Faculty Bibliography

The use of arthrotomography and postexercise spot films has increased the effectiveness of wrist arthrography in demonstrating triangular fibrocartilage abnormalities.

A radiographically nonspecific lytic lesion in the middle phalanx of the index finger with microscopic evidence of a benign fibrous stroma with giant cells and osteoid was investigated in an 18-year-old man. Giant cell reaction is a rare, benign lesion of the small bones of the hands and feet. Trauma as the cause of a giant cell lesion poses an interesting question.

The locked metacarpophalangeal joint of a finger is an unusual condition frequently confused with a "trigger finger." The causes can be classified into degenerative and spontaneous groups. Ten cases are presented. The cause of locking of one patient in the degenerative group was gouty arthritis, a cause not previously reported in the literature. Although surgery is usually necessary, joint mobility was restored in 30% of the cases by distending the joint capsule with an intraarticular injection of a local anesthetic followed by gentle manipulation. In addition to routine x-ray films, arthrotomography was found to be a useful diagnostic technique in determining the cause of locking.

In a single blind control study using adult rabbits, the effectiveness of locally applied dextran-70 and 1% hyaluronic acid were evaluated in the control of flexor tendon adhesions after laceration of the profundus tendon in Zone II. Dextran-70 proved effective, whereas application of hyaluronic acid did not.

The human lymphoblastoid cell line W1-L2-729-HF2 has been fused with B cells from a plasmaphoresed anti-D donor immunized with D+ cells. A stable monoclonal antibody-producing cell line has been produced which yields culture supernatant of good titre without the need for concentration. The production and use of this reagent as an alternative Rh D typing reagent for use by saline and enzyme manual tests and automated tests in a Technicon 16C machine is discussed. Du red cells are detected in enzyme enhanced tests.

Dorsal dislocations of the proximal interphalangeal joint are common injuries, and reduction is usually obtained by manipulation. We describe four cases of dorsal dislocation in which attempts at reduction by manipulation were not successful. Three of these injuries were open and one was closed. At surgery, the main block to reduction in all cases was the palmar plate that had ruptured from its proximal attachment and was interposed between the joint surfaces.

Isolated fractures of the hamulus, formerly considered rare, are being seen more frequently. Many of these injuries are sports related, particularly in golf, tennis, racquetball and baseball players. Failure to make an early diagnosis can result in severe pain and sometimes incapacitating disability. We studied the clinical and radiological findings in 12 patients who had fracture of the hook of the hamate. We propose three radiographic signs of fracture that are readily seen on routine PA projections: "absence" of the hook of the hamate; "sclerosis" of the hook; and lack of cortical density, i.e., a barely visible outline, of the hamulus.

Giant cell tumor of the tendon sheath is a soft tissue tumor which sometimes affects the adjacent bone structure, producing erosions. In certain rare instances it may manifest as a pathologic fracture.

A case of an intraosseous ganglion arising in a phalanx is described. This condition has not been reported previously.

A report of a case of long-standing Scleroderma (Progressive Systemic Sclerosis) is presented to emphasize the severe consequences of vascular compromise in the hand. The disease process is reviewed and is illustrated by the arteriographic findings in this patient.