Management of Zygomatic Fractures: A National Survey.

Introduction: Repair of zygomatic fractures can be classified into the early closed reduction or the more recent open reduction and rigid internal fixation (ORIF) methods. Surgical training and literature advocate ORIF, but the actual frequency of the different techniques in clinical practice is unknown. The purpose of this study was to determine the current trends in the management of zygomatic fractures among US surgeons and elucidate their influences.

Evidence-based medicine: thumb carpometacarpal arthroplasty.

Learning Objectives: After studying this article, the participant should be able to: 1. Recount the epidemiology of basilar joint arthritis. 2.

Desmoid tumor of the hand: a case report.

Extra-abdominal desmoid tumors are extremely rare in the hand. These tumors do not metastasize; however, they are potentially locally invasive and have extremely high local recurrence rates after surgical excision with reports of up to 78% recurrence, specifically in the hand. We describe the first case of a desmoid tumor originating from the extensor mechanism of a digit and discuss our treatment approach.

Longitudinal split tears of the ulnotriquetral ligament.

Unlike tears of the peripheral triangular fibrocartilage or avulsions of the distal radioulnar ligaments, longitudinal split tears of the ulnotriquetral (UT) ligament do not cause any instability to the distal radioulnar joint or the ulnocarpal articulation. It is mainly a pain syndrome that can be incapacitating. However, because the UT ligament arises from the palmar radioulnar ligament of the triangular fibrocartilage complex (TFCC), it is by definition, an injury of the TFCC.

Rapid intraoperative zygoma fracture imaging.

Background: A fractured zygoma frequently results in an aesthetically displeasing facial asymmetry. Open reduction and internal fixation may accurately realign the facial skeleton but often with undesirable sequelae. The authors' objective was to develop a precise technique of intraoperative zygoma fracture imaging using a C-arm to permit anatomical fracture realignment while reducing the extent of skeletal exposure required.

Long-term outcomes of first metacarpal extension osteotomy in the treatment of carpal-metacarpal osteoarthritis.

Purpose: The purpose of this study was to investigate the long-term outcomes of first metacarpal extension osteotomy in the treatment of osteoarthritis of the thumb carpal-metacarpal joint.

Methods: We retrospectively reviewed 8 patients treated by a single surgeon with first metacarpal extension osteotomy.

Results: Preoperative Eaton stage was I in 3 patients, II in 3 patients, and III in 2 patients.

Atypical rheumatoid nodules: a possible precursor to a rheumatoid variant in a rheumatoid-factor-negative patient. Case report.

Subcutaneous nodules occur in approximately 20-25% of rheumatoid factor (RF)-positive rheumatoid patients. In this paper, we present a unique case of a 47-year-old healthy RF-negative woman with a 3-year history of necrobiotic nodules over the dorsum of her hands, extensor forearms, and lower extremities. This may represent an atypical presentation or a new rheumatoid variant.

First carpal-metacarpal joint dislocation and trapezial fracture treated with external fixation in an adolescent.

The intrinsic joint stability of the first carpal-metacarpal joint (CMC) makes dislocation a rare injury with fewer than 40 cases described. The degree to which supporting ligaments have been disrupted is reflected clinically by a spectrum of joint stability. Close review of radiographs and an attentive physical examination are necessary to make the diagnosis.

Algorithm for head computed tomography imaging in patients with mandible fractures.

Purpose: Trauma to the mandible can potentially increase our predictive accuracy for intracranial injuries (ICIs) because of the mandible's strength, anatomic proximity, and direct connection to the skull base. Our goals were to: 1) investigate the association of mandible fractures with traumatic brain injury (TBI) and intracranial lesions (ICLs); and 2) determine predictors of ICIs in a level 1 Canadian trauma center with distinct patient demographics and fracture etiologies.

Patients And Methods: A retrospective chart review was performed of medical records of mandible-fracture patients treated at our institution from 1997 to 2003.

Effect of treatment delay on mandibular fracture infection rate.

Background: The incidence of infection secondary to mandibular fractures ranges from 0 to 30 percent, resulting in significant sequelae. Unlike other variables that may influence infection, delayed repair is often unavoidable. The objective of this study was to accurately identify the effect of treatment delay on mandibular fracture infection rate by adjusting for confounders, thus providing strong evidence for preoperative management of these patients.

Clinical features of multiple glomus tumors.

Background: While glomus tumors are usually solitary, multiple glomus tumors do occur. The purpose of this study was to review the clinical characteristics and outcomes in a series of patients with multiple glomus tumors presenting to our institution.

Methods: A retrospective review of patients with multiple glomus tumors seen at our institution over the past 25 years was performed.

ALK1 opposes ALK5/Smad3 signaling and expression of extracellular matrix components in human chondrocytes.

Introduction: TGF-beta is a multifunctional regulator of chondrocyte proliferation, differentiation, and extracellular matrix production. Dysregulation of TGF-beta action has been implicated in cartilage diseases such as osteoarthritis. TGF-beta signaling is transduced through a pair of transmembrane serine/threonine kinases, known as the type I (ALK5) and type II receptors.

Preliminary results of nonconstrained pyrolytic carbon arthroplasty for metacarpophalangeal joint arthritis.

Purpose: To review early outcomes of arthritic metacarpophalangeal (MCP) joints treated with nonconstrained pyrolytic carbon implants to evaluate efficacy, clinical outcomes, and durability.

Methods: One hundred forty-two consecutive arthroplasties (61 patients) were retrospectively reviewed. Diagnoses included osteoarthritis (OA), traumatic arthritis, and inflammatory arthritis.

Objective interpretation of surgical outcomes: is there a need for standardizing digital images in the plastic surgery literature?

Background: Subjective interpretation of preoperative and postoperative photographs is heavily relied on for evaluating standards of care. For preoperative and postoperative digital images to accurately reflect surgical outcomes, image characteristics, other than acquisition, must be rigidly standardized. The authors investigated, using objective methodology, the consistency of published images within the plastic surgery literature.

Extradigital glomus tumors: a 20-year experience.

Objective: To review a large series of extradigital glomus tumors in order to gain a better understanding of their presentation and provide guidelines to aid in their diagnosis and treatment.

Patients And Methods: We performed a retrospective review of all extradigital glomus tumors seen at our institution during a 20-year period (1985-2005) to document the incidence of the classic triad of symptoms, the duration of symptoms, the contribution of imaging to making a definitive diagnosis, and the effectiveness of treatment.

Results: Fifty-six different patients with extradigital glomus tumors presented as follows: glomus tumors in the hand (3), wrist (4), forearm (11), elbow (4), arm (4), shoulder (2), buttock (1), thigh (5), knee (10), leg (3), ankle (2), foot (2), back (1), nose (1), cheek (1), ear lobe (1), and trachea (1).

Large area local anesthesia (LALA) in submuscular breast augmentation.

Background: Large area local anesthesia (LALA) has been recommended for decreasing localized pain and shortening discharge time after breast augmentation surgery. However, quantifiable, objective outcome data for evaluation of the effectiveness of LALA in aesthetic plastic surgery procedures have not yet been reported.

Objective: We conducted a retrospective patient chart review to determine whether irrigation of the submuscular pocket with bupivacaine in retropectoral breast augmentation procedures quantifiably alters the patient's postoperative course with respect to narcotic requirement, nausea and vomiting, and time to discharge.

Severe myositis ossificans in a paraplegic trauma patient: Influence in pressure sore management.

Myositis ossificans (MO) is a benign, progressive, ossifying lesion that displays a characteristic zonal histological appearance. MO traumatica is a localized form of heterotopic bone formation, associated with repetitive micro- and/or macrotrauma in the majority of cases. The importance of imaging to differentiate MO from sarcomatous change and to determine maturity of the lesion is identified because suboptimal operative intervention on immature MO inevitably results in recurrence.

A case of epiphora and recurrent basal cell carcinoma of the nasal tip and review of acquired nasolacrimal system obstruction.

A case of a 67-year-old man with recurrent basal cell carcinoma of the nasal tip and an incidental symptom of epiphora (volunteered by the patient) is presented. Epiphora is an abnormal overflow of tears that fail to drain into the inferior nasal meatus via the nasolacrimal system. Within the differential diagnosis of epiphora and nasolacrimal obstruction is neoplasm - primary, secondary or metastatic.

Endoglin is expressed on human chondrocytes and forms a heteromeric complex with betaglycan in a ligand and type II TGFbeta receptor independent manner.

Previous work has implicated transforming growth factor beta (TGFbeta) as an essential mediator of cartilage repair and TGFbeta signaling as a requirement for the maintenance of articular cartilage in vivo. However, the mechanisms regulating TGFbeta action in chondrocytes are poorly understood. Endoglin, an accessory receptor of the TGFbeta receptor superfamily, is highly expressed on endothelial cells and has been shown to potently modulate TGFbeta responses.