The non-operative management of bony mallet injuries.

Over a 4-year period, 218 mallet fractures in 211 adult patients were treated using a custom-made thermoplastic splint. Clinical results were collected prospectively, including the visual analogue score for pain, the range of motion and extensor lag, and the Patient Evaluation Measure (PEM). The joints were congruent in 168 and subluxed in 50.

Articular cartilage and soft tissue damage from radiofrequency thermal ablation wands at wrist arthroscopy.

We report six cases of complications from use of a thermal wand at wrist arthroscopy. Complications included skin necrosis, extensor tendon lesions and thermal articular cartilage damage, one with a catastrophic outcome. Thermal wands have the potential for substantial soft tissue damage causing severe harm to patients.

Fractures at the junction of diaphysis and metaphysis of the proximal phalanges in adults.

Unlabelled: We describe the treatment of 101 patients with 113 fractures of the proximal phalanx at the junction of the diaphysis with the proximal metaphysis. Fractures were stabilized using a single extra-articular percutaneous Kirschner wire passed lateral to the metacarpal head into the base of the phalanx base and across the fracture to engage the lateral cortex. Patients were treated semi-electively on a day surgery unit.

The Mediterranean deep-water kelp is an endangered species in the Adriatic Sea.

Deep-water kelps are little-known large brown algae occurring close to the lower limit of photosynthetic life in the sea. This study compares historical and recent records of the deep-water Mediterranean kelp in the Adriatic Sea. Historical records include data from herbarium collections and trawling fishery expeditions in the mid-twentieth century, while recent data comprise records of the last 17 years from MEDITS expeditions, ROV surveys of historical kelp locations, benthic surveys and records by fishermen.

Arctic marine phytobenthos of northern Baffin Island.

Global climate change is expected to alter the polar bioregions faster than any other marine environment. This study assesses the biodiversity of seaweeds and associated eukaryotic pathogens of an established study site in northern Baffin Island (72° N), providing a baseline inventory for future work assessing impacts of the currently ongoing changes in the Arctic marine environment. A total of 33 Phaeophyceae, 24 Rhodophyceae, 2 Chlorophyceae, 12 Ulvophyceae, 1 Trebouxiophyceae, and 1 Dinophyceae are reported, based on collections of an expedition to the area in 2009, complemented by unpublished records of Robert T.

The management of clenched fist 'fight bite' injuries of the hand.

We present a prospective study outlining the management of clenched fist 'fight bite' injuries. Over a 4-year period all patients with such injuries had surgical exploration with further débridements as necessary. For metacarpophalangeal joint injuries, a midline tendon-splitting approach was used.

Cleland's ligaments and Dupuytren's disease.

The aim of this study was to investigate whether Cleland's ligaments are affected by Dupuytren's disease and assess their contribution to the flexion contracture of the proximal interphalangeal (PIP) joint. Twenty patients with Dupuytren's disease undergoing fasciectomy for a PIP joint contracture > 40° (mean 61°, range 45°-100°) were included. After excision of all other identifiable digital disease, Cleland's ligaments were assessed.

Condylar fractures of the proximal and middle phalanges.

We describe the treatment of 74 patients with phalangeal condylar fractures. Twelve patients presenting with undisplaced fractures were initially treated nonoperatively; of these, five displaced, requiring fixation. The remaining seven patients, all children, united uneventfully.

Analysis of the cathelicidin 1 gene locus in Atlantic cod (Gadus morhua).

Cathelicidins are one of the major families of antimicrobial peptides produced as part of the innate immune responses. We have studied the gene locus of the Atlantic cod cathelicidin gene (gmCath1) by sequencing of a BAC clone. Results have revealed the genes upstream and downstream of gmCath1 in a sequence of >92.

The 'metacarpal cascade lines'; use in the diagnosis of dislocations of the carpometacarpal joints.

Dislocations of the carpometacarpal joints of the ring and little fingers are common and are frequently missed at presentation. We describe a radiographic observation which assists in the confirmation of the diagnosis.

Collateral ligament avulsion fractures from the heads of the metacarpals of the fingers.

Nineteen patients with collateral ligament avulsion fractures from the metacarpal heads of the fingers were treated during a 6 year period. Seven undisplaced fractures were initially treated conservatively. Four united with full movement.

Avulsion fractures from the base of the proximal phalanges of the fingers.

Thirty-three patients with avulsion fractures from the base of the proximal phalanges were treated during a 6-year period. All eight fractures treated conservatively failed to unite and subsequently required surgery. The remaining 25 patients were treated with primary internal fixation using a single lag screw through a palmar approach.

Use of an elastic intramedullary nail in difficult humeral fractures.

Debate continues over implant selection when surgical intervention is deemed necessary in the management of diaphyseal fractures of the humerus. We present a series of patients in which we used an elastic intramedullary nail to manage a variety of difficult humeral fractures and discuss the theoretical advantages which we feel this method offers.

Vascularized pedicle graft of the lower trunk for reconstruction of the branchial plexus.

The middle trunk of an injured brachial plexus was reconstructed using a vascularized graft of the lower trunk, which was expendable because of irreparable damage to the C8 and T1 nerve roots. The graft was transferred on a vascular pedicle of mesoneurium. Useful recovery was achieved at 3 years.

Experience of the early use of technetium 99 bone scintigraphy in wrist injury.

In a retrospective study, patients with suspected scaphoid fracture had an average of three sets of scaphoid radiographs prior to scintigraphy. Scans were performed an average of 3 months after injury and many were inconclusive because of disuse changes. A prospective analysis of early scintigraphy in 35 cases over 18 months was carried out.

Injuries to the hand in rugby union football.

Hand injuries are a common consequence of playing rugby. A prospective study of all rugby injuries referred to a hand clinic over the course of one season was carried out. 72 patients with such injuries were seen.

Phalangeal fractures resulting from finger wrestling.

Two cases of proximal phalangeal fracture following finger wrestling are described. The mechanism of the injury is discussed.

Fractures of the distal femur treated with the AO dynamic condylar screw.

We report the results of treatment with the dynamic condylar screw of 21 cases of supracondylar and intercondylar fractures of the femur in patients aged 22 to 91 years. There were two nonunions and no deaths. We found the device easy to use and the good fixation allowed early patient mobilisation.