We assessed the effect of an early transfer of pronator teres to extensor carpi radialis brevis on hand function in patients with high radial nerve paralysis. Power grip and precision grip were measured preoperatively and postoperatively using a dynamometer. Fifteen patients were operated on, of which ten could be assessed at the end of 6 months. At 6 months after surgery, there was a median increase of 48% in power grip, 162% in tip pinch, 90% in key pinch and 98% in palmar pinch. Decreased palmar flexion was seen in four patients. Fraying of the periosteal extension and rupture of sutures at the junction site were each seen in one patient, leading to unsatisfactory results. Early tendon transfer quickly restored efficient grip while awaiting reinnervation of wrist extensors, avoiding the need for prolonged external splintage.
An anterior tibial artery pseudoaneurysm is a rare and unexpected complication of Steinmann pin insertion. We describe the case of an 18-year-old boy, who sustained such an injury to the anterior tibial artery during this procedure. Diagnosis was confirmed on a magnetic resonance (MR) angiogram. Aneurysmal sac excision with lateral repair of the vessel wall was performed. Postoperatively, a good flow was documented on a follow-up MR angiogram. This case highlights a major and unexpected complication of a so-called minor procedure. Too posterior a pin placement in the proximal tibia should be avoided to prevent such injuries.
Aim: To assess the physical and mechanical properties of plaster of Paris (POP) bandage cast used as a splinting and casting materials.Materials and Methods: POP casts were divided into three Groups A, B and C with 2, 3 and 8 layer for POP bandage, respectively (n=6 in each group). Handling characters, technical easiness or difficulties, setting time, weight, diameter and thickness of the casts were recorded for different groups. The casts were mounted on universal testing machine and axial load was applied @ 10 mm/min until failure. The load deflection graphs were plotted. The maximum force at which failure of the casts occurred was recorded. Stress, strain, modulus of elasticity (MOE) and stiffness of casts were calculated.Result: Construction of POP bandage cast was messy and required 45-60 min for hardening. 8 layer POP cast was comparatively heavier in weight and thicker in cross section than 3 layer cast followed by 2 layer cast. Under axial compression, the load bearing capacity of 8 layer POP casts was more than 2 and 3 layer cast.
Conclusion:The values of load bearing capacity, stress, stiffness and MOE of cast were the highest for 8 layer POP cast followed by 2 and 3 layer cast. Use if splints with POP cast is recommended due to its poor mechanical properties.
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