In the absence of unreducible rotational malalignment, fourth metacarpal fractures may be adequately treated nonoperatively with a protocol of casting and outrigger.

Three studies were performed to investigate the mechanism of action and evaluate the efficacy of a topical cosmetic slimming product combining tetrahydroxypropyl ethylenediamine, caffeine, carnitine, forskolin and retinol. The Ex vivo study on skin explants showed that caffeine and forskolin both stimulated glycerol release and demonstrates for the first time that retinol and carnitine in combination synergistically stimulated keratinocyte proliferation, which leads to an increase epidermal thickness. The double-blind, randomized, placebo-controlled clinical study associating circumference measurements on five selected parts of the body, cutaneous hydration measurements as well as blinded expert grading of skin aspect was conducted on 78 women who applied the product or placebo twice daily for 12 consecutive weeks. After 4 weeks of twice-daily application of the product, significant reductions in circumference of abdomen, hips-buttocks and waist were already observed. Improvements concerned all the measured body parts after 12 weeks. Orange peel and stubborn cellulite decreased significantly from 4 weeks of treatment and tonicity improved from 8 weeks, demonstrating that the product improved skin aspect. At the end of the study, eight parameters of the thirteen evaluated were significantly improved in the active group and compared with placebo.

The skin structure of SD is qualitatively and quantitatively different compared to healthy skin. Altered skin relief reflects structural modifications in the dermis. Flattening of the dermal-epidermal junction maybe functionally related to the observed collagen fiber alignment. Observations by non-invasive methods were in line with the histological findings and therefore relevant in studies assessing the efficacy of SD treatment options.