Moving car-tire injury of the foot is a condition that appears to be a new clinical entity in Istanbul, in which the non-weight-bearing surface of the foot is prone to be injured. Between 1992 and 1995, eight moving car-tire injuries of the foot were managed. Patient age averaged 10.25 years (range: 7 to 21 years). All patients presented with soft-tissue loss combined with extensor tendon and bone lesions. In 6 patients, immediate flap coverage after initial debridement and, in 2 patients, delayed coverage after multiple debridements, were performed. All the flaps survived. Although in all patients, the weight-bearing region was always intact, some had gait-pattern abnormalities due to the bone and soft-tissue injuries. Early removal of all devitalized tissues and closure of the wounds with transfer of healthy tissue have a higher rate of success, lower incidence of infection, require fewer operative procedures, and shorter hospitalizations.
In the Istanbul Hand Surgery and Microsurgery Centre, between 1991-1996, 28 out of 54 patients who had clean-cut median nerve laceration at the wrist level were evaluated in a detailed manner regarding the improvement of sensibility following primary repair. Semmes-Weinstein monofilament and vibration tests form the group of threshold tests, and static and dynamic two-point discrimination tests and the Moberg pick-up test form the group of functional tests which were applied to the patients. Follow-up was from 1 to 5 years. Moreover, subjective findings such as cold intolerance, pain, and paraesthesia were also evaluated. All the results obtained were evaluated in relation to the SO-S4 sensibility improvement criterion which Waylett-Rendall recommended. The following results were obtained: S4 in 35.7% of the patients, S3+ in 28.5%, S3 in 14.2%, S2+ in 7.14%, S2 in 10.7%, and S1 in 3.5%. In our opinion the most important reason for the high rate of success was the fact that we worked with a highly selective group of patients and the fact that there was a high rate of young patients in this group (21.4% of them were under the age of 15). It was observed that there was a significant correlation between age and functional sensibility improvement (P = 0.04). Moreover, when we observed the relation between age and Semmes-Weinstein monofilament, static two-point discrimination, and dynamic two-point discrimination tests, it was seen that age had a significant correlation with each of the parameters (r = 0.61, P = 0.001; r = 0.58, P = 0.002; r = 0.57, P = 0.002). There was a clear decline in the intensity of the paraesthesia in S3+ and S4 group (X2 = 4.7, P = 0.02) and in these groups the period of Moberg pick-up test was meaningfully short (P < 0.05).
We reviewed seven thumbs in six children at a mean of 43 months after repair of the flexor pollicis longus tendon in zone 2. Using the classification of Buck-Gramcko et al. (1976) the results were excellent in six and good in one.
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