Arthroscopic removal of a .44 caliber bullet from the hip.

Hip arthroscopy is far less invasive than standard open arthrotomy and offers unparalleled visualization of the acetabulum and femoral head. Diagnostic arthroscopy is becoming increasingly accepted as therapeutic options are still evolving. We report the case of the arthroscopic removal of a .

The use of arthroscopy to document accurate position of core decompression of the hip.

The use of hip arthroscopy is documented as a means of determining accurate placement for core decompression of the femoral head. The authors describe the technique whereby the patient is placed on the fracture table in the supine position and the guide wire for the core decompression is inserted into the middle of the infarct. The surgeon is assured of accurate placement within the center of the infarct.

Anterior interosseus nerve injury following elbow arthroscopy.

Elbow arthroscopy is becoming an increasingly invaluable tool for both evaluation of and treatment of a variety of interarticular disease processes. Case reports have documented radial and posterior interosseus injuries following anterior capsular release. To date, this is the first report of an anterior interosseus nerve injury following arthroscopic surgery of the elbow.

The fibula-flexor hallucis longus osteomuscular flap.

Limb salvage after loss of bone and soft tissue may require many operations to obtain soft-tissue cover and bony continuity. We describe a fibula-flexor hallucis longus osteomuscular flap which can provide both soft tissue and bone in a single stage. The flap is based on the peroneal vessels and is covered by a split-thickness skin graft.

Management of vasospastic disorders of the hand.

Vasospastic disorders of the upper extremity are common and often difficult to treat. Using the proposed classification system (Table 2) allows management based upon pathologic condition, physiologic staging, and response to treatment. Identifying patients in this way also helps in determining which treatments are most appropriate.

The histological effect of barrier vein wrapping of peripheral nerves.

Twenty-four Sprague-Dawley rats underwent exploration and exposure of the sciatic nerve, followed by sham isolation, irrigation, and subsequent wound closure (Group 1); barrier vein wrapping of the nerve using glutaraldehyde-preserved allograft inferior vena cava (Group 2); or barrier vein wrapping of the nerve with femoral vein autograft from the contralateral extremity (Group 3). Four months later, the rats were sacrificed and the nerves fixed in situ in buffered glutaraldehyde. Sections proximal, mid-portion, and distal to the barrier and vein wrap were fixed with osmium tetroxide, epon embedded, stained with toluidine blue, and studied under x200 and x400 light microscopy.

Endoscopic carpal tunnel release. The Agee technique.

The authors describe their technique for endoscopic carpal tunnel release using the Agree device. Technical points, illustrations, and postoperative regimen are provided.

Arthroscopic management of partial scapholunate and lunotriquetral injuries of the wrist.

Outcome was studied in 14 patients with chronic mechanical (crepitant) wrist pain (symptomatic for more than 6 months) who had undergone arthroscopic debridement and early mobilization for the treatment of isolated partial scapholunate and lunotriquetral ligament injuries. Fourteen patients were available for a minimum 2-year follow-up interview, physical examination, and x-ray film evaluation. Eleven patients had complete relief of symptoms and had returned to work within 7 weeks of surgery.

The restoration of elbow flexion with intercostal nerve transfers.

Seventeen patients with absent elbow flexion secondary to brachial plexus avulsion injury underwent intercostal neurotization of the biceps muscle. Followup was performed at an average of 5 years. The average age in this series was 21.

Arthroscopic categorization of intercarpal ligamentous injuries of the wrist.

Recent advances in our knowledge of wrist ligamentous anatomy, as well as improvements in arthroscopic techniques, permit the diagnosis and treatment of a wide variety of wrist injuries. The authors review current concepts in wrist ligamentous anatomy, patterns of instability, and the role of the arthroscope in the evaluation and treatment of such instability. Specifically, wrist portal anatomy and techniques of arthroscopic treatment of patients with partial and complete intercarpal ligament injuries are described.

Arthroscopic treatment of Panner's disease.

Panner's disease, or osteochondrosis of the capitellum, may actually be a continuum of disorders. In the past, such lesions were treated conservatively with surgery as a final option. With the advent of arthroscopy, a diagnosis can be made, and treatment with limited invasiveness instituted.

The landscape of meniscal injuries.

This article analyzes meniscal injuries seen in 10,117 knee arthroscopies. The information was compiled by a centralized data base at Surgical Data Management. The study suggests two patterns of meniscal injuries, degenerative and traumatic.

Elevated alpha-fetoprotein and a normal fetal sonogram: association with placental abnormalities.

This report documents the outcome of 25 pregnancies with elevated serum alpha-fetoprotein levels on two separate samplings despite normal anatomic appearance of the fetus on a detailed "consultative" sonographic examination. Six of these also had elevated amniotic fluid alpha-fetoprotein. All fetuses in this series were anatomically normal at time of delivery; one aborted fetus was triploid.