Open Reduction and Screw Fixation of a Diastatic Bipartite Hallux Sesamoid in Turf Toe Injury: A Case Report.

We present a case of a 25-year-old male professional soccer player who complained of severe pain over the first metatarsal head after opponent contact during a soccer game. Clinical findings showed swelling and tenderness. Initial radiographs showed a diastasis of a bipartite medial sesamoid between the fragments as compared to radiographs taken 4 years earlier of the same foot. A computed tomography scan was performed objectifying the widened interval and also showing an angulation of the proximal fragment. Open reduction and screw fixation were performed, leading to adequate positioning of the 2 bipartite fragments. The patient showed good clinical recovery and returned to the same performance level. Turf toe injury with diastasis of a medial bipartite sesamoid can be treated successfully with this operative technique.Levels of Evidence: Level V: Case report.

Simultaneous traumatic dislocation of the posterior tibial tendon and long peroneal tendon: a case report.

BACKGROUND: Viewing the existing literature, one can find several documents about dislocation of the peroneal tendons. Clinical findings, diagnostics, and therapy are well described. Instead, the list of documents describing dislocations of the posterior tibial tendon is short. We found no case in which a dislocation of both long peroneal tendon and posterior tibial tendon is described. CASE PRESENTATION: We present a case of a 29-year-old male patient who sustained an ankle injury after a fall at a boulder gym. He admitted himself with severe pain, tenderness, and swelling of his left ankle. Dislocation of the posterior tibial tendon and simultaneous dislocation of the long peroneal tendon was diagnosed using x-ray, computed tomography, and magnetic resonance imaging. Transosseous suture repair with periosteal augmentation of the flexor retinaculum was performed at the medial malleolus. At the lateral malleolus, transosseous suture was used to repair the superior retinaculum. The ankle was immobilized following surgery. The patient underwent physical therapy afterwards. The treatment resulted in good recovery, and the patient returned to the same level of performance at rock climbing. CONCLUSION: Our novel finding is that simultaneously sustained dislocations of the posterior tibial tendon and the long peroneal tendon may occur and can be successfully treated as if each injury is treated individually. Level of evidence Level V, case report.

Therapeutic potential of adipose-derived stromal cells in age-related osteoporosis.

Adipose-derived stromal cells (ASCs) are increasingly being used for orthopedic-based tissue engineering approaches due to their ability to readily undergo osteogenic differentiation. In the present study, we used in vitro and in vivo approaches to evaluate the use of ASCs as a treatment strategy for age-related osteoporosis. Molecular, histological and micro-computed tomography (micro-CT) based approaches confirmed that ASCs isolated from 18-week-old osteoporotic senescence-accelerated mice (SAMP6) were capable of undergoing osteogenesis when cultured in either silk fibroin (SF) scaffolds or scaffold-free microtissues (ASC-MT). A single intratibial injection of CM-Dil-labeled isogeneic ASCs or ASC-MT into SAMP6 recipients significantly improved trabecular bone quality after 6 weeks in comparison to untreated contralateral bones, as determined by micro-CT. Injected ASCs could be observed in paraffin wax bone sections at 24 h and 6 weeks post treatment and induced a significant increase in several molecular markers of bone turnover. Furthermore, a significant improvement in the osteogenic potential of osteoporotic patient-derived human bone marrow stromal cells (BMSCs) was observed when differentiated in conditioned culture media harvested from osteoporotic patient-derived human ASCs. These findings therefore support the use of ASCs as an autologous cell-based approach for the treatment of osteoporosis.

Cisplatin induced mitochondrial DNA damage in dorsal root ganglion neurons.

Cisplatin is a platinum-based chemotherapeutic agent that induces peripheral neuropathy in 30% of patients. Peripheral neuropathy is the dose limiting side effect, which has no preventative therapy. We have previously shown that cisplatin induces apoptosis in dorsal root ganglion (DRG) sensory neurons by covalently binding to nuclear DNA (nDNA), resulting in DNA damage, subsequent p53 activation and Bax-mediated apoptosis via the mitochondria. We now demonstrate that cisplatin also directly binds to mitochondrial DNA (mtDNA) with the same binding affinity as nDNA. Cisplatin binds 1 platinum molecule per 2166 mtDNA base pairs and 1 platinum molecule per 3800 nDNA base pairs. Furthermore, cisplatin treatment inhibits mtDNA replication as detected by 5-bromo-2'-deoxy-uridine (BrdU) incorporation and inhibits transcription of mitochondrial genes. The relative reduction in mtDNA transcription is directly related to the distance the gene is located from the transcription initiation point, which implies that randomly formed platinum adducts block transcription. Cisplatin treated DRG neurons exhibit mitochondrial vacuolization and degradation in vitro and in vivo. Taken together, this data suggests that direct mtDNA damage may provide a novel, distinct mechanism for cisplatin-induced neurotoxicity separate from the established nDNA damage pathway.