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Background The normal ability to distinguish two points from one is known as the two-point discriminative (2PD) sense. This forms an extremely important assessment in patient with injuries to the nerves distributed to the upper extremity. Objective The aim of this study was to estimate the normal reference values of static 2PD in healthy adults and children. Materials and Methods A total of 624 normal adults comprising 380 men and 244 women were recruited randomly for the study at three different centers. Additionally, 172 healthy children, comprising 110 boys and 62 girls, were studied. Eight sensory areas in the palmar surface of the hand were delineated. The ability to distinguish the static 2PD was estimated in millimeters by using disk discriminator. The results were tabulated and statistically analyzed. Results The mean static 2PD in the adult population ranged from 2.78 to 3.5 mm in the fingertips and 5.39 to 7.13 mm in the mid-palm. There was a statistically significant difference between men and women in zones 6, 7, and 8. In children, the observed 2PD values were 2.15 to 3.63 mm in the fingertips and 4.10 to 5.77 mm in the palm. Children have a significantly better 2PD sense when compared with adults. Conclusion The normal value of static 2PD in the palmar surface of the hand among the Indian pediatric and adult populations was established in the study. [ABSTRACT FROM AUTHOR]

Objective The aim of this study is to create clinical normative data for ulnar length in the pediatric population and to demonstrate the usefulness of such data. Materials and Methods A nationally representative sample of healthy children aged 1 day to 18 years from five centers across India was collected. The percutaneous length of the ulna was measured by using a certified calibrated measuring tape across all centers. Other variables such as geographical domicile, dominance of the hand, age, body mass index (BMI), and sex of the child were also recorded. Results In total, 1,300 children (883 males and 417 females) with age ranging from 1 day to 18 years were included in the study. Gradual lengthening of the ulna was seen in both male and female children with increasing age without a significant difference; however, at 8, 9, and 14 years, there was significant lengthening of the ulna in males compared with females although the difference was statistically insignificant at 17 years. Apropos BMI at 16 years of age, a longer ulna was observed in obese children. Later on, at 18 years, the difference in ulnar length was insignificant. South Indian children had a significantly longer ulna up to the age of 11 years, but after the age of 11 years there was no difference in ulnar length in all zones. The length of the ulna was not affected by hand dominance. There was good inter-observer agreement and reliability between different centres. Age, zone, and gender, had statistically significant effect on the length of ulna but BMI and hand dominance was not significant. Conclusion This multicentric study provides normative data on the percutaneous length of the ulna in the Indian pediatric population. Gradual lengthening of the ulna was seen in all children with increasing age. The length of the ulna was significantly more in male, obese, and in South Indian children. However, except for age, other factors become insignificant at maturity. [ABSTRACT FROM AUTHOR]

Background The first web space of the hand plays a crucial role in determining the hand's span. Our study aims to examine and quantify the first web space angle in both hands of adult individuals within the Indian population with no upper limb pathologies. The primary objective of this study is to establish normative data. These data will be useful in surgical correction for the first web release, recommending corrective splints, and calculating the percentage of disability in hand function. Materials and Methods Data from 800 individuals from various regions across India, ranging in age from 20 to 50 years who had no pathology in both upper limbs were collected. A goniometer was used to measure the first web space angle of both hands by keeping the forearm pronated, elbow flexed, and arms adducted. The subjects from different states were divided into various zones. Results In 800 subjects, the average measurement in the right hand was 97.28 degrees, and in the left hand, 99.76 degrees. In males, the average measurement in the right hand was 97.54 degrees, and in the left hand, it was 99.61 degrees. In females, in the right hand, it was 96.93 degrees, and in the left hand 100 degrees. The result was recorded in subjects from each zone in the country. Conclusion The large sample size from various parts of the country makes the study more reliable. The technique of measuring the angles was easily reproducible. Our findings provide crucial normative data for clinicians and therapists. [ABSTRACT FROM AUTHOR]

Byline: Kirti. Garude, Shankar. Srinivasan, Nikunj. Mody, Bipin. Ghanghurde, Jovita. Saldanha, Arvind. Vartak, Suhas. Abhyankar Sir, We put forth our experience in the use of bed pads as an alternative [...]

We report the management of a 45-year-old man with a ring stuck in his dominant thumb for 3 weeks causing vascular and neural compromise and deep-seated infection. Previous reports have described rings embedded in the digits, though we were not able to find any reports of such rings causing ischaemia. We performed staged reconstruction to salvage the thumb. The thumb viability was confirmed after ring removal and the infection was treated as per culture sensitivity report. Both digital nerves were reconstructed with sural nerve graft and the circumferential soft tissue defect was covered with bilobed first dorsal metacarpal artery flap from index and middle finger. At the 6-month follow-up, the patient had useful function of the thumb with well-settled donor site on index and middle finger. Level of Evidence: Level V (Therapeutic).