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JBJS Case Connect 2021 06 15;11(2). Epub 2021 Jun 15.

Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.

Case: This is a case of a 41-year-old man who sustained a traumatic proximal transfemoral amputation with loss of adductor function and inadequate soft tissue. Wound closure was achieved with split-thickness skin grafting. Subsequently, femoral lengthening was achieved with an internal magnetic lengthening nail. Read More

Front Sports Act Living 2021 28;3:683691. Epub 2021 May 28.

CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France.

Athletes fear stress fracture (SF) injuries as they can put a premature end to their athletic careers. Understanding any mechanical constraints can suggest preventive management approach. Specifically, for the triple jump, the mechanical stresses that occur during the event appear to be the main factors for risk of injury. Read More

Front Oncol 2021 27;11:605941. Epub 2021 May 27.

Department of Dermatology, City of Hope Los Angeles, Duarte, CA, United States.

Treatment of head and neck cancers requires multidisciplinary collaboration to reduce morbidity and mortality associated with the tumor burden, as well as to preserve function of organs and structures. With the use of various new targeted therapies come new adverse events including dermatologic toxicities, which may consist of xerosis, nail and hair changes, morbilliform or papulopustular rashes, to more severe eruptions such as Stevens-Johnson syndrome. We describe the dermatologic toxicities and corresponding grades of severity and associated pathophysiology resulting from seven therapeutics used to treat head and neck cancers: cetuximab, trastuzumab, pembrolizumab, nivolumab, lentatinib, larotrectinib, and entrectinib. Read More

Cureus 2021 May 2;13(5):e14810. Epub 2021 May 2.

Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

Giant cell tumors (GCTs) are primary bone tumors that occur most commonly in long bones, with half such tumors occurring in the distal femur, proximal tibia, and fibula. Around 12% of patients present with a pathological fracture indicating more aggressive disease. Arthrodesis after tumor resection is a popular choice due to its affordability and early postoperative mobilization, as well as low risks of implant loosening, infections, malignant lesions, or mortality. Read More

JBJS Essent Surg Tech 2021 Jan-Mar;11(1). Epub 2021 Mar 2.

Washington University in St. Louis, St. Louis, Missouri.

Background: Flexible intramedullary nailing is performed for femoral fractures in pediatric patients who may be too large for spica cast immobilization but who have substantial growth remaining and who are not a candidate for rigid intramedullary nailing. Flexible nailing allows the surgeon to obtain correct alignment of the femur fracture so as to allow for healing without a lower extremity deformity.

Description: The patient is positioned on a radiolucent table, flexible nails are chosen according to the diameter of the medullary canal, medial and lateral incisions are made along the distal aspect of the thigh, and access to the canal is obtained with use of a drill-bit of the appropriate size. Read More

J Am Podiatr Med Assoc 2021 Jun 11. Epub 2021 Jun 11.

Foot and nail care specialists spend a great portion of their day using nail drills to reduce nail thickness and smooth foot callouses. This process generates a large amount of dust, some of which is small enough to breathe in and deposit into the deepest regions of the respiratory tract, potentially causing health problems. Foot and nail dust often contain fungi, from both fungally-infected and healthy-looking nails. Read More

Int J Hyg Environ Health 2021 Jun 10;236:113781. Epub 2021 Jun 10.

Environmental Health Research Division, National Institute of Environmental Research, Ministry of Environment, Incheon, Republic of Korea. Electronic address:

Parabens are used as a preservative in several consumer products including cosmetics, personal care products, and medicinal products. These chemicals have been suspected for estrogenicity and potential adverse endocrine outcomes in humans. For the first time, exposure profiles and potential sources of major parabens are investigated for a nationally representative population of children and adolescents of Korea. Read More

Asian J Surg 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedics, Neijiang Hospital of Traditional Chinese Medicine, Neijiang, 641000, China.

Adv Rheumatol 2021 Jun 12;61(1):36. Epub 2021 Jun 12.

Department of Radiology, The First Affiliated Hospital of Anhui Medical University, 210 Jixi Road, Hefei, 230022, Anhui, China.

Objectives: To investigate the diagnostic performance of single-source dual-energy computed tomography (DECT) based on gemstone spectral imaging technology (including Discovery CT750HD and Revolution CT) in patients with suspected feet/ankles gouty arthritis, and evaluate the urate deposition with a novel semi-quantitative DECT scoring system.

Methods: A total of 196 patients were consecutively included. Feet and ankles were evaluated in all patients by single-source DECT scan. Read More

J Invest Dermatol 2021 Jun 8. Epub 2021 Jun 8.

Department of Dermatology, Stanford University, Palo Alto, CA. Electronic address:

Pachyonychia congenita (PC) is a genetic disorder of keratin that presents with nail dystrophy, painful palmoplantar keratoderma, and other clinical manifestations. We investigated genotype-structurotype-phenotype correlations seen with mutations in keratin genes (KRT6A, KRT6B, KRT6C, KRT16, KRT17) and utilized protein structure modeling of high frequency mutations to examine the functional importance of keratin structural domains in PC pathogenesis. Participants of the International PC Research Registry underwent genetic testing and completed a standardized survey on their symptoms. Read More

Int Endod J 2021 Jun 11. Epub 2021 Jun 11.

Department of Biochemistry, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey.

Aim: To evaluate in a laboratory study the effect of different irrigation solutions and activation techniques on transforming growth factor (TGF-β1), insulin growth factor-1 (IGF-1), bone morphogenetic protein-7 (BMP-7) and vascular endothelial growth factor-A (VEGF-A) release levels from the dentine of extracted teeth.

Methodology: Seventy premolar teeth with single root and canal were used. The lengths of the root segments were standardized to 12 mm and the root canals were prepared up to size 100 with hand files. Read More

Forensic Sci Med Pathol 2021 Jun 11. Epub 2021 Jun 11.

Division of Pathology, San Salvatore Hospital, 67100, L'Aquila, Coppito, Italy.

Celestine V is considered one of the most enigmatic Popes. He has been the subject of much speculation, with legends claiming he was murdered by order of his successor Boniface VIII. Assassination rumors first started in medieval times, but they were renewed in 1630 by the discovery of a nail that fitted perfectly into a square opening in his skull. Read More

Medicine (Baltimore) 2021 Jun;100(23):e26089

Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano.

Rationale: COVID-19 presentation is multifaceted and up to 44% of patients affected by COVID-19 experience musculoskeletal complaints, mostly in the form of diffuse aspecific arthromyalgias. Nevertheless, only a few cases of arthritis following SARS-CoV2 infection are reported.

Patient Concerns: A 27-year-old man affected by nail psoriasis presented with monoarthritis 2 weeks after being diagnosed with COVID-19. Read More

Australas J Dermatol 2021 Jun 11. Epub 2021 Jun 11.

Dermatology Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia.

Nail psoriasis significantly impacts quality of life and is notoriously difficult to treat. Tildrakizumab, an IL-23 inhibitor, has shown significant clinical improvement in the treatment of moderate-to-severe chronic plaque psoriasis. We report 2 cases of treatment resistant nail psoriasis which showed marked improvement with the use of off-label tildrakizumab. Read More

Cureus 2021 May 8;13(5):e14907. Epub 2021 May 8.

Dermatology, King Abdulaziz Medical City, Jeddah, SAU.

Background: Psoriasis is a chronic, inflammatory, and immune-mediated dermatological disease of unknown etiology with predominant involvement of the skin, nails, and joints. This study aimed to assess comorbidities patterns in psoriasis patients.

Methods: This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Read More

J Craniofac Surg 2021 Jun;32(4):1297-1301

Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

Background Introduction: Nail injuries are important causes of penetrating craniocerebral injuries. Theirs incidence is very low, but the injuries can be fatal. Since the nail gun was gradually popularized in 1959, the incidence of nail injuries has been increasing. Read More

J Pak Med Assoc 2021 Jun;71(6):1679-1681

Department of General Surgery Unit-1, Lahore General Hospital, Lahore, Pakistan.

Occupational trauma in carpentry is common in our society due to lack of awareness on occupational safety and poor availability and adherence towards protective equipment. Given below is an unusual case of a young carpenter who presented in the orthopaedic outpatient department with complaint of difficulty in walking for the last four days. On examination, restricted movement of the hip joint on extension was observed. Read More

Front Surg 2021 24;8:652528. Epub 2021 May 24.

Trauma Department, Hannover Medical School, Hannover, Germany.

Due to demographic changes, proximal femoral fractures (PFF) in the elderly rise constantly. The standard diagnostic tool is still the X-ray of the pelvis/hip in two planes. Our hypothesis was that the lateral-view X-ray has little influence on classification, planning of the operative procedure, and choice of implant in geriatric patients. Read More

Dermatology 2021 Jun 9:1-9. Epub 2021 Jun 9.

Psoriasis Center at the Department of Dermatology, University Medical Center Schleswig-Holstein, Kiel, Germany.

Objectives: The purpose of this study was to investigate the attainment of treatment goals according to the European Consensus Programme (ECP-TGs) from 2011 in patients with moderate to severe psoriasis (Pso) treated with the first conventional systemic therapy and to identify factors that might compromise the attainment of these treatment goals.

Methods: In a multicenter, prospective observational study, patients with moderate to severe Pso, defined as either body surface area (BSA) >10% or psoriasis area severity index (PASI) >10 and dermatology life quality index (DLQI) >10, received a conventional systemic therapy that could be modified at each follow-up visit over the course of 18 months. All subjects signed an informed consent form, were ≥18 years of age as well as systemic therapy naïve, and had regular study visits at months 3, 6, 9, 12, and 18 after baseline. Read More

Expert Rev Anti Infect Ther 2021 Jun 9. Epub 2021 Jun 9.

Mediprobe Research Inc., London, ON, CAN.

Introduction: Onychomycosis, a common nail disorder caused by fungal infection, can be managed pharmaceutically with oral or topical treatments. While oral treatments are often used first-line to treat nail infections, these systemic antifungals are not appropriate for all patients, and no oral treatments are approved for use in children in the USA. Given this need, topical antifungals were developed, which can be used as monotherapy or in combination with oral drugs. Read More

J Burn Care Res 2021 Jun 9. Epub 2021 Jun 9.

Department of Surgery, University of Washington Medicine UW Medicine Regional Burn Center, Seattle, WA.

Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are acute, life-threatening diseases that cause sloughing of the skin and mucous membranes. Despite improved survival rates, few studies focus on long-term outcomes. We conducted a single-center review of all patients with SJS/TEN admitted from January 2008-2014. Read More

Pediatr Dermatol 2021 Jun 8. Epub 2021 Jun 8.

Department of Dermatology, Uniformed Services University, Bethesda, MD, USA.

Background/objective: Proteus syndrome, caused by a mosaic activating AKT1 variant, typically presents in toddlers with progressive, asymmetric overgrowth of the skin and bones. We aimed to define the spectrum of dermatologic disease in individuals with genetically confirmed Proteus syndrome.

Methods: We conducted a retrospective review of records from dermatologic examinations of individuals evaluated at the NIH with a molecular diagnosis of Proteus syndrome. Read More

Plast Reconstr Surg Glob Open 2021 Jun 7;9(6):e3624. Epub 2021 Jun 7.

Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Replantation is an ideal method for treating fingertip amputation. However, in some cases, replantation is known to be a challenging issue. This report described a successful thumb tip reconstruction performed with bone and nail bed salvaged as spare parts, and a free posterior interosseous artery perforator (PIAP) flap. Read More

SAGE Open Med Case Rep 2021 30;9:2050313X211020220. Epub 2021 May 30.

Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.

An 11-month-old male child with a complex past medical history presented for admission due to failure to thrive. He had hair loss throughout his scalp, and his abdomen was distended. There was parental report of hair pulling and hair in his stool. Read More

Turkiye Parazitol Derg 2021 06;45(2):149-152

Necmettin Erbakan University Meram Medical School, Department of Pathology, Konya, Turkey

Lichen planus is a traumatic (koebner positive), chronic, inflammatory and autoimmune disease affecting the oral and genital mucosa, scalp and nails. The Food and Drug Administration approved the use of medical leeches for therapeutic purposes (hirudotherapy) in 2004 to ensure flap nutrition in plastic surgery. A 34-year-old male patient was admitted to our dermatology outpatient clinic with a swollen, itchy and purple-coloured rash on legs and back for a month, and white and reticulated plaques in the mouth. Read More

Acta Orthop 2021 Jun 8:1-7. Epub 2021 Jun 8.

Orthopaedic Reconstruction and Children's Orthopaedics, Aarhus University Hospital, Aarhus, Denmark.

Background and purpose - We noted several adverse events in patients in whom the first version of the STRYDE limb-lengthening nail (NuVasive Specialized Orthopaedics, San Diego, CA) had been implanted. Pain, osteolysis, periosteal reactions, and cortical hypertrophy at the nail junction were noted. Here, we present the analysis of 23 retrieved STRYDE implants. Read More

Brain Cogn 2021 Jun 5;152:105758. Epub 2021 Jun 5.

Laboratory of Experimental Psychology, Suor Orsola Benincasa University, Naples, Italy.

Most recent research on human tool use highlighted how people might integrate multiple sources of information through different neurocognitive systems to exploit the environment for action. This mechanism of integration is known as "action reappraisal". In the present eye-tracking study, we further tested the action reappraisal idea by devising a word-priming paradigm to investigate how semantically congruent (e. Read More

Orthop Traumatol Surg Res 2021 Jun 5:102981. Epub 2021 Jun 5.

Institut Européen de la Main, Hôpital Kirchberg, 9 rue Edward Steichen, L-2540 LUXEMBOURG.

Introduction: Anterograde homodigital neurovascular island flaps are very useful for reconstructing proximal fingertip amputations with exposed bone but have the disadvantage of bringing about proximal interphalangeal joint (PIPJ) stiffness. The addition of a single or double V-Y plasty increases mobility without having to extend the dissection beyond the PIPJ. The purpose of this study was to examine the long-term functional outcome of patients who received a "short" anterograde homodigital neurovascular island flap with a single or double V-Y plasty. Read More

Eur J Rheumatol 2021 May 24. Epub 2021 May 24.

Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa School of Medicine, İstanbul, Turkey.

Juvenile spondyloarthropathies (JSpA) are defined as a heterogeneous group of diseases that start before the age of 16, which is associated with peripheral joint (especially large joints of the lower limbs) and axial skeletal (spine and sacroiliac joint) involvement, enthesitis, and human leukocyte antigen (HLA) B27 positivity. Juvenile spondyloarthropathies mainly cover juvenile ankylosing spondylitis (JAS), psoriatic arthritis, reactive arthritis, inflammatory bowel disease-associated arthritis, seronegative enthesopathy, arthropathy syndrome (SEA), and enthesitis-associated arthritis. Symptoms associated with spondyloarthropathies are enthesitis, inflammatory low back pain, dactylitis, nail changes, psoriasis, acute anterior uveitis, and inflammatory bowel disease-related symptoms. Read More

Commun Biol 2021 Jun 7;4(1):692. Epub 2021 Jun 7.

Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Research on human nail tissue has been limited by the restricted access to fresh specimen. Here, we studied transcriptome profiles of human nail units using polydactyly specimens. Single-cell RNAseq with 11,541 cells from 4 extra digits revealed nail-specific mesenchymal and epithelial cell populations, characterized by RSPO4 (major gene in congenital anonychia) and SPINK6, respectively. Read More