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1.
Hand Surg Rehabil ; 43(2): 101643, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38228245

ABSTRACT

This study investigated whether dorsoradial ligament repair with internal brace augmentation provided more immediate stability in the trapeziometacarpal joint than dorsoradial ligament repair alone. Seven matched pairs of cadaveric hands were used. One specimen from each pair was assigned to the repair-only group and the other to the repair + internal brace augmentation group. Trapeziometacarpal joint range of motion and translation were quantified under different conditions for both groups: (1) intact, (2) transected dorsoradial ligament, and (3) repaired dorsoradial ligament or repaired dorsoradial ligament plus internal brace augmentation. Load-to-failure tests were performed after repair. Range of motion and translation were increased by dorsoradial ligament transection and were decreased by dorsoradial ligament repair; however, compared to the intact condition, the repair-only group demonstrated greater flexion/extension range, while the repair + internal brace group showed no significant difference in range of motion. Mean loads at 2- and 3-mm displacements were greater in the repair + internal brace group than in the repair-only group (18.0 ± 1.8 N vs. 10.8 ± 1.3 N for 2 mm displacement and 35.3 ± 3.7 N vs. 23.1 ± 2.9 N for 3 mm displacement, respectively). Internal brace augmentation improved the load-to-failure characteristics of dorsoradial ligament repair without compromising range of motion. LEVEL OF EVIDENCE: IV.


Subject(s)
Braces , Cadaver , Carpometacarpal Joints , Ligaments, Articular , Range of Motion, Articular , Humans , Ligaments, Articular/surgery , Range of Motion, Articular/physiology , Biomechanical Phenomena , Carpometacarpal Joints/surgery , Carpometacarpal Joints/physiopathology , Female , Male , Middle Aged , Aged
2.
Cancers (Basel) ; 16(2)2024 Jan 08.
Article in English | MEDLINE | ID: mdl-38254764

ABSTRACT

Extra-abdominal desmoid-type fibromatosis (EADTF) is a rare neoplastic condition of monoclonal fibroblastic proliferation characterized by local aggressiveness with a distinct tendency to recur. Although EADTF is a benign disease entity, these tumors have a tendency to infiltrate surrounding normal tissues, making it difficult to completely eliminate them without adjacent healthy tissue injury. Surgical excision of these locally aggressive tumors without clear resection margins often leads to local recurrence. The aim of this thorough review was to assess the current treatment concepts for these rare tumors. A comprehensive search of articles published in the Cochrane Library, MEDLINE (PubMed), and EMBASE databases between January 2008 and February 2023 was conducted. Surgical intervention is no longer the first-line approach for most cases; instead, strategies like active surveillance or systemic therapies are used as initial treatment options. With the exception of EADTFs situated near vital structures, a minimum of 6-12 months of active surveillance is currently advocated for, during which some disease progression may be considered acceptable. Non-surgical interventions such as radiation or cryoablation may be employed in certain patients to achieve local control. The currently preferred systemic treatment options include tyrosine kinase inhibitors, low-dose chemotherapy, and gamma-secretase inhibitors, while hormone therapy is not advised. Nonsteroidal anti-inflammatory drugs are utilized primarily for pain management.

4.
Sci Rep ; 13(1): 20431, 2023 11 22.
Article in English | MEDLINE | ID: mdl-37993627

ABSTRACT

Orthopaedic surgeons need to correctly identify bone fragments using 2D/3D CT images before trauma surgery. Advances in deep learning technology provide good insights into trauma surgery over manual diagnosis. This study demonstrates the application of the DeepLab v3+ -based deep learning model for the automatic segmentation of fragments of the fractured tibia and fibula from CT images and the results of the evaluation of the performance of the automatic segmentation. The deep learning model, which was trained using over 11 million images, showed good performance with a global accuracy of 98.92%, a weighted intersection over the union of 0.9841, and a mean boundary F1 score of 0.8921. Moreover, deep learning performed 5-8 times faster than the experts' recognition performed manually, which is comparatively inefficient, with almost the same significance. This study will play an important role in preoperative surgical planning for trauma surgery with convenience and speed.


Subject(s)
Deep Learning , Tomography, X-Ray Computed , Tomography, X-Ray Computed/methods , Fibula/diagnostic imaging , Tibia/diagnostic imaging , Imaging, Three-Dimensional/methods , Image Processing, Computer-Assisted/methods
5.
Polymers (Basel) ; 15(18)2023 Sep 20.
Article in English | MEDLINE | ID: mdl-37765690

ABSTRACT

Tannic acid (TA) can be used as an additive to improve the properties of hydrogels, but it acts as a radical scavenger, which hinders radical polymerization. In this study, we successfully and easily synthesized a TA-incorporated 2-acrylamido-2-methylpropanesulfonic acid (AMPS) hydrogel using an electron beam (E-beam) in a one-pot process at room temperature. TA successfully grafted onto AMPS polymer chains under E-beam irradiation, but higher TA content reduced grafting efficiency and prevented hydrogel formation. Peel strength of the AMPS hydrogel increased proportionally with TA, but cohesive failure and substrate residue occurred above 1.25 phm (parts per 100 g of AMPS) TA. Tensile strength peaked at 0.25 phm TA but decreased below the control value at 1.25 phm. Tensile elongation exceeded 2000% with TA addition. Peel strength varied significantly with substrate type. The wood substrate had the highest peel strength value of 150 N/m, while pork skin had a low value of 11.5 N/m. However, the addition of TA increased the peel strength by over 300%. The ionic conductivity of the AMPS/TA hydrogel increased from 0.9 S/m to 1.52 S/m with TA content, while the swelling ratio decreased by 50% upon TA addition and increased slightly thereafter.

6.
J Clin Med ; 12(13)2023 Jun 29.
Article in English | MEDLINE | ID: mdl-37445404

ABSTRACT

PURPOSE: Magnetic resonance imaging (MRI) is useful in the diagnosis of local recurrence, but few studies have explored recurrence in MRI in patients after reconstructive surgery. The purpose of this study was to analyze MRI findings of locoregional recurrence following reconstructive surgery after malignant soft tissue tumor resection. METHOD: Fifty-three postoperative MRIs from 37 patients who underwent reconstructive surgery after malignant soft tissue tumor resection were retrospectively reviewed. A total of 76 enhancing lesions, including 40 locoregional recurrences and 36 postoperative changes, were analyzed regarding morphology (location on the transplanted tissue, border, and shape) and the signals on T1- and T2-weighted imaging (T1WI, T2WI), fat-suppressed (FS) T2WI, and contrast-enhanced FS T1WI. Diffusion-weighted imaging with an apparent diffusion coefficient was assessed. A chi-squared test and Fisher's exact test were used for statistical analysis. RESULTS: The most common site of recurrent tumors and postoperative changes was the peripheral margin on transplanted tissue (63% and 61%, respectively p = 0.907). Recurrent tumors commonly appeared with well-defined borders (75%) as well as nodular appearance (98%), hyperintensity on T2WI (85%) and FS-T2WI (95%), isointensity on T1WI (65%), impeded water diffusion (55%), and intense (50%) or moderate (45%) enhancement. Postoperative changes showed ill-defined borders (75%), nodular appearance (56%), facilitated water diffusion (69%), and moderate (86%) enhancement, which were significantly different from those of recurrent tumors (p ≤ 0.020). CONCLUSIONS: Common and partitioning MRI features of locoregional recurrence were well-defined borders, nodular shape, impeded water diffusion, and intense enhancement. Peripheral margins on transplanted tissue were common sites in both recurrent tumors and postoperative changes.

7.
Sci Rep ; 13(1): 10542, 2023 06 29.
Article in English | MEDLINE | ID: mdl-37386116

ABSTRACT

Pelvic bone fracture is highly complex, and its anatomical reduction is difficult. Therefore, patient-specific customized plates have been developed using three-dimensional (3D) printing technology and are being increasingly used. In this study, the reduction status in five representative pelvic fracture models was compared between two groups: the 3D printing plate (3DP) group using a patient-specific 3D printed plate after virtual reduction and the conventional plate (CP) group using a conventional plate by manual bending. The 3DP and CP groups included 10 and 5 cases, respectively. The fractured models were reduced virtually and their non-locking metal plates were customized using 3D printing. The process of contouring the conventional plates to fit the contact surface of the bone with the bending tool was conducted by an experienced pelvic bone trauma surgeon. The reduction and fixation achieved using the two different plate groups was compared, and the significance of differences in the results was analyzed using paired t-tests, after verifying the normality of data distribution. The vertex distances between the surface of the bone and the contact surface of the plate were significantly lower in the 3DP group than in the CP group (0.407 ± 0.342 and 2.195 ± 1.643, respectively, P = 0.008). Length and angular variations, which are measurements of the reduction state, were also lower in the 3DP group than in the CP group (length variation: 3.211 ± 2.497 and 5.493 ± 3.609, respectively, P = 0.051; angular variation: 2.958 ± 1.977 and 4.352 ± 1.947, respectively, P = 0.037). The customized 3D printed plate in the virtual reduction model provided a highly accurate reduction of pelvic bone fractures, suggesting that the customized 3D printed plate may help ensure easy and accurate reduction.


Subject(s)
Fractures, Bone , Pelvic Bones , Plastic Surgery Procedures , Humans , Psychotherapy , Bone Plates , Fractures, Bone/surgery , Printing, Three-Dimensional
8.
PLoS One ; 18(5): e0286417, 2023.
Article in English | MEDLINE | ID: mdl-37256875

ABSTRACT

Many previous studies focused on differentiating between benign and malignant soft tissue tumors using radiomics model based on various magnetic resonance imaging (MRI) sequences, but it is still unclear how to set up the input radiomic features from multiple MRI sequences. Here, we evaluated two types of radiomics models generated using different feature incorporation strategies. In order to differentiate between benign and malignant soft tissue tumors (STTs), we compared the diagnostic performance of an ensemble of random forest (R) models with single-sequence MRI inputs to R models with pooled multi-sequence MRI inputs. One-hundred twenty-five STT patients with preoperative MRI were retrospectively included and consisted of training (n = 100) and test (n = 25) sets. MRI included T1-weighted (T1-WI), T2-weighted (T2-WI), contrast-enhanced (CE)-T1-WI, diffusion-weighted images (DWIs, b = 800 sec/mm2) and apparent diffusion coefficient (ADC) maps. After tumor segmentation on each sequence, 100 original radiomic features were extracted from each sequence image and divided into three-feature sets: T features from T1- and T2-WI, CE features from CE-T1-WI, and D features from DWI and ADC maps. Four radiomics models were built using Lasso and R with four combinations of three-feature sets as inputs: T features (R-T), T+CE features (R-C), T+D features (R-D), and T+CE+D features (R-A) (Type-1 model). An ensemble model was built by soft voting of five, single-sequence-based R models (Type-2 model). AUC, sensitivity, specificity, and accuracy of each model was calculated with five-fold cross validation. In Type-1 model, AUC, sensitivity, specificity, and accuracy were 0.752, 71.8%, 61.1%, and 67.2% in R-T; 0.756, 76.1%, 70.4%, and 73.6% in R-C; 0.750, 77.5%, 63.0%, and 71.2% in R-D; and 0.749, 74.6%, 61.1%, and 68.8% R-A models, respectively. AUC, sensitivity, specificity, and accuracy of Type-2 model were 0.774, 76.1%, 68.5%, and 72.8%. In conclusion, an ensemble method is beneficial to incorporate features from multi-sequence MRI and showed diagnostic robustness for differentiating malignant STTs.


Subject(s)
Sarcoma , Soft Tissue Neoplasms , Humans , Retrospective Studies , Magnetic Resonance Imaging/methods , Diffusion Magnetic Resonance Imaging/methods , Soft Tissue Neoplasms/diagnostic imaging , Machine Learning
10.
Clin Orthop Surg ; 15(2): 318-326, 2023 Apr.
Article in English | MEDLINE | ID: mdl-37008974

ABSTRACT

Background: Compared to the classic open technique, limited exposure techniques have the advantages of less scar pain, more grip and pinch strength, and earlier return to daily life. We evaluated the effectiveness and safety of our novel method of minimally invasive carpal tunnel release using a hook knife through a small transverse carpal incision. Methods: This study included 111 carpal tunnel decompressions in 78 patients who underwent carpal tunnel release from January 2017 to December 2018. We performed carpal tunnel release using a hook knife through a small transverse incision just proximal to the wrist crease under local infiltration of lidocaine with tourniquet inflation in the upper arm. All patients were tolerable during the procedure and discharged following the procedure on the same day. Results: At an average of 29.4 months of follow-up (range, 12-51 months), all but one patient (99%) revealed complete or near complete symptomatic recovery. The average of the symptom severity score on the Boston questionnaire was 1.31 ± 0.30 and the average of the functional status score was 1.19 ± 0.26. The final mean Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) score was 8.66 (range, 2-39). There was no superficial palmar arch injury or nerve injury of the palmar cutaneous branch, recurrent motor branch, or median nerve itself as a complication of the procedure. No patient showed any wound infection or wound dehiscence. Conclusions: Our carpal tunnel release using a hook knife through a small transverse carpal incision performed by an experienced surgeon is a safe and reliable method that is expected to have the benefits of simplicity and minimal invasiveness.


Subject(s)
Carpal Tunnel Syndrome , Humans , Carpal Tunnel Syndrome/surgery , Median Nerve , Wrist Joint/surgery , Wrist , Hand Strength , Treatment Outcome
11.
RSC Adv ; 13(17): 11874-11882, 2023 Apr 11.
Article in English | MEDLINE | ID: mdl-37077996

ABSTRACT

Photoreactive pressure-sensitive adhesives (PSAs) were prepared by grafting mono- or difunctional photoreactive monomers onto acrylic PSA, and their adhesion properties were evaluated before and after ultraviolet (UV) curing for application as dicing tape. In this study, the NCO-terminated difunctional photoreactive monomer (NDPM) was newly synthesized and compared with 2-acryloxyloxyethyl isocyanate (AOI), a monofunctional monomer. The 180° peel strengths of pristine and photoreactive PSAs were similar before UV curing (1850-2030 gf/25 mm). After UV curing, the 180° peel strengths of the photoreactive PSAs decreased significantly and converged to nearly zero. When a UV dose of 200 mJ cm-2 was used, the 180° peel strength of 40% NDPM-grafted PSA decreased to 8.40 gf/25 mm, which was much lower than that of 40% AOI-grafted PSA (39.26 gf/25 mm). NDPM-grafted PSA also showed that its storage modulus shifted more to the upper right side of Chang's viscoelastic window than AOI-grafted PSA, and this is because NDPM provided a higher degree of crosslinking than AOI. Furthermore, SEM-EDS analysis showed that UV-cured NDPM-grafted PSA retained almost no residue on the silicon wafer after debonding.

12.
RSC Adv ; 13(3): 1672-1683, 2023 Jan 06.
Article in English | MEDLINE | ID: mdl-36688068

ABSTRACT

Developing a high-performing hydrogel with long-lasting skin adhesion, high ionic conductivity, mechanical stability, and fatigue resistance is a crucial issue in the field of wearable electronic devices. Because of their weak mechanical properties, zwitterion-based hydrogels are not suitable for application in wearable strain sensors despite their excellent adhesion to the skin. In this study, a hydrogel of polymer without additive was prepared by using polymerizable monomers consisting of zwitterionic 3-(1-vinyl-3-imidazolio)propanesulfonate (VIPS), anionic 2-acrylamido-2-methyl-1-propanesulfonic acid sodium salt (AMPSs), and acrylamide (AAm); the hydrogel is abbreviated as P(AMPSs/VIPS-co-AAm). The P(AMPSs/VIPS-co-AAm) hydrogel shows exceptional adhesive strength, reaching up to 26.29 kPa (lap shear to porcine skin) and high stretchability (with a fracture strain of 1282% and stress of 40 kPa). The high polarity of the AMPSs/VIPS pair improves the interfacial adhesion to the skin, the internal cohesion and recovery tendency. Unique structural characteristics of the hydrogel impart excellent fatigue resistance, network toughening, and electrical stability after multiple deformations. Thus, the prepared hydrogel has an ionic conductivity (0.51 S m-1), strain sensitivity, and long-term skin adhesion, and it demonstrates potential to be applied for wearable strain sensors.

13.
J Magn Reson Imaging ; 57(3): 752-760, 2023 03.
Article in English | MEDLINE | ID: mdl-35808915

ABSTRACT

BACKGROUND: Determination of preoperative soft tissue sarcoma (STS) margin is crucial for patient prognosis. PURPOSE: To evaluate diagnostic performance of radiomics model using T2-weighted Dixon sequence for infiltration degree of STS margin. STUDY TYPE: Retrospective. POPULATION: Seventy-two STS patients consisted of training (n = 58) and test (n = 14) sets. FIELD STRENGTH/SEQUENCE: A 3.0 T; T2-weighted Dixon images. ASSESSMENT: Pathologic result of marginal infiltration in STS (circumscribed margin; n = 27, group 1, focally infiltrative margin; n = 31, group 2-A, diffusely infiltrative margin; n = 14, group 2-B) was the reference standard. Radiomic volume and shape (VS) and other (T2) features were extracted from entire tumor volume and margin, respectively. Twelve radiomics models were generated using four combinations of classifier algorithms (R, SR, LR, LSR) and three different inputs (VS, T2, VS + T2 [VST2] features) to differentiate the three groups. Three radiologists (reader 1, 2, 3) analyzed the marginal infiltration with 6-scale confidence score. STATISTICAL TESTS: Area under the receiver operating characteristic curve (AUC) and concordance rate. RESULTS: Averaged AUCs of R, SR, LR, LSR models were 0.438, 0.466, 0.438, 0.466 using VS features, 0.596, 0.584, 0.814, 0.815 using T2 features, and 0.581, 0.587, 0.821, 0.821 using VST2 features, respectively. The LR and LSR models constructed with T2 or VST2 features showed higher AUC and concordance rate compared to radiologists' analysis (AUC; 0.730, 0.675, 0.706, concordance rate; 0.46, 0.43, 0.47 in reader 1, 2, 3). DATA CONCLUSION: Radiomics model constructed with features from tumor margin on T2-weighted Dixon sequence is a promising method for differentiating infiltration degree of STS margin. EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 2.


Subject(s)
Sarcoma , Soft Tissue Neoplasms , Humans , Magnetic Resonance Imaging/methods , Retrospective Studies , Sarcoma/diagnostic imaging , Sarcoma/pathology , ROC Curve
14.
Diagnostics (Basel) ; 14(1)2023 Dec 20.
Article in English | MEDLINE | ID: mdl-38201320

ABSTRACT

Utilizing "You only look once" (YOLO) v4 AI offers valuable support in fracture detection and diagnostic decision-making. The purpose of this study was to help doctors to detect and diagnose fractures more accurately and intuitively, with fewer errors. The data accepted into the backbone are diversified through CSPDarkNet-53. Feature maps are extracted using Spatial Pyramid Pooling and a Path Aggregation Network in the neck part. The head part aggregates and generates the final output. All bounding boxes by the YOLO v4 are mapped onto the 3D reconstructed bone images after being resized to match the same region as shown in the 2D CT images. The YOLO v4-based AI model was evaluated through precision-recall (PR) curves and the intersection over union (IoU). Our proposed system facilitated an intuitive display of the fractured area through a distinctive red mask overlaid on the 3D reconstructed bone images. The high average precision values (>0.60) were reported as 0.71 and 0.81 from the PR curves of the tibia and elbow, respectively. The IoU values were calculated as 0.6327 (tibia) and 0.6638 (elbow). When utilized by orthopedic surgeons in real clinical scenarios, this AI-powered 3D diagnosis support system could enable a quick and accurate trauma diagnosis.

15.
Article in English | MEDLINE | ID: mdl-36288400

ABSTRACT

Defense against chemical warfare agents (CWAs) is regarded as a top priority for the protection of humanity, but it still depends on physical protection with severe limitations such as residual toxicity and post-treatment requirement. In this study, a strategically designed functional polymeric substrate was composited with a metal-organic framework catalyst to remove toxicity immediately. A series of PMMA-BPEI copolymers exhibited high processability as a coating and accelerated the catalytic activity of Zr(IV)-based metal-organic framework catalysts (UiO-66). Among them, PMB12_40 composite coating on a cotton fabric, containing a PMMA-BPEI copolymer (PMMA/BPEI = 1/2) and 40% of UiO-66 catalyst, can efficiently decompose nerve agent simulants (methyl-paraoxon) under both liquid phase (t1/2 = 0.14 h) and humidified (t1/2 = 4.8 h) conditions. Moreover, a real agent, GD, was decomposed 100% by PMB12_40 in 4 h at 25 °C and 65% relative humidity. On the basis of superior catalytic activity, the PMB composites are anticipated to be a potential material for active chemical protection coating.

16.
Polymers (Basel) ; 14(13)2022 Jun 22.
Article in English | MEDLINE | ID: mdl-35808593

ABSTRACT

In this study, ionic conductive hydrogels were prepared with 2-acrylamido-2-methyl-1-propanesulfonic acid (AMPS). Acrylic acid (AA), acrylamide (AAm), and 2-hydroxyethyl acrylate (HEA) were used as comonomers to complement the adhesion properties and ion conductivity of AMPS hydrogels. Hydrogels were prepared by irradiating a 20 kGy dose of E-beam to the aqueous monomer solution. With the E-beam irradiation, the polymer chain growth and network formation simultaneously proceeded to form a three-dimensional network. The preferred reaction was determined by the type of comonomer, and the structure of the hydrogel was changed accordingly. When AA or AAm was used as a comonomer, polymer growth and crosslinking proceeded together, so a hydrogel with increased peel strength and tensile strength could be prepared. In particular, in the case of AA, it was possible to prepare a hydrogel with improved adhesion without sacrificing ionic conductivity. When the molar ratio of AA to AMPS was 3.18, the 90° peel strength of AMPS hydrogel increased from 171 to 428 gf/25 mm, and ionic conductivity slightly decreased, from 0.93 to 0.84 S/m. By copolymerisation with HEA, polymer growth was preferred compared with chain crosslinking, and a hydrogel with lower peel strength, swelling ratio, and ionic conductivity than the pristine AMPS hydrogel was obtained.

17.
Diagnostics (Basel) ; 12(6)2022 Jun 02.
Article in English | MEDLINE | ID: mdl-35741182

ABSTRACT

Background: The purpose of this study was to demonstrate the usefulness of 3D image-based virtual reduction by validating the evaluation criteria according to guidelines suggested by the AO Surgery Reference. Methods: For this experiment, 19 intact radial ORTHObones (ORTHObones radius, 3B Scientific, Germany, Hamburg) without any fractures were prepared. All ORTHObones with six cortical marking holes (three points on the distal part and three points on the proximal part) were scanned using a CT scanner twice (before/after intentional fracture of the ORTHObone). After the virtual reduction of all 19 ORTHObones, accuracy evaluations using the four criteria (length variation, apposition variation, alignment variation, Rotation Variation) suggested in the AO Surgery Reference were performed. Results: The mean (M) length variation was 0.42 mm, with 0.01 mm standard deviation (SD). The M apposition variation was 0.48 mm, with 0.40 mm SD. The M AP angulation variation (for alignment variation) was 3.24°, with 2.95° SD. The M lateral angulation variation (for alignment variation) was 0.09°, with 0.13° SD. The M angle of axial rotation was 1.27° with SD: 1.19°. Conclusions: The method of accuracy evaluation used in this study can be helpful in establishing a reliable plan.

18.
J Pers Med ; 12(6)2022 Jun 02.
Article in English | MEDLINE | ID: mdl-35743711

ABSTRACT

The purpose of this study was to evaluate the restoration of original anatomy after fixation of sawbone fractures using case-specific 3D printing plates based on virtual reduction (VR). Three-dimensional models of 28 tibia sawbones with cortical marking holes were obtained. The sawbones were fractured at various locations of the shaft and 3D models were obtained. The fractured models were reduced virtually and customized non-locking metal plates that fit the reduced model were produced via 3D printing. The fractured sawbones were actually fixed to the customized plate with nonlocking screws and 3D models were generated. With the proximal fragments of the 3D models overlapped, the changes in length, 3D angulation, and rotation of the distal fragment were evaluated. Compared to the intact model (IN), the virtual reduction model (VR) and the actual fixation model (AF) showed no significant differences in length. Compared to the IN, the VR and the AF had mean 3D angulations of 0.39° and 0.64°, respectively. Compared to the IN model, the VR and the AF showed mean rotations of 0.89° and 1.51°, respectively. A customized plate based on VR facilitates the restoration of near-original anatomy in fractures of tibial sawbone shaft.

19.
Healthcare (Basel) ; 10(5)2022 Apr 30.
Article in English | MEDLINE | ID: mdl-35627965

ABSTRACT

The purpose of this study was to investigate whether a watch-shaped external wrist band brace improves distal radioulnar joint (DRUJ) stability. Seven fresh cadaveric arms were used. Using a customized testing system, volar and dorsal translation forces were applied to the radius externally while the ulna was fixed. The test was performed with the forearm in neutral, 60° pronated, and 60° supinated positions, once without the brace and once with the brace applied. In each condition, the amount of translation was measured. Then, the triangular fibrocartilage complex (TFCC) was detached from the ulnar styloid process and the fovea ulnaris, and the same tests were performed again. Detachment of the TFCC significantly increased volar and dorsal translations in all forearm rotations compared to the intact condition (p < 0.05), except for the pronated dorsal translation of the radius (p = 0.091). Brace application significantly reduced volar and dorsal translations in all forearm rotations both in intact specimens and in TFCC-detached specimens (p < 0.05), except for pronated volar and dorsal translations in TFCC-detached specimens (p = 0.101 and p = 0.131, respectively). With the brace applied, the TFCC-detached specimens showed no significant difference in volar or dorsal translation in all forearm rotations compared to the intact specimens (p > 0.05). The external wrist band brace improved DRUJ stability in both normal and TFCC-torn wrists and reduced the DRUJ instability caused by TFCC tear to a near-normal level.

20.
Cell Tissue Bank ; 23(3): 591-606, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35277795

ABSTRACT

Management of peripheral nerve defects is a complicated problem in clinical contexts. Autologous nerve grafting, a gold standard for surgical treatment, has been well known to have several limitations, such as donor site morbidity, a limited amount of available donor tissue, and size mismatches. Acellular nerve allografts (ANAs) have been developed as an alternative and have been applied clinically with favorable outcomes. However, because of the limited availability of commercialized ANAs due to supplier-related issues and high costs, efforts continue to produce alternative sources for ANAs. The present study evaluated the anatomical and histological characteristics of human peripheral nerves using 25 donated human cadavers. The length, diameter, and branching points of various peripheral nerves (median, ulnar, tibial, lateral femoral cutaneous, saphenous, and sural nerves) in both the upper and lower extremities were evaluated. The cross-sectional area (CSA), ratio of fascicular area, and numbers of fascicles were also evaluated via histologic analysis. CSA, the ratio of fascicular area, and the number of fascicles were analyzed statistically in correlation with demographic data (age, sex, height, weight, BMI). The mean length of all evaluated nerves ranged from 17.1 to 41.4 cm, and the mean diameter of all evaluated nerves ranged from 1.2 to 4.9 mm. Multiple regression analysis revealed correlations between the ratio of fascicular area and sex (p = 0.005) and BMI (p = 0.024) (R2 = 0.051). The results of the present study will be helpful in selecting necessary nerve allograft sources while considering the characteristics of each nerve in the upper and lower extremities during ANAs production.


Subject(s)
Hematopoietic Stem Cell Transplantation , Nerve Tissue , Cadaver , Humans , Peripheral Nerves/anatomy & histology , Peripheral Nerves/transplantation , Sural Nerve
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