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In addition to topical non-steroidal anti-inflammatory drugs that are used in hand osteoarthritis, there are other drugs that can reduce pain in osteoarthritis, such as topical cetylated fatty acids. Previous studies have reported that topical CFAs are effective in all knee OA patients, with slightly higher evidence for those with advanced disease. The mechanism of pain in OA knee and OA hand is similar. Furthermore, there are no previous studies on CFAs in OA hand. Patients fulfilling the American College of Rheumatology criteria for hand OA participated in this randomized, double-blind, placebo-controlled study. Eligible patients were over 40 years of age, had at least one tender joint, and had a joint pain visual analog score of 30-60 mm. Patients received topical CFA (n = 36) or placebo (n = 36) twice daily for six weeks. The primary outcome was the Functional Index for Hand Osteoarthritis (FIHOA) at 2, 4, and 6 weeks. The secondary outcome measures included the Visual Analog Score (VAS), Patient Global Assessment (PGA), and skin irritation at 2, 4, and 6 weeks. At baseline, no statistically significant differences were observed among the assessment parameters. Upon concluding the 6-week study period, it was evident that patients in the CFA group exhibited a notably lower mean pain score compared to those in the placebo group (2.2 ± 1.9 vs. 3.2 ± 2.2, P < 0.05) and achieved superior PGA scores (2.1 ± 1.7 vs. 3.1 ± 2.2, P < 0.05). However, no significant disparity was detected in terms of FIHOA between the two groups. Additionally, adverse reactions were reported by two patients in the placebo group, whereas no such reports were documented in the CFA group. Topical CFAs demonstrate efficacy in alleviating pain and enhancing patient global satisfaction in the treatment of hand osteoarthritis. However, a more extended follow-up period is imperative to ascertain whether disparities exist in the safety profile and functional outcomes between topical CFAs and a placebo., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Consent for publication: Informed consent to be included in the study and subsequent publication of the results was obtained from all individual participants included in the study., (© 2025. The Author(s).) more...

Identification of the radial nerve is important during the posterior approach to a humerus fracture. During this procedure, the patient can be placed in the prone or lateral decubitus position depending on the surgeon's preference. The distance from the radial nerve to the osseous structures will be different in each position. The purpose of this study was to identify the safety zones in various patient and elbow flexion positions. The distances from the olecranon to the center of the radial groove and intermuscular septum and lateral epicondyle to the lateral intermuscular septum were measured using a digital Vernier caliper. The measurements were performed with cadavers in the lateral decubitus and prone positions at different elbow flexion angles. The distance from where the radial nerve crossed the posterior aspect of the humerus measured from the upper part of the olecranon to the center of the radial nerve in both positions at different elbow flexion angles varied from a mean maximum distance of 130.00 mm with the elbow in full extension in the prone position to a minimum distance of 121.01 mm with the elbow in flexion at 120° in the lateral decubitus position. The mean distance of the radial nerve from the upper olecranon to the lateral intermuscular septum varied from 107.13 to 102.22 mm. The distance from the lateral epicondyle to the lateral edge of the radial nerve varied from 119.92 to 125.38 mm. There was not significant contrast in the position of the radial nerve with osseous landmarks concerning different degrees of flexion, except for 120°, which is not significant, as this flexion angle is rarely used., (© 2021. The Author(s).) more...