Aneurysmal bone cyst of the thumb metacarpal: En-block resection and free toe phalanx transplantation

WOS: 000187397000013PubMed: 14690296

Sonographic evaluation of scapholunate ligament: Value of tissue harmonic imaging

WOS: 000237172400001PubMed: 16547997Purpose. The aim of this study was to compare tissue harmonic imaging (THI) and conventional (fundamental) sonography in the evaluation of the scapholunate ligament (SLL). Methods. The bilateral SLL of 3 patients with unilateral SLL rupture and the bilateral SLL of 20 volunteers without history of trauma were examined. THI findings were compared with conventional sonographic findings. Results. On conventional sonographic evaluation of 43 normal wrists, the dorsal component of the SLL was partially visible in 10 of the 43 normal wrists (23%) and was completely visible in 33 of 43 (77%) normal wrists. Using THI, the SLL was visible in its entirety in 39 of 43 normal wrists (91%) and was partially visible in 4 of 43 normal wrists (9%). The mean scapholunate distance was 3.3 mm (range, 2.9-4.5 mm) in normal wrists. THI improved visualization of SLL continuity and demonstration of its fibrillar echotexture. In the 3 wrists with clinical and/or radiological evidence of SLL rupture, the SLL was not visible with conventional sonography nor THI; the mean scapholunate distance was 6.1 mm (range, 5.6-6.8 mm). Conclusions. THI improves visualization of the SLL. (C) 2006 Wiley Periodicals, Inc

Modification of the extension block Kirschner wire technique for mallet fractures

Annual Meeting of the Knee-Society/Association of-Hip-and-Knee-Surgeons -- 2002 -- DALLAS, TEXASWOS: 000179273100043PubMed: 12439271A modification of the extension block Kirschner wire technique that is used for closed reduction of mallet fractures is described. Eighteen mallet avulsion fractures of the distal phalanx treated with this modification were included in this prospective study. The fingers affected were nine small fingers, eight ring fingers, and one long finger. Surgical indications included fractures involving more than 33% of the articular surface and fractures associated with subluxation of the distal phalanx that could not be corrected by closed reduction. The average joint surface involvement was 39.8%. At followup, only one patient had pain, and that was graded as minimal. Objectively, congruous and satisfactory joint surfaces were present in 17 patients. No patient had pseudarthrosis. The average active flexion of the distal interphalangealjoint was 81.1degrees and the average extensor lag was 1.6degrees. Neither pin tract infections nor migration of the pins occurred. The average followup was 27.3 months. This modification increased range of motion at the distal interphalangeal joint and showed a trend toward reduced permanent extensor lag when compared with the original method. This technique should be considered when treatment of the mallet fracture is being planned using the extension block Kirschner wire technique.Knee Soc, Assoc Hip & Knee Surgeon

Medial elbow dislocation associated with a fracture of the lateral humeral condyle in a child.

PubMed: 19292145[No abstract available

Ultrasonographic findings in pediatric fractures

WOS: 000184220200010PubMed: 12921301The aim of this study was to document and, analyze ultrasonographic (US) findings in different types of pediatric, fractures. Thirty-nine patients, aged between 1 and 14 years, with a fracture were included in the study. Patients were classified as complete or incomplete fractures. Greenstick fractures, torus fractures and plastic deformations were considered as incomplete fractures.. Ultrasonographic findings (subperiosteal hematoma, bending, cortical disruption, and reverberating echo) were analysed for each type of fracture. Subperiosteal hematoma was present in all patients in the study. Bending sign was present in all patients in the incomplete fracture group, but not present in complete fractures. Cortical disruption and reverberating echo were present in all patients with complete and greenstick fractures. In conclusion, whether the fracture is complete or incomplete, subperiosteal hematoma, together with a cortical disruption, bending sign, or reverberating echo shown on US. can confirm the fracture diagnosis in children

Reliability of the safe area for the superior gluteal nerve

WOS: 000183929900018PubMed: 12838060The authors investigated the reliability of the safe area, which previously was defined to prevent injury to the superior gluteal nerve during the lateral approach to the hip, and its relation to body height. The distance between the point of entry of the superior gluteal nerve into the gluteus medius muscle and the greater trochanter, in the regions which were defined as the anterior and posterior halves of the muscle, were measured in 23 cadaveric hips. There was a significant correlation between the height of the cadavers and the distance in the anterior and posterior regions. In all of the anterior regions and 78% of the posterior regions of the hips, the superior gluteal nerve as found to be in the safe area. The current study showed that the average distance between the innervation point of the gluteus medius muscle and the greater trochanter might change as a function of body height. The risk of damage to the superior gluteal nerve may be higher if the direct lateral approach to the hip is used. These data show that it is possible that the safe area is not always safe

Chondroitin sulfate-coated polyhydroxyethyl methacrylate membrane prevents adhesion in full-thickness tendon tears of rabbits

KORKUSUZ, PETEK/0000-0002-7553-3915WOS: 000174437300013PubMed: 11901389Polyhydroxyethyl methacrylate (pHEMA) membranes coated on one side with chondroitin sulfate (CS) were used to block adhesion physically and to reduce friction between healing flexor tendons and the surrounding tissue in rabbit forepaws after surgical repair. Digits with pHEMA-only, standard tendon sheath repair, and with no sheath repair were the controls. Over 12 weeks the CS-coated membranes were evaluated for joint flexion, adhesion limitation, and tendon healing progress. The membranes initially allowed for better flexion (i.e, for 6 weeks), but their relative superior effectiveness faded afterward. Histology showed that adhesions were less severe and healing was better in the CS-pHEMA membranes at 3 and 6 weeks. If further studies determine precise amounts or thicknesses of CS coats that will maximize its healing properties, CS-pHEMA should prove useful in clinical settings in which restoration of tendon sheath integrity with a minimum of adhesions is not possible. Copyright (C) 2002 by the American Society for Surgery of the Hand

Innervation pattern of the abductor digiti minimi muscle of the hand

WOS: 000178866900009PubMed: 12367541This cadaver study investigated the innervation patterns of the abductor digiti minimi in Guyon's canal. There was only one branch to the abductor digiti minimi in 22 of the 30 specimens. Two branches were found in three hands, and three branches in two. Three other variations were documented