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Objectives: The purpose is to study how the perception of home training has changed through data comparison before and after the COVID-19 pandemic, to find out the changes in people’s perception of home training, which has become a new sports culture, to provide basic data and to suggest directions on how research using big data can be used in the sports field.Methods: In order to compare before and after the COVID-19 pandemic, text mining analysis was conducted by setting keywords as home training in Naver and Daum by setting from February 1, 2020 to November 30, 2020, when the first COVID-19 confirmed patient in Korea came out, and from February 1, 2019, to November 30, 2019.Results: As a result of CONCOR analysis between words related to home training, a total of 16 clusters were formed, eight each, including smart home training, YouTube, and health programs before COVID-19, and eight each, including smart home training, YouTube, and home training exercise equipment and types.Conclusions: This study can be used as a tool to understand the market status, trends, and directions of interest by grasping the public’s perception and status of home training.

Background and Objectives The purpose of this study was to examine the benefits of ultrasonography performed by a surgeon rather than a radiologist.Subjects and Method This retrospective study enrolled 122 cases of ultrasonography performed by a head and neck surgeon and 116 cases of the same examination performed by a radiologist before surgery. The time intervals between the first visit and surgery were compared in both groups.Results The average waiting time for surgery after the first hospital visit was significantly reduced when a surgeon performed the ultrasound examination. Furthermore, there was no significant difference in sampling inadequacy rate on thyroid fine needle aspiration (FNA) between FNA performed by a head and neck surgeon and a radiologist.Conclusion Surgeons can utilize ultrasound as a diagnostic and therapeutic tool in an office-based setting. For patients, diagnosis and treatment provided by a single doctor will lead to more efficient outcomes.

Benign cartilaginous tumors, known as chondrogenic tumors, show cartilage components in the microscopic diagnosis. We present two clinical cases with cartilaginous tumors of the toes showing distinctive clinical manifestations. Two juvenile patients visited our outpatient clinic due to tumors with toenail deformities. A 10-year-old girl presented with a palpable mass with a nail deformity on the left third toe. The initial pathology report was soft tissue chondroma until complete resection. Another 15-year-old male patient visited the dermatology department with a toenail deformity and underwent a punch biopsy. The pathology report was fibrosis with myxoid degeneration. Excisional biopsies were performed for both patients. In the operative field, we observed exophytic tumors connected to the distal phalangeal bones. The final pathology reports were subungual osteochondroma on both patients. The specimen exhibited mature bone trabeculae with a focal cartilaginous cap. Benign cartilaginous tumors have a slow, progressive course and do not show significant symptoms. However, tumors in subungual areas are accompanied by toenail deformities and they can cause pain. Their clinical characteristics lead to a delayed diagnosis. Surgeons can be confused between soft tissue and chondrogenic tumors. When they conduct physical examinations, these categories should be considered in the differential diagnosis.

Recapitulating inherent heterogeneity and complex microarchitectures within confined print volumes for developing implantable constructs that could maintain their structure in vivo has remained challenging. Here, we present a combinational multimaterial and embedded bioprinting approach to fabricate complex tissue constructs that can be implanted postprinting and retain their three-dimensional (3D) shape in vivo. The microfluidics-based single nozzle printhead with computer-controlled pneumatic pressure valves enables laminar flow-based voxelation of up to seven individual bioinks with rapid switching between various bioinks that can solve alignment issues generated during switching multiple nozzles. To improve the spatial organization of various bioinks, printing fidelity with the z-direction, and printing speed, self-healing and biodegradable colloidal gels as support baths are introduced to build complex geometries. Furthermore, the colloidal gels provide suitable microenvironments like native extracellular matrices (ECMs) for achieving cell growths and fast host cell invasion via interconnected microporous networks in vitro and in vivo. Multicompartment microfibers (i.e., solid, core-shell, or donut shape), composed of two different bioink fractions with various lengths or their intravolume space filled by two, four, and six bioink fractions, are successfully printed in the ECM-like support bath. We also print various acellular complex geometries such as pyramids, spirals, and perfusable branched/linear vessels. Successful fabrication of vascularized liver and skeletal muscle tissue constructs show albumin secretion and bundled muscle mimic fibers, respectively. The interconnected microporous networks of colloidal gels result in maintaining printed complex geometries while enabling rapid cell infiltration, in vivo.

The choice of implant used for primary total knee arthroplasty (TKA) may have an impact on clinical outcomes. Clinical outcomes after TKA with gradually reducing radius implants (group G) vs single-radius implants (group S) were evaluated among Asian patients. This study included 541 patients (754 knees) in group G and 187 patients (275 knees) in group S. Range of motion (ROM), flexion contracture, American Knee Society Knee and American Knee Society Function scores (KSKS and KSFS, respectively), and mechanical and anatomic tibiofemoral angles (MTFA and ATFA, respectively) were evaluated with electronic medical records. In univariate analysis, improvements in ROM, KSKS, and KSFS were significantly better in group G compared with group S at 1-year follow-up. Multivariable analyses showed greater ROM (4.52°, P =.002), decreased flexion contracture (−2.80°, P =.011), and improved KSKS (15.57, P Orthopedics . 2022;45(6):367–372.]

Evaluating lower extremity alignment using full-leg plain radiographs is an essential step in diagnosis and treatment of patients with knee osteoarthritis. The study objective was to present a deep learning-based anatomical landmark recognition and angle measurement model, using full-leg radiographs, and validate its performance.A total of 11,212 full-leg plain radiographs were used to create the model. To train the data, 15 anatomical landmarks were marked by two orthopaedic surgeons. Mechanical lateral distal femoral angle (mLDFA), medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), and hip-knee-ankle angle (HKAA) were then measured. For inter-observer reliability, the inter-observer intraclass correlation coefficient (ICC) was evaluated by comparing measurements from the model, surgeons, and students, to ground truth measurements annotated by an orthopaedic specialist with 14 years of experience. To evaluate test-retest reliability, all measurements were made twice by each measurer. Intra-observer ICCs were then derived. Performance evaluation metrics used in previous studies were also derived for direct comparison of the model's performance.Inter-observer ICCs for all angles of the model were 0.98 or higher (p 0.001). Intra-observer ICCs for all angles were 1.00, which was higher than that of the orthopaedic specialist (0.97-1.00). Measurements made by the model showed no significant systemic variation. Except for JLCA, angles were precisely measured with absolute error averages under 0.52 degrees and proportion of outliers under 4.26%.The deep learning model is capable of evaluating lower extremity alignment with performance as accurate as an orthopaedic specialist with 14 years of experience.III, retrospective cohort study.

The aim of this study was to develop a green method to fabricate a novel CS modified N-(4-hydroxyphenyl)- methacrylamide conjugate (CSNHMA) and to evaluate its biomedical potential. CSNHMA has been prepared by a simple method via aza Michael addition reaction between CS and N- (4-hydroxyphenyl)-methacrylamide (NHMA) in ethanol. Its structural and morphological properties were characterized by various analysis techniques. The obtained results confirmed that a highly porous network structure of CSNHMA was successfully synthesized via aza Michael addition reaction. Consequently, it was analyzed as a drug and gene carrier. CSNHMA/pGL3 showed an enhanced buffering capacity due to the presence of NHMA moiety leading to higher transfection efficiency in all cancer cells (A549, HeLa and HepG2) as compared to native CS and Lipofectamine®. Therefore, these findings clearly support the possibility of using CSNHMA as a good transfection agent. For in vitro drug release study, we prepared CSNHMA nanoparticles (NPs) and curcumin loaded CSNHMA NPs of size230 nm respectively via the non-toxic ionic gelation route and the encapsulation efficiency of drug was found to be 77.03%. In vitro drug release studies demonstrated a faster and sustained release of curcumin loaded CSNHMA NPs at pH 5.0 compared to physiological pH.

The human facial skeleton consists of multiple segments and causes difficulty during analytic processes. We developed image analysis software to quantify the amount of injury and validate the smooth curvature of the surface after facial bone reduction surgery. Three-dimensional computed tomography images of facial bone were obtained from 40 patients who had undergone open reduction surgery to treat unilateral zygomaticomaxillary fractures. Analytic software was developed based on the discrete curvature of a triangular mesh model. The discrete curvature values were compared before and after surgery using two regions of interest. For the inferior orbital rim, the weighted average of curvature changed from 0.543 ± 0.034 to 0.458 ± 0.042. For the anterior maxilla, the weighted average of curvature changed from 0.596 ± 0.02 to 0.481 ± 0.031, showing a significant decrement (P P

Background and Objectives Follicular thyroid carcinoma (FTC) is the second common thyroid cancer which comprises about 10% of differentiated thyroid carcinoma. Hurthle cell carcinoma (HCC) is a relatively rare disease that has been classified as a subtype of FTC. However, there have been insufficient reports about these two similar thyroid cancers in South Korea due to low incidences. This study aims to present clinical features and evaluate prognostic factors of FTC and HCC.Subjects and Method We reviewed data of 189 FTC and 12 HCC patients who underwent surgery in our center from January 2000 to December 2020. Variables such as clinical characteristics, surgical method, pathologic result, post-operative treatment, survival rate and prognostic factors were included in our study.Results As for age, 67.2% of patients in FTC group and 33.3% of patients in HCC group were older than 55 years-old (p=0.017). The average tumor sizes of FTC and HCC were 2.98 and 3.1 cm, respectively. The 10-year overall survival rates of FTC and HCC were 96.5% and 100%, respectively. The 10-year disease free survival rates of FTC and HCC were 89.1% and 91.7%, respectively. Subclassification (widely invasive: p=0.036) and initial distant metastasis (p

Previous studies have reported the relationship between coronal alignment of the lower limbs and the rotational profile of the femur and tibia. However, the relationship between coronal alignment of the femur and tibia and their rotational profiles in patients with varus osteoarthritic knees is unclear. One hundred women with varus osteoarthritic knees (varus OA group) and 50 women with neutrally aligned lower limbs without osteoarthritis (non-OA group) were evaluated retrospectively. The coronal alignment and rotational profile of the femur and tibia were evaluated, and the correlation between coronal alignment and rotational profile was analyzed, respectively. The femoral anteversion, posterior condylar angle of the distal femur, and tibial torsion were significantly smaller in the varus OA group than in the non-OA group. In the varus OA group, the femoral anteversion and rotational profile of the distal femur had significantly negative correlations with the degree of femoral varus, while tibial torsion was not related to the degree of tibial varus. In the non-OA group, there was no relationship between coronal alignment and rotational profiles of the femur and tibia in both the varus OA and non-OA groups. Femoral anteversion and the rotational profile of the distal femur were negatively correlated with the degree of femoral varus in Asian women with varus osteoarthritic knees. This study enhanced the understanding of the relationship between changes in coronal alignment of the femur and tibia and their rotational profiles in patients with varus osteoarthritic lower limbs, although this study was limited by the small sample sizes and methodological quality.

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease characterized by a single mass on the face or upper part of the trunk. It usually presents an asymptomatic and favorable progression, and its histopathologic findings include small and medium-sized lymphoid cells. The authors report a case of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder on the forehead. A 51-year-old man presented with a protruding mass on his forehead that the patient had noted 1 month previously. Surgical excision and a permanent biopsy were performed under local anesthesia. Based on the biopsy results, the mass was diagnosed as a primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was no evidence of recurrence at a 15-month follow-up visit.

Background Hypertrophic scars are devastating outcomes of severe burn injuries, producing physical and mental burdens. Adequate treatment is of benefit to relieve these burdens. Laser therapy has shown scar reducing effects. In this study, we compared outcomes after combination of two different lasers or single laser treatment to treat severe hypertrophic burn scars. Methods Forty patients with hypertrophic burn scars were included in one of two therapeutic groups: continuous wave CO2 laser and fractional ablative CO2 laser group (group 1, n = 20) or fractional ablative CO2 laser alone group (group 2, n = 20). Hypertrophic scars were evaluated by the observer-rated Vancouver Scar Scale (VSS) before and after treatment and by patient-completed questionnaires after treatment. Comparative analyses were performed before and after treatment, and time-dependent improvement was also analyzed. Results Forty patients (54 hypertrophic scars) completed the laser treatment protocols. Group 1 exhibited significantly more improvement in VSS vascularity, pliability, and height indices than group 2 (p Conclusion Effective scar reduction was achieved using combination laser treatment, with significant improvement in multiple observer- and patient-reported outcomes. The shorter treatment period of the combination method can be a merit, as prolonged hypertrophic scars may increase morbidity. Nonetheless, cautious treatment protocols are necessary to avoid undesirable sequelae related to laser application.

OBJECTIVES The present study is aimed at observing the physiological response imagery running with an avatar in 3D virtual reality (VR) and to explore the differences in physiological responses between imagery running with and without an avatar in 3D VR.METHODS We randomly assigned 32 healthy adults to either a group with Avatar (n = 19) or a group without (n = 13). The group with avatar performed imagery exercise with an avatar in 3D VR and the group without Avatar performed it without an avatar in 3D VR. Both groups were instructed to mentally imagine performing running in VR without executing actual physical movements. We recorded electro-physiological data before, during, and after the 20-min intervention. We also measured the participants’ level of presence and intensity of experienced cybersickness.RESULTS In the group with Avatar, all physiological responses increased from the resting to the intervention period. The group with Avatar also showed a higher level of presence and fewer cybersickness symptoms than the group without Avatar.CONCLUSIONS The results suggest imagery running with an avatar in 3D VR might be effective as an alternative exercise.

Background We sought to determine (1) the success rate of debridement, antibiotics, and implant retention (DAIR) for acute periprosthetic joint infection (PJI) of the knee in patients with acute postsurgical infection and in those with acute hematogenous infection via a multicenter study, (2) the factors related to the failure of DAIR for overall acute PJI and acute hematogenous PJI via subgroup analysis, and (3) whether the PJI recurrence patterns differed between the two groups over time after DAIR. Methods This retrospective multicenter study included 101 acute knee PJI. Acute postsurgical PJI was defined as PJI diagnosed Results The overall success rate of DAIR was 77%. The success rate tended to be higher in the postsurgical group than in the hematogenous group (p = 0.060). However, there was no significant factor related to DAIR failure in the subgroup analysis of acute hematogenous PJIs. In the postsurgical group, the recurrence of PJI occurred until 3 months, whereas in the hematogenous group, recurrence occurred for up to 2 years. Conclusions The failure rate tended to be higher in the acute hematogenous PJI group than in the acute postsurgical PJI group. Since acute hematogenous infections may recur for a longer period than postsurgical infections, careful follow-up is required after DAIR.

The human facial skeleton consists of multiple segments, and causes difficulty during analytic processes. We developed image analysis software to quantify the amount of injury and validate the smooth curvature of the surface after facial bone reduction surgery. Three-dimensional computed tomography (CT) images of facial bone were obtained from 40 patients who had undergone open reduction surgery to treat unilateral zygomaticomaxillary fractures. Analytic software was developed based on the discrete curvature of a triangular mesh model. The discrete curvature values were compared before and after surgery using two landmarks. For the inferior orbital rim, the weighted average of curvature changed from 0.543±0.034 to 0.458±0.042. For the anterior maxilla, the weighted average of curvature changed from 0.596±0.02 to 0.481±0.031, showing a significant decrement (PP

Background This study investigated whether achieving a higher degree of knee flexion after TKA promoted the ability to perform high-flexion activities, as well as patient satisfaction and quality of life. Methods Clinical data on 912 consecutive primary TKA cases involving a single high-flexion posterior stabilized fixed-bearing prosthesis were retrospectively analyzed. Demographic and clinical data were collected, including knee flexion angle, the ability to perform high-flexion activities, and patient satisfaction and quality of life. Results Of the cases, 619 (68%) achieved > 130° of knee flexion after TKA (high flexion group). Knee flexion angle and clinical scores showed significant annual changes, with the maximum improvement seen at 5 years and slight deterioration observed at 10 years postoperatively. In the high flexion group, more than 50% of the patients could not kneel or squat, and 35% could not stand up from on the floor. Multivariate analysis revealed that > 130° of knee flexion, the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient satisfaction after TKA, while the ability to perform high-flexion activities (sitting cross-legged and standing up from the floor), male gender, and bilateral TKA were significantly associated with patient quality of life after TKA. Conclusions High knee flexion angle (> 130°) after TKA increased the ease of high-flexion activities and patient satisfaction. The ease of high-flexion activities also increased quality of life after TKA in our Asian patients, who frequently engage in these activities in daily life.

To investigate factors contributing to the de novo hyperextension after posterior cruciate ligament substituting (PS) total knee arthroplasty (TKA). Through a retrospective case–control study, de novo hyperextension patients were compared with patients without hyperextension after primary PS TKA. Eighty-five hyperextension patients were compared with 85 patients in a control group matched by age, sex, surgeon and implant. The clinical and radiographic parameters, including the mechanical axis (MA), joint line convergence angle (JLCA), posterior tibial slope angle (PTSA), posterior condylar offset (PCO), and the gamma angle, were evaluated preoperatively and immediate postoperatively. Comparisons between the two groups and logistic regression analysis were performed to investigate factors contributing to de novo hyperextension. Among the clinical factors, preoperative flexion contracture was less (5° ± 6° vs. 11° ± 6°, p

The posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ± 3.4 and 120.1 ± 15.4 degrees preoperatively to 2.0 ± 1.3 and 128.4 ± 9.3 degrees postoperatively, and the mean PTS change was 7.6 ± 3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA

Several environmental and genetic factors affect the isoflavone and anthocyanin contents in soybeans. This study aimed to assess the influences of cotyledon color and harvest period on the contents of five major isoflavones and three major anthocyanins in 323 black soybean landraces grown in Korea. In all the soybeans, malonylgenistin, malonyldaidzin and cyanidin-3-O-glucoside were the foremost components. The total isoflavone (TIC) and total anthocyanin (TAC) contents were in the ranges of 491.29-1998.39 μg/g and 452.60-2789.37 mg/100 g on dry weight basis, respectively. Both the average TIC and TAC were higher in green cotyledon soybeans (1493.93 μg/g and 1656.05 mg/100 g, respectively) than in yellow cotyledon soybeans (1423.09 μg/g and 1489.30 mg/100 g, respectively). With respect to the harvest period, the average TIC was in the order of Late-October (1517.31 μg/g) > Mid-October (1454.54 μg/g) > Early-October (1340.95 μg/g). Moreover, the average TAC decreased in the order of Late-October (1765.76 mg/100 g) > Mid-October (1503.93 mg/100 g) > Early-October (1350.91 mg/100 g). In general, cotyledon color appeared to cause a significant variation on TAC (P 1800 μg/g) and TAC (> 2000 mg/100 g) in their seeds and hence, could be considered as important sources of dietary isoflavones and anthocyanins. Besides, they possibly provide a wide spectrum of options if considered during the development of improved soybean genotypes.

Background: Many wound assessment systems including the Wagner classification and University of Texas (UT) grading system have been previously described. The authors of this study applied the DIRECT (Debridement of necrosis, Infection control, Revascularization, Exudate control, Chronicity, and Top surface) wound coding system for initial assessment of diabetic foot ulcers (DFUs) to predict limb salvage and prognosis.Methods: From January 2016 to February 2020, a total of 169 first-time DFU patients were retrospectively evaluated using the DIRECT wound coding assessment system. DFUs were followed up for at least 6 months, and scores in each component of the coding system according to final limb status were statistically evaluated. The coding assessment’s ability to predict major amputation was compared to those of the Wagner classification and the UT grading system.Results: Subjects were divided into complete healing (n=80, 47.3%), not healed (n=71, 42%), and amputation (n=18, 10.7%) groups. The mean values of each component of DIRECT assessment for the complete healing/amputation groups were D 0.86/1.56 (PConclusion: The DIRECT coding system shows a greater association with prediction of amputation or complete healing, compared with the Wagner and UT wound classification systems. This more accurate wound assessment system will be helpful in predicting prognosis and planning treatments.

The primary bioactive components of buckwheat seeds, rutin, and quercetin, have health-related benefits such as anti-inflammatory, antioxidant, anti-diabetic, and anti-cancerous. In the current study, we characterized the agro-morphological traits of diverse tartary buckwheat germplasm accessions under the spring cultivation and estimated the major flavonoid contents of seeds. The content of rutin and quercetin ranged from 4354.1 to 17,196.01 and 8.9 to 611.7 µg g−1 DW, respectively. The highest content of rutin was found in ‘C9714’ collected from China. The highest and lowest content of quercetin was found in Indian accessions ‘I8345’ and ‘I8622’, respectively. Moreover, we found that accessions with dark-brown seed coat color had a significantly higher mean rutin content than that of accessions with other seed coat color. In the principal component analysis, the first three components (PC1, PC2, and PC3) accounted for 77.14% of the total variation. The number of nodes and branches, number of days to flower, and maturity were the main contributors of variability to PC1. The 1000-seed weight was the main contributor of variability to PC2; whereas, the rutin and quercetin were the main contributors of variation to PC3. We identified nine accessions with the rutin content above 10,000 µg g−1 DW and three accessions with quercetin content above 40 µg g−1 DW. The selected accessions could be used as a nutritional source of health-related bioactive metabolites.

Background and Objectives: Non-linear frequency compression (NLFC) technology compresses and shifts higher frequencies into a lower frequency area that has better residual hearing. Because consonants are uttered in the high-frequency area, NLFC could provide better speech understanding. The aim of this study was to investigate the clinical effectiveness of NLFC technology on the perception of speech and music in patients with high-frequency hearing loss.Subjects and Methods: Twelve participants with high-frequency hearing loss were tested in a counter-balanced order, and had two weeks of daily experience with NLFC set on/off prior to testing. Performance was repeatedly evaluated with consonant tests in quiet and noise environments, speech perception in noise, music perception and acceptableness of sound quality rating tasks. Additionally, two questionnaires (the Abbreviated Profile of Hearing Aid Benefit and the Korean version of the International Outcome Inventory-Hearing Aids) were administered.Results: Consonant and speech perception improved with hearing aids (NLFC on/off conditions), but there was no significant difference between NLFC on and off states. Music perception performances revealed no notable difference among unaided and NLFC on and off states. The benefits and satisfaction ratings between NLFC on and off conditions were also not significantly different, based on questionnaires, however great individual variability preferences were noted.Conclusions: Speech perception as well as music perception both in quiet and noise environments was similar between NLFC on and off states, indicating that real world benefits from NLFC technology may be limited in Korean adult hearing aid users.

Background Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Methods Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed. Results Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.