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Chronic flexor tenosynovitis in the hand caused by non-tuberculous mycobacterial (NTM) infection is uncommon. Although some authors have recommended combining surgical and drug therapy, there are few reports about the timing of drug administration after operation. The purpose of this retrospective study was to analyse the clinical outcome of the protocol, which consisted of extensive tenosynovectomy and drug therapy administered after culture results had been obtained. Four men and one woman were included. Average age was 57.4 years and average follow-up period was 46.7 months. Extensive tenosynovectomy was performed and surgical specimen was examined histopathologically and microbiologically. After a positive culture result had been obtained, three kinds of drugs were administered. Clinical outcome including infectious condition, range of motion, and grip strength was examined. All patients were immunocompetent and had no underlying disease. Three patients were diagnosed at first operation and two were diagnosed at second operation. The average period of drug therapy was 5.5 months. In four patients, infection resolved with combination therapy. In one patient with surgical treatment, only swelling remained. Osteomyelitis of the scaphoid was found in one patient to whom systemic steroid had been administered because of a negative culture result at first operation. For immunocompetent patients, flexor tenosynovitis in the hand caused by NTM was resolved with a combination of surgical and drug treatment. Drug treatment seemed to be essential after a reduction of the infectious lesion and the timing of administration was safe enough to resolve in four patients. [ABSTRACT FROM AUTHOR]

Volar locking plate (VLP) fixation for distal radius fractures (DRF) is a technically demanding procedure, where accurate placement of the distal screws for subchondral articular support is essential. The purpose of this retrospective, case-control study was to compare a computed tomography (CT) navigation system for VLP fixation of intra-articular DRF with conventional freehand fluoroscopy guided surgery. Twelve consecutive patients with DRF, AO type C3.1, underwent VLP fixation using intraoperative CT navigation (navigated group) and 16 consecutive patients had conventional freehand fluoroscopy guided surgery (non-navigated group). Follow-up was done mean 12 (range, 4–18) months after surgery. Radiological outcomes included evaluation of placement for the distal fixation screws and radiological parameters such as; radial inclination, palmar tilt, ulnar variance, fracture-gap, and step-off. Clinical outcomes included grip strength, wrist range of motion, Mayo wrist score, and the Disabilities of the arm, shoulder and hand (DASH) questionnaire. Dorsal cortical and articular screw penetrations were significantly more common in the non-navigated group compared with the navigated group. At the final follow-up, a significantly larger intra-articular fracture gap was observed in the non-navigated group compared to the navigated group. There were no significant differences in clinical outcomes between the two treatment groups. Our results suggest that CT navigation guided surgery for VLP fixation of type C3 DRF, compared with conventional freehand fluoroscopy guided surgery, provides a more accurate placement of the distal screws which minimize the risk for intra-articular and dorsal cortical screw penetration. [ABSTRACT FROM AUTHOR]