The Arthroscopic Ulnohumeral Arthroplasty: From Mini-Open to Arthroscopic Surgery

In cubarthritis—osteoarthritis of the elbow—surgical procedures may be considered to debride the elbow joint to reduce pain, to increase mobility, and to postpone joint replacement surgery. The ulnohumeral arthroplasty as described by Outerbridge and Kashiwagi was originally introduced to debride both anterior and posterior elbow compartments through a direct posterior mini-open approach. To achieve this, a distal humeral fenestration throughout the humeral fossa is performed. Although with an elbow arthroscopy, a technique that was obviously developed later on, all compartments can be easily visualized. The arthroscopic fenestration of the humerus preserves its advantages, with good clinical results focused on pain relief and gaining mobility. On top, future elbow joint locking based on degenerative loose bodies can be prevented. Therefore, this surgery is often done in young, more active patients and even in sportsmen. These patients, however, need to be prompted to restrict loading on the elbow in the immediate postoperative period, because the elbow is biomechanically weakened and may be prone to a fracture. However, both outcome and postoperative rehabilitation are promising and the arthroscopic Outerbridge procedure is a reliable procedure with an easy rehabilitation. Therefore, the threshold is relatively low in early cubarthritis and recurrent locking of the elbow. In this paper, we present a literature review and the author's experience and own research on the Outerbridge procedure

MRI diagnosis of carpal boss and comparison with radiography

Background: A carpal boss is a potentially painful bony mass in the region of the second or third carpometacarpal joint. The combination of clinical examination and radiography is usually sufficient for the diagnosis. Purpose: To determine whether magnetic resonance imaging (MRI) examination of the quadrangular joint can assist the diagnosis of persistent pain near a carpal boss. Material and Methods: Fifty-seven patients with a carpal boss were retrospectively reviewed using MRI and conventional radiographs and compared to an asymptomatic control group. Results: MRI demonstrated a variable morphology and a variety of bone and soft tissue abnormalities associated with carpal boss. Bone marrow edema around the quadrangular joint shows a significant correlation (Fisher's exact test: P< 0.001) and a positive correlation (Pearson's test r = 0.632, significant at the 0.01 level [two-tailed]) with a painful carpal boss. Conclusion: MRI offers detailed examination of bone and soft tissue abnormalities associated with a carpal boss. Local bone marrow edema strongly correlates with a painful carpal boss

Predicting small-scale, short-lived downbursts : case study with the NWP limited-area ALARO model for the Pukkelpop thunderstorm

The authors consider a thunderstorm event in 2011 during a music festival in Belgium that produced a short-lived downburst of a diameter of less than 100 m. This is far too small to be resolved by the kilometric resolutions of today's operational numerical weather prediction models. Operational forecast models will not run at hectometric resolutions in the foreseeable future. The storm caused five casualties and raised strong societal questions regarding the predictability of such a traumatic weather event.In this paper it is investigated whether the downdrafts of a parameterization scheme of deep convection can be used as proxies for the unresolved downbursts. To this end the operational model ALARO [a version of the Action de Recherche Petite Echelle Grande Echelle-Aire Limitee Adaptation Dynamique Developpement International (ARPEGE-ALADIN) operational limited area model with a revised and modular structure of the physical parameterizations] of the Royal Meteorological Institute of Belgium is used. While the model in its operational configuration at the time of the event did not give a clear hint of a downburst event, it has been found that (i) the use of unsaturated downdrafts and (ii) some adaptations of the features of this downdraft parameterization scheme, specifically the sensitivity to the entrainment and friction, can make the downdrafts sensitive enough to the surrounding resolved-scale conditions to make them useful as indicators of the possibility of such downbursts

Dieren als drijfkracht = Animals powering machines

A short description is given of horse- and dog-powered machines, which freed humans from several types of hard slave labor. Horse-driven norias helped to evacuate water in the construction of canals. The well-known horse mills were mainly used for milling wheat and other grains to meal. On dairy farms, dog-powered treadmills took over from maids and peasant women the heavy task of producing butter by keping cream in rapid motion in order to separate fat. Dogs also powered very diverse ustensils such as roasting spits in large kitchens and bellows in forgeries