bluuebunny/crossref_metadata_2025 huggingface dataset:
Twenty‐first century education: Toward greater emphasis on context—social, economic, and educational
Authors: Peterson Roger L.
Published: June 2005

In calling for a greater emphasis on the social, economic, and educational contexts, the discussion presented in this article is generally supportive of C.R. Snyder and T.R. Elliott's (this issue) vision of 21st century graduate education in clinical psychology. Attention is directed toward the asocial nature of professional psychology, a brief analysis of the influence of economics on the development of clinical psychology education, and the American Psychological Association's accreditation process as it shapes professional psychology education. © 2005 Wiley Periodicals, Inc. J Clin Psychol.
Encouraging use of seasonal climate forecasts by farmers
Authors: McCrea Rod , Dalgleish Len , Coventry Will
Published: June 2005

What encourages use of seasonal climate forecasts? Considerable effort is being applied in developing seasonal climate forecasts and demonstrating the potential benefits available to farmers from using seasonal climate forecasts. This study examines three factors underlying the use of seasonal climate forecasts by farmers: the level of forecast understanding by farmers, the format presentation of the forecasts, and the attitude of farmers towards the usefulness of forecasts as indicators of future rainfall. Using judgement analysis, the use of forecasts in cropping decisions was determined for 73 Australian farmers. Then a moderated regression analysis was used to predict forecast use from the three underlying factors. The study found that a good understanding of the forecast was more important than the forecast format in predicting its use. However, this main effect of good understanding on higher use was qualified by a three‐way interaction, such that good understanding was only associated with higher use when farmers had a favourable attitude toward the usefulness of seasonal climate forecasts and the forecasts were presented in a frequency format. Thus, the study found all three factors were important in predicting the use of seasonal climate forecasts by farmers. However, relatively little is known about farmer attitudes toward the usefulness of seasonal climate forecasts and how these attitudes arise, and further research is recommended in these areas. Copyright © 2005 Royal Meteorological Society
The kinetics of reaction of copper with substituted benzyl bromides in dipolar aprotic solvents
Authors: Egorov Anatoly M. , Matyukhova Svetlana A. , Anisimov Alexander V.
Published: June 2005

The reaction of copper with benzyl bromides in dipolar aprotic solvents has been studied. There are no linear or other simple relations between ε, 1/ε, Y, P, n, and the rate of reaction. The activity of the solvent is determined by donor number (DN) in reaction under consideration. The kinetic and thermodynamic parameters of the reaction of copper with benzyl bromide in dimethyl sulfoxide (DMSO) have been clarified. Hammett plots of log (k/k°) vs. the substituent constant σ gave good correlations (ρ = 0.18, Sρ = 0.02, r = 0.961 in dimethyl sulfoxide and ρ = 0.21, Sρ = 0.02, r = 0.947 in dimethylacetamide (DMAA)). The structure of the organic group has little effect on the rate of reaction of benzyl bromide with copper. The Hammett ρ value also depends on DN. © 2005 Wiley Periodicals, Inc. Int J Chem Kinet 37: 496–501, 2005
Absence of previously reported variants in the SCNA (G88C and G209A), NR4A2 (T291D and T245G) and the DJ‐1 (T497C) genes in familial Parkinson's disease from the GenePD study
Authors: Karamohamed Samer , Golbe L.I. , Mark M.H. , Lazzarini A.M. , Suchowersky O. , Labelle N. , Guttman Mark , Currie L.J. , Wooten G.F. , Stacy M. , Saint‐Hilaire M. , Feldman R.G. , Liu J. , Shoemaker C.M. , Wilk J.B. , DeStefano A.L. , Latourelle J.C. , Xu G. , Watts R. , Growdon J. , Lew M. , Waters C. , Vieregge P. , Pramstaller P.P. , Klein C. , Racette B.A. , Perlmutter J.S. , Parsian A. , Singer Carlos , Montgomery E. , Baker K. , Gusella J.F. , Herbert A. , Myers R.H.
Published: June 2005

Parkinson's disease (PD) is a neurodegenerative disorder in which relatives of the probands are affected approximately 4 times as frequently as relatives of control subjects. Several genes have been implicated as genetic risk factors for PD. We investigated the presence of six reported genetic variations in the SCNA, NR4A2, and DJ‐1 genes in 292 cases of familial Parkinson's disease from the GenePD study. None of the variants were found in the GenePD families. Our results suggest that other variants or genes account for the familial risk of PD within the GenePD study. © 2005 Movement Disorder Society
Activity‐dependent influences are greater for fibers in rat medial gastrocnemius than tibialis anterior muscle
Authors: Roy Roland R. , Zhong Hui , Siengthai Boonclaire , Edgerton V. Reggie
Published: June 2005

Skeletal muscles are highly adaptive to changes in loading or activation. A model of neuromuscular inactivity (spinal cord isolation, SI) was used to determine the role of activity‐independent and ‐dependent neural influences on the size and myonuclei number in type‐identified fibers of a fast extensor (medial gastrocnemius, MG) and flexor (tibialis anterior, TA) rat muscle. Fibers were categorized based on myosin heavy chain isoform composition. Four days after SI, all fiber types tended to atrophy and lose myonuclei, with the percent loss of myonuclei being disproportionately less than the decrease in fiber size. At 60 days after SI, all fiber types in MG and the fastest fibers in TA were significantly smaller and had fewer myonuclei than control. The disproportionate amount of atrophy resulted in a smaller myonuclear domain. These effects were greater in MG than TA, indicating that activity‐dependent influences were greater in the extensor than flexor. The smaller myonuclear domains after a period of chronic inactivity suggest the presence of intrinsic mechanisms operating to maintain the genetic material necessary to recover from atrophic conditions. Muscle Nerve, 2005
Novel thermally stable poly(amine hydrazide)s and poly(amine‐1,3,4‐oxadiazole)s for luminescent and electrochromic materials
Authors: Liou Guey‐Sheng , Hsiao Sheng‐Huei , Su Tzy‐Hsiang
Published: June 2005

We describe the preparation, characterization, and luminescence of four novel electrochromic aromatic poly(amine hydrazide)s containing main‐chain triphenylamine units with or without a para‐substituted N,N‐diphenylamino group on the pendent phenyl ring. These polymers were prepared from either 4,4′‐dicarboxy‐4″‐N,N‐diphenylaminotriphenylamine or 4,4′‐dicarboxytriphenylamine and the respective aromatic dihydrazide monomers via a direct phosphorylation polycondensation reaction. All the poly(amine hydrazide)s were amorphous and readily soluble in many common organic solvents and could be solution‐cast into transparent and flexible films with good mechanical properties. These poly(amine hydrazide)s exhibited strong ultraviolet–visible absorption bands at 346–348 nm in N‐methyl‐2‐pyrrolidone (NMP) solutions. Their photoluminescence spectra in NMP solutions or as cast films showed maximum bands around 508–544 and 448–487 nm in the green and blue region for the two series of polymers. The hole‐transporting and electrochromic properties were examined by electrochemical and spectroelectrochemical methods. All obtained poly(amine hydrazide)s and poly(amine‐1,3,4‐oxadiazole)s exhibited two reversible oxidation redox couples at 0.8 and 1.24 V vs. Ag/AgCl in acetonitrile solution and revealed excellent stability of electrochromic characteristics, changing color from original pale yellow to green and then to blue at electrode potentials of 0.87 and 1.24 V, respectively. © 2005 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 43: 3245–3256, 2005
Management of empyema in children
Authors: Jaffé Adam , Balfour‐Lynn Ian M.
Published: June 2005

The incidence of empyema complicating community‐acquired pneumonia is increasing and causes significant childhood morbidity. Pneumococcal infection remains the most common isolated cause in developed countries, with Staphylococcus aureus the predominant pathogen in the developing world. Newer molecular techniques utilizing the polymerase chain reaction have led to an increase in identification of causative bacteria, previously not isolated by conventional culture techniques. This remains an important epidemiological tool, and may help in guiding correct antibiotic use in the future. There are many treatment options, however, and the care a child currently receives is dependent on local practice, which is largely determined by availability of medical personnel and their preferences. Although there are many reported case series comparing treatment options, only two randomized controlled studies exist to guide treatment in children. There is an urgent need for this to be addressed, particularly with the introduction of relatively new surgical techniques such as video‐assisted thorascopic surgery. Pediatr Pulmonol. 2005; 40:148–156. © 2005 Wiley‐Liss, Inc.
Early Mobilisation of Acute Middle Slip Injuries
Authors: O’DWYER F. G. , QUINTON D. N.
Published: June 2005

After operative repair, the conventional management of open injuries to the middle slip of the extensor tendon involves prolonged immobilisation of the P.I.P. joint. We report our results using controlled mobilisation with a Capener splint after two weeks rigid splintage. In a series of 99 patients seen soon after injury, 88% had excellent or good results after six months. Poor results were more common in patients with complex joint injuries and in patients who did not comply with the treatment. We advocate early mobilisation following repair of the middle slip.
Operative Treatment of the Post-Traumatic Boutonnière Deformity
Authors: CAROLI A. , ZANASI S. , SQUARZINA P. B. , GUERRA M. , PANCALDI G.
Published: June 2005

We report 20 cases of post-traumatic boutonnière deformity treated by a modification of the direct anatomical repair technique, particularly indicated in late cases which have complete passive motion. A swallow-tailed flap is excised from the fibrous tissue between the two ends of the central slip. The proximal one is then advanced up to the coaptation with the distal edge of the scarred capsular tissue at the insertion on the middle phalanx to which it is sutured in correct tension. Excellent results have been obtained in 72% of cases and good in 5.5%. The 16% of fair results are probably due to the fact that patients didn't use the splint post-operatively and didn't cooperative with physiotherapy.
On the Priorities of Publication of some Operative Procedures on the Distal end of the Ulna
Authors: BUCK-GRAMCKO D.
Published: June 2005

A search of the relevant literature concerning various procedures done to the distal ulna in post-traumatic conditions has shown that several terms are inappropriate to the procedures they describe. This paper tries to clarify the situation and help in correct citation.
Cold-Induced Arterial Spasm after Digital Amputation
Authors: BACKMAN C. , NYSTRÖM A. , BACKMAN C.
Published: June 2005

The incidence and intensity of cold-induced digital vasospasm was investigated in 18 patients with digital amputation injuries. Nine patients had undergone replantation surgery, while in the remaining nine cases the injury had been treated by stump revision and closure. The vascularity of the injured digits and of uninjured fingers in both hands, was studied. The results confirm that cold-induced vasospasm is no more conspicuous in replanted fingers than in amputation stumps. Pathological vascular reactions to cold were also common in uninjured fingers in both hands.
Vascularised Bone Transfer for Defects and Pseudarthroses of Forearm Bones
Authors: OLEKAS J. , GUOBYS A.
Published: June 2005

During a five-year period, 15 patients with defects or pseudarthroses of the forearm bones were operated on. All had previously undergone one to six conventional operations. A vascularised fibular graft was used in ten cases, a radial graft in three cases and a humeral graft in two cases. Bone graft viability and healing were assessed clinically and patients have been observed for seven months to five years. 14 patients have finished treatment: 13 were cured and only two repeat osteosyntheses were required. In one case there was resorption of the central part of the fibular graft. Primary bony union was achieved in three to six months. Care must be taken in precise pre-operative assessment of the state of the forearm arteries. We advocate wider usage of vascularised radial and humeral grafts.
The Function of the Abductor Pollicis Longus Muscle as a Joint Stabiliser
Authors: VAN OUDENAARDE E.
Published: June 2005

The abductor pollicis longus and extensor carpi ulnaris muscles function as a dynamic collateral ligament of the wrist. There are indications of a comparable situation over the carpo-metacarpal joint of the thumb. From experiments with tendon movements, we found that in passive motions of the thumb only the tendons of the superficial division show an excursion, regardless of the position of the wrist joint. However, in motions of the wrist joint the tendons show an identical excursion over an equal distance. These are small in pronation and supination but much larger in the mid-position between them. On some movements of the thumb and the wrist, no tendon excursions can be measured. There are strong indications that the deep division, particularly, has a stabilising function on the basal joint of the thumb.
Contracture of the Proximal Interphalangeal Joint in Dupuytren’s Disease
Authors: ANDREW J. G.
Published: June 2005

The correction of fixed flexion deformity at the P.I.P. joint in Dupuytren’s disease is often difficult. This paper reports an anatomical study of this joint in fingers amputated because of this condition. All the joints would extend fully after release of the accessory collateral ligaments and volar plate. Lateral and dorsal structures showed severe secondary damage and it is suggested that these changes may explain the poor results of corrective surgery to this joint in Dupuytren’s disease.
Surgical Treatment of Fixed Flexion Contractures in the Hands of Institutionalised Patients
Authors: NEEDOFF M. , MOULTON A.
Published: June 2005

Three severely demented elderly patients had fixed flexion contractures of all fingers of one or both hands. This caused an unpleasant problem of hygiene and of nail ingrowth into the palm. A surgical solution to this problem is described, with good results.
Congenital Sarcoma in the Forearm
Authors: MATEV I. , STOYTSCHEFF K.
Published: June 2005

A child with congenital fibrosarcoma in the forearm, of microscopically differentiated type, is described. Early radical extirpation of the fibrosarcoma with the periosteum led to an apparent cure after 15 years.
Neurotropism, Frozen Muscle Grafts and Other Conduits
Authors: LUNDBORG G.
Published: June 2005

Axonal regeneration following nerve transection requires a number of cellular and biochemical phenomena in the axons as well as the nerve cell bodies. The nerve cells must survive the trauma. Since axonal severance means amputation of a large axoplasmic volume from the remaining parts of the nerve cell, the cell body must prepare for increased synthesis of axoplasm to replace the missing parts. A sprouting process must be initiated at the level of transection. Regenerating axonal processes are to regenerate towards peripheral targets, a process regulated by an interaction between genetic mechanisms in the nerve cell body and biochemical information at the molecular level along the pathway.
Experimental Studies on Surgical Treatment of Avulsed Spinal Nerve Roots in Brachial Plexus Injury
Authors: CARLSTEDT T.
Published: June 2005

This review summarises studies aiming at a surgical treatment of spinal nerve root avulsions from the spinal cord in brachial plexus lesions. After dorsal root injury, regrowth of nerve fibres into the spinal cord occurs only in the immature animal. After ventral root avulsion and subsequent implantation into the spinal cord, neuroanatomical and neurophysiological data show that motoneurons are capable of producing new axons which enter the implanted root. Intra-neuronal physiological experiments demonstrate that new axons can conduct action potentials and elicit muscle responses. The neurons are reconnected in segmental spinal cord activity and respond to impulses in sensory nerve fibres. In primate experiments, implantation of avulsed ventral roots in the brachial plexus resulted in functional restitution. These studies indicate the possibility of surgical treatment of ventral root avulsion injuries in brachial plexus lesions in humans.
A Fourth Type of Brachial Plexus Lesion: The Intermediate (C7) Palsy
Authors: BRUNELLI G. A. , BRUNELLI G. R.
Published: June 2005

A new type of brachial plexus lesion has been defined to be added to the classical types, i.e. the upper (Duchenne Erb), the lower (Dejerine Klumpke) and the total type. This new type is the intermediate palsy. The lesion is a partial involvement of the plexus, the predominant lesion of which involves C7 with a variable involvement of the upper or lower plexus. By observations during operation, and in cadavers, three different mechanisms are considered responsible for the three different types of lesion. A trauma with downwards traction principally involves the upper plexus. Trauma in abduction first involves the lower plexus while a traumatic force acting from an anterior to a posterior direction involves firstly and predominantly the C7 spinal nerve which is in an anterior position and less oblique than the other roots. Avulsion from the cord or rupture are possible. 33 cases have been observed.
The Superficial Anastomosis on the Palm of the Hand between the Ulnar and Median Nerves
Authors: FERRARI G. P. , GILBERT A.
Published: June 2005

The communications between the median and ulnar innervated territories on the palm of the hand have been studied anatomically and microscopically. A communicating branch is well appreciated but its description has had little emphasis in anatomical or surgical literature. 50 cadaveric palms were dissected in both sexes and an anastomotic branch was found in 45 hands. In 43 of them it originated proximally from the ulnar nerve and proceeded distally to enter the third common digital nerve; in the other two hands it left the median nerve to reach the fourth common digital nerve.

By microscopic dissection we have seen that the ulnar fibres of the anastomotic branch which join the median nerve may contribute to the sensory innervation of the radial half of the ring finger and ulnar side of the middle finger on its palmar surface. We have therefore described a cutaneous area on the palm where care must be taken to avoid surgical damage to this branch.
Shock Absorbing Finger Cap
Authors: STILWELL J. H. , MARTIN A. J.
Published: June 2005

We describe the use of a custom-made cap or sleeve made of a visco-elastic polymer offering protection for the tip of the hypersensitive finger or thumb. Of 35 digits treated, relief of symptoms was achieved in 83%. In many cases, cold intolerance was also relieved.
Correlation of Physiological Cross-Sectional Areas of Muscle and Tendon
Authors: AN K.-N. , LINSCHEID R. L. , BRAND P. W.
Published: June 2005

Muscle physiological cross-sectional area, as defined and measured by dividing the volume of the muscle by its fibre length, is proportional to the maximum strength of the muscle. It is one of the important parameters when considering muscle mechanics in sports science and, clinically in tendon transfer procedures. This study reports that tendon cross-sectional area correlated well with the physiological cross-sectional area of associated muscles.
Median Nerve Compression by the Supracondylar Process: A Case Report
Authors: AL-QATTAN M. M. , HUSBAND J. B.
Published: June 2005

A case of median nerve compression by the supracondylar process relieved surgically is reported. The same patient had undergone a similar and successful operation 25 years earlier.
Peripheral Nerve Palsy Associated with Congenital Constriction Band Syndrome
Authors: UCHIDA Y. , SUGIOKA Y.
Published: June 2005

Of 21 patients with congenital constriction band syndrome treated in our clinic from 1967 to 1988, four had constriction bands proximal to the wrist. Three of these also had a peripheral nerve palsy. Late surgical decompression does not help but early diagnosis, using electrodiagnosis methods, and neurolysis or nerve grafting as soon as possible may improve nerve function.
Scapho-Trapezio-Trapezoid Arthrodesis in the Treatment of Kienböck’s Disease
Authors: VOCHE P. , BOUR C. , MERLE M.
Published: June 2005

Sixteen scapho-trapezio-trapezoid arthrodeses were performed for Kienböck’s disease. In ten cases, a prosthetic replacement of the lunate was inserted at the same time. Clinical results were good with regard to pain and fair with regard to grip strength which was improved by an average of 32%. In contrast, the arc of flexion-extension was 38% less than on the unoperated side. Long-term radiographic assessment showed the efficacy of the procedure in maintaining carpal height. Biomechanical observations and a review of poor results showed the limits of the method and the importance of correct positioning of the scaphoid. We concluded that triscaphe arthrodesis was a useful procedure for the treatment of Kienböck’s disease in Decoulx’s stage 3.
Magnetic Resonance Imaging in Scaphoid Fractures
Authors: IMAEDA T. , NAKAMURA R. , MIURA T. , MAKINO N.
Published: June 2005

The use of a 1.5 tesla superconducting M.R. imager and surface coil was found to enhance the ability of M.R.I, to depict the fine anatomy of the wrist. Five healthy volunteers and 28 patients with scaphoid fractures underwent M.R.I., which made possible a definitive diagnosis of scaphoid fractures at an early stage. A fresh fracture was identified by decreased or iso signal intensity on the T1-weighted image and increased signal intensity on the T2-weighted image. This increase continued until bony union was apparent on radiographs. On the T2-weighted image, high signal intensity was characteristic of fresh fractures and suggested that bony union was possible. When bony union was complete, the intensity of the signal for the scaphoid on both T1 and T2-weighted images returned to normal. M.R.I. should thus prove useful in the diagnosis of scaphoid fractures.
The Long Term Result of Digital Nerve Repair in No-Man’s Land
Authors: GOLDIE B. S. , COATES C. J. , BIRCH R.
Published: June 2005

30 isolated lesions of digital nerves which had been repaired by microsurgical techniques were examined in 27 patients. The average length of follow-up was 25 months (range: 12–48 months). Patients were assessed subjectively using a visual analogue scale and examined for light touch, pain, two-point discrimination, electrical conductance and sensory threshold. Although 37% of fingers regained normal two-point discrimination, only 27% of patients graded their overall result as excellent and 40% complained of persistent hyperaesthesia for up to two years. None felt that their finger had regained normal sensation. All patients undergoing digital nerve repair should be warned that hyperaesthesia may persist for several years and that an adult will never regain normal sensation.
Brachial Plexus Injury: A Survey of Incidence and Referral Pattern
Authors: GOLDIE B. S. , COATES C. J.
Published: June 2005

The aim of this study was to establish the incidence and the pattern of referral of injuries to the brachial plexus for a single calendar year: 1987. A questionnaire was sent to every orthopaedic consultant and referral centre in the United Kingdom. Replies were received from 402 surgeons. It is estimated that in 1987 there were at least 336 patients with traumatic injuries and 137 patients with other problems related to the plexus. Only 145 patients were seen at a referral centre. The anatomical nature, mode of injury and methods of treatment were analysed for both the referred and unreferred patients. We found that injuries to the brachial plexus are far more common than is generally appreciated, but only a minority of patients are referred for specialist evaluation and treatment.
The Effect of Constant Direct Electrical Current on Intrinsic Healing in the Flexor Tendon in Vitro
Authors: FUJITA M. , HUKUDA S. , DOIDA Y.
Published: June 2005

Light and electron microscopy were performed in a study of the effects of electrical stimulation upon the reparative processes in flexor tendons cultured in vitro. After one or two weeks of incubation, the unstimulated control tendons were covered with fibroblastic surface cells, thought to have originated from the epitenon. In contrast, the tendons subjected to electrical stimulation had no proliferation of the epitenon cells in the surface layer. The results indicate that electrical currents of low amperage suppress adhesion-causing synovial proliferation in the epitenon and promote active collagen synthesis in the tenocytes. This suggests the potential value of electrical stimulation in the control of adhesion formation after flexor tendon repair.
Strength of the Suture in the Epitenon and within the Tendon Fibres: Development of Stronger Peripheral Suture Technique
Authors: MASHADI Z. B. , AMIS A. A.
Published: June 2005

In tendon repair, the peripheral stitches are usually placed in the epitenon, but it has not yet been defined whether the grasping strength of the sutures in the epitenon and within the tendon fibres are different. The first stage of this work investigated this difference and found that peripheral stitches within cadaveric tendon fibres were 83% stronger than those in the epitenon layer. A new peripheral stitch, based on this finding, has been designed. Mechanical tests of a range of peripheral suture types in vitro found that the new technique gave a resistance to gap formation twice that of the peripheral stitches commonly in use at present and a rupture strength more than three times, while still avoiding eversion problems.
Transverse Sliding of the Median Nerve Beneath the Flexor Retinaculum
Authors: NAKAMICHI K. , TACHIBANA S.
Published: June 2005

Transverse sliding of the median nerve beneath the flexor retinaculum during active-resistant flexion of the fingers was sonographically demonstrated. Although it is a physiological phenomenon, it may cause mechanical nerve deformation in addition to longitudinal sliding when the nerve is subject to compression against the flexor retinaculum by tensed overlying flexor tendons.
Dupuytren’s and Epilepsy Revisited
Authors: ARAFA M. , NOBLE J. , ROYLE S. G. , TRAIL I. A. , ALLEN J.
Published: June 2005

The incidence of Dupuytren’s disease amongst the residents of two epileptic centres was found to be 12.0% in one and 38.1% in the other. The overall incidence at the second was significantly higher than a control population (16.0%) and this difference was particularly apparent in patients over 50 years old. The distribution of the Dupuytren’s disease was found to be very similar to that of non-epileptic patients. At both centres, the disease process was more severe, with an increased incidence of contractures. Drug therapy was not clearly implicated in the aetiology of this condition.
Subcutaneous or Submuscular Anterior Transposition of the Ulnar Nerve?
Authors: STUFFER M. , JUNGWIRTH W. , HUSSL H. , SCHMUTZHARDT E.
Published: June 2005

Precise clinical and electroneurographic examinations were made of 51 patients before and after anterior transposition of the ulnar nerve. The mean follow-up period was 9.6 years. In 86%, hand function improved, while in 10% it remained unchanged. Subcutaneous transposition was better than submuscular transposition, especially with regard to sensation. This method is simple and involves low morbidity for patients.
Simple Decompression of the Ulnar Nerve: An Alternative to Anterior Transposition
Authors: NATHAN P. A. , MYERS L. D. , KENISTON R. C. , MEADOWS K. D.
Published: June 2005

Anterior transposition and/or medial epicondylectomy are often considered procedures of choice for ulnar neuropathy at the elbow. Much experience suggests simple decompression to be a comparably effective alternative which involves less trauma, morbidity, and rehabilitation time. The post-operative clinical and electrophysiological results of 52 cases of simple decompression (41 patients) are summarized. Excellent or good clinical results were found in 75% of the nerves. Mean ulnar motor conduction velocities were significantly improved post-operatively, although nerve conduction parameters did not consistently correlate with clinical outcome. The average return-to-work time was 5.1 weeks. The advantages of simple decompression make it the procedure of choice for most cases of ulnar neuropathy.
Scapho-Lunate Dissociation Occurring with Scaphoid Fracture
Authors: BRAITHWAITE I. J. , JONES W. A.
Published: June 2005

In the most widely accepted model of injuries to the carpus, scaphoid fracture and scapho-lunate dissociation are held to be mutually exclusive. Four cases in which they occurred together are reported, and the likely mechanism proposed.
Trans-Carpal Injuries Associated with Distal Radial Fractures in Children: A Series of Three Cases
Authors: COMPSON J. P.
Published: June 2005

Isolated trans-carpal injuries in children are rare. This paper presents three cases of trans-carpal injury associated with an ipsilateral distal radial fracture. Two cases involved simultaneous fractures of the scaphoid and the capitate. The third case involved the scaphoid and the triquetrum. The full extent of these injuries was not recognized on the initial X-rays. If a child presents with a displaced fracture of one carpal bone it may not be an isolated injury.
Normal Palmar Tilt: is Dorsal Tilting Really Normal?
Authors: MANN F. A. , KANG S. W. , GILULA L. A.
Published: June 2005

Palmar tilt measured on true lateral radiographs of 100 normal wrists revealed that dorsal palmar tilt is not found in the normal adult, and women generally have a larger palmar tilt (average 12.4°) than men (average 9.3°).
Chromosomal Abnormalities in Dupuytren’s Contracture and Carpal Tunnel Syndrome
Authors: BONNICI A. V. , BIRJANDI F. , SPENCER J. D. , FOX S. P. , BERRY A. C.
Published: June 2005

The cytogenetics of cell cultures derived from Dupuytren’s tissue, adjacent palmar fascia and palmar skin from patients undergoing fasciectomy have been examined and the results compared to cell cultures established from palmar fascia, flexor retinaculum and palmar skin of patients undergoing carpal tunnel decompression. Chromosomal abnormalities were detected in cell cultures from Dupuytren’s tissue in eight of the nine patients studied. Clones of cells trisomic for chromosome 8 were found in five of the nine patients. Trisomy 8 was also present in two of five flexor retinaculum cultures from carpal tunnel syndrome cases. These findings in both Dupuytren’s contracture and carpal tunnel syndrome suggest the presence of chromosomal instability in the palmar fascia. The significance of the chromosomal abnormalities is however unclear, but they indicate a possible common pathway in the onset of pathological fibrosis.
Reversal of Digital Vasospasm by Glyceryl Trinitrate Patch
Authors: EVANS R. A. , SANDERSON P. L. , STANLEY J. K.
Published: June 2005

Localized digital ischaemia following tourniquet deflation is an event producing considerable concern after surgical procedures on the hand, and is more common when severe pre-operative deformity has been radically corrected. We describe three such cases of digital ischaemia, occurring immediately after the release of severe flexion contractures of the digits. Our cases were treated successfully by the application of a proximal cutaneous glyceryl trinitrate patch, which produced prompt recovery of the circulation in the affected digits. We suggest that this simple technique has an important role as theraputically, and possibly also as a diagnostic aid, in the evaluation and management of the post-operative ischaemic digit prior to re-exploration being undertaken.
High Ulnar Nerve Palsy Caused by the Arcade of Struthers
Authors: OCHIAI N. , HAYASHI T. , NINOMIYA S.
Published: June 2005

A case of ulnar nerve entrapment neuropathy caused by the arcade of Struthers is reported. Nerve conduction studies showed a complete block and surgical decompression was successful.
Nerve Conduction Studies after Treatment for Carpal Tunnel Syndrome
Authors: SEROR P.
Published: June 2005

125 cases of carpal tunnel syndrome confirmed electrophysiologically were the subject of longitudinal nerve conduction studies to assess spontaneous improvement and effect of treatment. 36 cases showed a slowly progressive deterioration which became stastistically significant only on lengthy follow-up; analysis of interval tests in these cases revealed that definite improvement or rapid worsening can occur in the interim.

The 56 cases studied after local corticosteroid injections showed a statistically significant improvement at one month followed by an overall progressive return to the previous abnormal values in six to 12 months, indicating only slight and temporary alteration in the natural progression of the conduction deficit.

The 33 cases which underwent surgical release of the median nerve were shown to have obvious and often rapid improvement, which was sustained for at least one year after surgery.
A Review of Attitudes to Splintage in Dupuytren's Contracture
Authors: Abbott Kate , Denney Joanna , Burke F. D. , McGrouther D. A.
Published: June 2005

A questionnaire on the use of splintage before and after operations for Dupuytren's contracture has been completed by 45 hand surgeons and ten hand therapists. None considered that pre-operative splintage was beneficial, but nearly all used some form of splintage after operation. The types of splint and programmes for using them varied widely, and these are discussed.
Changes in Carpal Alignment Following Radial Osteotomy for Kienböck’s Disease
Authors: TSUNODA K. , NAKAMURA R. , WATANABE K. , HORII E. , MIURA T.
Published: June 2005

Changes in carpal alignment following radial osteotomy were studied in 30 patients with Kienböck’s disease. The carpal height ratio and carpal-ulnar distance ratio were significantly less in wrists with Kienböck’s disease than unaffected wrists. This observation implies proximal-ulnar translation of the capitate. In addition, the lunate-covering ratio increased significantly, reflecting radial translation of the lunate. Radial osteotomy corrected ulnar translation of the capitate and increased the radial translation of the lunate, thus increasing the lunate-covering ratio. The increased lunate-covering ratio is believed to increase the area of distribution of the axial load through the lunate by increasing the contact area with the radius. The satisfactory clinical outcome of radial osteotomy is believed to be due to this effect on carpal alignment.
Camptodactyly Caused by Abnormal Insertion and Origin of Lumbrical Muscle
Authors: MINAMI A. , SAKAI T.
Published: June 2005

A 12-year-old boy had camptodactyly of the little finger. Operative findings revealed an abnormal origin of the lumbrical muscle from the transverse carpal ligament, and abnormal insertion into the tendon sheath of the flexor digitorum superficialis tendon. No similar case has been reported in the literature.
The Results of Secondary Microsurgical Repair of Radial Nerve in 33 Patients
Authors: KALLIO P. K. , VASTAMÄKI M. , SOLONEN K. A.
Published: June 2005

33 patients with injuries to the radial nerve were reviewed, on average, 12.1 (5–20) years after secondary repair. 24 were male and nine female, with a mean age of 29.8 (7–54) years. Most of the nerve lesions were blunt (17) or sharp (14) injuries. Division was total in 24 cases and they were mostly injured at the upper arm level (21 cases). The average interval between injury and repair was 6.0 (1–19) months. The procedures used were fascicular grafting in 21 and direct suture in 12 cases.

Motor and sensory recovery were evaluated quantitatively. Useful results were obtained in 65.0% and useless in 25.0%. Fascicular grafting restored a useful level of motor function in only 8/21 cases (38.1%). Pre-operative delay had a significant influence. Associated lesions proved to be the critical factor for restoration of radial nerve function.
Acute Calcification and Carpal Tunnel Syndrome
Authors: KNIGHT D. J. , GIBSON P. H.
Published: June 2005

Carpal tunnel syndrome is a common diagnosis, and often there is no identifiable cause. We describe the case of a patient who developed acute symptoms secondary to calcification in the carpal tunnel. The patient was treated by decompression, and made a slow, but uneventful recovery.
The Economic Impact of Hand Injuries
Authors: O’SULLIVAN M. E. , COLVILLE J.
Published: June 2005

The socio-economic effect of 156 hand injuries was studied prospectively. The average cost per injury was IR£474. 28 of the more serious injuries utilized two-thirds of the resources and resulted in 83% of the days lost from work. In the working population approximately 50% of hand injuries occurred at work. In assessing the economic impact of hand injuries, labour costs account for 55 to 65% of costs. Amputation and complicated laceration were the most costly and resulted in more days lost at work. Injuries at work result in greater costs because they involve more serious injuries, and because workers requiring manual skills need a higher level of hand rehabilitation to return to work. Unless the labour costs are taken into account, the true impact of hand injuries is greatly underestimated.
A Diagnostic Test for Carpal Tunnel Syndrome Using Ultrasound
Authors: Molitor P. J. A.
Published: June 2005

The paper describes the details of an ultrasound test for carpal tunnel syndrome and compares the results of this with EMG studies in a series of 19 patients. The equipment used was a standard therapeutic ultrasound unit and the tests were performed by a physiotherapist. The results were encouraging, with a 90% correlation with EMG results.
Ultrasonography in the Diagnosis of Carpal Tunnel Syndrome Caused by an Occult Ganglion
Authors: NAKAMICHI K. , TACHIBANA S.
Published: June 2005

A case is reported of carpal tunnel syndrome caused by an occult ganglion which was diagnosed pre-operatively by ultrasonography.
Haemostasis During Carpal Tunnel Release Under Local Anaesthesia: A Controlled Comparison of a Tourniquet and Adrenaline Infiltration
Authors: BRAITHWAITE B. D. , ROBINSON G. J. , BURGE P. D.
Published: June 2005

A randomized controlled comparison of tourniquet and local adrenaline infiltration for control of bleeding was performed in patients undergoing bilateral carpal tunnel release under local anaesthesia. Visual analogue scores for intra-operative pain were substantially greater for tourniquet (mean score 4.7) than for adrenaline (2.2). Incomplete control of bleeding was responsible for longer operating time and for the surgeons’ perception of slightly greater operative difficulty with the use of adrenaline. There were no complications attributable to the use of adrenaline. The use of adrenaline-containing local anaesthesia for carpal tunnel release avoids tourniquet pain and is preferred by patients.
Isolated Dislocation of the Pisiform Bone
Authors: SHARARA K. H. , FARRAR M.
Published: June 2005

A case is reported of dislocation of the pisiform, successfully treated by conservative means.
A High Velocity, High Temperature Injection Injury
Authors: ALMIND M. , BROENG L.
Published: June 2005

A case of high velocity, high temperature injection injury to the right index finger during welding is reported.
Subcutaneous Emphysema of the Upper Limb: An Air-Gun Injury
Authors: EYRES K. S. , MORLEY T.
Published: June 2005

We describe a case of subcutaneous emphysema of the hand and forearm from an air-gun.
A Study of the Repeatability of the Diagnosis of Dupuytren’s Contracture and its Prevalence in the Grampian Region
Authors: LENNOX I. A. C. , MURALI S. R. , PORTER R.
Published: June 2005

200 consecutive geriatric patients over 60 years of age (100 men and 100 women) were examined for signs of Dupuytren’s contracture and questioned about certain risk factors thought to be associated with the disease. Each patient was examined, independently, by two orthopaedic surgeons. The diagnosis of Dupuytren’s contracture was established by the finding of a thickening in the palm fixed to the palmar fascia as a nodule or band. However each patient was also examined for skin tethering, flexion contractures of digits and knuckle pads. The results were then analysed and a Kappa test performed on the data to assess the inter-observer variability in eliciting the signs of Dupuytren’s contracture. Using the Kappa test agreement between the two observers was found to be, on average, 1.0 for observing flexion contractures, 0.8 for observing skin tethering, 0.7 for observing palmar nodules and 0.7 for observing knuckle pads. The two observers both made the diagnosis of Dupuytren’s contracture in 21% of women and 39% of men. These figures are high compared with previously published data from other centres and confirm the locally held belief that Dupuytren’s contracture is particularly prevalent in North-east Scotland.
Intra-Operative Tunnel Expansion to Prevent Tunnel Compression Following Latissimus Dorsi Muscle Transfers
Authors: MUTAF M. , USTUNER E. T. , SENSOZ O.
Published: June 2005

The intra-operative tunnel expansion technique is described to prevent tunnel compression following muscle transfers. The results of ten cases of latissimus dorsi transfer using this new technique are reported.
Repair of Digital Nerve Defect with Autogenous Vein Graft during Flexor Tendon Surgery in Zone 2
Authors: TANG J. B. , GU Y. Q. , SONG Y. S.
Published: June 2005

Autogenous vein graft was used to fill 18 digital nerve defects between 0.5 to 5.8 cm in length during flexor tendon surgery in zone 2. The vein was taken from the forearm and reversed to bridge the digital nerve. For nerves with defects over 2.0 cm, normal nerve slices were inserted inside vein conduits. Recovery of sensibility was evaluated by von Frey test, pin-prick detection, localization of stimulus, moving two-point discrimination and sweating on the finger pulp. Follow-up revealed excellent recovery in two digital nerves, good in nine, fair in five and poor in two. The results suggest that vein graft provides a simple and practical method to reconstruct a digital nerve defect during tendon repair in zone 2.
Intrinsic Reinnervation—Myth or Reality?
Authors: LESTER R. L. , SMITH P. J. , MOTT G. , McALLISTER R. M. R.
Published: June 2005

A clinical and electromyographic study of major nerve transections at the wrist in 22 patients has shown that electrical recovery nearly always occurs in the intrinsic muscles, despite the absence of clinically detectable function. There appears to be a level of electrical reinnervation above which clinically detectable intrinsic muscle power is usually present. This level would appear to be 50% of the contralateral maximum evoked muscle action potential; above this the “myth” of clinical recovery becomes a reality.
Bone Infection Resembling Phalangeal Microgeodic Syndrome in Children
Authors: HOWARD C. B. , ALKRINAWI S. , GADALIA A. , MOZES M.
Published: June 2005

Phalangeal microgeodic syndrome of childhood is a rare condition and is the result of necrosis and repair within the phalanges. The cause is unknown. We present a case in which Brucella melitensis was grown from one of the lesions.
Resection of Vascular Malformations
Authors: HILL R. A. , PHO R. W. H. , KUMAR V. P.
Published: June 2005

A retrospective study was undertaken of 15 cases of congenital vascular malformations of the upper limb with a mean follow-up of 5.6 years. Malformations were classified on the basis of tissue involvement into local and diffuse types and the outcome of a radical surgical approach was assessed. There were seven cases of recurrence (47%). Recurrence was more frequent in the diffuse type and when excision was considered incomplete.
A Post-Operative Regime after Digital Flexor Tenolysis
Authors: FOUCHER G. , LENOBLE E. , BEN YOUSSEF K. , SAMMUT D.
Published: June 2005

Tenolysis of the flexor tendons was performed in 78 fingers (72 patients) by the same surgeon. Two technical modifications were introduced: reconstruction of a robust pulley; and initial immobilization with the tendon in a proximally migrated position, permitting later breakdown of early adhesions by gentle extension either by the surgeon or using an extension spring. After a mean follow-up of 21.5 months, the total active movement was improved from 135° (pre-operative) to 203° (post-operative) in 84% of fingers and from 65° to 115° in 78% of thumbs. This corresponds to a reduction in impairment of 10.1% for the thumb and 21.6% for the fingers. There was no improvement in four digits and nine cases were made worse, averaging a loss of range of 25.4°. Among these were two cases of skin breakdown and two cases of tendon rupture (2.5%), one combined with skin necrosis.
An Unusual Variety of Scapho-Capitate Syndrome
Authors: MILLIEZ P. Y. , DALLASERRA M. , THOMINE J. M.
Published: June 2005

We report a patient who sustained a displaced fracture of the lunate in association with fractures of the scaphoid and capitate. Union of the scaphoid and capitate fractures followed fixation with Herbert screws, 25 additional cases from the literature have been reviewed.
An Analysis of the Results of Late Reconstruction of 132 Median Nerves
Authors: KALLIO P. K. , VASTAMÄKI M.
Published: June 2005

132 patients with injuries to the median nerve were assessed on average 10.4 years after repair. There were 106 males and 26 females, with a mean age of 28.4 years. Most of the nerve lesions were sharp (76) or blunt (47) injuries. Division was total in 87 cases, and most were at the wrist level. Secondary repair was performed in 34 cases and fascicular grafting in 98 cases. The average gap was 5.8 cm. A quantitative evaluation and grading according to the MRC classification was created to reflect sensory and motor recovery. Excellent or good results were obtained in only 49.2%. The age of the patient, the width of contusion, the pre-operative delay, the length of grafting and the level of the injury influenced the results significantly. The result of nerve repair was poor in patients aged over 54 years, when the level of the injury was more than 56 cm proximal to the finger tip, if the pre-operative delay was more than 24 months, or if the graft length was more than 70 mm.
Axonal Transport and Morphological Changes Following Nerve Compression
Authors: DAHLIN L. B. , ARCHER D. R. , McLEAN W. G.
Published: June 2005

Axonal transport and morphological changes were studied in the rabbit vagus nerve after the nerves had been subjected to compression at either 0, 50 or 200 mmHg for two hours. Slow axonally transported proteins, tubulin and actin, were radiolabelled with 35S-methionine two, seven or 14 days after the injury and the distribution of radiolabelled tubulin and actin within component b of slow transport was measured three days later by densitometric analysis of fluorographs of polyacrylamide gel. No significant differences were found in the distribution of tubulin two (50 and 200 mmHg) or seven (200 mmHg) days after injury, but at 14 days (200 mmHg) there was significantly increased radiolabelling of tubulin relative to actin in the nerve 60 to 70 mm from the nodose ganglion. Morphometric measurements of the nerve cell bodies two days after the compression injury at 200 mmHg revealed no significant changes. Previous work has shown that morphological changes, similar to those found after axotomy, were present in nerve cell bodies seven days after a compression injury. This, taken together with the present results, indicates that compression can induce both morphological and biochemical changes in the neurone. The altered axonal transport of tubulin associated with nerve injury follows a slower time course and does not precede the morphological changes. The findings may be of relevance when discussing the double crush syndrome.