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Background: Olecranon bursitis (OB) involves fluid accumulation in the bursa, with common causes being trauma and preexisting conditions. Its incidence is difficult to quantify, and risk factors such as diabetes, obesity, and male gender are frequently noted. Hyperlipidemia has been linked to musculoskeletal disorders, but its role as a risk factor for OB remains unexplored. This study aimed to investigate the association between OB and hyperlipidemia, diabetes, obesity, cardiovascular disease, and statin use. Methods: A retrospective cohort study analyzed a large-scale database (2005–2020), ultimately including 10,301 patients with olecranon bursitis and 44,608 controls after applying exclusion criteria. Participants were aged 18–90 years, with BMI between 10 and 55. Key variables such as smoking, diabetes, hyperlipidemia, statin use, cardiovascular diseases (CVDs), and cerebrovascular accidents (CVAs) were analyzed. Logistic regression models were applied with stabilized inverse probability of treatment weighting (IPTW) to estimate odds ratios (ORs) for risk factors, and p-values were adjusted using the Benjamini–Hochberg method. Results: OB was significantly associated with male gender (OR: 1.406; p < 0.0001), hyperlipidemia (OR: 1.239; p < 0.0001), statin use (OR: 1.117; p = 0.0035), and smoking (OR: 1.068; p = 0.0094). Age and BMI were significant continuous variables influencing OB risk, particularly in older patients and those with elevated BMI. CVDs and diabetes were not significantly linked to OB. Hyperlipidemia increased OB risk, especially in males and individuals with higher BMI. Conclusions: Male gender, hyperlipidemia, and smoking are key risk factors for OB, with hyperlipidemia posing a notable risk in older individuals and those with higher BMI. Statin use did not significantly alter OB risk in hyperlipidemic patients. Further studies are needed to clarify the mechanisms behind these associations. [ABSTRACT FROM AUTHOR]

Idiopathic avascular necrosis of the scaphoid bone, Preiser's disease, was originally described as a deteriorative pathology whereby the osseous structure necroses due to loss of blood supply. It may present with multifactorial etiology, which is still largely not well understood. We describe a case of Preiser's disease in a 70-year-old female, with worsening pain and loss of range of motion in her right wrist over a two-year period. Past medical history was significant for Sjogren's disease, fibromyalgia, and dystonia. Pain began several months following traumatic right dorsal wrist injury. Diagnosis of traumatic scaphoid fracture was originally suspected. Conservative treatment was unsuccessful. Radiographs did not demonstrate evidence of primary fracture. CT scan and MRI demonstrated osteonecrosis of the proximal pole of the scaphoid, but no evidence of fracture, either residual or healing, was found. Proximal row carpectomy was performed for avascular necrosis of the scaphoid. Histology confirmed diagnosis and verified absence of fracture. Postoperatively, the patient's pain and range of motion improved. This report combines histological findings of Preiser's disease with radiographic images which may ameliorate understanding of the clinical pathophysiology. We describe an unusual manifestation of Preiser's disease whereby a single traumatic event, in the absence of fracture, led to idiopathic scaphoid avascular necrosis, which may have been associated with Sjogren's syndrome and fibromyalgia. These conditions may have negatively impacted microvasculature and decreased bone mineral density, inversely correlated with the production of fatty marrow, facilitating the onset of osteonecrosis in the scaphoid. [ABSTRACT FROM AUTHOR]

Background: De Quervain (DQ) disease is caused by stenosis of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis. This condition affects women 6 times more than men and is also commonly reported in pregnant and lactating women. The natural course of the disease and associated risk factors are not well understood. In this study, we described the gestational risk factors associated with postpartum DQ. Methods: Sixty-three postpartum women with DQ were included in final study population. Medical records were reviewed for patient characteristics, including age, comorbidities, and body mass index (BMI), and gestational information, including length of pregnancy, gestation number, single or twin birth, and weight at birth. Odds ratio (OR) for developing DQ tenosynovitis were calculated with the control group of 630 postpartum women without DQ who gave birth between 2012 and 2020 in the same district. Results: Length of pregnancy (>40 weeks, OR = 5.81 [3.29-10.28]), first childbirth (OR = 2.23 [1.32-3.77]), and weight (BMI > 25, OR = 2.08 [1.14-3.81]) were all statistically significant risk factors associated with developing DQ. Number of fetuses > 1 (OR = 0.98 [0.29-3.33]) and birth weight more than 3.5 kg (OR = 0.60 [0.30-1.21]) were not associated with higher risk of DQ. Conclusions: Gestational risk factors associated with developing postpartum DQ include first pregnancy and long pregnancy of more than 40 weeks. Interestingly, child's birthweight and number of fetuses, both factors that might increase load on the first dorsal compartment while holding the child, were not shown to increase the risk of postpartum DQ. [ABSTRACT FROM AUTHOR]

Objective: Arthrodesis of the first metatarsophalangeal joint (MTPJ) is a reliable procedure for treating various pathologies related to this joint. However, non-union is a common and debilitating complication of the procedure. The purpose of this study was to assess whether the use of a mechanical reamer to prepare the joint surface increases the risk of non-union compared to traditional manual osteotomy. Methods: A retrospective study of all patients who underwent their first MTPJ arthrodesis surgery in our medical center between 2010 and 2015. The articular surface preparation of the MTPJ was either manually performed (Group 1) or mechanically conducted with reamers (Group 2). Data regarding demographic characteristics, indications for surgery, osteosynthesis methods, and post-operative complications, including non-union, infection, and revision rates, were collected for all patients. Results: A total of 83 patients with 92 primary first MTPJ arthrodesis (44 cases in Group 1 and 48 cases in Group 2) were included with a mean follow-up time of 45.3 months (SD 16.8). The two groups were comparable in terms of age, gender, comorbidities, indication for surgery, and follow-up time. The non-union rate was 15.9% in Group 1 and 25% in Group 2 (p = 0.28). Group 2 showed a significantly higher rate of revision surgery compared to Group 1 (43.7% vs. 22.7%, p = 0.03). Conclusions: The mechanical reamer group had a higher non-union rate and a significantly higher rate of revision surgery compared to low-energy manual joint preparation. In light of these findings, the use of mechanical reamers for joint preparation in the first MTPJ arthrodesis was discontinued at our medical center. [ABSTRACT FROM AUTHOR]

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Background: Flexor digitorum superficialis (FDS) hemitenodesis is a common procedure to treat swan neck deformity (SND). We hypothesize that this surgical technique is a biomechanically effective way to reduce strain in the volar plate at the proximal interphalangeal joint (PIPJ). Methods: Fifteen digits from 5 cadaveric specimens were tested using a novel in vitro active finger motion simulator under 4 finger conditions: intact, SND, FDS hemitenodesis, and FDS hemitenodesis with distal interphalangeal (DIP) joint fusion. Tensile loads in FDS and flexor digitorum profundus (FDP) and joint ranges of motion were measured by electromagnetic tracking. In addition, strain gauges were inserted under the volar plate to measure strain during PIPJ hyperextension. Results were analyzed using 1-way repeated-measures analysis of variance tests. Results: The SND condition increased volar plate strain by 176% ± 25% (P <.001) compared with the intact condition. The FDS hemitenodesis repair relieved more than 50% of the SND strain, restoring it to within no statistical difference from intact. The DIP fusion further reduced strain with no further statistical significance. At full flexion, FDS and FDP tendon loads diverged as a function of the test condition (P <.001). With the FDS hemitenodesis, the FDP load increased by 2.1 ± 1.5 N from the SND condition (P <.001), whereas the FDS load decreased by 1.3 ± 1.3 N (P =.012). Conclusion: The FDS hemitenodesis repair restored strains to within 3.0 milli-strain of the intact condition with no significant difference. Application of DIP fusion did not further protect the PIPJ from increased hyperextension and further exacerbated the imbalance of flexor tendon loads. [ABSTRACT FROM AUTHOR]

Background: Resection of the distal pole of the scaphoid has been advocated as a simple alternative to other wrist salvage procedures for scaphoid nonunion advanced collapse and scaphotrapezio-trapezoid arthritis. However, the extent of scaphoid that may be resected without adversely affecting carpal kinematics has never been clearly defined. Methods: Seven cadaveric upper extremities were tested in a custom motion wrist simulator. A 3-stage sequential sectioning of the distal scaphoid protocol was performed in 25% increments then cyclic active wrist flexion-extension and dart thrower's motion trials were recorded. Results: The extent of distal scaphoid resection had no effect on overall wrist range of motion. The lunate assumed a more extended position following resection of the distal scaphoid compared to intact. At 25%, 50%, and 75% of distal scaphoid resection, the lunate extended to 13.32° ± 9.4°, 23.43° ± 7.5°, and 15.81° ± 16.9°, respectively. The capitate migrated proximally with 25% and 50% distal scaphoidectomy, and proximally and radially with 75% of the scaphoid resected. Resection of 75% of the scaphoid resulted in unstable wrist kinematics. Conclusions: Resection of up to 25% of the distal scaphoid did not significantly influence carpal kinematics and induced mild lunate extension deformity. Resection of 50% of the scaphoid induced further and potentially clinically significant lunate extension and dorsal intercalated segment instability. Further removal of 75% of the distal scaphoid induced capitate migration radially and unpredictable wrist kinematics. Consequently, removal of over 25% of the scaphoid should be avoided or supplemented with partial wrist fusion. [ABSTRACT FROM AUTHOR]