Three-Dimensional Characterization of Trabecular Bone Mineral Density of the Distal Radius Utilizing Quantitative Computed Tomography.

Distal radius (DR) fractures demonstrate patterns of predictable fragments. Bone mineral density (BMD) measurements of these regions of interest (ROIs) may guide more precise treatment. Computed tomography (CT) scans of the DR of 42 healthy volunteers (23 female) were analyzed using quantitative CT software, measuring BMD within trabecular bone.

Snapping at the Lateral Aspect of the Elbow: A Case Report and Review of the Literature.

Case: A 59-year-old man presented with snapping at the lateral aspect of the elbow and associated pain. Magnetic resonance imaging demonstrated extensor tendinopathy and thickening of the radial collateral ligament. Ultrasonography showed entrapment of a synovial fold in the radiohumeral joint.

Utility of Prolotherapy for Upper Extremity Pathology.

Prolotherapy is a method of treatment of painful musculoskeletal conditions whereby a sclerosing agent is injected into an area of tendinosis or osteoarthritis to strengthen and repair painful connective tissue. It is a safe, effective, and relatively inexpensive nonsurgical treatment modality. This article provides a history of prolotherapy, discusses its proposed mechanisms of action, and provides a review of the existing literature on prolotherapy as a treatment for upper extremity pathologies, specifically, hand osteoarthritis, lateral epicondylitis, and rotator cuff disease.

Hand and arm pain: A pictorial guide to injections.

This article, with illustrative figures, will help you get to the cause of your patient's pain and guide your administration of corticosteroid injections.

Evaluation of Ulnar-sided Wrist Pain.

Determining the etiology of ulnar-sided wrist pain is often challenging. The condition may be acute or chronic, and differential diagnoses include injuries to the ulnar carpal bones, ligament tears, tendinitis, vascular conditions, osteoarthritis and systemic arthritis, and ulnar nerve compression. An anatomically based, methodical physical examination coupled with provocative maneuvers, including piano key, ulnar impaction, shuck, foveal stress, and extensor carpi ulnaris synergy tests, further defines the differential diagnosis.

Ulnar Styloid Base Fractures Cause Distal Radioulnar Joint Instability in a Cadaveric Model.

Background: The deep portion of the distal radioulnar ligaments (DRUL) inserts on the ulnar fovea and is the most important stabilizer of the distal radioulnar joint (DRUJ). Ulnar styloid base fractures that include the ulnar fovea may cause DRUJ instability.

Methods: DRUJ stability in pronosupination was evaluated in 12 fresh-frozen upper extremities (4 female) aged 52 to 68 years (mean: 58.

Patient Comprehension of Carpal Tunnel Surgery: An Investigation of Health Literacy.

Health literacy is the ability of a patient to understand their medical condition. The purpose of this investigation is to determine whether patients are able to obtain an elementary understanding of the fundamental principles of carpal tunnel release and the postoperative instructions after going through the process of informed consent and being provided an additional standardized postoperative instruction document. Our hypothesis is that patients will lack an understanding of these principles and, therefore, will be at risk for being noncompliant in their postoperative care.

An Anatomic Evaluation of Arthroscopic Access to the Radial Head.

Purpose: To determine the area of the radial head accessible for visualization and screw placement from the standard anteromedial and anterolateral portals used in elbow arthroscopy.

Methods: Five cadaveric elbows were arthroscopically evaluated using standard anteromedial and anterolateral portals. Markers (pins) were placed into the accessible portions of the radial head at maximal pronation and supination.

A Review of Anatomical Placement of Corticosteroid Injections for Uncommon Hand, Wrist, and Elbow Pathologies.

Corticosteroid injections are a common nonsurgical treatment of intersection syndrome, flexor carpi radialis tendonitis, flexor carpi ulnaris tendonitis, and medial epicondylitis. The benefits of corticosteroid injections for these conditions have been well studied and documented in the medical literature. Patients with less common upper extremity complaints usually first present to their primary care provider.

Trends in Revision Elbow Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers.

Purpose: To determine the frequency of revision elbow ulnar collateral ligament (UCL) reconstruction in professional baseball pitchers.

Methods: Data were collected on 271 professional baseball pitchers who underwent primary UCL reconstruction. Each player was evaluated retrospectively for occurrence of revision UCL reconstructive surgery to treat failed primary reconstruction.

Dual-camera technique for arthroscopic rotator cuff repair.

An all-arthroscopic rotator cuff repair demands a high level of technical skill and is associated with a steep learning curve. It is well accepted that small rotator cuff tears or partial tears can be more difficult than large or even massive tears to repair. Part of the reason is the difficulty in visualizing the tear, as well as important surrounding structures, during repair.

Volar wrist ganglion excision through the flexor carpi radialis sheath.

Volar wrist ganglions are much less frequent than their dorsal counterparts but provide much more surgical trepidation due to their proximity to the radial artery. With the majority arising from the radiocarpal joint, we have found that entering the flexor carpi radialis sheath and accessing the ganglion through the floor of the sheath allows for a relatively safe excision of these benign hand tumors.

Methylene blue-enhanced arthroscopic resection of dorsal wrist ganglions.

The ganglion is the most common soft tissue mass of the hand and wrist. Over the past 10 to 15 years, there has been a growing interest in arthroscopic treatment of dorsal wrist ganglions. Proposed advantages of arthroscopy include greater motion (particularly wrist flexion), improved cosmesis, and potential to identify/treat other intra-articular pathology.

Magnetic manipulation and optical imaging of an active plasmonic single-particle Fe-Au nanorod.

Superparamagnetic microbeads play an important role in a number of scientific and biotechnology applications including single-molecule force measurements, affinity separation, and in vivo and in vitro diagnostics. Magneto-optically active nanorods composed of single-crystalline Au and polycrystalline Fe segments were synthesized with diameters of 60 or 295 nm using templated electrodeposition. The Fe section was magnetically soft and had a saturation magnetization of approximately 200 emu/g, resulting in a 10-fold increase in magnetization relative to that iron oxide nanoparticles.

Arthroscopic technique for medial epicondylitis: technique and safety analysis.

Purpose: The goals of this study are to report on a novel arthroscopic technique for the treatment of medial epicondylitis and to further describe the anatomic relations between the site of arthroscopic debridement and both the ulnar nerve and medial collateral ligament (MCL) complex.

Methods: Arthroscopic debridement of the medial epicondyle was performed on 8 fresh-frozen cadaveric specimens. Each specimen was dissected, and the shortest distance from the debridement site to both the ulnar nerve and MCL complex was measured with a 3-dimensional motion-tracking system.

Arthroscopic treatment of lateral epicondylitis.

Lateral epicondylitis refractory to conservative care can be effectively treated by arthroscopic release of the extensor carpi radialis brevis origin. Advantages to the technique include the ability to address other intra-articular sources of pain (capsular tears, radiocapitellar plica, etc.), a potentially faster return to work and sports, and a smaller incision.

Carpal growth and function after pediatric transcarpal hand replant: case report.

This case discusses the technique, postoperative course, and functional outcomes 5 years after an amputation between the cartilaginous anlages of the growing carpus in a 7-year-old boy. The lunate remained attached to the arm, whereas the scaphoid and the remainder of the carpus were contained within the amputated part. After 5 years, the patient had 94% growth compared to the other side, a Minnesota dexterity test in the 75th percentile, 0/10 pain, near-normal sensation, grip strength 17% of the other side, and lateral pinch 79% of the other side.

Management of lateral epicondylitis: current concepts.

Lateral epicondylitis, or tennis elbow, is a common cause of elbow pain in the general population. Traditionally, lateral epicondylitis has been attributed to degeneration of the extensor carpi radialis brevis origin, although the underlying collateral ligamentous complex and joint capsule also have been implicated. Nonsurgical treatment, the mainstay of management, involves a myriad of options, including rest, nonsteroidal anti-inflammatory drugs, physical therapy, cortisone, blood and botulinum toxin injections, supportive forearm bracing, and local modalities.

Thumb carpometacarpal arthroscopy: a topographic, anatomic study of the thenar portal.

Arthroscopic treatment of osteoarthritis of the thumb carpometacarpal joint has been well described; however, the current site of the 2 working portals, especially the 1-R portal, may be complicated by neurovascular morbidity. This is owing to the close proximity of these portals to important nerves and vessels surrounding the carpometacarpal joint. We studied 7 cadaveric wrists to map out the topographic, anatomic, and arthroscopic position of a new thenar portal.