Traumatic Dorsal Hand Reconstruction through A free Anterolateral Thigh Flap, Induced Membrane Technique, Toe Joint Transfer, and Joint Prosthesis

Introduction:This study presents a case of post-traumatic dorsal hand reconstruction by describing the surgical technique in several stages and the outcome. Case report:It involves a patient with loss of cutaneous tissue, loss of bone, and tendon in the dorsal hand and fingers following a car accident. He was treated on a four-stage hand salvage and reconstruction. Stage one fulfilled in emergency involved K-wire and osseous filling through acrylic cement, hunter tendon rods, and a free anterolateral thigh flap. The second stage at 2 months involved osseous grafts and finger joint prostheses. The third stage time at 7 months involved a toe joint transfer. The last stage at 11 months involved extensor tendons graft reconstruction. The functional outcome at 2 years is acceptable. Conclusion:The post-traumatic dorsal hand reconstruction requires several techniques to reconstruct the losses of substances observed and this in several stages. It allowed to have an acceptable hand function. Keywords:Hand injuries, induced membrane, finger joint prosthesis, tendon transfer.

Effects of different concentrations of artificial joint prosthesis nanoparticles on cytotoxicity and osteogenic differentiation of bone marrow stromal cell (BMSCs) in vivo

To explore the effects of artificial joint prosthesis nanoparticles on cytotoxicity and osteogenic differentiation of Bone Marrow Stromal Cell (BMSCs). SD rats were used to isolate cells and titanium metal obtained from artificial joint revision surgery was prepared into nanoparticles by the direct current arc plasma method. The SD rats were then divided into control group, blank group (group A: D-MEM medium+10% FBS), low concentration group (group B: 0.01 mg/mL titanium alloy particles), medium concentration group (group C: 0.05 mg/mL titanium alloy particles), high concentration group (group D: 0.1 mg/mL titanium alloy particles plus D-MEM complete medium+10% FBS), followed by analysis of cytotoxicity and osteogenic differentiation of BMSCs. Among the three test groups, group B showed highest percentage of viable cells and group D had lowest. The percentages of viable cells in three test groups were significantly lower and cell death rate were higher than those in the control group (P < 0.05). Titanium alloy metal particles inhibited osteogenic differentiation of BMSCs in a dose dependent manner. The cells in control group were stained and dark brown nuclei were visible. The stained cells were almost invisible in group A, and less red-stained areas in group B, and with a small amount of cell nuclei. Artificial joint prosthesis particles had certain effects on cytotoxicity and osteogenic differentiation of BMSCs in vivo. Among them, the high concentration of titanium alloy nanoparticles test group had the highest percentage of viable cells.

Temporomandibular joint morphology in Korean using cone-beam computed tomography: influence of age and gender

Objectives The purpose of this study was to investigate the condylar morphology and position of Koreans using cone-beam computed tomography (CBCT) images. Analyzing the mean values of this study with reference to left and right sides, gender, and age will help to understand the size of the condyle and glenoid fossa, condylar morphology, and temporomandibular joint (TMJ) symmetry for establishing the standard temporomandibular joint structures of Koreans and then design the standard temporomandibular joint prosthesis for Koreans. Results There was no significant result in the condyle size, condyle axis angle, joint space, fossa depth, and mandibular body size between the left and right sides (p > 0.05). On the other hand, the mediolateral width of the condyle and mandibular body size show significantly different with the gender (P < 0.05). Also, significant differences were found in condyle size, joint space, fossa depth, and mandibular body size according to age groups (p < 0.05). Conclusions Condylar position and morphology vary according to side, age, and gender. The results of this study are expected to help in customizing a treatment for the patients who need TMJ reconstruction by predicting the TMJ morphology according to age and gender and design the standard temporomandibular joint prosthesis for the Koreans.