Background: Vitamin D deficiency is now recognized as an independent risk factor and is involved in the pathogenesis of carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the effects of vitamin D₃ supplementation on functional and symptomatic outcomes in CTS patients with vitamin D deficiency. Methods: This was a prospective, single-arm study with a pretreatment or posttreatment quasi-experimental design. Carpal tunnel syndrome patients with vitamin D deficiency were treated with vitamin D₃ (60 000 IU/week) plus standard treatment for a period of 3 months. Carpal tunnel syndrome–related pain and functional and symptomatic outcomes were assessed at baseline and at 3 months posttreatment using the Visual Analogue Scale (VAS) and the Boston Carpal Tunnel Questionnaire, respectively, along with serum vitamin D. Results: A total of 42 patients were analyzed. At 3 months posttreatment, there was a significant reduction in the severity of pain (VAS score) from baseline ( Z = −5.71, P < .001). Similarly, the functional and symptomatic outcomes (Boston symptoms severity scale [SSS] and Boston functional status scale [FSS] score) at 3 months posttreatment significantly improved in comparison with baseline (Boston SSS: Z = −5.66, P < .001; Boston FSS: Z = −5.68, P < .001). Conclusions: Vitamin D₃ supplementation was associated with improvement in functional and symptomatic outcomes and CTS-related pain in CTS with vitamin deficiency. However, further robust randomized controlled trials are warranted to validate the results.

Background: Caffeinated coffee, a psycho-stimulant, is widely consumed throughout the globe. However, its chronic consumption has deleterious effects on human health. Meanwhile, decaffeinated coffee has low content of caffeine and thus can be an alternative to caffeinated coffee. Therefore, the study was undertaken to explore and compare the acute effects of decaffeinated and caffeinated coffee on reaction time, mood and skeletal muscle strength in healthy volunteers. Methods: This was a prospective, interventional, comparative type of study. The study included 70 healthy adults divided into two groups (Caffeinated coffee group and Decaffeinated coffee group). The following parameters were assessed: reaction time was assessed by digital display multiple-choice apparatus, mood by Visual Analogue Scale (VAS) and Profile of Mood States revised version (POMS) and skeletal muscle strength by hand dynamometer. All parameters in both groups were assessed pre-intervention (baseline) and 30 min post-intervention. Results: In both groups (decaffeinated and caffeinated coffee) post-intervention, there was a statistically significant (p < 0.05) improvement in the reaction time (VRT) and mood (VAS, POMS) from the baseline. However, both groups did not show any significant effects on the skeletal muscle strength. Upon comparing the two groups, we found that caffeinated coffee showed higher and significant improvement of mood than decaffeinated coffee. Conclusions: Decaffeinated coffee exerts an acute significant stimulatory effect on the reaction time and mood. However, these effects in comparison to caffeinated coffee are low. Further randomized control clinical trials are thus needed to validate these interesting findings.

Background/Objectives: Dislocation of the acromioclavicular joint (ACJ) is a common injury for which numerous operative fixation and reconstructive techniques have been described. This technique combines a coracoclavicular ligament (CC) repair with an acromioclavicular ligament (AC) and CC reconstruction with an additional ACJ internal brace to address both horizontal and vertical instability. Methods: The surgery is performed through a superior approach in the following sequence: (1) CC ligaments are repaired using a TightRope construct, (2) CC reconstruction is performed using a peroneus longus tendon allograft, (3) AC ligaments are repaired using an internal brace, and (4) AC reconstruction is performed with a second peroneus longus tendon allograft. The results of consecutive patients with grade IIIB, IV, and V AC joint dislocations were included. Results: Six patients with acute and six patients with chronic injuries were eligible for inclusion. The Constant–Murley Score improved significantly from 27.6 (8.0–56.5) to 61.5 (42.0–92.0) (p = 0.006 paired t-test) at 12 months of follow-up. There was one complication (frozen shoulder) from which the patient recovered spontaneously; no other complications were observed with this technique. The coracoclavicular distance (CCD) was reduced from 18.7 mm (13.0–24.0) to 10.0 mm (6.0–16.0, p < 0.001) and 10.5 mm (8.0–14.0, p = 0.002) at 12 weeks and 12 months, respectively. Conclusions: This study describes a new technique to treat acute and chronic Rockwood stage IIIB–V ACJ dislocations with promising short-term clinical and radiological results. The results suggest that the combined repair and reconstruction of the AC and CC ligaments is a safe procedure with low complication risk in experienced hands. Addressing the vertical and horizontal stability in ACJ dislocation is key to achieving optimal long-term results. Further, follow-up is required to investigate the long-term outcomes.

Background: This retrospective observational study aimed to compare the outcomes of arthroscopic rotator cuff surgery using double row anchor repair (DRR) versus transosseous anchorless repair (TAR) in patients with small to large full-thickness rotator cuff tears.Methods: A total of 42 patients underwent either DRR (n=20) or TAR (n=22) between January 2022 and May 2023. Patients were matched based on age, sex, body mass index, and tear severity to ensure comparability. Baseline demographics, including age, sex distribution, diabetes mellitus, smoking status, and Cofield full-thickness tear classification, were compared between the two groups. Functional outcomes were assessed using the University of California, Los Angeles and American Shoulder and Elbow Surgeons scores, as well as range of motion (ROM) parameters including forward flexion (FF), extension (EXT), internal rotation (IR), external rotation (ER), and abduction (AB). Independent t-tests and chi-square tests were used to compare continuous and categorical variables, respectively, with a significance level set at P0.05 for all). At 3- and 6-month post-surgery, TAR demonstrated significantly higher ULCA scores compared to DRR (3 month: TAR, 23.82 vs. DRR, 22.30, P<0.001; 6 month: TAR, 8.18 vs. DRR, 26.60, P<0.001). Similarly, TAR showed superior ASES scores at 3 months (TAR, 67.55 vs. DRR, 64.49; P=0.025) and 6 months (TAR, 95.33 vs. DRR, 91.48; P0.05 for FF, EXT, IR, ER, AB).Conclusion: The DRR and TAR techniques resulted in comparable outcomes regarding baseline characteristics and 1-year functional recovery in patients undergoing arthroscopic rotator cuff repair for medium to large tears. TAR showed early advantages in functional scores at 3- and 6-months post-surgery, suggesting potential benefits in the initial recovery phase. These findings can aid the practitioner in selecting appropriate surgical techniques based on individual patient needs and expectations.Level of evidence: III.

Introduction: An exostosis is a benign growth of bone, which when capped with cartilage is called osteochondroma, which can appear as solitary or multiple, mostly affecting the long bones, pelvis, and shoulder region. The prevalence of known solitary exostosis is 1–2% in the general population. They are slow growing lesions with rare malignant transformation. In patients with a solitary exostosis, the chance of developing a chondrosarcoma out of an exostosis is around 1%. Case Report: A 12-year-old boy presented to our outpatient department with complaints of pain, and swelling at the right wrist since 1 year and tingling numbness on and around palmar aspect of index and middle finger since 6 months. The swelling was of size 3 cm × 2 cm, Tinel’s sign was positive. His blood parameters were normal. X-ray showed exostoses. Magnetic resonance imaging was suggestive of osteochondroma. Nerve conduction study was normal. Excision biopsy confirmed the diagnosis and also relieved all symptoms. Conclusion: Our case report is unique in its own way as it reminds us that when presented with a case of osteochondroma of the distal radius in children, carpal tunnel syndrome can also occur. Keywords: Osteochondroma, carpal tunnel syndrome, exostosis.