This retrospective study compares three of surgical treatments for osteoarthritis of the trapeziometacarpal joint of the thumb. We assessed the outcomes of a total of 83 operations at a follow-up of between 1 and 5 years. The types of treatment were, fusion of the carpometacarpal joint (36 operations), excision of the trapezium with or without a sling ligament reconstruction (25 operations), and silastic trapezial replacement (22 operations). Assessments included patient satisfaction, pain measurement, range of movement, tip and key pinch, and complication rates. There were no significant differences between the clinical outcome of the treatments, though there was higher rate of complications and reoperation in the fusion group.

Thirty-six patients were reviewed by questionnaire after operative treatment for trigger finger or thumb. Multiple digital involvement occurred in just under one third of the patients in this series and the index and little fingers were relatively rarely involved. Five patients had close relatives affected by the same condition. 17% of patients in this small series were dissatisfied with their operation scar.

The cytogenetics of cell cultures derived from Dupuytren's tissue, adjacent palmar fascia and palmar skin from patients undergoing fasciectomy have been examined and the results compared to cell cultures established from palmar fascia, flexor retinaculum and palmar skin of patients undergoing carpal tunnel decompression. Chromosomal abnormalities were detected in cell cultures from Dupuytren's tissue in eight of the nine patients studied. Clones of cells trisomic for chromosome 8 were found in five of the nine patients. Trisomy 8 was also present in two of five flexor retinaculum cultures from carpal tunnel syndrome cases. These findings in both Dupuytren's contracture and carpal tunnel syndrome suggest the presence of chromosomal instability in the palmar fascia. The significance of the chromosomal abnormalities is however unclear, but they indicate a possible common pathway in the onset of pathological fibrosis.

The results of posterolateral screw fixation using the Buck technique performed on 24 patients with painful isthmic spondylolysis and up to grade I spondylolisthesis in the lumbar spine are reported. The average age at operation was 29 years and average follow-up was 5 years with a range of 13 months to 12 years. Operations were performed for persistent disabling low back pain. At review 21 patients were either free of pain or complained of only occasional backache and discomfort. All but two patients were satisfied with the operation and rated the result as excellent or good. It is concluded that Buck screw fixation is a safe and reliable method of treatment for painful Grade I spondylolisthesis due to isthmic spondylolysis in the young active adult with a low complication rate.