The radial artery is a vital access point for various cardiovascular and neurological interventions yet detailed morphometric studies in African populations are limited. This study aimed to investigate the radial artery dimensions in thirty adult body donors housed in the Department of Clinical Anatomy, University of KwaZulu-Natal, Durban, South Africa. The external and internal diameters, along with wall thickness of the radial artery, were measured at three anatomical sites viz. the point of origin, at the wrist joint and in the anatomical snuffbox bilaterally using a digital vernier calliper in sixty upper limb specimens (BREC/00006978/2024). There was a progressive distal tapering pattern, with the external diameters of the radial artery decreasing from its point of origin to the anatomical snuffbox. The internal diameter of the radial artery was 2.98 ± 0.76 mm at the origin, 2.20 ± 0.75 mm at the wrist joint and 1.75 ± 0.69 mm in the anatomical snuffbox. The wall thickness of the radial artery also decreased distally, from its point of origin to the anatomical snuffbox. There were no statistically significant differences between biological sex or laterality. The internal radial artery diameters suggest that a 5 French (5Fr) sheath may be suitable in 32% of upper limbs at the wrist and in 38% of upper limbs in the anatomical snuffbox. The findings of this study can contribute to the existing knowledge in this field and may help clinicians during cardiovascular and neurological interventional procedures within this select sample.

Design and performance analysis of flexible wrist and elbow joint actuators for upper limb exoskeleton rehabilitation robot

The primary objective of this randomised, active-controlled, international, multicentre, phase IV clinical trial was to demonstrate noninferiority of the response of ultrasound-assessed synovitis to baricitinib treatment, alone and in combination with methotrexate (MTX), compared with etanercept with MTX in rheumatoid arthritis (RA). Adult patients with active RA and inadequate response to MTX were randomised into 3 parallel treatment groups: baricitinib monotherapy, baricitinib plus MTX, and etanercept plus MTX. The patients underwent clinical, ultrasound, and laboratory assessments at baseline, 4, 12, and 24 weeks. Ultrasound synovitis was scored 0 to 3 in B-mode, Doppler mode, and a combination of both modes. The primary endpoint was the change in the Global European Alliance of Associations for Rheumatology-Outcome Measures in Rheumatology Synovitis Score (GLOESS) for bilateral wrist and metacarpophalangeal joints at week 12. Noninferiority was stated if the changes in the baricitinib groups were above the lower limit of the noninferiority range, defined as 80% of changes observed in the etanercept plus MTX group. Changes in serum concentrations of different mediators were analysed at 24 weeks. One hundred fifty patients (109 women and 41 men) were randomised. All clinical and ultrasound variables showed significant improvement starting from week 4 across the 3 treatment arms (P < .050). Noninferiority of baricitinib (monotherapy and plus MTX) was confirmed against etanercept with MTX for GLOESS at week 12 (P < .050). Changes in metalloprotease-3 concentration significantly correlated with changes in all ultrasound scores. The response of ultrasound-assessed synovitis to baricitinib, alone or in combination with MTX, was noninferior to that of etanercept with MTX.

Background/Aims: Multiple epidemiological studies in different ethnic groups demonstrate diverse results about the prevalence of chondrocalcinosis (CC), yet no definitive data are available concerning its frequency in most countries. Furthermore, the prevalence of CC in the Turkish population is not known to date. The aim of this study was to investigate the frequency of radiographic CC in the knee, wrist, or both joints in individuals aged ≥50 years from the hospital records of the last 5 years. Materials and Methods: In this retrospective study, radiographs of the knee and/or wrist taken at Çukurova University Faculty of Medicine Balcalı Hospital were reviewed by an experienced physiatrist, rheumatologist, and radiologist. Results: A total of 1818 radiographs from 772 individuals were included in the study. A total of 32 individuals exhibited calcification in at least 1 knee or wrist in total. Of these, 9.3% were male and 90.6% were female, with an overall radiographic prevalence of 4.1%. The prevalence of radiographic knee CC was found to be 4.1%, while that of wrist CC was 3.2%. Only 2 female patients exhibited CC in both the knee and wrist joints simultaneously. The frequency of CC in bilateral knee joints have been increased with age and no significant association was found regarding CC coexisting with other comorbidities except hyperparathyroidism. Conclusion: The prevalence of radiographically detected knee and wrist CC in the Turkish population has not yet been reported. These findings emphasize the need for clinical research that could increase awareness and advance knowledge of the relationship between CC and possible risk factors in Türkiye. Cite this article as: Kozanoğlu E, Andırın M, Bıçkıcı Ö, Köse S. Prevalence of radiographic knee and wrist chondrocalcinosis in Adana province, Türkiye: A hospital-based retrospective study. ArchRheumatol. Published online 10, 2026. doi: 10.5152/ArchRheumatol.2026.25248.

The movement patterns of the wrist and metacarpal joints in spatial planes during typing as a foundation of possible kinematic risk factor of hand musculoskeletal disorders.

To systematically review the clinical presentation, imaging findings, arthroscopic characteristics, and treatment outcomes of dorsal wrist capsular impingement, a distinct cause of chronic dorsal wrist pain. A review was performed in accordance with PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, and CINAHL were searched from inception to January 11, 2026. Eligible studies included patients diagnosed with dorsal wrist capsular impingement. Data were synthesized narratively. Six studies comprising 231 patients (233 wrists) met inclusion criteria. Age ranged from 27 to 42 years, and 53% of patients were male (122/231). Follow-up ranged from 6 to 42 months. All patients presented with dorsal-central wrist pain (231/231, 100%). Extension-provoked pain was reported in 177 wrists (77%) and in all patients in the five studies describing this symptom. MRI findings were inconsistently reported and demonstrated limited correlation with intraoperative pathology. Across four studies, hypertrophied or redundant dorsal capsular tissue interposed within the radiocarpal joint was identified in all evaluated wrists (66/66, 100%). Following arthroscopic debridement, most treated wrists demonstrated postoperative pain reduction. QuickDASH scores improved across studies, decreasing from approximately 33-49 preoperatively to 4.8-17 at 3-12 months postoperatively. Recurrence was uncommon (2 wrists, 1%), and complications were rare. Dorsal wrist capsular impingement presents with chronic, extension-provoked dorsal-central wrist pain, often despite nondiagnostic imaging. Arthroscopy may aid diagnosis and management, with reported intraoperative findings and symptomatic improvement in selected patients. Current evidence is limited to small retrospective studies, and prospective research is needed to better define diagnostic criteria and outcomes.

The Association Between Lunate Morphology and Scaphoid Fractures: A Comparative Radiographic Assessment.

Volar Plating Versus Combined Plating For AO Type C Distal Radius Fracture: A Randomized Controlled Study Of 135 Patients With A 5-Year Follow-Up.

To evaluate whether operative irrigation and debridement (I&D) is necessary for the treatment of pediatric traumatic arthrotomies (TAs) secondary to gunshot wounds (GSWs) to prevent joint infections. Retrospective cohort study. US Academic Level I Trauma Center. Pediatric patients (age 0-17) with TAs secondary to GSW between 2016 and 2023 with at least 1-month follow-up were included. Arthrotomies included shoulder, elbow, wrist, hand, sacroiliac, hip, knee, ankle, or foot joints. The primary outcome was rate of joint infection between those who received acute operative I&D versus those who received nonoperative management. A subanalysis was completed only comparing "major joints." Within the cohorts, length of antibiotic treatment was compared. Fifty seven cases of ballistic TA (50 subjects, 82% male, mean age 14.6 years) were included. In total, 31 of 57 joints (54.4%) underwent formal operative I&D with or without fixation, while 26 joints (45.6%) did not. In the operative I&D cohort, 85% were male with a mean age 14.8 years versus 79% male with mean age of 14.3 years in the nonoperative group. Mean follow-up duration was 10.8 months (range 1-56 months) for both cohorts. No joint infections were documented between either group, regardless of treatment ( P = 1.0). In total, 38 TAs were major joints: 23 of 38 (60.5%) received I&D, while 15 of 38 (39.5%) did not. All joints received at least 1 dose of intravenous (IV) antibiotics. Among the operative group, 54.8% of joints received ≤72 hours of IV antibiotics (45.2% received >72 hours), compared with 46.2% of joints in the nonoperative group (53.8% received >72 hours). Formal operative I&D was not found to be necessary to prevent joint infection after TA secondary to GSW. Prolonged antibiotic use did not affect rates of infection. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

The association between scaphoid fractures and ligament injuries is uncertain, and the clinical relevance is not well established. The aim of this study was to undertake a secondary analysis of data from the Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) to evaluate the incidence of concurrent ligament injuries in patients with a scaphoid waist fracture displaced by ≤ 2 mm, explore the radiological changes between one and five years after the injury, and assess whether there is an association between the characteristics of the fracture and ligament injury. All 439 patients from the SWIFFT had baseline measurements available from plain radiographs and CT scans. Further follow-up measurements were undertaken from CT scans in 292 patients at 52 weeks and 239 patients at five years. A total of 345 patients had radiographs suitable for assessment of the scapholunate (SL) and lunotriquetral (LT) intervals at 52 weeks and/or five years. Only 12 patients (2.8%) had widening of the SL gap by > 3 mm on initial imaging. There was no progression of these gaps at five years, and no patient had widening of the LT gap. Injury to the interosseous intercarpal ligaments causing diastasis of carpal bones is rare in patients with a scaphoid waist fracture displaced by ≤ 2 mm. Treatment of the fracture with a cast or surgical fixation, without additional imaging or intervention for a potential ligament injury, appears adequate for most fractures. If there are ligament injuries not identified with standard imaging, they do not seem to progress.

The medial femoral trochlea flap is used for treating recalcitrant scaphoid proximal pole nonunions. Although this requires resecting a substantial portion of the scapholunate interosseous ligament, the intercarpal angular relationships are preserved. Studies have demonstrated that lunate alignment is preserved despite loss of the scapholunate ligament because the scaphoid is reconstructed with an osteochondral flap that is larger than the resected nonunited proximal scaphoid. The technique of purposeful expansion of the scaphoid height has been termed scaphoid overstuffing. The purpose of this study is to characterize the effect of scaphoid overstuffing on force transmission across the scaphoid and lunate facets of the radius. Eleven fresh frozen cadaveric upper extremities without ligament instability were selected. The radiocarpal joint was exposed via a dorsal approach, and electronic pressure sensors were introduced. Three different states of the wrist were evaluated: native, scapholunate dissociation (SLD), and overstuffed (OS). Pressures were measured in 4 positions: 30° flexion, full wrist extension, 30° extension, and clenched fist. Pressures were measured in kPa and contact areas in mm2. In all functional positions, the OS state had higher peak pressures across the scaphoid facet. This included 30° wrist flexion (OS 383 ± 221 kPa, P = .033), full wrist extension (OS 1068 ± 767 kPa, P = .022), 30° wrist extension (OS 880 ± 518 kPa, P < .001), and clenched fist (OS 1040 ± 736 kPa, P = .02). In functional wrist positions, overstuffing the scaphoid increases scaphoid facet peak contact pressures. Further study is needed to examine the long-term clinical consequences of these changes and the potential for accelerated cartilage degeneration.

Tremor is the most common movement disorder, and many individuals remain unsatisfied with outcomes from standard treatments, which intervene at the level of the central nervous system. Peripheral suppression methods, including botulinum toxin A injections, show promise but could be optimized by identifying the muscles most responsible for tremor. This study aimed to demonstrate the feasibility of a novel method for quantifying the contribution of individual wrist muscles to hand tremor. Surface electromyography from the four prime wrist muscles and motion capture of hand translation were recorded in 14 individuals with Essential Tremor. Subjects attempted to maintain a neutral wrist posture while the upper limb was constrained to isolate the wrist joint. Contributions of individual muscles to hand tremor were determined using excluded coherence (a novel measure capable of estimating input contributions in multi-input systems with correlated inputs) between muscle activity and hand motion. We found many statistically significant differences in tremor contributions between muscles. Across subjects, the flexor carpi radialis contributed the most to constrained wrist tremor, followed by the flexor carpi ulnaris and extensor carpi radialis. However, the dominant contributing muscles varied between individuals. Most tremor power was caused by direct contributions from individual muscles, not constructive interference between muscles. Additionally, we found that although suppressing certain muscles could theoretically increase tremor (because they interfere destructively with other muscles), this is unlikely to occur. This is the first quantification of muscle-specific contributions to tremor in multiple subjects. Excluded coherence analysis provides an effective tool for calculating these contributions.

Over the past two decades, there has been a significant increase in the use of immersive technologies in rehabilitation. VR technologies allow for the simulation of motor tasks in a safe gaming digital environment, which contributes to better integration of the patient into the rehabilitation process, activates the neuromuscular system and reduces psychoemotional stress during the restoration of motor functions. While traditional methods involving simple, repetitive movements can be exhausting for patients and make them less motivated to continue treatment. Objective. Examined the effectiveness of using VR technology as an auxiliary method of rehabilitation in patients with traumatic injuries of the upper limbs after a blast injury. Materials. The effectiveness of using VR technology as an auxiliary rehabilitation method in patients with traumatic injuries of the upper extremities after a blast injury was analyzed. Results. The study included a case series of 4 military personnel with traumatic injuries of the upper limbs resulting from a blast injury. The rehabilitation program included standard physical therapy and physiotherapy methods in combination with training in a virtual environment using virtual reality glasses with the VR Vitalis program. Patients performed tasks aimed at improving coordination, strength and amplitude of movements in the shoulder, elbow and radiocarpal joints, considering the need for movement restoration. The dynamics of the range of motion was assessed using goniometry, muscle strength using dynamometry, and the level of motivation for classes was assessed using a survey. Conclusion. It was found that the use of VR technologies as an additional method to traditional rehabilitation contributed to a noticeable improvement in the indicators of functional recovery of upper limb movements. Positive dynamics were recorded not only in physical indicators, but also in the psycho-emotional state. All participants reported increased motivation and better involvement in the treatment process.

Introduction: Fractures of the carpal bones are rare compared to fractures of the metacarpals and phalanges. The triquetrum and scaphoid are the most frequently involved, and the other bones injuries are less common. The aim of the study was to analyze the incidence of carpal fractures other than the scaphoid bone, methods and results of their treatment. Materials and methods: Between 2021 and 2023, 35 patients, 25 men (71%) and 10 women (29%), at the mean age of 49 years, with isolated fractures of the carpal bones other than the scaphoid, were treated at the author’s institution. Fractures of the triquetrum was the most commonly seen – 25 cases (71%), followed by the hamate bone – 6 cases (17%). Most fractures were treated conservatively with wrist immobilization for 5 weeks. Six patients (17%) required surgical treatment, most of them with the hamate fractures. Results: In a telephone interview at a mean of 16 months post-treatment, 31 patients (88%) had no symptoms in an affected wrist, and 32 (91%) rated the hand as fully functional, the same as before the injury. Three patients who assessed their hands as less functional, had accompanying injuries: distal radial fracture, fracture of the base of the first metacarpal bone, and metacarpo-phalangeal joints dislocation. All of these injuries required surgical treatment. Conclusions: Fractures of the carpal bones other than the scaphoid are moderately common, their treatment is mostly conservative, and the results of treatment, both conservative and surgical, are good.

AimsCurrent total wrist prostheses have defects, and their design requires further refinement. Therefore, we designed a novel customized anatomical total wrist prosthesis (CATWP) using 3D printing techniques, and evaluated its biomechanical properties.MethodsThe 3D wrist joint model and the models of the CATWP and Universal2 prosthesis were established based on biomechanical finite element analysis. The mechanical structure, stress distribution, joint surface contact patterns, and centre of rotation (COR) were compared between the designed prosthesis, Universal2 prosthesis, and a normal wrist joint.ResultsCompared with the Universal2 prosthesis, the CATWP effectively reduced the stress of the prosthesis (carpal platform and screws: maximum (Max), 65.27 MPa; radial shank: Max, 2.09 MPa) and the adjacent bone tissue (carpal bones: Max, 33.84 MPa), with a more uniform distribution. The contact stress curve of the distal/proximal joint surface became more stable during the ulnar-radial deviation movements than the Universal2 prosthesis (distal: Max, 13.47 MPa; proximal: Max, 16.42 MPa). The COR was located near the curvature centre of the prosthesis. Compared with the Universal2 prosthesis, the displacement fluctuation of the COR was effectively reduced by CATWP.ConclusionThe CATWP may outperform the Universal2 prosthesis in terms of restoring comprehensive wrist joint mobility and achieving a more uniform stress load distribution. However, further studies are required to confirm these findings.Cite this article: Bone Joint Res 2026;15(3):311–321.

To describe and demonstrate subjective and objective techniques for assessing the quality and passive range of motion (ROM) of the distal forelimb and hind limb joints of the horse. Special attention will be given to the tarsus, carpus, and fetlock joints, as these sites are most prone to injury and/or pathology and thus most clinically relevant. Adult horses undergoing distal limb joint ROM assessment for clinical diagnostic or treatment monitoring purposes. First, subjective techniques for assessing distal limb joint motion and end-feel as well as general guidelines for normal joint ROM are described and demonstrated in the sagittal plane (flexion/extension). Then, a step-by-step guide to objective joint ROM assessment using goniometry is presented for the metacarpophalangeal, metatarsophalangeal, radiocarpal, and tibiotarsal joints. Finally, clinical considerations, indications, and contraindications for distal limb joint ROM assessment are discussed, alongside common pathologies associated with increased or decreased joint ROM. Instructions for obtaining goniometric measures of joint flexion/extension angle in selected distal forelimb and hind limb joints are provided and, when executed correctly, correlate to radiographic measurements, offering a straightforward, objective technique for establishing a baseline and monitoring treatment progress. A systematic assessment of distal limb joint ROM, combining subjective and objective techniques, is an integral part of the clinical orthopedic examination of equine patients. When executed correctly, quantifying distal limb joint ROM with the use of goniometry, which has been shown to correlate with joint angles measured radiographically, can aid the clinical decision-making process and enables objective monitoring and response to treatment.

To compare clinical efficacy of closed reduction and elastic intramedullary nail fixation and open reduction and interal fixation with plates and screws in treating Galeazzi fracture. A retrospective analysis was performed on clinical data of 46 patients with Galeazzi fractures treated from January 2021 to June 2023. They were divided into intramedullary nail group and plate group according to different treatment methods. There were 26 patients in intramedullary nail group, including 14 males and 12 females, aged from 15 to 50 years old with an average of (28.85±10.56) years old;3 patients with typeⅠ, 15 patients with typeⅡand 8 patients with type Ⅲ according to Galeazzi fracture classification;treated with closed reduction and elastic intramedullary needle fixation. There were 20 patienst in tsteel plate group, including 13 males and 7 females, aged from 15 to 52 years old with an average of (31.50±12.36) years old;2 patients with typeⅠ, 12 patients with typeⅡ and 6 patients with type Ⅲ;treated with conventional open reduction and internal fixation with plates and screws. Operation time, intraoperative blood loss and fracture healing time between two groups were recorded and compared. The degree of pain relief was evaluated by visual analogue scale (VAS) before operation and on the 1st, 3rd, 7th and 14th days after operation, respectively. The recovery of wrist joint function of affected limb was evaluated by Gartland-Werley score at 12 months after operation. Both groups were followed up, and follow-up time of intramedullary nail group ranged from 12 to 16 months with an average of (14.57±3.63) months, and that of plate group ranged from 12 to 19 months with an average of (14.00±3.50) months;there was no statistically significant difference between two groups (P<0.05). VAS of intramedullary nail group at 1, 3, 7, and 14 days after operation were (5.23±1.31), (4.00±1.10), (2.43±0.95), and (1.00±0.85) points, respectively, which were lower than those of steel plate group (6.05±1.23), (4.80±0.83), (3.45±1.32), and (2.00±1.17), and the differences were statistically significant(P<0.05). The intraoperative blood loss, operation time and fracture healing time in intramedullary nail group were (33.85±10.98) mL, (76.92±11.41) min and (4.08±1.02) months, respectively, while steel plate groups were (102.50±27.51) mL, (97.25±20.16) min, and (6.20±1.44) months respectively, and there were statistically significant differences between two groups (P<0.05). At 12 months after operation, Gartland-Werley scores of wrist joint function in intramedullary nail group and plate group were (6.46±4.74) and (10.45±7.40), respectively, there was no statistically significant difference between two groups (P>0.05). Closed reduction and elastic intramedullary needle fixation for Galeazzi fractures could effectively relieve postoperative pain, shorten operation time, and accelerate the speed of fracture healing after opertaion. It is a good way to treat Galeazzi fractures.

To explore clinical efficacy of palmar incision and levering technique in the surgical treatment of distal radius fractures in the elderly. From October 2022 to December 2023, 28 patients with distal radius fractures who underwent surgical treatment were admitted. Among them, including 10 male and 18 female;the age was 68 (64, 72) years old; the disease duration was 3 (2, 7) days;bone density was -3.1 (-2.7, -3.3);11 patients on the left side and 17 patients on the right side;19 patients caused by injuries, and 9 patients caused by traffic accidents;according to AO classification, 20 patients with type A3 and 8 patients with type C2. Palmar inclination angle, ulnar deviation angle and radial height before treatment and the latest follow-up were observed and compared. The modified Mayo wrist score(MMWS) was used to evaluate the recovery of wrist joint function. The fracture healing and the occurrence of complications were also observed. All patients were followed up for 11 (9, 13) months. None of patients experienced complications such as incision infection, re-loss of fracture reduction, or non-union of fractures. The palmar inclination angle, ulnar deviation angle, and radial height improved from (-2.7±1.5)°, (16.2±2.7)°, and (2.1±1.3) mm before treatment to (12.1±2.6)°, (20.6±2.1)°, and (10.5±1.2) mm at the latest follow-up, and the differences were statistically significant(P<0.05);at the latest follow-up, MMWS score was (94.3±3.7) points, with 23 patients got excellent result and 5 good. Palmar window dislocation technique for treating patients with osteoporotic distal radius fractures could effectively restore palmar inclination angle of radius. Combined with the implantation of artificial bone, it could effectively maintain the fracture reduction and reduce risk of re-displacement.

To explore clinical efficacy of intramedullary space-filling with retrograde Kirscher needle through epiphyseal plate in treating fractures at the distal radius metaphysis junction in children. A retrospective analysis was conducted on 48 children with fractures at the distal radius metaphysis junction admitted from January 2020 to December 2023, and divided into Kirchstein needle group and plate group according to different treatment methods. There were 24 patients in Kirschner's injection group, including 14 males and 10 females, aged from 6 to 14 years old with an average of(9.2±2.4) years old;15 patients on the left side and 9 patients on the right side;the time from injury to operation was 3.00 (2.25, 3.00) days;intramedullary space-occupying lesion was treated with retrograde Kirschian needle of epiphyseal plate. There were 24 patients in steel plate group, including 12 males and 12 females, aged from 6 to 13 years old with an average of (9.1±2.2) years old;14 patients on the left side and 10 patients on the right side;the time from injury to operation was 5.00 (5.00, 5.75) days;treated with open reduction and internal fixation with steel plates. Operation time, intraoperative fluoroscopy frequency, blood loss, anteroposterior and lateral angulation of X-rays before and after operation, hospital stay, and fracture healing time between two groups were compared. Gartland-Werley wrist score was used to evaluate functional recoveryat 12 months after operation. All 48 patients were followed up for 12 to 23 (15.1±2.3) months. Operation time, hospital stay, fracture healing time and blood loss in Kirschner's needle group were (41.83±6.68) min, (5.50±1.00) d, (44.79±5.28) d and (14.38±5.77) mL respectively;while in steel plate groups were (53.38±8.54) min, (9.50±1.50) d, (48.42±6.14) d, and (32.29±8.34) mL respectively;Kirschner's needle group was superior to steel plate group, and the differences were statistically significant (P<0.05). The number of intraoperative fluoroscopy in Kirscher needle group was (9.25±1.54) times, which was more than that in steel plate group (6.87±1.30) times, and the difference was statistically significant (P<0.05). In Kirschner needle group, residual angulation immediately after operation was (3.21±1.50) ° on the normal position and (2.96±1.99) ° on the lateral position, at 12 months after operation, the residual angulation on the normal position (1.88±1.33) ° and the lateral position (1.88±1.23) ° was smaller than those on preoperative normal position(20.71±5.21) ° and lateral position(24.29±6.29) °;the difference were statistically significant(P<0.05);in steel plate group, the residual angulation immediately after operation was(2.58±1.28) ° on the normal position and(2.83±1.69) ° on the lateral position;at 12 months after operation, the residual angulation on normal position (2.00±1.10) ° and lateral position (2.04±1.34) ° was smaller than those on preoperative normal position(21.17±4.48) ° and lateral position(23.25±4.83) °;the difference were statistically significant(P<0.05);however, there were no statistically significant difference between two groups(P>0.05). At 12 months after operation, in Kirschner needle group, Gartland-Werley score of wrist joint was excellent in 16 patients and good in 8 patients;while 15 patients were excellent and 9 patients were good in steel plate group, there was no statistically significant difference between two groups(P>0.05). Both of intramedullary space-occupying transepiphyseal plate and open reduction plate could achieve good therapeutic effects in the treatment of fractures at the radial metaphysis junction in children. However, transepiphyseal plate has advantages of small incision, less bleeding, less trauma, fast healing and no need for the secondary surgery.

Nontuberculous mycobacterial (NTM) tenosynovitis is a rare extrapulmonary infection that presents as a painless, slow-growing mass and often evades timely diagnosis due to nonspecific symptoms. We report the case of an 89-year-old female farmer who developed a recurrent mass in her right forearm. Despite two prior excisions, the lesion recurred, prompting further investigation. Magnetic resonance imaging revealed low-intensity areas, and intraoperative findings included rice bodies. Histopathology showed an epithelioid granuloma, while the anti-GPL-core IgA antibody test was negative.Mycobacterium intracellulare, a species within the Mycobacterium avium complex (MAC), was identified by culture from the excised tissue, confirming the diagnosis. Treatment with antituberculous agents was administered, and no recurrence was observed at one-year follow-up. This case underscores the importance of integrating imaging, intraoperative findings, and microbiological testing in the diagnosis of NTM tenosynovitis.