Background: There is a need to clarify the usefulness of and problems associated with cylindrical costal osteochondral autograft for reconstruction of large defects of the capitellum due to osteochondritis dissecans. Methods: Twenty-six patients with advanced osteochondritis dissecans of the humeral capitellum were treated with use of cylindrical costal osteochondral autograft. All were males with elbow pain and full-thickness articular cartilage lesions of ‡15 mm in diameter. Clinical, radiographic, and magnetic resonance imaging outcomes were evaluated at a mean followup of thirty-six months (range, twenty-four to fifty-one months). Results: All patients had rapid functional improvement after treatment with costal osteochondral autograft and returned to their former activities, including sports. Five patients needed additional minor surgical procedures, including screw removal, loose body removal, and shaving of protruded articular cartilage. Mean elbow function, assessed with use of the clinical rating system of Timmerman and Andrews, was 111 points preoperatively and improved to 180 points at the time of follow-up and to 190 points after the five patients underwent the additional operations. Mean elbow motion was 126°of flexion with 16°of extension loss preoperatively and improved to 133°of flexion with 3°of extension loss at the time of follow-up. Osseous union of the graft on radiographs was obtained within three months in all patients. Revascularization of the graft depicted on T1-weighted magnetic resonance imaging and congruity of the reconstructed articular surface depicted on T2-weighted or short tau inversion recovery imaging were assessed at twelve and twenty-four months postoperatively. Functional recovery was good, and all patients were satisfied with the final outcomes. Conclusions: Cylindrical costal osteochondral autograft was useful for the treatment of advanced osteochondritis dissecans of the humeral capitellum. Functional recovery was rapid after surgery. Additional operations were performed for five of the twenty-six patients, whereas the remaining patients showed essentially full recovery within a year. All patients were satisfied with the results at the time of short-term follow-up. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. O steochondritis dissecans of the humeral capitellum is a common sports-related disorder in young athletes, especially baseball players and gymnasts. With severe osteochondritis dissecans, the damaged articular cartilage detaches from the capitellum and there is a full-thickness articular cartilage defect and radiocapitellar incongruity. Treatment for early-stage osteochondritis dissecans is principally nonoperative. When the lesion progresses to a large, full-thickness articular cartilage defect, treatment remains challenging. In the elbow, arthroscopic debridement has been widely applied with good Disclosure: None of the authors received payments or services, either directly or indirectly (...

The electrodeposition of noble metals, i.e., platinum, palladium, and gold, into macroporous p-type silicon was examined. For platinum and palladium, the electrodeposition proceeded preferentially from the pore bottom to the opening when sodium chloride was used as a supporting electrolyte. When sodium sulfate was used as a supporting electrolyte, the electrodeposition mainly proceeded at pore openings, leading to plugging. For gold electrodeposition, a condition for achieving pore filling from the bottom was not found in either the NaCl or Na 2 SO 4 solutions. Pore depth was another key factor to achieve continuous filling by electrodeposition. As the depth of pores became deeper, the electrodeposition proceeded preferentially from the bottom. The effect of mass transfer in pores was also investigated by changing the concentration of metal ions and applied potential.

Cylindrical costal osteochondral autograft was useful for the treatment of advanced osteochondritis dissecans of the humeral capitellum. Functional recovery was rapid after surgery. Additional operations were performed for five of the twenty-six patients, whereas the remaining patients showed essentially full recovery within a year. All patients were satisfied with the results at the time of short-term follow-up.

Pulled elbow is a common upper extremity injury in children. We present a retrospective study of 2331 pulled elbow cases examined in our hospital over the last ten years. All pediatric patients with a diagnosis of pulled elbow from January 2002 to December 2011 were retrospectively reviewed according to sex, age, affected arm, recurrence rate, mechanism of injury and treatment outcomes. There is no significant sex difference. The frequency of injury peaked for both boys and girls at 6 months and 2 years of age. The left arm was more affected than the right. The recurrence rate was 14%. In about 50% of cases, the cause of injury was forcible traction to the forearm. Almost all of the splinted patients, caused by severe pain or lack of mobility of the affected limb following reduction, recovered within 2 weeks, but 2 were later diagnosed with a fracture. For infants less than 1 year old, injury can often occur when rolling over. For children 1 year old or older the left arm is more commonly affected, and the frequency of injuries to the left arm increases with age, possibly because the left hand is commonly held by the guardian’s dominant right hand and faster development of muscle strength in the child’s dominant right arm works toward preventing injury to that arm with age.

Firstly, we designed a vein-implantation model using the rat femoral nerve and vein to study the morphometric changes in nerve endings inserted into venous lumina. By 4 weeks, nerve fibers had extended from the nerve stump into the lumen of the vein and along the endothelium of the vein. After 8 weeks, the lengths and number of nerve fibres extending into the vein lumen began to decrease. At 12 weeks, the nerve ending had developed a hemispherical shape. In none of the experiments was a neuroma formed. Secondly, we treated ten neuromas in ten patients by the vein-implantation method. We obtained excellent results in seven patients. Résumé Dans un premier temps nous avons conçu un modèle d'implantation qui utilise le nerf et la veine fémoral du rat pour étudier les changements morphometriques des terminaisons nerveuses insérées dans la lumière veineuse. A 4 semaines, les fibres du nerf s'étaient étendues à partir de l'extrémité nerveuse le long de l'endothélium de la veine. Après 8 semaines, les longueurs et le nombre de fibres nerveuses développées dans la veine ont commencé à diminuer. À 12 semaines, la terminaison nerveuse avait développé une forme hémisphérique. Dans aucun des cas un névrome ne s'est formé. Dans un deuxième temps nous avons traité 10 névromes chez 10 malades par la méthode de la veine-implantation. Nous avons obtenu d'excellents résultats pour 7 malades.