Gartland Type III Pediatric Supracondylar Humerus Fracture with Radial Nerve Laceration: A Case Report.

Case: A 6-year-old boy sustained complete radial nerve palsy with a Gartland type III supracondylar humerus fracture (SCHF). Posteromedial displacement of the distal fragment was so severe that the tip of the proximal fragment protruded subcutaneously at the anterolateral aspect of the antecubital fossa. Immediate surgical exploration was performed to reveal radial nerve laceration.

Midterm Surgical Outcomes of Duplicated Thumbs According to New Classification.

Background: Surgical outcomes of duplicated thumbs differ depending on the branching type. The authors developed a new classification system and report surgical outcomes with an average 10.2-year follow-up.

Associations between Depressive Symptoms, Work Environment, and Lifestyle in <40-year-old Male Orthopedic Physicians in Japan.

Introduction: Efforts are being made to reduce doctors' working hours and implement reforms in the way doctors work. This study aims to determine the associations between depressive symptoms and work environment/lifestyle among <40-year-old male orthopedic physicians in Japan.

Methods: Participants were 1,343 male orthopedic physicians selected from a survey ( = 25,139) of all regular members conducted in 2019 by the Japanese Orthopaedic Association.

Radial Osteotomy With Callus Distraction for the Correction of Severe Madelung Deformity.

We report a case of an 11-year-old girl with bilateral severe Madelung deformity who underwent radial osteotomy with callus distraction. The distal radial articulation was corrected at surgery, and a unilateral fixator was subsequently used for callus distraction. No postoperative complication was noted.

Hand Surgery in Japan.

Japan has faced the most challenging times in the past. Through precise diligence by stalwarts and doyens of initial hand surgeons, it led an incredible path for the most significant moments of hand surgery. This article describes the early phase of development of Japanese Society for Surgery of the hand, substantial and innovative contributions from surgeons.

Mallet Fractures with Long Fragment Had Poor Outcomes on Extension Block Pinning.

Although extension block pinning for mallet fracture is popular, it occasionally results in poor outcome. We reviewed previous cases to elucidate the factors associated with poor outcome. From 2012 to 2017, 50 mallet fingers in 50 patients were consecutively repaired by extension block pinning using modified Ishiguro method.

Assessment of hand function using the functional dexterity test after opponensplasty in young children with Blauth type 2 hypoplastic thumb.

The functional dexterity test (FDT) is a timed pegboard test based on the manipulation of each peg and suitable for young children as it is both simple and quick to perform. We assessed the postoperative FDT values for children with Blauth type 2 hypoplastic thumbs after opponensplasty. We evaluated hand function using FDT for 12 hands of 11 patients with Blauth type 2 hypoplastic thumbs.

Treatment of Extensor Lag Using the Flexor Digitorum Superficialis after Crushing-Penetrating Injury to the Metacarpophalangeal Joint.

We previously reported the beneficial effects of tendon transfer to eliminate extension lag of the interphalangeal joints, using the extensor carpi radialis longus prolonged by palmaris longus tendon grafts after crushing-penetrating injuries around the metacarpophalangeal (MP) joint of the middle finger. We used the flexor digitorum superficialis (FDS) as the alternative donor muscle and treated two cases of severe crushing injuries to MP joint, and then obtained good outcomes.

Comprehensive clinical and molecular studies in split-hand/foot malformation: identification of two plausible candidate genes (LRP6 and UBA2).

Split-hand/foot malformation (SHFM) is a clinically and genetically heterogeneous condition. We sequentially performed screening of the previously identified Japanese founder 17p13.3 duplication/triplication involving BHLHA9, array comparative genomic hybridization, and whole exome sequencing (WES) in newly recruited 41 Japanese families with non-syndromic and syndromic SHFM.

Surgical Treatment for Kirner's Deformity-Single Osteotomy through a Palmar Approach.

Background: Patients with Kirner's deformity often seek medical attention for aesthetic improvement when they reach the age of approximately 10 years, when the deformity becomes evident. The operative technique described in textbooks is the palmar opening-wedge with multiple osteotomies through a mid-lateral incision, which is technically demanding. The purpose of this article was to introduce our surgical technique of a single transverse osteotomy through a palmar approach and to present the short-term outcomes of this technique.

Mid- to long-term outcomes after surgical treatment of chronic anterior dislocation of the radial head in children.

Background: To evaluate the mid- to long-term clinical and radiographic outcomes after surgical treatment of chronic anterior dislocation of the radial head in children.

Methods: Open reduction was performed in 16 children (mean age, 9.3 years [range, 2.

Malunion of medial condyle fracture of the humerus: a case report.

Medial condyle fracture of the humerus is extremely rare in pediatric elbow fractures. We report a rare case of malunion of medial condyle fracture in a 10-year-old boy who had an injury on the right elbow at age 4. He was referred to our clinic because of severe varus deformity (the carrying angle was 191°, unaffected side 172°) with instability.

Tardy ulnar nerve palsy caused by chronic radial head dislocation after Monteggia fracture: a report of two cases.

Dislocation of the radial head is often encountered as a result of a pediatric Monteggia fracture. We report two rare cases of tardy ulnar nerve palsy associated with anterior radial head dislocation combined with anterior bowing of the ulna. They had cubitus valgus deformity, valgus instability, and osteoarthritis of the elbow, and had elbow injury more than 40 years back.

Cervical cord compression in pediatrics with hereditary multiple exostoses: a report of two cases and review of the literature.

Hereditary multiple exostoses (HME) generally involves the long tube bone or flat bone. Spinal involvement is rare, particularly in young children. We report two cases of children with HME who have myelopathy because of cervical spine involvement and then review the literature to clarify the clinical characteristics of spinal cord HME involvement in young children.

The Classification of Swanson for Congenital Anomalies of Upper Limb Modified by the Japanese Society for Surgery of the Hand (JSSH).

The aim of this study is to introduce the classification of Swanson for congenital anomalies of upper limb modified by the Japanese Society for Surgery of the Hand (the JSSH modification) in English. The Swanson classification has been widely accepted by most hand surgeons. However, several authors have suggested that complex cases, particularly those involving the complex spectrum of cleft hand and symbrachydactyly, are difficult to classify into the classification schemes.

Radial head dislocation due to gigantic solitary osteochondroma of the proximal ulna: case report and literature review.

Developmental anterior dislocation of the radial head resulting from a congenital solitary osteochondroma of the proximal ulna is an extremely rare condition. We present a case of a 4-year-old girl with this condition affecting her right elbow, which was treated by a trapezoidal shortening osteotomy at the radial neck following an oblique ulnar osteotomy with angulation and elongation after a complete resection of the tumor mass. The child remained asymptomatic with symmetric carrying angles during 2.

Unusual humeral medial condyle fracture in an adolescent because of a previous post-traumatic fishtail deformity: a case report.

A fishtail deformity is a well-known complication following pediatric lateral condyle fracture of the humerus. We report a rare case of a medial humeral condyle fracture in a 12-year-old boy who had had a fishtail deformity because of a lateral condyle fracture in childhood. Radiographs showed a longitudinal fracture plane of the medial condyle extending to the articular surface, which is different from the three types of medial condyle fracture classified by Kilfoyle.

Japanese founder duplications/triplications involving BHLHA9 are associated with split-hand/foot malformation with or without long bone deficiency and Gollop-Wolfgang complex.

Background: Limb malformations are rare disorders with high genetic heterogeneity. Although multiple genes/loci have been identified in limb malformations, underlying genetic factors still remain to be determined in most patients.

Methods: This study consisted of 51 Japanese families with split-hand/foot malformation (SHFM), SHFM with long bone deficiency (SHFLD) usually affecting the tibia, or Gollop-Wolfgang complex (GWC) characterized by SHFM and femoral bifurcation.

Single osteotomy at the radial diaphysis for congenital radioulnar synostosis.

Purpose: To report the effectiveness of single derotation osteotomy at the radial diaphysis for the treatment of congenital radioulnar (RU) synostosis.

Methods: Since 2000, we performed 35 radial diaphysis osteotomies on 17 boys and 9 girls younger than 9 years old (average, 5 y). The radius was cut at the midshaft and manually rotated to a neutral position.

Flexor pollicis longus reconstruction using the palmaris longus in anterior interosseus nerve syndrome.

In anterior interosseus nerve syndrome, reconstruction of the paralyzed flexor pollicis longus is occasionally required. Traditionally, the brachioradialis has been used as a motor, but we utilised the palmaris longus, which is expendable. The palmaris longus tendon was transferred in an end-to-side manner, leaving the flexor pollicis longus in situ.

Severe forearm deformity and instability after Monteggia fracture-dislocation: a case report.

A 16-year-old boy presented with a painful deformity of the forearm. At the age of 11 years, he had sustained a Monteggia fracture-dislocation. Radiographs indicated nonunion of the ulna, radial head dislocation, and degenerative changes of the radiocapitellar joint.

Stabilizing incomplete reduction of the radial head using a hinged splint: conservative treatment for a Monteggia equivalent lesion.

Radial head dislocation associated with plastic bowing of the ulna is classified as a Monteggia equivalent lesion. This injury in children can be treated by closed reduction, but manipulative reduction may not completely correct plastic bowing of the ulna. We encountered two cases of incomplete reduction in which the radial head was reduced in a supination position, but redislocated during rotation from neutral to a pronation position.