Fingers In Children Research Articles

Multiple congenital bilateral trigger fingers in a 2-year-old child: A case report

BackgroundCongenital trigger finger is a rare pediatric condition characterized by a finger fixed in a flexed position due to tendon anomalies. This rare condition involves multiple trigger fingers in children and is not extensively covered in the medical literature. MethodsWe examined a 2-year-old boy with multiple trigger fingers present since birth. Surgical release of the A1 pulleys was performed. ResultsSurgery resulted in normal finger function at the one-year follow-up. ConclusionsAlthough rare, congenital trigger finger is treatable in children. Adaptive and timely interventions can significantly improve outcomes and reduce disability. This case highlights the importance of early and effective treatment strategies.

Long-Term Clinical Outcomes Following Nonsurgical Management of Salter-Harris Type II Fractures of the Proximal Phalanx of the Small Finger: A Prospective Cohort Study

Juxta-physeal fractures at the base of the proximal phalanx (FBPP) of the small finger are one of the most common hand fractures in children. Although many of these fractures are treated nonsurgically, it is unclear which fractures benefit from surgery or the degree of acceptable angulation appropriate for nonsurgical management. Our study aimed to assess long-term, patient-reported outcomes regarding function, appearance, and pain after nonsurgical management of FBPP of the small finger in a pediatric population. Our hospital Picture Archiving and Communication Systems database was queried to identify radiographs of the small finger of children between the ages of 8 and 16 years old taken from 2011 to 2021. Displacement on initial injury radiographs was calculated using the diaphyseal-metacarpal head angle. Patient-reported function, appearance, and pain were measured using standardized assessment tools sent to patients and parents electronically. Optional clinical photographs were uploaded by parents and assessed for residual clinical deformity. One hundred eighty-one eligible subjects were identified. Eighty (44%) agreed to participate, and 40 (22%) parent and 38 patient surveys were completed. The mean age at the time of injury was 11 years old (8-14 years), and the mean age at the time of survey completion was 17 years old (11-23 years). Patient T-scores were higher than the average reference T-score on the Patient-Reported Outcomes Measurement Information System Short Form v2.0-Upper Extremity. Overall, greater than 78% of patients and parents reported appearance as 8/10 or above on a VAS. Ninety-five percent (108/114) of patients reported no pain (0/10) for pain during activities and at rest. Children with up to 26° of initial coronal plane angulation reported better function than a reference population, good appearance, and no pain, at a mean of 6 years after injury. Our findings support nonsurgical management of most FBPP of the small finger in children. Therapeutic IV.

Retrospective study of Ishiguro's technique for mallet bone finger in children: long-term follow-up and analysis of predictors in outcomes.

There is no consensus on the optimal treatment of bony mallet finger in the paediatric population due to a lack of studies in children. The Ishiguro technique is simple and less invasive, and treatment with K-wire fixation seems to provide better results for extension lag in bony mallet finger according to the literature. A retrospective cross-sectional study with long-term follow-up was performed to evaluate the functional and clinical outcomes of this method in children. Preoperative and intraoperative predictors of outcome were investigated. From June to December 2022, we evaluated 95 children who underwent extension K-wire block from 2002 to 2012. Eighty-four children were included (mean age 14.8 ± 1.68years) for a mean long-term follow-up of 11.6 ± 2.3 (8-16) years. Clinical and radiographic features were assessed. Pain and functional outcomes were assessed using Crawford criteria, range of motion (ROM) at the distal interphalangeal joint (DIPJ), loss of extension, and VAS scale. Univariate and multivariate regressions were used to assess which variables might predict the worst outcomes at long-term follow-up. Bone union and pain relief were always achieved. There were no complaints of potential growth impairment or nail deformity. 82.1% of patients showed excellent and good results. Fifteen patients had fair results. Although there are currently no significant differences between surgery and orthosis in adults, the Ishiguro technique is more effective in children when it comes to outcomes in the treatment of mallet fingers. A high percentage of excellent and good results were achieved, and no epiphyseal damage or nail deformity was reported. A strong and significant correlation was found between the worst outcomes and either delayed treatment time or excessive flexion angle.

Test-retest reliability of corticokinematic coherence in young children with cerebral palsy: An observational longitudinal study

ObjectivesTo assess the test-retest reliability of the corticokinematic coherence (CKC), an electrophysiological marker of proprioception, in children with cerebral palsy (CP). MethodsElectroencephalography (EEG) signals from 15 children with unilateral or bilateral CP aged 23 to 53 months were recorded in two sessions 3 months apart using 128-channel EEG caps. During each session, children's fingers were moved at 2 Hz by an experimenter, in separate recordings for the more-affected (MA) and less-affected (LA) hands. The CKC was computed at the electrode and source levels, at movement frequency F0 (2 Hz) and its first harmonic F1 (4 Hz). A two-way mixed-effects model intraclass-correlation coefficient (ICC) was computed for the maximum CKC strength across electrodes at F0 and F1 obtained during the two sessions. ResultsICC of the CKC strength acquired from LA and MA hands pooled together were respectively 0.51 (95% CI: 0.30–0.68) at F0 and 0.96 (95% CI: 0.93–0.98) at F1. The mean distances separating the CKC peaks in the source space at the two evaluation times were in the order of a centimeter. ConclusionCKC is a robust electrophysiologic marker to study the longitudinal changes in cortical processing of proprioceptive afferences in young children with CP.

One-stage reconstruction of four fingers in children using microsurgical autotransplantation of foot tissue complexes

BACKGROUND: Toe-to-hand transfer is still the most promising and relevant method for restoring fingers that are missing from birth or after injury. In cases requiring the restoration of two or more digits, simultaneous transplantation of tissue complexes from both feet, including one or two toes, is possible and necessary. Thus, a maximum of four fingers can be restored during one operation. Such operations, according to the literature, are performed extremely rarely because they are very extensive and time-consuming.
 AIM: To present the results of simultaneous microsurgical autotransplantation of four toes to the hand in children with congenital and acquired pathologies.
 MATERIALS AND METHODS: The study used clinical, radiological, and biomechanical methods to assess the results of nine patients with congenital and acquired upper limb deformities who underwent simultaneous microsurgical autotransplantation of two tissue complexes from each foot, including toes II–III. The indications for performing this method of microsurgical reconstruction in children with the absence of four (or all five) fingers have been determined. The results, postoperative complications, and conditions of the donor and recipient zones were analyzed.
 RESULTS: To date, 914 such operations have been performed in children. In nine cases, four toes were simultaneously transplanted (two from each foot). The average age of the patients was 4.2 years. Two children had congenital malformations of the hand, and seven had consequences of trauma. In eight cases, fingers II–V were restored, and in one case, fingers I–IV were restored. Complications associated with impaired blood circulation in the grafts were observed in 22% of the cases; however, they were temporary. All transplanted grafts survived. All patients required continued surgical treatment after the toe transfer to improve their appearance and function. Biomechanical examination methods showed complete restoration of function on average of 4 months (±1 month) after surgery.
 CONCLUSIONS: This study showed the possibility and effectiveness of using toes for hand transfer in children with both congenital and acquired hand pathologies that require the restoration of four fingers. Simultaneous microsurgical transplantation of toes ensures the restoration of a good appearance of the hand and its functionality.

MENINGKATKAN MOTORIK HALUS ANAK MELALUI KEGIATAN MENJAHIT POLA PADA KELOMPOK A DI TKIT BINA PRESTASI

The progress of fine motor skills of children aged 4-5 years at TKIT Bina Prestasi has not resulted in the expected development of most in one class for the flexibility of children's fingers. Through sewing patterns of varying complexity and simplicity, it is possible for researchers to use them on the fine motor skills being learned. Because the lack of stimulating children's balance between fine motor skills such as tracing and various other activities such as tracing, drawing, cutting and pasting as well as hand-eye coordination in art learning activities makes their fingers flexible. So that these children's fine motor skills will prepare them better for independent tasks. This research was conducted in group A, where the task of the researcher worked according to the conditions faced by the class. This is shown by the fact that the majority of 5 out of 8 children have a stiff tendency when holding skills or objects with both hands. The methods used and research procedures include planning, implementing, observing, and reflecting. Data collection was carried out through observation and documentation, and percentage techniques were used to process the data. There are five meetings in each of the two research cycles. Through sewing activities, this study aims to improve children's fine motor skills. The results of the research cycle I while far from the standard of sewing mastery that has been determined then need to be adjusted. On the criteria for sewing mastery, children's fine motor skills increased in cycle II. Based on research, it shows that activities such as sewing patterns can support children in developing their fine motor skills

Feasibility and Diagnostic Value of Recording Smartwatch Electrocardiograms in Neonates and Children.

The objective of this study was to evaluate the agreement of smartwatch-derived single-lead electrocardiogram (ECG) recordings with 12-lead ECGs for diagnosing electrocardiographic abnormalities. A 12-lead ECG and an ECG using Apple Watch were obtained in 110 children (aged 1week to 16years) with normal (n=75) or abnormal (n=35) 12-lead ECGs (atrioventricular block [7], supraventricular tachycardia [SVT] {5}, bundle branch block [12], ventricular preexcitation [6], long QT [5]). In children aged <6years, the ECG recording was performed with the active participation of an adult who applied the neonate or child's finger to the crown of the watch. In older children, tracings were obtained after brief teaching without adult guidance. All 12-lead ECGs were independently evaluated by 2 blinded cardiologists. Apple Watch ECGs were independently evaluated by another blinded cardiologist. In 109 children (99.1%), the smartwatch tracing was of sufficient quality for evaluation. Smartwatch tracings were 84% sensitive and 100% specific for the detection of an abnormal ECG. All 75 normal tracings were correctly identified. Of the 35 children with abnormalities on 12-lead ECGs, 5 (14%) were missed, most often because of baseline wander and artifacts. Rhythm disorders (atrioventricular block or SVT) and bundle branch blocks were correctly detected in most cases (11 of 12 and 11 of 12, respectively); preexcitation and long QT was detected in 4 of 6 and 4 of 5, respectively. Smartwatch ECGs recorded with parental assistance in children aged up to 6years and independently in older children have the potential to detect clinically relevant conditions.

PENERAPAN KEGIATAN KOLASE SETELAH MENJIPLAK DI ATAS SKETSA BERGAMBAR UNTUK MENINGKATKAN ASPEK PERKEMBANGAN MOTORIK HALUS ANAK USIA 4-5 TAHUN DI TK AISYIYAH BUSTANUL ATHFAL II PERUMNAS

The importance of increasing fine motor development in early childhood so that children carry out motor movements and activate their eyes with interesting and unique activities. Fine motor development in children, especially tracing by pasting grains on the child's tracing results. This study aims to determine the extent to which aspects of children's motor development are improved by tracing activities and then the results of the child's tracings are attached with green beans and peanuts at the age of 4-5 years. This community service research in the form of service learning was conducted at Aisyiyah Bustanul Athfal II Kindergarten with a total of 5 children. The instruments used are animal sketches, observation sheets for children and evaluation of the implementation of the intervention. Data were analyzed using descriptive statistics. The results showed that children were able to trace through pictorial sketches, then green seeds and peanuts were attached to the tracing results. The findings in this study imply that by applying the collage activity after tracing, it can train children's fingers to choose the seeds to be pasted on top of the tracing.&#x0D;

Retrospective analysis of longitudinal melanonychia: A Chinese experience.

We aimed to analyze the clinical and histopathologic characteristics of longitudinal melanonychia (LM), explore the differences between adults and children, and propose some recommendations. Data on pigmentation, lentigo, subungual melanoma (SUM), and nail matrix nevus (NMN) were acquired for comparison. Lesions on thumbs in the children's group were significantly fewer (p = 0.006) than in adults. Lesions on little fingers in children were more than in adults; the difference was statistically significant (p = 0.025). The widths of bands in adults were wider than in children (p < 0.001), and the duration and width were positively correlated (r = 0.474). There was more pigmentation in adults than in children; the difference was statistically significant (p = 0.005). NMN was reported in 56.1% children and 34.3% adults; the difference was statistically significant (p = 0.005). Adults had six SUM cases, whereas none in children; the difference was statistically significant (p = 0.006). The recurrence rate in adults was significantly higher than in children (p = 0.019). The widths of bands increase with the course, indicating that LM may be progressive. The four pathological types have different distributions with age, and each type requires different treatment. The lower recurrence rate in children suggests that LM needs diagnosis and appropriate treatment as soon as possible.

Retracted: Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children.

[This retracts the article DOI: 10.1155/2022/9631858.].

Bilobed Flap for Post-Traumatic Angular Deformity Correction of the Fingers in Children

Bilobed Flap for Post-Traumatic Angular Deformity Correction of the Fingers in Children

Tactile Perception of the Hand in Children With an Upper Neonatal Brachial Plexus Palsy

ObjectiveTo investigate factors that cause impairment of hand function in children with an upper Neonatal Brachial Plexus Palsy (NBPP), we performed an in-depth analysis of tactile hand sensibility, especially the ability to correctly localize a sensory stimulus on their fingers. DesignA cross-sectional investigation of children with NBPP, compared with healthy controls. The thickest Semmes-Weinstein (SW) monofilament was pressed on the radial or ulnar part of each fingertip (10 regions), while a screen prevented seeing the hand. SettingTertiary referral center for nerve lesions in an academic hospital in The Netherlands. The control group was recruited at their school. ParticipantsForty-one children with NBPP (mean age 10.0 y) and 25 controls (mean age 9.5 y; N=41). InterventionsNot applicable. Main Outcomes MeasuresCorrect localization of the applied stimuli was evaluated, per region, per finger, and per dermatome with a test score. The affected side of the NBPP group was compared with the non-dominant hand of the controls. ResultsThe ability to localize stimuli on the tips of the fingers in children with an upper NBPP was significantly diminished in all fingers, except for the little finger, as compared with healthy controls. Mean localization scores were 6.6 (thumb) and 6.3 (index finger) in the NBPP group and 7.6 in both fingers for controls (maximum score possible is 8.0). Localization scores were significant lower in regions attributed to dermatomes C6 (P<.001) and C7 (P=.001), but not to C8 (P=.115). ConclusionChildren with an upper NBPP showed a diminished and incorrect ability to localize sensory stimuli to their fingers. This finding is likely 1 of the factors underlying the impairment of hand function and should be addressed with sensory focused therapy.

Treatment of fractures of the main phalanx of the fingers in children

BACKGROUND: Fractures of the bones of the hand and wrist account for 25% of all fractures in children, whereas the phalanges are the most common localization of these injuries and account for 15%30% of all fractures of the upper limb. To fix fractures of the neck of the middle and main phalanx of the fingers, traumatologists resort to retrograde osteosynthesis with a spoke, which in all cases passes through the articular surface of the distal fragment, thereby blocking the joint adjacent to the fracture. This significantly complicated postoperative rehabilitation to restore movements.&#x0D; AIM: This study aimed to comparatively analyze the results of extra-articular osteosynthesis of fractures of the distal metaphysis of the main phalanx of childrens fingers.&#x0D; MATERIALS AND METHODS: A prospective cohort study included 52 children with fractures of the main phalanx of the fingers. The study cohort of children was divided into two groups. The main group included 29 children who underwent osteosynthesis of the distal fragment of the phalanx with spokes according to the authors method without passing them through the distal or proximal interphalangeal joint. The comparison group included 23 children who, during osteosynthesis, had spokes carried out retrogradely, through the articular surface of the distal phalanx fragment. The total volume of the restored active movements in the proximal interphalangeal joint was compared after 3, 6, and 12 weeks from the moment of surgery, including local signs of inflammation in the needle insertion site after 3 and 7 days from the moment of surgery.&#x0D; RESULTS: In the main group, signs of inflammation were found only in 10% of the cases, whereas in the comparison group, more serious signs were observed, such as the release of exudate along the spokes in two cases on day 3. The average values of the amplitude of movements at week 3 in the main group are more than two times higher than the average values of the comparison group, 12.06 and 5.56, respectively. The volume of movements in the main group was restored more than two times more efficiently, and in several patients, by week 12, it was restored to 100 of the total volume of active movements in the joint (p 0.05).&#x0D; CONCLUSIONS: The authors method of extra-articular and antegrade osteosynthesis of the fractures of the neck of the main phalanges in children made it possible to achieve better functional results in comparison with the standard method.

Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children.

Objective After replantation of severed fingers in infants, the utility model patent upper limb restrictive brace-assisted bed rest braking, combined with psychological intervention, can alleviate children's anxiety, so as to reduce the occurrence of vascular crisis. Methods The study period was from April 2015 to July 2018. In this paper, 30 children with finger injuries in hand surgery in the CIS electronic medical record system of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects. Replantation was performed in 30 infants with severed fingers. Among them, 15 cases were applied with the method of aircraft chest arm gypsum splint combined with sedative drug braking and the utility model patented product upper limb restrictive brace fixation-assisted bed rest braking, and the method of psychological intervention was applied at the same time. Results Among the 15 fingers in the control group, 6 had vascular crisis and 1 in the experimental group. The incidence of vascular crisis in the experimental group was lower, and the difference between the two groups was statistically significant (P < 0.05). The patients were followed up for 9~18 months, with an average of 9.72 ± 1.07 months. In the control group, 15 cases of severed fingers survived, and there were 13 cases of replantation finger necrosis in 2 cases of intractable arterial crisis. In the experimental group, 14 cases of severed fingers survived in 15 cases and there was 1 case of replanted finger necrosis in intractable arterial crisis after operation. There was no significant difference in the survival rate between the two groups (P > 0.05). In addition, the replanted finger function was evaluated. In the control group, 9 cases were excellent, 4 cases were good, and 1 case was fair. In the experimental group, 14 cases were excellent, 1 case was good, and 0 case was fair. The functional evaluation of the experimental group was better than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). Conclusion For infants after replantation of severed fingers, the application of the utility model patented product upper limb restrictive brace can effectively make up for the insufficient fixation of aircraft chest arm gypsum splint, reduce the occurrence of vascular crisis, and assist children in bed. In addition, the application of psychological intervention can reduce children's postoperative crying and is conducive to children's postoperative recovery.

LANGUAGE FORMS INDICATING THE DANI CULTURE AS DESCRIBED IN THE NOVEL SALI, KISAH SEORANG WANITA SUKU DANI

There have been several studies discussing the novel Sali: The Story of a Dani Woman. These studies generally use sociological literature, feminist literary criticism, and gender perspectives. This paper comes with a different perspective, namely the ethnolinguistic approach. This paper describes the linguistic forms in the novel that represent the Dani culture and reveals the cultural meaning of the linguistic forms in the novel. The linguistic data is taken entirely from the novel and the meanings obtain apart from the novel are also from other sources as listed in the references. The results of data analysis show that linguistic forms indicating the Dani culture include the level of words, phrases, clauses, or sentences. Furthermore, the cultural meaning of language forms in terms of words indicating Dani culture, namely: (1) Abambuk which means tribal chief, Dani tribal leader. (2) Pig which means a dowry given to a girl or a widow to marry. (3) Hunting which means the dominant male activity to show his self-esteem. (4) Ebeai which means a house that a wife/woman, children and husband/men may enter to gather. (5) Fugima which means a place to end life/everything for a woman/wife who has given up on her fate. 6) Honai which means a traditional house located in silimo. (7) Koteka which means penis genital cover has many meanings. The variation indicates that the more varied the koteka, the higher the class of men who wear it. (8) Noken which means a replacement for the ballot box which means a form of appreciation for the cultural values and local wisdom of the Dani community. (9) Pilamo which means a place to limit women's movement. This was a house that only men could enter to ensure that they and the war equipment were free from the dirty blood of women. (10) Sali which means wife indexer. (11) Silimo which means a family residence consisting of honai, ebeai, and pilamo, the three of which are far from each other in a certain area. Furthermore, the linguistic forms in the form of phrases are (1) Chewing greedily which means eating food in an unethique way. (2) Tribal war which means the implementation of a war caused by a member of the Dani community was being killed. (3) Polygamous marriage which means the family of the prospective wife. (4) Cutting a child's finger which means a meaningful representation of emotional pain which is important for the process of grieving the death of the child's parents. It is a symbol of grief at the loss of a family member. (5) The cry of mourning which means that family members have to cry for a long time as hard as possible to mark the mourning of being left dead by a member of a communal system 6) Cremation, or the burning of a corpse which means an attempt to take the white ashes of the corpse. (7) Relative-exchange marriage which means marry to the wife's sister in order to get a replacement from the pig keeper, the caretaker of his children and himself. Finally, the forms of clauses/sentences indicating Dani culture are: (1) Keeping the younger sister away from her twin means avoiding bad things. The younger sister in the twins is believed to be the daughter of the devil, so she must be exiled, otherwise a disaster will come that will harm the family. (2) Leaving sali on the rocks in Fugima which means the owner has died as a form of surrendering to the problems of life that surrounds her so that in a very tragic way her life is ended.

Growing into your hand: the developmental trajectory of the body model.

We rely on accurate body representations to successfully interact with the environment. As adults, we rely on many years of experience with a body that has stayed relatively the same size. Children, however, go through periods of rapid growth and whether or not their body representation matches this physical growth is unknown. To address this question, we examined the developmental trajectory of the body model of the hand. The body model is the representation of our bodies that underlies position sense. We recruited a group of children (8-16years) and a control group of young adults (18-26years) and asked them to complete the body model task. In this task, participants estimated the location of ten different landmarks (the tips and metacarpophalangeal joints of each of their five fingers). The position (XY location) of each estimate was tracked using an Optotrak camera. From the XY locations we derived hand width and finger length. Not surprisingly, children's physical hand width and finger length were smaller than adults but remarkably, the body model, was similar for both groups. This result indicates that children overestimate hand size and suggests that the body model is ahead of physical growth. This result contradicts the notion that body representation lags physical growth during puberty, accounting for the clumsy motor behaviour characteristic of teens. We discuss the results in relation to the different taxonomies of body representation and how an enlarged representation of the hand during childhood may influence action.

1070 A Systematic Review of Seymour Fracture Management

Abstract Aim Seymour fractures are distal phalanx fractures of the finger in children with a juxta-epiphyseal or Salter-Harris Type I/II pattern associated with a nail-bed injury. There remains a paucity in literature regarding the development of complications between Seymour fracture management options, with early studies encouraging non-operative management due to the increased rates of post-operative infection. This systematic review aims to identify present-day, optimal management strategies for Seymour fractures, with further analysis of infection rates and secondary outcomes during post-operative recovery. Method Free-text search, MeSH terms and expanded keywords/phrases were employed to search the PubMed, Embase (via Ovid), Web of Science and CINAHL databases. Studies that described the management of Seymour fractures in paediatric patients were included, subject to inclusion/exclusion criteria. The data extracted included the sample size, intervention, infection rates and secondary outcomes. Results An initial search identified 305 articles, following the PRISMA guidance, 8 studies were eligible for full-text analysis. Across all studies, 307 Seymour fractures were identified (mean age, 10±1.2 years). A cross-study analysis showed a lower rate of adverse outcomes (including malunion/non-union and unplanned operative intervention) for K-wire fixation when compared to external splinting, 8.3% and 20.7% (P ≤ 0.001), respectively. Conclusions There was no statistically significant difference between non-operative and operative management in rates of infection and adverse outcomes. However, further analysis revealed a significantly lower risk of complications in patients who received K-wire fixation when compared to external splinting. Nonetheless, further studies with greater levels of evidence need to be carried out to consolidate this.

Free transplantation of medial plantar Flow-through venous flap for primary repairing children's finger wounds with digital artery defect

To explore the feasibility and effectiveness of free transplantation of medial plantar Flow-through venous flap for primary repairing children's finger wounds with digital artery defect. Between July 2016 and October 2020, 9 children who suffered finger wounds with digital artery defect were primary repaired with free transplantation of medial plantar Flow-through venous flap. There were 6 boys and 3 girls, with an average age of 6.8 years (range, 4-13 years). The defects were caused by heavy weight puncture injury in 5 cases and strangulation injury in 4 cases. Among them, there were 3 cases of index finger wounds, 3 cases of middle finger wounds, 2 cases of ring finger wounds, and 1 case of little finger wounds. The wound area ranged from 1.8 cm×1.5 cm to 4.0 cm×2.5 cm. The time from injury to operation was 1.3-8.6 hours, with an average of 4.8 hours. The flap area ranged from 2.0 cm×1.6 cm to 4.2 cm×2.6 cm. After the flaps were inverted, the veins were used to bridge the finger arteries while repairing the wounds. The donor site of the foot was sutured directly in 4 cases, and repaired with full-thickness skin grafts in 5 cases. All flaps survived, and hand wounds healed by first intention; 8 cases of foot donor site wounds healed by first intention, and 1 case had partial necrosis in the marginal area of the skin graft, which healed after dressing change. All 9 children were followed up 3-24 months, with an average of 9 months. The color and texture of the flap were similar to those of the surrounding normal skin, and the protective feeling was restored. The two-point discrimination of the flap was 7-10 mm, with an average of 8 mm. At last follow-up, according to the upper limb function evaluation standard of Hand Surgery Society of Chinese Medical Association, the finger function was excellent in 5 cases and good in 4 cases. There was no ulcer formation and scar hyperplasia in the foot donor site, which did not affect walking. The free transplantation of medial plantar Flow-through venous flap is an ideal repair method for repairing children's finger wounds with digital artery defect. It has the advantages of simple flap extraction, thin flap, similar color and texture to the skin of the hand, and concealed donor site.

ETHNO-TERRITORIAL FEATURES OF SOME OSTEOMETRIC PARAMETERS OF THE PROXIMAL PHALANGES OF THE HAND IN MALE CHILDREN AND ADOLESCENTS IN TAJIKISTAN AND WESTERN INDIA

The aim of the study is to establish ethno-territorial differences in the linear parameters of the proximal phalanges of the fingers in children and adolescents of the male sex of Tajikistan and Western India, regression equations that allow determining the nature of the dependence of the age of the examined and linear sizes of phalanges. On 366 radiographs of the right hand in children and adolescents aged 6-17 years from Tajikistan and India (Mumbai), the length of the proximal phalanges and the width of their diaphysis were measured. To determine the relationship between the age and the length, as well as the width of the diaphysis, Spearman's nonparametric correlation coefficient was used, because the age distribution does not correspond to normal. One-way ANOVA demonstrates the statistical significance of the increase in the length and width of the diaphysis of the proximal phalanges in boys and young men of Tajikistan and India with age, but the growth of these bones is uneven. For both Tajik and Indian boys, the closest correlation with age was found for the length of the second finger phalanx. It was found that in children in the smallest regions compared, the correlation was determined between their age and the length of the phalanx of the fifth finger. The length of the phalanx of the third finger increased most significantly with age in boys of the compared ethnic groups. The smallest height in length was determined for the phalanx of the fifth finger in boys in India and for the phalanx of the first finger in adolescents in Tajikistan. The maximum growth of the diaphysis in width was observed in the phalanx of the second finger, the smallest in the phalanges of the first and fifth fingers. The highest reliability was found with the length of the phalanx of the second finger. For Tajik boys, the parameters of the length of the phalanges of the III and IV fingers also have a correlation coefficient, therefore, they can be used to identify their age.

Treatment of children with skin and soft tissue defects of distal phalanges of the fingers

Introduction. This article discusses the relevance of performing organ-preserving operations for traumatic skin and soft tissue defects in children. The author analyzes the traditional types of skin grafting procedures and their application in children. From the authors' point of view, the most acceptable skin grafting method is a displaced island flap on a neurovascular pedicle with direct blood flow.&#x0D; Materials and methods. The operating technique of lifting a displaced island flap on a neurovascular pedicle with direct blood flow is shown. The features of its implementation, the number of children, and their distribution by groups are shown. From 2016 to 2019, 15 children with traumatic defects of the distal phalanges of the fingers were operated on in the microsurgical Department of the Khabarovsk KKB No. 2 using a displaced neurovascular island flap on the leg with direct blood flow. The children ranged in age from four to 14 years. The number of children and the frequency of damage to the right and left hands was approximately the same.&#x0D; Results. Positive results of using this technique in the Department of Microsurgery of KKB No. 2 are presented. In all cases, it was possible to close the existing defects with the primary closure of the donor defect simultaneously; Sensitivity was preserved in all operated children, and movements in the finger joints were almost complete.&#x0D; Discussion. This flap method has undeniable advantages, although it is quite time-consuming and requires microsurgical skills, techniques, and appropriate equipment. The proposed skin grafting results are encouraging and satisfying for both doctors and children with parents.&#x0D; Conclusions. The authors recommend this skin grafting method for traumatic defects of the distal phalanges of the fingers in children.