OKOJ, Volume 12, No. 12

Diagnosis and Management of Dorsal Wrist Ganglions

Ganglions are the most common benign soft-tissue tumors of the hand and wrist. The most common location for these lesions, in 60% to 70% of patients, is the dorsum of the hand and wrist (dorsal wrist ganglions). Mostly, they arise from the wrist joint and extensor tendon sheath, but they may also be intratendinous. Nonsurgical treatment of dorsal wrist ganglions includes observation, splinting of the hand and wrist for comfort, and aspiration of the cyst. Surgical treatment involves open marginal excision of the cyst that includes the body of the cyst and the stalk from which the cyst arises. Open marginal excision is an effective surgical treatment for dorsal wrist ganglions, with a recurrence rate ranging from 5% to 10%. Arthroscopic resection is a relatively new option, and provides a minimally invasive and effective alternative to open ganglionectomy, with comparable outcomes.

      • Subspecialty:
      • Hand and Wrist

    Polymeric Scaffolds in Orthopaedic Tissue Engineering: A Review of Current Research and Future Technology

    Tissue engineering and regenerative medicine will continue to play a significant role in the development of new techniques directed at hastening the repair of injured musculoskeletal tissues. Tissue scaffolds, the structural elements of tissue engineering, are intended to function as guides for the formation of new tissue and as supports for biomechanical loads. Because a major goal of tissue engineering is to encourage the body to completely repair or regenerate a specific tissue, scaffolds must be resorbable in vivo. The complex requirements for the biocompatibility, structural morphology, and biomechanical properties of tissue scaffolds make polymeric materials the leading candidates for the development of these constructs in orthopaedic surgery. This article is a review of emerging technologies for the engineering of polymeric tissue scaffolds for the regeneration of bone, articular cartilage, tendons and ligaments, intervertebral disk, and meniscus.

      • Keywords:
      • tissue engineering

      • polymers

      • scaffolds

      • regenerative medicine

      • Subspecialty:
      • Basic Science

    Selection of Fusion Levels in Idiopathic Scoliosis

    The selection of fusion levels in idiopathic scoliosis requires the consideration of many factors. As modern instrumentation systems for correcting spinal curvature have developed, control of the correction of spinal deformity in all planes has improved, and the “rules” regarding selection of fusion levels have evolved with a trend toward fusing fewer segments of the spine. However, the principles and variables to consider in selecting levels of the spine for fusion have remained consistent. This article is designed to review these principles and to offer basic guidelines in selecting fusion levels in scoliosis treated through posterior fusion and instrumentation.

      • Keywords:
      • posterior spinal fusion

      • fusion level

      • idiopathic scoliosis

      • instrumentation

      • Subspecialty:
      • Spine