Biomechanical evaluation of chronic boutonnière reconstructions.

The magnitudes of the extensor forces generated across the proximal interphalangeal joint by the Littler-Eaton, Matev, Hellmann, and Fowler reconstructive procedures for posttraumatic chronic boutonnière deformity were measured in a laboratory study. The purpose of the experiment was to determine whether the mechanical design of a procedure had a significant impact on biomechanical performance. Results showed that each method produced adequate extensor forces and restored full proximal interphalangeal joint extension. There were few statistically significant differences among the procedures for the different joint angles and load conditions tested. The data suggest that the mechanical designs of these reconstructions are satisfactory for correction of the extensor deficit of the deformity. The preoperative condition of the finger is probably responsible for the variations seen in clinical results.

Acute anterior thigh compartment syndrome complicating quadriceps hematoma. Two case reports and review of the literature.

Acute compartment syndrome of the thigh has been reported infrequently. To date, only eight cases from isolated blunt trauma without fracture have been reported. Two additional cases caused by intramuscular hematomas following blunt, low-energy trauma, which were treated successfully with emergency fasciotomies, are presented. The morbidity from this syndrome varies from mild, with quadriceps weakness, fatigue, and myositis ossificans, to severe, with limb-threatening vascular compromise. Morbidity can be avoided if a high level of suspicion is maintained, compartment pressures are measured, fasciotomies are performed, and hematomas are drained. Postoperatively, patients can expect a dramatic decrease in pain and a quick return of quadriceps function with aggressive physical rehabilitation.

The effects of tissue pretreatment and pepsin levels on the isolation of collagens from human placenta.

A comparative study has been undertaken to ascertain the effects of different tissue pretreatment procedures on the recovery of the major genetic types of collagen from human placenta. Essentially the same recovery of types I, III, IV and V collagen was obtained from placenta which was directly processed, from placenta which was stored at -70 degrees C after washing, and from dried acetone extracts of this tissue. Each collagen type isolated from the treated tissue preparations displayed properties consistent with those exhibited by its counterpart obtained from fresh tissue which was directly processed. Furthermore, it was observed that while the amount of types I and III collagen recovered was directly proportional to the level of pepsin employed, the recovery of types IV and V collagen was inversely related to this isolation parameter. These results establish that human placenta can be either stored frozen or as a dry acetone extract without affecting either the yield or the profile of the different genetic types of collagen recovered and that the amounts of different genetic types of collagen recovered can be modulated by the amount of pepsin employed in the isolation.