bluuebunny/crossref_metadata_2025 huggingface dataset:
The Constitutional Type Questionnaire: validation in the patient population of the Royal London Homoeopathic Hospital
Authors: van Haselen RA , Cinar S , Fisher P , Davidson J
Published: September 2002

In homeopathy the choice of a medicine is based on the total ‘picture’ presented by the patient. This picture includes ‘constitutional type’ which comprises personality, and general physical features. The Constitutional Type Questionnaire (CTQ) is designed to systematically assess constitutional types. This study examines the reliability and validity of the CTQ. Four hundred and seventy-two outpatients attending clinics at the Royal London Homoeopathic Hospital completed the CTQ, a 152-item scale rating features traditionally considered typical of 19 constitutional homeopathic medicine ‘pictures’ on 5-point frequency or severity scales. A subsample was retested after 1 week to measure the test–retest reliability. Another subsample was prescribed a medicine by a homeopathic doctor. Prescriptions were compared with the CTQ, to assess the content validity of the scale. The construct validity was measured by Grade of Membership (GOM) analysis. The scale demonstrated good test–retest reliability (r=0.73), internal consistency (r=0.95). The correlation between CTQ results and the medicine prescribed by the homeopathic doctor was 75.8%. The GOM analyses are reported by Davidson et al elsewhere in this issue of the journal. Although the CTQ could be improved, the scale displays good reliability and validity.
Algodystrophy and its Association with Dupuytren’s Disease
Authors: LIVINGSTONE J. A. , FIELD J.
Published: September 2002

Seventy-two patients were examined 9 weeks after sustaining a Colles’ fracture of the wrist for evidence of algodystrophy. They were examined 18 months later for evidence of Dupuytren’s disease to determine the incidence of the association between the two conditions. Forty-one per cent of all patients had evidence of Dupuytren’s disease at 18 months following Colles’ fracture. Sixty-seven per cent of patients with algodystrophy had evidence of Dupuytren’s disease compared with 19% of patients who showed no features of algodystrophy.
An Aid to Digit Replantation: A New Use for the Harris Silicone Tile
Authors: ESTELA C. , SAMMUT D.
Published: September 2002

We have used the Harris silicone tile to provide secure anchorage of amputated digits during dissection and preparation for replantation. Sound anchorage is obtained and the identification and dissection of structures is facilitated.
Onychomatricoma
Authors: VAN HOLDER C. , DUMONTIER C. , ABIMELEC P.
Published: September 2002

We report a case of onychomatricoma, which is a rare benign tumour originating in the germinal matrix of the nail. The diagnosis can be made on the typical clinical findings and confirmed by histology. Complete excision is the treatment of choice.
Biceps-to-Triceps Transfer in Tetraplegia
Authors: REVOL M. , BRIAND E. , SERVANT J. M.
Published: September 2002

Eight tetraplegic patients (13 elbows) were treated by biceps-to-triceps transfer. To avoid the risk of radial nerve injury, we chose a medial routing of the biceps. The mean follow-up after surgery was 17.8 months (range, 4–47 months). No complications were encountered. Active extension of the elbow was achieved in each case. The mean postoperative active range of motion of the elbow was 6° extension and 137° flexion. After the biceps-to-triceps transfer mean extension torque of the elbow was 3.7 Nm and mean flexion torque was 10 Nm. In eight elbows in which it was measured, there was a 47% reduction in elbow flexion power. Nevertheless no patient complained about that reduction, and all of them were satisfied.
In Vivo MR Studies of Dynamic Changes in the Interosseous Membrane of the Forearm During Rotation
Authors: NAKAMURA T. , YABE Y. , HORIUCHI Y.
Published: September 2002

In vivo dynamic changes in the interosseous membrane (IOM) during forearm rotation were studied using magnetic resonance imaging (MRI). The right forearms of 20 healthy volunteers were examined in five different rotational positions. Axial slices were obtained at the proximal quarter, the middle and the distal quarter of the forearm. The changes in shape of the IOM during rotation were observed in an axial MR plane. For each image, we measured the interosseous distance and the length of the interosseous membrane. Images of the tendinous and membranous parts of the IOM could be differentiated by thickness. There were minimal dynamic changes in the tendinous part on the MRI while the membranous part showed numerous changes during rotation. The interosseous distance and the length of the interosseous membrane were maximum from a neutral to a slightly supinated position. The tendinous part is considered to be taut during rotation to provide stability between the radius and the ulna, but the membranous part which is soft, thin and elastic, allows smooth rotation.
A Reliable Technique for Radiographic Imaging of the Pisotriquetral Joint
Authors: GARDNER-THORPE D. , GIDDINS G. E. B.
Published: September 2002

We report a novel technique for radiographic imaging of the pisotriquetral joint. This technique has proved useful for five consecutive patients presenting with pisotriquetral osteoarthritis. It is consistently reliable in imaging the joint and reduces the number of unsuccessful radiographic attempts.
One Thousand Intercarpal Arthrodeses
Authors: WATSON H. K. , WEINZWEIG J. , GUIDERA P. M. , ZEPPIERI J. , ASHMEAD D.
Published: September 2002

Limited wrist arthrodesis is a useful method for treating specific carpal disorders that maximizes residual wrist motion and strength while eliminating pain. Selective fusion of specific carpal units can be used in degenerative arthritis, rotary subluxation of the scaphoid, midcarpal instability, scaphoid nonunion, Kienböck’s disease, and congenital synchondrosis or partial fusion of specific carpal joints. This report presents our experience with more than 1000 limited wrist arthrodeses, and provides a review of the indications and technical considerations for specific intercarpal fusions, and subsequent results. To date this is the largest series of intercarpal arthrodeses and the study has demonstrated that these techniques are reliable and effective in dealing with a wide range of wrist disorders.
Triquetral Impingement Ligament Tear (Tilt)
Authors: WATSON H. K. , WEINZWEIG J.
Published: September 2002

Ulnar wrist pain is a complex problem whose cause often remains elusive. A diagnostic triad of localized triquetral pain, history of a wrist hyperflexion injury, and normal radiographs, accompanied by ulnar wrist swelling and limited wrist motion, is often attributable to a syndrome we have termed triquetral impingement ligament tear (TILT). The mechanism of injury causes a cuff of fibrous tissue to be displaced distally from the ulnar sling mechanism, resulting in chronic impingement on the triquetrum that causes hyperaemia, loss of articular cartilage, and softening of the bone. Surgical repair consists of simply excising the impinging fibrous cuff. The outcome of 44 patients treated for TILT over a 6-year period is reviewed. In all cases, TILT repair resulted in improved wrist motion and strength. Ninety-five percent of patients reported a significant improvement in pain both at rest and with activity.
Nonoperative Treatment of Fixed Flexion Deformity of the Proximal Interphalangeal Joint
Authors: HUNTER E. , LAVERTY J. , POLLOCK R. , BIRCH R.
Published: September 2002

Sixty-one stiff, stable proximal interphalangeal joints were treated by exercise and splinting. The average range of movement was 24° to 67° before treatment; this increased to 8° to 98° after treatment. The indications and technique are described.
Pseudarthrosis of the Middle Metacarpal Following Intramedullary Fixation of a Wrist Arthrodesis
Authors: FERGUSON P. C. , BOGOCH E. R.
Published: September 2002

We describe the case of a 36-year-old woman who presented with an unusual seronegative monoarthropathy of the right wrist and who was treated with fusion by the method of Clayton (1965) . The patient probably sustained a metacarpal fracture during intramedullary Steinmann pin insertion, and subsequently developed a pseudarthrosis.
The Simmen Classification of Wrist Destruction in Rheumatoid Arthritis
Authors: ZANGGER P. , KACHURA J. R. , BOGOCH E. R.
Published: September 2002

In this radiological study, bilateral radiographs of the wrist in 48 patients with early rheumatoid arthritis (RA) were graded by the Simmen classification, at different times, to determine its potential use in early disease. Interobserver agreement was good. The Simmen classification of wrist destruction in RA could be applied to the radiographs of approximately 50% of patients with early disease. It has some consistency over time.
Paediatric Hand Injuries Caused by Spiked Railings
Authors: RASHEED T. , HILL C. , KHAN K. , BRENNEN M.
Published: September 2002

We report five cases of hand injuries caused by spiked palisade railings. One patient sustained an open fracture of the distal phalanx with a disruption of the nail bed, and two patients had digital nerve injuries. Two patients presented with the railing still impaled in the fingers, one of whom had an ischaemic digit at presentation. All patients were male, between 9 and 12 years of age, and presented in the course of 1 month. Railings of this type would appear to be a significant cause of hand injuries, which may be prevented by legislation or a change in railing design.
Self-Mutilation in Children with Obstetric Brachial Plexus Palsy
Authors: AL-QATTAN M. M.
Published: September 2002

In a prospective study, the incidence and clinical presentation of self-mutilation was documented in 127 consecutive cases of obstetric brachial plexus injury. Six out of the 127 cases (4.7%) had clinical evidence of self-mutilation. The incidence of self-mutilation was much higher among children with total palsy (4/37) than Erb’s palsy (2/90). All affected children were able to bring the mutilated hand or forearm to the mouth without assistance from the contralateral normal limb. Mutilation in patients with total palsy was generally severe and usually involved biting the tips of the digits. However, mutilation in patients with upper (Erb’s) palsy was mild in degree and tended to involve the dorsum of the hand. Similarity between human self-mutilation and animal autotomy following denervation are discussed along with the different theories explaining the mechanism of this abnormal behaviour.
Periosteal Chondroma of the Distal Radius
Authors: SINHA S. , SINGHANIA G. K. , CAMPBELL A. C.
Published: September 2002

We report a case of periosteal chondroma in an unusual location at the distal end of the radius.
A Comparison of Dominant and Non-Dominant Hand Strengths
Authors: ARMSTRONG C. A. , OLDHAM J. A.
Published: September 2002

This study compares dominant and non-dominant hand strength in both right- and left-handed participants. Maximum voluntary contraction (MVC) of the first dorsal interosseous (FDI) muscle, power grip strength and pulp-to-pulp pinch strength were assessed under carefully controlled conditions. No significant differences were observed between dominant and non-dominant hands in left-handed participants for all tests. Small but significant differences (0.1–3%) were observed between dominant and non-dominant hands in right-handed participants for all three tests. These differences were much smaller than those reported in other studies. Furthermore, considerable variability was observed in the relative strengths of the two hands for each participant. We conclude that clinicians must be cautious when using the ‘10% rule’ to make comparisons between injured and uninjured hands.
Hypothenar Hammer Syndrome
Authors: DE MONACO D. , FRITSCHE E. , RIGONI G. , SCHLUNKE S. , VON WARTBURG U.
Published: September 2002

The hypothenar hammer syndrome is an uncommon lesion of the ulnar artery caused by repetitive trauma to the ulnar portion of the hand. It characteristically occurs in the dominant hand of middle-aged craftsmen, but also in athletes practising various types of sports. We present a retrospective study of nine patients between 1988 and 1999. The follow-up ranged from 1 to 10 years. We recommend surgical treatment, by resection of the involved arterial segment and revascularization either by direct anastomosis or by means of a venous interpositional graft.
Neurothekeoma of the Hand
Authors: BHASKAR A. R. , KANVINDE R.
Published: September 2002

Neurothekeomas are rare, benign connective tissue tumours probably of Schwann cell origin. We report an unusual case of a neurothekeoma involving the hand. Histological examination revealed characteristic myxoid nodules with spindle shaped cells. The immunocytochemical reaction for S-100 protein and neuron-specific enolase was positive. Complete excision proved curative as the tumour was well encapsulated.
The Influence of Delay and the Effect of Fibrin Sealant on the Cut Surface of the Peripheral Nerve
Authors: JOU I-M. , CHEN W-C. , SHEN C-L. , MATSUDA H.
Published: September 2002

Thirty-two sciatic nerves in 16 rats were divided to investigate the effect of delay in fixation and the use of fibrin sealant at the site of the division on the nerve end. Specimens were assessed by morphological and morphometric criteria using scanning electron microscopy and longitudinal sections. All specimens showed a protruded nerve end. Wrapping the nerve with fibrin sealant before division and immediate fixation of the specimen resulted in less protrusion.
Is Dupuytren’s Disease Caused by an Imbalance between Proliferation and Cell Death?
Authors: JEMEC B. , GROBBELAAR A. O. , WILSON G. D. , SMITH P. J. , SANDERS R. , McGROUTHER D. A.
Published: September 2002

Dupuytren’s contracture shares certain properties with malignant tumours, characterized by proliferation and lack of apoptosis, which may be induced by the c- myc oncogene. Because of these similarities, the relationship between the c- myc oncogene expression, bcl-2 oncogene (antiapoptotic gene) and proliferation was investigated in Dupuytren’s disease. Proliferation was assessed by immunohistochemical staining of the mib-1 antibody. Results were compared with those from fibrosarcoma specimens, representing a related malignant tumour. Non-diseased fascia from Dupuytren patients and flexor retinaculum from patients undergoing carpal tunnel release without Dupuytren’s disease were used as controls. Expression of c- myc was elevated in primary Dupuytren’s disease and fibrosarcoma specimens, whilst recurrent Dupuytren’s disease, non-diseased Dupuytren fascia and flexor retinaculum exhibited significantly lower levels. Neither bcl-2 nor mib-1 were detected in Dupuytren’s disease, non-diseased fascia or flexor retinaculum, in contrast to fibrosarcoma. The imbalance between proliferation and apoptosis, producing malignant growth was thus confirmed for fibrosarcoma, but not for Dupuytren’s disease.
Italian Multicentre Study of Carpal Tunnel Syndrome
Authors: PADUA L. , PADUA R. , APRILE I. , TONALI P.
Published: September 2002

The Italian Carpal Tunnel Syndrome Study Group has carried out a multicentre study on 1123 hands with idiopathic carpal tunnel syndrome. We have compared the findings on clinical examination, the neurophysiological data and a patient-oriented assessment in men and women. The patient-oriented assessment showed that men complain of less discomfort than women; clinical examination was similar in the two populations and neurophysiological investigations showed greater changes in men.
The Radio-Radial External Fixator in the Treatment of Fractures of the Distal Radius
Authors: FISCHER T. , KOCH P. , SAAGER C. , KOHUT G. N.
Published: September 2002

The technique of radio-radial monobloc-fixation with the small AO external fixator device has been applied to 17 consecutive Colles’ fractures. The fracture types were mainly A3 and C2, according to the AO classification. We found this technique to be easy and quick in application and stable in fixation. Direct, precise and atraumatic reduction can be achieved by using the distal pins as joy-sticks. Furthermore, disimpaction of the fracture to regain length is possible without bone grafting. Normal carpal mobility and load transfer is preserved during fracture healing and the injured hand can be used in daily life with certain restrictions. To prevent pin-track infections, early mobilization of the wrist should be avoided. We recommend this technique in the treatment of comminuted AO-type A3 fractures of the distal radius and in certain type C2 cases.
Internal Fixation of Scaphoid Fractures With an Ao Mini-Fragment Lag Screw, Using Temporary Interoperative Ao Mini External Fixation
Authors: CHRISTODOULOU L. , CHAMBERLAIN S. T.
Published: September 2002

We present the results of our technique for bone grafting and internal fixation of scaphoid fractures using 2.0 mm or 1.5 mm AO mini fragment screws and temporary intraoperative AO mini external fixation. Union was achieved in 14 out of 16 fractures.
Clinical Results of Contralateral C7 Root Neurotization to the Median Nerve in Brachial Plexus Injuries with Total Root Avulsions
Authors: WAIKAKUL S. , ORAPIN S. , VANADURONGWAN V.
Published: September 2002

This prospective study was carried out to assess motor and sensory recovery after contralateral C7 root to median nerve neurotization in brachial plexus injuries with total root avulsions. The survey was carried out from 1993 to 1995 and the patients were followed up for at least 3 years. There were 96 male patients with ages ranging from 13 to 48 years. All had a unilateral brachial plexus injury with avulsion of all roots. This was confirmed by clinical assessment and exploration. The anterior part of the contralateral C7 root was used for neurotization via a reversed pedicular ulnar nerve graft and the proximal end of the graft was connected to the median nerve. Furthermore, phrenic nerve to suprascapular nerve and spinal accessory nerve (via a sural nerve graft) to musculocutaneous nerve neurotizations were also carried out to obtain shoulder abduction and elbow flexion. At the 3 year follow-up, most patients had encouraging recovery of sensory function in the hand but motor function of the forearm and hand muscles was rather poor. Acceptable motor function was found in only 50 to 60% of the patients who were younger than 18 years.
The Role of Mepitel Silicone Net Dressings in the Management of Fingertip Injuries in Children
Authors: O’DONOVAN D. A. , MEHDI S. Y. , EADIE P. A.
Published: September 2002

Forty-five children with isolated fingertip injuries were randomized for treatment with either Mepitel silicone net dressings or paraffin gauze dressings. Over a 4 week period, the objective adherence of the dressing, and the perceived level of stress caused to the child by the dressing change were scored by linear analogue scales. The wounds were also assessed for the progress of healing and presence of infection. Twenty children received Mepitel dressings and 25 had paraffin gauze dressings. There was no difference in duration of healing or complication rates between the two groups. Statistically lower scores were seen for the Mepitel group for the first 3 weeks in both adherence and stress scores. These results suggest that silicone net dressings may be a less adherent and less painful method of dressing fingertip injuries in children.
Nerve Transfer to the Median Nerve Using Parts of the Ulnar and Radial Nerves in the Rabbit – Effects on Motor Recovery of the Median Nerve and Donor Nerve Morbidity
Authors: LUTZ B. S. , CHUANG D. C. C. , CHUANG S. S. , HSU J. C. , MA S. F. , WEI F. C.
Published: September 2002

In this study, motor re-innervation of the median nerve by transfer of one-third, one-half, and two-thirds of either the agonistic ulnar nerve or the antagonistic radial nerve was investigated in both extremities of 20 rabbits.

Recipient median nerve: Muscle contraction force of the flexor digitorum sublimus muscle after a one-third and a one-half of the ulnar nerve transfer achieved an average of 75 and 97% muscle power respectively as compared to conventional end-to-end neurorrhaphy. Muscle contraction force after one-third or one-half of the radial nerve transfer was significantly lower (36%).

Donor nerves: Extensor carpi radialis muscle or flexor carpi ulnaris muscle contraction force 6 months postoperatively demonstrated a significant decrease after a one-half ulnar nerve and a two-thirds ulnar or radial nerve transfer, but not after a one-third transfer of either radial or ulnar nerves.

Histologically, the number of axons in the re-innervated median nerve and both donor nerves distal to the coaptation site seemed to follow variable patterns.

It was concluded that in the rabbit use of one-third of the agonistic ulnar nerve for re-innervation of the median nerve results in useful motor recovery with negligible donor site morbidity. Clinically, this technique may offer an alternative option for proximal nerve injuries or for free functioning muscle transplantations.
The Donor Foot in Free Toe or Joint Transfers
Authors: YANG X. B. , GU Y. D.
Published: September 2002

Eighty-four cases of free second toe, multiple toe or second metatarsophalangeal joint transfers were studied by case review and follow-up. The function of the donor foot had recovered completely within 6 months in 89% of patients. The wounds on the donor foot healed in 2–3 weeks in 90% of patients. Slight numbness on the dorsal aspect of the donor foot, intolerance to cold, mild reduction in push-off, scar tenderness and pain or swelling occurred in only a few patients and generally were not considered of significance. Multiple toe transfers created more donor problems in terms of healing and appearance. Some foot deformities with plantar callosities were observed at long term review. However, all patients were capable of work and normal activities.
Rhys-Davies Exsanguinator: Pressure Characteristics and Technique for Improving Performance
Authors: HARRIS P. C. , ATKINSON D. , EVANS R. A.
Published: September 2002

This paper reports the results of an investigation into the pressure exerted by the Rhys-Davies exsanguinator on the palm and dorsum of the hand. We hypothesised that, due to the shape of the hand, the palm is shielded from the full effect of the exsanguinator, but our study showed that it is compressed as well as the dorsum. However, placing a bag of fluid in the patient’s palm significantly increased the pressure applied to the palm.
Digital Arterial Occlusion in Scleroderma: Is There a Role for Digital Arterial Reconstruction?
Authors: TOMAINO M. M.
Published: September 2002

A 47-year-old patient with Raynaud’s phenomenon secondary to scleroderma developed long finger ischaemic pain. This was successfully treated with a palmar sympathectomy and a long finger digital artery reconstruction using a reversed small calibre vein graft between a perforator from the deep palmar arch and the radial digital artery at the level of the distal interphalangeal joint.
T Incision for Exposure of the Distal Radius and Wrist
Authors: DAO K. D. , SHIN A. Y. , BERGER R. A.
Published: September 2002

A retrospective review of 66 T-shaped incisions for exposure of the dorsal distal radius and wrist was performed. The incision provided excellent exposure in all cases and no additional incisions were required. Cosmesis was considered acceptable by all patients. Complications occurred in 6% and were more likely in patients undergoing fixation of acute distal radius fractures using Kirschner wires which protruded through the skin flaps.
Schwannomas of the Upper Extremity
Authors: KANG H. J. , SHIN S. J. , KANG E. S.
Published: September 2002

This study presented the clinical characteristics, MRI features and postoperative results of 20 schwannomas in the arms of 13 patients. Twelve tumours had a positive Tinel’s sign, one caused weakness of the wrist and another in Guyon’s canal caused hypothenar muscle atrophy. Of the nine cases which underwent magnetic resonance imaging preoperatively, six were correctly diagnosed as schwannomas. All masses were excised using microsurgical techniques and two transient neurological complications occurred.
Trapeziometacarpal Instability Treated with Modified Brunelli Ligamentoplasty
Authors: BOTELHEIRO J. C.
Published: September 2002

Seventeen cases of instability of the trapeziometacarpal joint were treated surgically using either the original Brunelli technique or one of two modifications. Six patients achieved very good, nine achieved good and two achieved poor results. The results of the three surgical techniques were similar and we recommend the use of the palmaris longus tendon for the ligament reconstruction, as it is the easiest to perform.
Wrist Position Affects Loading of the Dorsal Scaphoid: Possible Effect on Extrinsic Scaphoid Blood Flow
Authors: BUTTERMANN G. R. , PUTNAM M. D. , SHINE J. D.
Published: September 2002

Cadaver studies using radial artery injection techniques were used to study the vascular supply along the dorsal ridge of the scaphoid. These revealed an intraarticular membrane between the wrist capsule and the dorsal ridge of the scaphoid through which arteriolar vessels (25–100 μm internal diameter) passed. Biomechanical tests revealed that the extensor carpi radialis brevis may apply significant pressure to the dorsal ridge of the scaphoid when the wrist is flexed. The highest pressures occurred with the wrist flexed at 60° or 90° and in slight (15°) ulnar deviation. The authors suggest that these vascular and biomechanical factors may contribute to the aetiology for idiopathic osteonecrosis of the scaphoid.
A Biomechanical Analysis of Intrascaphoid Compression Using the 3.00 mm Synthes Cannulated Screw and Threaded Washer: an in vitro Cadaveric Study
Authors: LO I. K. Y. , KING G. J. W. , PATTERSON S. D. , JOHNSON J. A. , CHESS D. G.
Published: September 2002

This study evaluated the compressive capabilities of the 3.0mm Synthes cannulated screw and threaded washer. A transverse osteotomy was performed at the waist of eight cadaveric scaphoids and a custom-designed load cell was inserted before internal fixion with a 3.0mm cannulated screw and threaded washer. The mean intrascaphoid compression achieved was 108 (SD, 60) N. This compressive force is comparable to that produced by standard cortical screws.
A Simple Technique for Testing the Viability of Cross-Finger Pedicle Flaps
Authors: STEENLAGE E. , BLAZAR P. , WEGNER D. , PECTOL R.
Published: September 2002

A simple test to determine the viability of cross-finger pedicle flaps is described. This test can be performed in the office or operating theatre to help determine the optimal timing for division of the flap pedicle.
Mallet Deformity in Sport
Authors: SIMPSON D. , McQUEEN M. M. , KUMAR P.
Published: September 2002

During a four month period 851 patients presented to the Edinburgh Orthopaedic Trauma Unit with an acute sporting injury. Eighteen (2%) patients had either a soft tissue or bony mallet deformity. Six different sports were identified with rugby accounting for eight of the 18 mallet deformities. All patients were treated with splintage. Fourteen patients returned questionnaires regarding subjective digit function following treatment and nine patients claimed excellent function. The average splinting time for this group was 6 weeks and sports were avoided for an average of 5 weeks.

Mallet deformity accounts for a minority of sporting injuries, but excellent functional outcome can be achieved with splintage and avoidance of the causative sport while splinted.
Streptococcus Milleri Infection
Authors: LUNN J. V. , RAHMAN K. J. , MACEY A. C.
Published: September 2002

We report three cases of flexor sheath infection due to Streptococcus milleri in two patients. Soft tissue damage was extensive despite surgical debridement and appropriate antibiotic therapy. One patient had two digits amputated and the other had the affected digit amputated at the level of the proximal interphalangeal joint.

These cases illustrate the potential pathogenicity of a bacterium which is often regarded as a commensal.
Ganglia: The Patient’s Perception
Authors: WESTBROOK A. P. , STEPHEN A. B. , ONI J. , DAVIS T. R. C.
Published: September 2002

This study investigates the concerns of 50 patients with ganglia and their reasons for primary care consultation and referral to a hand unit. Although a minority of patients sought advice and treatment because of pain, more (38%) were concerned about the cosmetic appearance and a significant number (28%) were concerned that their ganglion was a malignant growth. The general practitioners referred 70% of patients to the hand clinic for “excision of the ganglion” and 30% for further “advice and treatment”. However, 74% of patients were satisfied with aspiration of the ganglion and general advice.
Comparison of Mechanical Properties of Polyvinylidene Fluoride and Polypropylene Monofilament Sutures Used for Flexor Tendon Repair
Authors: WADA A. , KUBOTA H. , HATANAKA H. , MIURA H. , IWAMOTO Y.
Published: September 2002

We performed an experimental study to evaluate the mechanical properties of polyvinylidene fluoride sutures and to compare their use with that of standard polypropylene sutures for the circumferential, epitendinous suture of a flexor tendon repair. Polyvinylidene fluoride sutures had a smaller suture diameter, a greater knot pull strength and less delayed extension when under creep testing, than polypropylene sutures. Tendons repaired using polyvinylidene fluoride sutures had significantly greater gap and breaking strengths than those repaired using polypropylene sutures.
The Ulnar Nerve at the Elbow and its Local Branching: An Anatomic Study
Authors: GONZALEZ M. H. , LOTFI P. , BENDRE A. , MANDELBROYT Y. , LIESKA N.
Published: September 2002

Thirty nine cadaver elbows were dissected and the branching of the ulnar nerve, as well as the cubital tunnel and adjacent potential sites of nerve compression were studied. An arcade of Struthers was present in 26 specimens and Osborne’s ligament was present in all specimens. A discrete flexor pronator aponeurosis overlying the ulnar nerve was present in 17 specimens. An average of one (range, 0–3) capsular nerve branches were noted. These originated an average 7 mm proximal (range, 45 mm proximal to 24 mm distal) to the medial epicondyle. An average of three (range, 1–6) motor branches to the flexor carpi ulnaris muscle were noted, and one of these originated proximal to the medial epicondyle in two specimens. Significant variation was noted in the capsular and motor branching of the ulnar nerve. Care must be taken to identify the motor branches of the ulnar nerve when performing a transposition.
Early Breaking Strength of Repaired Flexor Tendon Treated with 5-Fluorouracil
Authors: CEROVAC S. , AFOKE A. , AKALI A. , McGROUTHER D. A.
Published: September 2002

This study investigated the effect of a single intraoperative application of 5-fluorouracil, which may diminish peritendinous adhesion formation, on the tensile strength of repaired digital flexor tendons after 7, 14 and 21 days of healing. Twenty-seven deep flexor tendons from 14 rabbits were exposed to 5-fluorouracil (50 mg/ml) for 5 minutes immediately after repair whereas matched control tendons were exposed to normal saline. Tensile testing at 7, 14 and 21 days revealed no significant differences in the gap or ultimate strengths of the 5-fluorouracil treated and control tendons.
Vascular Blood Supply of the Dorsal Side of the Thumb, First Web and Index Finger: Anatomical Study
Authors: PISTRE V. , PELISSIER P. , MARTIN D. , BAUDET J.
Published: September 2002

Twenty-nine hands were dissected in order to define the dorsal blood supply of the thumb, the first web and the index finger. The main objective was to determine if it is possible to create a local osteocutaneous flap to cover partial and complex tissue defects in the distal part of the thumb. We found that the thumb metacarpal could be used as a donor site in these situations, with either a radiodorsal pedicle or an ulnadorsal pedicle.
Absorbable Versus Non-Absorbable Suture in Carpal Tunnel Decompression
Authors: EREL E. , PLEASANCE P. I. , AHMED O. , HART N. B.
Published: September 2002

This randomised prospective clinical study compared the use of an absorbable suture (subcuticular 4 : 0 polyglactin 910) and a non-absorbable suture (5 : 0 monofilament polypropylene) for elective carpal tunnel decompression wound closure. An increased perception of pain was reported by the patients in the polypropylene (Prolene®) group. At the 6-week assessment, there was a higher level of residual wound inflammation in the polyglactin 910 (Vicryl®) group.
Percutaneous Release of Trigger Digits
Authors: BLUMBERG N. , ARBEL R. , DEKEL S.
Published: September 2002

Twenty nine patients with 31 trigger digits were treated by percutaneous release under local anaesthesia using an 18 gauge needle. One patient was lost to follow up, and the remainder were examined at a mean follow-up of 14 months. One patient (one thumb) experienced recurrent symptoms, and required an open release. The remaining 27 patients with 29 trigger digits had complete relief of their symptoms.
Carpal Impaction with the Ulnar Styloid Process: Treatment with Partial Styloid Resection
Authors: TOMAINO M. M. , GAINER M. , TOWERS J. D.
Published: September 2002

Carpal impaction with the ulnar styloid process (stylocarpal impaction) occurs less frequently than with the ulnar head (ulnocarpal impaction), and more commonly develops in wrists with negative ulnar variance. Physical examination, radiographic evaluation, and wrist arthroscopy are all helpful in excluding alternative causes of ulnar wrist pain. When an ulnocarpal stress test elicits pain, and radiographs suggest that this is due to carpal impaction with the ulnar styloid, partial resection of the styloid process provides successful treatment, so long as the insertion of the triangular fibrocartilage at the base of the styloid is not disrupted.
An in Vitro Comparison of Human Flexor and Extensor Tendon Cells
Authors: EVANS C. E. , TRAIL I. A.
Published: September 2002

This study examined the in vitro phenotype of cells cultured from both flexor and extensor tendons. Matrix proteins secreted by tendon cells were examined, together with their response to mechanical strain, using cells from the two types of tendon. Immunocytochemical staining using specific antibodies to matrix proteins demonstrated that flexor tendon cells synthesised only three of the five proteins stained for, whilst extensor tendon cells synthesised all five. Gel electrophoresis (used to separate mixtures of proteins) demonstrated that protein secretion was similar for both cell types. Both cell types showed similar patterns of synthesis for total collagen and total protein over time. No difference was found in the response to cyclical strain of cells from the two types of tendon; both cell proliferation and collagen synthesis were stimulated. The study demonstrated that cells obtained from two different types of tendon behave similarly when exposed to identical environmental conditions in vitro.
Wrist Arthrodesis with the AO Titanium Wrist Fusion Plate: A Consecutive Series of 42 Cases
Authors: HOUSHIAN S. , SCHRØDER H. A.
Published: September 2002

In a 4 year period (1996–1999), 42 total wrist fusions in 25 men and 17 women were performed using the AO/ASIF Titanium wrist fusion plate. The median age of the patients at the time of surgery was 41 (range, 19–72) years. The indication for fusion was post-traumatic arthritis in 29 wrists, Kienböck’s disease in eight, rheumatoid arthritis in three, mono-arthritis in one and Volkmann’s contracture in one. All patients were reviewed at a median follow-up of 23 (range, 6–50) months. The Buck–Gramcko and Lohmann score for functional evaluation was excellent in 35, good in 5 and satisfactory in 2 patients. We conclude that wrist arthrodesis with the AO/ASIF Titanium wrist fusion plate is an excellent option for treatment of various painful disorders of the wrist.
Dorsal-Enhanced Sutures Improve Tension Resistance of Tendon Repair
Authors: CAO Y. , XIE R. G. , TANG J. B.
Published: September 2002

Thirty-six fresh pig flexor tendons were repaired using either the modified Kessler method or the Tang method. Nine tendons from each group were tested in an Instron tensile testing machine with the tendons passing 90° around a pulley. The other nine tendons from each group were pulled linearly by the testing machine. The 2mm gap formation force of the tendons repaired with the modified Kessler and Tang methods and pulled at 90° were 64%±5% and 79%±9% respectively of those forces recorded during linear testing. The ultimate strengths of tendons repaired by the modified Kessler and Tang methods and pulled at 90° were 76%±6% and 81%±8% respectively of the forces measured during linear testing. The percentage gap formation and ultimate strength of the Tang method was significantly higher than that of the modified Kessler suture when the tendons were pulled around a pulley. This demonstrates that the Tang suture, with its main components in the dorsal part of the repaired tendon, has greater tension resistance capacity than conventional tendon sutures which are placed in the middle of the tendon. This study suggests that dorsally-enhanced multiple tendon sutures are better placed to sustain the tension generated during active finger flexion.
Management of Acute Fractures and Nonunions of the Proximal Pole of the Scaphoid
Authors: KRIMMER H.
Published: September 2002

It is my belief that all acute proximal pole fractures should be treated by open reduction and internal fixation, via a dorsal approach. There is no longer any place for conservative treatment of these fractures, because a lengthy period of plaster immobilization is required and there is an unacceptably high risk of nonunion with conservative management. Unfortunately, nonunion of the proximal pole remains a common and disabling problem which demands careful evaluation and treatment. Internal fixation combined with limited cancellous bone grafting produces very satisfactory results in terms of pain relief and function, and clinical results are as good as those reported for more complex procedures involving vascularized grafts and prolonged cast immobilization. While the place for vascularized grafting has yet to be clearly defined, at present it is a technique which should be reserved for cases with long-standing ischaemia or failed previous surgery.
Thumb Function without the Abductor Pollicis Longus and Extensor Pollicis Brevis
Authors: BRITTO J. A. , ELLIOT D.
Published: September 2002

Two patients are reported in which one thumb has lost the abductor pollicis longus and extensor pollicis brevis tendons. This is an uncommon injury in isolation, and these cases provide an opportunity to assess the functional importance of these musculotendinous units.
A Prospective, Controlled, Randomized Trial Comparing Early Active Extension with Passive Extension Using a Dynamic Splint in the Rehabilitation of Repaired Extensor Tendons
Authors: CHESTER D. L. , BEALE S. , BEVERIDGE L. , NANCARROW J. D. , TITLEY O. G.
Published: September 2002

This prospective, randomized, controlled trial compared two methods of rehabilitating extensor tendon repairs in zones IV–VIII. Group A patients followed an early active mobilization regimen and Group B patients followed a dynamic splintage regimen. Data on 19 patients in Group A and 17 patients in Group B were collected at 4 weeks and at final follow-up (3 months median follow-up for both groups). Extension lag, flexion deficit and total active motion (TAM) were measured. At 4 weeks, patients in Group B had a better TAM (median 87%, range 56–102%) compared to patients in Group A (median 77%, range 52–97%). At final follow-up, there were no significant differences in the results of the two groups. There were no ruptures in either group.
Cross Sections for Electron Collisions With Carbon Dioxide
Authors: Itikawa Yukikazu
Published: September 2002

Cross section data have been compiled for electron collisions with carbon dioxide (CO2) molecules, based on 75 references. Collision processes considered are: total scattering, elastic scattering, momentum transfer, excitations of vibrational and electronic states, ionization, electron attachment, and emission of radiation. Molecular properties of CO2 are summarized as far as they are helpful in understanding those collisional processes. With an evaluation of the compiled data, recommended values of the cross section are presented in a tabular form. The literature was surveyed through early 2001, but more recent data available to the author are also considered.
Langmuir probe diagnostic studies of pulsed hydrogen plasmas in planar microwave reactors
Authors: Rousseau A. , Teboul E. , Lang N. , Hannemann M. , Röpcke J.
Published: September 2002

Langmuir probe techniques have been used to study time and spatially resolved electron densities and electron temperatures in pulse-modulated hydrogen discharges in two different planar microwave reactors (fmicrowave=2.45 GHz, tpulse= 1 ms). The reactors are (i) a standing-wave radiative slotted waveguide reactor and (ii) a modified traveling-wave radiative slotted waveguide reactor, which generate relatively large plasmas over areas from about 350 to 500 cm2. The plasma properties of these reactor types are of particular interest as they have been used for basic research and for plasma processing; for example, for surface treatment and layer deposition. In the present study the pressures and microwave powers in the reactors were varied between 33 and 55 Pa and 600 and 3600 W, respectively. In regions with high electromagnetic fields, shielded Langmuir probes were used to avoid disturbances of the probe characteristic. Close to the microwave windows of the reactors both the electron density and the electron temperature showed strong inhomogeneities. In the standing-wave reactor the inhomogeneity was found to be spatially modulated by the position of the slots. The maximum value of the electron temperature was about 10 eV, and the electron density varied between 0.2 and 14×1011 cm−3. The steady-state electron temperature in a discharge pulse was reached within a few tens of microseconds, whereas the electron density needed some hundreds of microseconds to reach a steady state. Depending on the reactor the electron density reached a maximum between 80 and 200 μs after the beginning of the pulse.
A physical model for the hysteresis phenomenon of the ultrathin ZrO2 film
Authors: Wang J. C. , Chiao S. H. , Lee C. L. , Lei T. F. , Lin Y. M. , Wang M. F. , Chen S. C. , Yu C. H. , Liang M. S.
Published: September 2002

This work studies and presents an inner-interface trapping physical model for the ultra-thin (effective oxide thickness=15 Å) zirconium oxide (ZrO2) film to explain its hysteresis phenomenon. The shift of the capacitance–voltage characteristics swept from accumulation to inversion and then swept back with light illumination is about 110 mV, which is larger than the shift without light illumination (∼45 mV). The mobile ion effect is obviated using bias-temperature stress measurement. The proposed model successfully explains not only the phenomenon but also the thickness effect for the capacitance–voltage characteristics and the different turn-around voltages of the current density–voltage characteristics of the zirconium dielectrics.
Hole mobility enhancements and alloy scattering-limited mobility in tensile strained Si/SiGe surface channel metal–oxide–semiconductor field-effect transistors
Authors: Leitz C. W. , Currie M. T. , Lee M. L. , Cheng Z.-Y. , Antoniadis D. A. , Fitzgerald E. A.
Published: September 2002

Strained Si-based metal–oxide–semiconductor field-effect transistors (MOSFETs) are promising candidates for next-generation complementary MOS (CMOS) technology. While electron mobility enhancements in these heterostructures have been thoroughly investigated, hole mobility enhancements have not been explored in as much detail. In this study, we investigate the dependence of hole mobility in strained Si MOSFETs on substrate Ge content, strained layer thickness, and channel composition. We show that hole mobility enhancements saturate at virtual substrate compositions of 40% Ge and above, with peak mobility enhancements over twice that of coprocessed bulk Si devices. These results represent peak hole mobilities above 200cm2/V-S. Furthermore, we demonstrate that hole mobility in strained Si/relaxed Si0.7Ge0.3 heterostructures displays no strong dependence on strained layer thickness, indicating that strain is the primary variable controlling channel mobility in strained Si p-type MOSFETs (p-MOSFETs). We then compare these results to previous studies on channel mobility in strained Si n-type MOSFETs. Finally, we measure channel mobility in Si1−yGey (y=0.1, 0.2, 0.3, and 0.4) surface channel MOSFETs under equal tensile strain and directly compare electron and hole mobility degradation due to alloy scattering. In agreement with theoretical predictions, electron mobility is degraded more severely than hole mobility in these heterostructures. Though these heterostructures were capped with very thin strained Si layers to preserve the high-quality MOS interface, electrical measurements indicate that interface state density increases significantly for 30% Ge and 40% Ge alloy channels. Overall, these results demonstrate the possibility of obtaining symmetric electron and hole mobility enhancements in strained Si CMOS technology and present a comprehensive evaluation of heterostructure channel engineering in strained Si p-MOSFETs.
Ultrathin liquid films under alternating intermolecular potential fields and capillary force
Authors: Suh Kahp Y. , Lee Hong H.
Published: September 2002

A unique experimental system is devised that reveals the interplay among capillary force and alternating intermolecular forces. As a consequence of the interplay, untrathin (<10 nm) liquid films, which invariably experience dewetting, can be made stable, leading to a smooth and dropless minimum-potential surface. Theory and experiment show that the film thickness is <1 nm when the film recedes in spite of the capillarity and it is <3 nm when it rises into a cavity.
Surface enhanced Raman spectroscopy of carbon nanotubules deposited on a silver self-affine fractal surface
Authors: Livneh Tsachi , Moskovits Martin
Published: September 2002

The observed Raman intensity measured from carbon nanotubules with well-defined diameters and wall thicknesses of ∼50 and ∼4 nm, respectively, deposited on a self-affine fractal silver surface was found to be enhanced by a factor of ∼1.4–1.7, relative to that of freestanding nanotubules in the absence of silver. Using an analysis in which the calculated distribution of tubules-to-silver distances determined by atomic force microscopy, was convolved with the expected nanotubule-silver distance dependence of the surface enhanced Raman (SERS) enhancement, this observation was reconciled with typical SERS enhancements observed in most silver-adsorbate systems. The analysis also took into account the attenuation of the incident laser intensity, which was determined from the reduction in the resonant Raman background signal that accompanies SERS.
Two-dimensional reconstruction theory of thermal conductivity profiles based on the thermal wave technique
Authors: Zhou Q. B. , Lu Y. K. , Zhang S. Y. , Cheng J. C. , Shui X. J.
Published: September 2002

A two-dimensional (2D) theory of thermal wave reconstruction is presented. By using a pulse spectrum technique and a Newton-like iteration method, the 2D inverse problem is expressed by a 2D Fredholm integral equation of the first kind. Further, the integral equation is approximated by a set of ill-posed linear algebraic equations, and a regularization method is introduced to overcome the singularity of the ill-posed linear algebraic equations. Finally, an error function is defined to choose the regularization parameter automatically to converge the iteration rapidly. The important developments in 2D inverse problem, compared with the one-dimensional problem, are that a line source is used instead of the source with a large cross section, and a finite difference method is adopted for numerical solution of the 2D heat equation. Numerical simulations demonstrate that this approach is effective and stable even with 5% random noise disturbance in the signal.