Free medialis pedis venous flap transfer for reconstruction of volar finger defects: Clinical application and esthetic evaluation.

Background: There have been many reports about venous flaps, which are often used for the reconstruction of soft tissue defects after finger injury because such flaps are simple to elevate. Recently, high viability rates and nearly normal histological findings were reported for venous flaps, although the mechanism of flap survival remains unclear. This study investigated the esthetic outcomes after the reconstruction of volar finger defects with free medialis pedis venous flaps, which are venous flaps that elevated between the submalleolar and medial plantar regions.

Tarsal Tunnel Syndrome Due To Three Different Types of Ganglion During a 12-Year Period: A Case Report.

A 52-year-old male complained of numbness and radiating pain affecting the plantar region of his left foot. He was found to have recurrent tarsal tunnel syndrome due to posterior tibial nerve compression by 3 different types of ganglion during a 12-year period. To the best of our knowledge, a similar case has not been documented.

Three-dimensional ultrasonography for visualization of muscular anomalies in type VI and VII radial polydactyly.

Objective: To describe a technique and its clinical applications of three-dimensional ultrasonography to type VI and VII radial polydactyly for identification of potential muscular anomalies.

Materials And Methods: Ultrasonographic examinations were performed at an out-patient department without sedation or an operative room prior to surgery. The palm was scanned in the transverse direction using a 18-MHz linear transducer under speed regulation at 3 mm/s.

Simultaneous Regional Fasciectomy, Skin Grafting, and Distraction Arthrolysis of the Proximal Interphalangeal Joint for Dupuytren's Contracture of the Little Finger.

We present a 58-year-old right-handed man, who consulted us with an 11-year history of Dupuytren's disease. To correct contracture of the little finger, we performed regional fasciectomy, skin grafting, and distraction arthrolysis of the proximal interphalangeal (PIP) joint using an external fixator. Preoperative or postoperative skeletal traction has been advocated to treat potential or residual stiffness of the PIP joint in Dupuytren's contracture, but its intraoperative use has not been reported before.

Venous varix on the dorsal aspect of the thumb: report of two cases.

Venous varix on the volar aspect of the digits or the hand is a rare subcutaneous lesion that is usually described as a firm, blue, and painful single nodule that contains thrombus. However, there have been no reports about venous varix on the dorsal aspect of the digits or the hand, so its features are unknown. We treated two patients who each had a soft blue painless mass on the dorsal aspect of the thumb that became enlarged with the tourniquet test.

Free arterialised flow-through venous flap with venous anastomosis as the outflow (A-A-V flap) for reconstruction after severe finger injuries.

Abstract For reconstruction of volar defects, an arterialised flow-through venous flap (A-A flap) can be used to restore the soft tissues and the digital artery at the same time. However, there have been reports that the circulation of this flap is inadequate. This study used a venous flap with only one venous anastomosis for the outflow of an A-A flap (A-A-V flap) to solve this problem.

Importance of the reconstruction of the extensor retinaculum after injury.

We reconstructed an extensive soft tissue defect of the dorsum of the left wrist after an injury using a free anterolateral thigh flap and a tendon graft, and intending to substitute the extensor retinaculum for the fascia in this flap. As a result, maximum function of the extension mechanism was restored to the reconstructed hand.

Loss of Smad3 gives rise to poor soft callus formation and accelerates early fracture healing.

Smad3 is an intracellular signaling molecule in the transforming growth factor β (TGF-β) pathway that serves as a regulator of chondrogenesis and osteogenesis. To investigate the role of the TGF-β/Smad3 signaling in the process of fracture healing, an open fracture was introduced in mouse tibiae, and the histology of the healing process was compared between wild-type (WT) and Smad3-null (KO) mice. In KO mice, the bone union formed more rapidly with less formation of cartilage in the callus and eventually the fracture was repaired more rapidly than in WT mice.

Distraction arthrolysis using an external fixator and flexor tenolysis for proximal interphalangeal joint extension contracture after severe crush injury.

Purpose: To introduce a technique for distraction arthrolysis with an external fixator followed by flexor tendon tenolysis for extension contracture of the proximal interphalangeal (PIP) joint after severe crush injury. We also assessed the results of this method in all patients treated.

Methods: Five fingers of 4 men with extension contracture of the PIP joint after severe injury underwent distraction arthrolysis using an external fixator, followed by flexor tenolysis.

Free latissimus dorsi musclocutaneous flap transfer for chronic osteomyelitis of the tibia: 16-year follow-up.

Free latissimus dorsi musculocutaneous flap transfer is one of the surgical methods for treating the difficult problem of chronic osteomyelitis of the tibia. We evaluated the viability of the flap and the influence on the bone in a patient at 16 years after surgery by using X-ray films, computed tomography and magnetic resonance imaging.

A case of venous varix of the volar digit and review of the literature.

Venous varix of the volar digit (VVVD) is a rare condition that is usually described as a firm, blue, and painful mass. However, the clinical features of VVVD are still unclear. We treated a patient who had a firm, normal-skin-colored, and painless mass on the volar aspect of a digit.

Dorsal digital perforator flap for reconstruction of distal dorsal finger defects.

Three patients are presented in whom defects of the distal part of the dorsum of the finger were covered with a rotation flap or V-Y advancement flap based on a single perforating branch of the digital artery running from the volar to the dorsal side. This method is useful for the reconstruction of the distal dorsal region of the fingers, because the flap is more mobile, has a smaller skin island and is less invasive compared to the previous flaps. This type of flap conforms to the concept of a perforator flap arising from the main artery.

TNF-alpha deficiency accelerates renal tubular interstitial fibrosis in the late stage of ureteral obstruction.

TNF-alpha and TGF-beta1 have a complementary relationship in fibrogenesis. This study was performed to investigate the role of TNF-alpha in renal tubular interstitial fibrosis. We compared the extent of renal tubular interstitial fibrosis after unilateral ureteral obstruction (UUO) between wild-type and TNF-alpha-deficient mice by using immunohistochemistry, enzyme-linked immunoassay, and the real-time polymerase chain reaction (PCR).

Trps1 deficiency enlarges the proliferative zone of growth plate cartilage by upregulation of Pthrp.

We have reported that elongation of the columnar proliferative zone of long bone growth plates in Trps1-/- mice during the late fetal stage in the previous study [1]. Since expression of Trps1 protein was found to overlap with that of mRNAs for Indian hedgehog (Ihh), PTH/PTHrP receptor (PPR), and PTHrP, we hypothesized that Trps1 may inhibit the hypertrophic differentiation of chondrocytes by interacting with the Ihh/PTHrP feedback loop. To investigate whether Trps1 has a role in this Ihh/PTHrP feedback loop, we compared the growth plates of Trps1-/- mice and wild-type (Trps1+/+) mice.

Two-stage arthroplasty with joint distraction and costal osteochondral grafting for ankylosis of a metacarpophalangeal joint: nine years' follow-up.

After ankylosis of a finger has occurred, it is often difficult to restore joint mobility. We report a two-stage arthroplasty procedure for correcting ankylosis of the metacarpophalangeal joint, which involved joint distraction to extend the soft tissues, followed by costal osteochondral autografting. After 9 years of follow-up, the results are acceptable.

Trps1 plays a pivotal role downstream of Gdf5 signaling in promoting chondrogenesis and apoptosis of ATDC5 cells.

Tricho-rhino-phalangeal syndrome (TRPS) is an autosomal dominant skeletal disorder caused by mutations of TRPS1. Based on the similar expression patterns of Trps1 and Gdf5, we hypothesized a possible functional interaction between these two molecules. Using a chondrogenic cell line (ATDC5), we investigated the association of Gdf5-mediated signaling pathways with Trps1 and the phenotypic changes of ATDC5 cells due to over-expression or suppression of Trps1.

Modified posterior interosseous flap in hand reconstruction.

Hand reconstruction methods using posterior interosseous flaps have the merits of being thin and pliable, they do not require sacrifice of any major hand arteries, and closure of the donor site is readily performed. Drawbacks include unreliability of blood flow due to the presence of posterior interosseous artery anatomic variants or damage to the venous circulation. We present some modifications to methods for the preparation of posterior interosseous flaps with which we have achieved some favorable results.