Drill and Fill Technique for the Treatment of Scaphoid Delayed Unions and Nonunions.

 This article reviews the results of a surgical technique using three iterations of , autologous cancellous bone grafting ( ), and use of an intraosseous compression screw for the treatment of nondisplaced or minimally displaced scaphoid delayed unions or nonunions.  Part 1-Cadaveric study: Three cadaveric scaphoids underwent stained cancellous bone graft packing and headless cannulated compression screw placement using a single iteration of drilling and graft packing. Three additional scaphoids were allocated to the triple "drill and fill" group, and underwent three iterations of drilling and graft packing before screw insertion.

Modeling choice paradoxes under risk: From prospect theories to sampling-based accounts.

Important developments in the study of decision making have been based on the establishment and testing of choice paradoxes (e.g., Allais') that reject different theories (e.

Costs Associated With Single-Use and Conventional Sets for Distal Radius Plating.

Purpose: Volar plating of distal radius fractures is an increasingly common procedure. Presterilized, single-use volar plate fixation sets have been purported to increase operating room efficiency and decrease cost. The purpose of this study was to compare the actual cost of using a conventional set compared with the projected cost of using its single-use counterpart.

Right Ring Finger Volar Mass in a 14-Year-Old Boy.

A trigger digit is relatively uncommon in adolescents and often has a different etiology in that age group vs adults. In the pediatric population, trigger digits frequently arise from a variety of underlying anatomic situations, including thickening of the flexor digitorum superficialis or flexor digitorum profundus tendons, an abnormal relationship between the flexor digitorum superficialis and flexor digitorum profundus tendons, a proximal flexor digitorum superficialis decussation, or constriction of the pulleys. In addition, underlying conditions such as mucopolysaccharidosis, juvenile rheumatoid arthritis, Ehlers-Danlos syndrome, and central nervous system disorders such as delayed motor development have been associated with triggering.

Lipoma of the Tendon Sheath in the Fourth Extensor Compartment of the Hand.

Lipoma of an extensor tendon compartment is an exceedingly rare tumor of the hand. Although benign, it can often cause localized pain and finger stiffness, necessitating surgical excision. We report a case of a lipoma of the tendon sheath in the fourth dorsal compartment of the hand that was successfully treated with surgical excision.

Perilunate Injuries.

Perilunate injuries often result from high-energy trauma to the carpus. Despite the severity of these injuries, they are often missed initially because of their subtle radiographic and physical examination findings. Early anatomic reduction of any carpal malalignment is paramount to a successful outcome.

Profound sinus bradycardia due to diltiazem, verapamil, and/or beta-adrenergic blocking drugs.

Both beta-adrenergic receptor antagonist drugs (beta-blockers) and non-dihydropyridine calcium-channel blockers (non-DHP CCBs), ie, diltiazem and verapamil, can cause sinus arrest or severe sinus bradycardia, and when drugs from the two classes are used together, these effects may be more than additive. We report nine patients in whom a beta-blocker (one patient), a non-DHP CCB (one patient), or the combination (seven patients) caused sinus arrest or severe sinus bradycardia which resulted in hospitalization in six of the nine. Although this combination of drugs always has the potential for causing profound bradycardia, certain aspects of the history, such as age, the presence of renal or hepatic disease, and the number and types of other medications, are further predictors of marked bradycardia with hypotension.

Management of acute ST-segment elevation myocardial infarction. II. Beyond reperfusion.

The last issue of the Journal contains a continuing medical education article on reperfusion therapy in acute ST-segment elevation myocardial infarction (STEMI), and this article completes the sequence by discussing other aspects of the management of acute STEMI.