Left Thumb Research Articles

Lipoma digits: Commonest tumour – Uncommonest sites: Report of 2 cases

Lipomas may occur anywhere within the body. However, their occurrence in the digits is very rare. We report 2 cases of lipoma in the digits. The first case is of a 70 years lady who had a soft painless swelling in the left thumb while the second case was of a 40 years lady who presented with a swelling over the medial aspect of right foot. Excision biopsy in both the cases proved them to be lipoma. The cases are presented due to the rarity of their sites as only 14 cases of lipoma in the digits have been reported earlier. Keywords: Lipoma, Digits.

QOL-40. THE IMPACT OF TASK COMPLEXITY ON INFORMATION PROCESSING SPEED AND NEURAL COMMUNICATION IN PAEDIATRIC BRAIN TUMOUR SURVIVORS

Paediatric brain tumour survivors (PBTS) experience slower information processing speed (IPS) that contributes to difficulty performing tasks of minimal (MC) and greater complexity (GC), and is related to aberrant neural communication. It is still unknown whether deficient IPS exists during increasing complexity. We aim to determine if PBTS experience deficient IPS and neural communication relative to typically developing children (TDC) during an increasingly complex visual-motor reaction time (RT) task. During magnetoencephalography recording, participants (n=58, 12.69 ±3.24 years) pressed a button with their left or right thumb after an arrow pointing in the corresponding direction appeared on a screen. During two MC conditions, the arrow pointed in a single direction. During a GC condition, the arrow alternated direction randomly. Mean RT >3SD and signal artifacts were removed prior to analyses. The phase lag index (PLI) estimated neural communication between 90 cortical sources. Linear regression and Network Based Statistics assessed group differences in mean RT and the PLI. PBTS demonstrated increased RT relative to TDC during the GC condition (p=0.04, MPBTS=354.00s, MTDC=326.00s). Group differences in mean RT during MC conditions and the PLI during all conditions were not detected (p>0.05). These results suggest PBTS experience slower IPS during GC. Reduced IPS is thought to contribute to difficulty recruiting cognitive resources needed to perform more complex tasks. Subtle deficits in neural communication may underlie slower IPS. The weighted PLI is superior to the PLI when estimating small differences in neural communication. We will now use the weighted PLI to assess task-related neural communication.

Ray Resection for Recurrent Invasive Squamous Cell Carcinoma: A Case Report

Squamous cell carcinoma is the most common tumor of the hand. This malignancy requires unique treatment considerations; the surgeon and patient must balance retention of maximal functional capacity of the hand and minimization of the risk of recurrence and metastasis. Digital-sparing and digital-sacrificing therapies should be considered. Chance for cure, recurrence and metastasis risk, cosmetic concerns, and functional concerns should be addressed on a case-by-case basis. We report a case of a fifty-three-year-old man with cutaneous squamous cell carcinoma of his non-dominant hand. Ulceration and rapid growth of a long-standing lesion of the dorsal hand prompted evaluation and treatment. Over the course of a year, three separate surgeries including digital amputations and metacarpal resections were required to manage this recurrent and invasive malignancy. Seven years post-operatively, our patient retained a full, painless range of motion arc of the left thumb and ability to grip utilizing a functional brace. Treatment of squamous cell carcinoma of the hand is not always straightforward. High rates of local recurrence require negative margins and diligent postoperative surveillance. Digital sparing therapy should be considered to minimize functional impairment and maximize cosmesis. However, aggressive treatment and amputation must be considered for advanced disease and if pursued, should focus on maximization of functional capacity as one of the treatment goals.

Thermal quantitative sensory testing in burning mouth syndrome.

Subjects with burning mouth syndrome (BMS) have altered sensitivity and pain thresholds for thermal stimuli compared to a control group. Fourteen women and 6 men (average age = 62.60 years, median = 63.50) with BMS and a control group were tested using the method of thermal quantitative sensory testing (tQST) (tip, right, and left lateral border of the tongue, left thumb) to determine their heat/cold detection threshold (WDT/CDT) and heat/cold pain threshold (HPT/CPT). Only the CPT values at the tip and both lateral border of the tongue show a statistically significant difference: tip of the tongue: sick = 12.0 ± 5.5 °C, median 14.2°C; healthy = 4.5 ± 2.9 °C; median = 6.4 °C; p = 0.000; right lateral border: sick = 8.55 ± 3.34 °C; healthy = 4.46 ± 1.90 °C; median 5.8 °C; p < 0.001; left lateral border: sick = 10.18 ± 3.94 °C¸ healthy = 4.15 ± 2.18 °C; median = 6.0 °C; p < 0.001. BMS may be a combination of a dysfunction of free nociceptive nerve endings in the peripheral nervous system and impaired pain processing in the central nervous system. This preliminary study provides hints to other causes of BMS. This offers the possibility of further therapeutic options.

Cosmetic Glove-Like Finger Prosthesis—A Novel Technique: A Case Report

ABSTRACT Introduction Complete or partial finger loss is the most frequently encountered form of partial hand loss, which can result in physical, psychosocial, and economic damage to an individual. Thus, fabrication of a prosthesis that can offer a psychological, functional, and rehabilitative advantage can be a big morale booster to such individuals. Materials and Methods This clinical report presents a novel technique of prosthetic rehabilitation of a left thumb with thermoplastic resin and silicone material. Methods include making impressions of the donor and recipient finger, duplication of wax patterns of the donor finger, fabrication of a master cast for the fabrication of the finger using thermoplastic resin and silicone material, and external characterization. Results The thermoplastic resin silicone elastomeric prosthesis clearly fulfilled the patient's objective of restoring his defect with an aesthetically superior, lightweight prosthesis without the need to undergo any surgical procedures. The patient was comfortable using the prosthesis and was satisfied with the retention of the prosthesis. However, application of external characterization was required every 6 months. Discussion This article presents a new application of thermoplastic resin in maxillofacial prosthesis. This technique eliminates lengthy laboratory and clinical procedures and reduces the chair side time for practitioner and patient. It also is a cost-effective technique. Conclusion A convenient and affordable method of prosthetic rehabilitation of amputated fingers has been presented. The morale of the patient was also boosted to a great extent.

Comparison of Prevalence of Osteoarthritis in the Hand: A Multicenter Retrospective Cohort Study

Introduction Several studies have previously been undertaken to investigate the prevalence of radiologic hand osteoarthritis (OA) in Caucasian, Japanese, Chinese, and Arabic populations. To date, there has been no direct international comparison study on the prevalence of radiologic hand OA between a Western and a Southeast Asian population. We hypothesize that there is difference in the pattern of joint involvement among individuals of both populations.Materials and Methods Consecutive hand radiographs from individuals aged 60 years and above were reviewed. Radiographic evidence of osteoarthritis in the various joints in the hands was graded using Kellgren–Lawrence (K-L) score. Chi-square test, Fisher's exact test, or Student's t-test was used as appropriate. Multiple logistic regression analysis was performed to evaluate the associations and relationships of radiographic hand OA between joints.Results A total of 194 patients exhibited radiographic OA. Singaporean patients were more likely to have radiographic OA of the thumb interphalangeal joint (IPJ) (65.1%) compared with the thumb carpometacarpal joint (CMCJ; 40.2%); British patients were more likely to have CMCJ (43.3%) OA than thumb IPJ (21.0%). The difference was statistically significant (p = 0.00026). In the Singapore population, it was more likely that a patient had concurrent OA of both thumb and finger joints, whereas in the British population, this was apparent in only the above-80-year-old group. The most commonly affected joint was the left thumb IPJ (joint specific prevalence of 35%) in the Singapore population, and the right index finger distal interphalangeal joint (DIPJ; joint specific prevalence of 41.5%) in the British population.Conclusion Our study, the first study to compare between Singaporean and British populations, showed statistically significant difference in the prevalence of OA in the hands. These findings suggest ethnic and cultural factors play a part in such a distribution trend.

A multi-instance cancelable fingerprint biometric based secure session key agreement protocol employing elliptic curve cryptography and a double hash function

The generation of cryptographic keys using the biometric features of both communicating parties throughout the sessions of communication avoids the process of key sharing through some insecure channel, difficulty in remembering the large key(256 or 1024 bits key), and storing the key in some safe place. At the same time preserving the safety of cryptographic keys. Nonetheless, the biometric-based cryptographic key formation contains few matters so as the secrecy of biometrics, distributing biometric data among both communicating users, and creating the revocable key of irrevocable biometric. The present work discusses the above-mentioned concerns. Here a structure for a reliable session key agreement protocol has been suggested. For this, communication a 256-bit session key is created by both communicating parties at their end. For the generation of the 256-bit key, each of the left and right thumb was captured in each session. The right thumb impressions of the communicating parties are used to generate the cancelable fingerprint biometric s and the left thumb impressions of each communicating parties are used to generate a 64-bit hash value by applying the proposed double hash function. After that both communicating parties generate secret value using elliptic curve cryptography from their cancelable biometrics data and share along with the generated hash value. At the end of the process generated secret value and the hash value are concatenated to generate the revocable key for session key agreement protocol. For better performance and security purposes, all the actions of this protocol are based on elliptic curve cryptography. Proposed protocol precludes undesired third-parties from requiring a key selection on this agreeing parties. Based on the experimental evaluation across four datasets of FVC2002, the proposed structure is privacy-preserving and is excellently fitting for various real-time biometric-based applicability.

Anatomical and Immunohistochemical Variations Regarding the Epidermal Stem Cell among Different Traumatic Fingers of Hands in Iraqi Male Workers

Background: The role of stem cell during the whole life of human constricted into two stages. First stage occurred during prenatal life when stem cell take part in formation of organ in process called embryogenesis. Second stage occurred in postnatal life when these cells contribute in regeneration of damaged or old tissue as repairing or substituting cell in adults. Patient and Method: 150 male volunteers who work in different industries with traumatic finger of the right or left hand (33 right thumb,25 right middle finger ,22 right little finger,28 left thumb,26 left middle fingers 16 left little finger) were taken on from the Department of surgery, Baghdad Hospital, Baghdad; Iraq from February 2019 to October 2019. Results: Anatomical results showing that The grip was affected only in case of traumatic thumb. Vimentin rich-stem cells were highly positive in the proximal epidermal areas of traumatic fingers more than the stem cells in the distal areas of the same fingers. Conclusion: there is a little hope in the near future that the injured or even amputated finger or any part of the body could be replaced by new one made by culturing stem cells in laboratories.

Assessing diagnostic variations and correlates of fasting blood glucose

Objective: To assess the diagnostic variables of blood glucose level among students of basic medical Sciences of Delta State University, Abraka Nigeria.Methods: A descriptive cross sectional survey on a total of one hundred and ten (110) students of the Faculty of Basic Medical Science, Delta State University, Abraka was conducted. Descriptive statistics was used to analyze the differences in the data collected.Results: The fasting blood glucose levels of 87.5% and 85% of the students had a normoglycemic level as indicated by the left and right thumb respectively. Also, a greater percentage (69.1%) of the students were between the age range 21 – 25. Furthermore, 72.7%, 76.4% and 64.5% of the students had normal weight, normal WHR and normal BP respectively.Conclusion: There is no significant difference in the diagnostic assessment of blood glucose level using either right or left thumb.&#x0D; Keywords: Fasting blood glucose, diabetes, diagnostic, Delta State, hypertension.

Shoulder Pain-Wheelchair Basketball

HISTORY: 39 year old male wheelchair basketball player was referred for shoulder pain and need for potential glenohumeral joint injection. He had experienced one year of left-sided shoulder pain that began after colliding with an opponent at high velocity during a game. At the time of the trauma, he had sudden onset burning left sided neck pain that radiated down his arm to his left thumb. He noticed that raising his left arm above his shoulder worsened the shoulder pain. Additionally, he noticed left-sided weakness with elbow flexion and shoulder abduction that made wheelchair transfers difficult. PHYSICAL EXAMINATION: 4/5 strength with left shoulder abduction and elbow flexion. Active left shoulder abduction and flexion was limited to 90 degrees, due to pain. Empty can, Hawkin’s, and Neer’s tests caused left anterior shoulder pain. Decreased sensation over the left lateral upper arm to pinprick and light touch. Hoffman’s elicited on the left. Reflexes: 3+ left biceps. Cervical forward and left lateral flexion limited due to pain. Left Spurling’s exacerbated shoulder pain. DIFFERENTIAL DIAGNOSIS 1. Cervical radiculopathy/myelopathy 2. Left supraspinatus tear 3. Left subacromial impingement 4. Left adhesive capsulitis 4. Left brachial plexopathy TESTS AND RESULTS Left Shoulder MRI -No supraspinatus tear -Subtle superior/posterior labral tear -Trace biceps tenosynovitis Cervical Spine MRI -Left paracentral disc herniation causing moderate spinal canal stenosis with compression of spinal cord and myelomacia at C5-6 level. -Moderate to severe foraminal stenosis, worse on the left at C5/6. Left Brachial Plexus MRI -No abnormality Upper Extremities EMG/NCS -Left primarily demyelinating median nerve mononeuropathy across the wrist. -Denervation and re-innervation at the level of the left triceps brachii muscle without abnormalities in other C6 or C7 innervated muscles or radial innervated muscles to assist with innervation suggestive of cervical radiculopathy FINAL WORKING DIAGNOSIS -Left cervical radiculopathy with myelopathic features TREATMENT AND OUTCOMES -Referral to Neurosurgery for potential surgical decompression in setting of cervical myelopathic findings. - Initiated physical therapy focusing on McKenzie based program with spine stabilization.

Hand Injury - Basketball

HISTORY: 16-year-old male presenting with left thumb injury. Patient presented due to thumb injury during basketball 5 weeks prior to presentation. He reported a basketball was thrown extremely hard and hit him on the lateral side of the thumb, pushing his thumb towards his 5th digit. Despite pain, he was able to finish the game. He had noticeable swelling when the game ended. Despite icing, he continued to have swelling in addition to pain with pinching items or texting. This led him to the urgent care 1 week prior to presentation. X-rays were obtained at the urgent care and he was sent to sports medicine clinic. PHYSICAL EXAMINATION: Examination of left hand showed noticeable deformity at MCPJ, with proximal phalanx appearing subluxed on MC. Flexible deformity on radial aspect of the thumb MCP joint. Tenderness to palpation over the radial side of the MCP joint where there is a prominence. No swelling or bruising. Full range of motion of the thumb without limitation. Strength 4/5 with thumb flexion, extension, abduction, adduction. Pain with thumb manual muscle strength testing. Stable to UCL stress at 0 and 30 degrees. RCL laxity at 0 and 30 degrees without clear endpoint. Normal thumbs up and okay sign. Normal thumb to pinky opposition. Normal grip. Neurovascularly intact. DIFFERENTIAL DIAGNOSIS: 1.Radial collateral ligament tear 2.Flexor pollicis brevis tear 3.1st proximal phalanx fracture 4. Sesamoid fracture TESTS AND RESULTS: XR Left Hand Impression: No fractures identified. Subluxation of thumb at MCP joint. MRI Left Hand Impression: Complete disruption of radial collateral ligament of the MCP joint of the thumb with ulnar subluxation of the phalanx compared to the metacarpal. Significant joint fluid. Ulnar deviation of the flexor policis longus and sesamoids. Some marrow edema of the distal metacarpal as well as subchondral bone of first phalanx. FINAL/WORKING DIAGNOSIS: Chronic radial collateral ligament rupture at metacarpal level TREATMENT AND OUTCOMES: 1.Surgical radial collateral ligament repair 2.Initially immobilized with thumb spica splint 3.Casted from 1-5 weeks post operatively 4.Out of cast at 5 weeks post op out; into OT formed hand-splint and range of motion exercises started 5.Follow up planned 9 weeks post-op. Work with OT to achieve full, painless ROM and normal strength prior to returning to basketball

Tubercular dactylitis with deformity ipsilateral involvement of hand and foot in an adult: a case report

&lt;p&gt;Tubercular dactylitis is a rare entity and usually involves bones of hands and feet, involvement of feet is less common. Here we report case of 18 years old female with neglected tubercular involvement of her left thumb and left great toe of foot with hallux varus deformity. Her diagnosis was delayed as she did not seek any healthcare advice for a long time and also lack of suspicion of entity. This entity which should be kept in mind when making differential diagnosis that can be treated conservatively when diagnosed early.&lt;/p&gt;

A rare case report of bilateral distal radius fractures including bilateral isolated metacarpophalangeal joint dislocations in a piano artist

Bilateral distal radius fractures are rare injuries and only a small number of case reports exist. Literature reports of low velocity as well as high velocity injuries. It has been found that high velocity injuries are frequently associated with injury to carpals, metacarpals and phalanges. No case has yet been reported in medical literature with respect to bilateral distal radius fractures associated with bilateral single finger Metacarpophalangeal (MCP) joint dislocation. The aim of this case report is to emphasize the rarity of this injury and the associated trauma which are sometimes missed or diagnosed late. This case also highlights the role of skilful urgent reduction and stabilisation of such injuries followed by an early aggressive hand and wrist rehabilitation program to ensure an excellent outcome for the patient. Case Report: We report a case of bilateral distal radius fracture with MCP joint dislocation of the right index finger and MCP joint dislocation left thumb in a professional pianist following a high energy trauma due to a road traffic accident. The patient underwent surgery in the form of closed reduction and a wrist spanning radial distractor application with pinning of bilateral wrist. Closed reduction was done for the MCP joint dislocation left thumb and open reduction for the MCP joint dislocation right index finger. Patient was on an aggressive physiotherapy regime from the early postoperative period. Both the distal radius fractures united adequately by three months as well as the MCP joint dislocations restored with a satisfactory DASH functional scores. Conclusion: High energy traumas to the hand and wrist can result in ipsilateral or even bilateral injuries of the distal radius, ulna, carpals, metacarpals and phalanges. Hence, it is important not to miss any associated injury in the small bones of the hand when there is a fracture in the forearm and arm bones. Initiation of an early and intense rehabilitation program requires immediate reduction and fixation of the fractures and dislocations in order to gain the best functional outcome for the patient.

Application of a modified dorsoulnar artery pedicle flap in the repair of thumb tip defects: A case report.

Between February 2012 and March 2014 10 patients were admitted to the Affiliated Hospital of Nantong University for surgery due to a thumb tip defect. Nine of these patients were male and one was female and there were 7 cases of left thumb defects and 3 cases of right thumb defects. The surgical procedures followed were first, modification of the flap tail to an equilateral triangle, which facilitated pedicle suturing of soft tissue defects, caused mild tension and effectively reduced venous disorders, and second complete opening of the flap pedicle to the soft tissue defects at the tunnel. All patients were followed up at 6 and 12 months after surgery. Grip and pinch strength were measured 6 and 12 months after surgery. Static two-point discrimination testing of the modified flap showed minor differences from the uninjured hand. Post-surgery grip and pinch strength were restored to approximately 85% of the level of that in the uninjured hand. The modified dorsoulnar artery pedicle flap provided excellent thumb tip defect coverage and is an effective and safe technique for the restoration of grip and pinch strength to the hand after the repair of a thumb tip defect.

625 Death Due to Fractal Wood Burning: An Emerging Public Health Problem

Abstract Introduction The art of pyrography, creating designs in wood with a thermal heat source, dates back to prehistory. Risks include cutaneous burns and airway injury. Fractal woodburning is a niche method of pyrography utilizing a high-voltage electrical source to burn branched designs – Lichtenberg patterns – into the surface of wood. While this technique has grown in popularity, the associated risks are not well described. Methods We describe a patient who presented to our burn center after sustaining high-voltage electrical burns from a homemade high-voltage device constructed for fractal woodburning. We also evaluated publicly reported cases of death or injury due to this technique. Results An otherwise healthy 17-year-old male was admitted to our burn center with injuries sustained while making fractal wood art. The patient improvised a high-voltage transformer from a discarded microwave, generating 2000 volts from household current. While using this device to burn Lichtenberg patterns in wood, he contacted the electrodes and sustained full-thickness electrical burns to the neck, chest, and bilateral upper extremities. Bilateral upper extremity fasciotomies were required on admission. Multiple subsequent operative procedures culminated with autografting to the majority of the wounds and ongoing complex reconstruction of the left thumb. In evaluating online news reports, we found 21 unique individuals with death or injury attributed to fractal woodburning. Four sustained substantial injuries, while 17 reportedly died. The first reported incident occurred in July 2016 and the most recent report was from July 2019. Ages ranged from 17 years old to the 60s. Eighteen individuals were younger than 50 years old. All of the mortalities and 3 of the 4 injuries occurred in males. Of the survivors, 3 sustained significant upper extremity injuries and 2 suffered cardiac arrest at the time of injury. The devices used in 4 incidents were microwave transformers and generated 2000 volts. Device characteristics were not identified in the remainder of cases. Conclusions Fractal woodburning is associated with devastating high-voltage electrical injuries and death. Prevention efforts should be focused on the potential risks of this art form. Applicability of Research to Practice News reports likely underestimate the actual incidence of injury and death due to fractal woodburning, however, even this limited data suggests an emerging public health problem requiring further study and public education.

&lt;p&gt;Rare Site Hepatocellular Carcinoma Metastasis&lt;/p&gt;

IntroductionBesides more common sites such as lung or peritoneum, hepatocellular carcinoma (HCC) can metastatize to rare sites. We report herein a new metastatic site of HCC: the nail-bed. We also review other recently reported rare site HCC metastases (RSHM).Case ReportA 66-year-old woman with a 12-year history of resected-stage IA HCC who later presented lung, spleen and brain metastases treated with surgery, systemic therapies (sorafenib, sunitinib, capecitabine) and radiotherapy. The patient was referred to us because of a painful and rapidly evolving mass in the nail-bed of the left thumb. Biopsy confirmed nail-bed HCC metastasis, and the finger was amputated. The patient died few weeks later.ConclusionThis case was an opportunity for us to review RSHM. This type of metastasis seems to be an early event, in the context of advanced stage HCC with elevated protein induced by vitamin K absence-II (PIVKA II). The Lee nomogram is useful in detecting patients at high risk of developing RSHM. We would suggest insisting on systemic treatment in these metastatic patients although overall survival after RSHM diagnosis is poor.

Fingerprint pattern of major ethnic groups among students of Ibrahim Badamasi Babangida University Lapai, Nigeria

This study is aimed at identifying fingerprint pattern of major ethnic groups among the students of Ibrahim Badamasi Babangida University (IBBU) Lapai, which can be helpful in resource management for Niger State of Nigeria. The students were grouped into Nupe, Gwari, Kambari and Non-Nigerlites. Occasions for specific ethnic groups were target for data collection which exclude exclusion criteria. The types of finger print patterns considered include Ulnar Loop, Radial Loop, Plain Arch, Tented Arch and Accidental Whorl, Plain Whorl, Double Loop Whorl and Central Pocket Whorl. The respondents’ fingerprints were collected using inked stamp pad, printed onto designated potions on coded paper. The data collected were represented in percentage occurrence of the fingerprint patterns for each group. Ulnar Loop was the commonest fingerprint pattern among the students of IBBU Lapai. Also common to the groups of the students are absence of Double Loop Whorl on the right ring finger, left and right little fingers as well as Tented Arch not on the right Thumb of the students. The finger print marker for the groups were absence of Double Loop Whorl on the right ring finger and absence of Tented Arch on the left Thumb of Nupe, absence of Double Loop Whorl on the left index fingers of Gwari, Tented Arch not on left and right little fingers of Kambari speaking people studying in IBBU Lapai, those of the Non-Nigerlite students of IBBU Lapai lack Tented Arch on all their fingers and Double Loop Whorl not on the right index finger.

Complications after the percutaneous release of trigger thumb in adults

Aim: Trigger finger is a common orthopedic problem causing pain and could restrsict daily activities. Surgical intervention can be done via open or percutaneously. There is not much data about minor complications in literature. In this study, we reported our results and complications of percutaneous release (PR) of trigger thumb.Material and Methods: Retrospective data of patients treated for trigger thumb with PR between September 2017 and January 2019 were reviewed. Age, gender, affected side, preoperative Quinnell grade of triggering; previous history of steroid injection and history of medical diseases (e.g. diabetes mellitus, rheumatoid arthritis) were recorded.Results: Thirty thumb of 28 patients who met the inclusion criteria treated with PR for trigger thumb included in the study. Mean age of patients was 53.7 ±9.95 months (range 36-73). Twenty (71%) of patients were female, 8 (29%) were male. Right hand was dominant side in all patients. Right thumb was affected in 18 (64%) patients, left thumb in 8 (29%) and 2 (7%) were bilateral. Due to Quinnell grading system 9 (32%) patients were grade 2 and 19 (68%) were grade 3. Twenty (71%) of patients had previous history of steroid injection. There were 5 complications in our patients. One recurrence of triggering and 4 ecchymosis and edema have been reported.Conclusion: Percutaneous release of trigger thumb is safe and reliable technique with low complication rate. To prevent complication surgeon should be careful during the procedure and should well inform patient what to do after procedure.

The Combination of Moberg Flap with V-Y Advancement and Reverse Adipofascial Cross Finger Flap for Coverage of Degloving Injury of the Thumb-Case Report

We report a case of 22 years old male patient who is a worker in a factory and sustained degloving injury of his left thumb in a machine while working. There was loss of the pulp of the thumb extending circumferentially to the dorsal aspect with loss of the skin of the terminal phalanx and part of the proximal phalanx. The nail and germinal matrix were lost with exposure of the bone and extensor pollicis longus tendon insertion. The thumb was totally covered with a combination of two flaps: Moberg flap with V-Y advancement was used to cover most of the volar surface of the thumb and reverse adipofascial cross finger flap from the adjacent index finger was used to cover the dorsal surface and the tip of the thumb. The reverse adipofascial cross finger flap was covered with split thickness skin graft. Three weeks later this flap was divided and the thumb was mobilized freely. The patient had a full range of movement of the thumb and index finger with few settings of physiotherapy postoperatively. We recommend combining both of these flaps to reconstruct degloving injury of the thumb as they provide near adjacent tissue of similar texture, preserve sensation at the volar aspect of the thumb and also avoid the complications of the distant flaps.

Fingerprint patterns through genetics

Fingerprints are unique identifiers, but it is unclear how much similarity/variation closely-related family members exhibit. This study explores the link between fingerprints and genetics by analyzing familial fingerprints to show how the fingerprints between family members, and in particular siblings, could be very similar. The left and right thumb and ring fingerprints were taken from seven related individuals (immediate family and grandparents) and were classified to see which fingerprint feature was dominant and how it was inherited through the different generations of the individuals tested. Ridge features between the three siblings out of the seven individuals were measured and analyzed. The hypothesis was that the fingerprints between siblings would be very similar and the dominant fingerprint features within the family would be the same throughout the generations. The experimental data suggested that these same common patterns were passed down, helping to support this link. Also, the fingerprints between the siblings showed a trend of similarity, with only very small differences which makes these fingerprints unique. This work helps to support this fascinating link between fingerprints and genetics while providing a modern technological application.