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This study developed a deep learning model for fully automatic segmentation and labelling of wrist bones from four-dimensional computed tomography (4DCT) scans. This is a crucial step towards implementing 4DCT for diagnosing wrist ligament lesions, reducing time-consuming analysis of extensive data. [ABSTRACT FROM AUTHOR]

Background: The hamster retractor muscle (RET) is used as an in vivo model in studies of skeletal muscle ischemia-reperfusion injury. The RET is unique in that the muscle can be isolated while preserving the primary vascular supply so that its contractile function can be measured simultaneously with local microvascular responses to experimental interventions. The goal of this study was to understand the anatomical origin of the vascular supply to the RET and determine whether the RET can be used as a free flap after surgical isolation of the thoracodorsal vessels. Methods: Microdissection was performed to determine the anatomy of the vasculature that supplies and drains the RET. Results: Distinct numbers and patterns of feed arteries (2–4) and collecting veins (1–3) were identified (n = 26 animals). Dye injection (n = 8) of the thoracodorsal artery demonstrated that the RET remains perfused following its isolation on the thoracodorsal pedicle. Heterotopic allograft transplantation of the RET (n = 2) was performed by anastomosing the thoracodorsal vessels to the femoral vessels using the end-to-side technique. Conclusions: The anatomical relationships indicate that the RET can be used as a free flap model for evaluating the effect of preservation strategies and transplantation on skeletal muscle microcirculation and contractile function. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aim: Early diagnosis of scapholunate ligament (SLL) injuries is crucial to prevent progression to debilitating osteoarthritis. Four-Dimensional Computed Tomography (4DCT) is a promising dynamic imaging modality for assessing such injuries. Capitalizing on the known correlation between SLL injuries and an increased scapholunate distance (SLD), this study aims to develop a fully automatic approach to evaluate the SLD continuously during wrist motion and to apply it to a dataset of healthy wrists to establish reference values., Materials and Methods: 50 healthy wrists were analysed in this study. All subjects performed radioulnar deviation (RUD), flexion-extension (FE), and clenching fist (CF) movements during 4DCT acquisition. A novel, automatic method was developed to continuously compute the SLD at five distinct locations within the scapholunate joint, encompassing a centre, volar, dorsal, proximal, and distal measurement., Results: The developed algorithm successfully processed datasets from all subjects. Our results showed that the SLD remained below 2 mm and exhibited minimal changes (median ranges between 0.3 mm and 0.65 mm) during RUD and CF at all measured locations. During FE, the volar and dorsal SLD changed significantly, with median ranges of 0.90 and 1.27 mm, respectively., Conclusion: This study establishes a unique database of normal SLD values in healthy wrists during wrist motion. Our results indicate that, aside from RUD and CF, FE may also be important in assessing wrist kinematics. Given the labour-intensive and time-consuming nature of manual analysis of 4DCT images, the introduction of this automated algorithm enhances the clinical utility of 4DCT in diagnosing dynamic wrist injuries., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Animal bite wounds are common and can cause serious hand infections. Risk factors not only include the oral flora of the animal and the anatomy of the teeth, but also the comorbidities of the bitten patient., Case Description: In this case report we describe a 46-years old female patient with comorbidities, including diabetes mellitus type 2 and peripheral artery disease, suffering a fulminant hand infection after a domestic rat bite with the newly described bacterium Rodentibacterratti. Despite extensive antibiotic therapy and surgical debridement, a ray amputation was inevitable to maintain adequate hand function., Conclusion: Infections after animal bites may be caused by a variety of pathogens. The pathogen Rodentibacterratti has not previously been associated with infections in humans and future research is indicated to assess therapeutic strategies. Patients should be referred to a (plastic) surgeon if there is no clinical improvement within 48 hours of initiating antibiotic treatment.

The aim of this study was to assess return to work (RTW) after open Triangular Fibrocartilage Complex (TFCC) reinsertion. RTW after open surgery for TFCC injury was assessed by questionnaires at 6 weeks, 3 months, 6 months, and 12 months post-operatively. Median RTW time was assessed on inverted Kaplan-Meier curves and hazard ratios were calculated with Cox regression models. 310 patients with a mean age of 38 years were included. By 1 year, 91% of the patients had returned to work, at a median 12 weeks (25%-75%: 6-20 weeks). Light physical labor (HR 3.74) was associated with RTW within the first 15 weeks; this association altered from 23 weeks onward: light (HR 0.59) or moderate physical labor (HR 0.25) was associated with lower RTW rates. Patients with poorer preoperative Patient-Rated Wrist Evaluation (PRWE) total score returned to work later (HR 0.91 per 10 points). Overall cost of loss of productivity per patient was €13,588. In the first year after open TFCC reinsertion, 91% of the patients returned to work, including 50% within 12 weeks. Factors associated with RTW were age, gender, work intensity, and PRWE score at baseline., (Copyright © 2021 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

A 79-year-old woman consulted a plastic surgeon, because since 3 years she had a large wound at the base of her left index finger. Histology of a skin biopsy showed cutaneous squamous cell carcinoma. Because of the extension of the defect, amputation of the index finger with a split-skin-graft was performed.

Introduction: Cold hypoxia is a common factor in cold tissue preservation and mammalian hibernation. The purpose of this study was to determine the effects of cold preservation on the function of the retractor (RET) muscle of the hamster in the non-hibernating state and compare these with previously published data (van der Heijden et al., 2000) on the rat cutaneus trunci (CT) muscle., Materials and Methods: After cold storage (16 h at 4 degrees C), muscles were stimulated electrically to measure maximum tetanus tension (P(0)) and histologically analyzed. The protective effects of addition of the antioxidants trolox and deferiprone and the calcium release inhibitor BDM to the storage fluid were determined., Results: After storage, the twitch threshold current was increased (from 60 to 500 microA) and P(0) was decreased to 27% of control. RET morphology remained unaffected. RET muscle function was protected by trolox and deferiprone (P(0), resp., 43% and 59% of control). Addition of BDM had no effect on the RET., Conclusions: The observed effects of cold preservation and of trolox and deferiprone on the RET were comparable to those on CT muscle function, as reported in a previously published study (van der Heijden et al., 2000). Both hamster RET and rat CT muscles show considerable functional damage due to actions of reactive oxygen species. In contrast to the CT, in the RET cold preservation-induced functional injury could not be prevented by BDM and was not accompanied by morphological damage such as necrosis and edema. This suggests that the RET myocytes possess a specific adaptation to withstand the Ca(2+) overload induced by cold ischemia.

The aim of this study was to investigate if the preservation of isolated skeletal muscles for 16 h at 4 degrees C could be improved by pre-storage perfusion (PSP). Two rat muscle models were used: the soleus (SOL) and a posterior strip of the cutaneous trunci (CT). The effects of a 10 min PSP (at 25 degrees C) with University of Wisconsin solution (UW) or HTK-Bretschneider solution (HTK) on muscle function were analysed. The perfusion model was validated by the demonstration that the SOL and CT could be perfused with donor blood, UW and HTK at a flow rate of 0.2 ml x min(-1) x g(-1) muscle for 10 min without any immediate adverse effects on muscle weight, function (maximum tetanus tension) and cytoarchitecture (multivariate analysis of variance, P >0.05; n =6). For each muscle type and for each solution, six perfused and six non-perfused muscles were stored for 16 h at 4 degrees C. In the perfused groups, the storage and perfusion solution were matched. For both muscle types, the function (maximum tetanus tension), weight and cytoarchitecture of pre-storage perfused muscles was not preserved any better than that of non-perfused muscles, irrespective of the solution used (multivariate analysis of variance, P >0.05). We conclude that PSP for 10 min with UW and HTK does not improve the preservation of function of rat skeletal muscles during storage for 16 h at 4 degrees C.