical effects of various needle surface patterns on Zusanli (ST36) without changing the radius of acupuncture needles.@*METHODS@#Five acupuncture needle models with different surface patterns, including the smooth needle, the lined needle, the ringed needle, the left-hand threaded needle and the right-hand threaded needle, and a layered model of the Zusanli acupoint were used to investigate how to reduce tissue damage and increase stimulation during acupuncture treatment. Puncturing of the skin as well as lifting-inserting and twisting needle manipulations were simulated using these models, and the degree of damage and force of stimulation caused by the acupuncture needles with different surface patterns during acupuncture were compared.@*RESULTS@#The smooth needle and the lined needle caused the least tissue damage during insertion, while the left-hand threaded and the right-hand threaded needles caused the most damage. The ringed needle, the left-hand threaded needle and the right-hand threaded needle stimulated the acupoint tissue more during lifting-inserting manipulations, while the lined needle and the smooth needle produced less stimulation. The stimulation of the lined needle on the acupoint tissue was the largest during twisting manipulation, whereas the left-hand threaded needle and the right-hand threaded needle had smaller effects. In lifting-inserting and twisting manipulations, both the left-hand threaded needle and right-hand threaded needle provided more stimulation, but the torsion direction in which they produced better stimulation was the opposite.@*CONCLUSION@#According to the simulation results, the ringed pattern enhances stimulation best in the lifting-inserting manipulation, whereas the lined pattern enhances stimulation best in the twisting manipulation. Both the right-hand and left-hand thread patterns have certain enhancing effects in these two operations. Taking the geometric properties of the pattern into account, the left-hand thread pattern and the right-hand thread pattern have the geometric characteristics of both the lined pattern and the ringed pattern. To conclude, a pattern perpendicular to the movement direction during the acupuncture manipulation creates more stimulation. These results have significance for future needle design. Please cite this article as: Sun MZ, Wang X, Li YC, Yao W, Gu W. Mechanical effects of needle texture on acupoint tissue. J Integr Med. 2023; 21(3): 254-267.


Subject(s)
Acupuncture Points , Needles , Acupuncture Therapy/methods , Hand
10.
Chinese Critical Care Medicine ; (12): 757-758, 2023.
Article in Chinese | WPRIM | ID: wpr-982668

ABSTRACT

Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.


Subject(s)
Humans , Wrist , Intensive Care Units , Critical Care , Hand , Upper Extremity , Restraint, Physical
11.
Acta cir. bras ; 38: e384323, 2023. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1519873

ABSTRACT

Purpose: The primary objective of this study was to compare the WALANT (wide awake, local anesthesia, no tourniquet) technique with local anesthesia associated with sedation in relation to pain intensity for minor hand surgical procedures. The secondary objective was to evaluate the need for analgesic complementation. Methods: A prospective, randomized, comparative, and clinical study was carried out. The sample size in each group was determined after statistical evaluation of the results of a pilot project. The participants were allocated to one of two groups; those in group 1 were submitted to the WALANT technique, and those in group 2, to local anesthesia associated with sedation, for elective surgery. The surgical procedures were carpal tunnel syndrome, De Quervain's tenosynovitis, synovial cyst, finger cyst, and trigger finger. Pain intensity, need for complementation and evolution to complex regional pain syndrome were evaluated. Results: There was no difference between groups in pain intensity after WALANT and need for intraoperative complementation. There was no significant difference in the amount of opioid applied postoperatively between the groups. There was no difference between groups regarding comfort during surgery. There was no difference in adverse effects and complications between the groups. Hematoma was the most frequent adverse event. No severe adverse events were observed. Conclusions: The WALANT technique promoted an analgesic effect similar to that of local anesthesia associated with sedation, without increasing adverse effects.


Subject(s)
Pain Measurement , Epinephrine , Hand/surgery , Anesthesia, Local , Anesthetics , Lidocaine
12.
Rev. venez. cir. ortop. traumatol ; 54(2): 96-103, dic. 2022. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1516775

ABSTRACT

El objetivo de esta investigación es evaluar la utilidad de la Técnica de WALANT en cirugías ambulatorias de mano en pacientes post Covid-19 en el Hospital General del Sur "Dr. Pedro Iturbe", Maracaibo, Estado Zulia, durante el periodo de julio del 2020 a octubre del 2021. Se realizó un estudio pre-experimental, longitudinal y prospectivo. El muestreo fue probabilístico al azar simple. Se aplicó un análisis estadístico de tipo descriptivo. Se incluyeron 50 pacientes con edad promedio de 37,02+/- 14,1(18-64) años, 52% de sexo femenino y 48% masculino. De ocupación 46% comerciante y obrero. Ama de casa y oficinista 44%, otros 10%. Con diagnóstico de dedo en gatillo 20%, síndrome del túnel carpiano 24%. Con la técnica se realizaron procedimientos quirúrgicos tipo neuroadhesiolisis del nervio mediano 24%, exéresis 22%. Tiempo quirúrgico de 5 a 10 minutos de duración en 56,9% de los casos. Se encontró punta de EVA: preoperatorio 56% de 7-10 ptos, Intraoperatorio 64% 0 ptos y postoperatorio 66% 0 ptos. Analgesia de rescate 92%. 88% sin complicaciones. La estancia Hospitalaria en 92% de los casos fue 1 hora. Reintegro a sus actividades 90%. Tiempo de reintegro en 46% de los casos de 1-5 días. 86% de los pacientes se sintieron satisfechos. En conclusión, la Técnica de WALANT en pacientes post Covid-19 es de gran utilidad para la realización de cirugías ambulatorias de bajo riesgo de mano, presentó pocas complicaciones, el tiempo quirurgo fue corto, el reintegro a sus actividades fue rápido y la satisfacción del paciente fue buena(AU)


The objective of this study is to evaluate the usefulness of the WALANT Technique in ambulatory hand surgeries in post- Covid-19 patients at the Hospital General del Sur "Dr. Pedro Iturbe", Maracaibo, Estado Zulia, during the period from July 2020 to October 2021. A pre-experimental, longitudinal and prospective study was made. Sampling was simple random probabilistic. A descriptive statistical analysis was applied. 50 patients were included with an average age of 37,02+/-14,1(18-64) years, 52,0% female and 48,0% male. Occupation 46,0% merchant and worker. Housewife and office 44,0%, others 10,0%. With a diagnosis of trigger finger 20,0%, carpal tunnel syndrome 24,0%. With the technique, 24,0% median nerve neuroadhesiolysistype surgical procedures were performed, 22,0% exeresis. Surgical time from 5 to 10 minutes in 56,9% of cases. A VAS tip was found: preoperative 56,0% 7-10 points, intraoperative 64,0% 0 points and postoperative 66,0% 0 points. Rescue analgesia 92,0%. 88,0% without complications. Hospital stay in 92,0% of cases was 1 hour. Refund to their activities 90,0%. Refund time in 46,0% of cases from 1-5 days. 86,0% of the patients felt satisfied. In conclusion, the WALANT Technique in post-COVID-19 patients is very useful for performing low-risk outpatient hand surgeries, it presented few complications, the surgical time was short, the return to their activities was fast and the satisfaction of the patient. patient was good(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Ambulatory Surgical Procedures , COVID-19 , Hand/surgery , Anesthesia, Local , Comorbidity , Upper Extremity , Patient Care , Hypertension , Lidocaine/administration & dosage
13.
Rev. argent. cir. plást ; 28(2): 75-80, 20220000. fig, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1413535

ABSTRACT

El colgajo antebraquial anterior es una excelente área dadora para transferir tejido. A lo largo de los años el colgajo antebraquial libre ha tomado fuerza dado que proporciona la cantidad de tejido a donar, su localización y, por sobre todo, la facilidad de disección, que se necesita para cubrir diferentes defectos en todo el cuerpo. Además, debe optimizar los resultados funcionales y estéticos. El sitio receptor debe cumplir en la medida de lo posible, utilizando colgajos con características similares, restablecer la integridad estructural o la función. Material y métodos. Se han realizado desde marzo 2021 a marzo del corriente año un total de 26 colgajos antebraquial libre. Los pacientes de esta serie fueron 80% hombres y 20% mujeres con un rango de edad de 25 a 73 años. Se utilizó tanto para patologías oncológicas, traumáticas e incluso colgajo de elección en pacientes trans para la creación del falo. Se tuvo en cuenta la utilización de la mano no hábil del paciente para así disminuir los riesgos de secuelas funcionales. Este colgajo aporta buen volumen de isla de piel, su pedículo es constante y confiable. La disección del colgajo, en manos entrenadas, acorta los tiempos quirúrgicos y demostró ser útil en muchísimas zonas receptoras del cuerpo. Resultados. Se logró el aporte de tejido necesario en todas las patologías a tratar, utilizando como zonas receptoras diferentes tipos de pedículos. También se logró un buen resultado tanto estético como funcional, volviendo a dar al paciente una calidad de vida aceptable. Conclusiones. El colgajo antebraquial libre ha demostrado ser útil en diversas patologías a tratar. Buen tegumento, su disección es fácil y accesible para cirujanos reconstructivos que recién comienzan su formación así como para cirujanos ya entrenados. Consta de un pedículo confiable con buen diámetro y longitud, lo cual lo hace aún más verídico para contar como primera opción cuando se lo necesita como colgajo libre.


The anterior antebrachial flap is an excellent donor area for tissue transfer. Over the years the free antebrachial flap has gained strength since it provides the amount of tissue to donate, its location and above all the ease of dissection, which is needed to cover different defects throughout the body. It must also optimize functional and aesthetic results. The receiving site should comply as far as possible, using flaps with similar characteristics, restore structural integrity or function


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Surgical Flaps , Plastic Surgery Procedures , Free Tissue Flaps/surgery , Forearm , Hand
14.
Rev. bras. ortop ; 57(4): 649-655, Jul.-Aug. 2022. tab, graf
Article in English | LILACS | ID: biblio-1394875

ABSTRACT

Abstract Objective To assess the satisfaction of patients undergoing hand surgery in relation to their hospitalization, their feelings, and the consequences resulting from the surgical procedure as well as to evaluate their opinion and feelings in relation to the surgical procedure and to detect possible weaknesses in the health care of patients undergoing hand surgery. Method Cross-sectional observational clinical study, with a quali-quantitative focus, carried out in an outpatient clinic of a teaching hospital specialized in hand care, with patients of both genders, aged 18 to 75 years, who have undergone corrective surgical procedures of hand pathologies in the last 5 years. Results We obtained a total of 54 participants, 26 females and 28 males, with a minimum age of 18 years and a maximum of 73 years. Patient satisfaction for the 11 moments evaluated had means between 8 and 10, showing great satisfaction. For the other five moments evaluated, the means were between five and eight. We did not get any satisfaction average below fivr. Conclusion The absolute satisfaction of patients undergoing hand surgery is dependent on the humanization of health care, especially in relation to surgical consequences, which require further follow-up. The surgical consequences that require greater follow-up and hinder the routine activities of patients are pain on hand mobilization, limitation of the range of motion, and parathesthesia; thus, proper management of these complaints leads to greater satisfaction.


Resumo Objetivo Determinar a satisfação dos pacientes submetidos a cirurgia de mão em relação a sua internação, seus sentimentos, e as consequências decorrentes do procedimento cirúrgico bem como avaliar sua opinião e seus sentimentos em relação ao procedimento cirúrgico e detectar possíveis fragilidades na atenção à saúde do paciente submetido a cirurgia de mão. Método Estudo clínico observacional de corte transversal, com enfoque quali-quantitativo, realizado em um ambulatório especializado em cuidado da mão de um hospital de ensino, com os pacientes de ambos os gêneros, com idade de 18 a 75 anos, que tenham sido submetidos a procedimentos cirúrgicos corretivos de patologias da mão nos últimos 5 anos. Resultados Obtivemos o total de 54 participantes, sendo 26 do sexo feminino e 28 do sexo masculino, com idade mínima de 18 anos e máxima de 73 anos. Em relação à satisfação dos pacientes em 11 momentos avaliados, as médias foram entre 8 e 10, mostrando grande satisfação. Para os outros cinco momentos avaliados, as médias ficaram entre cinco e oito. Não obtivemos nenhuma média de satisfação abaixo de cinco. Conclusão A satisfação absoluta dos pacientes submetidos à cirurgia de mão é dependente da humanização da assistência à saúde, principalmente em relação às consequências cirúrgicas, que demandam maior acompanhamento. As consequências cirúrgicas que demandam maior acompanhamento e que dificultam as atividades rotineiras dos pacientes são dor à mobilização da mão, limitação do arco de movimento, e parestesia; assim, o manejo adequado dessas queixas leva à maior satisfação.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Patient Satisfaction , Orthopedic Procedures , Humanization of Assistance , Hand/surgery
15.
Semina cienc. biol. saude ; 43(2): 199-208, jul./dez. 2022. tab
Article in Portuguese | LILACS | ID: biblio-1426353

ABSTRACT

Objetivo: este estudo buscou averiguar a possível discrepância bilateral de indicadores antropométricos de pessoas com e sem síndrome de Down (SD). Material e Método: para tal, contou-se com a participação de 60 indivíduos com e sem síndrome de Down, com idades entre 11 e 14 anos, que foram avaliados quanto à dominância lateral, dobras cutâneas, percentual de gordura, circunferência muscular de braço e antebraço e força de preensão palmar. Principais resultados: notou-se maior número de indivíduos sinistros e com indefinição na lateralidade no grupo com síndrome de Down do que nas pessoas com desenvolvimento típico. Os valores da percentagem de gordura, das medidas de dobra cutânea, da circunferência muscular do braço e da circunferência de antebraço foram maiores entre os participantes com síndrome de Down do que entre os do grupo controle. A força de preensão palmar foi maior nos indivíduos típicos. Não houve diferença na composição corporal bilateral dos indivíduos com síndrome de Down. Conclusão: os resultados encontrados demonstraram a existência de uma simetria bilateral nos indivíduos com e sem síndrome de Down.


Objective: this study sought to investigate the possible discrepancy in the bilateral anthropometric indicators of people with and without Down syndrome (DS). Material and Method: 60 individuals with and without Down syndrome, aged between 11 and 14 years, who were evaluated for lateral dominance, skinfolds, fat percentage, arm and forearm muscle circumference, and hand grip strength. Main results: there were a greater number of sinister individuals with a vagueness in laterality in the group with Down syndrome than in people with typical development. The percentage of fat, skinfold measurements, arm muscle circumference and forearm circumference were higher among participants with Down syndrome than those in the control group. Hand grip strength was greater in typical individuals. There was no difference in the bilateral body composition of individuals with Down syndrome. Conclusion: the results found demonstrated the existence of a bilateral symmetry in individuals with and without Down syndrome.


Subject(s)
Humans , Male , Female , Child , Adolescent , Syndrome , Body Composition , Down Syndrome , Functional Laterality , Persons , Hand
16.
Rev. cuba. ortop. traumatol ; 36(2): e524, abr.-jun. 2022.
Article in Spanish | LILACS, CUMED | ID: biblio-1409067

ABSTRACT

La posibilidad de operar a los pacientes con afecciones de la mano bajo anestesia local con la lidocaína y la epinefrina usando la técnica WALANT provocó una revolución en la cirugía de la mano, que facilitó la vida de los pacientes y disminuyó los costos de los servicios hospitalarios. Es necesario que los cirujanos conozcan la técnica y la historia de esta técnica. El objetivo fue identificar los orígenes del auge y la caída del mito y del dogma de la prohibición de la adrenalina en los bloqueos anestésicos de los dedos. Se realizó un análisis crítico de los principales textos de los artículos y los libros sobre el uso de la epinefrina en la anestesia de los dedos. La creación del mito de prohibir el uso de la epinefrina en los bloqueos anestésicos de los dedos se produjo debido a la mala interpretación de los informes de los casos de necrosis ocurridos que, en realidad, no fueron causados por la epinefrina. Ese mito influyó en la aparición de un dogma. La historia del uso de la epinefrina en los bloqueos de los dedos anestésicos demuestra que las interpretaciones superficiales y erróneas de las complicaciones clínicas publicadas como informes de casos pueden generar mitos y dogmas. Solo la ciencia puede prevenir y destruir tales mitos y dogmas médicos(AU)


The possibility of operating patients with hand conditions under local anesthesia, with lidocaine and epinephrine, using WALANT technique caused a revolution in hand surgery, which made life easier for patients and lowered the costs of hospital services. Surgeons need to be aware of the possibilities and history of WALANT technique. The objective was to identify the origins of the rise and fall of the myth and dogma of the prohibition of adrenaline in anesthetic finger blocks. A critical analysis of the main texts of the articles and books on the use of epinephrine in finger anesthesia was carried out. The conception of the myth of banning the use of epinephrine in anesthetic finger blocks occurred due to misinterpretation of reports of necrosis occurring, which were not actually caused by epinephrine. That myth influenced the appearance of a dogma. The history of the use of epinephrine in anesthetic finger blocks demonstrates that superficial and misleading interpretations of clinical complications published as case reports can breed myth and dogma. Only science can prevent and destroy such medical myths and dogmas(AU)


Subject(s)
Humans , Epinephrine/history , Epinephrine/therapeutic use , Hand/surgery , Anesthesia, Local/methods , Cocaine/therapeutic use
17.
Rev. colomb. gastroenterol ; 37(2): 174-185, Jan.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1394946

ABSTRACT

Abstract Introduction: The practice of digestive endoscopy is a physically demanding activity, with musculoskeletal disorders present in 39 % to 89 % of endoscopists, associated with "excessive use" maneuvers. Due to a lack of knowledge of this problem in endoscopists in Colombia, the main objective is to determine the prevalence, types, and risk factors of musculoskeletal disorders in specialists and graduate students. The secondary objective is to identify the occupational impact, treatments used, and importance of prevention and education in ergonomics. Materials and methods: Analytical cross-sectional observational study. Electronic survey methodology, open from June 1 to 30, 2021. Purposive sampling of 450 endoscopists from four scientific associations and eleven graduate programs, including 50 questions in six groups according to the objectives. We validated 203 responses, with 131 confirmations of musculoskeletal disorders, the group on which the analysis was performed. Results: Global prevalence of musculoskeletal disorders of 64.5 % and prevalence in graduate students of 58.6 %. There was more significant involvement of the upper limbs (right shoulder, left thumb, right elbow), followed by lower back, neck, knees, and hips. Graduate students reported pain in the right hand/fingers (right thumb) and the lower back. There was no significant difference due to work factors, but there was a tendency for more reports when increasing the volume of procedures and years of professional practice. The labor impact showed 78 % absenteeism. The most used treatments were medication, physiotherapy, and rest; 93.8 % had not received ergonomic education. However, there is a positive perception (74.1 % to 90.9 %) of receiving formal training. Discussion: The prevalence reflected the health and safety problem for the endoscopist. Demographic risk factors plus those of the endoscopic practice give rise to an individualized risk framework that enables endoscopists to understand learning and training as a way to prevent musculoskeletal disorders in themselves and their work team.


Resumen Introducción: la práctica de la endoscopia digestiva es una actividad físicamente exigente, con trastornos musculoesqueléticos presentes en el 39 % a 89 %, asociados con maniobras de "uso excesivo". Debido al desconocimiento de este problema en endoscopistas de Colombia, el objetivo principal fue determinar la prevalencia, tipos y factores de riesgo del trastorno musculoesquelético en especialistas y estudiantes de posgrado. El objetivo secundario fue identificar el impacto laboral, los tratamientos utilizados y la importancia atribuida a la prevención y educación en ergonomía. Metodología: estudio observacional de corte transversal analítico. Metodología de encuesta electrónica, abierta del 1 al 30 de junio de 2021. Muestreo intencionado a 450 endoscopistas de 4 asociaciones científicas y 11 programas de posgrado, en el que se incluyeron 50 preguntas en 6 grupos según los objetivos. Se validaron 203 respuestas, con 131 confirmaciones de trastornos musculoesqueléticos, grupo al cual se le realizó el análisis. Resultados: prevalencia global de trastornos musculoesqueléticos de 64,5 % y prevalencia en estudiantes de posgrado de 58,6 %. Hubo mayor afectación de miembros superiores (hombro derecho, pulgar izquierdo, codo derecho); luego, en la espalda baja y cuello; y en las rodillas y caderas. En estudiantes de posgrado se registró dolor en la mano-dedos derechos (pulgar derecho) y en la espalda baja. No hubo diferencia significativa por aspectos laborales, pero hubo tendencia a un mayor reporte al aumentar el volumen de procedimientos y años de práctica profesional. El impacto laboral mostró 78 % de ausentismo laboral. Los tratamientos más empleados fueron medicamentos, fisioterapia y reposo. El 93,8 % no había recibido capacitación ergonómica y hay percepción positiva (74,1 % a 90,9 %) de recibir una didáctica formal. Discusión: la prevalencia evidenció el problema de salud y seguridad para el endoscopista. Los factores de riesgo demográficos más los propios de la práctica endoscópica generan un marco de riesgo individualizado que le permite al endoscopista entender el aprendizaje y la capacitación para prevenir trastornos musculoesqueléticos en sí mismo y su equipo de trabajo.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Risk , Risk Factors , Endoscopy , Fingers , Ergonomics , Occupational Groups , Pain , Specialization , Therapeutics , Thumb , Health , Surveys and Questionnaires , Absenteeism , Equipment and Supplies , Hand , Neck
18.
Int. j. morphol ; 40(3): 742-749, jun. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1385659

ABSTRACT

RESUMEN: Nos motivó esta presentación los hallazgos observados en la sala de disección sobre las relaciones de la rama palmar profunda de la arteria ulnar y el ramo profundo del nervio ulnar, las diferentes disposiciones de esta rama, el cruzamiento, cuando existe, entre ambos elementos y las pocas referencias sobre el tema, todo con miras a favorecer el abordaje profundo de la palma de la mano y contribuir al conocimiento del área en donde se practican las neurotomías del ramo profundo del nervio ulnar y/ o sus ramas.


SUMMARY: We are motivated by the findings observed in the dissection room on the relationship between the deep palmar branch of ulnar artery and the deep branch of ulnar nerve, the different dispositions of this branch, the crossing, when it exists, between both elements and the few references on the subject, all with a view to favoring the deep approach to the palm and contributing to the knowledge of the area where neurotomies of the deep branch of ulnar nerve and/or its branches are performed.


Subject(s)
Humans , Ulnar Nerve/anatomy & histology , Ulnar Artery/anatomy & histology , Hand/anatomy & histology , Hand/innervation , Hand/blood supply
19.
Rev. cuba. ortop. traumatol ; 36(1)abr. 2022. ilus, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1409047

ABSTRACT

Introducción: En los últimos años la anestesia local sin torniquete y con el paciente despierto, técnica conocida por WALANT (por sus siglas en inglés), ha ganado mucha popularidad en las cirugías de la mano y la muñeca. Objetivo: Reportar nuestra experiencia con el uso de la técnica WALANT, a fin de prescindir del uso del torniquete en las cirugías de la mano. Métodos: En noviembre del 2020 fueron intervenidos 30 pacientes por diversas enfermedades ortopédicas, entre las que figuraron: dedos en resorte, síndrome del túnel carpiano, tenovaginitis estenosante del pulgar, gangliones del carpo y amputación del tercer radio por rigidez en extensión postraumática, entre otras. Para la evaluación de la técnica tuvimos en cuenta: tiempo quirúrgico, magnitud del sangrado, dolor durante la infiltración anestésica, la intervención, y en las primeras 24 horas del postoperatorio, la necesidad de refuerzo anestésico, uso de isquemia, complicaciones y nivel de satisfacción del paciente. Resultados: Los resultados obtenidos con esta técnica anestésica son semejantes a otras, con las ventajas que el sangrado es leve, no hay que utilizar isquemia, el tiempo quirúrgico es menor y el efecto anestésico duró entre 10 y 12 horas en todos los pacientes. En ninguno de los pacientes hubo necesidad de refuerzo anestésico. Conclusiones: Se demuestra la efectividad de la técnica WALANT en las cirugías de mano. Con ella se disminuye el gasto de materiales para el acto quirúrgico, así como de personal, es de fácil aplicación y disminuyen las sensaciones desagradables y los peligros del uso de isquemia en los pacientes(AU)


Introduction: Currently, the use of local anaesthetic with no tourniquet and wide awake patient (Wide Awake Local Anaesthetic No Tourniquet - WALANT) has gained popularity in surgeries of the hand and wrist. Objective: To report our experience in the use of WALANT technique in order to discard the use of tourniquet in hand surgeries. Method: In November 2020, thirty patients underwent surgery due to different orthopaedic conditions, among them trigger fingers, carpal tunnel syndrome, stenosing tenovaginitis of the thumb, carpal ganglion and amputation of the third radius due to post trauma stiffness, among others. In order to assess this technique, we considered surgical time, volume of bleeding, pain during anesthetic infiltration, intervention and the need for additional anesthetic during the first 24 hours after surgery; we considered also ischemia, complications and level patient´s satisfaction. Results: This technique had similar results to others; however, the bleeding is mild, there is no need for ischemia, the surgical time is lesser and the anesthetic effect lasted 10 to 12 hours in all patients. None of them required additional anesthetic. All subjects felt the initial infiltration but none complained of pain during the rest of the anesthetic injection or during the surgical act. There were no complications. Conclusions: The effectiveness of WALANT technique in hand surgeries is shown. The cost of materials for the surgical act is reduced with it, as well as the surgical staff, it is easy to use and unpleasant sensations and dangers of the use of ischemia in patients are reduced(AU)


Subject(s)
Humans , Bone Neoplasms/surgery , Epinephrine/administration & dosage , Sodium Bicarbonate/administration & dosage , Hand/surgery , Lidocaine/administration & dosage , Wrist/surgery , Effectiveness
20.
Rev. chil. neuro-psiquiatr ; 60(1): 124-129, mar. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1388417

ABSTRACT

Resumen El presente caso es un ejemplo del síndrome de la mano inútil de Oppenheim secundario a un astrocitoma cervical alto. La pérdida sensorial propioceptiva y discriminativa suspendida con conservación de la termoalgesia y el tacto crudo en ambas extremidades superiores es secundaria al daño a la entrada de la raíz dorsal y al núcleo cuneiforme. La torpeza y las dificultades para una prensión precisa con la mano se deben al daño del núcleo proprioespinal en las astas dorsales a nivel C3-C4. Este núcleo integra influencias excitadoras descendentes del tracto corticoespinal e interneuronas inhibitorias controladas por los sistemas descendentes y las aferencias de las extremidades anteriores. Probablemente la pérdida de las aferentes cervicales propioceptivas inhibitorias sea la culpable de las dificultades para agarrar con las manos.


The present case is an example of the useless hand syndrome of Oppenheim secondary to a high cervical astrocytoma. The suspended proprioceptive and discriminative sensory loss with conservation of thermoalgesia and crude touch in both upper extremities is secondary to damage to dorsal root entry and cuneate nucleus. The clumsiness and difficulties in precise grasping with the hand are due to damage of the propriospinal nucleus in the dorsal horns at C3-C4 level. This nucleus integrates descending excitatory influences from corticospinal tract and inhibitory interneurons controlled by descending systems and the forelimb afferents. Probably the loss of the inhibitory proprioceptive cervical afferents is the culprit of the difficulties in grasping by the hands.


Subject(s)
Humans , Male , Adult , Astrocytoma/complications , Spinal Neoplasms/complications , Stereognosis , Hand/physiopathology , Syndrome
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