Changes in tendon length and excursion following extensor tendon grafting at the distal radioulnar joint.

IV.

Long-term clinical and imaging outcomes after primary repair of small- to medium-sized rotator cuff tears.

Background: Rotator cuff tear is a common disease for middle-aged and elderly patients, and relatively good postoperative outcomes have been reported in the literature. The aim of the study was to examine cases that underwent miniopen rotator cuff repair and to clarify their long-term clinical and imaging outcomes.

Methods: A total of 68 patients who underwent a miniopen repair for small- to medium-sized rotator cuff tears with good cuff integrity and without retear on magnetic resonance imaging (MRI) at 1 year postoperatively were followed up for a minimum of 10 years (mean ± standard deviation: 11.

Bone Peg Grafting for Capitellar Osteochondritis Dissecans in Adolescent Baseball Players.

Background: Capitellar osteochondritis dissecans (OCD) is a focal injury of the articular cartilage involving separation of a segment of cartilage from the subchondral bone that is infrequently encountered in the dominant-side elbow of adolescent throwing athletes. The literature suggests that patients may achieve better short and mid-term results when treated with certain types of surgical procedures. Selection of the appropriate surgical method should be based on the International Cartilage Repair Society (ICRS) OCD classification system.

Myostatin promotes tenogenic differentiation of C2C12 myoblast cells through Smad3.

Myostatin, a member of the transforming growth factor-β (TGF-β) superfamily, is expressed in developing and adult skeletal muscle and negatively regulates skeletal muscle growth. Recently, myostatin has been found to be expressed in tendons and increases tendon fibroblast proliferation and the expression of tenocyte markers. C2C12 is a mouse myoblast cell line, which has the ability to transdifferentiate into osteoblast and adipocyte lineages.

Results of Bone Peg Grafting for Capitellar Osteochondritis Dissecans in Adolescent Baseball Players.

Background: Bone peg grafting (BPG) has been advocated for early-stage humeral capitellar osteochondritis dissecans (COCD). However, the clinical and radiological results of BPG, along with its indications, have not been described in detail.

Hypothesis: COCD classified as International Cartilage Repair Society (ICRS) osteochondritis dissecans (OCD) I or II in adolescent baseball players can be treated successfully by BPG.

Postoperative improvement in DASH score, clinical findings, and nerve conduction velocity in patients with cubital tunnel syndrome.

We investigated a recovery pattern in subjective and objective measures among 52 patients with cubital tunnel syndrome after anterior subcutaneous transposition of the ulnar nerve. Disabilities of the Arm, Shoulder and Hand (DASH) score (primary outcome), numbness score, grip and pinch strength, Semmes-Weinstein (SW) score, static 2-point discrimination (2PD) score, and motor conduction velocity (MCV) stage were examined preoperatively and 1, 3, 6, 12, and ≥24 months postoperatively. Statistical analyses were conducted to evaluate how each variable improved after surgery.

Tardy ulnar nerve palsy caused by chronic radial head dislocation after Monteggia fracture: a report of two cases.

Dislocation of the radial head is often encountered as a result of a pediatric Monteggia fracture. We report two rare cases of tardy ulnar nerve palsy associated with anterior radial head dislocation combined with anterior bowing of the ulna. They had cubitus valgus deformity, valgus instability, and osteoarthritis of the elbow, and had elbow injury more than 40 years back.

Factors affecting extension lag after tendon reconstruction for finger extensor tendon rupture due to distal radioulnar lesion.

Background: Although extensor tendon rupture associated with distal radioulnar joint disorder is often encountered, its treatment has not yet been established. We report the postoperative results for reconstruction of finger extensor tendon rupture due to distal radioulnar lesion and analyse the factors affecting postoperative extension lag.

Methods: We examined 74 index, middle, ring, or little fingers with extensor tendon rupture of 34 hands.

Arthrodesis of the carpometacarpal joint of the thumb with plate fixation and bone grafting: a retrospective review.

Background: Arthrodesis of the carpometacarpal (CM) joint of the thumb has been recognized as a common technique that gives pain relief, stability, and strength, but it has some disadvantages, such as nonunion, pantrapezial osteoarthritis, and reduced mobility.

Methods: Thirteen thumbs of 12 patients with CM joint arthritis who underwent CM joint arthrodesis were reviewed retrospectively. The average age of the patients was 61.

Magnetic Resonance Imaging Staging to Evaluate the Stability of Capitellar Osteochondritis Dissecans Lesions.

Background: Treatment for capitellar osteochondritis dissecans (COCD) lesions is usually based on their stability from the bony floor after arthroscopic or open direct observation. Thus, a noninvasive means of lesion stability assessment by use of imaging is desirable to preoperatively determine treatment strategy.

Purpose: To evaluate our modified MRI staging system for COCD, we compared the results of MRI staging with the International Cartilage Repair Society (ICRS) classification for lesion stability.

Correlation between motor function and axonal morphology in neonatally sciatic nerve-injured rats.

The present study was conducted to investigate the correlation between motor function and axonal morphology in neonatally sciatic nerve-injured rats. The left sciatic nerve of newborn rats was transected or crushed, and functionality of the sciatic nerve was assessed by the static sciatic index after 8 weeks. After functional assessment, the common peroneal nerves in the control, nerve-transected, and nerve-crushed rats were removed and prepared for morphometric examinations.

The effect of vascular pedicle preservation on blood flow and clinical outcome following ulnar nerve transposition.

Purpose: To evaluate the efficacy of a technique to preserve the extrinsic vascular supply to the ulnar nerve after transposition and its effect on blood flow and clinical outcome.

Methods: We included 36 patients with cubital tunnel syndrome. The patients were randomly selected to undergo vascular pedicles-sparing surgery for anterior ulnar nerve transposition (VP group) or nerve transposition and artery ligation (non-VP group).

Septic arthritis of the elbow in a child due to Pseudomonas aeruginosa: a case report.

We present a rare case of septic arthritis of the elbow in a child caused by Pseudomonas aeruginosa infection. In our patient, the 15-day delay before drainage may have led to the osteomyelitis of the capitulum and resulted in some persistent radiographic abnormalities. Although our patient has no subjective symptoms 5 years postoperatively, he has a slightly abnormal range of motion and gross lateral instability.

Intrasynovial tendon graft for chronic flexor tendon laceration of the finger: a case report.

We present the case of a patient with flexor digitorum profundus tendon laceration at the A2 pulley level caused by an injury to the base of the right ring finger by a knife. The patient was treated by flexor tendon reconstruction from the palm to the fingertip by using the left second toe flexor tendon as a graft, which improved the active range of motion. Further improvement was achieved by subsequent tenolysis, which eventually restored nearly normal function.

Technical difficulties and their prediction in 2-portal endoscopic carpal tunnel release for idiopathic carpal tunnel syndrome.

Purpose: This study aimed to identify technical difficulties encountered during 2-portal endoscopic carpal tunnel release (ECTR) and to determine their incidence. Furthermore, we assessed the possibility of preoperatively predicting such technical difficulties.

Methods: We retrospectively reviewed the records of 311 hands of 311 patients with idiopathic carpal tunnel syndrome who underwent ECTR with our modified Chow 2-portal technique.

Effects of repeated crush injuries on motor functional recovery of the sciatic nerve.

Objectives: The present study was conducted to examine whether repeated crush injuries have significant effects on motor functional recovery of peripheral nerves.

Methods: Repeated crush injuries of the sciatic nerve were inflicted on adult rats at 1-week intervals, and functionality of the sciatic nerve was assessed by the static sciatic index each week for 8 weeks after the final injury. To determine the effects of repeated crush injuries on motor functional recovery of the sciatic nerve, tibialis anterior muscle fibers from single and triple crush injuries were examined, and fiber size and fiber reinnervation during the 2- to 4-week period after the final injury were measured.

MRI-Based Identification of an Appropriate Point of Needle Insertion for Patients with Idiopathic Carpal Tunnel Syndrome to Avoid Median Nerve Injury.

To identify a safe entry point for needle insertion in patients with idiopathic carpal tunnel syndrome (CTS), cross-sectional images of the wrist MRI of 45 normal volunteers and 180 consecutive patients with idiopathic CTS were reviewed. Insertion of the needle from the five different entry points into the carpal tunnel was simulated by drawing a 1-pixel line, and the incidence of contact with the median nerve was compared. In the CTS patients, the lowest incidence was 3% when inserted at one-third of the length between the FCR and FCU tendons on the ulnar side at the level of the distal part of the distal radioulnar joint and 4% at the mid point between the palmaris longus tendona and the flexor carpi ulnaris tendon.

Differential onset patterns and causes of carpal tunnel syndrome after distal radius fracture: a retrospective study of 105 wrists.

Background: It is well known that carpal tunnel syndrome (CTS) can occur in a wide range of time periods after distal radius fracture (DRF). Few studies have evaluated in detail the relationship between fracture and electrophysiological finding characteristics and time to onset of CTS after DRF. To clarify the characteristics of CTS after DRF, we classified a large number of clinical cases based on the period from the injury to onset of CTS.

Electrophysiological responsiveness and quality of life (QuickDASH, CTSI) evaluation of surgically treated carpal tunnel syndrome.

Background: We evaluated the correlation between Japanese versions of patient-oriented questionnaires and electrophysiological examinations in patients with carpal tunnel syndrome (CTS).

Methods: A series of 45 patients who were diagnosed with carpal tunnel syndrome and subsequently underwent carpal tunnel release surgery were analyzed. There were 8 men and 37 women with an average age of 64.

Progressive symptomatic kyphotic deformity after decompressive surgery for lumbar destructive spondyloarthropathy.

Destructive spondyloarthropathy (DSA) is a serious complication of haemodialysis for end stage renal failure. We present a case of a patient who complained of back pain and cruralgia due to L2-3 disc degeneration with instability, and was treated with posterior decompression and bone grafting. Soon after surgery, the kyphotic deformity progressed and the symptoms deteriorated.

Abducens nerve palsy as a rare complication of spinal surgery: a case report.

We describe a case of diplopia due to abducens nerve palsy after upper cervical spinal surgery. A 22-year-old woman presented with a chief complaint of numbness and weakness in her left hand. A spinal cord tumor was detected at the C1/2 level.

Idiopathic spinal cord herniation associated with a large erosive bone defect: a case report and review of the literature.

We report a case of idiopathic spinal cord herniation associated with a large bone defect. MRI and computed tomographic myelography revealed ventral deviation of the spinal cord and erosion of the vertebral body at T6-T7. Microscopic surgery revealed a dural defect.

Microendoscopic discectomy (MED) for lumbar disc prolapse.

Microendoscopic discectomy (MED), which combines traditional lumbar microsurgical techniques with endoscopy, is being used as a minimally invasive procedure for lumbar disc herniation. We reviewed 30 patients who underwent MED at our institution and compared their outcome with that of patients subjected to the conventional method. Laboratory data suggested that MED was less invasive surgery.

The accuracy and safety of image-guidance system using intraoperative fluoroscopic images: an in vitro feasibility study.

The "virtual fluoroscopy" is a new navigation system that combines image-guided surgery and C-arm fluoroscopy. The purpose of this study was to evaluate the accuracy of this system in the case of pedicle screwing. The angular deviation in the axial and sagittal planes was measured using the bodies of 50 vertebral models.