Soft Tissue Infection of Immunocompetent Man with Cat-Derived Globicatella Species.

We report a novel Globicatella species causing extensive soft tissue infection in a man bitten by a stray domestic cat in the United Kingdom. We identified this bacterium by 16S rRNA gene sequencing, whole-genome sequencing, and biochemical profiling and determined antimicrobial drug susceptibility.

Bilateral Carpal Tunnel Syndrome Following COVID-19 Vaccination: A Case Report.

Coronavirus disease 2019 (COVID-19) continues to pose significant health challenges, with insights into long-term disease sequelae emerging. The post-viral effects resulting from COVID-19 are being investigated and 'long COVID-19' is now a recognised phenomenon. As part of the spectrum of comorbidities, acute-onset neuropathy is associated with infection. The public health response aimed at limiting morbidity and mortality is rooted in vaccination programmes. With the extensive roll-out of novel vaccinations, there has been careful monitoring of temporally associated health problems. Some of the documented associations include neuropathy and entrapment neuropathies. This case report details a patient presenting with bilateral carpal tunnel syndrome (CTS) post their second dose of AZD1222 (ChAdOx1 nCoV-19) vaccination. Though we do not claim causality, the emerging post-vaccination immune-mediated effects may ultimately be proven to include neuropathy exacerbation. Meticulous recording of such associations is required as it is of great relevance to the hand surgeon managing CTS. Level of Evidence: Level V (Therapeutic).

The Virtual Nose: Assessment of Static Nasal Airway Obstruction Using Computational Simulations and 3D-Printed Models.

Background: The use of virtual noses to predict the outcome of surgery is of increasing interests, particularly, as detailed and objective pre- and postoperative assessments of nasal airway obstruction (NAO) are difficult to perform. The objective of this article is to validate predictions using virtual noses against their experimentally measured counterpart in rigid 3D-printed models. Methods: Virtual nose models, with and without NAO, were reconstructed from patients' cone beam computed tomography scans, and used to evaluate airflow characteristics through computational fluid dynamics simulations. Prototypes of the reconstructed models were 3D printed and instrumented experimentally for pressure measurements. Results: Correlation between the numerical predictions and experimental measurements was shown. Analysis of the flow field indicated that the NAO in the nasal valve increases significantly the wall pressure, shear stress, and incremental nasal resistance behind the obstruction. Conclusions: Airflow predictions in static virtual noses correlate well with detailed experimental measurements on 3D-printed replicas of patient airways.

Intramedullary Cannulated Compression Screws for Extra-Articular Phalangeal Fractures.

Background: There is no consensus as to which is the best way to fix unstable extra-articular phalangeal fractures. We performed a literature review to determine outcomes using intramedullary cannulated compression screws. Methods: PubMed, Medline and Embase databases were searched for English language articles reporting the use of one or more intramedullary screw(s) for fixation of an acute extra-articular phalangeal fracture in adults that reported outcome data. Results: A total of 62 abstracts were identified, of which 14 full-text articles were eligible for full-text screening for the inclusion criteria. Of these 14 articles, seven articles were included in the final study. Data on 146 phalangeal fractures were aggregated with an average patient age of 36 (18-84). 89% (130/146) fractures were of the proximal phalanx, the remainder of the middle phalanx. Surgical technique was mostly a minimally invasive technique under fluoroscopy guidance using an anterograde technique. One paper described a retrograde method. Screw diameter varied from 2.2 mm to 3.2 mm. Where the radiographic union was reported, all fractures united. Range of motion averaged 231° (range 95°-295°) in four studies. Return to work was reported as 6.4 weeks (range 0.9-16.7 weeks) in one study. Different quality-of-life scores were reported by the studies (DASH 3.52 (range 1-45), QuickDASH score of 3.9 and DASH score of 3.9). Complications rate was 5% (8/146) including 5 major complications and 3 minor in the pooled results. Conclusions: This literature review demonstrates that fixation of extra-articular fractures of the proximal and middle phalanges with cannulated compression screws is a safe and successful surgical treatment with faster mobilization and return to work with fewer complications, including stiffness, than have been reported with plates and screws and percutaneous K-wires. This application is limited to transverse and short oblique extra-articular fractures.