Carpal tunnel syndrome (CTS) is defined by compression of the median nerve in the wrist. It is the commonest of the compressive syndromes and its most frequent cause is idiopathic. Even though spontaneous regression is possible, the general rule is that the symptoms will worsen. The diagnosis is primarily clinical, from the symptoms and provocative tests. Electroneuromyographic examination may be recommended before the operation or in cases of occupational illnesses.
The lower abdomen and the inner thigh may have higher processed lipoaspirate cell concentrations. These sites may turn out to be better sources of adult mesenchymal stem cells.
A silicone tube segment was used for repairing the median and ulnar nerves in the forearm. This study includes 26 patients (20 male and six female), with a mean age of 23 years (range, 18-26). Injuries were caused by saw, knife and glass accidents, the latter being most frequent. The mean interval between the injury and repair was 101 days. Fourteen patients had median nerve injuries, eight had ulnar nerve injuries and four had both median and ulnar nerve injuries. The technique was effective in the repair of peripheral nerve injuries with gaps of up to 3 cm, with better results in the ulnar nerves than in the median nerves.
This study describes the anatomy of the dorsal digital arteries in the 144 fingers of 18 pairs of fresh human cadaver hands. Previous studies have shown two constant branches in the proximal and middle pulp spaces from each proper digital artery. We have shown that these branches have consistent sites of origin at predictable distances from the proximal interphalangeal joint. Thus cutaneous flaps can be safely planned on these dorsal vessels.
The aim of this study was to evaluate the effect of Platelet Rich Plasma (PRP) and Platelet Rich Fibrin (PRF) on peripheral nerve repair. Thirty-two Wistar rats were randomly divided into four equal treatments groups: autologous nerve grafts (ANG), silicon tube plus saline solution (SS), silicon tube plus PRP, and silicon tube plus PRF. In ANG group, 10 mm segment from sciatic nerve was excised and reimplanted between the nerve stumps. In the SS, PRP, and PRF groups, 5 mm segment from sciatic nerve was excised and bridged with a 12 mm silicone conduit to create a 10 mm nerve gap. The conduit was filled in accordance with the different treatments. Walking track analysis was performed periodically and on the 90th post-operative day histomorphometric analysis was performed. The ANG, PRF, and PRP groups presented a significant functional improvement in relation to the SS group (P = 0.001) on 90 days after surgery. Histomorphometric analysis demonstrated that the ANG group achieved a larger nerve fiber diameter in proximal stump while comparing with the SS group (P =0.037) and showed larger fiber diameter in median stump in comparison to the PRP group (P = 0.002) and PRF group (P = 0.001). Axonal diameter and myelin sheath thickness showed no statistical significant difference between the groups in the three stumps (P ≥ 0.05). This study suggests that PRP and PRF have positive effects on the functional nerve recovery; however, these groups don't achieve a significant improvement on the histomorphometric analysis.
We compared two surgical techniques for the treatment of scaphoid non-union, namely, using distal radius vascularised bone graft and iliac crest non-vascularised bone graft. Eighty patients with symptomatic scaphoid non-union underwent surgical treatment, including 35 patients treated with distal radius vascularised bone graft and 45 treated by iliac crest non-vascularised bone graft. Patients were assessed objectively by examination of wrist range of motion, grip strength and radiographic findings in the postoperative period after a mean time of 2.8 (1.4) (range 1-5.2) years. Similar functional results were obtained with the two techniques. All cases of non-union in the non-vascularised group obtained consolidation in a mean time of 8.89 (2.26) months and in the vascularised group in a mean time of 7.97 (3.06) months. Three cases of consolidation failure occurred in the vascularised group and were related to technical difficulties.
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