Complete Avulsion of the Extensor Mechanism of a Finger with Simultaneous Dislocation of the Proximal Interphalangeal Joint

We report a rare case of open dislocation of the proximal interphalangeal (PIP) joint, associated with simultaneous avulsion of the central band and distal insertion of the extensor mechanism, rapture of the proximal volar plate, and rapture of the ulnar collateral ligament of the PIP joint

The first description in the literature, of a complication during the extraction of a retrograde expandable intra-medullary nail in three patients

Ankle fractures in elderly people are low-energy fractures characterised by fragility. In the majority, they are unstable and challenging to manage.Retrograde expandable intra-medullary nails (Fixion®, Biomet Merck Limited) inserted through the calcaneum across the sub-talar and ankle joints into the tibia have been successfully used in the treatment of fragility fractures and non-unions of the distal tibia and ankle, where the use of an antegrade locked nail would not provide adequate fracture stability for union.Primary fracture management involves removing the nail at least 3–4 months after radiological check. In cases of treatment of non-unions a longer treatment period is often required before removal of nail is considered.We present three patients where breakage of the Fixion® nail during surgery caused problems in nail extraction. Keywords: Ankle fracture, Intramedullary nail, Fixion nail, Retrogade nail, Tibia fracture, Complicatio

Temporal and spatial expression of TGF-β1 in an Achilles tendon section model after application of platelet-rich plasma

Background: To investigate the effect of platelet-rich plasma (PRP) on TGF-β1 expression during tendon healing. Methods: We used 48 skeletally mature New Zealand White rabbits. 24 rabbits received the PRP, and 24 rabbits served as an untreated control group. Equal numbers of animals were sacrificed at 1st, 2nd, 3rd, and 4th week. The surgical procedure involved a transverse incision to transect the Achilles tendon. A volume of 1. ml of PRP was then injected into the tendon mass in the PRP group. Histological and immunohistochemical evaluations with an anti-TGF-β primary antibody were performed. Results: The pattern of expression of TGF-β1 in the PRP group was characterized by a significant upregulation during the first 2 weeks and subsequently significant downregulation in the 3rd and 4th week in comparison with the controls. Conclusions: Our results suggest that PRP may affect the tendon healing process by altering the expression of TGF-β1. © 2009 European Foot and Ankle Society