Synovial Osteochondromatosis of the elbow presenting with ulnar nerve neuropathy.

Synovial chondromatosis is an uncommon disorder in which cartilaginous material is formed within synovial tissue. The cartilaginous nodules may undergo enchondral ossification, described as synovial osteochondromatosis. The nodules may be shed from the synovium and become intra-articular loose bodies. The presenting symptoms are usually diffuse discomfort in the affected joint and decreased range of motion with an accompanying gritty or locking sensation. The authors present the case of a young man with elbow synovial osteochondromatosis associated with ulnar nerve neuropathy.

The locked metacarpophalangeal joint: report of four cases and review of the literature.

Four cases of locked finger metacarpophalangeal joints are reported. Two of these cases were caused by entrapment of the sesamoid behind an exostosis off the second metacarpal head. The third was from subluxation of the dorsal interosseous tendon over a dorsal osteophyte on the metacarpal. The fourth was from an exostosis tethering the accessory collateral ligament. Surgical exploration using a palmar approach was the treatment of choice. All patients regained full range of motion within two months. A review of the various causes and treatment options for this unusual condition is presented.

Correction of the severe nonrheumatoid chronic boutonnière deformity with a modified Matev procedure.

Twenty consecutive patients with severe chronic nonrheumatoid deformities were treated with a modification of the Matev procedure. Fourteen of the 20 had normal passive range of motion preoperatively, with the proximal interphalangeal joints lacking 59 degrees of active extension and the distal interphalangeal joints hyperextended 17 degrees. In the other six patients with PIP contracture at the time of reconstruction, PIP joints lacked 68 degrees of active extension and the DIP joints were hyperextended 13 degrees. Follow-up averaged 8 months, and at that time the patients with no contracture had an average of 14 degrees/96 degrees of active motion at the PIP joint and 9 degrees/59 degrees of motion at the DIP joint. The group with contracture had an average of 21 degrees/80 degrees of active motion at the PIP and 13 degrees/41 degrees of motion at the DIP joint. There were 85% good or satisfactory outcomes in the group without contracture and 67% good or satisfactory outcomes in the group with contracture.

Two cases of chondroid syringoma of the hand.

Two cases of benign chondroid syringoma of the hand are described. Both patients did not have this tumor in the differential diagnosis at the time of operation. The importance of this tumor lies in its recognition. Eighty-two percent of the malignant chondroid syringomas occur in the extremities, and the differences in benign versus malignant presentation are discussed.

Scapholunate dissociation from a fall on the elbow.

We report an undescribed mechanism of injury that caused scapholunate dissociation. Scapholunate dissociation has been previously described as resulting from a fall on the outstretched hand. In this case injury was caused by a fall on the elbow. The mechanism is compared to that of an axe head that is repositioned by butting the handle of the axe on the ground. Recognition of this mechanism may help in the diagnosis of this injury.

Irreducible acute anterior dislocation of the shoulder: case report.

A 91-year-old woman presented with an acute anterior dislocation of the shoulder which could not be reduced by closed manipulation. Open reduction demonstrated a fresh dislocation which could not be reduced until the subscapularis muscle was divided. Only 2 previous cases of irreducible anterior dislocation of the shoulder seem to have been reported in the recent or readily available literature.

A simple and sensitive micro-haemagglutination inhibition assay for the semi-quantitation of the third component of complement.

C3-coated cells have been prepared by incubating sensitised erythrocytes with the appropriate dilutions of serum. Inhibition of agglutination of these cells by an anti-C3 serum provides a sensitive and specific assay for C3 detection and semi-quantitation.

Restoration of strong opposition after median-nerve or brachial plexus paralysis.

In hands in which the superficial flexors of the fingers and thenar muscles of opposition are denervated, usually as the result of high median-nerve or brachial plexus injury, thumb opposition can be restored by transfer of the superficial flexor of the ring finger to the thumb through a dynamic pulley made from the distal segment of flexor carpi ulnaris which is attached to the proximal segment of flexor carpi ulnaris to the transferred paralyzed superficial ring-finger flexor tendon. Of sixteen patients treated by this method, twelve had good or satisfactory results; one had a poor result; and three were lost to follow-up.

Urinary excretion of C3 antigen in glomerulonephritis.

C3 and fibrin degradation products (F.D.P.) have been measured in early morning urine samples from 38 normal people and 123 patients with glomerulonephritis. Normal urine contained less than 0.3 mug of either antigen per ml. C3 and F.D.P. were both detected in the urine of many patients with glomerulonephritis. Levels above 1 mug/ml were exceptional in patients with "minimal change," and the highest excretion of both antigens occurred in mesangiocapillary glomerulonephritis, membranous nephropathy, and focal glomerulosclerosis.Both C3 and F.D.P. excretion showed considerable variation with time, with parellel fluctuations in the two antigens. These fluctuations did not depend on the total protein leakage and suggest that the complement and clotting sequence are closely related in these glomerular disorders.