The incidence of scarring on the dorsum of the hand

When undertaking image comparison of the hand between accused and perpetrator, it is not unusual for scars to be identified on the back of the hand. To investigate the occurrence of scarring in a discreet sample, a database of 238 individuals was examined, and the dorsum of the right and left hands was gridded for each individual. The position, size and type of scar were recorded within each grid. It was found that, in general, males exhibited a higher incidence of scarring than females. However, males were more likely to show scarring on their left hand whereas females were more likely to exhibit scarring on their right hand. Contrary to the literature, scarring was not most prevalent along the borders of the hand but occurred more frequently in association with the index and middle finger corridor regions. Surgical scars were rare as were large scars whereas linear scars smaller than 6 mm were the most frequently identified. Close to half of the sample did not exhibit scarring on one hand. The importance of understanding the pattern of scarring on the back of the hand is discussed in the light of forensic image comparison analysis

Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report

The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous injury and subsequently these were confirmed on surgery

Topical haemostatic agents for skin wounds: a systematic review

Background: Various agents and techniques have been introduced to limit intra-operative blood loss from skin lesions. No uniformity regarding the type of haemostasis exists and this is generally based on the surgeon's preference. To study the effectiveness of haemostatic agents, standardized wounds like donor site wounds after split skin grafting (SSG) appear particularly suitable. Thus, we performed a systematic review to assess the effectiveness of haemostatic agents in donor site wounds. Methods. We searched all randomized clinical trials (RCTs) on haemostasis after SSG in Medline, Embase and the Cochrane Library until January 2011. Two reviewers independently assessed trial relevance and quality and performed data analysis. Primary endpoint was effectiveness regarding haemostasis. Secondary endpoints were wound healing, adverse effects, and costs. Results: Nine relevant RCTs with a fair methodological quality were found, comparing epinephrine, thrombin, fibrin sealant, alginate dressings, saline, and mineral oil. Epinephrine achieved haemostasis significantly faster than thrombin (difference up to 2.5 minutes), saline or mineral oil (up to 6.5 minutes). Fibrin sealant also resulted in an up to 1 minute quicker haemostasis than thrombin and up to 3 minutes quicker than placebo, but was not directly challenged against epinephrine. Adverse effects appeared negligible. Due to lack of clinical homogeneity, meta-analysis was impossible. Conclusion: According to best available evidence, epinephrine and fibrin sealant appear superior to achieve haemostasis when substantial topical blood loss is anticipated, particularly in case of (larger) SSGs and burn debridement

Islamic influences on urban form in Sumatra in the seventeenth to nineteenth centuries CE

This article focuses on the evolution of three urban centres: Palembang, Padang and Tanjung Pinang. Where appropriate, brief information about other towns is added which shows that the three towns are typical for towns on the east coast, the west coast and the islands in the Straits of Malacca respectively. Unfortunately, there is no place in the Minangkabau highlands for which historical sources exist that can help to reconstruct the townscape in a comparably detailed way. The descriptions of Palembang, Padang and Tanjung Pinang give details of Islamic buildings and provide information about the development of the settlements as a whole. These morphological histories have a value in their own right. They form a baseline to assess fully the specific Islamic influence on urban form in the disruption of some Islamic transformations. The Dutch changes bring out the previous Islamic influences more sharply. In the last section the emic (indigenous) conceptions of 'urban' will be analysed, by exploring the contrast between town and village and the role of Islamic buildings to accentuate the difference. The conclusion will list the most important empirical generalisations drawn from the descriptions. © 2004 Editors, Indonesia and the Malay World

Correlações entre força de preensão manual e variáveis antropométricas da mão de jovens adultos

O objetivo do estudo foi correlacionar a força de preensão palmar em diferentes posições de abertura, com variáveis antropométricas da mão. Participaram 73 voluntários de ambos os sexos (40 homens e 33 mulheres), com idade média de 23±4,61 anos. As medidas antropométricas largura da palma, comprimento do dedo indicador, espessura da palma, largura da mão, circunferência da palma e da mão foram realizadas bilateralmente. Para as medidas lineares, utilizou-se um paquímetro digital e, para as medidas de circunferência, a fita métrica. As medidas de força de preensão foram realizadas por meio de um dinamômetro hidráulico (UFTM) Jamar®. Os valores antropométricos foram correlacionados com as medidas de força nas cinco posições de abertura. Os homens e as mulheres tiveram maior força na mão direita e, entre as posições, a maior força dos homens foi na de número 3 (45,5±15,53 kgf) e das mulheres, na de posição 2 (25,5±6,28 kgf). Verificaram-se correlações significativas entre a força e os valores antropométricos nas medidas da largura da mão e circunferência da palma - que representam a maior medida transversal e o maior trofismo da mão, respectivamente, no grupo dos homens e a medida de comprimento do dedo, que representa a maior medida longitudinal no grupo das mulheres. Com isso, pode-se concluir que, para os homens, a maior força está relacionada à maior medida transversal e ao maior trofismo da mão e, para as mulheres, ao maior comprimento longitudinal da mão.The aim of this study was to correlate the grip strength of hand, in different opening positions, with hand anthropometric measures. The study included 73 volunteers (40 male and 33 female) with mean age of 23±4.61 years old. Anthropometric measures, such as palm width, forefinger length, palm thickness, hand width, palm and hand circumferences, were performed bilaterally. For linear measures, a digital caliper rule was used as well as a tape measure for circumference measures. Grip strength measures were performed by means of a Jamar® hydraulic dynamometer. Anthropometric values were correlated with strength measures in the five positions of the opening. Both men and women had greater strength in the right hand. Regarding the positions, the bigger strength of men was in the number 3 (45.5±15.53 kgf) and that of women in position 2 (25.5±6.28 kgf). Significant correlations were verified among strength and anthropometric values in the hand width measure and palm circumference - that represent the greater transversal measure and the greater throphism of left hand, respectively, in men's group -, and the finger length measure, that represents the greater longitudinal measure in women's group. Thus, it may be concluded that for men the greater strength is related to the greater transversal measure and to the greater throphism of hand, while for women, it is related to the greater longitudinal length of hand

The Epidemiology, Genetics and Future Management of Syndactyly

Syndactyly is a condition well documented in current literature due to it being the most common congenital hand defect, with a large aesthetic and functional significance