[Angularly stable radius plate: progress in treatment of problematic distal radius fracture?]. / Winkelstabile, volare Plattenosteosynthese komplexer artikulärer Frakturen am distalen RadiusLösung einer Problemfraktur?

Fractures of the distal radius represent one of the most common fractures and have high socioeconomic relevance. Using the volar approach to avoid the soft tissue problems associated with dorsal plating, we treated a consecutive series of 49 displaced intra-articular distal radius fractures with a new fixed-angle internal fixation device. According to the AO classification, there were 21 C1, 19 C2, and nine C3 fractures. A retrospective study was carried out to obtain the functional results after open reduction and plate osteosynthesis. Loss of correction between postoperative and follow-up radiography was 1 degrees in volar tilt and radial inclination. The radial shortening was 1 mm. Wrist motion at final follow-up examination had recovered to an average of 80% of that at the normal, contralateral site. Overall outcome according to the Gartland and Werley scales showed 35% excellent, 50% good, and 15% fair results. Using the Martini score, we obtained 85% excellent and good results. The DASH score represented high subjective satisfaction.

[Diagnosis and surgical therapy of diffuse pigmented villonodular synovitis of the hip joint]. / Diagnostik und operative Therapie der diffusen pigmentierten villonodulären Synovitis des Hüftgelenks.

Pigmented villonodular synovitis (PVNS) of the hip is a monoarticular proliferative process involving the synovial membrane. A chronic inflammation as well as a neoplastic process have been proposed in the literature. PVNS is usually found in adults aged 20-50 years, without sex predilection. The knee is by far the commonest location, followed by the hip. We present a detailed case report of a 25-year-old man with PVNS of the hip. The physical examination was completely normal. Radiographs of the hip show erosions in the head and neck of the femur and the acetabulum. Magnetic resonance imaging showed a suspected malignant soft tissue mass involving the hip joint. The diagnosis of PVNS was confirmed by arthroscopy and biopsy, and the treatment of choice was an open synovectomy. One year after the operation the clinical examination was normal.

Quantification of proliferating lymphocyte subsets appearing in the intestinal lymph and the blood.

Lymphocyte emigration from the intestinal wall via lymphatics is necessary to maintain gastrointestinal immunity and also to connect the different parts of the mucosal immune system. In the present study the numbers and time kinetics of proliferating lymphocyte subsets leaving the gut wall via intestinal lymphatics were analysed in mesenteric lymph node adenectomized minipigs (n = 8). After cannulation of the major intestinal lymph duct, afferent lymph was collected under non-restraining conditions. In four pigs lymphocytes taken from the intestinal lymph and blood were incubated in vitro with the thymidine analogue bromodesoxyuridine (BrdU) to label all lymphocytes in the S-phase of the cell cycle. The other four pigs received a single i.v. injection of BrdU 1 week after cannulation. The initial percentage of BrdU+ lymphocyte subsets in the intestinal lymph 15 min after BrdU injection was comparable to that after the in vitro labelling (1.5 +/- 0.7% in T cells, 10.6 +/- 1.6% in IgM+ cells and 30.0 +/- 11.9% in IgA+ cells). From this level onwards, the percentage of in vivo labelled BrdU+ lymphocyte subsets reached a maximum at 12 h after BrdU application. A different pattern of BrdU+ subsets was seen in the blood. After an early peak at around 3-4 h, the frequency of BrdU in vivo labelled cells decreased. Each subset had a maximum between 12 h and 48 h after BrdU application (maximum of BrdU+ CD2+ T cells at 12 h, 4.6 +/- 1.5%; IgM+ BrdU+ at 48 h, 8.8 +/- 3.3%). The present results provide a basis to determine the time necessary for induction of specific intestinal immunity during oral vaccination studies.