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Camitz opponensplasty using the palmaris longus has been used in patients undergoing open carpal tunnel release. It is considered to have several advantages over other opponensplasty techniques, but it provides weak flexion and pronation, which are prerequisites for opposition. To address this shortcoming, we have used a modified Camitz procedure with a pulley at the radial side of the dissected flexor retinaculum and have assessed the results in comparison with the conventional Camitz procedure. Both procedures provided significant improvements in palmar abduction and Disabilities of the Arm, Shoulder, and Hand and Kapandji scores at 3 months post-operatively, but patients who underwent the modified Camitz procedure showed better improvement in pulp pinch, palmar abduction, and thumb pronation.

The purpose of this study was to compare the degree of enlargement of the spinal canal between two methods of cervical laminoplasty (open-door laminoplasty and double-door laminoplasty) and to determine their appropriate surgical indications based on the results. Tension-band laminoplasty (TBL, one method of open-door type) was performed in 33 patients and double-door laminoplasty (DDL) in 20 patients. The operation level ranged from C2 to C7 in all patients. The width of the spinal canal and the inclination angle of the lamina at the C5 and C6 levels were measured using a computer software program (Image J) and pre-and postoperative CT films. Concerning the degree of enlargement of the spinal canal, the mean expansion ratio at the C5 level was 148.9% in TBL and 148.2% in DDL, and there was no significant difference between them. However, at the C6 level, it was 159.0% in TBL and 140.3% in DDL, which was significantly larger in TBL than DDL (p \ 0.05). The increase of inclination angle of the lamina was 11.0°in TBL and 19.0°in DDL at the C5 level, and 9.2°in TBL and 19.3°in DDL at the C6 level. At both the C5 and C6 levels, it was significantly larger in DDL than TBL (p \ 0.0001). In conclusion, the appropriate surgical indications of TBL were considered to be (1) cervical spondylotic myelopathy (CSM) combined with hemilateral radiculopathy, (2) severe prominence of ossification of the posterior longitudinal ligament (OPLL), and (3) patients with tiny spinous processes who cannot undergo DDL. Those of DDL were considered to be (1) usual CSM, (2) small and slight prominence of OPLL, (3) CSM combined with bilateral radiculopathy, and (4) cervical canal stenosis combined with instability necessitating posterior spinal instrumentation surgery.

We report three cases of para-articular chondroma and osteochondroma in the region of infrapatellar fat pad. All three lesions were resected and examined histologically. Two of them were primarily cartilaginous with a lobular pattern internally, and one uniformly osseous with peripheral cartilage. We conclude that these lesions are not the same. The former should be designated para-articular chondroma after Jaffe and the latter, osteochondroma.Résumé Nous rapportons trois cas de chondrome paraarticulaire et d'ostéochondrome situés dans le corps adipeux infrapatellaire. Ces trois lésions ont été résequèes et examinées histologiquement. Deux d'entre elles étai-ent au départ cartilagineuses et avaient une forme lobulaire interne, et l'autre était uniformement osseuse avec un cartilage périphérique. Nous en concluons que ces lés-ions ne sont pas les mêmes histopathologiquement. Les premières devraient être appelées, à la suite de Jaffe, chondrome para-articulaire et la troisième, ostéochond-rome, de façon à l'opposer aux dénominations équivo-ques utilisées dans les présentations précédentes.

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The purpose of this study is to observe type I and type 111 procollagen gene expressions in the healing ligament using in situ hybridization histochemistry. The rabbit medial collateral ligaments were incised and harvested at 3, 7, 14, and 28 days postoperatively. The healing ligament showed increased expression of both procollagen genes through this period compared with the unoperated ligament. The peak expression level was observed at 7 or 14 days for type I and at 7 days for type 111, respectively. The strongest expression of both genes was detected in the scar tissue created between the ends of the old ligament. Although type 111 procollagen gene expression was observed almost only in the newly created scar tissue, type I procollagen gene was expressed not only in the scar tissue, but also at the ends of the previously normal ligament. These results suggest that type I collagen synthesis begins shortly after ligament injury and occurs at the ends of the injured ligament as well as in the scar tissue, and that type 111 collagen is largely synthesized in the scar tissue around one week after injury but continues being synthesized for at least four weeks after injury. 0 2001 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. lntroduction Materials and methods Animals und treatmentCollagen is the most abundant substance in the norma1 ligament [7], and the mechanical properties of ligInstitutional Review Board Approval was obtained before beginning all animal studies. Twenty adult Japanese white rabbits, weighing ament depend primarily On ' ' ' lagen fibers L1 51' 3.24.4 kg, were used. Each animal was anesthetized with an intraveTherefore, collagen synthesis plays an important role in nous injection of pentobarbital. The medial collateral ligament (MCL) the healing process of the ruptured ligament. In the of the left knee was exposed through longitudinal medial incisions in the skin and fascia [6j. The MCL was cut transversely at the level of the suprameniscal recess with a scalpel [16]. Ligament ends were allowed to with less than lo'% being type I11 [7]. Although the retract and were not repaired surgically. Skin was approximated with healing ligament is known to contain an increased 3-0 nylon sutures. NO immobilization was used after surgery.With a lethal injection of a euthanasia solution, the animals were

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