Open traumatic scapulothoracic dissociation is a rare and devastating injury. We are reporting a 21-year-old male factory worker who sustained a traumatic open scapulothoracic dissociation. His left arm was caught in conveyer belts resulting the arm, scapula, clavicle, and pectoral muscle torn from the body by tremendous traction force. He presented with pulseless, flail and cold limb and was promptly resuscitated and surgically managed with forequarter amputation.

Introduction?Carpal tunnel syndrome (CTS) is one of the most common compression neuropathies in the upper limbs and requires surgery if conservative treatment fails. This study assessed the functional outcome of vertical mini carpal tunnel release (CTR) at distal wrist crease. Objective?To evaluate prospectively the safety, effectiveness, and reproducibility of vertical mini-open blind technique for CTR. Methods?In total, 36 patients (40 hands) aged between 22 and 71 years with mild to moderate CTS based on nerve conduction studies were selected and screened based on inclusion and exclusion criteria. The surgery was done with vertical mini-incision CTR at distal wrist crease. The preoperative and postoperative clinical outcomes and grip strength were evaluated with Levine?Katz questionnaire and JAMAR Hydraulic Hand Dynamometer with 3 months follow-up after surgery. Results?The mean score for both symptom severity and functional status reduced and mean handgrip strength improved 29.5% at 3 months after surgery. All the patients were satisfied with the cosmetic outcome of the scar. Three patients had scar tenderness. All patients were able to return to work within 4 weeks after surgery, except one who developed chronic regional pain syndrome. Conclusion?The vertical mini-open blind technique has been shown to be safe and easily reproducible and has short recovery period. All patients return to good functional status 3 months postoperative.

In this study, we retrospectively reviewed our results of managing the clasped thumb deformity in arthrogryposis multiplex congenita patients with first web space deepening and abductor pollicis brevis (APB) rerouting. Twenty-six thumb deformities in 16 children with a mean age of 6.2 years were treated with a mean follow-up of 89.6 months. Following reconstruction with the Spinner flap, the mean angle of the first and second metacarpal axis (M1M2) showed significant improvement from 42° to 61° indicating a wider first web space, and the postoperative mean angle of the thumb proximal phalanx to its metacarpal axis (M1P1) was reduced from 41° to 18°, indicative of a straighter thumb. Following reconstruction with a double-opposing Z-plasty, the mean M1M2 and M1P1 also improved from 38° to 52° and 18° to 9°, respectively. Rerouting of the APB with first web deepening is an efficient and reproducible procedure in improving thumb position. Level of evidence III

Background: The rapidly aging population in Malaysia is no more a surprise especially due to the sudden increasing rate of infertility and greater life expectancy creating an impact on the overall mortality percentage. Nearly half or 40% of healthcare expenses are expected to yield from the growing number of elderly people. Purpose: Theory of Planned Behavior (TPB) which analyses the behavioral intention, is incorporated into this study on the use of IoT among elderly NCD-patients. According to TPB particular “cognitive-emotional” and “attitudinal” factors determine the behavioral intention of consumer or user. It is assumed that intention is required for a particular behavior in any context. This study also intend to explain the intention of elderly NCD-patients in Malaysia, while promoting a healthy lifestyle. Design/methodology/approach: The conceptual framework developed in this study will evaluate the current attitude of elderly patients in incorporating IoT-technology, societal and environmental factors influencing them to adopt IoT-technology, along with the constraints – leading the intension/behavior among the population. This, in turn, is expected to render developing efficient communication to all the stakeholders in increasing awareness among the targeted elderly NCD patients. Findings: The outcomes of this study are expected to produce meaningful insights for regulators, healthcare institutions and IT technology enterprises to collaborate in designing meaningful campaigns disseminating true benefits of IoT devices, by aiming to change the attitudes of elderly patients, improve their confidence Research limitations: The study was undertaken in a single country (Malaysia), which is a constraint on generalizability. This study only applied a quantitative method Originality/value: Analyzing the relational impacts of the constructs in the framework for this study will ultimately enhance the intention of IoT technology’s use among elderly patients in Malaysia.