ali ajvadi

Post-operative rehabilitation for patients with flexor tendon injuries is necessary for a full recovery. Thisrandomized controlled trial study investigates the effectiveness of a text message-based rehabilitation program (i.e.,TextRehab) on the improvement rate of hand rehabilitation in patients with flexor tendon injuries after repair. This study is designed as a randomized, three-month, single-center, two-arm, parallel controlled trial. A totalof 40 patients will be randomly classified as either the control or intervention group. Both groups receive usual care;however, the intervention group is also asked to perform the designed rehabilitation activities through the TextRehabprogram. The activity instructions are sent to patients step by step at least once a day. Self-reported outcomes will beassessed at 6 and 12 weeks after discharge and include self-reported Patient Rated Wrist Evaluation, self-reportedQuick-Disability of Arm, Shoulder, and Hand, and Visual Analogue Scale. Moreover, the reports of the physicianregarding the grip strength and Total Active Motion will be assessed at week 12. The development of the message scheduling system and its contents is completed. This trial has the code ofethics in research (removed due to blinding issues). Study results are expected to be available in mid-2021. The TextRehab program is developed to provide advice, motivation, information, and care for patientswith hand flexor tendon injuries after repair. This trial provides evidence of the effectiveness of sending text messageson persuading patients to perform home-based rehabilitation activities.Level of evidence: Not applicable

The value of external fixation in complex hand injuries is well established. Expenses and technical difficulties of commercial mini external fixator sets have led to the innovation of handmade external fixators. These fixators are used as versatile facilities to treat certain hand fractures. Usually, these structures are made by k-wires crossed filled with cement plastic tube. However, these fixators have multiple deficiencies that should be addressed.
In this study, we described in detail the surgical technique of a handmade concrete like mini external fixator and report its clinical use and results.
Our handmade external fixator was applied for 52 patients with 56 fractures. Only 5% of the fractures were closed, non-comminuted extra-articular, and the other 51 fractures were more complex injuries. The mean follow up time was 9.3 months. At the end of the follow up, radiologic and functional assessment (DASH: Disability of arm, shoulder and hand and TAM: Total active motion) was evaluated.
All 56 fractures were united completely. None of the cases experienced pin loosening or reduction loss. Of the fractures, 8.9% malunited due to fracture complexity. The mean dash score was 3.76. TAM was excellent in 45% of the fractures; it was good in 7% and fair in 4%.
This type of handmade external fixator is simple, lightweight, and cheap. Furthermore, all implements are readily available in most operating fields. The probability of loosening has been greatly diminished because of the concrete like structure. Easy and fast assembly and good clinical and functional results are the other advantages of this technique. Due to the less complication and benefits, this technique could be used for many phalangeal and metacarpal fractures with confidence.

The relationship between negative ulnar variance and Kienböck’s disease is unknown and does not justify all of the cases. The present study planed the hypothesis that maybe the pressure from distal structures to the lunate bone plays a role in the etiology.
The current study aimed to investigate the possibility of a relationship between an increased length of the third metacarpal and the capitate with Kienböck’s disease .
The study compared the wrist posteroanterior (PA) X-ray images of 105 healthy individuals with those of 91 patients with Kienböck’s disease . Meticulous measurement criteria were defined in the present study to measure the third metacarpal and the capitate lengths. These lengths along with ulnar variance were measured on each X-ray. The Lichtman classification was used for staging. A new index, named capitate-index, was defined due to the linear relationship between the capitate and the third metacarpal lengths.
Comparing the two groups, no meaningful difference was observed between the capitate and third metacarpal bone lengths in patients and the control group. Also, there was no significant difference in the capitate-index (capitate length/3rd metacarpal length) between the groups. Furthermore, no differences were observed comparing the patients with ulnar variance ≧ 0 and patients with ulnar variance Based on the above-mentioned findings, the existence of a relationship between the third metacarpal and the capitate lengths and the Kienböck’s disease is unlikely.

Hand surgery literature is full of disease names and terms. Some of them are misnomers, which are misleading to physicians outside the specialty. Therefore, we decided to collect all misnomers and provide them via this paper. Considering development of sciences in future, perhaps avoidance from new misnomers is impossible, but awareness of this fact, lead us to be more ingenious in interpretation. On the other hand, we believe this collection would be interesting for most specialists in hand surgery and as well informative for others.

Background and Osteoid Osteoma is a benign tumor often involving long bones of lower limb and diaphysis. This article is a case report of osteoid osteoma of the right distal metaphysis of radius.The Patient: A 26-year male computer operator referred with the chief complaint of pain in the right wrist from three years ago manifested as a small bone tumor in the distal radius. The pain was intermittent tending to become more severe at night with only ibuprofen (tablet) being effective on his pain. MRI and X-ray images taken from the wrist signified osteoid osteoma. Finally the tumor was removed under general anesthesia and biopsy confirmed the osteoid osteoma too. One of the causes of chronic wrist pain can be osteoid osteoma and should be differentiated from Carpal tunnel syndrome osteomyelitis rheumatoid arthritis and lymphoproliferative Synovitis.