In vivo non-contact regions of proximal scaphoid in six extreme wrist positions.

Introduction: Fractures of the scaphoid are the most common carpal injuries, account for 80-90% of all carpal fractures. 5-15% nonunion of scaphoid fractures were reported even with adequate primary treatment, which probably progresses to osteoarthritic changes several decades later. Researches regarding to scaphoid physiological characteristic in vitro and in vivo and kinds of trials in clinical practice are being kept on going, which contribute much to our clinical practice.

Functional reconstruction of severe hand injuries using allogeneic tendons: a retrospective study.

Objective: To evaluate the effectiveness and safety of allogeneic tendons for functional reconstruction of severe hand injuries.

Methods: From August 2007 to July 2014, we performed functional reconstruction with tendon allografts for severe hand injuries affecting two or more tendons. At the final follow-up, we assessed total active motion (TAM); pincer pinch strength; grip strength; Disabilities of the Arm, Shoulder, and Hand (DASH) score; degree of satisfaction; and adhesion.

Medial versus lateral approach to harvesting of anterolateral thigh flap.

Objective: This study was performed to evaluate two classic procedures guided by anatomic markers for harvesting the anterolateral thigh (ALT) flap: one began with an incision on the lateral side to identify perforators emerging from the muscle to the superficial tissue and to track the perforators upward to the upper stem vessel, and the other began with an incision on the medial side to identify the vessel branch from the stem artery and to track it downward to the flap perforators.

Methods: Twenty-eight consecutive patients with tissue defects repaired with ALT flaps were investigated; 13 and 15 patients underwent the lateral and medial incision technique, respectively. The surgeon's subjective view regarding procedural difficulty and the operative times were statistically analyzed.

In Vivo Contact Characteristics of Distal Radioulnar Joint With Malunited Distal Radius During Wrist Motion.

Purpose: To determine whether distal radioulnar joint (DRUJ) contact characteristics were altered in patients with malunited distal radius fractures.

Methods: We obtained computed tomography scans at 5 positions of both wrists of 6 patients who had unilateral malunited distal radius fractures with dorsal angulation from 10° to 20° and ulnar variance less than 3 mm. We reconstructed 3-dimensional images and mapped contact regions of DRUJ by calculating the shortest distance between the 2 opposing bones.

Allograft tendon for second-stage tendon reconstruction.

Tendons are made of compact dense collagen fibers with only sparse cellularity and naturally low immunogenicity. Allogenic tendons may be preserved through deep freezing methods and retain excellent mechanical properties after revitalization. Allogenic tendons were used in 22 patients (30 tendons) for second-stage tendon reconstruction in the hand.

In vivo length and changes of ligaments stabilizing the thumb carpometacarpal joint.

Purpose: To investigate the lengths and changes of selected ligaments stabilizing the thumb carpometacarpal (CMC) joint during thumb motion in vivo.

Methods: We obtained serial computed tomography scans of the thumb CMC joints of 6 healthy volunteers during thumb flexion, abduction, and opposition. We reconstructed the 3-dimensional structures of the bones of the thumb CMC joint using customized software and modeled the paths of fibers of 5 principal ligaments--deep anterior oblique (beak), dorsoradial, posterior oblique, intermetacarpal, and dorsal intermetacarpal--at each of the CMC joint positions studied.

Scaphoid and lunate movement in different ranges of carpal radioulnar deviation.

Purpose: We aimed to investigate scaphoid and lunate movement in radial deviation and in slight and moderate ulnar deviation ranges in vivo.

Methods: We obtained computed tomography scans of the right wrists from 20° radial deviation to 40° ulnar deviation in 20° increments in 6 volunteers. The 3-dimensional bony structures of the wrist, including the distal radius and ulna, were reconstructed with customized software.

[Kinematics of the triangular fibrocartilage complex during forearm rotation in vivo].

Objective: To investigate three-dimensional kinematics of the superficial and deep portion of triangular fibrocartilage complex (TFCC) in different parts of the forearm rotation.

Methods: Six wrists of 6 volunteers were used to obtain CT scans at different positions of the wrist. The wrists were scanned from 90 degrees of pronation to 90 degrees of supination at an interval of 30 degrees.

[Measurements of parameters of posteroanterior X-ray films of distal radial fracture and their significance].

Objective: To provide the basic knowledge of wrist joint for diagnosing of these morphological change in pathological condition by measuring the posteroanterior X-ray films of different types of distal radius fracture by AO classification.

Methods: Eleven radiographic indexes were measured including following 7 new parameters of 83 cases of distal radius fracture: ulnar styloid length (USL), ulnar head length (UHL), ulnar head diameter (UHD), maximal distal radius width (MDRW), proximal distal radius width (PDRW), sigmoid notch length (SNL) and sigmoid notch width (SNW) by Pacs system in standard X-ray films. The indexes were defined by the ratio of these parameters to the length of the third metacarpal.

A2 pulley incision or one slip of the superficialis improves flexor tendon repairs.

Outcomes of flexor tendon repairs in the area covered by major pulleys are often unpredictable. We performed an in vivo study to investigate biomechanical effects of pulley incision, Kapandji pulley plasty, excision of one slip of the flexor digitorum superficialis, or closure of the incised pulley on function of the profundus tendons. Both long toes (104 total) of 52 leghorn chickens were divided into four experimental groups and one control group.

Influence of core suture purchase length on strength of four-strand tendon repairs.

Purpose: Recently the length of core suture purchase has been identified as a variable affecting the strength of tendon repairs. The influence of the length of the core suture purchase on the strength of multistrand locking and grasping suture repairs, however, has not been studied extensively in transversely lacerated tendons. We assessed the effects of the length of the core suture purchase on the strength of three 4-strand grasping or locking repair techniques.

Core suture purchase affects strength of tendon repairs.

Purpose: It generally is considered that a certain distance should be maintained between the site of the tendon-suture junction and the laceration level of the tendon. In this study we assessed how the length of core suture purchase may affect the repair strength of transversely cut tendons using a 2-strand modified Kessler method and a 4-strand circle-locking method.

Methods: Seventy-four fresh pig flexor tendons were transected.

Investigation of locking configurations for tendon repair.

Purpose: Locking sutures have proven beneficial to the strength of the repaired tendon. In this study we investigated the effects of 3 locks in the tendon-suture junction and their effect on repair strength.

Methods: Forty-seven fresh pig flexor tendons were transected and repaired using 4-strand repairs with 3 different configurations of locks in each tendon-suture junction: 1 exposed cross-lock, 1 embedded cross-lock, and 1 circle lock.

Effects of locking area on strength of 2- and 4-strand locking tendon repairs.

Purpose: The area of the tendon within the locking suture configuration of the modified Pennington repair is an important determinant of eventual tendon strength. This 2-strand repair's loop configurations encompass a large cross-sectional area of the tendon. Many recently proposed repairs, however, consist of locks in a number of narrow sites on the tendon surface and most are multistranded.

[Management of sheath after repair of double tendons in zone II d].

Objective: To evaluate the management of sheath after repair of double tendons in clean-cut injury or severe injury in zone II d.

Methods: Forty-eight white leghorn chickens were divided into 4 groups. Both FDS and FDP tendons in zone II d of long toes were repaired with modified Kessler suture after tendon transection in group A (clean-cut tendon injury, sheath closure), group B (clean-cut tendon injury, sheath excision), group C (severe tendon injury, sheath closure) and group D (severe tendon injury, sheath excision), respectively.

[Application of reversed digital artery cross-finger flap with a compound skin pedicle].

Objective: To summarize the application of reversed digital artery cross-finger flap with a compound skin pedicle in soft tissue defect of hand.

Methods: From October 1997, 35 fingers of 30 cases, with soft tissue defect at the dorsal side of digital interphalangeal joint and at the fingertips, were repaired by the reversed artery cross-finger flap with a compound skin pedicle, 1.5 cm x 1.

[Proliferative ability of the central area tenocytes of flexor tendons in vitro].

Objective: To study the healing ability of the central area tissue of flexor tendons after injury.

Methods: Tendons of flexor digitorum profundus of the long toes from 8 white Leghorn hens were harvested in zone II. Tissues were cut in 4 mm segments and divided into the experimental group (the central area tissue of flexor tendons) and the control group (the tendon segments without epitenon).