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The displaced flexion type supracondylar humeral fractures (SCHF) are inherently unstable and there is great intraoperative difficulty in obtaining and maintaining the fracture reduction by closed means. We introduced a technique for closed reduction and K-wires pinning of displaced flexion type SCHF. Fourteen patients with flexion-type SCHF (9 boys and 5 girls) underwent a reduction technique using a construct of three K-wires. The proximal wire was used for rotational control of the proximal fragment and the two distal wires were used for correction of the flexion and rotational deformity of the distal fragment. The patient's mean age was 7 (6-11) years. Results were evaluated by the anterior humeral line, Baumann's angle, carrying angle radiographically and Flynn's criteria clinically. The mean time for the union was 4.8 (4-6)  weeks. The anterior humeral line passed through the middle one-third of the capitulum in 12 patients and the anterior third in two patients. The mean Baumann's angle was 19.60 ± 3.8 and the mean carrying angle was 14.21 ± 3.04. We reported no cases of failed closed reduction. The median operation time in this study was 30 (25-40)  min. The mean number of C-arm images was 33.5 ± 5.23. According to Flynn's criteria; 10 cases (71.4%) were excellent and 4 (28.6%) were good. This technique can achieve the accurate reduction of flexion type SCHF and avoid the complications of both repeated closed reduction trials and open reduction. Level of Evidence: Level IV, case series., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

MicroRNAs are a type of noncoding RNAs that regulates the expression of target genes at posttranscriptional level. MicroRNAs play essential roles in regulating the expression of different genes involved in pancreatic development, β-cell mass maintenance, and β-cell function. Alteration in the level of miRNAs involved in β-cell function leads to the diabetes. Being an epidemic, diabetes threatens the life of millions of patients posing a pressing demand for its urgent resolve. However, the currently available therapies are not substantial to cure the diabetic epidemic. Thus, researchers are trying to find new ways to replenish the β-cell mass in patients with diabetes. One promising approach is the in vivo regeneration of β-cell mass or increasing the efficiency of β-cell function. Another clinical strategy is the transplantation of in vitro developed β-like cells. Owing to their role in pancreatic β-cell development, maintenance, functioning and their involvement in diabetes, overexpression or attenuation of different miRNAs can cause β-cell regeneration in vivo or can direct the differentiation of various kinds of stem/progenitor cells to β-like cells in vitro. Here, we will summarize different strategies used by researchers to investigate the therapeutic potentials of miRNAs, with focus on miR-375, for curing diabetes through β-cell regeneration or replacement.

Patients with arthrogryposis multiplex congenita have a characteristic upper extremity resting posture consisting of internal rotation of the shoulders, elbow extension, flexed wrists, thumb-in palm deformities, and variable degrees of finger contractures. Treatment of these patients is aimed at improving independence and performance of activities of daily living. Although each area needs to be assessed independently for the most appropriate surgical procedure, often multiple areas can be addressed at the same operative setting. This limits the number of anesthetic exposures and cast immobilization time. The following is a synopsis of treatment strategies presented at the second international symposium on Arthrogryposis which took place in St Petersburg in September 2014.

The aim of this study was to characterize a group of patients with hypoplasia of the thumb, classifying them, describing the associated anomalies and to evaluate the results of surgical treatment of such cases. Thumb hypoplasia is a complex and heterogeneous congenital disorder that is detrimental to hand functions. The characteristics of patients with these anomalies are not well described in the literature. A prospective study on 51 patients with 82 hypoplastic thumbs was done. All the patients' data regarding their personal, family, pregnancy and developmental histories were recorded. All the patients were exposed to thorough clinical examination with genetic assessment and radiological examination including abdominal ultrasonography and echocardiography when requested by the paediatrician. The cases were classified using the modified Blauth classification into five types and we added the five-fingered hand. Surgical treatment was performed for 26 hands in 18 patients and the postoperative results were recorded with an average duration of follow-up of 38.6 months. Of the 51 patients, there was a positive consanguinity in 23.5%. Eighty-six per cent were found to have associated anomalies. Type V thumb hypoplasia was the most common type followed by type IV, with type I being the least common. All the patients' parents were satisfied with the results of surgical treatment and noticed improvement of the performance of the operated hands in the daily activities. We detected some anomalies that have never been described before or described as case reports only; such as lacunar skull, congenital facial palsy and toe amputation; we also described familial radial side dysplasia with variable presentation of congenital anomalies of the thumb in the families. In addition, we think that the five-fingered hand should be added to the classification of thumb hypoplasia. Our study agrees with the literature regarding the distribution of different types of hypoplasia of the thumb, the incidence of associated anomalies and the results of surgical treatment.