The impact of routines on emotional and behavioural difficulties in children and on parental anxiety during COVID-19.

Background: The Covid-19 pandemic and related public health measures, including lockdowns and school closures, have impacted on mental health of children.

Aims And Hypothesis: We hypothesised that there would be an association between maintaining a routine during lockdown and both lower emotional and behavioural difficulties in children and lower parental anxiety. Routine was taken as keeping to the same basic activities such as mealtimes and bedtimes.

Touch localization after nerve repair in the hand: insights from a new measurement tool.

Errors of touch localization after hand nerve injuries are common, and their measurement is important for evaluating functional recovery. Available empirical accounts have significant methodological limitations, however, and a quantitatively rigorous and detailed description of touch localization in nerve injury is lacking. Here, we develop a new method of measuring touch localization and evaluate its value for use in nerve injury.

Reducing the carbon footprint in carpal tunnel surgery inside the operating room with a lean and green model: a comparative study.

The primary aim of our study was to assess the environmental impact of moving from a standard to a lean and green model for a carpal tunnel decompression. We objectively measured the clinical waste generated, the number of single use items and the number of sterile instruments required for a standard procedure, and then moved to smaller instrument trays, smaller drapes and fewer disposables. These two models were compared for waste generation, financial costs and carbon footprint.

Analysis and validation of a 3D finite element model for human forearm fracture.

Most researchers have performed finite element (FE) analysis of the human forearm fracture by exploring the strength and load transmission of the bones. However, few studies concentrated a complete simulation of the whole forearm complex including ligaments. This paper aims to investigate the load transmission through the bones, contact stress at the joints and strain in the ligaments by using an elaborate FE model, further validating the fracture condition for human forearm.

Selective Fiber Degeneration in the Peripheral Nerve of a Patient With Severe Complex Regional Pain Syndrome.

Complex regional pain syndrome (CRPS) is characterized by chronic debilitating pain disproportional to the inciting event and accompanied by motor, sensory, and autonomic disturbances. The pathophysiology of CRPS remains elusive. An exceptional case of severe CRPS leading to forearm amputation provided the opportunity to examine nerve histopathological features of the peripheral nerves.

The management of chronic non-arthritic scapholunate dissociation: a systematic review.

Unlabelled: A systematic review was conducted to identify the best management for chronic scapholunate dissociation. EMBASE, MEDLINE, and CENTRAL were searched from 1965-2016. A narrative synthesis was performed.

An analysis of the operative experience of plastic surgery trainees in the United Kingdom using eLogbook.

Introduction: We performed a comprehensive analysis of the operative experience of UK Plastic Surgery Trainees using the web-based eLogbook.

Methods: An analysis of data recorded prospectively by Plastic Surgery Registrars 2010-2014 in eLogbook.

Results: The eLogbook data of 336 Specialty Registrars entered from 2010 to 2014 was analysed.

Impact of Long Flexor Versus Intrinsic Dominance in the Generation of Arc of Finger Flexion.

Finger flexion is a composite movement involving both long flexors and intrinsic hand muscles. Previous studies have characterized this but have not investigated differences within the normal population. Were discrete finger motion patterns identified, this could guide rehabilitation programs following flexor tendon surgery.

Anatomic Relationships of the Distal and Proximal Radioulnar Joints Articulating Surface Areas and of the Radius and Ulna Bone Volumes - Implications for Biomechanical Studies of the Distal and Proximal Radioulnar Joints and Forearm Bones.

Background: Previous work from this laboratory has evidenced the biomechanical role of forearm osseoligamentous structures in load transfer of applied forces. It has shown that forces transmitted across the distal radioulnar joint (DRUJ) and proximal radioulnar joint (PRUJ) are similar, though not identical, under axial loading conditions. The purpose of the study was to assess the articulating surface areas of the radioulnar joints and the volumes of the forearm bones addressing the hypothesis that there may be anatomic adaptations that reflect the biomechanical function of the integrated forearm unit.

The Effect of Elbow Extension on the Biomechanics of the Osseoligamentous Structures of the Forearm.

Purpose: To investigate the hypothesis that elbow extension alters the biomechanics of forearm rotation including force transmission in the distal and proximal radioulnar joints (DRUJ and PRUJ) and the interosseous ligament (IOL).

Methods: A cadaver model with a custom-designed jig was used to measure forearm pronosupination ranges, transmitted forces and contact areas across the PRUJ and DRUJ, and tension in the 3 main components of the IOL's central band. Testing with applied loads was undertaken throughout pronosupination with the elbow fully flexed (n = 15) and fully extended (n = 11).

Adipose-derived stem cells: selecting for translational success.

We have witnessed a rapid expansion of in vitro characterization and differentiation of adipose-derived stem cells, with increasing translation to both in vivo models and a breadth of clinical specialties. However, an appreciation of the truly heterogeneous nature of this unique stem cell group has identified a need to more accurately delineate subpopulations by any of a host of methods, to include functional properties or surface marker expression. Cells selected for improved proliferative, differentiative, angiogenic or ischemia-resistant properties are but a few attributes that could prove beneficial for targeted treatments or therapies.

A multicentre, randomized, double-blind trial of the safety and efficacy of mannose-6-phosphate in patients having Zone II flexor tendon repairs.

The safety, tolerability and preliminary efficacy of mannose 6-phosphate in enhancing the outcome in Zone II flexor tendon repair was studied in a multicentre parallel double-blinded randomized controlled trial. Eight UK teaching hospitals were involved in treating repaired flexor tendons with a single intraoperative intrathecal dose of 600 mM mannose 6-phosphate, with follow-up over 26 weeks. A total of 39 patients (mannose 6-phosphate, n = 20; standard care, n = 19) were randomized.

The biomechanical and functional relationships of the proximal radioulnar joint, distal radioulnar joint, and interosseous ligament.

This biomechanical study assessed integrated function of the proximal radioulnar joint (PRUJ), interosseous ligament (IOL), and distal radioulnar joint (DRUJ). Tekscan™ pressure sensors were inserted into the DRUJ and PRUJ of 15 cadaveric specimens. MicroStrain(®) sensors were mounted onto the IOL on nine of these specimens.

Considerations in the surgical use of the flexor sheath and pulley system.

The use of the digital flexor sheath to reconstruct damaged structures in the fingers is an intriguing but under-investigated subject. The sheath is anchored firmly to the phalanges and palmar plates and has well-vascularized outer and synovial inner layers. The middle layer is strong and fibrous and not all of it is required for its main biomechanical function of maintaining the moment arm of the flexor tendons.

Functional anatomy of the distal radioulnar joint in health and disease.

The distal radioulnar joint (DRUJ) is critical to the function of the forearm as a mechanical unit. This paper is concerned with the concepts and observations that have changed understanding of the function of the DRUJ, notably with respect to the biomechanics of this joint. The DRUJ has been shown to be important in acting to distribute load and removal of the ulna head leads to the biomechanical equivalent of a one-bone forearm.

Arterial injuries at the elbow carry a high risk of muscle necrosis and warrant urgent revascularisation.

Introduction: Revascularisation following axial arterial system injury is effective in upper limb salvage but necrosis of muscle, the tissue most sensitive to ischaemia, may still occur. We examined the frequency of necrosis, its related factors and its functional significance.

Methods: The clinical findings and operative management of 13 patients with injuries at the elbow referred to 2 plastic surgical hand surgery units over a 30-month period were reviewed.

Subluxation-related ulnar neuropathy (SUN) syndrome related to distal radioulnar joint instability.

Ulnar neuropathy coexistent with distal radioulnar joint (DRUJ) instability has previously been observed in our practice. The aim of this study was to define this phenomenon and investigate the hypothesis that the cause of this intermittent, positional ulnar neuropathy is related to kinking of the ulnar nerve about the DRUJ. Ulna neuropathy was present in 10/51 (19.

Fibre bundles in the human extensor carpi ulnaris tendon are arranged in a spiral.

The extensor carpi ulnaris musculotendinous unit has important agonist and antagonist action in wrist motion, including the dart-throwing action, and is a dynamic stabilizer of the distal radioulnar joint during forearm rotation. Despite its functional and clinical importance, little is known about its internal structure. Investigation of the ultrastructure of the human extensor carpi ulnaris (ECU) tendon was undertaken using plane polarized light microscopy and microcomputer tomography with 3D reconstruction.

Effective animal health disease surveillance using a network-enabled approach.

There are many benefits that derive from real-time knowledge of the health status of the national livestock population. Effective animal disease surveillance is a requirement for countries that trade in live animals and their products in order to comply with the World Organization for Animal Health (OIE) guidelines. Rapid identification of introduced and emerging disease allows rapid response and mitigation of the economic consequences.

The functional anatomy of forearm rotation.

The elbow, forearm and wrist act as a unified structure to provide a stable, strong and highly mobile strut for positioning the hand in space and for conducting load-bearing tasks. An understanding of the relevant anatomy and biomechanics is important for the surgeon assessing and treating disorders of forearm function. This paper is concerned with illuminating the principles and concepts governing forearm rotation and load-bearing functions.