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The aim of this retrospective study was to investigate the effect of subungual glomus tumour size and localization in the germinal or sterile matrix on tumour recurrence and aesthetic outcomes.From 35 patients who underwent surgery for a subungual glomus tumour between February 2013 and February 2020, 26 patients - 17 women and 9 men - with 27 subungual glomus tumours fulfilled the inclusion criteria. The average age was 37.3 (22-58) years. According to the patients' surgical notes and preoperative magnetic resonance images 14 tumours were located in the sterile, 13 in the germinal matrix, and the mean size of the glomus tumours located in the germinal matrix was 4.9±1.7 mm, in the sterile matrix 3.6±1.0 mm. At the postoperative 12th month follow-up visit nail aesthetic was evaluated objectively according to Zook's fingernail appearance scoring. In addition, patients were asked to evaluate the pain and nail appearance in the involved finger by VAS (Visual Analog Scale 0-10). Patients who experienced recurrence were noted.No significant Zook's fingernail appearance score differences were observed between germinal and sterile matrix groups (p=0.097). Comparison of VAS score for pain and VAS score for nail appearance between the two groups also yielded similar values (p=0.449 and 0.395, respectively). The recurrence rate was similar at both locations (p=0.557) with 3 recurrences in the germinal, and 2 in the sterile matrix group. There was no relation between tumour size, Zook's fingernail appearance score (p=0.874) and recurrence (p=0.784). The observed germinal matrix glomus tumours were significantly larger than the sterile matrix tumours (p=0.031).Neither subungual glomus tumour size nor localization in the germinal or sterile matrices has different effects on nail appearance and recurrence.ZIEL: Diese retrospektive Studie untersucht, ob die Größe und Lokalisation subungualer Glomustumoren in der germinalen oder sterilen Matrix Einfluss auf das postoperative Erscheinungsbild der Fingernägel und die Rezidivrate haben.Von 35 Patienten, bei denen zwischen Februar 2013 und Februar 2020 ein subungualer Glomustumor entfernt wurde, erfüllten 26–17 Frauen und 9 Männer – mit 27 subungualen Glomustumoren die Einschlusskriterien. Das Durchschnittsalter betrug 37,3 (22–58) Jahre. Die Auswertung der Patientenakten und der präoperativen Kernspinuntersuchungen ergab, dass 14 Tumoren in der sterilen und 13 in der germinalen Matrix lokalisiert waren sowie dass die durchschnittliche Größe der Glomustumoren der germinalen Matrix 4,9±1,7 mm und die der sterilen Matrix 3,6±1,0 mm betrug. Bei der Nachuntersuchung nach 12 Monaten wurde das Erscheinungsbild und die Qualität des Fingernagels der betroffenen Finger objektiv mittels des Fingernail Appearance Score von Zook beurteilt. Zusätzlich bewerteten die Patienten das Erscheinungsbild des Fingernagels als auch vorhandene Schmerzen mittels der visuellen Analogskala (VAS 0–10). Weiterhin wurde die Rezidivrate erfasst.Zooks Fingernail Appearance Score ergab keinen signifikanten Unterschied zwischen Glomustumoren der germinalen und sterilen Matrix (p=0,097). Auch bzgl. vorhandener Schmerzen und der subjektiven Beurteilung des Erscheinungsbildes der Fingernägel durch die Patienten anhand der VAS ergaben sich keine signifikanten Unterschiede zwischen den beiden Gruppen (p=0,449 und 0,395). Ebenso ergab sich bzgl. der Rezidivrate kein signifikanter Unterschied zwischen den Gruppen (p=0,557) bei 3 Rezidiven nach Tumoren der germinalen und 2 der sterilen Matrix. Die Tumorgröße hatte weder auf Zooks Fingernail Appearance Score (p=0,874) noch auf die Rezidivrate (p=0,784) Einfluss. Glomustumoren der germinalen waren signifikant größer als Glomustumoren der sterilen Matrix (p=0,031).Weder die Größe subungualer Glomustumoren noch deren Lokalisation in der germinalen oder sterilen Matrix haben Einfluss auf das postoperative Erscheinungsbild und die Qualität des Fingernagels und die Rezidivrate.

Introduction We evaluated the clinical and radiological outcomes of capitellar fractures treated with modified screw insertion (inserting the first fixation screw anteroposteriorly and the second screw posteroanteriorly), a technique that can be applied with a minimally invasive lateral elbow approach. Materials and Methods Twenty-one isolated capitellum fractures that were surgically treated were included in the study. Fixation was achieved with two headless cannulated compression screws placed in anteroposterior and posteroanterior order using the modified lateral elbow approach. The Broberg-Morrey rating system was used to assess the post-operative functional status of the patients. Results According to the Broberg-Morrey criteria, the mean score was 92.7 (77-100) and 13 cases had excellent, 7 had good, and 1 had fair results. None of the patients developed avascular necrosis or heterotopic ossification. According to the Broberg-Morrey arthrosis score, two cases had Grade 1 and one had Grade 2 arthrosis. One patient had a superficial wound site infection that was treated with antibiotics, and in one case a 60° extension loss was observed in the elbow. Conclusion Treatment of isolated capitellar fractures with 2 headless screws placed anteroposteriorly and posteroanteriorly can provide stable fixation and is less traumatic for the elbow joint. Level of Evidence IV; Therapeutic Studies - Investigating the results of treatment. RESUMO Introdução Avaliamos os resultados clínicos e radiológicos das fraturas do capítulo do úmero tratadas com a técnica de inserção de parafuso modificada (inserção do primeiro parafuso de fixação anteroposterior e do segundo parafuso posteroanterior), que pode ser aplicada com acesso lateral minimamente invasivo do cotovelo. Material e Método Foram incluídas no estudo 21 fraturas isoladas do capítulo que foram tratadas cirurgicamente. A fixação foi obtida com dois parafusos de compressão canulados sem cabeça colocados em ordem anteroposterior e posteroanterior, usando acesso lateral modificado do cotovelo. O sistema de classificação Broberg-Morrey foi usado para avaliar o estado funcional pós-operatório dos pacientes. Resultados De acordo com os critérios de Broberg-Morrey, o escore médio foi de 92,7 (77-100) e 13 casos foram excelentes, 7 bons e 1 regular. Nenhum paciente desenvolveu necrose avascular ou ossificação heterotópica. De acordo com o escore de artrose de Broberg-Morrey, dois casos tinham Grau 1 e um tinha artrose de Grau 2. Um paciente tinha infecção superficial da ferida, que foi tratada com antibióticos, e em um caso observou-se perda de 60° da extensão do cotovelo. Conclusão O tratamento de fraturas isoladas do capítulo do úmero com 2 parafusos sem cabeça colocados anteroposterior e posteroanteriormente pode proporcionar fixação estável e é menos traumático para a articulação do cotovelo. Nível de evidência IV; Estudos terapêuticos - Investigação dos resultados do tratamento.

The purpose of the study was to compare clinical and radiological outcomes of autografts obtained from the iliac crest (IC) and distal radius (DR) and to evaluate their superiority for surgical treatment of solitary finger enchondromas.Twenty-five patients for whom curettage and autografting were carried out for finger enchondroma were retrospectively analyzed. DR autograft was used in eight patients and IC autograft was used in 17 patients. Data on pre-operative total active motion (TAM), disabilities of the arm, shoulder, and hand (DASH) score, and pain visual analog scale (VAS) scores of the involved finger, duration of surgery, amount of bleeding during the operation, length of hospital stay, presence of complications related to anesthesia, and post-operative donor site morbidity were obtained. Pre-operative and post-operative 12No statistically significant difference could be identified between post-operative TAM (p=0.154), DASH (p=0.458), pain VAS scores (p=0.571), remnant volume (p=0.496), Tordai radiologic evaluation grade (p=0.522), duration of surgery (p=0.288), and amount of bleeding (p=0.114) between DR and IC groups. However, mean hospital stay duration was shorter for the DR group (p=0.0001). Recurrence was observed in one patient in the DR group and three patients in the IC group (p=0.996).The clinical and radiological outcomes of grafting from the DR and IC were similar in the treatment of hand enchondromas. However, grafting from the DR may result in shorter hospital stay compared to IC grafting.

Purpose Opening-wedge osteotomy of the ulna restores normal ulnar length and corrects the angulation of the ulna in patients with chronic Monteggia fracture–dislocations. In addition, this eases the reduction of the radial head . Morbidity caused by annular ligament reconstruction surgery can be prevented by preserving the intact annular ligament. After dilatation and mobilization of the annular ligament, reduction of the radial head can be accomplished. This study evaluated the effectiveness of corrective opening-wedge ulnar osteotomy and radial head relocation into the intact annular ligament in the treatment of radiocapitellar instability secondary to pediatric chronic Monteggia fracture–dislocation. Methods Fourteen patients diagnosed with radial head dislocation associated with plastic deformation of the ulna or ulnar fracture were included in the study. Radiologic and clinical results of these patients who underwent corrective ulnar osteotomy and radial head relocation into an intact annular ligament were evaluated retrospectively. Results The mean age of the patients at the time of injury was 7.4 years (range, 3 years to 12 years). The average time between the injury and surgery was 19.1 months (median, 8 months; range, 3 months to 66 months); the average follow-up period was 28.7 months (range, 12 months to 60 months). The mean Kim score was 69.6 (range, 50 to 75) preoperatively and 92.9 (60 to 100) at last follow-up. According to Kim score, the results were considered excellent in 12 cases and poor in 2 cases. Radial head subluxation recurred in 2 separate cases. In addition, chondrolysis changes were seen in 1 case. Reduction loss and osteoarthritic changes in the radiocapitellar joint were considered poor results in follow-up radiographs. Conclusions Corrective ulnar osteotomy and relocating the radial head into the intact annular ligament can be safely used for treating chronic Monteggia fracture–dislocation cases without radial head and capitellum deformity. Type of study/level of evidence Therapeutic IV