Spontaneous compartment syndrome of the forearm in association with nephrotic syndrome and transient bacteremia

We present a patient with spontaneous compartment syndrome of the upper extremity in association with nephrotic syndrome and transient bacteremia, of which the exact cause of compartment syndrome was unclear. This is an extremely rare occurrence, and index of suspicion should be maintained even in the absence of trauma when a patient presents with acute swelling of the upper or lower extremity together with nephrotic syndrome.

Open reduction and interfragmentary screw fixation for symptomatic nonunion of distal phalangeal fractures

Although most distal phalangeal fractures can be treated conservatively, there exists a subset of patients who are liable to develop symptomatic non-union, manifesting as pain and/or instability, and who may benefit from early fracture fixation. This group of patients includes those with displaced or comminuted fractures of the shaft or neck and those with oblique fractures prone to displacement. This paper reviews the use of a cortical miniscrew for fixation of fracture non-union in these patients and shows that this is an effective treatment modality with minimal morbidity. Fourteen patients with fractures of the shaft or neck of the distal phalanx complicated by symptomatic non-union were treated by open reduction and interfragmentary screw fixation. All of the fractures united at a mean of 4.2 months and all patients regained normal function of the finger.

A comparative analysis of scaffold material modifications for load-bearing applications in bone tissue engineering

To facilitate optimal application of appropriate scaffold architectures for clinical trials, there is a need to compare different scaffold modifications under similar experimental conditions. In this study was assessed the effectiveness of poly-e-caprolactone (PCL) scaffolds fabricated by fused deposition modelling (FDM), with varying material modifications, for the purposes of bone tissue engineering. The incorporation of hydroxyapatite (HA) in PCL scaffolds, as well as precalcification through immersion in a simulated body fluid (SBF) to produce a biomimetic apatite coating on the scaffolds, was assessed. A series of in vitro studies spanning 3 weeks as well as in vivo studies utilizing a subcutaneous nude mouse model were carried out. PCL and HA-PCL scaffolds demonstrated increasing tissue growth extending throughout the implants, as well as superior mechanical strength and mineralization, as evidenced by X-ray imaging after 14 weeks in vivo. No significant difference was found between PCL and HA-PCL scaffolds. Precalcification with SBF did not result in increased osteoconductivity and cell proliferation as previously reported. Conversely, tensile forces exerted by tissue sheets bridging adjacent struts of the PCL scaffold caused flaking of the apatite coating that resulted in impaired cell attachment, growth and mineralization. The results suggest that scaffolds fabricated by FDM may have load-bearing applications.