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The aim of this study is to assess outcomes of a lateral surgical approach for proximal interphalangeal joint arthroplasty with NeuFlex® silicone implants for primary degenerative osteoarthritis. We reviewed 51 arthroplasties performed on 43 patients. The mean follow up period was 36 months (range 18–42). The average preoperative range of motion (ROM) was 38°. The average postoperative ROM was 63°. In 21/51 (41%) cases, there was an average axial deviation of 17° (range 10–30°). VAS and Quick DASH scores improved. In 5/51 (10%) cases, further surgery was required. Our lateral approach seems to be effective and minimally invasive, providing adequate exposure. Contralateral incision and contralateral ligament reinforcement should be performed, whenever necessary, to improve lateral stability. [ABSTRACT FROM PUBLISHER]

We evaluated the efficacy of a biomaterial composed of oxidised regenerated cellulose (Divide) in decreasing the formation of peri-tendinous adhesions in an experimental and clinical study. The experimental study was carried out in 47 New Zealand white rabbits whose Achilles tendons were subjected to a crush injury. The left Achilles tendon served as a control, while the right tendon was wrapped in a sheet of Divide®. Six weeks later the range of motion at the ankle was measured, the tendons were histologically analysed for peri-tendinous adhesions, the tendon sheath was examined using a scanning electron microscope for determining resorption of the biomaterial and the mechanical properties evaluated. The clinical study was performed on 22 patients; 16 requiring post-traumatic extensor tenolysis and six who underwent dorsal synovectomy for rheumatoid arthritis. A sheet of Divide® was placed either between the periosteum and the tendon or around the tendon in all patients. Total active motion and grip strength was evaluated in all patients pre-operatively and at regular intervals post-operatively. The experimental study showed that ankle range of motion was similar between the control and Divide® treated groups in two rabbits, better in the Divide® group in seven rabbits and better in the control group in two rabbits. The results were not statistically significant ( P ≤ 0.262) since the numbers were quite low. Histological analysis showed that the treated tendon had a better gliding surface and minimal inflammation/reaction compared to the control group. Scanning electron microscopy on the 10th post-operative day revealed the formation of a new tendon sheath in the Divide® group. The mechanical properties of both the control and experimental Achilles tendon were similar and comparable to a human tendon. The clinical study demonstrated that Divide® was completely resorbed, perfectly biocompatible and non-allergenic. The mean T.A.M. improved from 159.4° to 187.3° ( P ≤ 0.074) and grip strength from −26.7 kgF to 10.7 kgF on the 84th post-op day in the extensor tenolysis group (16 digits), while mean return of function to pre-operation level was achieved at 42nd post-operative day and grip strength increased from −3.4 kgF in the immediate, post-operative period to +5.7 kgF at the 84th day in the rheumatoid arthritis group. [ABSTRACT FROM AUTHOR]

We evaluated the efficacy of a biomaterial composed of oxidised regenerated cellulose (Divide) in decreasing the formation of peri-tendinous adhesions in an experimental and clinical study. The experimental study was carried out in 47 New Zealand white rabbits whose Achilles tendons were subjected to a crush injury. The left Achilles tendon served as a control, while the right tendon was wrapped in a sheet of Divide®. Six weeks later the range of motion at the ankle was measured, the tendons were histologically analysed for peri-tendinous adhesions, the tendon sheath was examined using a scanning electron microscope for determining resorption of the biomaterial and the mechanical properties evaluated. The clinical study was performed on 22 patients; 16 requiring post-traumatic extensor tenolysis and six who underwent dorsal synovectomy for rheumatoid arthritis. A sheet of Divide® was placed either between the periosteum and the tendon or around the tendon in all patients. Total active motion and grip strength was evaluated in all patients pre-operatively and at regular intervals post-operatively. The experimental study showed that ankle range of motion was similar between the control and Divide® treated groups in two rabbits, better in the Divide® group in seven rabbits and better in the control group in two rabbits. The results were not statistically significant ( P ≤ 0.262) since the numbers were quite low. Histological analysis showed that the treated tendon had a better gliding surface and minimal inflammation/reaction compared to the control group. Scanning electron microscopy on the 10th post-operative day revealed the formation of a new tendon sheath in the Divide® group. The mechanical properties of both the control and experimental Achilles tendon were similar and comparable to a human tendon. The clinical study demonstrated that Divide® was completely resorbed, perfectly biocompatible and non-allergenic. The mean T.A.M. improved from 159.4° to 187.3° ( P ≤ 0.074) and grip strength from −26.7 kgF to 10.7 kgF on the 84th post-op day in the extensor tenolysis group (16 digits), while mean return of function to pre-operation level was achieved at 42nd post-operative day and grip strength increased from −3.4 kgF in the immediate, post-operative period to +5.7 kgF at the 84th day in the rheumatoid arthritis group. [ABSTRACT FROM AUTHOR]

Combined Bennett’s fracture and the body of the trapezium are rare. The authors report a case in which closed reduction and internal fixation were performed to stabilize these fractures. The result at 5-month follow-up was good in terms of range of motion and radiological aspect. A literature review and treatment methods are included. [Copyright &y& Elsevier]

The authors report a case of mucinous adenocarcinoma of the urachus treated with partial cystectomy. The urachal cancer is an uncommon clinicopathologic entity associated with a poor prognosis. Anatomical considerations, clinical features and treatement are discussed. [Copyright &y& Elsevier]