Accuracy of intrasheath injection techniques for de Quervain's disease: a cadaveric study.

The purpose of this study was to assess the accuracy of injections of dye into the first extensor compartment of the wrist using three different techniques in 150 wrists in 75 fresh cadavers. To compare injections, 50 wrists from 25 cadavers were used for each technique. After the injections, the first extensor compartment was dissected and the dispersion of dye around the abductor pollicis longus and extensor pollicis brevis tendons was investigated. In 72 % of all the wrists, acrylic dye was dispersed into one compartment containing both the abductor pollicis longus and extensor pollicis brevis tendons, but in 28% of the wrists there was a separate compartment for extensor pollicis brevis and dye entered only one of the compartments (14% for each compartment). For accurate injections, we think the injections should be made separately over the two tendons, to allow for the possibility of a septum within the compartment.

Surgical outcome of thoracolumbar burst fractures with flexion-distraction injury of the posterior elements.

Between 1991 and 2002 we treated 48 patients surgically for thoracolumbar burst fractures associated with flexion-distraction injury of the posterior elements. The degree of kyphotic deformity and the degree of vertebral wedging deformity were measured on plain lateral radiographs. The spinal canal compromise was measured on computer tomography. The mean postoperative follow-up was 70 (24-108) months. The preoperative kyphosis averaged 25.7 degrees and the mean sagittal index was 28.8 degrees . The mean wedging deformity of the fractured vertebral body was 46% (24-66%). The mean preoperative spinal canal compromise secondary to retropulsed bony fragments was 64%. Immediately after surgery, the correction of kyphosis averaged 98%. There was no loss of correction at the final follow-up. A satisfactory reduction and good stabilisation with solid fusion were achieved in all cases.