Shear-wave elastography of canine patellar tendons in healthy dogs and the influence of stifle joint angle.

Elastography is a sonographic modality that measures tissue stiffness, a mechanical property of tissues, and a biomarker for disease. Canine musculoskeletal application to the patellar tendon has been limited to semiqualitative strain elastography. This prospective study aimed to quantitatively evaluate patellar tendon stiffness using shear-wave elastography with a color map superimposed over the tendon, a propagation map for quality control, and measurements at specific regions of interest in 16 clinically normal sedated dogs weighing 25 kg or greater.

Anthropometry of the Human Scaphoid Waist by Three-Dimensional Computed Tomography.

Published measurements for the scaphoid are scarce. The purpose of this study is to define anthropometric norms for the waist of the scaphoid to assist in optimizing bone graft quantity and implant use. Computed tomography images of the wrist were reviewed by three surgeons.

Fifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting: results of a prospective, multicenter, randomized trial.

Introduction: The majority of fifth metacarpal neck fractures (boxers fracture) are treated conservatively without surgery. The purpose of this prospective, randomized, multicenter trial was to determine if the outcomes of soft wrap and buddy taping (SW) was noninferior to reduction and cast (RC) in boxer's fracture with palmar angulation ≤70° and no rotational deformity.

Materials And Methods: Sixty-eight patients with similar characteristics were prospectively enrolled and randomized at four institutions.

Treatment of split-thickness skin graft-related forearm scar contractures with a carbon dioxide laser protocol: 3 case reports.

Split-thickness skin grafts in the forearm can lead to motion restriction and disability through the dense scarring of the skin and formation of graft-tendon adhesions. Three patients were referred for laser treatment of motion-limiting scar-associated split-thickness skin grafts to the forearm. All patients had reached a plateau in range of motion despite aggressive hand therapy and underwent serial laser scar treatments at 6- to 8-week intervals.

Scapula fractures: interobserver reliability of classification and treatment.

Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.

Hand infections.

Hand infections are commonly seen by orthopedic surgeons as well as emergency room and primary care physicians. Identifying the cause of the infection and initiating prompt and appropriate medical or surgical treatment can prevent substantial morbidity. The most common bacteria implicated in hand infections remain Staphylococcus aureus and Streptococcus species.

Two unusual cases of coronal lunate fracture.

Volar lunate fractures are rare injuries, usually seen as a result of high-energy trauma and often in association of other carpal injuries. We present 2 unusual cases of coronal volar lunate fractures. The first case involved a proximal pole scaphoid fracture in association with a volar lunate fracture.

Hypersensitivity to polymethylmethacrylate following shoulder hemiarthroplasty.

Acrylic resins have been used for many years in several health-related applications due to their ease of use, favorable material properties, and relative cost. Cements containing polymethylmethacrylate (PMMA), in particular, have been widely accepted for use in orthopedic surgery, as well as in other fields of medicine. Although relatively rare, the potential for acrylic resins such as PMMA to induce hypersensitivity reactions via cutaneous or mucosal exposures has been reported; however, comparatively few cases have been described of patients reacting adversely to acrylic resins used as permanent cements during surgical procedures.

Comparison of 2 methods of immobilization of fifth metacarpal neck fractures: a prospective randomized study.

Purpose: The objective of this study was to prospectively compare the effectiveness of 2 methods of cast immobilization for fifth metacarpal neck fractures with respect to the time required for cast application, durability and tolerability of the cast, efficacy of maintaining reduction, and postimmobilization range of motion.

Methods: After closed reduction, 81 predominately young, active-duty patients were prospectively randomized to a short-arm cast with volar outriggers (SAC-VOR) or to a short-arm cast extended to the proximal interphalangeal joint with a 3-point mold (MCP-ext). Radiographs were obtained before reduction and after reduction at 1 and 4 weeks.

Arthroscopic hemitrapeziectomy for first carpometacarpal arthritis: results at 7-year follow-up.

The purpose of this study was to determine the outcome of arthroscopic hemitrapeziectomy combined with thermal capsular plication and temporary K-wire fixation in patients with painful thumb basal joint due to either osteoarthritis or posttraumatic arthritis. There were 18 thumbs that were evaluated in this retrospective study of arthroscopic hemitrapeziectomy of the distal trapezium in addition to a pancapsular thermal shrinkage at an average of 7.6-year follow-up.

The diagnostic utility of midcarpal anesthetic injection in the evaluation of chronic wrist pain.

The evaluation of chronic wrist pain can be a diagnostic dilemma. Lidocaine injections combined with corticosteroids are often used for both diagnosis and therapy. The purpose of this study was to determine if a midcarpal injection of lidocaine could serve as a diagnostic tool in patients with chronic wrist pain.

Anterior and posterior interosseous neurectomy for the treatment of chronic dynamic instability of the wrist.

The purpose of this study was to determine the results of combined anterior and posterior interosseous neurectomy (AIN/PIN) in patients with chronic wrist pain secondary to dynamic instability, and to determine the predictability of selective AIN/PIN blocks with respect to pain relief, grip strength, and outcome of the neurectomy. A prospectively accrued chronic wrist pain registry was undertaken. Inclusion criteria were patients with arthroscopically confirmed dynamic wrist instability who had undergone a diagnostic AIN/PIN injection, followed by a single dorsal incision neurectomy.

Treatment of advanced carpometacarpal joint disease: trapeziectomy and hematoma arthroplasty.

Some surgical treatment options of painful basal joint arthritis do not require complex arthroplasty or suspensionplasty techniques. Simple trapeziectomy with temporary pinning of a slightly overdistracted thumb metacarpal can provide reliable pain relief, good motion, and functional stability. Recent literature supports alternative options when compared with formal ligament reconstruction or suspensionplasty procedures.

Zone I rupture of the flexor digitorum profundus tendon caused by blunt trauma: a case report.

Traumatic ruptures of flexor tendons as a result of blunt trauma without an associated pathologic condition are rare. This is a case of a midsubstance flexor tendon rupture as a result of closed direct trauma. The patient sustained a flexor digitorum profundus (FDP) rupture 1 cm proximal to its insertion on his right ring finger without any accompanying laceration.

Injuries sustained to the upper extremity due to modern warfare and the evolution of care.

The formation of the American Society for Surgery of the Hand was related to world conflicts and hostilities. Therefore, it is appropriate that upper-extremity surgeons understand injuries resulting from modern-day combat. Because of ongoing warfare, many countries have experienced a large increase in the number of wounded service members and civilians, particularly wounds of the extremities.

A unique case of ulnar tunnel syndrome in a bicyclist requiring operative release.

The continued growth of recreational and competitive sports is accompanied by the need for health care providers to recognize and treat conditions in athletes that have been traditionally associated with other occupational injury. This is particularly important when early diagnosis and prompt intervention for prevention and treatment may alter the outcome. We present an interesting case of ulnar tunnel syndrome in a high-performance bicyclist with compressive ulnar neuropathy refractory to nonoperative management but successfully treated with surgical release.

Percutaneous fixation of stable scaphoid fractures.

The increased awareness of scaphoid fractures and their complications has prompted early aggressive treatment to prevent the sequelae of nonunions and degenerative changes in the carpus. Despite this, many fractures require prolonged immobilization, often resulting in diminished motion and time lost in sports or employment. In an effort to diminish the time to union and decrease prolonged immobilization, percutaneous fixation techniques have been described and recently popularized by several authors.

Delayed flexor digitorum superficialis and profundus ruptures in a trigger finger after a steroid injection: a case report.

We report a case of delayed rupture of the flexor digitorum superficialis and profundus tendons after the use of local corticosteroid injections for trigger finger. The treatment involved the exploration, debridement, and placement of a silicone rod for planned flexor digitorum profundus staged reconstruction.