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1. Triangular Fibrocartilage Complex Repair Through Bone Tunnels (Palmer Type 1D)

Author

Gerlach DJ, Chun KF, and Trumble TE

Abstract

The triangular fibrocartilage complex (TFCC) is an important and complex anatomic structure. At the distal radioulnar joint (DRUJ), the TFCC provides mechanical stability and absorbs axial and translational forces. Discrete anatomic structures impart specific functions. By adulthood, the blood supply is limited to the peripheral border, and the radial origin of the TFCC has minimal vascularity. Acute traumatic tears frequently follow high-force injuries onto an outstretched hand and are classified according to Palmer. Tears occurring along the radial border of the TFCC (Palmer class 1D) have poor healing potential because of the lack of vascularity. Magnetic resonance arthrogram has high sensitivity and specificity for TFCC injuries. Palmer class 1D lesions are identified by standard wrist arthroscopy. TFCC tears are debrided, with the radial TFCC origin is resected to bleeding bone. Meniscal repair sutures are carefully placed through the TFCC via an ulnar-based cannula. Bone tunnels are then created in the appropriate orientation, and the sutures are passed through the radius. A small radial-sided incision is made overlying the exiting sutures, which are tensioned and tied over bone or a biotenodesis screw. Patients are immobilized in a long-arm splint for 2 weeks followed by a graduated rehabilitation program. [ABSTRACT FROM AUTHOR]

Published
2010
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2. [F18]-fluoroethylcholine combined in-line PET-CT scan for detection of lymph-node metastasis in high risk prostate cancer patients prior to radical prostatectomy: preliminary results from a prospective histology based study.

Author

Steuber T, Schlomm T, Heinzer H, Zacharias M, Ahyai S, Chun KF, Haese A, Klutmann S, Köllermann J, Sauter G, Mester J, Mikecz P, Fisch M, Huland H, Graefen M, and Salomon G

Abstract

Purpose: To evaluate the diagnostic potential of PET/CT using ([F18]fluorethylcholine (FEC) for lymph node (LN) staging in high risk prostate cancer (PCa) patients prior to radical prostatectomy (RP). Patients and methods: Twenty patients with localised PCa and >/= 20% LN risk according to a published nomogram were prospectively enrolled. FEC PET/CT was done minimum 14 d after prostate biopsy. Afterwards, open RP and extended pelvic LN dissection (ePLND) were performed. Clinical stage, Prostate Specific Antigen (PSA) and biopsy Gleason Grading were assessed and histopathological evaluation of the RP-specimens and dissected LN has been performed. The results from PET/CT were compared with LN metastasis according to their anatomical site. Results: Overall, 285 LN have been removed with a mean number of 15 nodes per patient (7-26). Of the 20 patients, 9 men were LN positive (45%), which corresponds to 31 positive LN with a mean size of 7 mm (0.8-12 mm). Dissection of the obturator fossa, external iliac artery/vein and internal iliac artery/vein revealed 36%, 48% and 16% of positive LN, respectively. FEC PET/CT did not detect one single positive LN, thus was false-negative in 31 metastasis and true negative in 254 LN. Conclusion: Based on our results which confirmed experience from the previous studies, FEC PET/CT scan did not prove to be useful for LN staging in localised PCa prior to treatment and should thus not be applied if clinically occult metastatic disease is suspected. [ABSTRACT FROM AUTHOR]

Published
2010
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