“Review of contemporary non-surgical management techniques for metacarpal fractures: Anatomy and rehabilitation strategies”

This comprehensive study explores the various aspects of metacarpal fractures, a prevalent condition in hand injuries. We delve into the anatomy of the metacarpals, elucidating how their structural characteristics influence fracture mechanics and treatment options. Special attention is given to the diverse types of fractures, particularly the differing tolerances for angular, shortening, and rotational deformities. The manuscript extensively reviews conservative treatment approaches, emphasizing the efficacy of non-surgical methods like modified braces and active mobilization techniques. Additionally, we provide a nuanced understanding of specific fracture types, such as neck fractures, highlighting their unique healing dynamics. This research offers valuable insights for orthopedic and plastic surgery practitioners, advancing the understanding and management of metacarpal fractures

Effectiveness of neurodynamic treatment in managing lateral epicondylitis: a systematic review

Background: Lateral epicondylitis, commonly known as “tennis elbow,” is a prevalent musculoskeletal condition affecting up to 3% of the population, primarily in individuals over 40 years old. It leads to pain and dysfunction at the lateral epicondyle, primarily involving the tendons of forearm extensor muscles, innervated by the radial nerve. Recent insights suggest a multifactorial etiology, questioning the traditional tendinopathy model. Neurodynamics, exploring nerve mechanics, emerges as a potential treatment approach. Methods: A systematic review following PRISMA guidelines searched multiple databases for clinical trials investigating neurodynamic interventions for lateral epicondylitis. Inclusion criteria involved lateral epicondylitis patients receiving neurodynamic treatment, with pain, disability, and functional improvement as primary outcomes. Results: Six studies met the inclusion criteria. Neurodynamic techniques, including radial nerve mobilization and home exercises, showed positive outcomes. Significant pain reduction, improved grip strength, and increased ulnar deviation angle were observed in several studies. However, heterogeneity in study design, follow-up durations, and small sample sizes limit conclusive evidence. Conclusion: Neurodynamic treatment, particularly radial nerve mobilization, appears promising in alleviating pain and improving nerve mechanosensitivity in lateral epicondylitis. High-quality research is needed to establish its efficacy, considering the limitations in existing studies. A multidisciplinary approach and standardized patient inclusion criteria should be emphasized to advance the management of this condition

Three-Dimensional Printed Custom-Made Prostheses after Partial Scapulectomy: A Case Report

Abstract: This case study focuses on scapula reconstruction using three-dimensional printing in a patient with low-grade osteosarcoma. Malignant tumors originating from the scapula often lead to destructive surgery, with poor functional status and quality of life for the patients. Using custom prosthetic technology through three-dimensional printing could be a possible solution for reconstruction with greater long-term functional outcomes. This study aims to assess the functional outcomes of the reconstruction. A 39-year-old patient with low-grade central osteosarcoma involving the lateral two-thirds of the scapula underwent a custom prosthetic reconstruction. The patient subsequently followed a rehabilitation protocol for 12 months. The results indicate that even though there was a slight decrease in the range of movement, and an increase in the disabilities of the arm, shoulder, and hand (DASH) score, no relevant increase in activities of daily living (ADL) disability was present at follow-up. The patient returned to carry out his daily activities without pain and with a minimal functional reduction in movement. In conclusion, three-dimensional prosthetic reconstruction is a valid alternative for scapula reconstruction, allowing excellent functional and aesthetic results in oncological cases

The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients

Abstract: Background Gait speed represents a functional predictor and an impairment severity index in stroke survivors; gait analysis parameters are descriptors of walking strategies used to compensate for the muscle impairment such as vaulting, circumduction and hip hiking. The aim of this study was to assess if there is a relationship between the gait compensatory strategy and gait speed of progression. Methods A sample of 30 patients with post-stroke hemiparesis was assessed for gait compensatory patterns through gait analysis and videorecording. BMI, pain-VAS, Barthel Index, Nottingham Extended ADL Scale, Motricity Index, lower limb muscles strength and aROMs were also included in the assessment. Results In 19 patients it was possible to identify one or more compensatory strategies; in 11 patients no specific gait pattern was found. The vaulting and hip hiking combined gait strategy had an effect on gait speed. Gait speed was directly related to Barthel Index, Nottingham Extended ADL Scale, Motricity Index of the paretic side and in particular with quadriceps and iliopsoas strength and hip extension aROM. Gender, age and paretic side did not influence gait speed. Conclusion Compensatory gait strategies influence gait speed but studies with larger sample size are needed to better highlight their impact

Polyamine supplementation reduces DNA damage in adipose stem cells cultured in 3-D

According to previous research, natural polyamines exert a role in regulating cell committment and differentiation from stemness during skeletal development. In order to assess whether distinct polyamine patterns are associated with different skeletal cell types, primary cultures of stem cells, chondrocytes or osteoblasts were dedicated for HPLC analysis of intracellular polyamines. Spermine (SPM) and Spermidine (SPD) levels were higher in adipose derived stem cells (ASC) compared to mature skeletal cells, i.e. chondrocytes and osteoblasts, confirming the connection of polyamine content with stemness. To establish whether polyamines can protect ASC against oxidative DNA damage in a 3-D differentiation model, the level of gamma H2AX was measured by western blot, and found to correlate with age and BMI of patients. Addition of either polyamine to ASC was able to hinder DNA damage in the low micromolecular range, with marked reduction of gamma H2AX level at 10 mu M SPM and 5 mu M SPD. Molecular analysis of the mechanisms that might underlie the protective effect of polyamine supplementation evidences a possible involvement of autophagy. Altogether, these results support the idea that polyamines are able to manage both stem cell differentiation and cell oxidative damage, and therefore represent appealing tools for regenerative and cell based applications

The expression of hyperpolarization activated cyclic nucleotide gated (HCN) channels in the rat ovary are dependent on the type of cell and the reproductive age of the animal: a laboratory investigation

<p>Abstract</p> <p>Background</p> <p>Aim of this study was to test the hypothesis that levels of hyperpolarization activated cyclic nucleotide gated channels 1 to 4 (HCN1-4) are linked to the reproductive age of the ovary.</p> <p>Methods</p> <p>Young, adult, and reproductively aged ovaries were collected from Sprague-Dawley rats. RT-PCR and western blot analysis of ovaries was performed to investigate the presence of mRNA and total protein for HCN1-4. Immunohistochemistry with semiquantitative H score analysis was performed using whole ovarian histologic sections.</p> <p>Results</p> <p>RT-PCR analysis showed the presence of mRNA for HCN1-4. Western blot analysis revealed HCN1-3 proteins in all ages of ovarian tissues. Immunohistochemistry with H score analysis demonstrated distinct age-related changes in patterns of HCN1-3 in the oocytes, granulosa cells, theca cells, and corpora lutea. HCN4 was present only in the oocytes, with declining levels during the reproduction lifespan.</p> <p>Conclusion</p> <p>The evidence presented here demonstrates cell-type and developmental age patterns of HCN1-4 channel expression in rat ovaries. Based on this, we hypothesize that HCN channels have functional significance in rat ovaries and may have changing roles in reproductive aging.</p

Up-regulation of L- and non-L, non-N-type Ca2+ channels by basal and stimulated protein kinase C activation in insulin-secreting RINm5F cells

AbstractWe studied the effect of protein kinase C (PKC) inhibition and activation on voltage-dependent Ca2+ channels in rat insulinoma RINm5F cells. PKC down-regulation by chronic (24 h) treatment with the PKC activator phorbol 12-myristate 13-acetate (PMA) reduced by about 60% the Ba2+ currents through L- and non-L, non-N-type high-voltage-activated Ca2+ channels, indicating that PKC tonically up-regulates the two main Ca2+ channel subtypes of RINm5F cells under basal conditions. Consistently, PKC activation by acute PMA application caused only a modest increase (average 23%) of Ba2+ currents in a minority of cells (24%). L- and non-L, non-N-type channels were differentially up-regulated by either basal or stimulated PKC activation. Acute up-regulation was predominant on L-type channels and caused an I/V shift of the Ba2+ currents in the hyperpolarizing direction. Non-L, non-N-type channels were less affected by acute PMA application, possibly reflecting a more effective tonic PKC up-regulatory action. Unexpectedly, the increase of Ba2+ currents during acute PMA application was followed by a progressive current decrease, which was also observed in isolation in another 24% of the cells and could be ascribed to PKC-induced ATP depletion, rather than to a direct effect of PKC on Ca2+ channels. We also provide evidence that PKC-mediated phosphorylation is not involved in the G-protein-mediated noradrenergic modulation of Ca2+ channels in RINm5F cells