Self-reinforced bioabsorbable miniplates for skeletal fixation in complex hand injury: three case reports.

We report our preliminary experience with 3 cases in which internal fixation with a self-reinforced poly-l/dl-lactide 70/30 miniplate and 1.5-mm or 2.0-mm screws were used to stabilize an open metacarpal fracture, a metacarpophalangeal arthrodesis in a thumb replantation, and an interposed bone graft for reconstruction of a thumb.

Sonographic evaluation of primary peripheral nerve repair.

Objective: This feasibility study was undertaken to define the potential of sonography for the follow-up evaluation of patients with surgical repair after nerve transection and persistent impairment of nerve function.

Methods: Nineteen patients with primary repair of a transected peripheral nerve because of direct trauma or complex fractures were evaluated with sonography. All patients had persistent clinical symptoms and neurologic signs of impaired nerve function.

Distally based abductor hallucis muscle flap: anatomic basis and clinical application.

Although rarely used, the abductor hallucis muscle has its indications in coverage of small defects at the medial aspect of the hindfoot as a proximally based muscle flap. The authors describe a 69-year-old female patient in whom the abductor hallucis muscle was used as a distally based flap to reconstruct a defect in the forefoot. An anatomic study was undertaken on two cadaveric feet to explore the practicality of the distally based abductor hallucis muscle flap before it was applied clinically.

Treatment of distal radioulnar joint disorders with a modified Sauvé-Kapandji procedure: long-term outcome with special attention to the DASH Questionnaire.

Introduction: An intact distal radioulnar joint (DRUJ) is essential for normal functioning of the upper limb. Osteoarthritis of the DRUJ often leads to ulnar wrist pain, limitation of forearm rotation and reduced grip strength, all of which limit activities of daily living. Once the joint is damaged, salvage procedures are recommended.

Muscle-sparing latissimus dorsi myocutaneous flap with maintenance of muscle innervation, function, and aesthetic appearance of the donor site.

In this report, the authors describe the application of a muscle-sparing technique to harvest a myocutaneous latissimus dorsi muscle flap, including only a tiny lateral muscle segment but carrying a large skin paddle, with the advantage of leaving intact innervation and function of the remaining latissimus dorsi muscle. According to the experiences and complications associated with the pure thoracodorsal artery perforator harvest at the authors' institution, the necessity of increasing the reliability of the vascular pedicle demands that a small muscle strip be left embedding the perforator vessels attached to the skin paddle. This procedure was applied in eight cases with only one minor complication, which was a distal flap tip necrosis in the largest flap used.

Ultrasonographic appearance of supinator syndrome.

Objective: To describe ultrasonographic findings in 4 patients with supinator syndrome (i.e., deep branch of the radial nerve).

Ultrasonography of the accessory nerve: normal and pathologic findings in cadavers and patients with iatrogenic accessory nerve palsy.

Objective: To determine feasibility of ultrasonography in detecting the normal accessory nerve as well as pathologic changes in cases of accessory nerve palsy.

Methods: Four patients with accessory nerve palsy were investigated by ultrasonography. Three cases of accessory nerve palsy after lymph node biopsy and neck dissection were primarily diagnosed on the basis of ultrasonography using a 5- to 12-MHz linear transducer.

Receptors for NGF and GDNF are highly expressed in human peripheral nerve neuroma.

Immunhistochemistry of 10 traumatic human peripheral nerve neuromas and 5 normal digital nerves revealed a high immunoreactivity for the nerve growth factor (NGF) receptors p75 and trkA and the glial cell line-derived neurotrophic factor (GDNF) receptor GFRalpha-1. Semiquantitative image analysis showed a significantly increased trkA immunoreactivity in the neuroma group. The presence of the receptors may provide a way to influence therapy of peripheral nerve neuroma by administration of neurotrophins or other substances with binding sites similar to those of a neurotrophic factor.

High-resolution sonography of lower extremity peripheral nerves: anatomic correlation and spectrum of disease.

Objective: The value of sonography for the diagnosis of diseases of the peripheral nervous system is only little known. This image presentation is intended to raise the awareness of sonographers and clinicians of the potential of sonography by giving an anatomic-sonographic correlation of lower extremity peripheral nerves and an overview of commonly encountered diseases.

Methods: On 2 lower extremity cadaver specimens, peripheral nerves were imaged in typical locations such as the tarsal tunnel.