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Osteoarthritis is a common degenerative disease that most frequently involves the hand. The objective was to compare clinical functional outcome measures including hand grip, pinch strength, and dexterity with various electrophysiological measures in patients of different ages with hand osteoarthritis with or without the presence of carpal tunnel syndrome (CTS). Patients with hand osteoarthritis (208 patients, 404 hands) who underwent hand-function tests and motor and sensory nerve conduction studies (NCS) between June 2015 and June 2016 were enrolled. The patients’ hands were assigned to carpal tunnel syndrome (CTS) (206 hands; mean age, 56.37 ± 10.52; male:female, 46:160) or control groups (198 hands; mean age, 57.88 ± 9.68; male:female, 55:143). The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. The CTS group showed significantly lower hand grip and lateral pinch strength, and a longer time to complete the 9HPT in comparison with the control group. Female patients showed significantly lower hand grip and lateral pinch strength than male patients. However, there was no difference in the 9HPT completion time between genders. Multivariate regression analysis identified the amplitude of the median compound muscle action potential (CMAP), age, and male gender as independent predictors of grip strength (adjusted R2 = 0.679), and amplitude of median CMAP and male gender as independent predictors of KP strength (adjusted R2 = 0.603). Velocity of median CMAP, amplitude of median sensory nerve action potential, and age were identified as independent predictors of 9HPT time (adjusted R2 = 0.329). Nerve conduction measurements were significantly related to hand-function test results, and CTS induced significant deficits in strength and performance of the affected hand.

Purpose:To evaluate the clinical and radiologic efficacy of posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC) alone with autogenous iliac corticocancellous bone graft for single-level degenerative lumbar spinal disorders. Materials and Methods: Thirty-eight consecutive patients receiving PLIF with TFC alone were evaluated with at least three years of follow-up. Clinical outcome and satisfaction were assessed using Ragab's measurements. Radiological outcomes were analyzed in terms of lumbar lordosis, segmental lordosis, disc height, and fusion rates. Results: Disc height was 6.18±2.54 mm, 11.71±1.60 mm and 9.94±1.94 mm on average for preoperative, postoperative, and final follow-up, respectively. Lumbar lordosis was 27.46±11.47 o , 31.41±8.89 o on average for preoperative and at final follow-up, respectively. Segmental lordosis was 11.51±9.35 o preoperatively, and 10.86±7.49 o at final follow-up. Satisfactory clinical outcome were obtained in 89.2% of patients with successful bone fusion in 73.0% of patients. Conclusion: Stand alone TFC is an effective treatment modality in maintenance of disc height and lumbar lordosis, with satisfactory long term clinical outcomes in the treatment of single-level degenerative lumbar spinal disorders.

Distal tibia fractures in children are rare and surgical treatments are not well known. Distal tibia fractures with concomitantfibular fracture are caused by high-energy injury in most cases and it makes surgical treatment difficult due to soft tissue injuryand instability of fracture fragments.So, we report 4 cases, who were diagnosed as unstable distal tibia fracture, and underwent percutaneous plating byLCP(locking compression screw), and were followed-up for more than 1 year.