bluuebunny/crossref_metadata_2025 huggingface dataset:
Phylogeny and systematics of the Trapeziidae Miers, 1886 (Crustacea: Brachyura), with the description of a new family
Authors: CASTRO PETER , NG PETER K.L. , AHYONG SHANE T.
Published: September 2016

A revision of the family Trapeziidae Miers, 1886, has shown that it consists of three clades, one of which is elevated to family status, Tetraliidae fam. nov., for the genera Tetralia Dana, 1851, and Tetraloides Galil, 1986. The genera Trapezia Latreille, 1828, Calocarcinus Calman, 1909, Hexagonalia Galil, 1986, Philippicarcinus Garth & Kim, 1983, Quadrella Dana, 1851, and Sphenomerides Rathbun, 1897, remain in the Trapeziidae; Domecia Eydoux & Souleyet, 1842, Jonesius Sankarankutty, 1962, Maldivia Borradaile, 1902, Palmyria Galil & Takeda, 1986, and the fossil genus Eomaldivia M ller & Collins, 1991, in Domeciidae Ortmann, 1893. Cladistic analysis shows that Trapeziidae sensu Miers, 1886, consists of three clades that show convergence as a result of similar habits as symbionts of reef corals and other cnidarians. A list of all recognised genera and species in the three families and their primary synonyms is provided. Keys are also included for four families of Brachyura symbiotic with reef corals, and for the genera and species of Domeciidae, Tetraliidae, and Trapeziidae. Some rare colour figures are reproduced. Three name changes have resulted within the Tetraliidae: Cancer glaberrimus Herbst, 1790, for Tetralia fulva Ser ne, 1984, and Cancer mutus Linnaeus, 1758, for Tetralia armata Dana, 1852, and Tetralia vanninii Galil & Clark, 1988. Nomenclatural problems associated with the repeated use of "forma typica" for various species of Trapezia and Tetralia are resolved. To stabilise the nomenclature of a number of well-known species, neotypes are designated for 13 species of Trapeziidae for which type material is not extant: Trapezia cymodoce (Herbst, 1801), and its three synonyms (Trapezia dentifrons Latreille, 1828, Trapezia dentata var. subintegra Dana, 1852, Trapezia cymodoce var. ornatus Chen, 1933); Trapezia bidentata (Forsk l, 1775), and one of its synonyms (Trapezia ferruginea Latreille, 1828); Trapezia digitalis Latreille, 1828, and one of its synonyms (Trapezia nigrofusca Stimpson, 1858); Trapezia septata Dana, 1852, and one of its synonyms (Trapezia reticulata Stimpson, 1858); Trapezia areolata Dana, 1852; Trapezia bella Dana, 1852; and Trapezia speciosa Dana, 1852. Neotypes are also designated for seven species of Tetraliidae: Tetralia glaberrima (Herbst, 1790), and three synonyms (Trapezia integra Latreille, 1828, Trapezia serratifrons Jacquinot, 1846, Tetralia laevissima Stimpson, 1858); Tetralia muta (Linnaeus, 1758), and one of its synonyms (Tetralia armata Dana, 1852); and Tetraloides nigrifrons (Dana, 1852).
The genus Trischizostoma (Crustacea: Amphipoda: Trischizostomidae) from the Southwest Atlantic, collected by the REVIZEE Program
Authors: FREIRE PABLO R. , SEREJO CRISTIANA S.
Published: September 2016

Based on material collected by the REVIZEE Program along the Brazilian coastline between latitudes 11 to 22 S, five species of Trischizostoma were recorded, four are known species and are herein redescribed: T. denticulatum Ledoyer, 1978, T. longirostrum Chevreux, 1919, T. raschi Boeck, 1861, T. richeri Lowry & Stoddart, 1994, and one species is new, Trischizostoma costai sp. nov. Despite the wide world distribution of the genus, this is the first record of Trischizostoma from the southwestern Atlantic.
Taxonomy of the monotypic genus Koehleria Cherbonnier, 1988 (Echinodermata: Holothuroidea: Cucumariidae)
Authors: THANDAR AHMED S. , SAMYN YVES
Published: September 2016

Voucher material recently collected from the 2-Mile Reef at Sodwana Bay (Republic of South Africa), allows the evaluation of the monotypic genus Koehleria Cherbonnier, 1988 and its species K. unica Cherbonnier, 1988 collected from Tul ar (Madagascar). Cherbonnier s (1988) conclusion, that Koehleria is most related to the also monotypic genus Pseudocolochirus Pearson, 1910 is correct, but the differences between Koehleria and Pseudocolochirus are too small to justify the retention of Koehleria. Koehleria is relegated herein to the synonymy of Pseudocolochirus. Such a step decreases the velocity with which monotypic genera are currently described within the Dendrochirotida.
The bee flies (Diptera: Bombyliidae) of Jordan
Authors: ARABYAT SAHAR , KATBEH-BADER AHMAD , GREATHEAD DAVID
Published: September 2016

Weekly field trips to collect bee flies were carried out from October 2001 to November 2002. More than 870 specimens from 72 localities were collected. Specimens of Bombyliidae collected previously from Jordan and preserved in the University of Jordan Insect Museum as well as in other Jordanian collections were studied. The specimens were found to belong to 131 species in 41 genera and eight subfamilies. Of these, 123 species are recorded for the first time. The number of specimens examined, localities, and dates in Jordan are provided for each species followed by remarks.
A taxonomic revision of the genus Paradynomene Sakai, 1963 (Crustacea: Decapoda: Brachyura: Dynomenidae)
Authors: MCLAY COLIN L. , NG PETER K.L.
Published: September 2016

The Indo West Pacific dynomenid genus Paradynomene Sakai, 1963, previously regarded as monotypic, is revised and six species are now recognized, viz. P. tuberculata Sakai, 1963, P. quasimodo n. sp., P. demon n. sp., P. diablo n. sp., P. teufel n. sp. and P. rotunda n. sp.. Most of the species are from deep to relatively deep waters with only one species (P. rotunda) known from shallow water. The species are distinguished by a combination of carapace features, notably carapace shape and height, form of the areolae, and position of major tubercles.
A new species of Nasusina Pearsall from Colorado (Lepidoptera: Geometridae: Eupitheciini)
Authors: FERRIS CLIFFORD D.
Published: September 2016

Nasusina vallis, new speices, is described from Mesa Co., Colorado and compared with its apparent closest relative Nasusina inferior Hulst. The adults and male and female genitalia of both species are illustrated, along with pertinent head and leg structures.
Ensemble Prediction with Different Spatial Resolutions for the 2014 Sochi Winter Olympic Games: The Effects of Calibration and Multimodel Approaches
Authors: Frogner Inger-Lise , Nipen Thomas , Singleton Andrew , Bremnes John Bjørnar , Vignes Ole
Published: September 2016

Three ensemble prediction systems (EPSs) with different grid spacings are compared and evaluated with respect to their ability to predict wintertime weather in complex terrain. The experiment period was two-and-a-half winter months in 2014, coinciding with the Forecast and Research in the Olympic Sochi Testbed (FROST) project, which took place during the Winter Olympic Games in Sochi, Russia. The global, synoptic-scale ensemble system used is the IFS ENS from the European Centre for Medium-Range Weather Forecasts (ECMWF), and its performance is compared with both the operational pan-European Grand Limited Area Ensemble Prediction System (GLAMEPS) at 11-km horizontal resolution and the experimental regional convection-permitting HIRLAM–ALADIN Regional Mesoscale Operational NWP in Europe (HARMONIE) EPS (HarmonEPS) at 2.5 km. Both GLAMEPS and HarmonEPS are multimodel systems, and it is seen that a large part of the skill in these systems comes from the multimodel approach, as long as all subensembles are performing reasonably. The number of members has less impact on the overall skill measurement. The relative importance of resolution and calibration is also assessed. Statistical calibration was applied and evaluated. In contrast to what is seen for the raw ensembles, the number of members, as well as the number of subensembles, is important for the calibrated ensembles. HarmonEPS shows greater potential than GLAMEPS for predicting wintertime weather, and also has an advantage after calibration.
Tackling absenteeism in Chicago
Authors: Allensworth Elaine , Evans Shayne
Published: September 2016

Incisive research from the University of Chicago Urban Education Institute on the prevalence and consequences of absenteeism in Chicago schools has highlighted the dramatic effects of even moderate amounts of absences on grades, graduation rates, and student success in college. These insights spurred not only an ambitious 98% attendance goal on the university’s four charter school campuses but also a deeper collaboration between researchers and practitioners. Data-driven integration of research and practice is informing both the schools’ strategies and the researchers’ studies — and the early result is a steady uptick in student attendance.
Leadership
Authors: Starr Joshua P.
Published: September 2016

System leaders must be very clear about who makes different kinds of decisions in a school district, ensuring that the process of decision making is transparent and has integrity, and not being afraid to stand by the final decisions regardless of the consequences to oneself.
Washington View
Authors: Ferguson Maria
Published: September 2016

Education may not have played a big role in the 2016 presidential campaign, but that doesn’t mean that children aren’t being schooled in the political process. They are listening and learning from all of the adult antics. Ultimately, this year’s experiences will play a role in their decisions about what to say, how to say it, and how to participate in this country’s political future.
Double Perspective
Authors: Ginsberg Gina , Weiner Ann
Published: September 2016

We have a six year old gifted little boy who wants to know everything about dinosaurs. He taught himself to read in kindergarten and has by now exhausted the information about dinosaurs in our local library. He still wants more and more books about them. His first grade teacher has not been much help. She says that he does his work well enough, but that he is capable of doing much better. She also thinks he should be more sociable becadse he has no friends. How can we help our son satisfy his thirst for knowledge about dinosaurs?
Preparing Gifted Leaders for a Futuristic Society
Authors: Stacy Mona , Mitchell Bruce
Published: September 2016

Other generations believed that they had the luxury of preparing their children to live in a society similar to their own. Ours is the first generation to have achieved the Socratic wisdom of knowing that we do not know the world in which our children will live.

John I. Goodlad
Annotated Bibliography of Simulations and Games in Health Education
Authors: Sleet David A. , Stadsklev Ron
Published: September 2016

This annotated bibliography describes 66 simulation games in health education under the headings: diseases; drug use and abuse; ecology; family planning and human sexuality; health care planning; mental health; nursing; nutrition; physical fitness; and safety. Those reviewed are a selection of the more useful games from among a large number available Few health education games are suitable for classroom use and few include social modeling through simulation, Games in drug education and mental health areas may contain distorted, out-of-date, or false information. Promising areas for development include: aging, venereal disease, sexuality, consumer health, health careers, safety education, and health planning.
Design of Process Evaluation within the Child and Adolescent Trial for Cardiovascular Health (CATCH)
Authors: McGraw Sarah A. , Stone Elaine J. , Osganian Stavroula K. , Elder John P. , Perry Cheryl L. , Johnson Carolyn C. , Parcel Guy S. , Webber Larry S. , Luepker Russell V.
Published: September 2016

Process evaluation complements outcome evaluation by providing data to describe how a program was implemented, how well the activities delivered fit the original design, to whom services were delivered, the extent to which the target population was reached, and factors external to the program that may compete with the program effects. The process evaluation system used in the Child and Adolescent Trial for Cardiovascular Health (CATCH) is presented in this paper. The conceptual model underlying the CATCH process evaluation system is described, and process measures and data collection protocols are reviewed. Functions of process evaluation data in the trial include: (1) describing the implementation of the program, (2) quality control and monitoring, and (3) explaining program effects. The importance of incorporating process evaluation into final outcome analyses and assessments of program impact is emphasized.
Evaluation of Postoperative Radiocapitellar Joint Alignment in Congenital Radioulnar Synostosis Patients
Authors: Kuniyoshi Kazuki , Akasaka Tomoyo , Suzuki Takane , Matsuura Yusuke , Abe Rei , Ueno Keisuke , Kiuchi Hitoshi , Kanaduka Aya , Hirosawa Naoya , Iwase Maki , Yamazaki Atsuro
Published: September 2016

Hypothesis: No study has evaluated radiocapitellar joint alignment or proximal radioulnar joint alignment postoperatively in congenital radioulnar synostosis patients. The aim of this study was to clarify the postoperative clinical results and radiocapitellar joint alignment. Methods: Eight forearms in 7 patients (6 males and 1 female with a mean age of 8.8 years) with congenital radioulnar synostosis, who underwent surgery with a minimum of a year and a mean of 2.1 years of follow-up, were evaluated. The surgery consisted of division of the synostosis and interposition with a pedicled vascularized adipofascial flap between the radius and the ulna. A corrective radial osteotomy was performed in 3 patients at the radial neck, which had a great angular deformity, and in 1 patient at the mid-diaphysis, which had a great bowing deformity. Radiocapitellar joint alignment was evaluated in a lateral view radiograph and classified into 3 types as anterior, intermediate, or posterior, defined by whether the radial neck and head axis were above, within, or below the capitellum. This alignment was evaluated preoperatively and at final follow-up. The active range of prono-supination was also evaluated as a clinical outcome. There was no patient who had recurrence of bony union at the divided synostosis. Results: Preoperatively, there were 5 forearms of the anterior type, 1 intermediate type, and 2 of the posterior type. At final follow-up, there were 2 forearms of the anterior type and 6 of the posterior type. Four forearms were changed into a posterior type. At the final follow-up, the active range was 37.5 ± 8° in pronation and 20 ± 10° in supination in the anterior type, and was 41 ± 23° in pronation and 26 ± l8° in supination in the posterior type. There was no significant difference in pronation or supination between types. It was more difficult to improve supination than pronation in each type. Summary points: In this case series, it was difficult to reconstruct the proper radiocapitellar alignment. To better improve the range, especially of supination, reconstruction of the radiocapitellar joint or the proximal radioulnar joint with a more accurate corrective radial osteotomy or sigmoid notch plasty should be considered.
Modified Bilhaut-Cloquet Procedure for Hypoplasia of the Duplicated Thumbs
Authors: Weiyang Gao , Jian Ding , Anyuan Wang
Published: September 2016

Objective: To develop the Bilhaut-Cloquet procedure according to the complication and take the review to analyze the results postoperation. Methods: Develop a modified Bilhaut-Cloquet procedure in hypoplasia of the duplicated thumbs as follows: A new nail reconstruct technique includes side incision and comprehensively considers the nail plate, nail lunula, and nail fold reconstruction, a bone reconstruction of intact joint function. From January 2010 to April 2014, 39 thumbs of 36 cases acquired more than 1-year follow-up. All cases were hypoplastic and had nail width less than 80% of that on the nonaffected side or less than 130% of that on the index. Results: According to the Tada scoring system, results were excellent in 30 thumbs, good in 8 thumbs, poor in 1 thumb. According to Wang-Gao scoring system, nail appearance was excellent in 32 thumbs, good in 7 thumbs. Conclusions: The nail deformity is inevitable according to our technique, but the sore of nail appearance and the function is satisfying. The modified Bilhaut-Cloquet should be recommended as the first-line therapy in hypoplasia of duplicated thumbs.
Thumb Duplication With Atypical Flexor Tendon Insertion
Authors: Hülsemann Wiebke , Winkler Frank , Mann Max
Published: September 2016

Background: Frequently we find atypical tendon insertions when we correct duplicated thumbs. Tendon realignment is mandatory to gain upright position. The insertion of the flexor tendon can be centralized by transposing it ulnarly. But tendon sheath cannot be centralized perfectly. Recurrence of radial tilt at the interphalangeal (IP)-joint level in growth is possible. We want to investigate whether the upright position persists and how often a recurrence can be expected. Patient and Method: We retrospectively analyzed our patients operated from 2000 to 2010 with a minimum follow-up of 3 years postoperation. They are analyzed for sex, age at operation, type of duplication, position, and active and passive range of motion of the IP-joint. Results: Over a period of 11 years, we had operated 28 children with a double thumb showing an atypical flexor tendon insertion which was corrected by tendon transposition: 24 patients came to a follow-up, 3 to 12 years postoperation (mean, 5.2 years). Mostly ( n = 16) they suffered by a Wassel IV duplication. Ten patients received a perfect result (straight thumb without deviation), 5 children a light deviation of 10°, and 8 patients developed a clear visible radial deviation of 20° or functional disturbing 30° flexion position of the IP-joint. The malposition developed mainly 5 years postoperation. Four patients of these underwent IP-arthrodesis for secondary correction and 2 are scheduled for this. The IP-joint was always stable and had mostly no, and in some cases up to 40° active mobility. Conclusion: As far as our experience goes, the transposition of the flexor tendon insertion is initially a technique which works for straightening up the IP-joint of a doubled thumb. The impediment in growth occurred mostly around 5 years after the transposition and can be corrected by a straightening IP-arthrodesis.
The Correlation of Fracture Patterns of Distal Radius Fractures and Triangular Fibrocartilage Complex Injures
Authors: Xing Shu Guo , Xie Ren Guo , Tang Jin Bo
Published: September 2016

Purpose: The aim of the study was to determine the correlation of patterns of distal radius fractures with the triangular fibrocartilage complex (TFCC) injures. Methods: Sixty adult patients (mean age, 43 years) with distal radius fractures were included. The patients were analyzed according to the fracture character at the time of injury and classified with an Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification system. Wrist arthroscopy was performed for all cases to identify and classify TFCC injuries according to Palmer’s classification system. Results: TFCC lesion of varying severity was present in 39 fractures. Statistical analysis yielded a correlation with any patterns of the distal radius fractures with the associated TFCC injuries. The comminution or dorsal angulation of the distal radius, ulnar styloid fracture, and AO classification system have no correlation with associated TFCC injuries. Conclusions: The patterns of a distal radius fracture do not predict a TFCC injury. TFCC injury should be considered with all distal radial fractures.
Fragment-Specific Fixation Versus Volar Locking Plates in Primarily Nonreducible or Secondarily Redisplaced Distal Radius Fractures
Authors: Abramo Antonio , Landgren Marcus , Geijer Mats , Kopylov Philippe , Tägil Magnus
Published: September 2016

Purpose: To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Methods: Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures, were randomized to open reduction and internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disability of the Arm, Shoulder and Hand [QuickDASH]), pain (Visual Analog Scale [VAS]), health-related quality of life (Short Form 12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. Results: At 12 months, no difference was found in grip strength, which was 87% of the uninjured side in the volar plate group and 89% in the fragment-specific fixation group. No differences were found in the range of motion, and the median QuickDASH score was 5 in both groups. In the perioperative radiographs, 2° of volar angulation was achieved in the volar plate group versus 5° dorsal angulation in the fragment-specific group, but the difference disappeared thereafter. The overall complication rate was 21% in the volar locking plate group, compared with 52% in the fragment-specific group. Conclusions: In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group.
Do Ligamentous Tears Heal After Anatomically Reduced Distal Radius Fracture?
Authors: Fok Margaret Woon Man , Fang Christian Xinshuo , Lau Tak Wing , Fung Boris Kwok Keung , Leung Frankie Ka Li
Published: September 2016

Objectives: Distal radius fracture was associated with a high incidence of ligamentous injury, including triangular fibrocartilage complex (TFCC) tear, scapholunate ligament (SL) tear, and lunotriquetral (LT) tear. This study aims to evaluate the status of these ligaments after the healing of distal radius fractures with plate fixation. Materials and Methods: Patients who were elected for the removal of plate after the healing of their distal radius were recruited for the study from August 2014 to January 2016. Concomitant wrist arthroscopy was performed to assess the status of the TFCC, SL, and LT. Results: In total, 34 patients with an average age of 53 years with healed distal radius fractures were recruited for the study. Twelve patients had extra-articular distal radius fractures; 15 patients had preoperative symptoms, including ulnar wrist pain; and 24 were noted to have distal radial ulnar joint (DRUJ) instability on examinations. The findings of wrist arthroscopies revealed 25 complete TFCC tears and 9 incomplete tears, showing signs of healing. Four patients had combined TFCC tears. All patients with symptoms and signs had TFCC tears, while the 9 patients with intact TFCC tear had neither symptoms nor signs. Sixty-seven percent of the patients had TFCC tears arisen from the sigmoid notch, and 29% had fovea tears. There was no correlation between ulnar wrist pain and the location of the TFCC tears, and there was no correlation between TFCC tear and the presence of ulnar styloid fractures. There were 26 SL tears and 15 LT tears. One patient with LT tear suffered from volar intercalated segment instability (VISI). None of the patients with SL and LT tears suffered from clinical signs and symptoms. No significant correlation was found between the SL and LT tears and the TFCC tears. Conclusion: A high incidence of TFCC, SL, and LT tears was noted after the union of anatomically reduced distal radius fractures. While TFCC tears may give rise to clinical signs and symptoms in terms of DRUJ instability, patients with SL and LT tears are relatively asymptomatic.
Wrist Hemiarthroplasty for Distal Radius Fractures
Authors: Roux Jean-Luc
Published: September 2016

Objective: Since 2005, we use a replacement and resurfacing prosthesis for complex intra-articular fractures of the distal radius. The prosthesis is composed of a radial stem and an epiphyseal-metaphyseal block articulating both with the carpal condyle and the ulnar head. This prosthesis is used in elderly and osteoporotic patients when reconstruction of the distal radius is too difficult, particularly when comminution and central impaction are associated. Materials and Methods: Since March 2005, 23 prosthesis were implanted on 23 patients (22 women and 1 man), the mean age was 77 years, from 38 to 102. Twenty-two cases concerned elderly and osteoporotic patients: 17 times for complex intra-articular fractures and 5 times for malunions. In one case, the procedure concerned a young man with a pathologic fracture (giant cell tumor). The patients were reviewed at 3 weeks, 6 weeks, 3 months, 1 year, and then each year. Results: Twenty patients came to follow up regularly. A patient operated in 2005 died in 2010; she retained a good result at the wrist. Two patients are lost at follow-up. The mean follow-up is 56 months, from 3 to 128 months. Seventeen patients are satisfied or very satisfied, and 3 patients are moderately satisfied. Twelve patients had no pain (Visual Analog Scale [VAS] = 0), and 8 patients complain of pain during strength activities or barometric pain. The Disability of the Arm, Shoulder and Hand (DASH) score is 26. The mean mobilities are as follows: extension 62°, flexion 37°, ulnar deviation 26°, radial deviation 21°, pronation 72°, and supination 68°. The mean strength was 79% of the contralateral strength. The implants are perfectly stable on the x-rays with a mean follow-up of 56 months. In 16 cases, we found periprosthetic ossifications. Wrist hemiarthroplasty for distal radius fractures is a simple solution for very complex problem. This concept allows the treatment of the most complex distal radius fractures with metaphyseal instability and intra-articular comminution. The clinical results are good, better, and quicker than those obtained with complex reconstruction surgery. Mobility is greater than that obtained with palliative surgery: radiolunate or radioscapholunate arthrodesis. The extension of the wrist allows these old patients to push up on their hands. Conclusions: The treatment of complex intra-articular distal radius fractures by an hemiarthroplasty of the wrist is a solution we can now use in elderly and osteoporotic patients. This solution must be known for distal radius tumors.
Results of Surgical Treatment of Distal Humerus (AO/OTA Type C) Fractures Using Double Anatomical Plates
Authors: Ikeguchi Ryosuke , Ohta Souichi , Ito Hiromu , Furu Moritoshi , Matsuda Shuichi
Published: September 2016

Objective: Distal humerus fractures are complex injuries that are particularly challenging to treat. For predictable outcomes and early joint mobilization, they should be surgically treated using double anatomical locking plates. However, several complications have been reported, such as stiffness, decreased range of motion, nerve dysfunction, posttraumatic degenerative changes, and wound and skin infections. The purpose of this study was to report the outcomes and complications after open reduction and internal fixation of intra-articular distal humerus fractures using double anatomical locking plates. Materials and Methods: Between April 2010 and May 2013, we treated 11 patients with intra-articular distal humerus fracture (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association [AO/OTA] type C). Four patients were male and 7 were female. The average age was 47.0 (range, 22-80). The pretreatment AO/OTA type was C1 in 2 patients, C2 in 6, and C3 in 3. All fractures were treated with open reduction and internal fixation using double anatomical locking plates. Intraoperative ulnar nerve anterior transposition was performed for 10 patients. Postoperative immobilization was 1 week followed by active range of motion. Results: All patients obtained bone union. Regarding range of motion, mean elbow flexion arc was 106.5° (mean extension was −11.5° and mean flexion was 118°). The Mayo Elbow Performance Score was excellent in 4 patients, good in 6, and fair in 1. Radiographic evaluation was performed immediately and 6 months after surgery. There was no significant reduction loss between these time periods. Postoperative complications in the 10 cases included 7 with ulnar nerve neuropathy (3 with motor weakness and 4 with sensory disturbance), 2 with refixation of the olecranon, and 1 with infection. All patients with motor weakness improved and 5 patients had persistent numbness. Conclusions: No significant reduction loss was seen between the postoperative radiological evaluation performed immediately after surgery and that performed 6 months after surgery. For treating distal humeral intra-articular fractures, double anatomical locking plates can provide good stability for early active mobilization. However, this surgical method includes some complications, especially ulnar nerve dysfunction. Because gentle management of the ulnar nerve is necessary, hand surgeons should perform this surgery.
How to Avoid Damaging the Terminal Branches of the Medial Antebrachial Cutaneous Nerve and the Medial Brachial Cutaneous Nerve During Operations Involving the Medial Elbow?
Authors: Chen Jing , Tan Jun , Zhu Bin , Tang Jin Bo
Published: September 2016

Objective: Medial elbow incision is obligatory for cubital tunnel syndrome surgical treatment. However, the terminal branches of both the medial antebrachial cutaneous nerve (MACN) and the medial brachial cutaneous nerve (MBCN) are likely to be harmed using the current incision technique. The aim of this study was to seek a new incision to avoid damaging the branches of MACN and MBCN during the operation for cubital tunnel syndrome. Methods: Ten fresh frozen cadaver upper extremities and 20 clinical cases (elbows) were analyzed. A conventional incision and a new incision were used in the cadaveric specimens and the clinical cases, respectively. The medial epicondyle was set as the reference landmark to quantify the location of the terminal branches, with the elbow at full extension. The numbers of the terminal branches and their locations were noted for MACN and MBCN, and the locations of the posterior branch of the MACN were recorded in the elbow medial incision. Results: The average numbers of MACN’s posterior terminal branches were 2.6 ± 1.6 and 4.4 ± 2.4 in the cadaveric specimens and clinical cases, respectively. The average number of MBCN’s terminal branches was 2 ± 0.87 in the cadaveric specimens. The MACN’s posterior terminal branches were located at 19 and 45 mm, respectively, measuring from the medial epicondyle. And the posterior branch of MACN was always located in between the medial epicondyle and the basilic vein, and the average distance was 10 ± 6 mm to the medial epicondyle. We could preserve all the MBCN’s terminal branches in the new incision. The MACN’s posterior terminal branches could be perfectly exposed by the use of the antegrade dissection technique, finding the MACN’s posterior branch in advance. Conclusions: The new elbow medial incision technique could reduce the risk of injuring the terminal branches from the MBCN. The medial epicondyle and the basilic vein are reliable anatomical landmarks to identify the posterior branch of the MACN. An antegrade method of dissection can effectively identify and avoid the injury to the terminal branches of the MACN in the elbow medial incision.
Correlation of Albumin/Globulin Ratio With Forearm Bone Mineral Density in Women Above 50 Years of Age
Authors: Furukawa Kayoko , Zenke Yukichi , Menuki Kunitaka , Yamanaka Yoshiaki , Sakai Akinori
Published: September 2016

Objective: We aimed to determine whether blood test values correlate with bone mineral density by body part. Participants and Methods: We included data on 78 forearms of 78 women, aged 50 or older, treated for distal radius fracture at our hospital from October 2007 to October 2012. All underwent DXA (dual-energy x-ray absorptiometry) scan of the second to fourth lumbar vertebrae, femoral neck, and forearm bone (divided into 3 parts: ultra-distal [UD], mid-distal [MD], and proximal shaft [shaft]). The following blood test values were determined: ALB (albumin), A/G (albumin/globulin) ratio, AST (aspartame aminotransferase), ALT (alanin aminotransferase), LDH (lactate dehydrogenase), ALP (alkaline phosphatase), GTP (gamma-glutamyl transferase), Ca (calcium), P (phosphorus), BUN (blood urea nitrogen), Crea (creatinine), eGFR (estimated glomerular filtration rate), WBC (white blood cell), Hb (hemoglobin), Hct (hematocrit), and PT-INR (international normalized ratio of prothrombin time). Statistical Analysis: Using Pearson product-moment correlation coefficients, we analyzed the DXA scan results (lumbar vertebrae, femur, and 3 forearm parts) for correlations with age, height, weight, body mass index (BMI), and blood test values. Results: ALB, A/G ratio, LDH, Hb, and PT-INR correlated positively with bone mineral densities of the forearm (UD, MD, and shaft) and femur (neck), but not with those of the lumbar vertebrae. TP (total protein), AST, ALT, γGTP (γ-Glutamyltranspeptidase), P, BUN, Crea, eGFR, WBC, Hb, and Hct did not correlate with any bone mineral density values. Discussion: The A/G ratio had a stronger correlation with the bone mineral density of the proximal shaft (0.39), which has a high percentage of cortical bone than with those of MD (0.38) and UD (0.26). The A/G ratio also correlated with femoral neck bone mineral density (0.23), but not with those of the lumbar vertebrae. Our results thus suggest a correlation between cortical bone amount and albumin metabolism. Conclusions: Our statistical analyses identified correlations between blood test values and bone mineral density by body part in middle-aged and elderly females with distal radius fracture. Serum albumin and the A/G ratio correlated positively with forearm and femoral neck bone mineral densities, but not with lumbar vertebrae bone mineral densities. From the resultant value, albumin 3.3g/dL or A/G ratio 0.96 is equivalent to −2.5 SD in DXA. Serum albumin and AJG ratio can be a surrogate marker for screening osteoporosis.
Involvement of the Lesser Sigmoid Notch in Elbow Fracture Dislocations
Authors: Kachooei Amir R. , Mellema Jos , Tarabochia Matthew , Chen Neal , Ring David
Published: September 2016

Purpose: To address the primary null hypothesis that there is no difference in the articular surface area of the lesser sigmoid notch involved among Mayo classes. Second, we analyzed the fracture line location and the pattern of lesser sigmoid notch articular surface involvement among Mayo classes. Methods: Using quantitative 3-dimentional computed tomography, we reconstructed and analyzed fractures involving the lesser sigmoid notch articular surface in 52 patients. Furthermore, we assessed the surface area involved in the fracture, the number of fracture fragments, and the location and direction of the fracture lines. Coronoid fractures were classified according to Mayo types. Results: There was no significant difference between Mayo types 1 and 2 in any characteristic of the involvement of the lesser sigmoid notch articular surface, whereas Mayo type 3 was significantly different from both Mayo types 1 and 2 in the area involved in the fracture (42% in Mayo type III vs 9% in Mayo types I and II), the number of articular fragments (>3 fragments in type III vs 2 fragments in types I and II), and the direction of fracture line (both horizontal and vertical lines in type III vs only horizontal line in types I and II). Conclusion: Mayo type III results in a more complex fracture, which might need to be addressed directly or indirectly during open reduction internal fixation of the olecranon fracture dislocations because changes in the geometry of lesser sigmoid notch may affect the radioulnar joint if it remains incongruent.
A 10-Year Prospective Outcome Study of Pi2 Pyrocarbon Arthroplasty for the Treatment of Thumb Metacarpal Joint Osteoarthritis
Authors: Agout Charles , Bellemère Philippe , Ardouin Ludovic
Published: September 2016

Introduction: The surgical management of rhizarthrosis may use many techniques. The implant interposition pyrocarbon Pi2 is one possible solution after total trapeziectomy. The aim of this study was to evaluate the clinical and radiological results of this implant with a minimum of 10 years follow-up. Material and Methods: Forty-two consecutive cases (34 women for 5 men; mean age, 63 years; 76% retired) of total trapeziectomies with free interposition implants in pyrocarbon, Pi2, placed between March 2003 and April 2005 for stage 3 or 4 osteoarthritis in the classification described by Dell. Clinical judgment criteria included satisfaction, pain (visual analogue scale [VAS]), mobility with opposition Kapandji index, strength (grip and pinch), and the QuickDASH functional score. The radiological analysis was performed on anterior-posterior (AP) and lateral Kapandji views. Results: With a mean follow-up of 125.49 months (10.5 years), 96.6% of patients were very satisfied or satisfied. The mobility was improved especially on the opposition (Kapandji = 9.60) with no major aggravation of the metacarpophalangeal extension of the thumb. The strength of the pinch after surgery was 5.9 kg and that of the grip was 24.2 kg. The mean time to resuming daily activities was 76 days (range, 30-240 days). The mean QuickDASH score was 19.9, and the overall Patient-Rated Wrist Evaluation (PRWE) score at the last follow-up was 16.4 out of 100. Bone remodeling, mainly in the scaphoid, was found in 48.2% of cases, stable between 5 and 10 years and with no clinical and functional significance. Two implant dislocations (4.6%) were suffered in our series but did not require surgical revision. The implant survival rate was 100%. Discussion: Subjective and objective clinical outcomes of Pi2 are good, thanks in part to the conservation of the height of the column of the thumb, protective factor against hyperextension of the metacarpophalangeal joint. The payback period is short, and dislocations in our series are related to the learning curve of the implant stabilization technique that must be rigorous. The evolution of radiological remodeling remains something to watch over the very long term. Conclusion: The results of more than 10 years of free interposition implant Pi2 confirm that it is a valid solution for the treatment of advanced rhizarthrosis subject to a very precise surgical technique.
Extending Vascularized Composite Tissue Survival Using Near-Normothermic Ex Situ Perfusion
Authors: Wemer Nicole , Alghanem Fares , Rakestraw Stephanie L , Rojas-Pena Alvaro , Ozer Kagan
Published: September 2016

Objective/Hypothesis: Currently, vascularized composite allografts (VCAs) are cold preserved (4°C) until transplantation. This process is time limited, as the tissue has to be revascularized within 4 to 6 hours to minimize ischemia reperfusion (IR) injury. Normothermic perfusion was proposed as an alternative method of preservation in solid organ transplantation. This method helps to avoid complications associated with cold preservation and maintains tissue viability without inducing IR injury. Using this method, previous investigators demonstrated its potential to prolong swine forelimb allograft survival up to 24 hours. In this study, we aimed to test this system on human forearm allografts. Material and Methods: Five human forearms were procured from brain-dead adult donors under tourniquet control. Following elbow disarticulation, the brachial artery was cannulated. The limb was flushed with heparinized saline and connected to a temperature-controlled (30°C-33°C) ex situ perfusion system for 24 hours. The perfusate consisted of plasma and red blood cells with a target hemoglobin (Hb) concentration of 4 to 6 g/dL. Muscle biopsies (flexor carpi radialis) were obtained at 0, 12, and 24 hours. Results: Average warm ischemia time was 76 minutes. Average arterial systolic pressure was 93 ± 2 mm Hg, perfusion flow 310 ± 20 mL/min (~6%-8% of the donor’s estimated cardiac output), and vascular resistance 153 ± 16 mm Hg/mL/min. Perfusate had an average pH of 7.43 ± 0.04, pCO2 32 ± 1 mm Hg, pO2 317 ± 18 mm Hg, and Hb 4.8 ± 0.4 g/dL. Electrolytes (sodium, potassium, chloride) remained within a physiologic range. Lactate started to increase steadily throughout the experiment; however, neuromuscular electrical stimulation revealed ongoing contraction throughout the experiment. Hematoxylin-eosin staining showed mild fatty infiltration on some myocytes at 24 hours. There was minimal change in fiber size, likely due to variation in age and gender between donors. Muscle architecture was preserved at the end of 24 hours perfusion. Conclusions: All limbs remained viable after 24 hours of near-normothermic ex situ perfusion as evidenced by ongoing neuromuscular stimulation. While no assumptions can be drawn about the long-term function of the extremity, this approach could help extend VCA transplantation to a wider geographic area. It also has the potential to circumvent complications associated with cold preservation.
Mechanical Properties and Clinical Results of Novel Bioabsorbable Plates for the Treatment of the Hand Fractures
Authors: Sakai Akinori , Zenke Yukichi , Menuki Kunitaka , Hirasawa Hideyuki , Yamanaka Yoshiaki , Tajima Takafumi , Furukawa Kayoko , Hamada Daishi
Published: September 2016

Objective: The use of bioabsorbable implants that would negate the need for subsequent removal could offer major clinical advantages for the fixation of fractures. However, previous bioabsorbable plates have had several issues with regard to clinical usage. The aims of this study were to compare the mechanical properties of novel bioabsorbable plates with those of titanium plates in a fracture model and to demonstrate the clinical results of these new plates for hand fractures. Materials and Methods: The first set of experiments compared the mechanical properties of bioabsorbable and titanium plates. Two types of bioabsorbable plates made of hydroxyapatite/poly-L-lactide (1/3- and 1/2-circle in cross-section) and two types of titanium plates (for 1.5- and 2.0-mm screws) were tested. Each plate was fixed on a polyether ether ketone (PEEK) rod, which was transversely cut at its midsection. The second part of the studies demonstrated the clinical results of bioabsorbable plates used in 62 cases of 70 hand fractures including 39 metacarpal, 20 distal ulna, 5 distal radius, and 6 radial head fractures since July 2008. The mean age of the patients was 48.4 years (range, 13-89). The follow-up period ranged from 3 month to 4 years 9 months. Results: The bending strength and stiffness of 1/3-circle bioabsorbable plate constructs were comparable with those of titanium plates for 1.5-mm screws, and those of 1/2-circle bioabsorbable plates were comparable with those of titanium plates for 2.0-mm screws. The torsional strength of 1/2-circle bioabsorbable plates (mean ± standard deviation: 79.0 ± 7.9 N⋅cm) was significantly greater than that of titanium plates for 2.0-mm screws (56.7 ± 4.0 N⋅cm; P < .05). The nonunion rate was 2.9% (2 cases in radial head fractures/70 cases). About 4.3% (3/70 cases) was necessary for implant removal because of loose screws in 2 cases of metacarpal fractures and limited range of motion in 1 case of radial head fracture. For the consecutive cases with metacarpal fractures, there were no significant differences in 6-month postoperative clinical results between patients receiving bioabsorbable plates after July 2008 and titanium plates before July 2008 (267.0 ± 6.0 vs 250.0 ± 28.3 degrees of total range of active motion, and 92.7 ± 19.7 vs 86.4 ± 28.6% of contralateral grip strength). Conclusions: The bending strength, stiffness, and torsional strength of novel 1/3- or 1/2-circle bioabsorbable plates, when fixed on a PEEK rod, were comparable with those for titanium plates for 1.5- or 2.0-mm screws. The clinical study of bioabsorbable plates used in hand fractures revealed satisfactory results for union rate, range of motion, and grip strength. For metacarpal fractures, there were no significant differences in clinical results between bioabsorbable and titanium plates.
International Hand Trauma Registry
Authors: Nizar Bafiq , Lloyd-Hughes Hawys , Jandali Zaher , Foster Mark , Power Dominic
Published: September 2016

Background: The exponential development of the Internet and mobile phone technology has led clinicians to interact with a more informed patient population with higher expectations. Health care providers on the other hand are under duress to deliver quality care within their financial constraints. Trauma registries are an integral component of a comprehensive trauma care system. They are used for research, education, performance improvement, and patient and public involvement (PPI). Hand trauma registries with patient and therapy outcomes are virtually nonexistent. There is a critical need for a bespoke system that addresses the current issues, multilingual, and resilient to future developments. Materials and Methods: We have collaborated with several key stake holders in the field of hand trauma and designed a Hand Trauma Registry that can be easily customizable and used across various parts of the world. We have chosen PostgreSQL, which is the world’s most advanced open source database for our design. The chosen platform for the front-end framework is Bootstrap, which has a fluid grid layout that dynamically achieves responsiveness. The registry incorporates all popular patient-related outcome measures (PROMs) with a provision to add multiple customizable PROMs. Results: The registry is a collective database of traumatic injury event as well as their outcome measures. This allows us to compare against multiple data sets: different clinicians, institutions, patient population, and national and international standards. Conclusion: To address the demands of the 21st-century patients, we have designed and developed a bespoke system that is both redundant and resilient. This is an invaluable tool for improving outcomes for patients and the international health care community as a whole.
Metacarpal and Proximal Phalangeal Fracture
Authors: Freitas Afrânio , Yánez Marco , Otto Rafael , Pardini Arlindo
Published: September 2016

Purpose: The purpose of this study was to present a new technique for fixation of metacarpal and proximal phalangeal fractures. This hybrid dynamic minifix, as called for us, consists of a combination of intramedullary fixation and external fixation, stable but not a rigid fixation that permits early motion. Methods: We present a retrospective study of 33 with extra-articular metacarpal (14) and proximal extra-articular phalangeal (19) fractures with a minimum of 3 months of follow-up, range from 3 to 8 months. The patients were clinically and radiologically evaluated using range of motion, time to healing, time to get back to work, complication, and patient’s satisfaction. Results: All fractures got healed with the average time to union being 4 weeks. No differences were statistically significant to any aspect evaluated; all patients were satisfied and all of them got back to work in an average time frame of 2 months. Conclusion: This technique provides stable fixation, associated with a low complication rate; at the same time, it avoids the disadvantages of the open fixation and permits early motion. It showed to be safe and effective when used for treatment of extra-articular metacarpal and proximal phalangeal fractures.