Wide Awake Open Carpal Tunnel Release: The Effect of Local Anesthetics in the Postoperative Outcome.

 Wide awake open carpal tunnel decompression is a procedure performed under local anesthesia. This study aimed to present the effect of various local anesthetics in peri and postoperative analgesia in patients undergoing this procedure.  A total of 140 patients, with 150 hands involved, underwent carpal tunnel release under local anesthesia.

Giant Median Nerve Due to Hamartoma Causing Severe Carpal Tunnel Syndrome.

Introduction: Lipofibromatous hamartoma (LFH) is a very rare, benign, slow-growing peripheral nerve tumor.

Case Report: We present a case of LFH of the median nerve, which caused enlargement of the median nerve and the digital branches in a young male, and was treated surgically. Our treatment choice was resection of large portions of the fibrofatty tissue and decompression of the carpal tunnel.

Trimalleolar Fracture-Dislocation of the Ankle with a Double Fragment of the Medial Malleolus: A Separate Fracture Subtype?

Introduction: Lauge-Hansen classification for ankle fractures is helpful in directing the management of the fracture and has got prognostic significance. However, trimalleolar fractures with double medial malleolar fracture are not yet described.

Case Report: Two cases of trimalleolar fracture-dislocation of the ankle with a double fracture of the medial malleolus are reported.

New Treatment Strategy for a Delayed Skin Necrosis Related to a Calcaneal Fracture.

In calcaneal avulsion fractures, skin necrosis as a result of pressure from the underlying fragment is a fairly common and serious complication. In spite of proper treatment, skin healing complication may occur. We report a calcaneal fracture case complicated by skin necrosis and managed with a novel treatment strategy including application of Platelet Rich Plasma (PRP) and Vacuum Assisted Closure (VAC).

Hallux Osteoid Osteoma: A Case Report and Literature Review.

Osteoid osteoma is a benign bone tumour that mostly affects males in the second and third decade of their life. The lesion mainly occurs in long bones, usually in the femur and tibia, causing severe localized pain that is worse at night and responds to nonsteroidal anti-inflammatory drugs (NSAIDs). Diagnosis is usually made on the basis of history and radiographic findings.

Small diameter acetabulum and femoral head in total hip arthroplasty for developmental dysplasia of the hip, with no femoral osteotomy.

We present the results of 66 total hip arthroplasties in 62 patients of mean age 46 years (24-74 years), with developmental dysplasia of the hip. In all cases the centre of rotation of the new hip was positioned at the site of the true acetabulum. In all patients cementless press fit acetabular components of small diameter (42-44 mm) were used, articulating exclusively with a 22.

A Missing Flexor Hallucis Longus Muscle and Tendon in a Young Female Patient: A Case Report of a Rare Anomaly.

Anatomic variations of the long flexor tendons of the foot are not common. Tendinous bands connecting the flexor hallucis longus and the flexor digitorum longus are well known and have even been classified. Although the congenital absence of the flexor pollicis longus in the hand is well known, we found no reports of the absence of the flexor hallucis longus in the foot.

Modified Wilson's Osteotomy for Hallux Valgus Deformity. A New Approach.

We introduce a new set of modifications and present the results from 48 patients (a total of 60 feet operated), who underwent this modified Wilson's osteotomy for the correction of Hallux Valgus. Patients were of an average age of 52 years old (from 21 to 75 years of age) and were followed up for a mean of 12 months post-operatively. Patient evaluation was made with the symptom scoring system as presented by Kataraglis et al.

Systematic effects of surgical treatment of hip fractures: gliding screw-plating vs intramedullary nailing.

Aim: Numerous studies have been published regarding the comparison between intramedullary nail and the dynamic hip screw and plate for the fixation of intertrochanteric fractures in elderly patients. In this paper we present a comparative study of these two methods regarding their systemic effects on this group of patients.

Materials-methods: This is a randomized trial of 120 consecutive patients with an intertrochanteric fracture treated with either extramedullary fixation (dynamic hip screw and plate; DHS, Synthes-Stratec, Oberdorf, Switzerland) or intramedullary nail (Gamma nail, Stryker Howmedica, Freiburg, Germany and Endovis BA, Citieffe, Bologna, Italy).

Classifying fractures of the distal radius: impossible or unnecessary? Review of the literature and proposal of a grouping system.

Reviewing the literature it was found that no classification of fractures of the distal radius is universally accepted regarding reproducibility, treatment orientation, and ability to predict outcome. The authors find the use of the existing classifications extremely difficult in practice, especially when trying to communicate, and believe that classification, treatment, and prognosis cannot be directly connected because of the complexity of fracture patterns and treatment options. Five hundred fractures of the distal radius were studied and a grouping system was developed in which fractures are positioned according to the direction of displacement of the distal part and the existence of an intra-articular extension.

Littler's flap revisited: an anatomic study, literature review, and clinical experience in the reconstruction of large thumb-pulp defects.

Background: An anatomic study and the authors' clinical experience with 15 flaps used for resurfacing sizable thumb defects are presented.

Material/methods: Sixteen upper extremities from fresh cadavers were dissected to delineate the anatomy, vascular pattern, and reconstructive potential of the heterodigital island flap. Fifteen heterodigital island flaps were also performed between 1996 and 2004 in 15 patients (mean age: 41.

Diagnostic value of conventional arthrography in investigating post-traumatic ulnar wrist pain: are MRI and MR arthrography always necessary?

Background: Ulnar wrist pain is a difficult problem to diagnose and treat. Many diagnostic methods can be used, each having its own value, but the surgeon should know which is the simplest and most appropriate for each case.

Case Report: Such a case, investigated adequately by conventional arthrography is presented.

Mid-term results of total knee arthroplasty after high tibial osteotomy.

Background: The outcome of total knee arthroplasty (TKA) after high tibial osteotomy (HTO) is still controversial. In order to determine if osteotomy has any effect on this outcome we performed a medium-term review of a cohort of patients with knee osteoarthritis.

Materials And Methods: Thirty-two patients (38 knees), who were treated with a HTO before the TKA during the last 8 years, were compared with a matched group who underwent primary TKA.

Synergistic action of protease-modulating matrix and autologous growth factors in healing of diabetic foot ulcers. A prospective randomized trial.

This study tests the hypothesis that addition of a protease-modulating matrix enhances the efficacy of autologous growth factors in diabetic ulcers. Fifty-one patients with chronic diabetic foot ulcers were managed as outpatients at the Democritus University Hospital of Alexandroupolis and followed up for 8 weeks. All target ulcers were > or = 2.

Sternoclavicular joint septic arthritis and mediastinitis. A case report and review of the literature.

Septic arthritis of the sternoclavicular joint is rare. Its causes have been reported to include immuno-compromizing diseases, intravenous drug abuse, fractures of the clavicle or catheterization of the subclavian vein. We report a case of septic arthritis of the SCJ in a diabetic patient following periarticular injection of steroids in the ipsilateral shoulder, as this route of infection has not been documented, to our knowledge, in the literature to date.

Knee osteonecrosis due to lead poisoning: case report and review of the literature.

Background: Though rare, a relationship between toxic heavy-metal accumulation and bone necrosis exists.

Case Report: A 28-year-old man suffered from chronic bilateral knee pain accompanied by muscle fibrillations and night cramps. On examiniation he presented tenderness and mild quadriceps muscle atrophy, but unaffected range of movement, sensation, and tendon reflexes and no effuision.

External fixation of femoral fractures in multiply injured intensive care unit patients.

We report the results of a prospective study of 42 patients with multiple injuries, including femoral fractures, who required intensive care unit (ICU) admission and whose fractures were treated by means of external fixation. The Injury Severity Score (ISS) ranged from 18 to 41 and the average Glasgow Coma Scale (GCS) on admission was 12. Seventeen fractures were open.

Seventh cervical vertebral body solitary osteochondroma. Report of a case and review of the literature.

Solitary osteochondroma of the cervical spine is a rare manifestation of a common bony tumour. It can create symptoms, depending on the adjacent compressed structures. In this report, a patient suffering solitary osteochondroma on the anterolateral aspect of the C7 vertebral body is presented and the literature is reviewed.