Trigger Finger: An Unusual Clue to Hashimoto's Thyroiditis.

Stenosing flexor tenosynovitis, commonly known as trigger finger (TF), is characterized by thickening and inflammation of the flexor tendon sheath (A1 pulley), leading to painful catching or locking of the finger in a flexed position. While often associated with conditions like diabetes and hypothyroidism, this case report presents a unique instance where surgical intervention for pharmacologically resistant TF ultimately led to the diagnosis of Hashimoto's thyroiditis. This case highlights the potential for underlying systemic conditions to manifest as TF and emphasizes the importance of a comprehensive diagnostic approach in patients with persistent or atypical presentations.

Four Anchor Repair of Jersey Finger.

Background: Various surgical techniques for treating avulsions of the flexor digitorum profundus tendon at the distal phalanx have been published but no ideal technique has emerged. We introduce a new all-internal 4-anchor flexor tendon repair technique and evaluate outcomes in three clinical cases.

Methods: In this retrospective case series, we reviewed three patients that sustained an avulsion of the flexor digitorum profundus tendon at the distal phalanx.

Nexplanon removal from intramuscular implantation in biceps: case report.

Contraceptive implant devices are relatively safe devices, but complications arise when implants become nonpalpable, and cannot be safely removed. In this case report, we describe the location of an implant in the subfascial plane of the upper arm, the diagnostic imaging findings we encountered during the workup, and the procedure necessary to remove it. We demonstrated that if the device is in close proximity to the fascia, it may be difficult to distinguish from the fascia on magnetic resonance imaging.

Modified full-face snorkel masks as reusable personal protective equipment for hospital personnel.

Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter (either a medical-grade ventilator inline filter or an industrial filter). This design has been tested for the sealing capability of the mask, filter performance, CO2 buildup and clinical usability.

Allogeneic Mesenchymal Stem Cells Ameliorate Aging Frailty: A Phase II Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Background: Aging frailty, characterized by decreased physical and immunological functioning, is associated with stem cell depletion. Human allogeneic mesenchymal stem cells (allo-hMSCs) exert immunomodulatory effects and promote tissue repair.

Methods: This is a randomized, double-blinded, dose-finding study of intravenous allo-hMSCs (100 or 200-million [M]) vs placebo delivered to patients (n = 30, mean age 75.

Dose Comparison Study of Allogeneic Mesenchymal Stem Cells in Patients With Ischemic Cardiomyopathy (The TRIDENT Study).

Rationale: Cell dose and concentration play crucial roles in phenotypic responses to cell-based therapy for heart failure.

Objective: To compare the safety and efficacy of 2 doses of allogeneic bone marrow-derived human mesenchymal stem cells identically delivered in patients with ischemic cardiomyopathy.

Methods And Results: Thirty patients with ischemic cardiomyopathy received in a blinded manner either 20 million (n=15) or 100 million (n=15) allogeneic human mesenchymal stem cells via transendocardial injection (0.

Allogeneic Human Mesenchymal Stem Cell Infusions for Aging Frailty.

Background: Impaired endogenous stem cell repair capacity is hypothesized to be a biologic basis of frailty. Therapies that restore regenerative capacity may therefore be beneficial. This Phase 1 study evaluated the safety and potential efficacy of intravenous, allogeneic, human mesenchymal stem cell (allo-hMSC)-based therapy in patients with aging frailty.

Randomized Comparison of Allogeneic Versus Autologous Mesenchymal Stem Cells for Nonischemic Dilated Cardiomyopathy: POSEIDON-DCM Trial.

Background: Although human mesenchymal stem cells (hMSCs) have been tested in ischemic cardiomyopathy, few studies exist in chronic nonischemic dilated cardiomyopathy (NIDCM).

Objectives: The authors conducted a randomized comparison of safety and efficacy of autologous (auto) versus allogeneic (allo) bone marrow-derived hMSCs in NIDCM.

Methods: Thirty-seven patients were randomized to either allo- or auto-hMSCs in a 1:1 ratio.

Transendocardial mesenchymal stem cells and mononuclear bone marrow cells for ischemic cardiomyopathy: the TAC-HFT randomized trial.

Importance: Whether culture-expanded mesenchymal stem cells or whole bone marrow mononuclear cells are safe and effective in chronic ischemic cardiomyopathy is controversial.

Objective: To demonstrate the safety of transendocardial stem cell injection with autologous mesenchymal stem cells (MSCs) and bone marrow mononuclear cells (BMCs) in patients with ischemic cardiomyopathy.

Design, Setting, And Patients: A phase 1 and 2 randomized, blinded, placebo-controlled study involving 65 patients with ischemic cardiomyopathy and left ventricular (LV) ejection fraction less than 50% (September 1, 2009-July 12, 2013).

White spotting variant mouse as an experimental model for ovarian aging and menopausal biology.

Objective: Menopause is a unique phenomenon in modern women, as most mammalian species possess a reproductive period comparable with their life span. Menopause is caused by the depletion of germ cell-containing ovarian follicles and in laboratory studies is usually modeled in animals in which the ovarian function is removed through ovariectomy or chemical poisoning of the germ cells. Our objective was to explore and characterize the white spotting variant (Wv) mice that have reduced ovarian germ cell abundance, a result of a point mutation in the c-kit gene that decreases kinase activity, as a genetic model for use in menopause studies.

Ulnar nerve component to innervation of thumb carpometacarpal joint.

Purpose: Thumb carpometacarpal (CMC) joint arthritis is one of the most common problems addressed by hand surgeons. The gold standard of treatment for thumb CMC joint arthritis is trapeziectomy, ligament reconstruction and tendon interposition. Denervation of the thumb CMC joint is not currently used to treat arthritis in this joint due to the failure of the procedure to yield significant symptomatic relief.

Stenosing synovitis of the extensor pollicis longus tendon.

There are only a few published cases of extensor pollicis longus (EPL) tenosynovitis in patients without rheumatoid arthritis. Even less common are cases of stenosing tenosynovitis of the EPL associated with triggering. This article presents 2 cases of EPL stenosing tenosynovitis with triggering of the thumb in the area of Lister's tubercle and addresses how to treat them.

Upper extremity fractures in pedestrian versus motor vehicle accidents: an underappreciated concern.

Background: Though pedestrian versus motor vehicle (PVMV) accidents are a common cause of trauma admission and subsequent orthopaedic consult, the prevalence of upper extremity fracture (UEF) in such events and its association with lower extremity injury (LEI) is unknown. We sought to describe UEF in PVMV accident patients at the time of orthopaedic consult.

Methods: A retrospective chart review was conducted for all pedestrian hit by motor vehicle cases for which an orthopaedic consult was performed at Jackson Memorial Hospital between July 2006 and January 2008.

Anterior tibial artery and deep peroneal nerve entrapment in spiral distal third tibia fracture.

The rate of injury to arterial structures following long bone injuries is low. The rate in tibial diaphyseal fractures is similarly low. This rate increases with open fractures, likely reflective of the higher energy nature of open fractures.

Metacarpophalangeal collateral ligament reconstruction after band saw amputation: case report with review of MCP anatomy and injury.

Reconstruction of the radial border of the index metacarpophalangeal (MCP) joint after band saw amputation is described. The entire radial MCP collateral ligament unit was cleanly retained within the amputated segment, still attached to wafers of corticocancellous bone from the radial aspect of the metacarpal head and base of the proximal phalanx. Acute bone to bone osteosynthesis of the amputated segment led to successful osseous integration of both bone fragments and restoration of stability of the joint.

Orthopaedic management improves the rate of early osteoporosis treatment after hip fracture. A randomized clinical trial.

Background: Although osteoporosis is strongly associated with hip fractures, the initiation of osteoporosis treatment following hip fractures occurs at surprisingly low rates of between 5% and 30%. Currently, most patients receiving treatment have been referred back to their primary care physician for osteoporosis management. The purpose of this study was to compare the effect of osteoporosis management initiated by the orthopaedic team and osteoporosis management initiated by the primary care physician on the rates of treatment at six months.

Band saw injury in a butcher.

Background: While treating an unusual amputation caused by a meat band saw in a 35-year-old butcher, we sought information from the medical literature that would be useful to other physicians who might encounter similar occupational injuries.

Methods: Using the Medline database and relevant search terms, we reviewed the literature concerning occupational saw blade injuries and porcine microbiology as they related to this injury.

Results: Among meat workers using powered cutting equipment, hand injuries and distal fingertip amputations appear to be common.

Spontaneous septic arthritis caused by Burkholderia cepacia.

We describe the first reported case of a spontaneous septic arthritis caused by Burkholderia cepacia, the organism responsible for onion skin rot. The source of infection was most likely from hematogenous spread, as the patient's blood cultures were positive for B. cepacia.

Necrotizing infection of the spine.

Study Design: Case report of multifocal necrotizing fasciitis with lumbar involvement.

Objectives: To raise awareness of an unusual, but potential, focus of a multifocal necrotizing infection in a diabetic patient.

Summary Of Background Data: Necrotizing fasciitis is a rapidly spreading infection of the soft tissue and fascia.

Vacuum-assisted closure complicated by erosion and hemorrhage of the anterior tibial artery.

We report an erosion and hemorrhage of a left anterior tibial artery associated with a vacuum-assisted closure device. To our knowledge, this report represents the first arterial erosion associated with a vacuum-assisted closure device. We estimate our patient lost 6 units of blood.