Cross-Shaped Bone Grafting and Locking Plate Fixation for Arthrodesis of the Trapeziometacarpal Joint: Surgical Technique and Early Mobilization.

Background: The trapeziometacarpal joint is the second most common site of osteoarthritis in the hand and the most frequent one to require surgery. Arthrodesis of the trapeziometacarpal joint is recognized as one of the valuable technique but unfortunately there has been wide variation in the union rate. The purpose of this study was to evaluate a new arthrodesis technique involving a cross-shaped bone graft and locking plate fixation.

Gait oscillation analysis during gait and stair-stepping in elder patients with knee osteoarthritis.

Background: Evaluation of knee and lower limb function alone is not sufficient to assess gait. For accurate assessment of gait abnormality, gait oscillation should also be measured. The goal of this analysis was to assess the influence of the knee joint on gait oscillation during gait and stair-stepping in patients with osteoarthritis of the knee.

Diffuse Pigmented Villonodular Synovitis Around the Ankle.

Background: Pigmented villonodular synovitis (PVNS) is a rare disorder around the ankle joint. The optimal treatment for diffuse-type PVNS is still controversial because of the high incidence of recurrence. We present the clinical features of our patients and review the current diagnostic and treatment modalities.

Dorsal Tear of Triangular Fibrocartilage Complex: Clinical Features and Treatment.

Background Several different triangular fibrocartilage complex (TFCC) tear patterns have been classified through the use of wrist arthroscopy. A tear of the dorsal aspect of the TFCC has been previously reported, but it is not included in Palmer original classification. Our purpose was to describe this type of tear pattern along with the clinical presentation.

Distal Femoral Cortical Irregularity in children.

Cortical abnormalities at the distal postero-medial femoral metaphysis may be relatively common. We reviewed the plain radiographs of 197 knees in 130 children aged between 5 and 12 years to investigate the incidence of distal femoral cortical irregularities (DFCI) and their association with symptoms. An adductor magnus lesion was found in 15% of cases, with an even number of irregular and cystic lesions.

Surgical treatment of metastatic femoral fractures: achieving an improved quality of life for cancer patients.

Background: The femur is the most common long bone affected by metastatic carcinoma. We report our experience regarding treatment of metastatic femoral fracture using femoral head prosthesis (FHP) or intramedullary nailing (IM nail) with augmentation by polymethylmethacrylate (PMMA).

Patients And Methods: Thirty-five complete fractures in 33 patients were treated surgically.

Vascularized bone graft for oncological reconstruction of the extremities: review of the biological advantages.

Vascularized bone graft (VBG) is a form of vascularized bone marrow transplant in which the bone marrow is surgically grafted with its microenvironment intact. Due to the preservation of cellular viability, VBG have significant advantages over non-vascularized bone grafts. Free vascularized fibula grafts have superior material properties and tolerate infection.

Functional reconstruction of the deltoid muscle following complete resection of musculoskeletal sarcoma.

Although the deltoid muscle has been assumed to be an essential shoulder muscle, the full extent of postoperative functions of the upper extremity following its complete resection due to sarcoma has not been thoroughly investigated. In this study, we review patients who underwent wide resection for sarcoma in the deltoid muscle, followed by functional reconstruction using pedicled latissimus dorsi (LD) muscle transfer. Four patients with sarcoma arising in the deltoid muscle were reviewed.

Large synovial osteochondromatosis arising from the interphalangeal joint of the thumb: a case report and review of the literature.

A 38-year-old woman presented with a very large synovial chondromatosis arising from the interphalangeal joint of the thumb. The tumor surrounded the interphalangeal joint and its size was approximately 3 cm. The range of motion was almost fused.

Symptomatic intraosseous lipoma in the calcaneus.

Background: Intraosseous lipoma remains a poorly-characterized tumor. In paticular, the natural course of intracalcaneus lipoma after conservative treatment and the appropriate surgical modalities are still quite controversial.

Patients And Methods: We reviewed six symptomatic patients who underwent curettage of intracalcaneus lipoma followed by grafting of α- or β-tricalcium phosphate.

Subungual glomus tumours: diagnosis and microsurgical excision through a lateral subperiosteal approach.

Digital glomus tumour is a rare neoplasm. Surgical excision is the only known curative treatment but the best approach for subungual glomus tumours is still controversial. A total of 12 patients with subungual glomus tumour were reviewed.

A new β-tricalcium phosphate with uniform triple superporous structure as a filling material after curettage of bone tumor.

Background: A new β-tricalcium phosphate with uniform triple superpore structure, SuperPore(®) (HOYA, Tokyo, Japan), has been in clinical use since 2010. As far as we are aware of, there have been no reported clinical studies using this material. We report on the first clinical cases of benign bone tumor filled with SuperPore(®).

Musculoskeletal sarcomas in the forearm and hand: standard treatment and microsurgical reconstruction for limb salvage.

Sarcomas in the forearm and hand are very rare, accounting for less than 1% of all upper-limb tumors and clinical outcomes after surgery and adjuvant therapies are uncertain. The forearm and hand present specific challenges due to their unique anatomical structures. There is little soft tissue and each compartment is narrow, such important structures exist in close proximity.

Vascularized sural nerve graft and extracorporeally irradiated osteochondral autograft for oncological reconstruction of wrist sarcoma: case report and review of literature.

For tumors that are located beside the main peripheral nerve, combined wide resection of both the tumor and peripheral nerve is mandatory. We here present an interesting case with synovial sarcoma of the wrist. An 8 cm of ulnar nerve defect was reconstructed by vascularized, folded sural nerve graft with the peroneal flap, whereas an 8 cm of distal ulna was reconstructed using extracorporeally irradiated osteochondral autograft.

Operative treatment for scaphoid osteonecrosis (Preiser disease): salvage or excision? Report on two cases and a review of the literature.

Idiopathic avascular necrosis of the scaphoid, or Preiser disease, is a rare condition. Both the etiology and the pathology are still not well understood. We here present 2 cases with this disease and discuss the recommended treatment according to the stage of disease progression and by reference to previous studies in the literature.

Unusual peroneal nerve palsy caused by intraneural ganglion cyst: pathological mechanism and appropriate treatment.

The origin of the peroneal intraneural ganglion and the outcome of treatment are still controversial. We report here three cases with peroneal intraneural ganglion and discuss the appropriate treatment. In our cases, 58-, 62-, and 65-year-old patients were operated on with extraneural decompression and epineurotomy within 4 months after onset of drop foot.

Severe ulnar nerve palsy caused by synovial chondromatosis arising from the pisotriquetral joint: a case report and review of literature.

We report here the unique case of 60-year-old man with severe ulnar nerve palsy caused by synovial chondromatosis arising from the pisotriquetral joint. At operation, the tumor entrapped the ulnar nerve proximal to the Guyon canal so that it was severely paralyzed. The ulnar neurovascular bundle could be separated safely under the microscope.

Less invasive surgery with wrist arthroscopy for distal radius fracture.

Background: We developed a surgical procedure that can facilitate arthroscopic intervention for volar locking plate fixation for distal radius fracture (DRF) with a less invasive technique. This study is to investigate the effectiveness of our original procedure for the treatment of DRF.

Methods: One hundred fifty-five wrists of 153 consecutive patients underwent our original procedure: the plate presetting arthroscopic reduction technique (PART) for DRF.

Paradoxical extension phenomenon of the little finger due to repetitive trauma to the palm.

We report a case of paradoxical extension phenomenon of the little finger, so called "lumbrical plus deformity" due to repetitive trauma to the ulnar side of the palm. The adhesion between the flexor digitorum profundus tendon and the lumbrical muscle was the cause of this phenomenon. The lumbrical muscle release was sufficient to solve this rare problem.

Ulnar-sided wrist pain due to isolated disk tear of triangular fibrocartilage complex within the distal radioulnar joint: two case reports.

Wrist arthroscopy has been successfully used with many modifications and improvements. However, distal radioulnar joint (DRUJ) arthroscopy is still uncommon. We experienced 2 cases of ulnar-sided wrist pain due to isolated triangular fibrocartilage complex (TFCC) disk tear within the DRUJ.

Biomechanics of cervical facet dislocation.

Objectives: The goal of this study was to compute the dynamic neck loads during simulated high-speed bilateral facet dislocation and investigate the injury mechanism.

Methods: Ten osteoligamentous functional spinal units (C3/4, n = 4; C5/6, n = 3; C7/T1, n = 3) were prepared with muscle force replication, motion tracking flags, and a 3.3-kg mass rigidly attached to the upper vertebra.

Plate presetting arthroscopic reduction technique for the distal radius fractures.

Wrist arthroscopy for the distal radius fractures is an effective adjunct to evaluate the reduction of intraarticular fragments and soft tissue injuries. In recent years, volar locking plate fixation has become popular, and arthroscopic procedures for distal radius fracture reduction have become problematic because vertical traction has to be both on and off during surgery. We developed a plate presetting arthroscopic reduction technique to simplify the combination of plating and arthroscopy.

Percutaneous ethanol injection therapy for advanced renal hyperparathyroidism in Japan: 2004 survey by the Japanese Society for Parathyroid Intervention.

Background. Marked hyperplasia of the parathyroid gland (PTG) is a characteristic feature of severe hyperparathyroidism in patients under chronic haemodialysis treatment. Percutaneous ethanol injection therapy (PEIT) is now becoming popular in Japan as a treatment option for secondary hyperparathyroidism (SHPT) and its cost is covered by the National Health Insurance (NHI) System.

Side impact causes multiplanar cervical spine injuries.

Background: Side impact may cause neck and upper extremity pain, paresthesias, and impaired neck motion. No studies have quantified the cervical spine mechanical instability and injury threshold acceleration due to side impact. The goals of the present study were to identify and quantify cervical spine soft tissue injury and the injury threshold acceleration for side impact, and to compare these results with previous findings.

Mechanism of cervical spinal cord injury during bilateral facet dislocation.

Study Design: An in vitro biomechanical study.

Objectives: The objectives were to: quantify dynamic canal pinch diameter (CPD) narrowing during simulated bilateral facet dislocation of a cervical functional spinal unit model with muscle force replication, determine if peak dynamic CPD narrowing exceeded that observed post-trauma, and evaluate dynamic cord compression.

Summary Of Background Data: Previous biomechanical models are limited to quasi-static loading or manual ligament transection.