Lunocapitate fusion using the OSStaple compression staple.

Midcarpal arthrodesis is a reliable procedure to treat individuals with symptomatic scapholunate advanced collapse (SLAC) who have failed nonoperative care. The principal keys to a successful midcarpal arthrodesis include achieving union, a proper reduction of the capitolunate interval, and avoiding hardware impingement. A variety of devices are used in an attempt to achieve this. These include Kirchner wires, stainless steel staples, compression screws, and, most recently, circular plates. The performance of these devices has not always been reliable leaving room for improvement. This report describes the use of a new device that facilitates the achievement of the key principals. Staples made of nitinol (OSStaple, BioMedical Enterprises Inc, San Antonio, TX) facilitate provisional reduction, provide continuous compression leading to rapid reliable union, and are low profile.

Volar plate arthroplasty for osteoarthritis of the proximal interphalangeal joint: a preliminary report.

Osteoarthritis of the hand, including involvement of the proximal interphalangeal joint, is common in the aging population. The purpose of this study is to provide a preliminary retrospective report on 12 volar plate arthroplasties in 9 patients who had volar plate advancement arthroplasty for osteoarthritis of the proximal interphalangeal joint. The average age of the patients was 67.6 years. All of the patients' data were obtained from office notes and hand therapy assessment sheets. The average time from surgery to follow-up evaluation was 36.5 months. All patients had significant pain relief. Range of motion was maintained; there was no significant difference between preoperative and final arc of motion values. Preoperative pinch and grip strengths did not differ significantly from the final values. Postoperative position was similar to preoperative angulation, with recognized lateral stability. Our results suggest that volar plate advancement arthroplasty represents a good primary surgical therapeutic option for the osteoarthritic proximal interphalangeal joint, providing pain relief while preserving motion, strength, and stability.

Flexible titanium nailing for the treatment of the unstable pediatric tibial fracture.

Tibia fractures in the skeletally immature patient can usually be treated without surgery. The purpose of this study was to assess the use of flexible titanium nails in the tibia that requires operative stabilization. Over a 5-year period, 16 unstable tibia fractures in 14 patients were treated with flexible titanium intramedullary nails. All charts and radiographs were reviewed. The average age was 10 years 4 months. There were three open fractures. All fractures healed. Closed injuries obtained union by an average of 8 weeks, open fractures by an average of 15 weeks. There were no malunions. The average follow-up was 1 year 5 months. There were no instances of growth arrest, remanipulations, or refracture. In the unstable pediatric tibia fracture, flexible titanium nails are an effective treatment to obtain and maintain alignment and stability.