A novel radiological assessment to identify acute vertebral compression fractures: A pilot observational study.

Aim: The diagnosis of acute vertebral compression fractures (AVCFs) is often challenging. An alternative to magnetic resonance imaging, which may not always be available, includes a comparison of supine and sitting/standing position radiographs. However, this cannot be accomplished in patients with acute vertebral compression fractures who require emergency transport and are in severe pain.

Ultrasound-guided Selective Sensory Nerve Block for Wide-awake Forearm Tendon Reconstruction.

Background: Wide-awake hand surgery is useful for tendon reconstruction because surgeons can observe the actual movement of the reconstructed tendons during the surgery. We hypothesized that accurate ultrasound-guided injection of local anesthetics into the sensory nerves contributes to reliable analgesia with a relatively small amount of anesthetic.

Methods: We enrolled 8 patients who underwent forearm tendon transfer.

Subclinical articular involvement in primary Sjögren's syndrome assessed by ultrasonography and its negative association with anti-centromere antibody.

Objectives: To evaluate the subclinical articular involvement in patients with primary Sjögren's syndrome (pSS) using musculoskeletal ultrasound (MSUS), and to correlate the findings with laboratory results and clinical manifestations.

Methods: Forty-eight consecutive patients with pSS were enrolled. The bilateral metacarpophalangeal, proximal interphalangeal, and interphalangeal joints were examined using MSUS, and the synovial hypertrophy and power Doppler signal were recorded for each joint using semi-quantitative scores (0 = normal, 1 = mild change compared with undamaged joint, 2 = moderate change, and 3 = severe change).

The "sliding door" technique for closure of abdominal wall defects after rectus abdominis musculocutaneous flap transposition.

Radical surgery is often necessary in patients with local recurrence of rectal cancer or in those with carcinoma associated with an anal fistula. The surgery may include extended excision of the perineal area and can create a large dead space in the pelvis and a large skin defect, often necessitating reconstruction of the pelvic floor using rectus abdominis musculocutaneous (RAM) flap transposition. Wound dehiscence and incisional hernia are common complications of RAM flap transposition.

[Arthroscopic synovectomy for rheumatoid arthritis].

Even though the paradigm shift was occurred in treatments for rheumatoid arthritis (RA), some patients are not well controlled with several treatments. Because arthroscopic techniques advanced remarkably, effectiveness of arthroscopic synovectomy is reconsidered, especially for residual synovitis in biologics unresponders. A combined therapy with biologics and arthroscopic synovectomy leads to improvement of composite measures such as DAS28.

Ewing sarcoma of the proximal phalanx: case report.

We report a case of primary Ewing sarcoma of the proximal phalanx of the right middle finger in an 18-year-old boy. He was treated with neoadjuvant chemotherapy, followed by ray amputation. To restore maximum function, the index ray was transferred to the base of the third metacarpal bone and fixed with a plate.

Osteogenesis of cryopreserved osteogenic matrix cell sheets.

Cryopreservation of tissue engineered bone (TEB), whilst maintaining its osteogenic ability, is imperative for large-scale clinical application. We previously reported a novel cell transplantation method, in which bone-marrow-derived mesenchymal stem cells (BMSCs) were cultured to confluence and differentiated down the osteogenic lineage to form osteogenic matrix cell sheets (OMCS). OMCS have high alkaline phosphatase (ALP) activity and osteocalcin (OC) contents and can be easily used for producing TEB.

Bilateral pediatric Kienböck's disease: a case report.

Bilateral Kienböck's disease in pediatrics is extremely rare. We report a case of a 14-year-old boy with bilateral pediatric Kienböck's disease who was treated by temporary scaphotrapeziotrapezoidal joint fixation, with a good clinical result and radiographic results.

Long-term follow-up of periarterial sympathectomy for chronic digital ischaemia.

This study investigates long-term clinical results (> 10 years) of periarterial sympathectomy in chronic ischaemic digits compared with intermediate-term results (3 years). Periarterial sympathectomy via the palm and volar wrist was carried out on 11 hands of seven patients with digital ischaemia but no gangrene or severe ulceration. The aetiology of ischaemia was Buerger's disease in four hands, collagen disease in three hands, and repetitive digital trauma in four hands.

Risk factors for the development of gastric mucosal lesions in rheumatoid arthritis patients receiving long-term nonsteroidal anti-inflammatory drug therapy and the efficacy of famotidine obtained from the FORCE study.

The objective of this study was to investigate the prevalence of gastric mucosal injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with rheumatoid arthritis (RA). Upper gastrointestinal endoscopy was performed on 100 RA patients treated with NSAIDs. Patient factors potentially contributing to the development of NSAID-induced gastric mucosal injury were identified by logistic regression analysis; gastric mucosal injury and ulcers were used as objective variables.

Wrist arthrodesis with vascularized fibular grafting.

Six patients underwent wrist arthrodesis using vascularized fibular grafting for treatment of a segmental bone defect across the wrist. Five patients had defects resulting from excision of a giant cell tumor at the distal radius, and one patient had a defect after debridement of a chronic infection. In all cases, bone union was achieved within 3 to 6 months after vascularized fibular grafting without additional procedures.

Epithelioid sarcoma of the forearm arising from perineural sheath of median nerve mimicking carpal tunnel syndrome.

We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8 x 4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma.

A pilot feasibility study for ultrasound evaluation of living human wrist cartilage: site-specific differences in acoustic properties.

Purpose: The field of cartilage repair has changed dramatically in the past decade but has not answered the question of how to treat an articular cartilage lesion in the wrist. Indeed, the characteristics of wrist articular cartilage, such as cartilage thickness, hardness, and smoothness, have not been clarified. The purpose of this study was to evaluate and quantify the acoustic properties of wrist articular cartilage quantitatively using a new acoustic probe under arthroscopic observation.

Pedicled vascularized bone graft from the medial supracondylar region of the femur for treatment of femur nonunion.

A free vascularized bone graft harvested from the supracondylar region of the femur was used to treat patients with nonunion but without a massive bone defect. This graft is vascularized by the descending genicular artery (DGA). In patients with femur nonunion, pedicled vascularized bone grafts are usable in some cases.

Vascularized proximal fibular autograft for treatment of post-traumatic segmental bony defects in the distal radius.

Vascularized proximal fibular autograft is reported as one of the reconstructive procedures for the wrists following tumor resection in the distal end of the radius. However, it is rarely performed for the treatment of segmental bony defects in the distal radius after trauma. A 19-year-old man who had traumatic bony defects in the distal radius involving the articular surface underwent vascularized proximal fibular grafting for reconstruction of the wrist.

Vascularized scapular grafting for treatment of osteonecrosis of the humeral head.

Eight dissections in four embalmed cadavers were performed to investigate the possibility of vascularized scapular grafting for osteonecrosis of the humeral head. When the angular branch was used as the nutrient vessel, the mean length of the vascular pedicle was 12.4 cm, which was sufficient for transferring the scapula into the humeral head.

Indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head.

Background: The present study aimed to determine the indications for free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head.

Methods: Seventy-one hips (60 patients) were clinically followed for a minimum of 3 years. Average follow-up period was 7 years.

Long-term outcomes of flap transfer for treatment of intractable venous stasis ulcers in the lower extremity.

There is little information about long-term outcomes of flap transfer for treatment of venous stasis ulcers in the lower extremity. Eleven patients who underwent free and pedicled flap transfer for treatment of intractable venous stasis ulcers were evaluated retrospectively. The operative procedures consisted of removal of the ulcer and surrounding lipodermatosclerotic tissue, venous stripping, and flap transfer.

Epiphyseal preservation and an intercalary vascularized fibular graft with hydroxyapatite composites. Reconstruction in metaphyseal osteosarcoma of the proximal tibia: a case report.

Unlabelled: BACKGROUND DATA AND OBJECTIVES: We present here a case report of a patient with metaphyseal osteosarcoma with a preserved epiphysis and reconstructed by a vascularized fibular graft and hydroxyapatite composites.

Methods: The case was a 14-year-old boy, who had osteosarcoma in the proximal tibia. After the diagnosis was confirmed by biopsy, the patient immediately received preoperative chemotherapy including high-dose Methotrexate, Cisplatin and Doxrubicin.

Restoration of elbow function with pedicled latissimus dorsi myocutaneous flap transfer.

Restoration of elbow function is a challenge for orthopaedic surgeons, and many procedures have been described. This study reviewed 17 patients who underwent latissimus dorsi myocutaneous flap transfer for functional reconstruction of elbow flexion or extension. Of the 10 patients who underwent reconstruction for elbow flexion, grade 4 strength of elbow flexion by manual muscle testing was obtained in 8 and grade 3 was obtained in 2.

Tissue-engineered approach for the treatment of steroid-induced osteonecrosis of the femoral head: transplantation of autologous mesenchymal stem cells cultured with beta-tricalcium phosphate ceramics and free vascularized fibula.

Autologous mesenchymal stem cells (MSCs) cultured with beta-tricalcium phosphate (beta-TCP) ceramics and with a free vascularized fibula were transplanted into three patients with steroid-induced osteonecrosis of the femoral head. The average follow-up period was 34 months and the average patient age at the time of surgery was 28 years old. Fifteen milliliters of bone marrow was obtained from the patients 4 weeks before surgery, and was used for in vitro proliferation of MSCs.

Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report.

An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery.

Free and island flap transfers for the treatment of motor vehicle injuries.

Thirteen patients (10 males and 3 females; age range at surgery: 2 to 41 years, average: 13.5 years) with motor vehicle injuries of the foot (n = 10) and leg (n = 3) were treated using free and island flaps. Donor flaps consisted of a scapular flap in six cases, a peroneal flap in four, a latissimus dorsi musculocutaneous flap in one, gracillis muscle flap in one, and gastrocnemius muscle flap in one case.

Giant-cell tumors of the carpus.

Giant cell tumor (GCT) of bone is a rare, benign tumor with some aggressive characteristics such as a high recurrence rate. The tumor usually occurs in the distal radius although it has been reported in the carpus. We reviewed 63 manuscripts published from 1935 to 2005 and report on the treatment of GCT of carpal bone in 29 cases.