An assessment of the effects of variations in the Palmaris longus tendon and the fifth superficial flexor digitorum on pinch and grip strength.

INTRODUCTION: The effect of the absence or presence of the Palmaris longus tendon on pinch and grip strength was investigated in this study. Similarly, the effect of the presence or absence of the fifth superficial flexor digitorum on grip strength in the hand was studied. The aim of the present study was to assess the combined effect of these anatomical variations on pinch and grip strength. MATERIALS AND METHODS: In this cross-sectional study, 523 volunteers and their 1046 hands were enrolled. Each hand was assessed for the presence or absence of the Palmaris longus tendon and for variations in the fifth superficial flexor digitorum function. Then the grip and pinch power of the hands were measured with the Jammar Dynamometer. RESULTS: The presence or absence of Palmaris longus had no effect on grip strength in the individuals studied. Likewise, variations in fifth superficial flexor digitorum function had no effect on grip and pinch strengths. But the results of statistical testing showed the effect of the presence of Palmaris longus on pinch strength (25.38 lbs in hands with Palmaris present vs 24.43 lbs in hands without Palmaris). Pinch and grip power was higher in men than in women and in the right hand than in the left. CONCLUSION: Based on the findings of the present study, it seems that absence of the Palmaris longus tendon is associated with a reduction in pinch strength but has no effect on grip strength, and the variations in the fifth superficial flexor digitorum (flexor digitorum superficialis, or FDS) have no effect on pinch and grip strengths.

Treatment of proximal phalanx fractures: transarticular pinning the metacarpophalangeal joint or cross pinning from the base of the proximal phalanx-a prospective study.

INTRODUCTION: For extraarticular proximal phalanx fractures, two methods are employed, transarticular fixation in which the metacarpophalangeal joint is crossed and the extraarticular method in which the pins are introduced through the base of the proximal Phalanx. MATERIALS AND METHODS: This study was a prospective one on patients with proximal phalanx transverse or short oblique fractures. In one of the groups we used parallel pins from metacarpal head through MCP joint to proximal phalanx. In the second, we used two cross pins from proximal phalanx the base of the proximal phalanx to fix the fracture. We evaluated metacarpophalangeal, proximal and distal interphalangeal joints active range of motion and how long it took the patient to resume their daily activities and work without difficulty, as well as post-operative complications such as wound infection, malunion, and nonunion in 3 and 6 months follow-up. RESULTS: Ultimately, 61 people entered the study, 29 in the parallel pins and 31 in the cross pins group. There was no significant difference between the two groups, but the improvement in all of the joints range of motion showed a statistically significant difference (P < 0.0001) from the 3 to 6 months follow-up. The final range of motion showed an inverse correlation with age of the patient (P < 0.05). Most of the patients were in the excellent grade of range of motion class and no serious complication was observed in any of them. CONCLUSION: The results of treatment in proximal phalangeal fractures with both methods were comparable and so the surgeon may select each based on the experience and training.

A survey on causes of amputation in a 9-year period in Iran.

BACKGROUND: Limb loss occurs as a result of different causes and has been increasing in many countries. This study determines the demography of amputees in one of the relatively large cities of Iran. METHODS: This retrospective study was undertaken on all of the amputees between 2003 and 2011. Patients' demographics including age, sex, the limb that had undergone amputation, etiology of limb loss and side and level of amputation were recorded. Also, the level of amputation was recorded as minor (below wrist or ankle) or major (above wrist or ankle). RESULTS: In total, 624 patients were enrolled in the study. The number of amputees was from 53 to 118/year. Of the patients, 508 were male (81.4 %) and 118 were female (18.6 %). The men with amputation were younger on average than women; 61.9 % of the amputations (386) were major and 38.1 % were minor (238). Overall, the most common cause of amputation was trauma and the most common level was transmetatarsal. The most common level for major amputations was below knee. CONCLUSION: In contrast to similar studies in developed countries, trauma was found to be the major cause of all types of amputations and in all age groups, which emphasizes the need for preventive measures in the country.