The Fine Wire Technique for Flexor Tenolysis.

BACKGROUND: Flexor tenolysis surgery for flexor digitorum profundus and superficialis adhesions is a common procedure performed by hand surgeons. Releasing these adhered tendons can greatly improve hand function and improve quality of life. Recent evidence, however, has shown that the outcomes of tenolysis surgeries are often suboptimal and can result in relapsing adhesions or even tendon ruptures. METHODS: This article describes a new technique with potential for reduced complication rates: The Fine Wire Technique for Flexor Tenolysis (FWT). RESULTS: Following FWT, the patient detailed in this article had an excellent recovery of function and no complications: including tendon rupture, infection, hematomas, or any other complications. She reported a major improvement from her preoperative functionality and continues to have this level of success. The wire's thinness allows for a swift tenolysis. CONCLUSIONS: The FWT is a new option available to the hand surgeon associated with good functional results. The wire is readily available to the clinician and is also inexpensive.

Impact of Total Shoulder Arthroplasty on Golfing Activity.

OBJECTIVE: Golf is a widely popular sport in the United States with 29 million Americans participating in the game. With an aging population and increased incidence of glenohumeral degenerative arthritis, the number of active golfers requiring total shoulder replacement is on the rise. This study aims to evaluate the effect of total shoulder replacement on golfing activity. DESIGN: Retrospective; questionnaire. SETTING: Survey. PARTICIPANTS: Three hundred sixty-seven patients were identified based on Current Procedural Terminology codes who underwent total shoulder arthroplasty (TSA) between January 2004 and January 2013. INTERVENTIONS: A voluntary anonymous questionnaire was sent to patients by mail including both objective and subjective questions about their level of golf activity and ability both before and after the surgery. MAIN OUTCOME MEASURES: Two hundred sixty-eight (73%) patients responded with 35 (34 right-handed and 1 left-handed patients) golfers completing the questionnaire. Results including visual analog pain scores, handicap change, and driving distance were evaluated statistically using the Student t test. RESULTS: Thirty-five golfers at an average time of 3.2 years after TSA completed the questionnaire with 31/35 being able to return to the sport at an average time of 8.4 months postoperatively. Thirty of 31 patients reported improvement in their pain level during and after golfing activity by an average of 4.3 (P < 0.05) on a visual analog scale (VAS) for pain. On average, driving distances increased by 12.5 yd (P = 0.0012) and handicap improved by 1.4 strokes (P = 0.03). CONCLUSIONS: Patients who undergo TSA for primary glenohumeral arthritis can safely return to golfing activity with a significant decrease in their perceived pain level as per VAS scores. Statistically significant findings included an increase in driving distance by 12.5 yd and an improvement in handicap by 1.4. CLINICAL RELEVANCE: In counseling patients, it is the authors' opinion that based on our experience with golfers undergoing TSA, patients can safely return to sport at an average of 8.4 months. The likelihood of return to play was quite high, but not 100%, and as such no guarantee should be provided to patients. Outcomes of patients with TSA desiring a return to golf are positive, and possible benefits include improvement of pain and possible improvements in driving distance and handicap. LEVEL OF EVIDENCE: IV.

Standoff detection of high explosive materials at 50 meters in ambient light conditions using a small Raman instrument.

We have designed and demonstrated a standoff Raman system for detecting high explosive materials at distances up to 50 meters in ambient light conditions. In the system, light is collected using an 8-in. Schmidt-Cassegrain telescope fiber-coupled to an f/1.8 spectrograph with a gated intensified charge-coupled device (ICCD) detector. A frequency-doubled Nd : YAG (532 nm) pulsed (10 Hz) laser is used as the excitation source for measuring remote spectra of samples containing up to 8% explosive materials. The explosives RDX, TNT, and PETN as well as nitrate- and chlorate-containing materials were used to evaluate the performance of the system with samples placed at distances of 27 and 50 meters. Laser power studies were performed to determine the effects of laser heating and photodegradation on the samples. Raman signal levels were found to increase linearly with increasing laser energy up to approximately 3 x 10(6) W/cm2 for all samples except TNT, which showed some evidence of photo- or thermal degradation at higher laser power densities. Detector gate width studies showed that Raman spectra could be acquired in high levels of ambient light using a 10 microsecond gate width.

Distal radioulnar allograft reconstruction after giant cell tumor resection.

Giant cell tumor of bone is considered to be a benign, locally aggressive lesion. When diagnosed early, it can be successfully treated with wide en bloc excision. No reports of complete distal radioulnar allograft reconstruction after en bloc excision of a distal ulnar lesion were found in the literature. We report a case of a distal ulnar giant cell tumor treated with wide en bloc excision and 2-stage allograft reconstruction and followed up for 40 months.