Accuracy in Screw Selection in a Cadaveric, Small-Bone Fracture Model.

Purpose: Using a cadaveric model simulating clinical situations experienced during open reduction and internal fixation of proximal phalangeal fractures, the aim of this study was to evaluate the relationship between level of training and the rates of short, long, and ideal screw length selection based on depth gauge use without fluoroscopy assistance.

Methods: A dorsal approach to the proximal phalanx was performed on the index, middle, and ring fingers of 4 cadaveric specimens, and 3 drill holes were placed in each phalanx. Volunteers at different levels of training then measured the drill holes with a depth gauge and selected appropriate screw sizes.

Simplified Cable Nerve Grafting with Nerve-Cutting Guides and Fibrin Glue.

Cable nerve grafting is the recommended surgical treatment for large peripheral nerve defects. Traditionally, this is performed by bridging a gap in the nerve with multiple autologous nerve cables, repairing the epineurium of each cable to the perineurium of a fascicle of the injured nerve that is similar in size to the graft. The authors present a new technique in which they used nerve-cutting guides to aid in the placement of fibrin glue to secure the sides of the cabled nerve graft together to facilitate handling of the cabled nerve graft and to expedite repair.

Response to Video Capture of Plastic Surgery Procedures Using the GoPro HERO 3+: Patient Privacy and Compliance.

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Bicolumnar intercarpal arthrodesis: minimum 2-year follow-up.

Purpose: To determine greater than 2-year outcomes for combined lunate-capitate and triquetrum-hamate arthrodeses.

Methods: We identified 16 patients who underwent scaphoid excision and combined arthrodeses of the lunate-capitate and triquetrum-hamate joints (bicolumnar arthrodesis) from 2007 to 2010. Eleven patients returned for follow-up evaluation, which included measurement of operative and contralateral control wrist flexion, extension, and grip strength, and completion of a patient-reported outcomes questionnaire, visual analog scale pain assessment, and Disabilities of the Arm, Shoulder, and Hand questionnaire.

Biomechanical effects of steroid injections used to treat pyogenic flexor tenosynovitis.

Background: A recent study from our laboratory has demonstrated improved range of motion in the toes of broiler chickens afflicted with pyogenic flexor tenosynovitis when treated with local antibiotic and corticosteroid injections, without surgical drainage. However, the use of corticosteroids as an adjunct treatment raised peer concern, as steroids are thought to have deleterious effects on tendon strength. The purpose of this study was to compare the tensile strength of the aforementioned steroid treated tendons, to a group of tendons administered with the current standard treatment: systemic antibiotics, surgical drainage and no corticosteroids.

Flexor tendon sheath infections of the hand.

Flexor tendon sheath infections of the hand must be diagnosed and treated expeditiously to avoid poor clinical outcomes. Knowledge of the sheath's anatomy is essential for diagnosis and to help to guide treatment. The Kanavel cardinal signs are useful for differentiating conditions with similar presentations.

Gap junctions in IL-1β-mediated cell survival response to strain.

Mechanical stimuli play important roles in proliferation and differentiation of connective tissue cells, and development and homeostatic maintenance of tissues. However, excessive mechanical loading to a tissue can injure cells and disrupt the matrix, as occurs in tendinopathy. Tendinopathy is a common clinical problem in athletes and in many occupational settings due to overuse of the tendon.

Corticosteroids as an adjunct to antibiotics and surgical drainage for the treatment of pyogenic flexor tenosynovitis.

Background: Many similarities exist between pyogenic flexor tenosynovitis and other closed-space infections such as septic arthritis. Previous studies have demonstrated that corticosteroids in conjunction with antibiotics considerably improve treatment outcomes in patients with septic arthritis. Using a chicken model, we investigated whether or not corticosteroids in combination with antibiotics and/or surgical drainage could minimize the loss of range of motion typically associated with pyogenic flexor tenosynovitis.

Pediatric scaphoid fractures.

Fractures of the immature carpal scaphoid can be challenging to manage. The diagnosis may be missed or delayed because of absent or minimal symptoms. Once diagnosed, most pediatric scaphoid fractures can be successfully treated with cast immobilization.

Management of intra-articular metacarpal base fractures of the second through fifth metacarpals.

Intra-articular fractures of the second through fifth metacarpal bases are uncommon injuries but can result in serious morbidity if improperly managed. These injuries usually occur because of forced flexion of the wrist with simultaneous extension of the arm, as occurs with a punch or a fall. As there are few large series of reports for these injuries, there is no consensus in the current literature on the most appropriate treatment for them.

Diaphyseal fractures of the radius and ulna in adults.

Diaphyseal fractures involving the radius and ulna, so called "both-bone" or "double-bone" forearm fractures are common orthopedic injuries. These injuries can result in significant loss of function if inadequately treated. As the upper extremity serves to position the hand in space, loss of forearm motion and/or muscle imbalance resulting from a poorly treated fracture can be particularly debilitating.

Interleukin-1beta increases elasticity of human bioartificial tendons.

Stiffness is an important mechanical property of connective tissues, especially for tissues subjected to cyclic strain in vivo, such as tendons. Therefore, modulation of material properties of native or engineered tissues is an important consideration for tissue repair. Interleukin 1-beta (IL-1beta) is a cytokine most often associated in connective tissues with induction of matrix metalloproteinases and matrix destruction.

Malunion of the distal radius.

Fractures of the distal radius are common injuries. Acceptable results typically can be obtained with appropriate surgical or nonsurgical management. However, a small percentage of these fractures can progress to symptomatic malunion, which traditionally has been treated with osteotomy of the distal radius.

IL-1beta decreases the elastic modulus of human tenocytes.

Cellular responses to mechanical stimuli are regulated by interactions with the extracellular matrix, which, in turn, are strongly influenced by the degree of cell stiffness (Young's modulus). It was hypothesized that a more elastic cell could better withstand the rigors of remodeling and mechanical loading. It was further hypothesized that interleukin-1beta (IL-1beta) would modulate intracellular cytoskeleton polymerization and regulate cell stiffness.

Family violence: tools for the orthopaedic surgeon.

Family violence, in the form of child abuse, adult domestic violence, and elder abuse, is a major public health problem in the United States. It leads to physical and psychological disability, loss of productivity, and even death. It can perpetuate itself through successive generations and contributes to the escalating costs of health care in this country.