Treatment of Intra-articular Distal Radius Fractures.

This review of current literature discusses the morphology of the volar aspect of the distal radius; the surgical procedure, arthroscopic findings, and clinical results of a plate presetting and arthroscopic reduction technique for acute intra-articular fractures; and a novel simulation guidance system for malunited intra-articular fractures. Classification of intra-articular distal radius fractures is also discussed, focusing on central depression fracture fragments, associated soft tissue injuries, and results for measuring scapholunate distances at different sites. Problems of the distal radioulnar joint are reviewed, in particular, functional outcomes of the authors' prospective cohort study on unstable intra-articular fractures involving the distal radioulnar joint.

Carpal tunnel syndrome associated with Kienböck disease.

We retrospectively reviewed 12 patients (3 men and 9 women, with a mean age of 72 years) who were surgically treated for carpal tunnel syndrome associated with Kienböck disease. All patients except 1 were incidentally diagnosed with Kienböck disease and had little or no wrist pain. Radiographic tests revealed advanced Kienböck disease in all patients.

Recovery function of somatosensory evoked brain response in patients with carpal tunnel syndrome: A magnetoencephalographic study.

Objective: The recovery function of somatosensory evoked magnetic fields (SEFs) was recorded to investigate excitatory and inhibitory balance in the somatosensory cortex of patients with carpal tunnel syndrome.

Methods: SEFs were recorded in patients and controls. Recordings were taken following median nerve stimulation with single and double pulses with interstimulus intervals of 10-200ms.

Underestimated associated features in CMT neuropathies: clinical indicators for the causative gene?

Introduction: Charcot-Marie-Tooth neuropathy (CMT) is a genetically heterogeneous group of peripheral neuropathies. In addition to the classical clinical phenotype, additional features can occur.

Methods: We studied a wide range of additional features in a cohort of 49 genetically confirmed CMT patients and performed a systematic literature revision.

Clinical experience of multiple flaps for the reconstruction of dorsal digital defects.

Objective: In this report, we present our experience with reconstruction of the skin defects on the dorsum of the digits using multiple flaps.

Methods: Between November 2010 and March 2013, 45 patients with dorsal digital defects underwent reconstruction using homodigital dorsal digital fasciocutaneous flap (n = 17), heterodigital dorsal digital fasciocutaneous flap (n = 14), dorsal metacarpal artery fasciocutaneous flap (n = 8) and free venous flaps (n = 6). The average flap size was 1.

The Triaging and Treatment of Cold-Induced Injuries.

Background: In Central Europe, cold-induced injuries are much less common than burns. In a burn center in western Germany, the mean ratio of these two types of injury over the past 10 years was 1 to 35. Because cold-induced injuries are so rare, physicians often do not know how to deal with them.

Surgical management of the infected reversed shoulder arthroplasty: a French multicenter study of reoperation in 32 patients.

Background: In a retrospective multicenter study, we evaluated the efficiency and outcomes of the different therapeutic options for infection after reversed shoulder arthroplasty.

Methods: Thirty-two patients were reoperated on for infection after reversed shoulder arthroplasty between 1996 and 2011. The mean age was 71 (55-83) years.

Thumb ligament injuries.

Thumb ligament injuries are common, particularly those involving the metacarpophalangeal joint. Our understanding and treatment of these injuries continues to evolve. This article provides a comprehensive review of recent literature with updates pertaining to the anatomy, function, diagnosis, and treatment of thumb ligament injuries.

Chronopharmacodynamics and mechanisms of antitumor effect induced by erlotinib in xenograft-bearing nude mice.

Receptor tyrosine kinases, mediators of a variety of critical cellular functions, contribute to tumor progression and metastasis. The epidermal growth factor receptor (EGFR), a member of the receptor tyrosine kinase family, is ubiquitously expressed on the surface of mammalian cells. Erlotinib hydrochloride (Tarceva) can inhibit the intracellular phosphorylation of tyrosine kinases.

Soft-Tissue Mallet Injuries: A Comparison of Early and Delayed Treatment.

Purpose: To compare the results of early and delayed extension orthosis fabrication in closed tendinous mallet injuries.

Methods: Between March 1992 and May 2011, 45 patients with isolated closed tendinous mallet finger injuries were treated with orthosis fabrication. The patients were classified into 2 different groups based on their date of presentation.

Distal scaphoid resection for degenerative arthritis secondary to scaphoid nonunion: a 20-year experience.

Purpose: To evaluate the long-term results of distal scaphoid excision for degenerative arthritis secondary to scaphoid nonunion and compare them with our original results published in 1999.

Methods: Nineteen patients who were treated by distal scaphoid resection arthroplasty from 1987 through 2010 were included. The mean follow-up was 15 years (range, 10-25 y) vs 4 years in the previous study.

A comparative study of four types of free flaps from the ipsilateral extremity for finger reconstruction.

Aim: To compare the outcomes of finger reconstruction using arterialized venous flap (AVF), superficial palmar branch of the radial artery (SPBRA) flap, posterior interosseous perforator flap (PIPF), and ulnar artery perforator free (UAPF) flap harvested from the ipsilateral extremity.

Methods: We retrospectively reviewed the outcomes for 41 free flaps from the ipsilateral extremity in the reconstruction of finger defects in 41 patients with small/moderate skin defects, including 11 AVFs, 10 SPBRA flaps, 10 PIPFs, and 10 UAPF flaps. Standardized assessment of outcomes was performed, including duration of operation, objective sensory recovery, cold intolerance, time of returning to work, active total range of motion (ROM) of the injured fingers, and the cosmetic appearance of the donor/recipient sites.

Simulated distal interphalangeal joint fusion of the index and middle fingers in 0° and 20° of flexion: a comparison of grip strength and dexterity.

Purpose: To evaluate dexterity and grip strength after simulated distal interphalangeal (DIP) joint fusion of the index and middle fingers in varying degrees of flexion.

Methods: Forty-six right-handed subjects performed grip and dexterity testing using the Grooved Pegboard Test in positions of index finger 20° flexion or full extension, middle finger 20° flexion or full extension, and unrestricted index and middle finger DIP joint motion (control). Simulated fusion was performed with the use of custom-molded thermoplastic orthoses.

Chronopharmacology and mechanism of antitumor effect of erlotinib in Lewis tumor-bearing mice.

The epidermal growth factor receptor (EGFR), a ubiquitously expressed receptor tyrosine kinase, is recognized as a key mediator of tumorigenesis in many human epithelial tumors. Erlotinib is tyrosine kinase inhibitor approved by FDA for use in oncology. It inhibits the intracellular phosphorylation of tyrosine kinase associated with the EGFR to restrain the development of the tumor.

Thumb opposition in severe carpal tunnel syndrome with undetectable APB-CMAP.

Thumb opposition does not always represent the function of the median nerve due to variations in thenar muscle innervation. One hundred and thirty hands of 109 idiopathic carpal tunnel syndrome (CTS) patients with an undetectable compound muscle action potential of the abductor pollicis brevis (APB-CMAP) were classified into one of four groups; Type 1 (86.2%) had thenar muscle atrophy and could not perform thumb opposition; Type 2 (10.

Ulnar impaction syndrome: incidence of lunotriquetral ligament degeneration and outcome of ulnar-shortening osteotomy.

Purpose: We hypothesized that most patients with ulnar impaction syndrome have degenerative changes of the proximal lunotriquetral (LT) membrane and that ulnar-shortening osteotomy is an effective procedure in these patients.

Methods: We retrospectively reviewed 50 wrists of 49 patients with idiopathic ulnar impaction syndrome who underwent an arthroscopic evaluation at the time of ulnar-shortening osteotomy, and subsequently at plate removal. Based on the Geissler classification, patients were divided into group A, normal, and group B, grades I to IV.

Malpractice in distal radius fracture management: an analysis of closed claims.

Purpose: Distal radius fractures comprise the majority of hand- and wrist-related malpractice claims. We hypothesized that a majority of lawsuits would be for malunions resulting from nonsurgical treatment. Additional goals of this study were to quantify costs associated with claims, determine independent risk factors for making an indemnity payment, and illustrate trends over time.

Comparison of two different measurement methods to determine glenoid bone defects: area or width?

Background: This study compared two different techniques that have been used to measure the glenoids of patients with recurrent anterior shoulder dislocation.

Methods: We analyzed 36 patients who had received arthroscopic Bankart repair for anterior shoulder instability. Retrospectively, 3-dimensional computed tomography images of both shoulders were available for these patients.

Long-term results of the Sauvé-Kapandji procedure in the rheumatoid wrist.

This retrospective long-term study evaluates the clinical and radiological results of the Sauvé-Kapandji procedure in rheumatoid wrists. Fourteen patients with rheumatoid arthritis who had undergone a Sauvé-Kapandji procedure were examined 10 to 16.5 years after surgery.

Further developments in the twisted-toe technique for isolated thumb reconstruction: our method of choice.

Background: Posttraumatic loss of the thumb is devastating. Toe-to-hand transfer is considered the criterion standard of reconstruction but is associated with donor-site issues. The twisted-toe technique uses parts from the great toe and the second toe, which allows for almost anatomical restoration of the donor foot.