Double-Bending Tension Band Wire for Olecranon Fractures: A Novel Technique.

Purpose: This retrospective study aimed to compare the clinical outcomes and complications of conventional tension band wire (TBW), TBW with penetrating technique, and double-bending technique. Methods: A total of 40 patients (17 men and 23 women; mean age: 64.0 ± 19.0 years) who underwent surgery for displaced olecranon fractures between January 2018 and December 2021 were included and divided into three groups based on the surgical method used (group A, conventional TBW; group B, TBW with penetrating technique; and group C, double-bending technique). Thirteen patients were assigned to group A, 17 to group B, and 10 to group C, including 2 Mayo type IB, 30 Mayo type IIA, and 8 Mayo type IIB fractures. Postoperative outcomes (elbow extension and flexion arc) and complications, such as backing out of the Kirschner wire (K-wire), were retrospectively evaluated. Results: No significant difference was found in the general characteristics of the patients and fracture type among the three groups. The mean elbow extension arc values were 6.2°, 10.9°, and 0° in groups A, B, and C, respectively; it was significantly better in group C than in group B (P = .001). The rates of backing out of the K-wire were 84.6% (11/13) in group A, 41.2% (7/17) in group B, and 0% (0/10) in group C; the rate was significantly lower in group C than in group A (P < .001). Conclusions: The double-bending technique may be the best procedure for preventing the backing out of the K-wire and postoperative complications, such as range of motion restriction, for treating olecranon fractures that are treatable by TBW. Type of study/level of evidence: Therapeutic IV.

Desmoplastic fibroma arising in the distal phalanx of the great toe: a case report.

Desmoplastic fibroma (DF) of the bone is a rare locally aggressive tumor usually occurring in adolescents and young adults. These tumors most commonly occur in the mandibles and metaphyses of long bones but are extremely rare in small bones, often resulting in diagnostic problems. The occurrence of these tumors in the foot is especially limited. We report the clinical, radiographic, and histologic features of DF arising in the distal phalanx of the great toe and a review of the published data.

A simple reduction technique in intramedullary nailing (MICRONAIL) of distal radius fracture - intrafocal elastic-spring pinning method.

On treating distal radius fracture with intramedullary nailing (MICRONAIL, Wright Medical), completed anatomical reduction is indispensable before inserting the nail. However, complete reduction in percutaneous pinning or in Kapandji intrafocal pinning is troublesome. Thus, majority of the operation time is usually spent on reducing the fracture appropriately. We have commenced the "intrafocal elastic-spring pinning" as a reduction technique and have simplified the reduction prior to nailing. First, curve the 1.5 mm Kirschner wire properly. Next, pins are introduced percutaneously and intrafocally into the marrow cavity. The nail is then inserted in a standard manner. With this technique, an average of 16 consecutive intraoperative surgical times was 32.1 minutes (range, 16-55); apparently shorter than other previous reports. The bending-induced tension in the pins counteracts the postero-lateral displacing forces, and is especially efficient in comminuted or osteoporotic fractures. The nail will just brush aside the elastic pins when the pins interfere with the nail insertion.

Dual functions of cell-autonomous and non-cell-autonomous ADAM10 activity in granulopoiesis.

Previous studies have revealed various extrinsic stimuli and factors involved in the regulation of hematopoiesis. Among these, Notch-mediated signaling has been suggested to be critically involved in this process. Herein, we show that conditional inactivation of ADAM10, a membrane-bound protease with a crucial role in Notch signaling (S2 cleavage), results in myeloproliferative disorder (MPD) highlighted by severe splenomegaly and increased populations of myeloid cells and hematopoietic stem cells. Reciprocal transfer of bone marrow cells between wild-type and ADAM10 mutant mice revealed that ADAM10 activity in both hematopoietic and nonhematopoietic cells is involved in the development of MPD. Notably, we found that MPD caused by lack of ADAM10 in nonhematopoietic cells was mediated by G-CSF, whereas MPD caused by ADAM10-deficient hematopoietic cells was not. Taken together, the present findings reveal previously undescribed nonredundant roles of cell-autonomous and non-cell-autonomous ADAM10 activity in the maintenance of hematopoiesis.