Wrist arthrodesis: modified Gill's technique.

Twenty-five wrist arthrodesis procedures were performed on 24 patients, applying a modification of Gill's technique, which used a corticocancellous strut graft from the distal radius. Patients were followed up until solid bony fusion was established. Union was achieved in 21 of 25 wrists and was subsequently achieved with a further procedure in the remaining four wrists. We have found that the modified Gill's technique is a reliable, simple procedure with a low complication rate which does not require the harvest of a distant bone graft.

True sagittal CT scanning of the elbow.

OBJECTIVE: A new method to obtain true sagittal CT scans of the elbow joint is described. MATERIALS AND METHODS: The patient is placed prone on the CT table with the arm around and under the table. RESULTS: True sagittal images of the elbow joints and all the articulating surfaces were easily obtained in a standard and reproducible manner. CONCLUSION: For CT scanning of the elbow, true sagittal scanning is superior to axial views and is readily obtained by the described method.

To trim or replant: a matter of cost.

Many factors are involved in the decision whether to complete the amputation of an injured digit and trim the stump or to replant the amputated member. This paper compares the cost of these two treatments so that this financial aspect might be included among the many factors which influence the surgeon's decision. The cost of these treatments was separated into two aspects. First, the overall cost of the medical and surgical expenses was calculated. Second, the cost which the Israeli social security granted the injured worker due to the disability was calculated. By comparing the total surgical and medical costs of amputations and replantations, trimming is far less expensive than replantation. In the long run, the compensation the insurer owes the disabled trimmed patient is far higher than the compensation given to those who were successfully replanted, provided the injured worker has a certain number of working years to retirement and has a yearly income of a certain level. Thus, in most cases, replantation is recommended from the cost benefit aspect.

Tenography in De Quervain's disease.

This paper describes our diagnostic method, which enables an early and immediate differentiation between those patients who could benefit from a single or several local corticosteroid injections, and those who will probably require surgery. The authors have no intention of advocating a preferred treatment, but try to predict the outcome of the various modes of therapy.

Choline acetyltransferase nerve identification method in early and late nerve repair.

Choline acetyltransferase (ChAC) measurement after complete transection of the sciatic nerve in rats revealed a steady increase in ChAC in the proximal nerve stump and a rapid drop in ChAC in the distal nerve stump. Ninety-six hours following transection no appreciable ChAC activity could be detected in the distal segment. The increase in the proximal segments was followed by a slight decline and leveling off at about twice the normal level. End-to-end nerve anastomosis, using the enzymatic nerve differentiation technique, could therefore be performed up to the first 96 hours. Nerve grafts could be used, with markedly improved results, up to the forty-fifth day following transection.