No abstract

Level III retrospective case control study.

Objective In this study, we aimed to evaluate the diagnostic sensitivities of 68 Ga-FAPI-04 PET/CT and 18 F-FDG PET/CT in the primary tumor, and nodal, peritoneal and distant organ metastases of primary and recurrent gastric adenocarcinoma (GAc) with patient and lesionbased comparison. Materials and methodTwenty-one patients with histopathologically proven newly diagnosed or recurrent GAc who underwent 18 F-FDG and 68 Ga-FAPI-04 imaging were included in the study. Both imaging techniques were evaluated visually according to the intensity of organbased uptake. SUVmax and tumor-to-background ratio (TBR) values obtained from primary tumor/relapse and metastatic organs were compared statistically.Results 68 Ga-FAPI-04 uptake was positive in all 15 newly diagnosed patients, while two patients among them who had mucinous and signet ring cell carcinoma did not exhibit 18 F-FDG uptake. The sensitivity and specificity of 68 Ga-FAPI-04 PET/CT in detecting primary gastric were 100%, while the sensitivity and specificity of 18 F-FDG were 86.6 and 100%, respectively. 68 Ga-FAPI-04 imaging revealed diffuse stomach uptake in seven patients, while 18 F-FDG could only show two of them. The sensitivity and specificity of in-patient-based detection of lymph node metastases were 100 and 95.2%, respectively, while these values were 71.4 and 93.7%, respectively, for 18 F-FDG. For peritoneal involvement 68 Ga-FAPI-04 had a sensitivity and specificity of 100%, whereas 18 F-FDG had a sensitivity of 40% and a specificity of 100%.Conclusion 68 Ga-FAPI-04 PET/CT is an imaging modality with the potential of yielding more sensitive and specific findings 18 F-FDG PET/CT. This modality may help avoid invasive diagnostic procedures that may be frequently required in GAc.

A retrospective evaluation was performed of 36 patients (25 males and 11 females; average age, 44 years) with displaced acetabular fractures who were treated with a modified Stoppa approach. Fractures included 18 anterior columns, 2 both columns, 8 anterior columns with posterior hemitransverse, 6 transverse, and 2 T-type, according to the Judet and Letournel classification. Range of motion, Harris Hip Scores, and Merle d'Aubigné scores were evaluated. Pre- and postoperative measurements taken included displacements and gaps on axial, coronal, and sagittal computed tomography (CT) images and postreduction quality assessed radiologically. Mean follow-up was 14.7 months. Mean perioperative bleeding was 970 cc (range, 800-1250 cc). Mean Harris Hip Score was 77.9, mean Merle d'Aubigné score was 16.4, mean flexion was 105.2°, and mean extension was 16.9°. Anatomical reduction of the acetabular fracture was achieved in 29 (80.5%) patients; it was satisfactory in 5 (13.8%) and poor in 2 (5%). Mean preoperative displacements on axial, coronal, and sagittal sections were 4.1, 3.6, and 3.1 mm, respectively, and mean postoperative displacements were 0.2, 0.3, and 0.2 mm, respectively. Mean preoperative gap distance was 14.5 mm, and mean postoperative gap distance was 1.1 mm. Postoperative foot drop was observed in 2 patients, obturator nerve damage in 1, partial iliac vein damage in 1, and avascular necrosis of the femoral head in 1. Despite a steep learning curve, the modified Stoppa approach is a good alternative to the ilioinguinal approach. It can be used to treat many complex acetabular fractures.

The aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford's criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy. Level of evidence: Level III.

No abstract

Prospective comparative study, Level II.

Schwannomas are also known as neurolemmas that are usually originated from Schwann cells located in the peripheric nerve sheaths. They are the most common tumours of the hand (0.8–2%). They usually present solitary swelling along the course of the nerve however multiple lesions may be present in cases of NF type 1, familial neurofibromatosis, and sporadic schwannomatosis. Schwannomas are generally represented as an asymptomatic mass; however pain, numbness and fatigue may take place with the increasing size of the tumour. EMG (electromyelography), MRI (magnetic resonance imagination), and USG (ultrasound) are helpful in the diagnosis. Surgical removal is usually curative. In this paper, we present a 24-year-old male referred to our clinic for a lump located at the volar side of the left wrist and a lump located in his left palm and numbness at his 3rd and 4th fingers. Total excision was performed for both lesions. Histopathological examination of the masses revealed typical features of schwannoma. At the 6th-month followup the patient was symptom-free except for slight paresthesia of the 3rd and the 4th fingers. For our knowledge, this is the second case in the literature presenting wrist and palm involvement of the median nerve schwannoma.