Small longitudinal S incision and page turning style of annular ligament partial resection to treat stenosing tenosynovitis of thumb flexor tendon.

BACKGROUND: To present the treatment outcome for patients with stenosing tenosynovitis of thumb flexor tendon treated with a small S incision and page turning style of annular ligament partial resection. MATERIAL AND METHODS: During a 2-year period between August 2011 and July 2013, 12 consecutive patients (mean age, 45.8 years) with stenosing tenosynovitis of the thumb flexor tendon were prospectively enrolled into this study. All 12 patients underwent longitudinal S skin incision to expose annular ligament and thumb flexor tendon, and with page turning style of annular ligament partial resection to finish the operation. The average range of motion of metacarpophalangeal thumb joint, Quick disability of arm, shoulder, and hand and Short Musculoskeletal Function Assessment Dysfunction score of arm and hand were primary outcome measures. RESULTS: There were 9 cases of stiff metacarpophalangeal joint of thumb and 3 cases of snapping thumb for stenosing tenosynovitis. At 1-year follow-up, all stenosing tenosynovitis had healed by an average of 4 weeks. The average range of motion of the metacarpophalangeal joint was 37.1° (range, 34-40°). No patients had recurrence, cicatricial contraction, or postoperative infection. The average disability of arm, shoulder, and hand was 0.3 out of 100 (range, 0-1.67), and average Short Musculoskeletal Functional Assessment Dysfunction score of arm and hand was 6.9 out of 40 (range, 0-15.6). All 12 patients stated that they were highly satisfied. CONCLUSIONS: Small S incision and page turning style of annular ligament partial resection for stenosing tenosynovitis of thumb flexor tendon is a safe, simple, and reliable alternative treatment with minimal soft-tissue irritation, good functional results and recovery can be expected.

[Effect of estrogen-deficiency on expression of osteoprotegerin in alveolar bone: experiment with rats with periodontitis].

OBJECTIVE: To investigate the effects of estrogen-deficiency upon the expression of osteoprotegerin (OPG) in alveolar bone so as to clarify the role of estrogen in alveolar bone metabolism. METHODS: Fifty-three SD rats were randomly divided into 3 groups: OVX group (n=18) undergoing bilateral ovariectomy, OVX + E2 group (n=18), undergoing bilateral ovariectomy and subcutaneous injection of estradiol once 3 days since day 2 after the operation, and sham operation group (n=17) undergoing sham operation. Four weeks after the operation periodontal ligature was conducted and high-sugar diet was fed to establish periodontitis models. Four weeks later the rats were killed. The morphological changes and expression of OPG in alveolar bone were observed by light microscopy and immunohistochemistry. RESULTS: All the rats showed sparseness of bone trabeculae in alveolar bone and osteoclasts and lacuna at the surface of alveolar bone, especially the rate of the group OVX. The A values (absorption of the OPG expression) in the alveolar bone of the OVX groups was 27 854 +/- 5246, significantly lower than those of the sham operation group and OVX + E2 group (38 799 +/- 6228 and 37 146 +/- 6394 respectively, both P < 0.05) without significant difference between the sham operation group and OVX + E2 group (P > 0.05). CONCLUSION: Estrogen deficiency decreases the expression of OPG in alveolar bone, and enhances the absorption of alveolar bone.

Association of WBC count and glucose metabolism among Chinese population aged 40 years and over.

Chronic subclinical inflammation may be involved in the pathogenesis of Type 2 diabetes. We examined whether elevated WBC count, a marker of inflammation, was associated with worsening of glucose tolerance among Chinese population aged 40 years and over. Based on the 75g OGTT, 1016 subjects aged from 40 to 88 years were classified into four groups: NFG/NGT (n=299), isolated IFG (n=213), IGT (n=213) and Type 2 diabetes (n=291). We compared the WBC count among the four groups and investigated relevant variables associated significantly with the WBC count. The IGT and Type 2 diabetes groups had a significantly higher WBC count than the NFG/NGT and isolated IFG groups. By stepwise regression analyses, we found that waist circumference, DBP, total cholesterol, HDL cholesterol and 2-h PG showed an independent association with the WBC count. In the analysis stratified by sex and smoking status, WBC count was independently associated with age and triglycerides in males, whereas it was associated with BMI, SBP, triglycerides and 2-h PG in females. BMI, SBP, triglycerides and 2-h PG showed an independent association with WBC count in subjects who never smoked. We concluded that an increase in WBC count was associated with the deterioration of glucose tolerance. WBC count was associated with lipid metabolism in males and with various components of the metabolic syndrome in females and subjects who never smoked.