Background:The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds,resulting in drop-hand syndrome.The aim of this study was to evaluate the outco...Background:The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds,resulting in drop-hand syndrome.The aim of this study was to evaluate the outcomes of tendon transfer in patients with drop-hand syndrome who had been injured in the Syrian Civil War.Methods:This level-II,prospective,comparative study included 13 civilians injured in the Syrian Civil War 2015 and 2017.The palmaris longus tendon was used for transfer to the extensor pollicis longus for thumb extension.The pronator teres was transferred to the extensor carpi radialis brevis for wrist extension.The flexor carpi radialis was transferred to the extensor digiti communis for 2 nd,3 rd,4 th,and 5 th finger extension.All outcomes of thumb abduction and extension,wrist extension,wrist flexion,and finger extension were assessed.Results:There was a high level of radial nerve injury in all patients included in the study.The time from injury to treatment ranged from 1.5 months to 9 months.The mechanism of injury most commonly observed was a gunshot wound,which was observed in 8 patients(61.5%),followed by a penetrating cutting tool injury(n=3;23.1%)and humerus fracture(n=2;15.4%).Conclusions:In radial nerve injuries,successful results can be achieved with tendon transfer.All patients regained thumb abduction of up to approximately 60°.All the patients were able to bend the wrist,grip,and extend the fingers while in wrist flexion,neutral wrist and wrist extension positions.Although the reason for the radial injury varied,the postoperative outcomes were good for all patients,and the rehabilitation period progressed successfully in patients who underwent tendon transfer repair within 90 days of injury.展开更多
Daraa City is widely known as the birthplace of the Syrian uprising.The uprising,which was initially motivated by high-minded ideas and opposition to the arbitrary violence of an authoritarian state,rapidly degenerate...Daraa City is widely known as the birthplace of the Syrian uprising.The uprising,which was initially motivated by high-minded ideas and opposition to the arbitrary violence of an authoritarian state,rapidly degenerated into a civil war orientated by external agendas and priorities.In this paper,I want to situate Daraa governorate at the centre of this development,with the intention of highlighting how the course of events in this small part of Syria had vital implications for the development of the Syrian Civil War.In seeking to develop an analysis of the interplay of internal dynamics and external influences,i seek to‘reconcile’the‘micro’and‘macro’dimensions of civil war,and also draw on contributions to the peacebuilding literature,and this enables me to reconceptualise the relationship between‘internal’and‘external’drivers of conflict.展开更多
文摘Background:The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds,resulting in drop-hand syndrome.The aim of this study was to evaluate the outcomes of tendon transfer in patients with drop-hand syndrome who had been injured in the Syrian Civil War.Methods:This level-II,prospective,comparative study included 13 civilians injured in the Syrian Civil War 2015 and 2017.The palmaris longus tendon was used for transfer to the extensor pollicis longus for thumb extension.The pronator teres was transferred to the extensor carpi radialis brevis for wrist extension.The flexor carpi radialis was transferred to the extensor digiti communis for 2 nd,3 rd,4 th,and 5 th finger extension.All outcomes of thumb abduction and extension,wrist extension,wrist flexion,and finger extension were assessed.Results:There was a high level of radial nerve injury in all patients included in the study.The time from injury to treatment ranged from 1.5 months to 9 months.The mechanism of injury most commonly observed was a gunshot wound,which was observed in 8 patients(61.5%),followed by a penetrating cutting tool injury(n=3;23.1%)and humerus fracture(n=2;15.4%).Conclusions:In radial nerve injuries,successful results can be achieved with tendon transfer.All patients regained thumb abduction of up to approximately 60°.All the patients were able to bend the wrist,grip,and extend the fingers while in wrist flexion,neutral wrist and wrist extension positions.Although the reason for the radial injury varied,the postoperative outcomes were good for all patients,and the rehabilitation period progressed successfully in patients who underwent tendon transfer repair within 90 days of injury.
文摘Daraa City is widely known as the birthplace of the Syrian uprising.The uprising,which was initially motivated by high-minded ideas and opposition to the arbitrary violence of an authoritarian state,rapidly degenerated into a civil war orientated by external agendas and priorities.In this paper,I want to situate Daraa governorate at the centre of this development,with the intention of highlighting how the course of events in this small part of Syria had vital implications for the development of the Syrian Civil War.In seeking to develop an analysis of the interplay of internal dynamics and external influences,i seek to‘reconcile’the‘micro’and‘macro’dimensions of civil war,and also draw on contributions to the peacebuilding literature,and this enables me to reconceptualise the relationship between‘internal’and‘external’drivers of conflict.
