Versatility of the medial corticoperiosteal flap: from recalcitrant non-unions up to large bony defects.

Background: Reconstructive microsurgery techniques using vascularized bone grafts have revolutionized the treatment of complex cases associated with recalcitrant non-unions or osteomyelitis. The medial femoral corticoperiosteal flap (MFCP flap) has emerged as a valuable option in bone reconstruction. Its clinical applications have been extended over the years considering this flap from non-unions with minimal bone lost, up to large intercalary defects of the upper and lower extremities.

Pain catastrophizing, kinesiophobia and fear-avoidance in non-specific work-related low-back pain as predictors of sickness absence.

The influence of pain catastrophizing, kinesiophobia and fear-avoidance attitudes towards non-specific low-back pain has been scarcely studied in an occupational insurance provider context. The objective of this work is to ascertain the relationship between these psychosocial variables with work absence, its duration and the disability of subjects with work-related low back pain. This is a descriptive observational methodological strategy.

Fear-Avoidance Behavior and Sickness Absence in Patients with Work-Related Musculoskeletal Disorders.

(1) : The purpose of this work is to determine the association of fear-avoidance attitudes with sickness absence status, its duration and disability in a work accident context. (2) This is a descriptive observational design, conducting the study in two occupational insurance provider clinics with patients with nonspecific low back and neck pain during the study period. Clinical variables were the Fear Avoidance Questionnaire, Roland Morris Disability Questionnaire, Neck Disability Index, Numerical Pain Scale; sociodemographic variables were sex, age, occupational, educational level, sickness absence status, and duration in days of absence from work.

Influence of Psychosocial and Sociodemographic Variables on Sickness Leave and Disability in Patients with Work-Related Neck and Low Back Pain.

The purpose of this study was to describe the association between psychosocial factors in patients with work-related neck or low back pain ( = 129), in order to study sickness leave, its duration, the disability reported, and to analyze the relationship of these factors with different sociodemographic variables. This was a descriptive cross-sectional study. Data on kinesiophobia, catastrophizing, disability, and pain were gathered.

An Alternative Thumb Reconstruction by Double Microsurgical Transfer From the Great and Second Toe for a Carpometacarpal Amputation.

Thumb amputation at the carpometacarpal level is very incapacitating. Pollicization may be considered. We describe an alternate technique for thumb reconstruction at the level of the metacarpal base using a trimmed great toe along with a vascularized second metatarsophalangeal joint, including the second metatarsal, all supplied on a single vascular pedicle.

Ultrasound-guided percutaneous needle electrolysis in chronic lateral epicondylitis: short-term and long-term results.

Background: Ultrasound (US)-guided percutaneous needle electrolysis (PNE) is a novel minimally invasive approach which consists of the application of a galvanic current through an acupuncture needle.

Objective: To evaluate the clinical and ultrasonographic effectiveness of a multimodal programme (PNE, eccentric exercise (EccEx) and stretching) in the short term for patients with chronic lateral epicondylitis, and to determine whether the clinical outcomes achieved decline over time.

Methods: A one-way repeated measures study was performed in a clinical setting in 36 patients presenting with lateral epicondylitis.

Frequency and characteristics of occupational dental trauma.

Background: Dental trauma at the workplace may have important clinical and occupational consequences, but little is known about its profile.

Aims: To describe the frequency and characteristics of work-related dental injuries.

Methods: For all patients with occupational dental trauma seen at the FREMAP Hospital of Barcelona (Spain) between January 2000 and December 2006, we recorded their characteristics, type of work and nature of the trauma, including cause of the accident, extent of trauma, reason for referral to a dentist, and days of sick leave.

Vascularized periosteal transfer from the medial femoral condyle: is it compulsory to include the cortical bone?

Background: The corticoperiosteal flap from the medial femoral condyle has become the workhorse in the management of recalcitrant nonunions with vascularized periosteum. Inclusion of the outer condylar cortex has been advocated to avoid damaging the osteogenic capacity of the periosteum and is at present an ordinary technical step in the procedure.

Patients: A clinical prospective study was undertaken to evaluate the effectiveness of periosteal-only microvascular transfers from the medial femoral condyle associated with bone grafts in the treatment of recalcitrant nonunions.

Bone lengthening osteogenesis, a combination of intramembranous and endochondral ossification: an experimental study in sheep.

We evaluated the morphological features of the newly formed tissue in an experimental model of tibial callotasis lengthening on 24 lambs, aged from 2 to 3 months at the time of operation. A unilateral external fixator prototype Monotube Triax(®) (Stryker Howmedica Osteonics, New Jersey) was applied to the left tibia. A percutaneous osteotomy was performed in a minimally traumatic manner using a chisel.

The evidence of low-intensity pulsed ultrasound for in vitro, animal and human fracture healing.

Background: Physical stimulation therapies are currently available to enhance fracture healing.

Sources Of Data: A search of PubMed, Medline, CINAHL, DH data and Embase databases was performed using the keywords 'ultrasound' and 'fracture healing'.

Areas Of Agreement: The evidence in vitro and animal studies suggests that low-intensity pulsed ultrasound (LIPUS) produces significant osteoinductive effects, accelerating the healing process and improving the bone-bending strength.

Non-surgical therapies for peripheral nerve injury.

Background: Non-surgical approaches have been developed to enhance nerve recovery, which are complementary to surgery and are an adjunct to the reinnervation process.

Sources Of Data: A search of PubMed, Medline, CINAHL, DH data and Embase databases was performed using the keywords 'peripheral nerve injury' and 'treatment'.

Areas Of Controversy: Most of the conservative therapies are focused to control neuropathic pain after nerve tissue damage.

Scanty integration of osteochondral allografts cryopreserved at low temperatures with dimethyl sulfoxide.

Purpose: To compare the integration of osteochondral allografts cryopreserved at different temperatures and different concentrations of dimethyl sulfoxide in an in vivo sheep animal model.

Methods: Thirty-six adult sheep were randomly allocated to 6 groups of allograft osteochondral transplantation. Six osteochondral cylinders were stored for 6 weeks at -80°C; 6 at -80°C with 10% dimethyl sulfoxide (DMSO); 6 at -80°C with 10% DMSO for 90 min; 6 at -186°C; 6 at -186°C with 10% DMSO; 6 at -186°C for 90 min.

Corticoperiosteal flap in the treatment of nonunions and small bone gaps: technical details and expanding possibilities.

The corticoperiosteal flap from the medial femoral condyle (CP) has proved to be highly reliable in the management of persistent, recurrent nonunion. However, much of the related literature has focussed on the flap aspects of the procedure and not so much on bone work-up. We present a series of 25 patients with nonunions and small bone gaps irresponsive to conventional therapy that were successfully treated with a CP with/without the addition of non-vascularised bone graft from the iliac crest.

The effects of previous meniscus and anterior cruciate ligament injuries in patients with total knee arthroplasty.

Background: Patients undergoing total knee replacements constitute a suitable population to study the natural history of traumatic joint injuries.

Material And Methods: We studied all the patients who received a TKA (Total knee arthroplasty) over the course of one year, in five different centers. The study included 474 patients who had undergone primary TKA for knee OA over a one-year period.

Platelet-rich plasma, rhOP-1 (rhBMP-7) and frozen rib allograft for the reconstruction of bony mandibular defects in sheep. A pilot experimental study.

A 6 cm bony defect in the mandible of 15 sheep, 8 years old, was reconstructed using variously allograft of frozen rib, rhOP-1 (rh BMP-7), platelet-rich plasma (PRP), and a combination of frozen rib allograft and rhOP-1. The histological, histomorphometric, immunohistochemical and radiographic features of reconstruction were analysed. The animals were euthanised at 2 months postoperatively.

Computed tomography-based study of age- and sex-related variation in morphology of the femur.

Background: The femur has a complex shape with marked individual differences. The aim of our study was to investigate the anatomy of the femur in normal subjects using computed tomography imaging with the aim of building a digital database of human femoral anatomy.

Material And Methods: We studied age- and sex-related variation in the shape of the femur in 169 normal subjects (80 men and 89 women) using Computed Tomography.

Gene expression and proliferation analysis in young, aged, and osteoarthritic sheep chondrocytes effect of growth factor treatment.

Cartilage is a support tissue with a poor capacity to self-repair. Its cells, chondrocytes, are responsible for synthesizing and renewing the matrix that surrounds them in a constant turnover mechanism. Autologous chondrocyte implantation (ACI) is one of the techniques that promises to be an alternative to common strategies for chondral lesions.