Both the angle-stable locking technique using four screws and conventional locking consisting of five screws showed high biomechanical properties. Hence, angle-stable locking reflects a potential to maintain fixation stability while reducing the number of locking screws compared with conventional locking in intramedullary nailed unstable distal tibia fractures.

The identification of myogenic precursor cells (mpc) is a key factor in determining the early events in the myogenesis and regeneration of skeletal muscle. Although satellite cells have long been established as the providers of myoblastic cells, very little is really known (apart from their anatomical location in relation to muscle fibres and their ability to migrate) about the precise role of satellite cells in myogenesis. Numerous techniques for labelling mpc have been devised, but none of these has proven to be completely reliable in firmly establishing the origin of myogenic cells. The use of tritiated thymidine to label DNA in proliferating mpc (which are not specifically distinguishable at the time) and the subsequent location of their labelled progeny in myotube nuclei has revealed a great deal of data on the timing of myogenesis, but not about the nature of mpc themselves. DNA synthesis can also be detected by antibodies to the thymidine analogue, bromodeoxyuridine, and also by antibody staining for proliferating nuclear cell antigen. Like tritiated thymidine, these other markers are not specific for muscle but are general markers for DNA synthesis. In situ hybridisation of various muscle-specific genetic markers and their products has been informative, as has immunolabelling of myogenin, MyoD1 and desmin. Desmin labelling has been particularly instructive in identifying mpc because it is one of the first muscle-specific proteins to be produced in mpc. This review covers some of the techniques mentioned above and their usefulness in determining the early events in myogenesis.

Background:It is now well established that mature skeletal muscle has the ability to regenerate, and reports on this phenomenon have existed in the research literature for some 40 years. However, it is only relatively recently, largely due to the advances in microsurgery, that practising surgeons can make direct use of the regenerative ability of skeletal muscle. Methods: Most of the key data on skeletal muscle regeneration have come from experimental studies on muscle grafts in small animal models. One such model is the transplantation of the extensor digitorum muscle of the mouse or rat into the contralateral site, or the relocation of this muscle onto the surface of the tibialis anterior muscle. These and other models, together with the important cellular mechanisms involved in the regeneration of skeletal muscle, are reviewed briefly in this article. Results: Skeletal muscle cells regenerate rapidly in muscle grafts, arising from satellite cells in the surviving peripheral fibres of the graft within 2 days after grafting. The resultant myoblasts progress towards the necrotic graft centre and occupy the area by 5 days. Revascularization commences at 3 days after grafting, but reinnervation takes many weeks to complete. Conclusions: With the established knowledge on skeletal muscle regeneration, largely gained from experimental studies of muscle grafts, an understanding of these mechanisms should now be fundamental knowledge for today's practising surgeons.

The results of the present study show that patients with varying sizes of bursal-side tears respond to ASAD as well as those with no rotator cuff tear.

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