Dupuytren’s disease is one of the most common condition seen by hand surgeons. It is not only prevalent but can also be a most debilitating condition resulting in significant loss of function of the fingers involved. The cause of this disease, however still remains largely unknown although some recent evidence suggests a stem cell etiology. This review article summarizes the current known knowledge of Dupuytren’s as well as the clinical findings, investigations and treatments available.

Introduction: Subsequent osteoporotic vertebral fractures (SOVF) are a serious complication of osteoporosis that can lead to spinal deformity, chronic pain and disability. Several risk factors have been previously identified for developing SOVF. However, there are conflicting reports regarding the association between sarcopenia and multiple vertebral compression fractures. As such, the goal of this study was to investigate whether sarcopenia is an independent risk factor of SOVF. Methods: This was a retrospective case–control study of elderly patients who underwent percutaneous vertebral augmentation (PVA) due to a new osteoporotic vertebral compression fracture (OVCF). Collected data included: age, sex, BMI, steroid treatment, fracture level and type, presence of kyphosis at the level of the fracture and bone mineral density (BMD). Identification of SVOFs was based on clinical notes and imaging corroborating the presence of a new fracture. Sarcopenia was measured using the normalized psoas muscle total cross-sectional area (nCSA) at the L4 level. Results: Eighty-nine patients that underwent PVA were followed for a minimum of 24 months. Average age was 80.2 ± 7.1 years; 58 were female (65.2%) and 31 male (34.8%). Psoas muscle nCSA was significantly associated with age (p = 0.031) but not with gender (p = 0.129), corticosteroid treatment (p = 0.349), local kyphosis (p = 0.715), or BMD (p = 0.724). Sarcopenia was significantly associated with SOVF (p = 0.039) after controlling for age and gender. Conclusions: Psoas muscle nCSA can be used as a standalone diagnostic tool of sarcopenia in patients undergoing PVA. In patients undergoing PVA for OVCF, sarcopenia is an independent risk factor for SOVF.

Study Design.: Prospective clinical pilot study and cadaveric study. Objective.: The aim of this study was to evaluate the spread of an ultrasound-guided interfascial plane blocks (UGIPBs) and its potential efficacy for cervical radiculopathy. Summary of Background Data.: Cervical radiculopathy is a common disorder, potentially leading to severe pain and disability. Conservative treatment with cervical epidural steroid injections (ESI) is limited by concerns regarding their safety. UGIPBs are used in cervical surgical procedures as part of the multimodal postoperative analgesia regimen however, were not described for cervical radiculopathy. Methods.: Twelve patients with acute cervical radicular pain who failed conservative treatment and were candidates for surgery were offered a cervical retrolaminar injection. A solution of 4 mL lidocaine 0.5% and 10 mg dexamethasone was injected, assisted by ultrasound guidance, at the posterior aspect of the cervical lamina corresponding to the compressed nerve root level. Additionally, a cadaver study was carried to evaluate the contrast spread and infiltration into near structures, both anatomically and radiographically. Results.: Twelve patients underwent the procedure, with a mean follow-up time of 14.5 weeks. Average numerical rating scale improved from 7.25 at baseline to 2.83 following the injection (P < 0.001). Three patients received 2 to 3 injections without significant improvement and were eventually operated. No adverse events were reported. In the cadaver study, fluoroscopy demonstrated contrast spread between T1 and T3 caudally, C2 to C5 cranially and facet joints laterally. Anatomically, the dye spread was demonstrated up to C2 cranially, T1 caudally, the articular pillars of C4 to C7, and the neural foramen of C6 laterally. Conclusion.: A solution injected into the cervical retrolaminar plane can diffuse in the cranial-caudal axis to C2-T3 and laterally to the facet joints and the cervical neural foramen. Our pilot study confirmed the feasibility of our study protocol. Future studies are needed to support our early results. Level of Evidence: 4