Good Grip Research Articles

Jockey Perception of Shoe and Surface Effects on Hoof-Ground Interactions and Implications for Safety in the Galloping Thoroughbred Racehorse

Riding racehorses is a high-risk profession and optimizing safety alongside performance is paramount. Horseshoes play a critical role in providing traction with the ground surface and are therefore a major determinant of safety. However, the subjective perceptions of expert riders influence attitudes towards using different shoes and must be taken into consideration before any changes may be implemented. This study used a questionnaire-based method to evaluate jockey opinion of four shoeing conditions (aluminum, steel, GluShu, and barefoot) trialed at gallop over turf and artificial surfaces. Nine Lickert-style questions explored impact, cushioning, responsiveness, grip, uniformity, smoothness of ride, safety, adaptation period, and overall rating for each shoe-surface combination. A total of 94 questionnaires, based on 15 horse-rider pairs, were assessed using descriptive statistics and linear mixed models performed in SPSS (P < .05). Data indicate that shoe type significantly affected all question responses, with the exception of impact. Surface-type significantly affected perception of grip and safety. Overall, jockeys showed a preference for aluminum and steel shoes across both artificial and turf tracks. These rated “excellent” and were considered to be “very supportive” in approximately 80% of trials, with a 100% “active” response, good grip, and a quick adaptation period. In contrast, barefoot and GluShu conditions were generally considered “moderately supportive,” with barefoot appearing favorable on the artificial surface. On turf, barefoot was deemed the least smooth and the only condition that jockeys sometimes marked “unsafe” (17% of responses). Future work aims to investigate the relationship between jockey opinion and hoof kinematic data.

Reconstruction of infected nonunion of the distal humerus by Ilizarov external fixator.

Infected nonunion of the distal humerus represents a true challenge as the fragment is usually small and difficult for fixation. The aim of the present study is to assess the results of Ilizarov external fixator in management of infected nonunion of the distal third humerus. Twenty-three patients with infected nonunion of the distal humerus were included in this study. The ages ranged from 19 to 58 years with an average of 35 years. Seventeen cases were males and 6 were females. All patients were treated by radical debridement and application of Ilizarov external fixator in one stage surgery. Bony union was achieved in all cases. Bone graft was required in 12 patients with hypotrophic nonunion. The external fixation time ranged from 4 to 9 months with an average of 5.6 months. Infection was controlled in all cases without recurrence during the period of follow up. The complications included pin tract infection in 7 cases, radial nerve injury in one case, elbow stiffness in 4 cases and refracture after frame removal in one case. Ilizarov external fixator is effective in management of infected nonunion of the distal humerus. The thin tensioned wires produce good grip in the small or osteoporotic bone fragments.

Evaluation of Hand Strength, Handwriting, and Functional Skills in Children with Developmental Coordination Disorder (DCD)

Dysgraphia and difficulty in activities of daily living skill are well documented in the research database as impairments affecting children with developmental coordination disorder. Pinch and grip strength has a predominant role in various activities of daily living skills, and a child can fulfil the playing skill only with good pinch and grip strength. To estimate hand strength evolution difference in children with developmental coordination disorder and to analyze the correlations in grip and pinch strength, handwriting and its components, and activities of daily living skills in children with and without developmental coordination disorder. Twenty children were selected and assigned into two groups, typically developing children and children with DCD. Each child was evaluated with pinch and grip strength, handwriting speed and legibility, pencil grip, and levels of performance in functional skills. When considering the strength development pattern, there exists a similar trend in children with and without DCD. Grip strength is having a perfect correlation with pencil control in both children with and without DCD. Handwriting is poor in the children with DCD but not in children without DCD. This study provides evidence that grip and pinch strength are important components when considering therapeutic intervention for enhancing handwriting skill in children with DCD.

What can hand sonography and nerve conduction velocity disclose regarding hand dysfunction in rheumatoid arthritis patients?

Hand function in rheumatoid arthritis (RA) is amajor determinant of functional ability. To explore hand dysfunction in RA patients and to investigate the role of ultrasonography and nerve conduction studies in detecting factors affecting hand dysfunction. One hundred RA patients were included in this cross-sectional study and subgrouped into those with aweak hand grip (groupA) and those with agood hand grip (groupB). Ultrasonographic examinations and nerve conduction studies were performed. Multiple regression analysis and receiver operating characteristic curves were used. The age of enrolled patients was 45.16 ± 11.66years, 88% were females. Patients in groupA had poorer hand function and quality of life compared to those in groupB (P < 0.001). Using musculoskeletal ultrasonography (MSUS), higher scores of synovial proliferation, bone erosion, and cartilage damage were found in groupA. Hands with weak grip strength had reduced sensory median and ulnar conduction velocity than those with good grip (P = 0.02 and 0.01, respectively). The grip strength test had 92% sensitivity and 95% specificity for prediction of hand dysfunction, while upon combining synovial proliferation with ulnar nerve sensory latency and the grip strength test, the greatest sensitivity (98%) was reached with 55% specificity. Median and ulnar sensory conduction changes together with signs of chronic inflammation and joint destruction in MSUS are prevalent in patients with poor hand grip. Combined grip strength, ulnar nerve sensory conduction study, and synovial proliferation could represent asensitive predictor of hand dysfunction in RA.

Outcome of proximal interphalangeal joint replacement with pyrocarbon implants: a long-term longitudinal follow-up study.

The aim of this study was to compare the short-, mid-, and long-term results of pyrocarbon PIPJ arthroplasty. Twenty-seven consecutive patients (9 males, 18 females) had arthroplasty for 32 pyrocarbon PIPJ prostheses. Two patients (two joints) were lost for follow-up. Four implants were removed during follow-up. Fifteen patients (18 implants) were available for a long-term follow-up assessment on average 9.7 (9-10.8) years postoperatively and seven patients with eight implants had telephone interviews to calculate the implant survival and complications. Of the 15 patients who came to the latest follow-up, 12 (14 implants) passed each of the three follow-up visits for short-term (ø 19months), mid-term (ø 54months), and long-term follow-up (ø 9.8years) to compare functional and radiological parameters longitudinally. In total, seven of the 30 joints (23%) required a revision surgery, all within the first 2years postoperatively, including three arthrodesis due to early infection or dislocation, and one distal component removal due to primary loosening. Three patients required soft tissue revisions. The implant survival after 9years was 87%. There was minimal pain at rest throughout the 9-year follow-up analysis; pain with activity was rated 1.9 at the short-term assessment, 1.5 at mid-term, and 1.6 at long-term. The average active range of motion was at short-, mid-, and long-term examination 49°, 50°, and 48° and grip strength averaged 24, 24, and 21kg, respectively. The DASH score was stable with 35, 36, and 33 points. At the long-term follow-up, all evaluated implants showed radiological signs of implant loosening or migration. According to the PIP joint outcome score, 57% resulted finally in a "good" outcome. Pyrocarbon PIPJ arthroplasty has a risk of early complications necessitating revision surgeries. In spite of radiological implant migration, good pain relief, grip strength, and high quality-of-life ratings are stable for a long time.

The Implementation of Mimicry Memorization Method for Novice Students in Learning Arabic Mufradat

Students of junior schools that have never studied Arabic language in elementary schools get more difficulties than the students that have studied it before. They are called novice students and must learn basic things of a new language such as mufradat because they must master, memorize, understand, and use it in order to have a good grip of mufradat, translate it, and able to use it in correct phrases and sentences. This research aimed to investigate the effectiveness of using mimicry memorization method for learning mufradat in Junior High School of Muhammadiyah and to investigate the extent which students improve memorization skills after using mimicry memorization method. The research was a quantitative method with a type of experimental research techniques. The data research was collected from observation, documentation, and oral tests techniques. The population of the study included 7th grade students of Junior High School Muhammadiyah 8 Batu and the samples were 7C students as experimental class and 7D students as control class. The results of research contributed that there was an increase 0.825 (large level) point in students’ memorizing ability after using mimicry memorization method. This method was effective to use for novice students in learning mufradat. A language teacher needs to consider this method for novice students. The study provides further support for the use mimicry memorization method for novice students in mastering new vocabularies.

Tardy posterior interosseous nerve palsy associated with operated proximal shaft of radius fracture: a rare case report

&lt;p&gt;Tardy Posterior interosseous nerve palsy (PIN) is rare diagnosis. It is a mostly motor nerve. It is prone to injury around radio-humeral joint due to its proximity to joint and neck of radius. Early diagnosis is must to improve recovery. In our case, 39-year-old male presented with tardy PIN palsy secondary to united proximal shaft radius fracture with implant in situ. Electrodiagnostic studies revealed motor radial neuropathy left upper limb. Magnetic resonance imaging (MRI) brachial plexus and screening of cervical spine was normal. After preoperative investigation, patient underwent PIN neurolysis with plate removal. Postoperatively patient started showing improvement after 2 months. Patient recovered to achieve good grip at end of 8 months. Early diagnosis followed by nerve exploration is necessary for good recovery and improvement.&lt;/p&gt;

Safety of the LCP Pediatric Hip Plate in Proximal Femoral Osteotomy in Children with Cerebral Palsy.

PurposeProximal femoral osteotomy in cerebral palsy patients is a demanding procedure. The fixation of the osteotomy can fail due to the weak osteoporotic bone. The LCP pediatric hip plate with its good grip makes these procedures safe. The aims of the present study are to evaluate the radiological outcome of proximal femoral osteotomy that was fixed with the pediatric LCP in cerebral palsy patients and to raise safety issues regarding its low rate of complications.Patients and MethodsSixteen patients with cerebral palsy who were operated in our department were included in this retrospective study. Data collected from medical charts and X-ray measurements retrospectively reviewed.ResultsIn total, 16 patients (21 hips), ie, 9 males and 7 females, were included in this analysis. The mean age at the time of the index surgery was 11.9 years (5.9–18.0). The mean follow-up period was 4.78 years (1.5–8.0). Five patients had bilateral hip involvement and 11 had unilateral involvement. All patients had spastic cerebral palsy. The mean values of varus correction and de-rotation were 25° (0°–45°) and 35° (20°–50°), respectively. Neck shaft angle and the Reimer’s migration index were significantly improved postoperatively (p<0.01 for both). Seventeen hips showed complete consolidation within 14 weeks of fixation and four hips needed 16 weeks. These four hips were in three patients who were 16 years of age or older. The correlation between age at surgery and the time needed for consolidation was statistically significant (p=0.005). Avascular necrosis, revision surgeries, failure of fixation, acetabular penetration, screw loosening or fracture of the femur were not seen in this study.ConclusionThe LCP pediatric hip plate can be used safely in CP patients. The plate provides a strong stable fixation on osteoporotic bone with a low rate of complications.

Evaluate clinical outcome of open reduction and internal fixation with volar locking plates for displaced unstable distal end radius fractures

Background: Fracture of distal radius usually occur as a result of high energy trauma in younger individual with good bone density and also reported in elderly osteoporotic bone. The management is done by cast immobilization to various operative modalities percutaneous K- wire fixation to provide good to excellent results. This study was done to determine the clinical outcome of displaced unstable distal end radius fracture treated with volar locking plates. Objectives: 1. To study the demographic factors of patients with displaced unstable distal end radius fracture. 2. To determine the clinical outcome of patients who treated with volar locking plates. Materials and Methods: This is a prospective observational study done on 33 patients with distal end of radius fracture. The detailed history of the patient was taken and radiographs were assessed. The data was quantified by Modified Gartland and Werley score in which outcome was evaluated. Patient was discharged on 12th postoperative day and followed up after 1st, 2nd, 3rd, 6thmonth and then yearly. Results: In the present study, 63.63% cases from were from the age group 20-34 years, we had 29 cases (87.88%) males. Most common mode of injury was road traffic accident, in 18 cases (54.55%). In the present study, as per Frykman type VIII type of fracture was the commonest with 21 cases (63.64%). Ulnar was 25 degrees and radial were 15.60. An equal grip strength of the affected as the normal was noted in 27 cases (81.82%). At the final analysis of the outcome of our study excellent results were noted in 15 cases 45.45%. Conclusions: Fracture of distal end of radius is one of the commonest fractures. This fracture is more common in males (87.8%) with predominance on right side. Road traffic accident is still the common mode of injury than fall. On follow up excellent functional outcome found in 45.45.% cases with 81.82% patients achieved good grip strength.

Diabetes vignette. Weak left hand – query stroke in a diabetic double amputee

The patient was a 75-year-old bilateral amputee with insulin-treated type 2 diabetes, hypertension and dyslipidaemia controlled on treatment, and peripheral vascular disease treated with aspirin. He was admitted having fallen while transferring from wheelchair to bed; this was a simple fall and he had normal glucose and blood pressure levels. He was an ex-smoker, but his chest X-ray was normal. He was very rapidly back to his pre-admission state and abilities. On the ward he was mobile unaided in his wheelchair, administering his own insulin; he enjoyed zipping along the smooth hospital corridors and going to the local pub either with permission and a member of staff, or with neither, but only ever drank 1 or 2 pints. A seminal paper on outcomes post amputation stated that only 5% of amputees rehabilitated well, to become independent of their wheelchair, and that more consideration should be given to surgery that optimised wheelchair rehabilitation;1 our patient was an excellent example of someone who was very able in a wheelchair. He was a bit of a rascal who spoke his mind; thus, he remained in hospital for four weeks with ongoing negotiations about returning home to his very sheltered residence who had a ‘can't do’ mentality. During his hospital stay, he developed a weak left hand (see Figure 1); stroke was diagnosed and CT scan brain showed an old small infarct in the cerebellum, but was otherwise normal. On careful examination he had a wrist drop with weak wrist and finger extension (0/5 MRC power scale) but wrist and finger flexion, and finger abduction and adduction were normal; there was numbness on the dorso-radial aspect of the hand. When examining a hand with wrist drop, it is important to support the hand in its neutral position to allow the intrinsic hand muscles (innervated by ulnar and median nerves) to not work at a disadvantage, otherwise these muscles may appear weak. It is well recognised that several entrapment neuropathies are associated with diabetes such as median, ulnar, and lateral popliteal nerves, and lateral cutaneous nerve of thigh;2 however, data on an association between radial nerve palsy and diabetes are scarce, despite the evidence that the nerves of people with diabetes are more prone to compression neuropathies.3 A leading textbook states that radial nerve palsy is not related to diabetes, but a pressure palsy had been seen following hypoglycaemic unconsciousness.4 However, Stamboulis and colleagues reviewed patients with focal neuropathies referred for nerve conduction studies; the prevalence of known diabetes in people with radial nerve palsies was 28% versus a local population prevalence of known diabetes of 7%.5 Causes of radial nerve palsy include fractured neck of humerus, gunshot wounds, and lying on the nerve due to decreased consciousness;6 none of these applied to our patient who never returned from the pub drunk, and whose blood glucose monitoring was consistently in the 5–10mmol/L range. In most wheelchair users, the weight of their two legs prevents the wheelchair from tipping over backwards. But this is a problem for double amputees; hence for double amputees, including our patient, the wheelchair rear wheels are moved further back7 to regain balance. It was noticed that as the patient was zooming around the hospital, he would move his arms far back for rapid self-propulsion and catch the inner upper arm on the wheelchair handles; this seemed the likely cause of his neuropraxia. Standard treatment of compression radial nerve palsy is to splint the wrist to allow the hand muscles to function with a good grip,6 and wait and see; this was done as well as advice to slow down. After one week, the wrist drop was markedly improved; radial nerve compression palsies are generally neuropraxic and resolve within one week. Unfortunately, one month after discharge the patient died suddenly, presumably from cardiovascular causes, exemplifying the high mortality rate of amputees.1 Accurate clinical skills and knowledge are important to avoid unnecessary consultations and investigations, particularly in these times of coronavirus pandemic. Alternatively, if one practises using pattern recognition, this just looks like a radial wrist drop.

Exploring the Sport's Potential of Primitive Tribes

The study aims to exploring the sport’s potential of primitive tribes. The habitation of primitive tribe is far into the forest which is difficult to reach by vehicles and must walk approximately 25 km from the nearest village or hamlet, this illustrates the endurance of their lungs very well. The result shows that coordination and agility are very good, because they have strength and agility in terms of climbing which in itself will have good arm strength and leg grip. Besides that they are proficient in hunting because hunting is the most important livelihood, they have the knowledge to succeed: the forest situation, natural signs, animal signs and how to catch them, because since childhood this generation has been trained to live deftly in the forest, of course has incredible speed and reaction and strength in getting hunted animals.

High school students’ grip on life and education

The school system increasingly focuses on the students’ grip on life challenges in general. In this article, a life-psychological approach to the development of a general grip on life is tested. The method can be implemented in schools, such as public schools, in high school, as well as in youth education programs. Such implementations can often be organizationally and financially costly, which is why the applicability of the method is tested as a cost-neutral, self-administered method among high school students. The results show that the life-psychological method and its tools can be successfully implemented in a self-administered way regarding development of a good grip on life and its challenges.

Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand

Background: Fracture and dislocation of hand most frequently encounter in orthopaedics injuries fracture of phalanges and metacarpal are approximately 10% of all fracture of skeleton system phalangeal fracture comprise 46% of hand fractures, metacarpal fractures 38% and fifth metacarpal fracture 9.7%, distal phalangeal fractures are most commonly encounter fracture of the hand. The annual incidence of phalangeal fracture in hand is 1% in normal population. And these injuries account for between. 2% and 3% of all patient visiting in accident and emergency unit thumb and middle finger are most frequently injured because they extend most distally during work activity. Aim &amp; Objectives: To evaluate the structural and functional outcomes and the results of operative and conservative management of metacarpal and phalangeal fractures of hand. Methods: The present study comprises of 62 patients of closed fractures of metacarpal and phalanx treated in the Department of Orthopaedic Surgery, Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital Rewa (M.P.) in a span of two years. Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand was done. Results: We achieved 24 (85.7%) excellent and good results in conservative method for metacarpal fractures and 10 (83.33%) operative methods. In Phalangeal fractures 09 (90.0%) excellent and good results were achieved in conservative method and 10 (83.34%) in operative methods. Excellent and good grip strength was noted in 53 (85.33%) cases. Single digit involvement had better TAM then multiple digits involvement. Poor results were noted in metacarpal fractures in 04 (14%) in conservative series and 02 (16.0%) in operative series. Poor results were seen in phalangeal fractures in 01 (10%) in conservative series and 02 (16.66%) in operative series. Most common complication was finger stiffness in conservative method and pin site infection in operative methods. Conclusion: Both conservative and operative methods (surgical stabilization) for metacarpal and phalangeal fractures of hand gave good functional outcomes, depending on the fracture pattern for treatment option, single digit involvement are important determinants to achieve a better grade of total active range of motion.

Principal components of variables hypothesised to cause project delays and cost overruns in Ghana

Many construction projects in developing countries suffer delays because timely completion, within budget, and being of desired quality is dependent on many variables, many of which are not properly managed in these environments. Attempts to get a good grip on reduced (or major) variables or factors to pay attention to have been varied and have yielded varied results. This paper argues that approaches to identifying the number of important variables that affect project delays can be improved further. It uses principal components analysis to identify components of 13 variables hypothesized to affect construction delays and quality in Ghana. A questionnaire was administered to industry stakeholders. The principal axis method was used to extract components which were then subjected to oblique rotation. Five components that explained two-thirds of the variance in the original 13 variables were retained. The study finds that the State of Industry, Infrastructure Availability, and Legal Issues, which proxy industrywide state of affairs in delivering projects load onto Component 1. Consultant Related and Labour Related issues, which speak to the state of human capital load onto Component 2. Project Preparation and Construction Methods load onto Component 3. These variables speak to preparations for specific projects and the methods by which they are undertaken. Change in Government Regulation and Force Majeure, which are exogenous to the industry, load onto Component 4. Finally, Construction Material issues and Equipment Related issues load onto Component 5. We see these variables as inputs to projects.Keywords: construction projects, principal components; Ghana; project delays; eigenvalues; cost overruns

Capacitive Sensing for a Gripper With Gecko-Inspired Adhesive Film

We present a capacitive sensor suitable for a gripper that uses thin films of gecko-inspired adhesives. The sensor is fabricated directly on the films and measures the area over which the adhesive makes intimate contact. In experiments, a new underactuated gripper uses adhesive films to acquire and hold objects having a variety of shapes and textures. Using the adhesive films, the gripper achieves 2.6 × greater pullout force on rough surfaces as compared to using soft rubber. For a good grip, as the applied load increases, the films adhere more tightly to object surfaces and the local capacitance increases at contact regions. With six taxels per finger, the sensor can also detect whether the contact pattern of a grasp matches the expectations.

The added value of combined functional tests on predicting future falls in Chinese community-dwelling elderly

Falls are one of the major causes of mortality and morbidity in older adults, which needs a practical fall risk assessment tool to predict future falls. Recent researches suggested various functional tests produce more power than a single test in many aspects. So we aimed to determine whether combined functional tests could increase predictive ability of future falls, especially recurrent-falls, which may result in stronger adverse impacts. This was a prospective cohort study (N = 875) among residents of Hangu area of Tianjin, China, who were ≥ 60 years old. Falls were ascertained after one year. Meanwhile, sociodemographic information, medical history and physical performance data were also collected. The Timed Up and Go Test (TUGT), walking speed (WS) and grip strength (GS) are more recommended as tests targeting on balance, mobility and muscle strength by many studies. Therefore, we selected these three tests to clarity our hypothesis. The mean age was 67.1 years; 58.6% were women. According to ROC area, the cutoff point of TUGT, GS and WS of falls is 10.31 s, 0.3742 kg/kg and 0.9467 m/s, respectively. Therefore we defined good performance on the tests as “ + ”, and poor performance as “ − ” with the cutoff point. Towards any-falls, combination of “TUGT−, GS−, WS + ” was most correlated with its occurrence, with odds ratio (OR) 2.197, 95% CI: 1.204–4.009. Meanwhile, combined “TUGT−, WS + ” (OR: 2.103, 1.367–3.235) and combined “TUGT−, GS+, WS − ” (OR2.071, 1.124-3.814) were also more related to any-falls than a single test, like TUGT− (OR: 1.676, 1.170–2.401). However, compared with a single test (TUGT−, OR: 2.192, 1.225–3.922), only the combination of “TUGT−, GS−,WS + ” (OR: 2.536, 1.025–6.272) was a more stronger predictor. A simple tool using TUGT, GS and WS has better predictive power on future falls. Based on this result, individuals who show poor ability in TUGT and WS but have good grip strength ought to be more concerned about the high-risk of future falls, especially the likelihood of recurrent-falls.

Tendon Transfers Around Wrist in Cases of Obstetric Brachial Plexus Injury

AbstractBackground: Wrist extension is essential in the develop-ment of motor skills in young children. Adequate wrist extension is important for good grip function of the hand, as a slightly extended wrist results in a better and stronger grip.Material and Methods: This prospective series reports on 32 patients with sequlae obstetric brachial plexus injury who underwent tendon transfer around wrist. The mean age at time of transfer was 9.9 years. FCU tendon was utilized in 25 cases, PT in 3 cases, BR in 2 cases, PL in 1 case and FDS in 1 case. The recipient tendon was ECRB in 14 cases, EDC in 12 cases, ECRL in 2 cases EPL in 2 cases, and FPL in 2 cases. Raimondi score, Toronto scale, Medical research council muscle grading system, Range of motion and hand grip strength were used to evaluate results. Good results (MRC grading of 4) were obtained in 24 cases (75%).Conclusion: Tendon transfers around wrist are considered good operative option in cases of sequlae of obstetric brachial plexus injury for restoration of hand function with or without other procedures tailored to the need of every case.

Treatment of proximal humerus fractures in children with a modified palm tree technique.

Although most pediatric proximal humeral fractures can be successfully treated conservatively with satisfactory results, many operative techniques have been described for the treatment of displaced proximal humeral fractures. The aim of this study is to evaluate the efficacy of percutaneous fixation using a modified palm tree technique for proximal humerus fractures in children. Between March 2011 and May 2013, the modified palm tree technique was used for the management of 30 children (20 boys and 10 girls) with displaced proximal humeral fractures. The average age of the patients was 11.5 years (age range from 8 to 15 years). They were evaluated clinically by the Constant-Murley score and by radiological analysis. The average follow-up duration was 18 months. The average time of fracture union was 6 weeks (range from 4 to 8 weeks). The average Constant score of the patients was 92 (range from 87 to 95), with excellent results in 27 (90%) cases, good results in three (10%) cases, and no fair or poor results (0%). The reported complications were superficial pin-tract infection in five cases, treated by daily dressing and local antibiotics, and malunion with a varus deformity in two cases (about 15°), with no recorded cases with deep infection. None of the cases required open reduction. No cases were complicated by avascular necrosis of the head humerus or loss of fixation. Kirschner wires were removed after an average period of 7 weeks. The modified palm tree technique represents an efficient method for the treatment of proximal humerus fractures in children. It produces a good grip in both the proximal and distal fragments. It allows for early joint movements.

Prevalence of geriatric syndromes among people aged 65 years and older at four community clinics in Moscow

BackgroundGeriatric syndromes (GSs) are common in older adults and have a significant effect on their quality of life, disability, and use of health care resources. Few studies have assessed the prevalence of GSs in Russia. The aim of this study is to assess the prevalence of GSs among older adults living in the community in Moscow.MethodsA cross-sectional study was conducted in four community clinics in Moscow. A total of 1,220 patients completed a screening questionnaire, and 356 of them also underwent a comprehensive geriatric assessment (CGA).ResultsThe mean age of the 1,220 participants was 74.9±6.1 years; 75.5% were women. Based on the questionnaire, 58.3% reported visual or hearing impairment, 58.2% cognitive impairment, 46% mood disorder, 42% difficulty walking, 28.3% urinary incontinence, 21.3% traumatic falls (over the previous year), and 12.2% weight loss. The mean number of GSs per patient was 2.9±1.5. Based on CGA, a decline in Instrumental Activity of Daily Living score was identified in 34.8% of the patients, a risk of malnutrition (Mini-Nutritional Assessment score, 17–23.5) in 25.8%, probable cognitive impairment (Mini-Mental State Examination score <25) in 8.6%, and symptoms of depression (15-item Geriatric Depression Scale score >5) in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s) and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men), but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more).ConclusionThe results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population.

Management of a 15-Year-Old Scaphoid Non-Union

Scaphoid non-union affects wrist joint function and is often associated with a predictable pattern of degenerative change. A 30-year-old man presented with a symptomatic 15-year-old right scaphoid fracture with secondary scaphoid non-union advanced collapse of his right wrist. There was no evidence of avascular necrosis. The initial injury was from a fall onto his outstretched hand. We performed a right scaphoid open reduction, internal fixation and iliac crest bone graft. One year after the operation, the patient had good wrist function and grip strength. A CT scan showed union of the fracture. Studies have shown that if the time between initial fracture and treatment of non-union exceeds 5 years, the chances of healing of the non-union are markedly reduced. In our case, despite the long duration between timing of injury and surgery, there was union and good return of function.