Defining a safe zone of dissection during the extensor digitorum communis splitting approach to the proximal radius and forearm: an anatomic study.

Purpose: The extensor digitorum communis (EDC) splitting approach is a direct lateral approach that can provide greater visualization of the proximal radius than the posterolateral approach to the elbow. The purposes of this study were to identify the anatomic relationships of the posterior interosseous nerve (PIN) during the EDC splitting approach to the proximal radius and to determine its safe zone.

Methods: A fellowship-trained attending hand surgeon performed the EDC splitting approach on 15 cadaveric arms, exposing the EDC origin from the lateral epicondyle and dissecting distally to expose the supinator muscle.

Comparison of needle position proximity to the median nerve in 2 carpal tunnel injection methods: a cadaveric study.

Purpose: Steroid injections are commonly performed by hand surgeons for relief of symptoms associated with carpal tunnel syndrome. The purpose of this study is to examine the relationship of the needle to the median nerve within the carpal tunnel and to the palmar cutaneous branch, using 2 injection techniques.

Methods: Simulated carpal tunnel injections were performed on 15 cadaveric arms using 2 methods.

Effects of a novel sterilization process on soft tissue mechanical properties for anterior cruciate ligament allografts.

Background: Allograft anterior cruciate ligament reconstruction provides benefits such as earlier return to activities and less pain, but concerns remain regarding potential infection and biomechanical stability.

Hypothesis: There is no difference in biomechanical properties of soft tissue allografts treated with the Biocleanse tissue sterilization process compared with irradiated and fresh-frozen allografts.

Study Design: Controlled laboratory study.

High-molecular-weight hyaluronan inhibits macrophage proliferation and cytokine release in the early wound of a preclinical postlaminectomy rat model.

Background Context: Failed back syndrome, a condition that affects 3-14% of postoperative spine patients, is characterized by the recurrence of radicular pain after spinal decompression. The source of this pain in some patients is thought by many investigators to be the result of epidural scarring and nerve root tethering, but this is controversial. We have previously demonstrated that in a disc-injury model the untreated postlaminectomy rats develop a significant proliferative fibrous response at 8 weeks with spinal nerve scarring to the disc and adjacent pedicle, and increased sensitivity to tactile allodynia testing in the related sensory dermatome.

Paraspinal muscle vasculature contributes to posterolateral spinal fusion.

Study Design: Study of posterolateral fusions in a rabbit model.

Objectives: To characterize the contribution of paraspinal musculature to the healing of posterolateral spinal fusions in a rabbit model.

Summary Of Background Data: Previous studies have demonstrated that successful spinal arthrodesis requires vascular ingrowth from adjacent decorticated bone.

Topical high molecular weight hyaluronan reduces radicular pain post laminectomy in a rat model.

Background Context: A controversy exists about the mechanism of causation of the post-laminectomy pain syndrome. Some believe that epidural scarring, and attendant spinal nerve and nerve root scarring and tethering to the disc or pedicle at the site of surgery contributes to post-laminectomy pain in such patients. However, clinical outcome studies on this question are inconclusive and the assertion remains controversial.

Brachymetatarsia.

Brachymetatarsia is a rare clinical entity that presents a complicated case to the treating surgeon. One-stage lengthening procedures with a variety of biologic and synthetic implants are preferred for metatarsals that only need to be lengthened up to 15 mm, whereas gradual lengthening allows for greater length gain and concomitant lengthening of the soft tissues. Adjacent metatarsal shortening may be used in conjunction with lengthening procedures to restore the parabolic arc of the metatarsal heads.