Background and objectives: Dupuytren’s contracture is a chronic fibroproliferative hand disorder with a varying pattern of genetic predisposition across different regions and populations. Traumatic events have been found to have influence on the development of this illness and are likely to trigger different clinical forms of this disease. The aim of this study was to evaluate the phenomenon of development of Dupuytren’s contracture (DC) following an acute injury to the hand, and to observe the incidence and clinical diversity of such cases in daily clinical practice. Materials and Methods: We collected data of patients presenting with primary Dupuytren’s contracture in the Lithuanian population and evaluated the occurrence and clinical manifestation of this specific type of DC, arising following acute hand trauma. The diagnosis of DC was based on clinical signs and physical examination. Digit contractures were measured by goniometry, and the staging was done according to Tubiana classification. Injury-induced (injury-related) cases were identified using the “Criteria for recognition of Dupuytren’s contracture after acute injury” (established by Elliot and Ragoowansi). Results: 29 (22%) of a total of 132 cases were injury-induced DCs. Twenty-six of 29 patients in this group presented with stage I–II contractures. Duration of symptoms was 6 (SD 2.2) and 3.8 (SD 2.2) years in the injury-related and injury-unrelated DC groups, respectively. Mean age on the onset of symptoms in the injury-induced and non-injury-induced groups was 52 (SD 10.7) and 56 (SD 10.9), respectively. Patients from both groups expressed strong predisposition towards development of DC. Conclusions: Around one-fifth of patients seeking treatment for primary Dupuytren’s contracture seemed to suffer from injury-induced Dupuytren’s contracture. We noted that injury to the wrist and hand seems to trigger the development of less progressive Dupuytren’s contracture in younger age. Prospective randomized studies are required to confirm our findings.

Objective. The aim of this study to investigate the associations of fracture type, age, and gender with hand function after distal radius fractures treated with a volar locking plate at a 6-month follow-up. Material and Methods. A total of 120 patients with displaced distal radius fractures were included into the study. They were operated on using a volar locking plate system. All the fractures were classified according to the AO classification, and the patients were divided into 3 groups by the fracture type. The range of motion and grip strength were evaluated at the 6-month follow-up. Multivariate linear regression analysis was used to evaluate the associations of age, gender, and fracture type with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire was completed as an outcome measure. Results. A total of 28 patients experienced type A fractures; 70 patients, type B fractures; and 22 patients, type C fractures. No statistically significant difference regarding age and sex among the groups was observed. At 6 months after the surgery, the mean DASH score for type A, B, and C fractures was 16, 13, and 32, respectively (P=0.01). After the surgery, the radiographic parameters such as the volar tilt and the ulnar variance were significantly worse in the patients with type C fractures. Grip strength and the range of motion of the contralateral healthy hand at the 6-month follow-up were significantly better than those of the operated hand. The linear regression analysis showed that the type C fracture was the only factor significantly associated with lower DASH score. Conclusions. The patients with type C fractures treated with a volar locking plate had a worse wrist function as compared with the patients type A and B fractures at the 6-month follow-up. The postoperative hand function was significantly associated only with the type C fracture, while age and gender had no significant impact.

No abstract

The early healing of recipient wounds after STSG transplantation with grafts of various thickness differed considerably, especially regarding wound epithelialisation and pain.

Darbo uždavinys. Išmatuoti pirštų lenkimo amplitudėspokyčius goniometru, taikant ankstyvą aktyviąreabilitaciją.Tyrimo metodika. Atliktas prospektyvinis tyrimas, įkurį įtraukti 18 Lietuvos sveikatos mokslų universitetoligoninės Kauno klinikų pacientų su izoliuotomisplaštakos lenkiamųjų sausgyslių traumomis, gydytųnuo 2017 metų rugsėjo iki 2018 metų gegužės mėnesio.Pacientams, iš kurių 13 vyrų (72,2 proc.), 5moterys (27,8 proc.), buvo taikyta ankstyva aktyvireabilitacija. Tiriamųjų amžiaus mediana 48,5 (20– 68) metų. Gauti rezultatai lyginti neparametriniuVilkoksono (Wilcoxon) kriterijumi, statistiškai reikšminguskirtumu laikėme p < 0,05. Apžvelgę tarptautinėsliteratūros rekomendacijas, sudarėme operacinįprotokolą, kuriuo rėmėmės tyrimo metu.Rezultatai. Įvertinus pirštų judesių amplitudę goniometrupo 2 ir po 4 savaičių gauti rezultatai atitinkamai:mediana 85 (65 – 90) laipsniai ir mediana 110(85 – 120) laipsnių. Gautas statistiškai reikšmingasskirtumas p < 0,001.Išvada. Ankstyva aktyvi „Saint John“ reabilitacijayra naujas ir efektyvus metodas pacientams po izoliuotųplaštakų lenkiamųjų sausgyslių sužalojimų,jeigu užtikrinaname tinkamą sausgyslės susiuvimąir pooperacinę priežiūrą.