To examine the antiadhesive effect of an alginate solution following tendon surgery, unilateral subtotal laceration of the flexor digitorum communis tendon was created in one hind limb while the other side was left intact in 32 Japanese white rabbits. The lesion was coated with alginate solution in 16 animals and not coated in the other 16. Degree of adhesion formation was assessed histologically and biomechanically by measuring the flexion angle of the first toe when the flexor digitorum tendon was pulled with a specified force at 4 weeks postoperatively. When compared with the control group, the alginate-treated group demonstrated significantly greater toe flexion, with less scar tissue formation at the repair site. Histologically, complete tendon healing with longitudinal remodeling of collagen fibers was observed in the alginate-treated group, while a random pattern of fibers was observed in the control group. Reduction in adhesion formation using alginate solution represents a novel strategy for the management of tendon injury and repair in the clinical setting.

There is no clear consensus about the best management of intra-articular distal ulnar fractures associated with distal radial fractures in older adults. We describe a treatment wherein the distal radial fractures were securely fixed with a palmar plate, leaving the associated ulnar fractures unfixed. The wrists of 14 patients with a mean age of 74 years were reviewed at an average of 18 months after surgery. The results were excellent in 11 cases and good in three, according to the modified Gartland and Werley score. All fracture sites displayed union, and there was no instability of the distal radioulnar joint. A widening of the distal radioulnar joint space was present in one wrist. Angular deformity of the distal ulnar metaphysis was seen in five wrists. This treatment could be an alternative to open reduction with internal fixation for intra-articular distal ulnar fractures in older adults.

Medial condyle fractures of the humerus are rare in any age group. We report a unique case of a humeral medial condyle fracture in a 15-year-old boy with posttraumatic fishtail deformity. The fracture line extended up from the top of the sharp trochlear wedge to the incomplete medial supracondylar cortical aperture. The appearance of the upward displacement and computed tomography imaging with three-dimensional reconstruction at the two different elbow positions suggested that an edge of the semilunar notch of the olecranon acted as a wedge to break and split the trochlea directly. This is the first visualized case of a wedge type injury and may provide evidence that humeral medial condyle fractures can be produced by the wedge force besides the valgus avulsion one.

Level IV, therapeutic case series.

These facts suggest that the pathogenesis of tumorous calcification causing carpal tunnel syndrome is comparable with that of calcifying tendinitis of the rotator cuff in which a cell-mediated reactive process plays an important role at the tendon insertion.