Does carpal tunnel release provide long-term relief in patients with hemodialysis-associated carpal tunnel syndrome?

Background: Carpal tunnel syndrome (CTS) is a common complication in patients receiving long-term hemodialysis. In the short-term however, these patients are less likely to have pain relief and restoration of function after carpal tunnel release. However, it is unclear whether patients who have release for hemodialysis-associated CTS have differing persisting relief of symptoms compared with patients with idiopathic CTS.

One-bone forearm procedure for acquired pseudoarthrosis of the ulna combined with radial head dislocation in a child: a case with 20 years follow-up.

This report describes a 6 year-old boy who was treated with one-bone forearm procedure for acquired pseudoarthrosis of the ulna combined with radial head dislocation after radical ulna debridement for osteomyelitis. At more than 20 years of follow-up, the patient had a nearly full range of elbow movements with a few additional surgical procedures. Pronation and supination was restricted by 45°, but the patient had near-normal elbow and hand functions without the restriction of any daily living activity.

Correction of long standing proximal interphalangeal flexion contractures with cross finger flaps and vigorous postoperative exercises.

Purpose: We reviewed the results of cross finger flaps after surgical release and vigorous postoperative exercises for long-standing, severe flexion contractures of the Proximal Interphalangeal (PIP) joints of fingers.

Materials And Methods: In 9 patients, all contracted tissue was sequentially released and the resultant skin defect was covered with a cross-finger flap. The cause of the contracture was contact burn in 4, skin graft in 3, and a previous operation in 2.

Decompression of the ulnar nerve and minimal medial epicondylectomy with a small incision for cubital tunnel syndrome: comparison with anterior subcutaneous transposition of the nerve.

Unlabelled: The objective of this study is to compare the results of ulnar nerve decompression and minimal medial epicondylectomy with a small incision (group I) and anterior subcutaneous transposition of the ulnar nerve (group II) for cubital tunnel syndrome.

Methods: Out of 56 patients with cubital tunnel syndrome, 29 were in group I and 27 were in group II. The mean age at the time of the operation was 48.

Carpal tunnel syndrome caused by space occupying lesions.

Purpose: To evaluate the diagnosis and treatment of the carpal tunnel syndrome (CTS) due to space occupying lesions (SOL).

Materials And Methods: Eleven patients and 12 cases that underwent surgery for CTS due to SOL were studied retrospectively. We excluded SOL caused by bony lesions, such as malunion of distal radius fracture, volar lunate dislocation, etc.

Segmental resection and replantation have a role for selected advanced sarcomas in the upper limb.

Unlabelled: Although limb salvage surgery for primary sarcoma of the upper limb is a standard procedure, it often is technically challenging. We asked whether segmental resection and replantation would provide (1) local control and long-term survival and (2) useful limb function in patients who had advanced primary malignant and aggressive tumors of the upper limbs. We retrospectively reviewed six patients treated with this procedure when a wide resection around the tumor could not be achieved with other limb-salvage procedures.

Corrective dome osteotomy for cubitus varus and valgus in adults.

A corrective dome osteotomy was performed in 19 adult patients for cubitus varus and valgus deformity. The mean age at operation was 31.1 years and the mean follow-up was 41 months.

The association of the activation-inducible tumor necrosis factor receptor and ligand with lumbar disc herniation.

Purpose: Herniated nucleus pulposus fragments are recognized by the immune system as a foreign-body, which results in an autoimmune reaction. Human activation-inducible tumor necrosis factor receptor (AITR) and its ligand, AITRL, are important costimulatory molecules in the pathogenesis of autoimmune diseases. Despite the importance of these costimulatory molecules in autoimmune disease, their role in the autoimmune reaction to herniated disc fragments has yet to be explored.

Clinical significance of margin status in postoperative radiotherapy for extremity and truncal soft-tissue sarcoma.

Purpose: To evaluate whether adjuvant radiotherapy (RT) in extremity and truncal soft-tissue sarcoma (STS) patients with microscopically positive or close margins after excision can achieve comparable local control to that of excision with negative margin plus RT.

Methods And Materials: A total of 150 patients (111 extremity and 39 trunk cases) treated with conserving surgery and adjuvant RT was analyzed. All surgical margins were classified as being a negative margin or a positive or close margin based on pathologic margin width.

Paraspinal abscess communicated with epidural abscess after extra-articular facet joint injection.

Facet joint injection is considered to be a safe procedure. There have been some reported cases of facet joint pyogenic infection and also 3 cases of facet joint infection spreading to paraspinal muscle and epidural space due to intra-articular injections. To the author's knowledge, paraspinal and epidural abscesses after facet joint injection without facet joint pyogenic infection have not been reported.

Treatment of osteofibrous dysplasia and associated lesions.

Purpose: To report long term treatment outcomes of osteofibrous dysplasia and association with adamantinoma.

Patients And Methods: From January 1984 to July 2001, 14 patients with osteofibrous dysplasia were followed for an average of 108 months (78 to 260 months). Our patient group consisted of 6 men and 8 women, with a mean age of 13.

A comparison of autologous and homologous transfusions in spinal fusion.

Autologous transfusion has been used to overcome adverse effects of homologous transfusion. Clinical studies evaluating general orthopaedic postoperative results have been designed to compare these transfusion methods. However, few studies have evaluated postoperative results in spinal fusion surgeries, which have larger blood loss volumes.

Cervical myelopathy from atlantal hypoplasia and torticollis.

Cervical myelopathy caused by atlantal hypoplasia has been reported in only 11 patients. Atlantal hypoplasia combined with torticollis has not been reported. Rotation of the atlantoaxial joint causes spinal canal narrowing at the atlantoaxial level and stretches the vertebral artery, which may aggravate the symptoms and signs of compressive cervical myelopathy from atlantal hypoplasia.

Operative treatment for proximal phalangeal neck fractures of the finger in children.

Displacement and inappropriate treatment of a proximal phalangeal neck fracture may result in malunion of the fracture with consequent loss of motion and gross deformity, especially in children. We performed a retrospective study of twenty-four patients who had undergone operative treatment for a proximal phalangeal neck fracture, with a mean follow-up evaluation of 14 months (range: 12-30 months). We analyzed the types of fractures, their causes, operative treatments, complications, and functional outcomes.

Tumor volume change after chemotheraphy as a predictive factor of disease free survival for osteosarcoma.

Change in tumor volume after chemotherapy appears to have a prognostic significance for the outcome of osteosarcoma. A newly developed volume measurement method based on three-dimensional summation with a proved reproducibility was utilized to measure osteosarcoma tumor volume. This retrospective analysis included 38 patients with biopsy- proven, nonsurface, skeletal high-grade osteosarcoma.

Chondrogenic differentiation of mesenchymal stem cells and its clinical applications.

Tissue engineering has the potential to provide cartilaginous constructs capable of restoring the normal function of native articular cartilage following joint injury or degradation. One approach to functional tissue engineering of cartilage involves the in vitro cultivation of tissue constructs by using: (i) chondrogenic cells that can be selected, expanded, and transfected to overexpress the genes of interest, (ii) scaffolds that provide a defined three-dimensional structure for tissue development and biodegrade at a controlled rate. Understanding the functional potential of the cells and the signaling mechanisms underlying their differentiation should lead to innovative protocols for clinical orthopaedic interventions.

Importance of integrin beta1-mediated cell adhesion on biodegradable polymers under serum depletion in mesenchymal stem cells and chondrocytes.

To evaluate the predominant mechanism of chondrogenic cell [mesenchymal stem cells (MSCs) and chondrocytes] adhesion under serum free conditions, we measured the surface roughness and wettability of poly(lactic acid:polyglycolic acid=75:25) (PLGA), poly(lactic acid) (PLA), and poly(-epsilon-caprolactone) (PCL)-coated glass plates. Also to evaluate the biological reactions involved in cell-polymer interactions, integrin beta1, one of the cell adhesion molecules, was blocked with monoclonal antibody. In cell attachment test, MSCs and chondrocytes adhesion to synthetic polymers in 1h were very low and ranged from 2.

Palmar divergent dislocation of scaphoid and lunate.

A 28-year-old man presented with a palmar divergent dislocation of the scaphoid and lunate. He was treated with an open reduction and an internal fixation with two Kirschner's wires after the 25th day of trauma due to a neurological injury. The results were satisfactory after 18 months follow up without any evidence of avascular necrosis and traumatic arthritis of the scaphoid and lunate.

Bone morphogenetic protein-2 facilitates expression of chondrogenic, not osteogenic, phenotype of human intervertebral disc cells.

Study Design: In vitro experiment using bone morphogenetic protein-2 (BMP-2) and human intervertebral disc (IVD) cells.

Objectives: To demonstrate the effect of BMP-2 on mRNAs expression (collagen type I, collagen type II, aggrecan, and osteocalcin), proteoglycan synthesis, expression of alkaline phosphatase, bone nodule formation in human IVD cells.

Summary Of Background Data: BMP-2 was widely known as a powerful agent for osteoinduction and a crucial growth factor for early chondrogenesis and maintenance of cartilaginous phenotype.

Correction of lumbosacral hyperlordosis in achondroplasia.

Anterior bulging of the abdomen and posterior protrusion of the buttocks are externally visible deformities reflecting lumbosacral hyperlordosis. Imbalance in pelvic femoral muscles may account for this posture. Despite the clinical significance of hyperlordosis, its surgical treatment has not been well-described.

Lower limb lengthening in turner dwarfism.

The aim of this study was to review our cases of lower limb lengthening to treat Turner dwarfism, and to speculate whether or not effective limb lengthening can be achieved in this rare condition. Twelve tibiae and 2 femora were lengthened in 6 patients using the Ilizarov method for the tibia and a gradual elongation nail for the femur. The mean age at the time of surgery was 19 years, and the patients were followed up for a minimum of 2 years.

The modulation of integrin expression by the extracellular matrix in articular chondrocytes.

Normal articular cartilage is composed of chondrocytes embedded within an extracellular matrix (ECM). The patterns of integrin expression determine the adhesive properties of cells by modulating interactions with specific ECMs. Our hypothesis is that chondrocyte integrin expression changes in response to changes in their microenvironment.

Surgical treatment of malignant and aggressive bone tumors around the knee by segmental resection and rotationplasty.

In patients having malignant or aggressive bone tumors around the knee joint and requiring amputation, segmental resection and rotationplasty was performed and the clinical results were analyzed. Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994. The mean follow-up period was 57 (6 - 120) months and the average age of patients was 21.

Operative treatment for isolated distal ulnar shaft fracture.

This study retrospectively evaluated the effectiveness of an open reduction and internal fixation of a tension band wiring technique for treating displaced or unstable comminuted distal ulnar shaft fractures without a radial fracture. Ten patients were treated for an isolated distal ulnar shaft fracture. There were 6 cases of a fracture 2.

Limb salvage using original low heat-treated tumor-bearing bone.

Limb salvage, using original low heat-treated tumor-bearing bone and a conventional joint prosthesis, was done in six patients with malignant tumors of the proximal humerus (one patient with chondrosarcoma and five patients with osteosarcoma) and in six patients with tumor of the proximal femur (two patients with malignant spindle cell sarcoma and four patients with osteosarcoma). Wide excision of the lesion was done and the tumor and surrounding soft tissues were removed. The excised bone was treated with heat and the prosthesis was inserted into the treated bone and fixed with cement.