Prevalence of First Carpometacarpal Joint Osteoarthritis and Carpal Tunnel Syndrome Among Dentists in Saudi Arabia.

Objectives This study aims to determine the prevalence of the first carpometacarpal (CMC) joint osteoarthritis and Carpal Tunnel Syndrome (CTS) among dentists from different specialties in Saudi Arabia and their association with gender, years of practice, and weekly working hours. Materials and Methods In this cross-sectional study, 361 dentists in Saudi Arabia have completed an online questionnaire of three parts: demographic and health data, the Thumb Disability Exam (TDX), and the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Univariate and multivariate analyses of logistic regression were performed to investigate the participants' predictors of the first CMC joint osteoarthritis and Carpal Tunnel Syndrome. The level of significance was set at α = 0.05 for all tests. Results Thumb disability was significantly associated with the female gender (aOR 2.21; 95 percent CI 1.31-3.56) and dentists aged 50 or older (aOR 9.63; 95 percent CI 1.05-88.47). The symptom severity scale (SSS) part of BCTQ was significantly associated with increased risk in the female gender (aOR 1.62; 95% CI 1.62-2.58). Limiting the clinical work to 10-20 hours per week showed a significant reduction in the odds of reporting CTS symptoms in SSS (aOR 0.44; 95% CI 0.21-0.90). CTS-related hand disability was more likely to be reported by the female gender (aOR 2.21; 95% CI 1.36-3.57) and less likely to be reported by endodontic specialists (aOR 0.15; 95% CI 0.04-0.58). Conclusion The female gender was significantly associated with first CMC joint osteoarthritis and CTS among dentists in Saudi Arabia. Other predictors were also identified in this cross-sectional study.

Heterotopic Ossification Complicating Traumatic Ulnar Nerve Palsy in a Child.

Heterotopic ossification (HO) refers to the process of forming bony tissues in extra-skeletal sites such as muscles and soft tissues. This pathological process most commonly commences following trauma, surgery, and fractures. Rarely, HO can compress nearby neurovascular structures. To the best of our knowledge, however, no previous reports exist of HO serving as second-hit to partially injured ulnar nerve in the pediatric population. We present a case of a 6-year-old girl with complete high ulnar nerve palsy caused by medial epicondylar fracture followed by development of HO around the elbow. The patient was initially managed conservatively. Four months after the first visit, she presented with complete ulnar nerve palsy that was not evident on the initial presentation. Based on further investigations, she was taken to OR for release of the cubital tunnel and anterior transposition of ulnar nerve. On further follow-up, the patient regained sensory and motor functions of the ulnar nerve with minimum sequalae. Post-traumatic ulnar nerve injury is well described in the literature as resulting from initial trauma or as an iatrogenic injury following fracture reduction and fixation. HO in the pediatric age group is considerably rare, occurring after trauma and burn injuries. Surgical timing of HO release remains controversial. No previous reports of HO complicating traumatic ulnar nerve palsy in pediatric patients exist. In the current case report, partial ulnar nerve injury was initially due to medial epicondylar fracture, but it had progressed to full blown ulnar palsy secondary to superimposed HO. Early HO takedown combined with decompression of ulnar nerve are crucial to ensure complete nerve recovery.

The Use of Intraoperative Radiography for Osteotomy Planning in Craniosynostosis Posterior Cranial Vault Distractor Application, Technique Description.

Posterior cranial vault distraction osteogenesis (PVDO) is evolving as one of the first-line treatments in managing craniosynostosis. Intraoperative decision for sites of osteotomies requires precise planning and accurate placement of distractors. OBJECTIVE: This technique helps in determining and confirming the pre-surgical planned osteotomy sites along with the distraction vectors. TECHNIQUE: intraoperative plain skull radiography is used to determine the osteotomy site guiding placement of distractors using radio-opaque instrument. RESULT AND DISCUSSION: we believe this technique helps translate the planned osteotomy sites and distraction vectors accurately to the skull and minimizes intra-operative error which will subsequently improve outcomes. CONCLUSION: This technique is a quick and safe tool for proper placement of posterior cranial vault distractor. However, further comparative studies are needed in addition to measuring cost, time added to the procedure, and radiation exposure.