BACKGROUND: Although there is consensus that closed tendinous mallet finger injuries should be treated conservatively, the best method of immobilization to be used is not clear and the existing data in the literature are not conclusive. The aim of this study is to compare the results of four different immobilization methods used in the conservative treatment of tendinous mallet finger injury. METHODS: Ninety-six patients with tendinous mallet finger injury were treated with four different immobilization methods (stack orthosis, thermoplastic orthosis, aluminum orthosis, and Kirschner wire [K-wire] immobilization). The patients then were assessed with distal interphalangeal joint extensor lag, total active motion (TAM), grip strength, and Abouna and Brown Criteria. RESULTS: No significant difference was found between four immobilization methods in extensor lag and TAM at the 8th and 12th weeks. According to grip strength assessment, stack orthosis group was found to have significantly better results than the K-wire and aluminum orthosis groups at 12 weeks, while the difference was not significant versus the thermoplastic orthosis group. CONCLUSION: In this first study making multiple comparisons between four immobilization methods used in the treatment of tendinous mallet finger injury, the only significant difference detected between the groups was the superior grip strength with stack orthosis compared with K-wire immobilization and aluminum orthosis.

Angioleiomyoma is a solitary form of leiomyoma which is typically encountered in the subcutis. They are mostly seen in lower extremities, and the upper extremity is the second most common location for these lesions. There are only a few reports about the presence of an angioleiomyoma within a peripheral nerve in the upper extremity. Here we report a 56-year-old male patient who was referred to our clinic after an attempt was made for removal of a forearm mass at another institution. The lesion was encased within the median nerve and there was an unusual hypervascularity around the tumor with numerous vessels entering the lesion. Removal of the tumor without apparent damage to nerve fascicles was possible. Histopathological examination of the excision material revealed an intraneural angioleiomyoma. Following surgery, the patient was free of any functional deficits and no evidence of recurrence was observed at one year follow-up. There is no data regarding recurrence in intraneural lesions due to the lack of a large series. It would not be wrong to recommend spare grossly uninvolved fascicles if the nerve in question is not expendable. ER -

Amaç: Bu çalışma periferik sinir yaralanması sonrasında düşük ayak gelişmiş bireylerde uygulanan tibialis posterior tendon transferlerinde, geç dönemde meydana gelen biyomekanik sorunlar ve bu sorunların tedavisi için uygulanan, geç dönem fizyoterapinin etkinliğini belirlemek amacıyla planlandı. Yöntem: Çalışmaya tendon transferi yapılmış ve 6 ay ve üzeri süreyi doldurmuş olan 22 birey dahil edildi. Bireylerle ilgili demografik bilgi ve komplikasyonlar kayıt edilerek, ayak bileği kas kuvveti, eklem hareket açıklığı ölçüldü. Ayrıca bireylerde eklem pozisyon hissi, denge ve yaşam kalitesi değerlendirildi. Cerrahi sonrası başarı için Stanmore Sistem Sorgulaması kullanıldı. Olgulara genel olarak, ısı modaliteleri, nöromuskuler elektrik stimülasyonu, egzersiz, bantlama ve ortezlemeyi içeren, bireylerin spesifik gereksinimleri gözetilerek planlanan fizyoterapi programı uygulandı. Tedavilere 6 hafta süreyle haftada 3 gün olmak üzere devam edildi. Tedavi öncesi yapılan değerlendirmeler, 4., 6. haftalarda ve 3 ayda tekrar edildi. Bulgular: Çalışma süresi içerisinde bireylerin ayak bileği kas kuvveti, her iki ayakta da arttı. Bunlara ek olarak, propriyosepsiyon ve dengede olumlu gelişmeler meydana geldi. Tüm bu gelişmeler sayesinde, olguların yaşam kalitesi de pozitif yönde etkilendi. Sonuç: Çalışma sonucunda, tendon transferi sonrası geç dönemde uygulanan fizyoterapi programının, geç dönemde olgularda görülen problemler üzerinde etkin olduğu gösterildi. Detaylı değerlendirme ile planlanan fizyoterapi programının, hasta memnuniyetini ve cerrahi başarıyı arttırdığı belirlendi.

Aims: To determine the one-year functional gain following secondary transfer surgery in children with BPBI and analyse the outcomes in relation to surgical timing and clinical changes over time after rehabilitation. Methods: Forty-seven children, aged 3 to 18 years, who underwent transfer surgery and completed a 3-month rehabilitation program post-surgery, participated in this study. Active shoulder range of motion and Modified Mallet Scoring were assessed preoperatively and at 3, 6, and 12 months postoperatively. Children were grouped as having surgery younger and older than 7 years old and the results were compared. The repeated measures analysis was completed for comparison, along with post-hoc tests. Cohen’s d formula is used for effect size calculation. Results: The increase in shoulder flexion, abduction and external rotation was significant for all groups. However, the children having surgery older than 7 years demonstrated greater effect sizes for all shoulder motion ranges except internal rotation at 3-month follow-up while the younger group had higher effect sizes for flexion and abduction at 6-month follow-up. In general, only abduction, internal rotation and hand-to-mouth parameters increase were significant at 12 months follow-up. Additionally, the increase in external rotation started to decrease after 6 months. Conclusion: The Hoffer technique increased shoulder flexion, abduction, and external rotation regardless of the onset of the surgery. However, hand-to-head function did not increase after 3 months and external rotation started to decrease after 6 months in general. It is important to develop strategies to maintain the gain after surgeries, especially in rotation angles.