Background and Aim: This study is performed to evaluate the results of lengthening of the fingers or congenitally short phalanxes, metacarpal and metatarsal bones by callus distraction technique. In this study we used a newly designed callus distraction device which is simple, reliable and easy to use.Material and Methods: This study included 46 patients, 20 females and 26 males with short bones of hands or feet. The mean age of the patients was 17 years (age range 4-23 years). 67% of our patients had traumatic amputation of fingers or toes. The mean duration of follow up of the patients was 56 months.Results: The mean length of metacarpal, phalangeal and metatarsal bones before surgery was 31 mm (range 30-35 mm). The mean bone length increase after surgery was 16 mm (range 15 to 27 mm) i.e. more than 50% of the bone length. Mean healing index ratio was 5.53 days/millimeter. No bone graft was required after bone lengthening. Complications were, pin tract infection in 2.5%, hypertrophic scar on the dorsum of foot in 8.5%, neurovascular complications in 1%, reversible stiffness in joints in 9.5% and bone pain in 12% of the patients.Conclusion: Callus distraction is an effective and reliable method for lengthening of short phalangeal, metacarpal and metatarsal bones. It also preserves the periosteal bone tissue. Our distractor device is reliable and highly effective for callotesis.

Melorheostosis is a rare disease also known as Leri disease with about 400 cases in the world with unknown etiology although relations with mitogen-activated protein kinase 1 gene and LEM domain-containing protein 3 gene mutations are described. We presented a case of melorheostosis referred to the rheumatology clinic with pain and swelling in the middle phalanx of the index finger and second metacarpal bone of right hand. X-ray of the hand showed a hyperdense lesions in the hand bones with obliteration of the medulla. Right hand magnetic resonance imaging showed signal loss of bone marrow in the second metacarpal bone and middle phalanx of the index finger along with severe periosteal edema. Bone biopsy confirmed melorheostosis.

Cleft hand deformity is a rare congenital anomaly of the hand with an incidence rate about 1.90000. It has two clinical types; Typical and Atypical. In this paper we are representing ten cases of this anomaly admitted during seven years from 1992 in Emam Khomeinie hospital. Some of the patients especially those with typical cleft hand deformity achieved good functional results after surgical correction of the deformity. In the younger age group we observed better functional results.

Background and Aim: The aim of the present study was to investigate the effect of the Hand Static Rest Splint on reducing the pain and other compliance of Rheumatoid Arthritis (RA). Materials and Methods: In the present clinical trial, 12 patients, aged 35-50 (average: 39 years) with RA, referring to the Occupational Therapy Unit of Taleghani hospital and meeting America College of Rheumatology diagnostic criteria, were included. Visual Analogue Scale (VAS) was administered and swelling, tenderness and morning stiffness were assessed. Moreover, assessments of active range of motion using goniometry and grip strength with Jamar dynamometer in both hands were performed. Statistical analysis of data was performed using t-test and Mann-Whitney Test for two independent samples and willcoxon tests and paired t-test for paired samples run in SPSS, version 18. The level of significance was set at p˂ 0. 05. Results: The findings showed that the Static Rest Splint led to improvement in the wrist range of motion (flexion p=0/005, extension p=0/03) when the two groups were compared, but it did not have a significant effect on Morning Stiffness (p=1), pain (p=0/1), Swelling (p=0/06), and Tenderness (p=0/2). However, when compared between after and before intervention in hand with splint, pain (p=0/02) and wrist range of motion (p=0/004) improved. Conclusion: Based on the findings of the current study, and since using splints only improve range of motion in the wrist compared between two groups and pain relief before and after the intervention, it seems that using hand Static Rest Splint to reduce other symptoms need further investigation and also given that the use of this position without stress on the tendon can be effective in reducing the causes deformity, further studies are needed to more delineate these points.

Introduction: The sutural bones and fontanelle of the skull display unique morphological characters. Sutural bones are also called supernumerary bones, ossicles, or Wormian bones (WBs). These irregularities develop from the independent ossification centers present along the cranial sutures. They appear on periosteal and endosteal surfaces of the skull with variations in size, number, shape, and location. In the current study, we aimed to determine the morphological characteristics of sutural bones and their association with parietal emissary foramina. Methods: The current study was done on 128 dry human skulls by a convenient sampling method. The skulls were collected from the Department of Anatomy. Many characteristic features of Inca and Wormian bones like shape, number, size, and location were recorded, including abnormal parietal emissary foramen associated with the Wormian and Inca bone, respectively. Results: Out of 128 dry skulls, the Wormian bones were seen in 13. 2% of skulls and the Inca bones in 5. 4%. Incorporation of Wormian bones in the lambdoid suture was noted in 12. 5% and the sagittal suture at 0. 7%, respectively. The Wormian bones were found frequently on the left side (n=12) compared to the right side (n=5). The morphometry of the accessory bones showed quadrilateral as the most common shape (n=9, 37. 5%), followed by triangular (n=4, 16. 6%). Radiological examination of all 24 skulls with accessory bones showed a zigzag pattern of accessory suture lines. The prevalence of abnormal parietal emissary foramen (bilateral and unilateral absence associated with the Wormian bone was noted at 23. 5%. The prevalence of abnormal parietal emissary foramen (unilateral absence and foramen on the sagittal suture) related to the Inca bone was reported at 71. 4%. Conclusion: The presence of Wormian and Inca bones can be easily confused with fractures of the corresponding bony regions. The surgeons must know this to make a proper and accurate diagnosis. Knowledge of these bones benefits the clinician, radiologist, and neurosurgeon highly.