Primary Distal Interphalangeal Joint Tenosynovial Chondromatosis of the Small Finger: A Case Report With Literature Review.

Primary synovial chondromatosis is a rare, benign proliferative disease of the joint synovium, tenosynovium, or bursal lining, in which cartilage metaplasia leads to the development of multiple intra-articular and periarticular loose osteocartilaginous bodies. This disease usually involves larger joints (knee, hip, elbow, and shoulder), but it has also rarely been reported in the hand. Patients with this disease complain of pain, swelling, nodules, and decreased range of motion of the affected joint. Due to its nonspecific symptoms and low prevalence, this disease often goes misdiagnosed, leading to delays in patient treatment. In the literature to date, there are only a few reports of primary synovial chondromatosis. In this case report, we present a patient with a rare case of primary synovial chondromatosis localized to right small finger distal interphalangeal joint.

Extra-articular Metacarpal Fractures: Closed Reduction and Percutaneous Pinning Versus Open Reduction and Internal Fixation.

BACKGROUND: There is no consensus on the optimal operative treatment of isolated closed metacarpal fractures as every technique is associated with advantages and shortcomings. This retrospective study aims to compare the outcomes of single metacarpal, extra-articular fractures treated with closed reduction and percutaneous pinning (CRPP) versus open reduction and internal fixation (ORIF). METHODS: The charts of all patients who underwent surgical repair of closed metacarpal fractures at our institutions from 2009 to 2016 were reviewed. 70 patients met the inclusion criteria, 44 had undergone CRPP and 26 ORIF with plate or lag screws. Subgroup analyses of all patients stratified by both fracture pattern and fracture location were performed. Additionally, subgroup analyses of outcomes based on the time from injury to surgery were conducted. Clinical outcomes included immobilization time, total active motion, stiffness, complication and reoperation rates, as well as occupational therapy referral rates and duration. Functional outcomes were determined using the Quick-DASH (Disabilities of the Arm, Shoulder and Hand) score via telephone questionnaire administered retrospectively. RESULTS: Overall, there was no significant difference in functional outcome parameters including total active motion (CRPP 91% of normal vs. ORIF 87% of normal), stiffness, therapy referrals, and complications between treatment groups. Patients treated with CRPP, regardless of fracture pattern or location, were operated on earlier than those treated with ORIF (avg. 7 days vs. 15 days). The immobilization time for patients treated with ORIF was significantly less than those treated with CRPP (19.7 vs. 30.7 days; p=0.001). This difference in the immobilization time also reflected the outcomes of the subgroup analyses based on the post-injury time of surgery. When transverse shaft fractures were examined independently as a subgroup, ORIF resulted in improved post-operative range of motion vs. CRPP (100% normal vs. 91% normal). The mean DASH score for each group was satisfactory and the difference was not statistically significant (16.3 for the CRPP and 18.7 for the ORIF group, p=0.805). CONCLUSION: Both CRPP and ORIF are viable techniques with good clinical outcomes and low complication rates. ORIF of closed metacarpal fractures allowed for earlier mobilization when compared with CRPP without compromising fracture stability, clinical or functional short-term outcomes.

Entangled Photon Excited Fluorescence in Organic Materials: An Ultrafast Coincidence Detector.

We report the fluorescence emission from organic systems selectively excited by entangled pairs of photons. We have demonstrated a linear dependence of this two-photon excited fluorescence on the excitation intensity which is a unique nonclassical feature of two-photon interactions induced by entangled photons. The entangled photon (ETPA) excited fluorescence has been detected in several organic molecules possessing a high entangled photon absorption cross section. The ETPA fluorescence showed a nonmonotonic dependence on the delay between signal and idler beams. The fluorescence signal was detectable within the signal-idler relative delay time interval of ∼100 fs. This time is comparable with the estimated entanglement time, TE, making the ETPA-excited fluorescence in organic materials an ideal ultrafast coincidence detector. These results have widespread impact in applications ranging from spectroscopy to chemical and biological sensing, imaging, and microscopy.

Calibrated lateral crus stabilizer.

BACKGROUND: Fundamental shortcomings of the currently available instrumentation prompted the need for a device that facilitates stabilization of the lateral crus while at the same time allowing for precise measurement of the retained cartilage fragment along the anatomic axis of the lateral crus. METHODS: This article presents a new instrument, the calibrated lateral crus stabilizer, and highlights its unique features, which facilitate the precise and symmetric excision of the lateral crural cartilage. RESULTS: A lateral crus stabilizer with a calibration mechanism is introduced that provides the means for precise removal of the excess portion of the lower lateral cartilage during rhinoplasty. CONCLUSIONS: There was a need for improved instrumentation to stabilize the alar cartilage than what is currently available. New instrumentation is presented that answers that need.