Ultrasound Evaluation of the Protector Role of the Pronator Quadratus Suture in Volar Plating

The main complication of volar locking plates for distal radius fractures is flexor tendon rupture. The flexor pollicis longus (FPL) is the most commonly ruptured. Repair of the pronator quadratus (PQ) is one of the ways to prevent tendon rupture. The main purpose of this series was to evaluate the role of PQ repair after volar plating to prevent flexor tendon rupture using ultrasound (US). This work was a mono‐operator prospective series of 20 consecutive patients with volar locking plates for distal radius fracture between September 2014 and May 2015. The PQ was repaired in all patients. A clinical, ultrasound, and perioperative evaluation of the flexor tendon was performed by this same surgeon. There was no flexor tendon rupture or tenosynovitis. There were no type A cases, which are characterized by contact between the plate and the FPL, and mostly type C cases, which are characterized by no contact between the plate and the FPL on US imaging. The suture of the PQ was sustainable over time when we removed the plate. Pronator quadratus repair is one of the ways to prevent flexor tendon rupture after volar plating. The outward‐running suture is an effective technique for repairing the PQ. Ultrasound may be helpful during follow‐up to detect asymptomatic flexor tendon irritation.     

Tenosynovial complications identify TTR cardiac amyloidosis among patients with hypertrophic cardiomyopathy phenotype

Recent evidence suggests that carpal tunnel syndrome (CTS) and brachial biceps tendon rupture (BBTR) represent red flags for ATTR cardiac amyloidosis (ATTR-CA). The prevalence of upper limb tenosynovial complications in conditions entering differential diagnosis with CA, such as HCM or Anderson–Fabry disease (AFD), and hence their predictive accuracy in this setting, still remains unresolved. Objective: To investigate the prevalence of CTS and BBTR in a consecutive cohort of ATTR-CA patients, compared with patients with HCM or AFD and with individuals without cardiac disease history. Participants: Consecutive patients with a diagnosis of ATTR-CA, HCM and AFD were evaluated. A control group of consecutive patients was recruited among subjects hospitalized for noncardiac reasons and no cardiac disease history. The presence of BBTR, CTS or prior surgery related to these conditions was ascertained. Results: 342 patients were prospectively enrolled, including 168 ATTR-CA (141 ATTRwt, 27 ATTRm), 81 with HCM/AFD (N = 72 and 9, respectively) and 93 controls. CTS was present in 75% ATTR-CA patients, compared with 13% and 10% of HCM/AFD and controls (P = 0.0001 for both comparisons). Bilateral CTS was present in 60% of ATTR-CA patients, while it was rare (2%) in the other groups. BBTR was present in 44% of ATTR-CA patients, 8% of controls and 1% in HCM/AFD. Conclusions: CTS and BBTR are fivefold more prevalent in ATTR-CA patients compared with cardiac patients with other hypertrophic phenotypes. Positive predictive accuracy for ATTR-CA is highest when involvement is bilateral. Upper limb assessment of patients with HCM phenotypes is a simple and effective way to raise suspicion of ATTR-CA.     

Anatomie et tendinopathie patellaire : un malentendu

The anatomical structure linking the patella and the tibia is called the “patellar ligament” in the international nomenclature. This term is well accepted yet can be a source of confusion for non-specialists. This is because the priority role of this structure is not to maintain joint stability, the primary role of the cruciate ligaments and the collateral ligaments, but rather to prolong the mechanical action of the quadriceps muscle onto the leg skeleton beyond the “patellar sesmoid”. Patellar tendon injuries are a common observation in sports medicine. The proximal third of the tendon below the patella is most generally involved. This highly frequent tendinopathy sometimes termed an “insertion” tendiopathy. Based on 100 consecutive magnetic resonance imaging studies and cadaveric dissection, we confirm that the insertion of the patellar tendon is situated on the anterior aspect of the patella and not the tip. We describe two anatomical variants of the healthy patellar tendon (type 1 and 2) that should not be confused with a site of tendinopathy. The anatomical limits between tendinous tissue and infrapatellar adipose body (the Hoffa adipose ligament), notably on the upper third is still debated and merits further work.     

胡连上清汤治疗咽喉口腔疾病的疗效观察

目的分析胡连上清汤治疗咽喉口腔疾病的疗效。方法选择2003年1月-2009年3月于我科就诊的咽喉口腔疾病患者108例，随机分为治疗组60例、对照组48例。治疗组胡连上清汤治疗，对照组西医治疗，比较两组患者疗效。结果治疗组总有效率93．30％，对照组总有效率77．08％。结论胡连上清汤治疗咽喉口腔疾病的疗效较佳，值得临床推广。     

终腱斜行游离延长治疗陈旧性锤状指畸形

正2013年10月~2015年9月,我们采用改良术式终腱斜行游离延长方法治疗14例陈旧性锤状指畸形患者,疗效满意,报道如下。1材料与方法1.1病例资料本组14例,男10例,女4例,年龄20~65岁。畸形手指:食指3例,中指5例,环指5例,小指1例。伤后至手术时间:7~12 d 11例,21 d以上3例。     

Ultrasound‐Guided Injection of the Temporalis Tendon: A Novel Technique

A novel technique, ultrasound‐guided injection of the temporalis tendon in adults, is described. Ultrasound‐guided injection of the temporalis tendon is based on visualization of the temporalis muscle, temporalis tendon, and coronoid process. A practical step‐by‐step guide to doing the procedure is given. This technique is effective and reproducible. Two patients successfully treated with this technique will be briefly discussed. The anatomic location and size of the temporalis tendon make it mandatory to use ultrasound to ensure precision.     

健脾养阴化瘀祛痰法治疗糖尿病合并脑梗死临床研究

目的：探讨健脾养阴化瘀祛痰法治疗糖尿病合并脑梗死的临床疗效。方法：将60例糖尿病合并脑梗死患者随机分为对照组和治疗组各30例，对照组给予常规治疗，治疗组在常规治疗的基础上给予健脾养阴、化瘀祛痰之健脾通络汤，观察两组疗效及不良反应。4周为1个疗程。结果：治疗组有效率为93.33%，对照组有效率为73.33%，治疗组明显优于对照组，差异具有统计学意义（P<0.05）。结论：健脾养阴化瘀祛痰法治疗糖尿病合并脑梗死，能明显减轻躯体不适症状，疗效稳定，安全可靠。文献引用：徐喜玲.健脾养阴化瘀祛痰法治疗糖尿病合并脑梗死临床研究[ J].中医学报，2014，29（11）：1575-1576.