Microanastomotic response to needle and suture size

This study was performed to examine the microanastomotic response to needle and suture size, comparing the 10-0 (75 mu needle/22 mu suture), the 11-0 (50 mu needle/18 mu suture), and a new modified 11-0 which has a 30 mu needle and a 14 mu suture. Each artery received five full thickness sutures of either suture. The vessels were harvested at 0, 7, 14, 21, and 28 days and checked for patency, aneurysm formation, and gross strength. Histologic slides and scanning electron micrographs (SEM) were made at 7, 21, and 28 days postoperatively. The 11-0 with the 30 mu needle gave better patency rates, less incidence of aneurysm formation, and as good or better recovery in gross strength, when compared with the 10-0 75 mu needle. Histologically and by SEM, the 11-0 with the 30 mu needle was far superior to the other two larger sized sutures, showing less trauma and inflammation. The use of the modified 11-0 suture with the 30 mu needle is advantageous in anastomosis of vessels 1 mm or smaller.     

Distal rupture of the palmaris longus tendon and fascia as a cause of acute carpal tunnel syndrome

Acute carpal tunnel syndrome is rare compared with its more chronic presentation. Previous reports in the literature have documented the most common causes. Rupture of the distal palmaris longus tendon into the palmaris fascia as a cause of an acute carpal tunnel syndrome has not been reported previous to this case report. Partial rupture of the tendon and hemorrhage around its insertion produced intrinsic compression on the transverse ligament and the underlying nerve.     

One in the eye for an orthopaedic surgeon.

Despite many reports of injuries to surgeons during operative procedures, there is no record of an eye injury caused by a foreign body. Orthopaedic surgeons are particularly vulnerable to such injury. An instance in which a penetrating eye injury occurred while hammering a rasp into the femur during a hip replacement is described. There is a potential oblique trajectory for a foreign body to reach the eye from the operative field despite the use of a visor for eye protection.     

A novel technique for the treatment of recurrent cubital tunnel syndrome: ulnar nerve wrapping with a tissue engineered bioscaffold

The purpose of this study was to assess subjective and objective outcomes in treating recurrent cubital tunnel at secondary neurolysis by nerve wrapping with a tissue engineered three-dimensional biomatrix. Five patients with a mean age of 44.1 years and an average follow-up of 13.3 months were included in the study. All patients had improvement in visual analogue scales. Four patients that had preoperative intrinsic atrophy with clawing had no clawing or intrinsic atrophy at final follow-up. Postoperatively, four of the five patients had two-point discrimination of 5?mm. Grip strength on average increased 90%. Three patients had an excellent outcome, one patient had a good outcome, and one patient had a fair outcome. All five patients said they would have surgery again.