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Sample records for internal fixation presenting

  1. Eighth international congress on nitrogen fixation

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  2. Eighth international congress on nitrogen fixation. Final program

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

    This volume contains the proceedings of the Eighth International Congress on Nitrogen Fixation held May 20--26, 1990 in Knoxville, Tennessee. The volume contains abstracts of individual presentations. Sessions were entitled Recent Advances in the Chemistry of Nitrogen Fixation, Plant-microbe Interactions, Limiting Factors of Nitrogen Fixation, Nitrogen Fixation and the Environment, Bacterial Systems, Nitrogen Fixation in Agriculture and Industry, Plant Function, and Nitrogen Fixation and Evolution.

  3. Management of Postoperative Spondylodiscitis with and without Internal Fixation.

    Science.gov (United States)

    Wang, Xiang; Tao, Hairong; Zhu, Yanhui; Lu, Xiongwei; Hu, Xiaopeng

    2015-01-01

    Postoperative spondylodiscitis is relatively uncommon. This complication is associated with increased cost, and long-term of inability to work, and even morbidity. Although the majority of postoperative spondylodiscitis cases can be well managed by conservative treatment, postoperative spondylodiscitis after internal fixation and those cases that are unresponsive to the conservative treatment present challenges to the surgeon. Here, a review was done to analyze the treatment of postoperative spondylodiscitis with/without internal fixation. This review article suggested that majority of postoperative spondylodiscitis without internal fixation could be cured by conservative treatment. Either posterior or anterior debridement can be used to treat postoperative spondylodiscitis without internal fixation when conservative treatment fails. In addition, minimally invasive debridement and drainage may also be an alternative treatment. In case of postoperative spondylodiscitis after internal fixation, surgical treatment was required. In the cervical spine, it can be well managed by anterior debridement, removal of internal fixation, and reconstruction of the spinal stability by using bone grafting/cage/anterior plate. Postoperative spondylodiscitis after internal fixation is successfully managed by combined anterior debridement, fusion with posterior approach and removal of pedicle screw or extension of pedicle screw beyond the lesion site, in the thoracic and lumbar spine.

  4. Comparison of Outcomes of Operatively Treated Bicondylar Tibial Plateau Fractures by External Fixation and Internal Fixation

    Directory of Open Access Journals (Sweden)

    CC Chan

    2012-03-01

    Full Text Available The outcome of bicondylar tibial plateau fractures treated with either external fixation (35 patients or internal fixation (24 patients was reviewed. Outcome measures included the Rasmussen score, clinical complications, development of osteoarthritis and the requirement for total knee replacement (TKR. Twenty-two (92% anatomical reductions were achieved in the internal fixation group compared to 27 (77% in the external fixation group. Infective complications were more common in the external fixation group (9 patients, 26% due to pin tract infection. There were no deep infections in the internal fixation group. The mean Rasmussen score was not significantly different (mean score 32 in external fixation and 29 in internal fixation between the two groups and the incidence of osteoarthritis was the same in both groups. Four patients in the external fixation group underwent a TKR compared to 5 patients in the internal fixation group. Bicondylar tibial plateau fractures have similar outcomes following external or internal fixation.

  5. Arthroscopic-Assisted Open Reduction Internal Fixation.

    Science.gov (United States)

    Hamilton, Graham A; Doyle, Matthew D; Castellucci-Garza, Francesca M

    2018-04-01

    The indications for arthroscopy have expanded over the years. Arthroscopic-assisted open reduction internal fixation in the setting of acute trauma is gaining popularity with foot and ankle surgeons. It serves to facilitate direct visualization of fracture fragments and allows for precise articular reduction with minimal soft tissue insult. Current evidence reports a high incidence of chondral injury with ankle fractures. Arthroscopy performed at the time of open reduction internal fixation allows for joint inspection and potential treatment of these posttraumatic defects. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. [Complex reconstruction with internal locking plate fixation for Charcot arthropathy].

    Science.gov (United States)

    Ramadani, F; Härägus, H; Radu, P; Trieb, K; Hofstaetter, S

    2015-01-01

    Osteosynthesis and reposition of the Charcot foot is challenging with respect to choice of a proper implant. There is currently no international consensus regarding the optimal implant. Locking plates seem to be an innovative and stable method for reconstruction. The aim of this work is to analyze bone fusion, complications, pseudoarthrosis, and patient satisfaction. This paper presents a retrospective analysis of 63 consecutive Charcot feet treated between 2004 and 2014. The mean follow-up time was 2.4 years. All Charcot feet treated between 2004 and 2014 were Sanders type II or III. A bony fusion was achieved in 50 % of the cases, 26 % had a functional pseudoarthrosis with intact implants and pain-free mobility, and 22 % showed no healing with broken implants. Conclusion Internal fixation with locking plates is superior to screw fixation only with regard to biomechanics. We prefer internal fixation plates to external fixation because of stability even in the case of pseudoathrosis and because of the learning curve.

  7. Internal Fixation of Open Ankle Fracture. Report of Two Cases

    OpenAIRE

    Yaniel Truffin Rodríguez; Juan C. Cabrera Suárez; Indira L. Gómez Gil; José Julio Requeiro Morejón

    2014-01-01

    Open ankle fracture is sporadically seen in the orthopedic practice. Its clinical course is subject to multiple factors, showing a propensity to cause ankle osteoarthritis over the years. Two cases treated at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos are presented. The patients underwent emergency surgical treatment consisting of surgical cleaning of the open wound, reduction of the dislocation and internal fixation of the fracture. These cases are presented du...

  8. Removal of internal fixation--the effect on patients' complaints: a study of 66 cases of removal of internal fixation after malleolar fractures

    DEFF Research Database (Denmark)

    Jacobsen, S; Honnens de Lichtenberg, M; Jensen, C M

    1994-01-01

    typically soreness over implant and cicatrix, reduced movement of the ankle joint, and strain-related pain. About 75% of these patients reported improvement after removal. The AO mode of fixation, i.e., typically by lateral semitubular plating and transsyndesmotic screw and a medial screw or pins......To estimate the effect of removal of internal fixation after treatment of malleolar fractures on postoperatively presented complaints, we retrospectively evaluated 66 patients by their records and by personal questionnaires. Of all the patients, 89.4% had one or more complaints. These were...... period. We conclude that removal of internal fixation after malleolar fractures is indicated when common types of complaints are presented....

  9. Design and Optimization of Resorbable Silk Internal Fixation Devices

    Science.gov (United States)

    Haas, Dylan S.

    Limitations of current material options for internal fracture fixation devices have resulted in a large gap between user needs and hardware function. Metal systems offer robust mechanical strength and ease of implantation but require secondary surgery for removal and/or result in long-term complications (infection, palpability, sensitivity, etc.). Current resorbable devices eliminate the need for second surgery and long-term complications but are still associated with negative host response as well as limited functionality and more difficult implantation. There is a definitive need for orthopedic hardware that is mechanically capable of immediate fracture stabilization and fracture fixation during healing, can safely biodegrade while allowing complete bone remodeling, can be resterilized for reuse, and is easily implantable (self-tapping). Previous work investigated the use of silk protein to produce resorbable orthopedic hardware for non- load bearing fracture fixation. In this study, silk orthopedic hardware was further investigated and optimized in order to better understand the ability of silk as a fracture fixation system and more closely meet the unfulfilled market needs. Solvent-based and aqueous-based silk processing formulations were cross-linked with methanol to induce beta sheet structure, dried, autoclaved and then machined to the desired device/geometry. Silk hardware was evaluated for dry, hydrated and fatigued (cyclic) mechanical properties, in vitro degradation, resterilization, functionalization with osteoinductive molecules and implantation technique for fracture fixation. Mechanical strength showed minor improvements from previous results, but remains comparable to current resorbable fixation systems with the advantages of self-tapping ability for ease of implantation, full degradation in 10 months, ability to be resterilized and reused, and ability to release molecules for osteoinudction. In vivo assessment confirmed biocompatibility, showed

  10. Complications of internal fixation of maxillofacial fractures with microplates

    NARCIS (Netherlands)

    Schortinghuis, J; Bos, RRM; Vissink, A

    Purpose: The aim of this retrospective study was to evaluate the complications of open reduction and internal fixation of maxillofacial fractures with microplates. Patients and Methods: In 44 patients with maxillofacial trauma, fractures of the maxillofacial skeleton were treated by open reduction

  11. Functional Outcome of Internal Fixation of Radial and Ulna Fracture

    Directory of Open Access Journals (Sweden)

    mehrdad Mansouri

    2006-02-01

    Conclusion: Anatomic reduction and internal fixation is the standard method for treatment of fractures by displacing radios and ulna in adults. According to results, it seems more intension to motions specially pronation and muscle strengthening foream after surgery will have affect on improving patients’ function specially pronation and Grip strength.

  12. Fixation of Radiological Contamination; International Collaborative Development

    Energy Technology Data Exchange (ETDEWEB)

    Rick Demmer

    2013-03-01

    A cooperative international project was conducted by the Idaho National Laboratory (INL) and the United Kingdom’s National Nuclear Laboratory (NNL) to integrate a capture coating with a high performance atomizing process. The initial results were promising, and lead to further trials. The somewhat longer testing and optimization process has resulted in a product that could be demonstrated in the field to reduce airborne radiological dust and contamination.

  13. Comparison of internal fixation techniques in metacarpal fractures.

    Science.gov (United States)

    Black, D; Mann, R J; Constine, R; Daniels, A U

    1985-07-01

    A biomechanical study assessed quantitative differences in the stability that was obtained by five commonly used types of internal fixation employed in metacarpal fractures. The techniques included dorsal plating, dorsal plating combined with an interfragmentary lag screw, crossed Kirschner wires, a single intraosseous wire combined with a single oblique Kirschner wire, and a single intraosseous wire alone. Rigidity and strength in torsion and bending were determined after transverse osteotomy and fixation of the metacarpal were performed. The failure modes for each fixation technique were also observed and described. Significant differences in rigidity were found between the plated configurations (with or without an interfragmentary lag screw) and the wired configurations in both apex dorsal bending and axial torsion. The three wired configurations were not significantly different from each other except in torsion. Analysis of the bending moments that were required to produce both yield and failure in apex dorsal bending and also the energy absorbed to yield showed similar disparity between plated and wired techniques. For metacarpal fixation, dorsal plating with or without lag screws provides significantly more stability than do wired techniques and approaches that provided by intact bones.

  14. Endophytic nitrogen fixation in sugarcane: Present knowledge and future applications

    International Nuclear Information System (INIS)

    Boddey, Robert M.; Urquiaga, Segundo; Alves, Bruno J.R.; Reis, Veronica

    2001-01-01

    In Brazil the long-term continuous cultivation of sugarcane with low N fertiliser inputs, without apparent depletion of soil-N reserves, led to the suggestion that N 2 -fixing bacteria associated with the plants may be the source of agronomically significant N inputs to this crop. From the 1950s to 1970s, considerable numbers of N 2 -fixing bacteria were found to be associated with the crop, but it was not until the late 1980s that evidence from N balance and 15 N dilution experiments showed that some Brazilian varieties of sugarcane were able to obtain significant contributions from this source. The results of these studies renewed the efforts to search for N 2 -fixing bacteria, but this time the emphasis was on those diazotrophs that infected the interior of the plants. Within a few years several species of such 'endophytic diazotrophs' were discovered including Gluconacetobacter diazotrophicus, Herbaspirillum seropedicae, H. rubrisubalbicans and Burkholderia sp. Work has continued on these endophytes within sugarcane plants, but to date little success has been attained in elucidating which endophyte is responsible for the observed BNF and in what site, or sites, within the cane plants the N 2 fixation mainly occurs. Until such important questions are answered further developments or extension of this novel N 2 -fixing system to other economically important non-legumes (e.g. cereals) will be seriously hindered. As far as application of present knowledge to maximise BNF with sugarcane is concerned, molybdenum is an essential micronutrient. An abundant water supply favours high BNF inputs, and the best medium term strategy to increase BNF would appear to be based on cultivar selection on irrigated N deficient soils fertilised with Mo. (author)

  15. Management of Subcondylar Fracture through Intraoral Approach with Rigid Internal Fixation.

    Science.gov (United States)

    Patil, Ravi S; Gudi, Santosh S

    2011-09-01

    In Oral and Maxillofacial Surgery, the majority of the condylar fractures are treated by closed reduction with generally satisfactory long term results. But in such cases of closed reduction, patient will be uncomfortable owing to long term application of inter maxillary fixation (IMF). Where as, Disadvantages of extra oral open reduction and fixation of condylar fracture includes facial nerve damage, facial scars etc. which are surely eliminated by the intraoral reduction and rigid fixation. The present study was conducted to determine the efficacy of reduction and fixation of low sub-condylar fractures through intra-oral approach. In this study, ten patients with low sub-condylar fracture, reported to department of Oral and Maxillofacial Surgery. P.M.N.M. Dental College and Hospital Bagalkot were included. These patients were treated by open reduction and internal fixation through intra-oral approach. All the patients were evaluated postoperatively for mouth opening, occlusion and mandibular deviation with regular radiographic examination for 6 weeks. All operated patients followed for 6 weeks, maximum mouth opening was more than 40 mm in seven patients (range from 40 to 50 mm) and less than 40 mm in three patients. Occlusion was satisfactory in all and none of the patients showed deviation of mandible on mouth opening. Statistical analysis showed that postoperative mouth opening was significant ('t' value = 7.88, 'P' = (0.000) value = 1.96, 'P' value (0.081), 0.05]. For occlusion standard photographs were obtained at sixth week and found minor occlusal corrections in two patients are treated by elastic traction for few days. Open reduction with internal fixation through intraoral approach has proved to be safe for early function and also effective by avoiding the patient discomfort due to long term intermaxillary fixation, psychological effect, facial nerve damage, facial scar and weight loss.

  16. Arthroscopic internal fixation of osteochondritis dissecans of the femoral head.

    Science.gov (United States)

    Matsuda, Dean K; Safran, Marc R

    2013-05-01

    Osteochondritis dessicans of the femoral head is an uncommon problem. Limited literature reports the incidence of osteochondritis dessicans and its treatment. The surgical technique used and outcomes for a 40-year-old man with symptomatic femoral head osteochonditis dissecans who was treated 11 years previously with retrograde drilling and hip arthroscopy are discussed.Despite temporary symptomatic improvement without subchondral collapse after his index procedure, increasing pain a decade later was thought to be caused by a large apical osteochondritic fragment and chondrolabral dysfunction from femoroacetabular impingement. Acetabuloplasty of acetabular overcoverage permitted arthroscopic internal fixation of the bone fragment by improving screw trajectory. Labral refixation and femoroplasty were subsequently performed. At 18-month follow-up, his nonarthritic hip score improved from 53 to 76 and his osteochondritic lesion had healed radiographically.Although clinical improvement with radiographic union has been reported following open screw fixation of femoral head osteochondritis dissecans, to the authors' knowledge this is the first published case with a similar outcome using arthroscopic techniques. Clinical improvement and union of even long-standing osteochondritis dissecans of the femoral head may occur with arthroscopic fragment fixation. Hip arthroscopy may play significant therapeutic and diagnostic roles in the treatment of this condition while offering a less invasive alternative to open osteosynthesis. Copyright 2013, SLACK Incorporated.

  17. REVERSE ENGINEERING OF THE MITKOVIC TYPE INTERNAL FIXATOR FOR LATERAL TIBIAL PLATEAU

    Directory of Open Access Journals (Sweden)

    Nikola Vitković

    2015-12-01

    Full Text Available In orthopaedic surgery it is very important to use proper fixation techniques in the treatment of various medical conditions, i.e. bone fractures or other traumas. If an internal fixation method, such as plating, is required, it is possible to use Dynamic Compression Plates (DCP or Locking Compression Plates (LCP and their variants. For DCP implants it is important to match the patient's bone shape with the most possible accuracy, so that the most frequent implant bending is applied in the surgery. For LCP implants it is not so important to match the patient’s bone shape, but additional locking screw holes are required. To improve the geometrical accuracy and anatomical correctness of the shape of DCP and to improve the LCP geometric definition, new geometrical modelling methods for the Mitkovic type internal fixator for Lateral Tibia Plateau are developed and presented in this research. The presented results are quite promising; it can be concluded that these methods can be applied to the creation of geometrical models of internal fixator customized for the given patient or optimized for a group of patients with required geometrical accuracy and morphological correctness.

  18. Numerical-experimental study of internal fixation system "Dufoo" for vertebral fractures.

    Science.gov (United States)

    Nieto-Miranda, J Jesús; Faraón-Carbajal Romero, Manuel; Sánchez-Aguilar, Jons

    2012-01-01

    We describe a numerical experimental study of the stress generated by the internal fixation system "Dufoo" used in the treatment of vertebral fractures with the purpose of validating the numerical model of human lumbar vertebrae under the main physiological loads that the human body is exposed to in this area. The objective is to model and numerically simulate the elements of the musculoskeletal system to collect the stresses generated and other parameters that are difficult to measure experimentally in the thoracic lumbar vertebrae. We used an internal fixator "Dufoo" and vertebrae L2-L3-L4 specimens from pig and human. The system uses a total L3 corpectomy. The fixator acts as a mechanical bridge implant from L2 to L4. Numerical analysis was performed using the finite element method (FEM). For the experimental study, reflective photoelasticity and extensometry were used. Torsion and combined loads generate the main displacements and stresses in the study system, determining that the internal fixation carries out part of the function of the damaged organ structure when absorbing the stresses presented by applied loads. Numerical analysis allows great freedom in the management of the variables involved in the developed models using radiological images. Geometric models are obtained and are entered into FEM programs that allow testing using parameters that, under actual conditions, may not be easily carried out, allowing to comprehensively determine the biomechanical behavior of the coupled system of study.

  19. Time to internal fixation of femoral neck fractures in patients under sixty years--does this matter in the development of osteonecrosis of femoral head?

    Science.gov (United States)

    Razik, Fathima; Alexopoulos, Anastasia-Stefania; El-Osta, Bassel; Connolly, Michelle J; Brown, Ashley; Hassan, Soueid; Ravikumar, Kasetti

    2012-10-01

    Osteonecrosis of femoral head remains a major complication of femoral neck fractures. It has been postulated that early internal fixation drastically reduces the incidence of osteonecrosis of the femoral head. However, there is a paucity of literature looking at the effect of time delay to internal fixation on the development of this late complication. In this study, we aim to assess the effect of time delay and method of internal fixation on the development of osteonecrosis in those less than 60 years of age. We retrospectively analysed 92 patients less than 60 years of age who presented with intracapsular neck of femur fractures that underwent internal fixation between 1999 and 2009. Of the 92 intracapsular fractures, 50 underwent fixation using cannulated screws, 32 using a dynamic hip screw, and ten using a dynamic hip screw with a derotation screw. In total, 13 patients (14.1 %) developed osteonecrosis of the femoral head, the highest incidence being in the cannulated screw fixation group with an osteonecrosis rate of 24 %. We did not find the time delay to internal fixation to be a significant predictor of the development of osteonecrosis. Our study demonstrated that the method of internal fixation rather than delay in internal fixation was more predictive of osteonecrosis of the femoral head. We did not find support to the current belief that early surgical fixation of neck of femur fractures reduces the risk of osteonecrosis in patients less than 60 years.

  20. Internal fixation of severe maxillofacial fractures in dogs.

    Science.gov (United States)

    Arzi, Boaz; Verstraete, Frank J M

    2015-05-01

    To describe internal fixation for maxillofacial fractures using titanium miniplates and report outcome in 7 dogs. Prospective case series. Skeletally mature dogs (n = 7) with maxillofacial fractures. After CT evaluation of fracture configuration, using a combination of extraoral and intraoral approaches as needed, non-locking titanium miniplates were contoured to match the normal anatomy of the fractured bones. Plates were secured using non-locking titanium screws and then covered with a soft-tissue envelope followed by routine intraoral and extraoral closure. Fractures healed rapidly after reconstruction with immediate return to normal function and occlusion. Follow-up time of up to 94 months indicated excellent long-term function and general lack of complications. One dog developed nasal aspergillosis 1.5 years after surgery and the miniplates were removed without adverse consequences. Internal fixation for maxillofacial reconstruction using titanium miniplates is an excellent solution for the treatment of comminuted and displaced maxillofacial fractures in dogs. © Copyright 2014 by The American College of Veterinary Surgeons.

  1. Biomechanical stability of a supra-acetabular pedicle screw Internal Fixation device (INFIX vs External Fixation and plates for vertically unstable pelvic fractures

    Directory of Open Access Journals (Sweden)

    Vigdorchik Jonathan M

    2012-09-01

    Full Text Available Abstract Background We have recently developed a subcutaneous anterior pelvic fixation technique (INFIX. This internal fixator permits patients to sit, roll over in bed and lie on their sides without the cumbersome external appliances or their complications. The purpose of this study was to evaluate the biomechanical stability of this novel supraacetabular pedicle screw internal fixation construct (INFIX and compare it to standard internal fixation and external fixation techniques in a single stance pelvic fracture model. Methods Nine synthetic pelves with a simulated anterior posterior compression type III injury were placed into three groups (External Fixator, INFIX and Internal Fixation. Displacement, total axial stiffness, and the stiffness at the pubic symphysis and SI joint were calculated. Displacement and stiffness were compared by ANOVA with a Bonferroni adjustment for multiple comparisons Results The mean displacement at the pubic symphysis was 20, 9 and 0.8 mm for external fixation, INFIX and internal fixation, respectively. Plate fixation was significantly stiffer than the INFIX and external Fixator (P = 0.01 at the symphysis pubis. The INFIX device was significantly stiffer than external fixation (P = 0.017 at the symphysis pubis. There was no significant difference in SI joint displacement between any of the groups. Conclusions Anterior plate fixation is stiffer than both the INFIX and external fixation in single stance pelvic fracture model. The INFIX was stiffer than external fixation for both overall axial stiffness, and stiffness at the pubic symphysis. Combined with the presumed benefit of minimizing the complications associated with external fixation, the INFIX may be a more preferable option for temporary anterior pelvic fixation in situations where external fixation may have otherwise been used.

  2. Biomechanical stability of a supra-acetabular pedicle screw internal fixation device (INFIX) vs external fixation and plates for vertically unstable pelvic fractures.

    Science.gov (United States)

    Vigdorchik, Jonathan M; Esquivel, Amanda O; Jin, Xin; Yang, King H; Onwudiwe, Ndidi A; Vaidya, Rahul

    2012-09-27

    We have recently developed a subcutaneous anterior pelvic fixation technique (INFIX). This internal fixator permits patients to sit, roll over in bed and lie on their sides without the cumbersome external appliances or their complications. The purpose of this study was to evaluate the biomechanical stability of this novel supraacetabular pedicle screw internal fixation construct (INFIX) and compare it to standard internal fixation and external fixation techniques in a single stance pelvic fracture model. Nine synthetic pelves with a simulated anterior posterior compression type III injury were placed into three groups (External Fixator, INFIX and Internal Fixation). Displacement, total axial stiffness, and the stiffness at the pubic symphysis and SI joint were calculated. Displacement and stiffness were compared by ANOVA with a Bonferroni adjustment for multiple comparisons The mean displacement at the pubic symphysis was 20, 9 and 0.8 mm for external fixation, INFIX and internal fixation, respectively. Plate fixation was significantly stiffer than the INFIX and external Fixator (P = 0.01) at the symphysis pubis. The INFIX device was significantly stiffer than external fixation (P = 0.017) at the symphysis pubis. There was no significant difference in SI joint displacement between any of the groups. Anterior plate fixation is stiffer than both the INFIX and external fixation in single stance pelvic fracture model. The INFIX was stiffer than external fixation for both overall axial stiffness, and stiffness at the pubic symphysis. Combined with the presumed benefit of minimizing the complications associated with external fixation, the INFIX may be a more preferable option for temporary anterior pelvic fixation in situations where external fixation may have otherwise been used.

  3. Influence of internal fixation systems on radiation therapy for spinal tumor.

    Science.gov (United States)

    Li, Jingfeng; Yan, Lei; Wang, Jianping; Cai, Lin; Hu, Dongcai

    2015-07-08

    In this study, the influence of internal fixation systems on radiation therapy for spinal tumor was investigated in order to derive a theoretical basis for adjustment of radiation dose for patients with spinal tumor and internal fixation. Based on a common method of internal fixation after resection of spinal tumor, different models of spinal internal fixation were constructed using the lumbar vertebra of fresh domestic pigs and titanium alloy as the internal fixation system. Variations in radiation dose in the vertebral body and partial spinal cord in different types of internal fixation were studied under the same radiation condition (6 MV and 600 mGy) in different fixation models and compared with those irradiated based on the treatment planning system (TPS). Our results showed that spinal internal fixation materials have great impact on the radiation dose absorbed by spinal tumors. Under the same radiation condition, the influence of anterior internal fixation material or combined anterior and posterior approach on radiation dose at the anterior border of the vertebral body was the greatest. Regardless of the kinds of internal fixation method employed, radiation dose at the anterior border of the vertebral body was significantly different from that at other positions. Notably, the influence of posterior internal fixation material on the anterior wall of the vertebral canal was the greatest. X-ray attenuation and scattering should be taken into consideration for most patients with bone metastasis that receive fixation of metal implants. Further evaluation should then be conducted with modified TPS in order to minimize the potentially harmful effects of inappropriate radiation dose.

  4. A new adhesive technique for internal fixation in midfacial surgery

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    Riediger Dieter

    2008-05-01

    Full Text Available Abstract Background The current surgical therapy of midfacial fractures involves internal fixation in which bone fragments are fixed in their anatomical positions with osteosynthesis plates and corresponding screws until bone healing is complete. This often causes new fractures to fragile bones while drilling pilot holes or trying to insert screws. The adhesive fixation of osteosynthesis plates using PMMA bone cement could offer a viable alternative for fixing the plates without screws. In order to achieve the adhesive bonding of bone cement to cortical bone in the viscerocranium, an amphiphilic bone bonding agent was created, analogous to the dentin bonding agents currently on the market. Methods The adhesive bonding strengths were measured using tension tests. For this, metal plates with 2.0 mm diameter screw holes were cemented with PMMA bone cement to cortical bovine bone samples from the femur diaphysis. The bone was conditioned with an amphiphilic bone bonding agent prior to cementing. The samples were stored for 1 to 42 days at 37 degrees C, either moist or completely submerged in an isotonic NaCl-solution, and then subjected to the tension tests. Results Without the bone bonding agent, the bonding strength was close to zero (0.2 MPa. Primary stability with bone bonding agent is considered to be at ca. 8 MPa. Moist storage over 42 days resulted in decreased adhesion forces of ca. 6 MPa. Wet storage resulted in relatively constant bonding strengths of ca. 8 MPa. Conclusion A new amphiphilic bone bonding agent was developed, which builds an optimizied interlayer between the hydrophilic bone surface and the hydrophobic PMMA bone cement and thus leads to adhesive bonding between them. Our in vitro investigations demonstrated the adhesive bonding of PMMA bone cement to cortical bone, which was also stable against hydrolysis. The newly developed adhesive fixing technique could be applied clinically when the fixation of osteosynthesis plates

  5. Internal Fixation of Cervical Fractures in Three Horses.

    Science.gov (United States)

    Rossignol, Fabrice; Brandenberger, Olivier; Mespoulhes-Rivière, Céline

    2016-01-01

    To describe the surgical treatment outcome of cervical fractures in 3 horses. Case report. Three client-owned horses with cervical vertebral fractures. Three horses were refered for neck stiffness, pain, and ataxia after a cervical trauma because of a fall. Radiographic examination showed an oblique displaced fracture of the caudal aspect of the body of the second cervical vertebra (C2) in horse 1, an oblique displaced fracture of the caudal aspect of C4 involving the disc between C4 and C5 in horse 2, and a displaced transverse fracture of the body of the axis (C2) extending to the lateral arches and involving the vertebral canal in horse 3. In horse 1, the fracture was reduced and stabilized using a 14-hole narrow DCP plate, applied ventrally, and fixed with cancellous screws. A cervical fusion was performed. In horses 2 and 3, fracture fixation was performed using a 5-hole narrow LCP and 5 mm locking screws. All horses showed improvement and returned to full activity. The fracture healed in all horses. Internal fixation of cervical fracture in these horses was associated with minimal complications, and was associated with healing and a highly functional outcome in all horses. The LCP was preferred and would be recommended for ventral stabilization of selected cases of vertebral fractures. © Copyright 2015 by The American College of Veterinary Surgeons.

  6. Open Reduction and Internal Fixation of a Fracture-dislocation of the Ankle

    OpenAIRE

    Yaniel Truffin Rodriguez; José Julio Requeiro Molina; Gerardo Águila Tejeda

    2015-01-01

    Open reduction and internal fixation of the fracture-dislocation of the ankle with plates, screws and Kirschner wires is a well-defined treatment method. This paper presents the management of a fracture-dislocation of the right ankle in a 33-year-old female patient stabilized by using a one-third tubular plate, screws, and Kirschner wires with tension-band wires. Results were satisfactory.

  7. A comparative study of internal fixation and intermaxillary fixation on bone repair of mandibular fractures through radiographic subtraction.

    Science.gov (United States)

    Queiroz, Christiano Sampaio; Sarmento, Viviane Almeida; de Azevedo, Roberto Almeida; de Oliveira, Thaís Feitosa Leitão; Bastos, Luana Costa

    2014-07-01

    Conventional radiographic evaluation of fracture healing is not a reliable method, because it depends on the examinator's experience and the quality of the exam. Therefore, serial images differing in density, contrast and geometrical projection can lead to a misdiagnosis on the postoperative fracture healing. Even in good quality images, little changes in calcified tissues often can't be visualized, because of its little sensibility and because of the limited human sight. The use of more sensitive and objective methods could increase the accuracy of this evaluation. This study intended to compare, by digitalized panoramic radiography, the mandible fracture healing after two different types of treatment: open reduction with internal fixation (group 1) and closed reduction with intermaxillary fixation (group 2). It was taken three postoperative radiographs (within a week, a month and three months after treatment), which were digitalized (600 dpi, 8 bits) and adjusted in brightness and size in Photoshop software. Then these images were evaluated by digital subtraction in ImageTool software. The results revealed greater areas of new bone formation in the internal fixation group, in all the evaluated times. Thus, open reduction with internal fixation resulted in more rapid fracture healing than closed reduction with intermaxillary fixation. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Effects of viewing time, fixations, and viewing strategies on visual memory for briefly presented natural objects.

    Science.gov (United States)

    Huebner, Gesche M; Gegenfurtner, Karl R

    2010-07-01

    We investigated the impact of viewing time and fixations on visual memory for briefly presented natural objects. Participants saw a display of eight natural objects arranged in a circle and used a partial report procedure to assign one object to the position it previously occupied during stimulus presentation. At the longest viewing time of 7,000 ms or 10 fixations, memory performance was significantly higher than at the shorter times. This increase was accompanied by a primacy effect, suggesting a contribution of another memory component-for example, visual long-term memory (VLTM). We found a very limited beneficial effect of fixations on objects; fixated objects were only remembered better at the shortest viewing times. Our results revealed an intriguing difference between the use of a blocked versus an interleaved experimental design. When trial length was predictable, in the blocked design, target fixation durations increased with longer viewing times. When trial length was unpredictable, fixation durations stayed the same for all viewing lengths. Memory performance was not affected by this design manipulation, thus also supporting the idea that the number and duration of fixations are not closely coupled to memory performance.

  9. A novel fixation system for sacroiliac dislocation fracture: internal fixation system design and biomechanics analysis.

    Science.gov (United States)

    Dawei, Tian; Na, Liu; Jun, Lei; Wei, Jin; Lin, Cai

    2013-02-01

    Although there were many different types of fixation techniques for sacroiliac dislocation fracture, the treat remained challenging in posterior pelvic ring injury. The purpose of this study was to evaluate the biomechanical effects of a novel fixation system we designed. 12 human cadavers (L3-pelvic-femora) were used to compare biomechanical stability after reconstruction on the same specimens in four conditions: (1) intact, (2) cable system, (3) plate-pedicle screw system, and (4) cable system and plate-pedicle screw combination system (combination system). Biomechanical testing was performed on a material testing machine for evaluating the stiffness of the pelvic fixation construct in compression and torsion. The cable system and plate-pedicle screw system alone may be insufficient to resist vertical shearing and rotational loads; however the combination system for unstable sacroiliac dislocation fractures provided significantly greater stability than single plate-pedicle or cable fixation system. The novel fixation system for unstable sacroiliac dislocation fractures produced sufficient stability in axial compression and axial rotation test in type C pelvic ring injuries. It may also offer a better solution for sacroiliac dislocation fractures. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Internal fixation and muscle pedicle bone grafting in femoral neck fractures

    Directory of Open Access Journals (Sweden)

    Gupta A

    2008-01-01

    Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

  11. Aramid-epoxy composite internal fixation plates: a pilot study.

    Science.gov (United States)

    Cochran, G V; Palmieri, V R; Zickel, R E

    1994-09-01

    Mechanical tests were conducted on an aramid-epoxy composite laminate in vitro and in vivo to determine its suitability for internal fixation plates. This material, fashioned into blank test coupons the size of the standard 4-hole AO-ASIF plates, had a tensile modulus of elasticity significantly lower than bone. In three-point bending, blank test coupons exhibited a low yield strength that would limit utility in significant load-bearing situations, but changes in the layer configuration of the composite could be expected to improve this characteristic. Under destructive loads, these specimens appeared to be less subject to catastrophic failure than carbon fibre composites. Using 4-hole test coupons fastened to a plastic tube simulating bone, four-point bending tests showed that strain-shielding was significantly reduced by aramid composite relative to carbon fibre composite or metal plates. Finally, in-vivo tests on canine femora demonstrated that aramid composite plates were well tolerated and caused less strain shielding during weightbearing, but significant differences in cortical atrophy and porosity beneath steel versus aramid plates were not apparent. Although the plates were relatively flexible, they could not be preformed during surgery like a metal plate. Copyright © 1994. Published by Elsevier Ltd.

  12. The knee: internal fixation techniques for osteochondritis dissecans.

    Science.gov (United States)

    Grimm, Nathan L; Ewing, Christopher K; Ganley, Theodore J

    2014-04-01

    For the athlete with a newly diagnosed osteochondritis dissecans of the knee, the first step in formulating a treatment plan is determining the stability of the lesion. When the lesion is found to be unstable but salvageable, several methods for fixation are available. Fixation of osteochondritis dissecans in the athletic population has been described and each has its own advantages and disadvantages. Determining the most appropriate method for fixation depends on several variables and should include the athlete's level of play, sport, and overall goals. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Proximal femoral reconstruction for failed internal fixation of a bisphosphonate-related femur fracture

    Directory of Open Access Journals (Sweden)

    Rishabh G. Jethanandani, BSE

    2016-12-01

    Full Text Available We present a case of a bisphosphonate-related femur fracture in an elderly woman, who failed treatment with both cephalomedullary nail and proximal femoral locking plate, leading to successful treatment with total hip arthroplasty. Hardware failure should be included in the differential of patients with previous internal fixation of bisphosphonate-related femur fracture that present with hip or groin pain. Arthroplasty can be an acceptable salvage option in an active elderly patient with a bisphosphonate-related femur fracture.

  14. Necrotizing fasciitis after internal fixation of fracture of femoral trochanteric ? ??

    OpenAIRE

    Santos, Leandro Em?lio Nascimento; Pires, Robinson Esteves Santos; Figueiredo, Leonardo Brand?o; Soares, Eduardo Augusto Marques

    2014-01-01

    Necrotizing fasciitis is a rare and potentially lethal soft tissue infection. We report a case of trochanteric femur fracture in a patient who underwent fracture fixation and developed necrotizing fasciitis. A literature review on the topic will be addressed.

  15. External Fixation versus two-stage Open Reduction Internal Fixation of distal intra-articular Tibia fractures; a Systematic Review

    DEFF Research Database (Denmark)

    Ladeby Erichsen, Julie; Jensen, Carsten; Damborg, Frank Lindhøj

    (>18 years) were included for review. 3071 studies were identified and screened by two independent authors according to the PRISMA guidelines. Cochrane Risk of bias Tool for RCT and non-randomised studies (ROBIN-1) were used to assess risk of bias. Results: One RCT study and four cohort studies......Background: Distal Intra-Articular Tibia Fractures (DIATF) is challenging to treat and severe loss of physical function affecting working abilities has been reported. Aim: To investigate differences in physical function and complications following DIATF surgery with two-stage Open Reduction...... Internal Fixation (ORIF) or External Fixation (EF). Method : A search was conducted using PUBMED, Embase, Cochrane Central, Open Grey, Orthopaedic Proceedings and WHO International Clinical Trials Registry Platform. Studies with level of evidence I-IV comparing EF with two-stage ORIF of DIATF in patients...

  16. Open reduction and internal fixation: Screw injury - Retrospective study

    Directory of Open Access Journals (Sweden)

    Preetha Balaji

    2017-01-01

    Full Text Available Background/Aims: Open reduction and internal fixation (ORIF is a standard surgical procedure in jaw trauma and in orthognathic surgery. Insertion of screws is a significant risk for accidental tooth root injury with varying outcomes. Contrary evidences are found in literature due to a variety of study designs. This study was undertaken to address the lacunae and possibly estimate the difference in occurrence of tooth damage during or after ORIF between trauma and planned osteotomies. Materials and Methods: In this retrospective study, the data of ORIF in either trauma or orthognathic surgery fulfilling inclusion and exclusion criteria were collected and analyzed. Results: There were 1632 patients fulfilling the inclusion and exclusion criteria and formed the study group, of which 663 were in orthognathic surgery, of whom 210 had bimaxillary orthognathic surgery. In the trauma group, 358 patients had fractures involving both jaws whereas 272 had maxilla alone and 339 had mandibular fractures alone. On comparing the outcome, of the 9073 screws studied, 93.40% were not involved in any contact with the teeth, 6.3% were in category of potential hits (near apices or the root surfaces, and only 0.28% had evidence of root damage with the screws. It is observed that molar and premolar had a significant difference in terms of the type of surgery (P ≤ 0.05 whereas canine (P = 0.75 and incisor (P = 0.67 showed no statistical difference. Conclusion: ORIF when used as mentioned is a safe way for the management of fractures. The incidence of root injury is not uncommon but can be avoided with careful planning and execution.

  17. Open reduction and internal fixation of posterior pilon fractures with buttress plate.

    Science.gov (United States)

    Chen, Da-Wei; Li, Bing; Aubeeluck, Ashwin; Yang, Yun-Feng; Zhou, Jia-Qian; Yu, Guang-Rong

    2014-01-01

    Posterior pilon fractures are rare injuries and have not yet gained well recognition. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate. In this retrospective study we identified patients with posterior pilon fractures of the distal tibia who had undergone open reduction and internal fixation at our institute. Between January 2007 and December 2009, 10 patients (mean age, 46.5 years) who had undergone buttress plating via either a posterolateral approach or a dual posterolateral-posteromedial approach, were selected. All 10 patients were available for follow-up. The clinical outcome was evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS). The radiological evaluation was performed using the osteoarthritis-score (OA-score). Satisfactory reduction and stable fixation were accomplished in all patients. At a mean follow-up of 36.2 months, all patients had good radiological results and showed satisfactory clinical recovery. The mean AOFAS sore was 87.8, the mean OA-score was 0.6, and the mean VAS scores during rest, active motion, and weight-bearing walking were 0.6, 0.8, and 1.4, respectively. Buttress plating for posterior pilon fractures gave satisfactory clinical outcomes. It also ensured rigid fixation which in turn enabled earlier postoperative mobilization. Level of Evidence IV, Retrospective Study.

  18. End-stage hindfoot arthrosis: outcomes of tibiocalcaneal fusion using internal and Ilizarov fixation.

    Science.gov (United States)

    Crawford, Brooke; Watson, J Tracy; Jackman, James; Fissel, Brian; Karges, David E

    2014-01-01

    End-stage post-traumatic pantalar arthrosis from ankle, pilon, and talus fractures has often been complicated by infection, bone loss, and a soft tissue deficit. Patients can present with neuropathy, diabetes, tobacco use, and previously failed arthrodesis. Fusion in this population has been challenging, with nonunion rates up to 30%, often leading to amputation. We reviewed the results of a standardized protocol that combined simultaneous internal fixation with the Ilizarov technique to achieve fusion in high-risk patients. With institutional review board approval, a retrospective review of the patients treated with simultaneous internal fixation and an Ilizarov frame was undertaken. The records and radiographs allowed identification of the comorbidities and the presence or absence of successful fusion. Complications were acknowledged and treated. Fifteen patients had undergone the procedure. The mean follow-up period was 27.9 (range 9 to 67) months. Thirteen patients (86.67%) had had previous fusion failure. Twelve patients (80%) had developed post-traumatic arthrosis, 5 (33.33%) of whom had open injuries. All patients had 1 comorbidity, and 10 (66.67%) had multiple, including rheumatoid arthritis, diabetes (types 1 and 2), and smoking. Four patients (26.67%) presented with deep infection and bone loss. Union was achieved in 11 (73.33%), with 12 (80%) patients experiencing profound pain relief. Seven patients (46.67%) required symptomatic hardware removal. Three patients (20%) eventually underwent below-the-knee amputation for recalcitrant nonunion. Statistically significant correlations were found between smoking and wound infection and revision and between nonunion and amputation. Our results have indicated that combined internal fixation with Ilizarov application can provide a strong surgical option for the management of end-stage, pantalar arthritis. More studies are needed to compare the cohort outcomes and gait analysis in these patients with those who have

  19. Treatment of Early Post-Op Wound Infection after Internal Fixation

    Science.gov (United States)

    2016-10-01

    Award Number: W81XWH-10-2-0133 TITLE: Treatment of Early Post -op Wound Infection after Internal Fixation PRINCIPAL INVESTIGATOR: William...14Sep2016 4. TITLE AND SUBTITLE Treatment of Early Post -Op Wound Infection after Internal 5a. CONTRACT NUMBER W81XWH-10-2-0133 Fixation 5b. GRANT...Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Severe fractures are common in modern warfare with fractures

  20. History of internal fixation (part 1): early developments with wires and plates before World War II.

    Science.gov (United States)

    Hernigou, Philippe; Pariat, Jacques

    2017-06-01

    Though the date at which an orthopaedic implant was first used cannot be ascertained with any certainty, the fixation of bone fracture using an iron wire was reported for the first time in a French manuscript in 1775. The first techniques of operative fracture treatment were developed at the end of the 18th and in the beginning of the 19th centuries. The use of cerclage wires to fix fractures was the most frequent fixation at this time. The French Berenger-Feraud (1832-1900) had written the first book on internal fixation. However internal fixation of fractures could not become a practical method before Lister had ensured the safety of open reduction and internal fixation in the treatment of fractures. Lister is not only the father of asepsis; he also used metal wires to fix even closed fractures. The first internal fixation by means of a plate and screws was described by Carl Hansmann in 1858 in Hamburg. Nevertheless, Arbuthnot Lane (1892) and Albin Lambotte (1905) are considered to be the founders of this method, which was further developed by Sherman in the first part of the 20th century.

  1. Management of open fractures using a noncontact locking plate as an internal fixator

    Directory of Open Access Journals (Sweden)

    Azad Yildirim

    2017-01-01

    Conclusions: This case series demonstrates that an “internal fixator technique” is an acceptable alternative to the management of open fractures of the femur or tibia in adult patients. The NC-LP method provided opportunities to achieve a stable fixation with noncontact between the implant and the bone tissues, and the fractures were sufficiently stabilized to allow union with a low complication rate.

  2. [Case-control study on effects of external fixation combined with limited internal fixation for the treatment of Pilon fractures of Rüedi-Allgower type III].

    Science.gov (United States)

    Duan, Da-Peng; You, Wu-Lin; Ji, Le; Zhang, Yong-Tao; Dang, Xiao-Qian; Wang, Kun-Zheng

    2014-01-01

    To analyze the effects of three surgical operations in the treatment of Pilon fracture of Rüedi-Allgower type III, and put forward the best therapeutic method. The clinical data of 33 patients with Pilon fracture who received surgical operations (plaster immobilization group, 10 cases; distal tibia anatomical plate group, 11 cases; external fixation with limited internal fixation group, 12 cases) from October 2009 to January 2012 were analyzed. There were 5 males and 5 females, ranging in age from 24 to 61 years in the plaster immobilization group. There were 7 males and 4 females, ranging in age from 21 to 64 years in the distal tibia anatomical plate group. There were 7 males and 5 females, ranging in age from 23 to 67 years in the external fixation with limited internal fixation group. The Ankle X-ray of Pilon fracture after operation, ankle score, early and late complications were collected. Bourne system was used to evaluate ankle joint function. After 8 months to 3 years follow-up, it was found that three kinds of treatment had significant differences in the outcomes and complications (P external fixation with limited internal fixation group got the best results. The number of anatomic reduction cases in the external fixation with limited internal fixation group (7 cases) and the distal tibia anatomical plate group (8 cases) was more than the plaster immobilization group (2 cases). According to the ankle score, 8 patients got an excellent result, 3 good and 1 poor in the limited internal fixation group ,which was better than those of distal tibia anatomical plate group (5 excellent, 4 good and 2 poor) and the plaster immobilization group (3 excellent, 4 good and 3 poor). The number of early and late complications in the external fixation with limited internal fixation group was more than those in the plaster immobilization group and the distal tibia anatomical plate group (Pexternal fixation with limited internal fixation in the treatment of Pilon fracture

  3. Treatment of stress fracture of the olecranon in throwing athletes with internal fixation through a small incision

    Directory of Open Access Journals (Sweden)

    Fujioka Hiroyuki

    2012-12-01

    Full Text Available Abstract The present study is a report of retrospective case series of stress fracture of the olecranon. Six patients presented posterior elbow pain in throwing in baseball and softball, but fracture was not diagnosed in radiographs. We detected stress fracture of the olecranon using computed tomographic (CT scan and treated the patient with internal fixation with a headless cannulated double threaded screw through a small skin incision. All patients returned to competitive level without elbow complaints after the operation. When throwing athletes present with unusual posterior elbow pain and no significant findings on radiographs, a CT scan examination should be performed. We recommend surgical treatment of internal fixation with a screw through a small skin incision, as a good option for stress fracture of the olecranon in order to allow early return to sports activity in competitive athletes.

  4. Distal tibial pilon fractures (AO/OTA type B, and C treated with the external skeletal and minimal internal fixation method

    Directory of Open Access Journals (Sweden)

    Milenković Saša

    2013-01-01

    Full Text Available Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60 years. The average follow-up was 21.86 (from 12 to 48 months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20 weeks. There were 4 (12.19% infections around the pins of the external skeletal fixator and one (3.22% deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90% patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for

  5. The timing of bone SPECT to predict osteonecrosis after internal fixation of femur neck fractures.

    Science.gov (United States)

    Kim, Ji Wan; Ryu, Jin-Sook; Baek, Sora; Byun, Seong-Eun; Chang, Jae Suk

    2017-05-01

    Bone SPECT can be used after a femur neck fracture to assess the circulation of the femoral head in the immediate postoperative period because the blood supply is one of the major factors affecting bone uptake of radiotracer on bone scintigraphy. The purpose of our present study was to investigate whether osteonecrosis of the femoral head (OFH) after internal fixation of femoral neck fracture could be predicted by early and late bone SPECT. This retrospective cohort study enrolled 44 patients (33 women; mean age, 66.9 years) who underwent surgical fixation for femoral neck fractures. Early and late bone SPECT images were obtained within 2 weeks postoperatively and at 3 months postoperatively. Patients were followed up for a minimum of 24 months (average, 34 months). OFH developed in 9 out of 44 patients but no patient showed nonunion. Seventeen patients with normal femoral head uptake on early bone SPECT were healed. Of 27 patients with decreased femoral head uptake on early bone SPECT, 2 patients developed OFH on radiography before 3 months postoperatively, 18 patients recovered to normal uptake on the late SPECT, and the remaining 7 patients still showed decreased uptake on the late SPECT at 3 months postoperatively. All of these 7 cases finally developed OFH on radiography. Bone SPECT can reliably predict the possibility of OFH with after femoral neck fracture at least 3 months after surgery, while early bone SPECT showed low specificity. Clinical. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  6. Only spinal fixation as treatment of prolapsed cervical intervertebral disc in patients presenting with myelopathy

    Science.gov (United States)

    Goel, Atul; Dharurkar, Pralhad; Shah, Abhidha; Gore, Sandeep; More, Sandeep; Ranjan, Shashi

    2017-01-01

    Aim: An alternative form of surgical treatment of prolapsed cervical intervertebral disc in patients presenting with symptoms related to myelopathy is discussed. The treatment involved fixation of the affected spinal segments and aimed at arthrodesis. No direct manipulation or handling of the disc was done. Materials and Methods: During the period August 2010 to June 2017, 16 patients presenting with symptoms attributed to myelopathy and diagnosed to have prolapsed cervical intervertebral disc were surgically treated by spinal stabilization. There were 11 males and 5 females and their ages ranged from 20 to 66 years (average: 40.6 years). Apart from clinical and radiological indicators, the number of spinal segments that were stabilized depended on direct observation of facetal morphology, alignment, and stability. Surgery involved distraction-fixation of facets using Goel facet spacer (8 patients), transarticular facetal fixation (5 patients) using screws or a combination of both facetal spacer, and transarticular screws (3 patients). Results: All patients had “remarkable” clinical improvement in the immediate postoperative period as assessed by visual analog scale, Goel's clinical grading, and Japanese Orthopedic Association scores. Follow-up ranged from 3 to 84 months (average: 50 months). The herniated disc regressed or disappeared at follow-up radiological assessment that ranged from 24 h to 3 months after surgery. Conclusions: Spinal segmental fixation aiming at arthrodesis with or without distraction of facets and without any direct surgical manipulation in the disc space or removal of the prolapsed portion of the disc can be considered in the armamentarium of the surgeon. PMID:29403240

  7. External versus internal fixation for bicondylar tibial plateau fractures: systematic review and meta-analysis.

    Science.gov (United States)

    Metcalfe, David; Hickson, Craig J; McKee, Lesley; Griffin, Xavier L

    2015-12-01

    It is uncertain whether external fixation or open reduction internal fixation (ORIF) is optimal for patients with bicondylar tibial plateau fractures. A systematic review using Ovid MEDLINE, Embase Classic, Embase, AMED, the Cochrane Library, Open Grey, Orthopaedic Proceedings, WHO International Clinical Trials Registry Platform, Current Controlled Trials, US National Institute for Health Trials Registry, and the Cochrane Central Register of Controlled Trials. The search was conducted on 3rd October 2014 and no language limits were applied. Inclusion criteria were all clinical study designs comparing external fixation with open reduction internal fixation of bicondylar tibial plateau fractures. Studies of only one treatment modality were excluded, as were those that included unicondylar tibial plateau fractures. Treatment effects from studies reporting dichotomous outcomes were summarised using odds ratios. Continuous outcomes were converted to standardized mean differences to assess the treatment effect, and inverse variance methods used to combine data. A fixed effect model was used for meta-analyses. Patients undergoing external fixation were more likely to have returned to preinjury activities by six and twelve months (P = 0.030) but not at 24 months follow-up. However, external fixation was complicated by a greater number of infections (OR 2.59, 95 % CI 1.25-5.36, P = 0.01). There were no statistically significant differences in the rates of deep infection, venous thromboembolism, compartment syndrome, or need for re-operation between the two groups. Although external fixation and ORIF are associated with different complication profiles, both are acceptable strategies for managing bicondylar tibial plateau fractures.

  8. A meta-analysis of external fixation versus open reduction and internal fixation for complex tibial plateau fractures.

    Science.gov (United States)

    Zhao, Xing-Wen; Ma, Jian-Xiong; Ma, Xin-Long; Jiang, Xuan; Wang, Yin; Li, Fei; Lu, Bin

    2017-03-01

    Both external fixation (ExFx) and open reduction and internal fixation(ORIF) were used to treat complex tibial plateau fractures, but it was not sure which one was better. So we did this meta-analysis to evaluate the outcomes of ExFx and ORIF in managing complex tibial plateau fractures. Articles published before August 5, 2016 were selected from PubMed, Cochrane library, and some other electronic database. Relevant journals were also searched manually with no language limited. Two independent reviewers searched and assessed the literature. A fixed effect model was initially used for meta-analyses with RevMan 5.3. When compared with ORIF, cases undergoing ExFx were more likely to return to the preinjury state at the early stage, but no difference in the later period of follow-up. However, ExFx group had higher infection rate (OR 1.98, 95% CI 1.08-3.63, P = 0.03), higher venous thromboembolism rate (OR 1.56, 95% CI 0.49-4.96, P = 0.45), higher re-operation rate (OR 0.87, 95% CI 0.47-1.62, P = 0.66) and lower compartment syndrome rate (OR 0.61, 95% CI 0.12-3.22, P = 0.56), lower TKA rate (OR 0.51, 95% CI 0.20-1.34, P = 0.17). There were no statistically significant differences in the rate of deep infection, venous thromboembolism, compartment syndrome and VTE between the two groups. Although external fixation may offer some advantages, both were acceptable strategies in managing complex tibial plateau fractures. According to our analysis results, we strongly recommend that selection of definitive fixators should base on the fracture patterns, soft-tissue condition as well as the injury stages in clinical practice. More important, further multicentered, randomized controlled studies should be implemented to get a more reliable and clear result. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  9. First metatarsophalangeal joint arthrodesis: a new technique of internal fixation by using memory compression staples.

    Science.gov (United States)

    Choudhary, Rakesh K; Theruvil, Bipin; Taylor, Graeme R

    2004-01-01

    A prospective clinical study of first metatarsophalangeal joint arthrodesis using memory compression staples is presented. In 27 patients, 30 feet underwent surgery. There were 24 women and 3 men, with a mean age of 61.2 years. Two memory compression staples were used at right angles to each other to achieve compression at the fusion site. Postoperatively, patients were allowed full weightbearing in a rigid-soled shoe. Subjective assessment was performed with a standard questionnaire, which included questions regarding level of pain, ambulation, and patient satisfaction. Objective assessment was performed by a clinical and included a radiographic examination. There was a postoperative reduction in the pain score from 4.6 to 1.6 (P memory compression staples for the internal fixation of first metatarsophalangeal joint arthrodesis. The implant is low profile, and postoperative cast immobilization is not required. The use of this device has a predictable success rate comparable to previously reported methods.

  10. Distal Radius Fracture Treated by Internal Fixation with Plates, Screws and the RALCA® External Mini-fixator

    OpenAIRE

    Rafael López Cuellar; Yaniel Truffin Rodríguez; Yudit Pérez Álvarez

    2016-01-01

    Distal radius fractures are very common in medical practice. In our service, we may not have the most widely used devices for fixation of these fractures at a given moment. For this reason, we must consider all possible combinations within our power to correct them since most of the time, it is impossible to maintain a fracture reduction using a single technique. We present the case of a 24-year-old female patient treated at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienf...

  11. Functional Outcome After Successful Internal Fixation Versus Salvage Arthroplasty of Patients With a Femoral Neck Fracture

    NARCIS (Netherlands)

    Zielinski, Stephanie M.; Keijsers, Noël L.; Praet, Stephan F. E.; Heetveld, Martin J.; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; van Lieshout, Esther M. M.; Swiontkowski, Marc; Devereaux, Philip J.; Guyatt, Gordon; Jeray, Kyle; Liew, Susan; Schemitsch, Emil H.; Thabane, Lehana; Walter, Stephen; Sprague, Sheila; Scott, Taryn; Swinton, Marilyn; Viveiros, Helena; Heels-Ansdell, Diane; Zhou, Qi; Buckingham, Lisa; Duraikannan, Aravin; Maddock, Deborah; Agel, Julie; Rangan, Amar; Hanusch, Birgit; Della Rocca, Gregory J.; Haverlag, Robert; Slobogean, Gerard; Katz, Jeffrey; Gillespie, Brenda; Greendale, Gail A.; Guy, Pierre; Hartman, Curtis; Rubin, Craig; Waddell, James; McCormack, Robert; Apostle, Kelly; Boyer, Dory; Moola, Farhad; Perey, Bertrand; Stone, Trevor; Viskontas, Darius; Lemke, H. Michael; Zomar, Mauri; Moon, Karyn; Moon, Raely; Oatt, Amber; Buckley, Richard E.; Duffy, Paul; Korley, Robert; Puloski, Shannon; Johnston, Kelly; Powell, James; Carcary, Kimberly; Sanders, David; Lawendy, Abdel; Tiezer, Christina; Stephen, David; Kreder, Hans; Jenkinson, Richard; Nousiainene, Markku; Axelrod, Terry; Murnaghan, John; Nam, Diane; Richards, Robin; Rodriguez-Elizalde, Sebastian; Wadey, Veronica; Yee, Albert; Milner, Katrine; Kunz, Monica; Macnevin, Melanie; Cagaanan, Ria; Bicknell, Ryan; Yach, Jeff; Bardana, Davide; Wood, Gavin; Harrison, Mark; Yen, David; Lambert, Sue; Howells, Fiona; Ward, Angela; Coles, Chad; Leighton, Ross; Biddulph, Michael; Johnston, David; Glazebrook, Mark; Alexander, David; Coady, Cathy; Dunbar, Michael; Trask, Kelly; MacDonald, Shelley; Dobbin, Gwen; Ahn, Henry; Hall, Jeremy A.; McKee, Michael D.; Whelan, Daniel B.; Nauth, Aaron; Vicente, Milena; Wild, Lisa; Khan, Ryan; Hidy, Jennifer; Zalzal, Paul; Brien, Heather; Naumetz, V.; Weening, Brad; Simunovic, Nicole; Wai, Eugene K.; Papp, Steve; Gofton, Wade T.; Liew, Allen; Kingwell, Stephen P.; Roffey, Darren M.; Borsella, Vivian; Avram, Victoria; Oliver, Todd M.; Jones, Vicki; Jones, Clifford; Ringler, James; Endres, Terrence; Sietsema, Debra L.; Jeray, Kyle J.; Broderick, J. Scott; Goetz, David R.; Pace, Thomas B.; Schaller, Thomas M.; Porter, Scott E.; Tanner, Stephanie L.; Snider, Rebecca G.; Nastoff, Lauren A.; Bielby, Shea A.; Marcantonio, Andrew J.; Iorio, Richard; Garfi, John; Prayson, Michael J.; Laughlin, Richard; Rubino, Joseph; May, Jedediah; Rieser, Geoffrey Ryan; Dulaney-Cripe, Liz; Gayton, Chris; Switzer, Julie A.; Cole, Peter A.; Anderson, Sarah A.; Lafferty, Paul M.; Li, Mengnai; Ly, Thuan V.; Marston, Scott B.; Foley, Amy L.; Vang, Sandy; Wright, David M.; Vallier, Heather A.; Dolenc, Andrea; Robinson, Chalitha; Gorczyca, John T.; Gross, Jonathan M.; Humphrey, Catherine A.; Kates, Stephen; Noble, Krista; McIntyre, Allison W.; Pecorella, Kaili; Shaer, James; Schrickel, Tyson; Hileman, Barbara; Davis, Craig A.; Weinerman, Stewart; Weingarten, Peter; Stull, Philip; Lindenbaum, Stephen; Hewitt, Michael; Schwappach, John; Baker, Janell K.; Mehta, Samir; Esterhai, John; Ahn, Jaimo; Horan, Annamarie D.; McGinnis, Kelly; Kaminiski, Christine A.; Kowalski, Brynn N.; Cannada, Lisa K.; Karges, David; Hill, Leslie; Tarkin, Ivan; Siska, Peter; Gruen, Gary; Evans, Andrew; Farrell, Dana J.; Irrgang, James; Luther, Arlene; Keeve, Jonathan P.; Anderson, Christopher G.; McDonald, Michael D.; Hoffman, Jodi M.; Jenkins, Mark; Dumais, Jules; Romero, Amanda W.; Hsu, Joseph R.; Ficke, James; Charlton, Michael; Napierala, Matthew; Fan, Mary; Cross, William W.; Cass, Joseph R.; Sems, Stephen A.; Torchia, Michael E.; Scrabeck, Tyson; Sagebien, Carlos A.; Butler, Mark S.; Monica, James T.; Seuffert, Patricia; Brennan, Michael L.; Probe, Robert; Kile, Evelyn; Mills, Kelli; Clipper, Lydia; Yu, Michelle; Erwin, Katie; Tornetta, Paul; Carlisle, Hope; Silva, Heather; Archdeacon, Michael; Finnan, Ryan; Le, Toan; Wyrick, John; Hess, Shelley; McBeth, Jessica; Aurang, Kamran; Zohman, Gary; Peterson, Brett; Huff, Roger B.; Baele, Joseph; Weber, Timothy; Edison, Matt; Schmidt, Andrew H.; Westberg, Jerald R.; DePaolo, Charles J.; Alosky, Rachel; Shell, Leslie E.; Hampton, Lynne; Shepard, Stephanie; Nanney, Tracy; Cuento, Claudine; Shively, Karl; Ertl, Janos P.; Mullis, Brian; Parr, J. Andrew; Worman, Ripley; Frizzell, Valda; Moore, Molly M.; Tobias, Erin; Thomas, Emily; Cantu, Robert V.; Henderson, Eric R.; Eickhoff, Linda S.; Zamorano, David P.; Pourmand, Deeba; Lawson, Deanna; Hammerberg, E. Mark; Stahel, Philip; Hak, David; Mauffrey, Cyril; Gibula, Douglas; Gissel, Hannah; Henderson, Corey; Crist, Brett D.; Murtha, Yvonne M.; McPherson, Melinda; Anderson, Linda K.; Dohm, Michael P.; Linehan, Colleen; Pilling, Lindsey; Horwitz, Daniel; Strohecker, Kent; Lewis, Courtland G.; Caminiti, Stephanie; Sullivan, Raymond J.; Roper, Elizabeth; Obremsky, William; Kregor, Philip; Richards, Justin E.; Stringfellow, Kenya; Goslings, J. Carel; Ponsen, Jan; Bronkhorst, Maarten W. G. A.; Guicherit, Onno R.; Eversdijk, Martin G.; Peters, Rolf; den Hartog, Dennis; van Waes, Oscar J. F.; Oprel, Pim; de Rijcke, Piet A. R.; Koppert, Cees L.; Buijk, Steven E.; Groenendijk, Richard P. R.; Dawson, Imro; Tetteroo, Geert W. M.; Bruijninckx, Milko M. M.; Doornebosch, Pascal G.; de Graaf, Eelco J. R.; Visser, Gijs A.; Stockman, Heyn; Silvis, Rob; Snellen, Jaap P.; Rijbroek, Bram; Scheepers, Joris J. G.; Vermeulen, Erik G. J.; Siroen, Michel P. C.; Vuylsteke, Ronald; Brom, Hans L. F.; Rijna, Herman; Roukema, Gert R.; Josaputra, Hong; Keller, Paul; de Rooij, Peter D.; Kuiken, Hans; Boxma, Han; Clefken, Berry I.; Liem, Ronald; Rhemrev, Steven J.; Bosman, Coks H. R.; de Mol van Otterloo, Alexander; Hoogendoorn, Jochem; de Vries, Alexander C.; Meylaerts, Sven A. G.; Poolman, Rudolf W.; Simons, Maarten P.; van der Heijden, Frank H. W. M.; Willems, W. Jaap; de Meulemeester, Frank R. A. J.; van der Hart, Cor P.; Turckan, Kahn; Festen, Sebastiaan; de Nies, Frank; Out, Nico J. M.; Bosma, Jan; van der Elst, Maarten; van der Pol, Carmen C.; van't Riet, Martijne; Karsten, Tom M.; de Vries, Mark; Stassen, Laurents P. S.; Schep, Niels W. L.; Schmidt, G. Ben; Hoffman, W. H.; Segers, Michiel J. M.; Zijl, Jacco A. C.; Verhoeven, Bart; Smits, Anke B.; de Vries, Jean Paul P. M.; Fioole, Bram; Hoeven, Henk van der; Theunissen, Evert B. M.; de Vries Reilingh, Tammo S.; Govaert, Lonneke; Wittich, Philippe; de Brauw, Maurits; Wille, Jan; Go, Peter M. N. Y. M.; Ritchie, Ewan D.; Wessel, Ronald N.; Hammacher, Eric R.; Verhofstad, Michiel H. J.; Meijer, Joost; van Egmond, Teun; van der Brand, Igor; van der Vis, Harm; Campo, Martin; Verhagen, Ronald; Albers, Albert Robert; Zurcher, Arthur W.; von Kampen, Albert; Biert, Jan; van Vugt, Arie B.; Edwards, Michael J. R.; Blokhuis, Taco J.; Frölke, Jan Paul M.; Geeraedts, Leo M. G.; Gardeniers, Jean W. M.; Tan, Edward T. C. H.; Poelhekke, Lodewijk M. S. J.; de Waal Malefijt, Maarten C.; Schreurs, Bart; Simmermacher, Rogier K. J.; van Mulken, Jeroen; van Wessem, Karlijn; van Gaalen, Steven M.; Leenen, Luke P. H.; Bedi, Harvinder; Carr, Ashley; Chia, Andrew; Csongvay, Steven; Curry, Hamish; Doig, Stephen; Donohue, Craig; Edwards, Elton; Etherington, Greg; Gong, Andrew; Jain, Arvind; Li, Doug; Miller, Russell; Moaveni, Ash; Russ, Matthias; Ton, Lu; Wang, Otis; Murdoch, Zoe; Sage, Claire; Frihagen, Frede; Clarke-Jenssen, John; Hjorthaug, Geir; Ianssen, Torben; Amundsen, Asgeir; Brattgjerd, Jan Egil; Borch, Tor; Bøe, Berthe; Flatøy, Bernhard; Hasselund, Sondre; Haug, Knut Jørgen; Hemlock, Kim; Hoseth, Tor Magne; Jomaas, Geir; Kibsgård, Thomas; Kristiansen, Bjorn; Lona, Tarjei; Moatshe, Gilbert; Müller, Oliver; Molund, Marius; Nicolaisen, Tor; Nilsen, Fredrik; Rydinge, Jonas; Smedsrud, Morten; Stødle, Are; Trommer, Axel; Ugland, Stein; Vesterhus, Elise Berg; Brekke, Anne Christine; Sharma, Ateet; Sanghavi, Amir; Tetsworth, Kevin; Geoff, Donald; Weinrach, Patrick; yang, Steven; Halliday, Brett; Gervais, Trevor; Holt, Michael; Flynn, Annette; Prasad, Amal Shankar; Mishra, Vimlesh; Gupta, Ajay; Jain, Niraj; Bahatia, Mahesh; Arora, Vinod; Bhatia, Mahesh; Sundaresh, D. C.; Khanna, Angshuman; Rai, Anil; Pirpiris, Marinis; Love, David; Bucknill, Andrew; Farrugia, Richard J.; Dadi, Akhil; Palla, Naveen; Rai, B. Sachidananda; Rajakumar, Janakiraman; Cherian, Joe Joseph; Olakkengil, Davy J.; Sharma, Gaurav

    2014-01-01

    Objectives: To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture. Design: Secondary cohort study to a randomized controlled trial.

  12. Femoral neck shortening after internal fixation of a femoral neck fracture

    NARCIS (Netherlands)

    Zielinski, Stephanie M.; Keijsers, Noël L.; Praet, Stephan F. E.; Heetveld, Martin J.; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; van Lieshout, Esther M. M.; Devereaux, Philip J.; Guyatt, Gordon; Jeray, Kyle; Liew, Susan; Richardson, Martin J.; Schemitsch, Emil H.; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen; Sprague, Sheila; Simunovic, Helena Viveiros Nicole; Heels-Ansdell, Diane; Buckingham, Lisa; Duraikannan, Aravin; Swiontkowski, Marc F.; Agel, Julie; Goslings, J. Carel; Haverlag, Robert; Ponsen, Kees Jan; Bronkhorst, Maarten W. G. A.; Guicherit, O. R.; Eversdijk, Martin G.; Peters, Rolf; den Hartog, Dennis; van Waes, Oscar J. F.; Oprel, Pim; de Rijcke, Piet A. R.; Koppert, C. L.; Buijk, Steven E.; Groenendijk, Richard P. R.; Dawson, I.; Tetteroo, G. W. M.; Bruijninckx, Milko M. M.; Doornebosch, Pascal G.; de Graaf, E. J. R.; Gasthuis, Kennemer; Visser, Gijs A.; Stockmann, Heyn; Silvis, Rob; Snellen, J. P.; Rijbroek, A.; Scheepers, Joris J. G.; Vermeulen, Erik G. J.; Siroen, M. P. C.; Vuylsteke, Ronald; Brom, H. L. F.; Ryna, H.; Roukema, Gert R.; Josaputra, H.; Keller, Paul; de Rooij, P. D.; Kuiken, Hans; Boxma, Han; Cleffken, Barry I.; Liem, Ronald; Rhemrev, Steven J.; Bosman, C. H. R.; van Otterloo, Alexander de Mol; Hoogendoorn, Jochem; de Vries, Alexander C.; Meylaerts, Sven A. G.; Poolman, Rudolf W.; Simons, Maarten P.; van der Heijden, Frank H. W. M.; Willems, W. J.; de Meulemeester, Frank R. A. J.; van der Hart, Cor P.; Turckan, Kahn; Festen, Sebastiaan; de Nies, F.; Out, Nico J. M.; Bosma, J.; van der Elst, Maarten; van der Pol, Carmen C.; van 't Riet, Martijne; Karsten, T. M.; de Vries, M. R.; Stassen, Laurents P. S.; Schep, Niels W. L.; Schmidt, G. B.; Hoffman, W. H.; Segers, Michiel J. M.; Zijl, Jacco A. C.; Verhoeven, Bart; Smits, Anke B.; de Vries, J. P. P. M.; Fioole, Bram; van der Hoeven, H.; Theunissen, Evert B. M.; de Vries Reilingh, Tammo S.; Govaert, Lonneke; Wittich, Philippe; de Brauw, Maurits; Wille, Jan; Go, Peter M. N. Y. M.; Ritchie, Ewan D.; Wessel, R. N.; Hammacher, Eric R.; Verhofstad, Michiel H. J.; Meijer, Joost; van Egmond, Teun; van der Brand, Igor; van der Vis, Harm M.; Campo, Martin; Verhagen, Ronald; Albers, G. H. R.; Zurcher, A.; van Kampen, A.; Biert, Jan; van Vugt, Arie B.; Edwards, Michael J. R.; Blokhuis, Taco J.; Frölke, Jan Paul M.; Geeraedts, L. M. G.; Gardeniers, J. W. M.; Tan, Edward T. C. H.; Poelhekke, L. M. S. J.; de Waal Malefijt, M. C.; Schreurs, Bart; Simmermacher, Rogier K. J.; van Mulken, Jeroen; van Wessem, Karlijn; van Gaalen, Steven M.; Leenen, Luke P. H.; Frihagen, Frede; Nordsletten, Lars; Stoen, Ragnhild Oydna; Brekke, Kine; Tetsworth, Kevin; Weinrauch, Patrick; Pincus, Paul; Donald, Geoff; yang, Steven; Halliday, Brett; Gervais, Trevor; Holt, Michael; Flynn, Annette; Pirpiris, Marinis; Love, David; Bucknill, Andrew; Farrugia, Richard J.; Dowrick, Adam; Donohue, Craig; Bedi, Harvinder; Li, Doug; Edwards, Elton; Csongvay, Steven; Miller, Russell; Wang, Otis; Chia, Andrew; Jain, Arvind; Mammen, Mathan; Murdoch, Zoe; Sage, Claire; Kumar, Anil; Pankaj, Amite; Singh, Ajay Pal; Pesantez, Rodrigo; Martinez, Adriana; Novoa, Catherine; Buckley, Richard E.; Duffy, Paul; Korley, Robert; Johnston, Kelly; Puloski, Shannon; Carcary, Kimberly; Avram, Victoria; Bicknell, Ryan; Yach, Jeff; Bardana, Davide; Lambert, Sue; Sanders, David W.; Howard, Jamie; Macleod, Mark; Bartly, C. T.; Tieszer, Christina; Peterson, Devin; Zalzal, Paul; Maumetz, Victor; Brien, Heather; Weening, Brad; Wai, Eugene K.; Roffey, Darren; McCormack, Robert; Stone, Trevor; Perey, Bertrand; Viskontas, Darius; Boyer, Dory; Perey, Bert; Zomar, Mauri; Moon, Karyn; Oatt, Amber; McKee, Michael; Hall, Jeremy; Ahn, Henry; Vicente, Milena R.; Wild, Lisa M.; Kreder, Hans J.; Stephen, David J. G.; Nousianinen, Markku; Cagaanan, Ria; Kunz, Monica; Syed, Khalid; Azad, Tania; Coles, Chad; Leighton, Ross; Johnstone, David; Glazebrook, Mark; Alexander, David; Trask, Kelly; Dobbin, Gwendolyn; Oliver, Todd M.; Jones, Vicky; Ronan, James; Brown, Desmond T.; Carlilse, Hope; Shaughnessy, Lisa; Schwappach, John; Davis, Craig A.; Weingarten, Peter; Weinerman, Stewart; Newman, Heike; Baker, Janell; Browner, Kieran; Hurley, Meghan; Zura, Robert; Manson, Maria J.; Goetz, David; Broderick, Scott J.; Porter, Scott; Pace, Thomas; Tanner, Stephanie L.; Snider, Becky; Schmidt, Andrew H.; Haas, Jonathan; Templeman, David; Westberg, Jerald R.; Mullis, Brian; Ertl, J. P.; Shively, Karl; Frizzel, Valda; Marcantonio, Andrew J.; Iorio, Richard; Lobo, Margaret; Kain, Michael; Specht, Lawrence; Garfi, John; Prayson, Michael J.; Davis, Craig; Laughlin, Richard; Rubino, Joe; Lawless, Mathew; DiPaola, Matt; Gaydon, Chris; Dulaney, Liz; Vallier, Heather A.; Wilber, John; Sontich, John; Patterson, Brendan; Dolenc, Andrea; Robinson, Chalitha; Wilber, Roger; DePaolo, Charles J.; Alosky, Rachel; Shell, Leslie E.; Keeve, Jonathan P.; Anderson, Chris; McDonald, Michael; Hoffman, Jodi; Baele, Joseph; Weber, Tim; Edison, Matt; Musapatika, Dana; Jones, Clifford; Ringler, James; Endres, Terrance; Gelbke, Martin; Jabara, Michael; Sietsema, Debra L.; Engerman, Susan M.; Switzer, Julie A.; Li, Mangnai; Marston, Scott; Cole, Peter; Vang, Sandy X.; Foley, Amy; McBeth, Jessica; Comstock, Curt; Ziran, Navid; Shaer, James; Hileman, Barbara; Karges, David; Cannada, Lisa; Kuldjanov, Djoldas; Watson, John Tracy; Mills, Emily; Simon, Tiffany; Abdelgawad, Amr; Shunia, Juan; Jenkins, Mark; Zumwalt, Mimi; Romero, Amanda West; Lowe, Jason; Goldstein, Jessica; Zamorano, David P.; Lawson, Deanna; Archdeacon, Michael; Wyrick, John; Hampton, Shelley; Lewis, Courtland G.; Ademi, Arben; Sullivan, Raymond; Caminiti, Stephanie; Graves, Matthew; Smith, Lori; Della Rocca, Gregory J.; Crist, Brett D.; Murtha, Yvonne; Anderson, Linda K.; Kliewer, Toni K.; McPherson, Melinda K.; Sullivan, Kelly M.; Sagebien, Carlos; Seuffert, Patricia; Mehta, Samir; Esterhai, John; Ahn, Jaimo; Tjoumakaris, Fotios; Horan, Annamarie D.; Kaminski, Christine; Tarkin, Ivan; Siska, Peter; Luther, Arlene; Irrgang, James; Farrell, Dana; Gorczyca, John T.; Gross, Jonathan M.; Kates, Stephen Lloyd; Colosi, Jen; Hibsch, Nancy; Noble, Krista; Agarwal, Animesh; Wright, Rebecca; Hsu, Joseph R.; Ficke, James R.; Napierala, Matthew A.; Charlton, Michael T.; Fan, Mary K.; Obremskey, William T.; Richards, Justin E.; Robinson, Kenya; Carroll, Eben; Kulp, Brenda

    2013-01-01

    This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventy-six patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and

  13. LCP external fixation - External application of an internal fixator: two cases and a review of the literature

    Directory of Open Access Journals (Sweden)

    Wong Merng-Koon

    2010-03-01

    Full Text Available Abstract The locking compression plate (LCP is an angle-stable fixator intended for intracorporeal application. In selected cases, it can be applied externally in an extracorporeal location to function as a monolateral external fixator. We describe one patient with Schatzker V tibial plateau fracture and one patient with Gustillo IIIB open tibia shaft fracture treated initially with traditional external fixation for whom exchange fixation with externally applied LCPs was performed. The first case went on to bony union while the second case required bone grafting for delayed union. Both patients found that the LCP external fixators facilitated mobilization and were more manageable and aesthetically acceptable than traditional bar-Schanz pin fixators.

  14. When do anterior external or internal fixators provide additional stability in an unstable (Tile C) pelvic fracture? A biomechanical study.

    Science.gov (United States)

    Mcdonald, E; Theologis, A A; Horst, P; Kandemir, U; Pekmezci, M

    2015-12-01

    This study aimed at evaluating the additional stability that is provided by anterior external and internal fixators in an unstable pelvic fracture model (OTA 61-C). An unstable pelvic fracture (OTA 61-C) was created in 27 synthetic pelves by making a 5-mm gap through the sacral foramina (posterior injury) and an ipsilateral pubic rami fracture (anterior injury). The posterior injury was fixed with either a single iliosacral (IS) screw, a single trans-iliac, trans-sacral (TS) screw, or two iliosacral screws (S1S2). Two anterior fixation techniques were utilized: external fixation (Ex-Fix) and supra-acetabular external fixation and internal fixation (In-Fix); supra-acetabular pedicle screws connected with a single subcutaneous spinal rod. The specimens were tested using a nondestructive single-leg stance model. Peak-to-peak (P2P) displacement and rotation and conditioning displacement (CD) were calculated. The Ex-Fix group failed in 83.3 % of specimens with concomitant single-level posterior fixation (Total: 15/18-7 of 9 IS fixation, 8 of 9 TS fixation), and 0 % (0/9) of specimens with concomitant two-level (S1S2) posterior fixation. All specimens with the In-Fix survived testing except for two specimens treated with In-Fix combined with IS fixation. Trans-sacral fixation had higher pubic rotation and greater sacral and pubic displacement than S1S2 (p pelvic fracture (OTA 61-C), anterior fixation with an In-Fix was biomechanically superior to an anterior Ex-Fix in the setting of single-level posterior fixation. There was no biomechanical difference between the In-Fix and Ex-Fix when each was combined with two levels of posterior sacral fixation.

  15. Internal fixation of an oblique femoral fracture in a German ...

    African Journals Online (AJOL)

    A 6 month old puppy with oblique femoral fracture on the right hind limb was treated by surgical manipulation which required internal stabilization using a lagscrew fixed in a craniocaudual direction, and a bone plate fixed laterally. Bone healing occurred without complications and the dog's limb was restored to its normal ...

  16. Combined circular external fixation and open reduction internal fixation with pro-syndesmotic screws for repair of a diabetic ankle fracture

    Directory of Open Access Journals (Sweden)

    Zacharia Facaros

    2010-10-01

    Full Text Available The surgical management of ankle fractures among the diabetic population is associated with higher complication rates compared to the general population. Efforts toward development of better methods in prevention and treatment are continuously evolving for these injuries. The presence of peripheral neuropathy and the possible development of Charcot neuroarthropathy in this high risk patient population have stimulated much surgical interest to create more stable osseous constructs when open reduction of an ankle fracture/dislocation is required. The utilization of multiple syndesmotic screws (pro-syndesmotic screws to further stabilize the ankle mortise has been reported by many foot and ankle surgeons. In addition, transarticular Steinmann pins have been described as an adjunct to traditional open reduction with internal fixation (ORIF of the ankle to better stabilize the talus, thus minimizing risk of further displacement, malunion, and Charcot neuroarthropathy. The authors present a unique technique of ORIF with pro-syndesmotic screws and the application of a multi-plane circular external fixator for management of a neglected diabetic ankle fracture that prevented further deformity while allowing a weight-bearing status. This technique may be utilized for the management of complex diabetic ankle fractures that are prone to future complications and possible limb loss.

  17. Management of intra-articular fracture of calcaneus by combined percutaneous and minimal internal fixation.

    Science.gov (United States)

    Lamichhane, A; Mahara, D

    2013-01-01

    Fractures of the calcaneus are among the most challenging for the orthopaedic surgeon. The treatment of the intra-articular calcaneum fracture remains controversial due to complications and complexity of surgical anatomy. Treatment of calcaneal fracture ranges from non-operative treatment to operative. We present intraarticular fracture of calcaneus treated by combined percutaneous and minimal internal fixation. All cases evaluated either by X-ray or CT scan. All fractures were sanders two or three type evaluated by CT scan and either joint depression or tongue type fracture by X-ray. Lateral approach was used, posterior facet was exposed, reduced and fixed with one 4 mm canulated cancellous screws and 2 axial pins percutaneously from tuberosity. Clinical evaluation of the outcomes was done by modified Rowe Score. Out of 22 patients, 14 were male and 8 cases were female. Average age of the patients was 30.5 yrs (15-63 yrs). Mode of the injury was RTA in 6 cases and fall from height in 16 cases. There was no soft tissue problem in any patient. All fractures united without secondary displacement in an average of 8 weeks. Average duration of follow up was 26 months (6-37 months). Average Modified Rowe Score was 80 (Range 55-95). Ten patients had excellent, 10 had good and 2 had satisfactory outcome. Intra-articular fracture of the calcaneus can be well managed by minimal opening at the fracture and fixation by single cancellous screw and 2 axial k-wires, so minimizes complications and results in comparable outcomes.

  18. Internal fixation of proximal fractures of the 2nd and 4th metacarpal and metatarsal bones using bioabsorbable screws.

    Science.gov (United States)

    Mageed, M; Steinberg, T; Drumm, N; Stubbs, N; Wegert, J; Koene, M

    2018-03-01

    Fractures involving the proximal one-third of the splint bone are relatively rare and are challenging to treat. A variety of management techniques have been reported in the literature. The aim of this retrospective case series was to describe the clinical presentation and evaluate the efficacy of bioabsorbable polylactic acid screws in internal fixation of proximal fractures of the 2nd and 4th metacarpal and metatarsal bones in horses. The medical records, diagnostic images and outcome of all horses diagnosed with a proximal fracture of the splint bones and treated with partial resection and internal fixation of the proximal stump using bioabsorbable polylactic acid screws between 2014 and 2015 were reviewed. Eight horses met the inclusion criteria. The results showed that there were no complications encountered during screw placement or postoperatively. Six horses returned to full work 3 months after the operation and two horses remained mildly lame. On follow-up radiographs 12 months postoperatively (n = 2) the screws were not completely absorbed. The screws resulted in a cone-shaped radiolucency, which was progressively replaced from the outer margins by bone sclerosis. The use of bioabsorbable screws for fixation of proximal fractures of the splint bone appears to be a safe and feasible technique and may offer several advantages over the use of traditional metallic implants. © 2018 Australian Veterinary Association.

  19. Combined fixation, intern and external, in proximal complex fractures of the tibia

    International Nuclear Information System (INIS)

    Quintero Laverde, Jaime; Lozano Ortiz, Victor Hugo; Rojas Duque, Guillermo

    2002-01-01

    Between August of 1997 and December of 2001, they were treated in the orthopedics department and traumatology of the Hospital Clinica San Rafael, 16 patients with proximal complex fractures of the tibia, using internal fixation with plate in the lateral column and an unilateral external fixer, for the medial column. It carries out a clinical and radiological pursuit with average of 27 months (minimum 4.5, maximum 40 months). In 15 patients (93,7%) it was obtained a primary consolidation and 1 case (6,2%) it presented retard in the consolidation being necessary the placement of bony implants. in 2 cases (12,5%) there was superficial infection, one in the itinerary of the nails and another in area of superficial necrosis in soft fabrics in a closed fracture. single 1 case (6,2) it presented deep infection, which, it improve with bony curettage and antibiotics. In the final radiographic evaluation, 2 cases (12,5%) they presented depression of the lateral plate; according to the functional scale of Rasmussen excellent results were obtained (27 to 30 points) in 11 cases (68,7%) and good (20 to 26 points) in 5 cases (31,2%). The radiographic results and functional global they suggest that the combination of a technique less invasive in this area criticizes, it represents a good alternative for the treatment of the proximal complex fractures of the tibia

  20. Does perioperative systemic infection or fever increase surgical infection risks after internal fixation of femur and tibia fractures in an intensive care polytrauma unit?

    Science.gov (United States)

    Large, Thomas M; Alton, Timothy B; Patton, Daniel J; Beingessner, Daphne

    2013-10-01

    We hypothesized that internal fixation procedures performed on trauma intensive care unit (ICU) patients with systemic infections, some also febrile, would be at increased risk for deep infection. A total of 128 patients (mean age, 37.4 years; mean Injury Severity Score [ISS], 34.7) admitted to the ICU with 179 femur or tibia fractures developed systemic infections. Systemic infections included sepsis, pneumonia, urinary tract infections, abdominal infections, and wound infections remote to the fracture. Of the fractures, 33 open and 146 closed underwent 150 intramedullary and 29 plate fixation procedures. Data were gathered regarding antibiotic use, systemic infection timing in relation to the date of fixation, and whether fever (>38.2°C) was present within 24 hours of fixation. Patients were followed up for a mean of 491 days. Twenty-eight procedures were performed a mean of 4.7 days after the diagnosis of a systemic infection, and 151 were performed a mean of 9.3 days before the diagnosis. Forty-five procedures were performed in patients who were febrile within 24 hours. Of the 179 procedures, 10 (5.6%) developed a deep infection. Four patients' implant infection was potentially hematogenously seeded with the same organism as their systemic infection. Neither the timing of the systemic infection in relation to the fixation procedure nor the presence of fever within 24 hours of fixation, days of preoperative antibiotics, location of the fracture, type of fixation (intramedullary nail vs. plate fixation), or type of systemic infection was significantly associated with the development of an infection. The only significant risk factor for developing an orthopedic infection was an open fracture (p close conjunction to the diagnosis of systemic infection led to a 5.6% infection rate, which compares favorably with historic infection rates for fixation of open or closed tibia and femur fractures. Therapeutic, level IV.

  1. An Overview of Internal Fixation Implant Metallurgy and Galvanic Corrosion Effects.

    Science.gov (United States)

    Koh, Justin; Berger, Aaron; Benhaim, Prosper

    2015-08-01

    Orthopedic and hand surgery implants for internal fixation of fractures have evolved substantially over the past 50 years. Newer metal compositions have been used, and new standards have been applied to older alloys, resulting in modern implants with unique physical properties and better clinical performances. Conventional wisdom has long dictated that implanting different metals should be avoided, but few guidelines exist regarding the safety of using in proximity implant systems of dissimilar metals. To better characterize the landscape of internal fixation implant metallurgy, we have compiled the recommendations and conclusions of the currently available and pertinent literature. Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Lengthening z-osteotomy of the fibula to correct persistent talar shift following open reduction internal fixation of ankle fractures.

    Science.gov (United States)

    Thangarajah, Tanujan; Lakdawala, Ayaz; Battaloglu, Emir; Malik, Atul; Tillu, Abhay

    2012-04-01

    In cases where ankle fracture union has been compromised by persistent syndesmotic diastasis following open reduction internal fixation, both external rotation and shortening of the fibula have been identified as prominent features. This study reports a technique that uses a z-osteotomy to achieve both lengthening and internal rotation of the fibula to correct persistent talar shift following ankle fracture fixation. Four patients with persistent talar shift following open reduction internal fixation for an ankle fracture received z-osteotomy of the fibula to achieve both lengthening and internal rotation. At the latest clinic review, all 4 ankles exhibited satisfactory clinical and radiological union. All patients have returned to full mobility and are satisfied with the outcome. This study demonstrates the effectiveness of lengthening z-osteotomy of the fibula in correcting persistent talar shift following internal fixation of ankle fractures. Therapeutic Level V.

  3. Humeral repair in birds by guided tissue regeneration and external and internal associated fixation techniques

    International Nuclear Information System (INIS)

    Delogu, M.

    1993-01-01

    Ten pigeons (Columba livia domestic form) with humeral diaphyseal fracture were treated with external and internal fixation techniques (Boston technique and intamedullary pin). Longitudinal space was intentionally left between fracture surfaces during osteosynthesis. This space was filled with bovine lyophilized collagen, set around an intramedullary pin, in five samples. Ossification process was checked by radiography every seven days. Results show the utility of this technique in pneumatic bird bones. In fact, shortening control and callus formation facility were observed [it

  4. Enhancement of Apoptosis by Titanium Alloy Internal Fixations during Microwave Treatments for Fractures: An Animal Study.

    Directory of Open Access Journals (Sweden)

    Gang Wang

    Full Text Available Microwaves are used in one method of physical therapy and can increase muscle tissue temperature which is useful for improving muscle, tendon and bone injuries. In the study, we sought to determine whether titanium alloy internal fixations influence apoptosis in tissues subjected to microwave treatments at 2,450 MHz and 40 W during the healing of fractures because this issue is not yet fully understood.In this study, titanium alloy internal fixations were used to treat 3.0-mm transverse osteotomies in the middle of New Zealand rabbits' femurs. After the operation, 30-day microwave treatments were applied to the 3.0 mm transverse osteotomies 3 days after the operation. The changes in the temperatures of the muscle tissues in front of the implants or the 3.0 mm transverse osteotomies were measured during the microwave treatments. To characterize the effects of titanium alloy internal fixations on apoptosis in the muscles after microwave treatment, we performed TUNEL assays, fluorescent real-time (quantitative PCR, western blotting analyses, reactive oxygen species (ROS detection and transmission electron microscopy examinations.The temperatures were markedly increased in the animals with the titanium alloy implants. Apoptosis in the muscle cells of the implanted group was significantly more extensive than that in the non-implanted control group at different time points. Transmission electron microscopy examinations of the skeletal muscles of the implanted groups revealed muscular mitochondrial swelling, vacuolization. ROS, Bax and Hsp70 were up-regulated, and Bcl-2 was down-regulated in the implanted group.Our results suggest that titanium alloy internal fixations caused greater muscular tissue cell apoptosis following 2,450 MHz, 40 W microwave treatments in this rabbit femur fracture models.

  5. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

    OpenAIRE

    Nauth, A. (Aaron); Creek, A.T. (Aaron T.); Zellar, A. (Abby); Lawendy, A.-R. (Abdel-Rahman); Dowrick, A. (Adam); Gupta, A. (Ajay); Dadi, A. (Akhil); Kampen, A.; Yee, A. (Albert); Vries, Alexander; de Mol van Otterloo, A. (Alexander); Garibaldi, A. (Alisha); Liew, A. (Allen); McIntyre, A.W. (Allison W.); Prasad, A.S. (Amal Shankar)

    2017-01-01

    textabstractBackground Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a...

  6. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones

    OpenAIRE

    Rubenbauer Bianka; Löffler Thomas; Zaspel Johannes; Wittmann Alexandra; Pieske Oliver; Trentzsch Heiko; Piltz Stefan

    2009-01-01

    Abstract Background Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the marke...

  7. Displaced tibial shaft fractures treated with ASIF compression internal fixation

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Larsen, T K; Petersen, O C

    1990-01-01

    Fifty-one tibial shaft fractures treated by ASIF compression osteosynthesis were seen at follow-up at a median time of 46 weeks after injury. Twenty-four were open fractures and the patients received prophylactic antibiotics. The median stay in hospital was 15 days for open fractures and 6 days...... for closed fractures. There were complications in 26 cases, with deep infection in 9 cases. At present we cannot advocate the use of ASIF compression osteosynthesis for displaced tibial fractures....

  8. Antegrade-retrograde opposing lag screws for internal fixation of simple displaced talar neck fractures.

    Science.gov (United States)

    Abdelkafy, Ashraf; Imam, Mohamed Abdelnabi; Sokkar, Sherif; Hirschmann, Michael

    2015-01-01

    The talar neck is deviated medially with reference to the long axis of the body of the talus. In addition, it deviates plantarward. The talar neck fracture line is sometimes observed to be oriented obliquely (not perpendicular to the long axis of the talar neck). This occurs when the medially deviated talar neck strikes the horizontally oriented anterior lower tibial edge. Internal fixation of a simple displaced talar neck fracture usually requires 2 lag screws. Because the fracture line is obliquely oriented, a better method for positioning the screws perpendicular to the fracture line is to place them in a reversed direction to provide maximum interfragmentary compression at the fracture site, which could increase the likelihood of absolute stability with subsequent improvement in the incidence of fracture union and a reduction of complications, such as avascular necrosis of the body of the talus. Two lag screws are used, with the first inserted from posteriorly to anteriorly (perpendicular to the fracture line) using a medial approach after medial malleolar chevron osteotomy. The second screw is inserted from anteriorly to posteriorly (perpendicular to the fracture line) using an anterolateral approach. Both screw heads should be countersunk. A series of 8 patients underwent this form of internal fixation for talar neck fracture repair, with satisfactory functional outcomes. In conclusion, the use of antegrade-retrograde opposing lag screws is a reasonable method of internal fixation for simple displaced talar neck fractures. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  9. 6th International Immunoglobulin Symposium: poster presentations

    NARCIS (Netherlands)

    Fernandez-Cruz, E.; Kaveri, S. V.; Peter, H.-H.; Durandy, A.; Cantoni, N.; Quinti, I.; Sorensen, R.; Bussel, J. B.; Danieli, M. G.; Winkelmann, A.; Bayry, J.; Käsermann, F.; Späth, P.; Helbert, M.; Salama, A.; van Schaik, I. N.; Yuki, N.

    2009-01-01

    The posters presented at the 6th International Immunoglobulin Symposium covered a wide range of fields and included both basic science and clinical research. From the abstracts accepted for poster presentation, 12 abstracts were selected for oral presentations in three parallel sessions on

  10. 6th International Immunoglobulin Symposium: Poster presentations

    NARCIS (Netherlands)

    Fernandez-Cruz, E.; Kaveri, S.V.; Peter, H.H.; Durandy, A.; Cantoni, N.; Quinti, I.; Sorensen, R.; Bussel, J.B.; Danieli, M.G.; Winkelmann, A.; Bayry, J.; Kaesermann, F.; Spaeth, P.; Helbert, M.; Salama, A.; van Schaik, I.N.; Yuki, N.

    2009-01-01

    P>The posters presented at the 6th International Immunoglobulin Symposium covered a wide range of fields and included both basic science and clinical research. From the abstracts accepted for poster presentation, 12 abstracts were selected for oral presentations in three parallel sessions on

  11. International nuclear energy law - present and future

    International Nuclear Information System (INIS)

    Barrie, G.N.

    1988-01-01

    International nuclear energy law, as discussed in this article, is the law relating to the global, peaceful uses of nuclear science and technology. The position of nuclear law in the wide realm of law itself as well as the present status of nuclear legislation is assessed. This article also covers the development of international nuclear energy law, from the first nuclear law - the New Zealand Atomic Energy Act of 1945-, the present and the future. National and international organizations concerned with nuclear energy and their contribribution to nuclear law are reviewed

  12. Quality of life following total hip arthroplasty in patients with acetabular fractures, previously managed by open reduction and internal fixation

    Directory of Open Access Journals (Sweden)

    Prasoon Kumar

    2016-08-01

    Conclusion: From this study it is inferred that the functional outcome of THR and quality of life in patients who had acetabular fractures and were initially managed by open reduction and internal fixation is good.

  13. Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing.

    Science.gov (United States)

    Oh, Hyoung-Keun; Choo, Suk-Kyu; Kim, Ji-Wan; Lee, Mark

    2015-12-01

    We present the surgical technique of separate vertical wiring for displaced inferior pole fractures of the patella combined with Krachow suture and report the surgical outcomes. Between September 2007 to May 2012, 11 consecutive patients (mean age, 54.6 years) with inferior pole fractures of the patella (AO/OTA 34-A1) were retrospectively enrolled in this study. Through longitudinal incision, all patients underwent open reduction and internal fixation by separate vertical wiring combined with Krackow suture. The range of motion, loss of fixation, and Bostman score were primary outcome measures. The union time was 10 weeks after surgery on average (range: 8-12). No patient had nonunion, loss of reduction and wire breakage. There was no case of wound problem and irritation from the implant. At final follow-up, the average range of motion arc was 129.4° (range: 120-140). The mean Bostman score at last follow-up was 29.6 points (range: 28-30) and graded excellent in all cases. Separate vertical wiring combined with Krackow suture for inferior pole fractures of the patella is a useful technique that is easy to perform and can provide stable fixation with excellent results in knee function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

    Directory of Open Access Journals (Sweden)

    TONG Da-ke

    2012-02-01

    Full Text Available 【Abstract】Objective: To investigate the efficacy of the locking internal fixator (LIF, which includes the locking compression plate (LCP and the less invasive stable system (LISS, in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the opera- tion with LIF by the minimally invasive plate osteosynthesis (MIPO technique. The data consisted of 43 proximal tibial fractures (type AO41C3 and 55 distal tibial fractures (type AO43C3. Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months. Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing. Key words: Internal fixator; Tibial fractures; Fracture fixation, intramedullary; Bone plates

  15. Internal Fixation of Complicated Acetabular Fractures Directed by Preoperative Surgery with 3D Printing Models.

    Science.gov (United States)

    Liu, Zhao-Jie; Jia, Jian; Zhang, Yin-Guang; Tian, Wei; Jin, Xin; Hu, Yong-Cheng

    2017-05-01

    The purpose of this article is to evaluate the efficacy and feasibility of preoperative surgery with 3D printing-assisted internal fixation of complicated acetabular fractures. A retrospective case review was performed for the above surgical procedure. A 23-year-old man was confirmed by radiological examination to have fractures of multiple ribs, with hemopneumothorax and communicated fractures of the left acetabulum. According to the Letounel and Judet classification, T-shaped fracture involving posterior wall was diagnosed. A 3D printing pelvic model was established using CT digital imaging and communications in medicine (DICOM) data preoperatively, with which surgical procedures were simulated in preoperative surgery to confirm the sequence of the reduction and fixation as well as the position and length of the implants. Open reduction with internal fixation (ORIF) of the acetabular fracture using modified ilioinguinal and Kocher-Langenbeck approaches was performed 25 days after injury. Plates that had been pre-bent in the preoperative surgery were positioned and screws were tightened in the directions determined in the preoperative planning following satisfactory reduction. The duration of the operation was 170 min and blood loss was 900 mL. Postoperative X-rays showed that anatomical reduction of the acetabulum was achieved and the hip joint was congruous. The position and length of the implants were not different when compared with those in preoperative surgery on 3D printing models. We believe that preoperative surgery using 3D printing models is beneficial for confirming the reduction and fixation sequence, determining the reduction quality, shortening the operative time, minimizing preoperative difficulties, and predicting the prognosis for complicated fractures of acetabulam. © 2017 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  16. [Application of the internal fixation of posterior fibula plate for the treatment of ankle fractures].

    Science.gov (United States)

    Xu, Shuo-gui; Wu, Ya-le; Zhang, Chun-cai; Pan, Si-hua

    2008-09-01

    To explore a new method for the treatment of ankle joint fractures, and to evaluate its therapeutic effects. Among 42 patients with ankle joint fractures, 34 patients had complete data for analysis, 19 patients were male and 15 patients were female, ranging in age from 21 to 61 years, with an average of 37 years. According to Weber-AO classification, there are 28 patients of B-type and 6 patients of C-type. The Baird and Jackson Rating System was used to evaluate therapeutic effects, and the relationship between the final function and fracture type, fracture fixation and, the time of functional training after operation were analyzed. Thirty-four patients with ankle joint fractures of B and C type were treated with internal fixation of posterior fibula plate to avoid injury of articular facet by the nails. The patients combined with the fractures of posterior malleolus were treated with fixation of both fibula and posterior malleolus through the same incision. All the patients were followed up ranging from 1.2 to 3.2 years, with an average of 1.8 years. According to evaluation criterion, 24 patients got an excellent result, 6 good and 4 fair, the excellent and good rate was 88.2%. The internal fixation of posterior fibula plate, as a treatment for ankle joint fractures, successfully avoids the injury of articular facet by the nails. Not only does it enhance the pullout strength of the nails, but it is able to treat the fracture of lateral malleolus and posterior malleolus with a single incision. It has provided a new way for the treatment of ankle fractures.

  17. [Case-control study on T-shaped locking internal fixation and external fixation for the treatment of dorsal Barton's fracture].

    Science.gov (United States)

    Chen, Huan-qing; Wen, Xi-le; Li, Yang-ming; Wen, Cong-you

    2015-06-01

    To compare clinical effect of T-shaped locking internal fixation and external fixation in treating dorsal Barton's fracture,and investigate selective strategy of internal fixation. From January 2008 to January 2013, 100 patients with dorsal Barton's fracture were randomly divided into two groups. In treatment group, there were 30 males and 20 females with an average age of (33.8±3.6) years old;30 cases were type B, 20 cases were type C;and treated with T-shaped locking internal fixation. In control group, there were 32 male and 18 females with an average age of (32.9±3.4) years old; 29 cases were type B, 21 cases were type C; and treated with external fixation. Volar tilt, ulnar deviation and radial height at 3 months after operation were detected and compared between two groups. Mechara functional evaluation were used to evaluate postoperative clinical effects. Clinical cure time, postoperative complications,joint mobility and function score were recorded and compared between two groups. In treatment group,volar tilt was (11.9±2.7)°, ulnar deviation was (20.8+ 2.9)°,and radial height was (10.9±1.8) mm; while volar tilt was (9.1±1.6)°, ulnar deviation was (17.1±2.9)°, and radial height was (8.1±1.5) mm in control group. Treatment group was better than control group in volar tilt, ulnar deviation and radial height. Clinical cure time in treatment group was(12.0±2.3) weeks, shorter than control group (18.0±4.1) weeks. The incidence of complications in treatment group was lower than control group. According to Mehara functional evaluation,20 cases got excellent results, 25 good, 3 moderate and 2 poor in treatment group; 16 cases got excellent results, 14 good, 10 moderate and 10 poor in control group. Treatment group was better than control group in clinical effects. T-shaped locking internal fixation with postoperative functional exercise for the treatment of dorsal Barton's fracture fits for biomechanics demands,and has advantages of stable fixation

  18. Hip fracture fixation in a patient with below-knee amputation presents a surgical dilemma: a case report

    Directory of Open Access Journals (Sweden)

    Rethnam Ulfin

    2008-09-01

    Full Text Available Abstract Introduction Hip fracture fixation surgery in patients with below-knee amputations poses a challenging problem to the surgeon in terms of obtaining traction for reduction of the fracture. The absence of the foot and part of the leg in these patients makes positioning on the fracture table difficult. We highlight this difficult problem and suggest techniques to overcome it. Case presentation A 73-year-old man with bilateral below-knee amputations presented with a history of fall. Radiographs revealed an inter-trochanteric fracture of the femur. A dynamic hip screw fixation was planned for the fracture but the dilemma was on how to position the patient on the fracture table for the surgery. Special attention was needed in positioning the patient and in surgical fixation of the fracture. Conclusion Hip fracture fixation in patients with below-knee amputations poses a special problem in positioning for fracture reduction and fixation. In this case report, we share our experience and suggest techniques to use when encountering this difficult problem.

  19. Internal fixation of the fibula in ankle fractures: a prospective, randomized and comparative study: plating versus nailing.

    Science.gov (United States)

    Asloum, Y; Bedin, B; Roger, T; Charissoux, J-L; Arnaud, J-P; Mabit, C

    2014-06-01

    Open reduction and internal plate fixation of the fibula is the gold standard treatment for ankle fractures. The aim of this study was to perform a prospective randomized study to compare bone union, complications and functional results of two types of internal fixation of the fibula (plating and the Epifisa FH intramedullary nail). Inclusion criteria were: closed fractures, isolated displaced fractures of the lateral malleolus, inter- and supra-tubercular bimalleolar fractures, and trimalleolar fractures. This study included 71 patients (mean age 53 ± 19): plate fixation group (n=35) and intramedullary nail fixation group (n=36). In seven cases, intramedullary nailing was technically impossible and was converted to plate fixation (the analysis of this sub-group was performed independently). Two patients died and two patients were lost to follow-up. The final comparative series included 32 cases of plate fixation and 28 cases of intramedullary nail fixation. Union, postoperative complications and Kitaoka and Olerud-Molander functional scores were analyzed after one year of follow-up. There was no significant difference in the rate of union (P=0.5605) between the two types of fixation. There were significantly fewer complications (7% versus 56%) and better functional scores (96 versus 82 for the Kitaoka score; 97 versus 83 for the Olerud-Molander score) with intramedullary nailing than with plate fixation. Intramedullary nailing of the lateral malleolus in non-comminuted ankle fractures without syndesmotic injury is a reproducible technique with very few complications that provides better functional results than plate fixation. II (randomized prospective study). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Interpretation of Post-operative Distal Humerus Radiographs After Internal Fixation: Prediction of Later Loss of Fixation

    NARCIS (Netherlands)

    Claessen, F.M.; Stoop, N.; Doornberg, J.N.; Guitton, T.G.; Bekerom, M.P. van den; Ring, D.; Biert, J.; et al.,

    2016-01-01

    PURPOSE: Stable fixation of distal humerus fracture fragments is necessary for adequate healing and maintenance of reduction. The purpose of this study was to measure the reliability and accuracy of interpretation of postoperative radiographs to predict which implants will loosen or break after

  1. Efficacy of Routine Postoperative CT Scan After Open Reduction and Internal Fixation of the Acetabulum.

    Science.gov (United States)

    Archdeacon, Michael T; Dailey, Steven K

    2015-08-01

    The purpose of this study was to evaluate the efficacy of routine postoperative computed tomography (CT) scan after open reduction and internal fixation of acetabular fractures. Retrospective review of prospectively collected acetabulum fracture database. Level I trauma center. A total of 606 consecutive patients underwent surgical fixation of 612 acetabular fractures. All patients were evaluated with intraoperative fluoroscopy in addition to 3 standard plain radiographs (AP pelvis and two 45 degrees oblique Judet views). Reduction and fixation were believed to be adequate and definitive before exiting the operative suite based on these imaging modalities. Axial postoperative CT scan of the pelvis was obtained in 563 of the patients (93%) after 569 operative cases. Revision acetabular surgery based on routine postoperative CT scan findings. There were no significant differences between index and revision surgery groups regarding age, gender, body mass index, fracture pattern, mechanism of injury, or surgical approach (P > 0.05). Evaluation of 563 postoperative CT scans of the pelvis resulted in revision acetabular surgery for 2.5% of patients (n = 14). There were 6 (1.1%) cases of intraarticular hardware not recognized on the intraoperative fluoroscopy or pelvic radiographs. Four patients (0.7%) had residual intraarticular osteochondral fragments deemed too large to leave in the hip joint. There were 3 cases (0.5%) of unacceptable malreduction, and 1 case (0.2%) of both malreduction and an intraarticular osteochondral fragment. A small percentage of patients (2.5%) will benefit from a routine CT scan after acetabular fracture fixation. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  2. Minimally invasive anterior pelvic internal fixation: An anatomic study comparing Pelvic Bridge to INFIX.

    Science.gov (United States)

    Reichel, Lee M; MacCormick, Lauren M; Dugarte, Anthony J; Rizkala, Amir R; Graves, Sara C; Cole, Peter A

    2018-02-01

    Anterior external fixation for pelvic ring fractures has shown to effectively improve stability and reduce mortality. However, these fixators can be associated with substantial morbidity such as pin tract infection, premature loss of fixation, and decreased quality of life in patients. Recently, two new methods of subcutaneous anterior pelvic internal fixation have been developed; the INFIX and the Pelvic Bridge. These methods have the purported advantages of lower wound complications, less surgical site pain, and improved quality of life. We sought to investigate the measured distances to critical anatomic structures, as well as the qualitative and topographic differences notable during implantation of both devices in the same cadaveric specimen. The Pelvic Bridge and INFIX were implanted in eleven fresh cadavers. Distances were then measured to: the superficial inguinal ring, round ligament, spermatic cord, lateral femoral cutaneous nerve (LFCN), femoral nerve, femoral artery, and femoral vein. Observations regarding implantation and topography were also recorded. The INFIX had greater measured distances from all structures except for the LFCN, in which its proximity placed this structure at risk. Neither device appears to put other critical structures at risk in the supine position. Significant implantation and topographic differences exist between the devices. The INFIX application lacked "safety margins" concerning the LFCN in 10/11 (90.9%) specimens, while Pelvic Bridge placement lacked "safety margins" with regard to the right superficial ring (1/11, 9%) and the right spermatic cord (1/11, 9%). Both the Pelvic Bridge and INFIX lie at safe distances from most critical pelvic structures in the supine position, though INFIX application places the LFCN at risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. International astronomical remote present observation on IRC.

    Science.gov (United States)

    Ji, Kaifan; Cao, Wenda; Song, Qian

    On March 6 - 7, 1997, an international astronomical remote present observation (RPO) was made on Internet Relay Chat (IRC) for the first time. Seven groups in four countries, China, United States, Canada and Great Britain, used the 1 meter telescope of Yunnan observatory together by the way of remote present observation. Within minutes, images were "On-line" by FTP, and every one was able to get them by anonymous ftp and discuss them on IRC from different widely separated sites.

  4. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

    Full Text Available 【Abstract】Objective: Debate continues regarding the management of calcaneal fractures, between open re- duction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional out- comes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with lock- ing calcaneal plate. Methods: In this series, 28 patients (26 unilateral and 2 bilateral with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury. Patients were evaluated in terms of associated injuries and X-rays of anteroposterior, lateral and axial views of the calcaneum. CT scan was done to assess the amount of com- minution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Radiologi- cal assessment was done by Bohler’s angle and Gissane’s angle along with measurement of calcaneal height and width. Functional outcome was assessed using the American Or- thopaedics Foot and Ankle Society (AOFAS scale. Results: At average follow-up of 14.5 months, average AOFAS score was 86.3 (range 66 to 97, with 86% having excellent to good results and 2 (7.7% and 1 (3.7% having fair and poor results respectively. All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°. Average subtalar range of motion was 17°. The mean Bohler’s angle, mean Gissane’s angle, calcaneal height and width were 25.47°, 121.3°, 4.32 cm and 3.81cm respectively at final follow-up. Three patients had flap ne- crosis at incision site and one had superficial and deep infection. Subtalar arthritis was seen in 5 patients, whereas sural nerve hypoaesthesia in 1 patient. None of the patients had compartment syndrome, heel pad problems, peroneal tendinitis, reflex sympathetic dystropy or implant failure. Conclusion: Open reduction and

  5. Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation (Best Poster Award)

    DEFF Research Database (Denmark)

    Bech, Rune Dueholm

    2008-01-01

     Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation Rune Bech*, Jens Lauritsen*+,Tine Dimon*, Ole Ovesen*, Claus Emmeluth, Søren Overgaard*. *:Dept. Ortopaedic Surgery, Odense University Hospital, +:Institute of Public Health-dept. biostatistics...... underwent osteosynthesis with 2 canulated hip screws and were prescribed regular paracetamol and supplementary opioid rescue analgesia as necessary. Pilot group: 11 patients received one peroperative (30 mL=100 mg) and 6 postoperative bolus installations  (10 mL=100 mg) of open label Ropivacaine through...

  6. [Iindividual choice of distal fibula internal fixation for ankle fractures in elderly].

    Science.gov (United States)

    Tang, Yang-Hua; Zeng, Lin-Ru; Xin, Da-Wei; Yue, Zhen-Shuang; Hu, Zhong-Qing; Xu, Can-da

    2016-12-25

    To explore individual choice and therapeutic effect of distal fibula internal fixation in treating ankle fractures in elderly. From May 2012 to April 2015, 68 elderly patients with ankle fractures were treated by surgical operation, included 37 males and 31 females with an average of 69.2 years old ranging from 62 to 81 years. According to Danis-Weber classification, there were 19 cases belong to type A, 31 cases belong to type B, and 18 cases belong to type C. According to Lange-Hanson classification, 22 cases were supinatio-extorsion, 18 were pronate-extorsion, 19 were supinatio-adduction, and 9 were pronate-abduction. All patients were performed individyually with different internal fixation methods for the treatment of distal fibula fracture according to different types of fracture. Clinical results were evaluated based on clinical examination, radiographic evaluation and AOFAS score. Twelve patients were treated with Herbert screw, 7 cases with Kirschner wire tension band, 5 cases with 1/3 tube plate, 6 cases with reconstruction plate, 17 cases with fibular end dissection steel plate composite, and 21 cases with distal fibula anatomic locking plate. All patients were followed up from 12 to 26 months with an average of 17.7 months. The operative incision of all patients were primary healed. And there was no bone nonunion, ankle instability, internal fixation loosening and fracture occurred. Fracture healing time ranged from 2.7 to 4 months with an average of 3.2 months, and had significant differences among different groups( P 0.05). Dorsal stretch was 6° to 18° with an average of 15°, plantar flexion ranged from 26°to 47° with an average of 37°. AOFAS score at the latest following-up was 88.4±4.3, 34 patients got an excellent result, 30 good and 4 fair. Good clinical results could be obtained by using individualized internal fixation for distal fibula fracture for the treatment of the ankle fractures in elderly.

  7. Treatment of irreducible old atlantoaxial subluxation with cable-dragged reduction and cantilever beam internal fixation.

    Science.gov (United States)

    Liu, Xi; Liu, Hao; Li, Tao; Gong, Quan; Song, Yueming; Liu, Limin; Shi, Rui; Zhao, Xiaodan; Zhang, Wenli; Feng, Ganjun; Wang, Beiyu

    2011-07-01

    Retrospective case series study of surgical outcome for 21 atlantoaxial subluxation patients treated with a new technique, called cable-dragged reduction/cantilever beam internal fixation. Surgery was performed by a single surgeon. To describe and evaluate the cable-dragged reduction/cantilever beam internal fixation technique for the treatment for old atlantoaxial subluxation irreducible by traction. Management of old atlantoaxial subluxation has always been a difficult task. A more effective way to achieve surgical reduction is needed. Twenty one patients, aged 31.6 ± 13.3 years (range, 11-67 years), 17 men and four women, with atlantoaxial subluxation that failed to be reduced after 10 to 111 days in traction, underwent posterior cable-dragged reduction/cantilever beam internal fixation surgery. Frankel classification of neural function before surgery was the following: Frankel B, four patients; Frankel C, five patients; Frankel D, four patients; and Frankel E, eight patients. Plain radiographs, computed tomographic three-dimensional reconstructive images and magnetic resonance images of the cervical spine were obtained at 3, 6, and 12 months after surgery, and each year thereafter. No patient was lost to follow-up, and the follow-up time ranged from 6 months to 4 years. Rate of reduction and C1∼3 fusion, as well as improvement of neural function, were recorded and analyzed. The average follow-up period was 13.2 months. Radiographic evaluation of the group at follow-up showed 16 complete and five partial reductions, and satisfactory decompression and C1∼3 fusion in all cases. Neural function at the end of the follow-up was Frankel B still in one patient, Frankel C in seven patients, and Frankel E in 13 patients. Cable-dragged reduction/cantilever beam internal fixation is almost as effective for reduction as anterior release but is less invasive and risky. It has similar operative time and blood loss to occipitocervical fusion but avoids arthrodesis of

  8. Present situation concerning studies on associative n-fixation in sugarcane, 'Saccharum officinarum' L

    International Nuclear Information System (INIS)

    Ruschel, A.P.; Vose, P.B.

    1977-01-01

    High nitrogenase activity in sugarcane has been confirmed, using 15 N procedure, which indicated rapid translocation of the fixed nitrogen to the plant tissue. It is observed that there are differences in variety concerning nitrogenase activity in the rhizosphere of sugarcane. Basic calculations and an evaluation of possible biological N-fixation with 15 N suggest that possibly as much as 25-30% of the plant nitrogen may be derived from biological fixation. Both eight and electron microscope studies suggest that there are bacteria inside healthy roots and if such a root is surface sterilized and placed ou nitrogen-free media then bacteria stream from the cut surface [pt

  9. The quality of life after a femoral neck fracture in elderly patients: a comparative study between internal fixation and arthroplasties

    Directory of Open Access Journals (Sweden)

    Dennis Sansanovicz

    2017-01-01

    Full Text Available Introduction: The femoral neck fracture is a frequent pathology in the elderly population, with about of 100,000 cases per year in Brazil. The surgical treatment by internal fixation or arthroplastic hip replacement is advocated today. The non-surgical treatment is reserved for cases of exception. Objective: To compare the quality of patient postoperative life treated for femoral neck fracture by two different techniques: hip arthroplasty and internal fixation. Methods: Through the SF-36 questionnaire, we study the quality of life of 60 patients with more than 65 years, treated between 2004 and 2012 in our service. Half of the patients was submitted to internal fixation and the other half to the arthroplastic replacement. Results: Higher averages in the large majority of the parameters of the questionnaire were obtained by the group which was carried out by internal fixation, but without statistical significance in most of these differences. Some international reports indicate that patients who have suffered a fracture of the femoral neck and were treated with internal fixation may recover the quality of life they had before the fracture. Paradoxically, there is a growing trend among orthopedic surgeons to perform a hip replacement surgery in these cases. Conclusion: Further studies are needed to define which is the best surgical treatment option.

  10. Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring

    Directory of Open Access Journals (Sweden)

    Khan I

    2016-07-01

    Full Text Available Aims: To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1 or transverse with mildly comminuted (AO34-C2 patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle. Results: There were eighteen males (72% and seven females (28%. The age group ranged from 24 to 58 years, with mean age of 38 years. The most common mode of injury was fall (72% followed by road traffic accident (20% and violent quadriceps contraction (8%. Transverse fracture was present in 60% and transverse fracture with mild comminution in 40% of patients. Mean time to achieve union was 10.7 weeks (range 8-12 weeks. Mean ROM at three months was 113.8 degree (90-130 and at final follow up this improved to 125.4 degrees (range 100-140. There was one case of knee stiffness and no case of implant failure was observed. Patients were evaluated using Bostman scoring, the mean score at three months being 26.04 which improved to 27.36 at the end of final follow up at one year. Conclusion: Cannulated cancellous screws with anterior tension band wiring is a safe, reliable and reproducible method in management of transverse patellar fractures, with less chances of implant failure and soft tissue irritation.

  11. Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures.

    Science.gov (United States)

    Karakasli, Ahmet; Hapa, Onur; Erduran, Mehmet; Dincer, Cemal; Cecen, Berivan; Havitcioglu, Hasan

    2015-01-01

    For talar neck fractures, open reduction and internal fixation have been thought to facilitate revascularization and prevent osteonecrosis. Newer screw systems allow for placement of cannulated headless screws, which provide compression by virtue of a variable pitch thread. The present study compared the biomechanical fixation strength of cannulated headless variable-pitch screw fixation and locking plate fixation. A reproducible talar neck fracture was created in 14 fresh cadaver talar necks. Talar head fixation was then performed using 2 cannulated headless variable-pitch 4-mm/5-mm diameter (4/5) screws (Acutrak; Acumed, Hillsboro, OR) and locking plate fixation. Headless variable-pitch screw fixation had lower failure displacement than did locking plate fixation. No statistically significant differences were found in failure stiffness, yield stiffness (p = .655), yield load (p = .142), or ultimate load between the 2 fixation techniques. Cannulated headless variable-pitch screw fixation resulted in better failure displacement than locking plate fixation in a cadaveric talus model and could be considered a viable option for talus fracture fixation. Headless, fully threaded, variable-pitch screw fixation has inherent advantages compared with locking plate fixation, because it might cause less damage to the articular surface and can compress the fracture for improved reduction. Additionally, plate fixation can increase the risk of avascular necrosis owing to the wider incision and dissection of soft tissues. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  12. [Clinical observation of dynamic cervical implant (DCI) internal fixation in the surgical treatment of cervical spondylosis].

    Science.gov (United States)

    Li, Zhong-hai; Hou, Shu-xun; Li, Li; Yu, Shun-zhi; Hou, Tie-sheng

    2014-12-01

    To investigate the early clinical effects and radiological outcome of dynamic cervical implant (DCI) internal fixation in treating cervical spondylosis, and evaluate its safety and efficiency. From June 2009 to December 2011, 19 patients with cervical spondylosis correspond to the indication of DCI internal fixation in the study, including 5 cases of cervical spondylotic myelopathy and 14 cases of cervical spondylotic radiculopathy. There were 8 males and 11 females, aged from 35 to 54 years with a mean of 43.2 years. Pathological segments included C3,4 in 1 case, C4,5 in 6, C5,6 in 6, C6,7 in 4, C3,4 and C5,6, C6,7 in 2. All patients were treated with anterior discectomy and decompression and DCI internal fixation, meanwhile, 2 cases of them with anterior cervical corpectomy and fusion plate fixation. Clinical evaluation included Modified Japanese orthopedics association (mJOA), neck disability index (NDI), visual analogue scale (VAS) score and patient satisfaction index (PSI) at pre-operation and final follow-up. Radiographic evaluation included flexion/extension lateral view at operative level and adjacent segment. The adjacent level degeneration was analyzed according to Miyazaki classification on MRI images. All patients were followed up from 12 to 42 months with an average of 19.8 months. Preoperative mJOA score was 13.6±1.1 and at final follow-up was 16.3±1.2 with improvement rate of 85.0%. Preoperative VAS,NDI was 6.6± 1.4, 17.1±7.4 and at final follow-up was 1.4±0.8, 6.1±3.9, respectively; there was statistical significance in all above-mentioned results between preoperative and final follow-up (P0.05). Preoperative DHI at operation level was (6.3±1.1) mm and final follow-up was (7.1±0.8) mm, there was statistical significance in DHI between preoperative and final follow-up (Pspondylosis with dynamic cervical implant can got satisfactory outcome in early follow-up. Activity of operative segment obtain reservation in some degree. The incidence of

  13. The functional outcome of surgically treated unstable pelvic ring fractures by open reduction, internal fixation

    Directory of Open Access Journals (Sweden)

    Kaykhosro Mardanpour

    2011-07-01

    Full Text Available Background:Unstable Pelvic fracture,a result of high energy antero-posterior compression injury, has been managed based on internal fixation and open reduction. The mode of fixation in Unstable Pelvic fracture has, however, been a subject of controversy and some authors have proposed a need to address the issue of partial breach of the pelvic ring elements in these injuries. This study was performed to evaluate the functional and radiological results of treatment of pelvic ring fractures by open reduction, internal fixation. Methods: Thirty eight patients with unstable pelvic fractures, treated from 2002 to2008 were retrospectively reviewed. The mean age of patients’ was 37 years old (range 20 to 67. Twenty six patients were men and 12 women. The most common cause was a road traffic accident (N=37, 97%. There were 11 type-C and 27 type-B fractures according to Tile’s classification. Thirty six patients sustained additional injuries. The most prevalent additional injuries were lower extremity fractures. Open reduction, internal fixation as a definite management was applied for all patients. Quality of reduction was graded according to the grades proposed by Matta and Majeed’s score was used to assess the clinical outcome. The mean period of follow-up was 25 months (ranged from 6 to 109 months. About 81.6% of patients had either good or excellent radiological reduction. Results: The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients. There were 4 postoperative infections. No sexual function problem was reported. Nerve deficits recovered completely in 2 and partially in 3 of 11 patients with preoperative neurologic deficiency. There was no significant relation between functional outcome and the site of fracture Conclusion: Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization that must be carried out as soon as the general ndition of the patient permits, and

  14. Operative treatment of early infection after internal fixation of limb fractures (exclusive of severe open fractures).

    Science.gov (United States)

    Bonnevialle, P

    2017-02-01

    Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique. A turning point in the local microbial ecology occurs around the third or fourth week, when a biofilm develops around metallic implants. This biofilm protects the bacteria. The treatment relies on both non-operative and operative measures, which are selected based on the time to occurrence of the infection, condition of the soft tissues, and stage of bone healing. Both the surgical strategy and the antibiotic regimen should be determined during a multidisciplinary discussion. When treating superficial SSIs after ORIF, soft-tissue management is the main challenge. The treatment differs according to whether the hardware is covered or exposed. Defects in the skin and/or fascia can be managed using reliable reconstructive surgery techniques, either immediately or after a brief period of vacuum-assisted closure. In deep SSIs, deciding whether to leave or to remove the hardware is difficult. If the hardware is removed, the fracture site can be stabilised provisionally using either external fixation or a cement rod. Once infection control is achieved, several measures can be taken to stimulate bone healing before the end of the classical 6-month interval. If the hardware was removed, then internal fixation must be performed once the infection is eradicated. Copyright © 2016. Published by Elsevier Masson SAS.

  15. 2000 Volvo Award winner in biomechanical studies: Monitoring in vivo implant loads with a telemeterized internal spinal fixation device.

    Science.gov (United States)

    Rohlmann, A; Graichen, F; Weber, U; Bergmann, G

    2000-12-01

    Implant loads were measured in 10 patients using telemeterized internal spinal fixation devices. To determine the postoperative temporal course of implant loads. Little information exists regarding the temporal course of loads on internal spinal fixation devices. The telemeterized internal spinal fixator allows the measurement of three force components and three moments acting in the fixator. Implant loads were determined in up to 20 measuring sessions for different activities, including walking, standing, sitting, lying in the supine position, and lifting an extended leg while in the supine position. Implant loads often increased shortly after anterior interbody fusion was performed. Several patients retained the same high level even after fusion had taken place. This explains the reason why screw breakage sometimes occurs more than half a year after implantation. The time of fusion could not be pinpointed from the loading curves. The results show that fixators may be highly loaded even after fusion has occurred. A flexion bending moment acts on the implant even with the body in a relaxed lying position. This means that already shortly after the anterior procedure, the shape of the spine is not neutral and unloaded, but slightly deformed, which loads the fixators. Pedicle screw breakage more than half a year after insertion does not prove that anterior interbody fusion has not occurred.

  16. Only spinal fixation as treatment of prolapsed cervical intervertebral disc in patients presenting with myelopathy

    Directory of Open Access Journals (Sweden)

    Atul Goel

    2017-01-01

    Conclusions: Spinal segmental fixation aiming at arthrodesis with or without distraction of facets and without any direct surgical manipulation in the disc space or removal of the prolapsed portion of the disc can be considered in the armamentarium of the surgeon.

  17. Dyaphiseal open fractures of the forearm follows internal or external fixation

    International Nuclear Information System (INIS)

    Gomez Aya, Oscar Andres; Bocanegra Navia, Sergio; Suarez Romero, Fabio

    2001-01-01

    The treatment of dyaphiseal open fractures of the forearm follows internal or external fixation. However, the effectivity of both approaches remains controversial. The aim of this descriptive, Wais study, to assess the osteosynthesis by limited approach (internal fixation) as treatment of this type of fractures. Between 1996 and 1999, 22 patients with open dyaphiseal forearm fractures caused by gunshot and treated with this technique were analyzed. The men age was 26.8 years. There were 13 patients with type lllA and 9 patients with type lllB fractures. The mean of comminution was 6.34 mm. Additionally; the mean of quirurgical rinses was 3.7. The complications were: superficial infections, insufficient osteosynthesis and pseudoarthrosis. According to a functional scale the outcomes were, excellent good acceptable and bad. Within parenthesis are the numbers of patients. On the other hand, there were nineteen successful bone consolidations. The observed relative success of the limited approach, with 17 excellent-good cases and 79 bone consolidating, can be explained by the avoiding of unnecessary manipulation of the fractures area which promotes consolidation and reduces infection risk. Moreover the acceptable functional recovery, the absence of complications due to the technique and the restrained use of bone grafts make this technique highly performable

  18. Clinical use of computed tomography and surface markers to assist internal fixation within the equine hoof.

    Science.gov (United States)

    Gasiorowski, Janik C; Richardson, Dean W

    2015-02-01

    To describe clinical use of computed tomography (CT) and hoof surface markers to facilitate internal fixation within the confines of the hoof wall. Retrospective case series. Horses (n = 16) that had CT-guided internal fixation of the distal phalanx (DP) or distal sesamoid bone (DSB). Drill bit entry point and direction were planned from CT image series performed on hooves with grids of barium paste dots at proposed entry and projected exit sites. Post-implantation CT images were obtained to check screw position and length as well as fracture reduction. Imaging, reduction, and surgical and general anesthesia times were evaluated. Outcome was recorded. Screw position and length were considered near optimal in all horses, with no consequential malposition of bits or screws. Fracture reduction was evident in all cases. Preoperative planning times (at least 2 CT image acquisitions and grid creation) ranged from 10 to 20 minutes. Surgery time ranged from 45 to 90 minutes (mean, 61 minutes) and general anesthesia time ranged from 115 to 220 minutes (mean, 171 minutes). The combination of CT and surface marker grids allowed accurate positioning of screws in clinical DP and DSB fractures. The technique was simple and rapid. An aiming device is useful for the technique. © Copyright 2014 by The American College of Veterinary Surgeons.

  19. Postoperative complications after closed calcaneus fracture treated by open reduction and internal fixation: a review.

    Science.gov (United States)

    Yu, Xiao; Pang, Qing-Jiang; Chen, Liang; Yang, Chang-Chun; Chen, Xian-Jun

    2014-02-01

    To review postoperative complications reported after closed calcaneus fracture treated by open reduction and internal fixation (ORIF). Postoperative complications reported in the literature between 1995 and 2012 were identified. Papers were retrieved from publicly available databases and included in this study if they met the following criteria: clinical research of cases of closed calcaneus fracture treated by ORIF; ≥10 cases; detailed information about complications, treatment and follow up. Twenty-one clinical reports were analysed (2046 cases). Reported complications (and incidence rates) were: infection and skin flap necrosis (13.6%); neurovascular injury (2.8%); post-traumatic arthritis (1.2%); malreduction/implant problems (0.8%); nonunion (0.1%). Postoperative complications after closed calcaneus fracture are common clinical problems that cannot always be avoided. They can even be life altering, due to the requirement for long-term treatment or amputation and their economic impact on the patient. Complications should be diagnosed and treated promptly, to achieve satisfactory outcomes. Nonsurgical treatment (e.g. local wound care, drugs or physical therapy) can be attempted. If such measures fail, surgical treatment (e.g. debridement, skin flap transplantation, implant removal, re-opening of the reduction and internal fixation or subtalar joint arthrodesis) should be considered.

  20. International Voluntary Renewable Energy Markets (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.

    2012-06-01

    This presentation provides an overview of international voluntary renewable energy markets, with a focus on the United States and Europe. The voluntary renewable energy market is the market in which consumers and institutions purchase renewable energy to match their electricity needs on a voluntary basis. In 2010, the U.S. voluntary market was estimated at 35 terawatt-hours (TWh) compared to 300 TWh in the European market, though key differences exist. On a customer basis, Australia has historically had the largest number of customers, pricing for voluntary certificates remains low, at less than $1 megawatt-hour, though prices depend on technology.

  1. [Choices of the internal fixation and approaches on unstable pelvic ring fractures].

    Science.gov (United States)

    Bi, Da-Wei; Zu, Gang; Han, Lei; Chen, Yi-Min; Ma, Hai-Tao; Hu, Gang-Feng; Zhu, Yuan

    2017-03-25

    To discuss the suitable surgical approach and the internal fixation of unstable pelvic pelvic fractures. From May 2010 to May 2015, 45 patients with unstable pelvic fractures were treated with different approaches and fixations, including 38 males and 7 females with an average age of 45 years ranging from 21 to 61 years. The course was within 2 weeks. According to Young-Burg classification, 23 patients were lateral compression injuries, 6 patients were vertical shearing injuries, 16 patients were anterior-posterior compression injuries. All patients had hip pain and limitation of motion, the X-rays showed the pelvic ring fracture. All wounds healed well without complications, 45 cases were followed up for a mean period of 13 months (ranged 9 to 21 months). Patients with hip pain had a good postoperative pain relief. The post-operative X-rays showed the reduction was satisfied and the pelvic ring shaped well. According to Majeed standards, the final follow-up score was 93.5±11.6, 35 cases got excellent results, 8 were good, 2 were fare. The unstable pelvic and acetabular fractures are always with compound injury. Beside the reduction, to decrease the second surgery trauma should take into consideration as well, the intra-articular reduction and the stability of the pelvic were especially valued, so combined the different approach with minimal invasive technique can get good clinical result.

  2. Distal radioulnar joint instability (Galeazzi type injury) after internal fixation in relation to the radius fracture pattern.

    Science.gov (United States)

    Korompilias, Anastasios V; Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Beris, Alexandros E; Soucacos, Panayiotis N

    2011-05-01

    The purpose of this study was to classify Galeazzi type injuries and determine the association of residual instability after rigid fixation with the fracture pattern of the shaft of the radius, using a system that is based on anatomic landmarks of the radial shaft. The clinical records of 95 patients (72 men and 23 women) with Galeazzi type injuries requiring open reduction and internal fixation of the fractures were retrospectively reviewed. The mean follow-up was 6.8 years (range, 18 mo to 11 y) after injury. Sixty-nine fractures occurred in the distal third of the radial shaft (type I), 17 fractures were in the middle third (type II), and 9 fractures were in the proximal third of the shaft of the radius (type III). Gross instability of the distal radioulnar joint (DRUJ) was determined intraoperatively by manipulation after radial fixation as compared to the uninjured side. Forty patients had DRUJ instability after internal fixation and were treated with temporary pinning with a K-wire placed transversely proximal to the sigmoid notch. Distal radioulnar joint instability after internal fixation was recorded in 37 type I fractures, 2 type II fractures, and 1 type III fracture. Distal radioulnar joint instability following radial shaft fracture fixation is significantly higher in patients with type I fractures than in patients with type II or type III fractures. The location of the radius fracture can be sufficiently used for preoperative estimation of percentage chance of potential DRUJ instability after fracture fixation. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  3. International Business Research: Past, Present and Future

    OpenAIRE

    David A Ricks

    1985-01-01

    The Editors of the Journal of International Business Studies (JIBS) always try to publish the best international business research. Unfortunately, there will probably never be a simple response to the question, What constitutes excellent international business research? We might make some progress, however, if we first attempt to define international business research and then identify several noteworthy examples.© 1985 JIBS. Journal of International Business Studies (1985) 16, 1–4

  4. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones.

    Science.gov (United States)

    Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

    2009-12-15

    Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG) or demineralized-bone-matrix (DBM). From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10) or DBM-augmentation (n = 10). At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014). Mean duration of follow-up was 56.6 months (ICABG-group) and 41.2 months (DBM-group). All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20%) whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146). No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20%) (p = 0.146). Pain intensity were comparable in both groups (p = 0.326). However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031). With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160 euro/case). Nevertheless, this study demonstrated that the

  5. What is the best internal fixation in pelvic fracture models with open-book injury and anterior sacroiliac joint disruption?

    Directory of Open Access Journals (Sweden)

    Ismail H. Dilogo

    2015-12-01

    Full Text Available Background: The best operative management for open-book pelvic injury with anterior sacroiliac disruption (OTA/AO B1.1 classification is still debated. This biomechanical study aimed to find the best internal fixation technique for such injury. Methods: Open-book injury with anterior sacroiliac joint disruption was simulated on 25 artificial pelvic bones. Twenty five artificial pelvic bones were divided into 5 groups (n=5 /group and fixated with five different fixation techniques: 1. 1SP+1IS; 2. 2SP; 3. 2SP+2SIP; 4. 1SP+2IS S1, and 5. 1SP+1IS S1+S2. Biomechanical properties of each fixation technique were assessed using Tensilon® RTF-1310 to measure the resistance to translation and load to failure. Data were statistically analyzed using one-way ANOVA followed by post-hoc Bonferroni test.Results: The highest mean load to failure of axial forces (1490.36 N was achieved by the fixation technique using one symphyseal plate and two iliosacral screws located at S1 dan S2. The addition of one iliosacral screw significantly increased the mean load to failure for axial compression (p<0.05.Conclusion: The addition of sacroiliac joint posterior fixation, either with plate or screw, will increase the fixation biomechanical strength. Single symphyseal plate and two iliosacral screws on S1 and S2 provided the best mechanical resistance to axial loading. Thus, it can be concluded that such fixation technique is best for open-book pelvic injury with anterior sacroiliac disruption.

  6. Biomechanical Evaluation of the MACSTL Internal Fixator for Thoracic Spinal Stabilisation

    Directory of Open Access Journals (Sweden)

    R. Veselý

    2008-01-01

    Full Text Available Unstable fractures of the thoracic spine in humans represent a serious social and economic issue. They may lead to persistent consequences and chronic disease. The anatomical and biomechanical characteristics of the thoracic spine are different from all the other spinal parts due to its higher mobility. The vertebrae of the chest area are less mobile, conferring a higher degree of rigidity to the spine. To destabilize this relatively rigid system, a considerable force is necessary. The treatment of unstable spinal fractures is solely surgical. The decompression of the spinal canal with reposition and stabilisation of the fracture is indicated urgently. This intervention is performed mostly from the posterior approach in the first phase. However, the anterior spinal column is the structure responsible for the stability of the spine. Therefore, the recent advances in spine surgery focus on this area of expertise. For this reason, we carried out a bio-mechanical study aimed at assessing the effectiveness of two surgical tactics used. The study consisted of comparative experiments performed by computer-aided device on segments of pig cadavers (n = 5. The experiment involved a comparison of segments of the thoracic spine under the following conditions: an anatomically intact segment, a spine segment with an artificially created anterior instability, and a segment with an applied internal fixator. The experiment compared the mechanical characteristics of these segments. The experiment has demonstrated that after application of the internal fixator used for stabilisation of the injured anterior spinal column at defined pre-loading of 200 N, the stability of damaged spinal segment in torsion increased twofold. It was also verified that sufficient stability can be ensured using the Modular Anterior Construct System (MACSTL implant for ventral stabilisation of thoracic spine unstable injuries. Endoscopic application of this implant represents an

  7. An in vivo evaluation of PLLA/PLLA-gHA nano-composite for internal fixation of mandibular bone fractures.

    Science.gov (United States)

    Peng, Weihai; Zheng, Wei; Shi, Kai; Wang, Wangshu; Shao, Ying; Zhang, Duo

    2015-11-09

    Internal fixation of bone fractures using biodegradable poly(L-lactic-acid) (PLLA)-based materials has attracted the attention of many researchers. In the present study, 36 male beagle dogs were randomly assigned to two groups: PLLA/PLLA-gHA (PLLA-grafted hydroxyapatite) group and PLLA group. PLLA/PLLA-gHA and PLLA plates were embedded in the muscular bags of the erector spinae and also implanted to fix mandibular bone fractures in respective groups. At 1, 2, 3, 6, 9, and 12 months postoperatively, the PLLA/PLLA-gHA and PLLA plates were evaluated by adsorption and degradation tests, and the mandibles were examined through radiographic analysis, biomechanical testing, and histological analysis. The PLLA/PLLA-gHA plates were non-transparent and showed a creamy white color, and the PLLA plates were transparent and faint yellow in color. At all time points following surgery, adsorption and degradation of the PLLA/PLLA-gHA plates were significantly less than those of the PLLA plates, and the lateral and longitudinal bending strengths of the surgically treated mandibles of the beagle dogs in the PLLA/PLLA-gHA group were significantly greater than those of the PLLA group and reached almost the value of intact mandibles at 12 months postoperatively. Additionally, relatively rapid bone healing was observed in the PLLA/PLLA-gHA group with the formation of new lamellar bone tissues at 12 months after the surgery. The PLLA/PLLA-gHA nano-composite can be employed as a biodegradable material for internal fixation of mandibular bone fractures.

  8. Return to Sports and Physical Activities After Open Reduction and Internal Fixation of Lisfranc Injuries in Recreational Athletes.

    Science.gov (United States)

    Mora, Allan David; Kao, Mark; Alfred, Terrence; Shein, Gregory; Ling, Jeff; Lunz, David

    2018-03-01

    The purpose of this study was to assess participation in sport and physical activity following open reduction and internal fixation of a Lisfranc injury in a cohort of recreational athletes. This study identified all adult patients aged 55 years or younger who presented with a Lisfranc injury and underwent open reduction and internal fixation (ORIF) using a Lisfranc screw combined with bridge plating technique. Sports and physical activity participation was assessed with a new sports-specific, patient-administered questionnaire. Clinical outcomes were assessed with the Foot and Ankle Outcome Score (FAOS). Thirty-three patients qualified for the study (21 men/12 women). Mean age and follow-up were 31.2 (range, 18-55) years and 2.9 (range, 1.5-5.4) years, respectively. Postoperatively, 31 patients (94%) were able to return to some form of sport. Twenty-two patients (66%) returned to playing sport at or above their preinjury level. Of the 11 patients who played less sport, 6 had ongoing pain, and the remaining 5 were asymptomatic but were participating less frequently because of other lifestyle reasons. In addition, of the 33 patients, 11 (33%) had some degree of ongoing pain that might limit their ability to return to sports and physical activities. There was strong correlation between overall FAOS and the Sports Questionnaire. Most patients who sustained a Lisfranc injury could return to sport and physical activity after ORIF. Patients should be counseled preoperatively that about 1 in 3 might experience continued pain at the injury site Level of Evidence: Level IV, retrospective case series.

  9. Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006).

    Science.gov (United States)

    Ahern, Benjamin J; Richardson, Dean W; Boston, Raymond C; Schaer, Thomas P

    2010-07-01

    To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Case series. Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5-fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings. Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.

  10. Arthroscopic assisted reduction and internal fixation of lateral femoral epiphyseal injury in adolescent soccer player: a report of one case.

    Science.gov (United States)

    Lee, Yong Seuk; Jung, Young Bok; Ahn, Jin Hwan; Shim, Jong Seop; Nam, Dae Cheol

    2007-06-01

    Ligament injuries are more common than fractures in adolescents. We operated on an adolescent soccer player, who had a lateral femoral epiphyseal injury using arthroscopic-assisted reduction and percutaneous internal fixation. During second-look arthroscopy 2 years after the first operation, there was articular cartilage congruity, without any visible step-off. The axial alignment did not reveal any residual valgus deformity.

  11. The effect of internal fixation lamp on anterior chamber angle width measured by anterior segment optical coherence tomography.

    Science.gov (United States)

    Nakamine, Sakari; Sakai, Hiroshi; Arakaki, Yoshikuni; Yonahara, Michiko; Kaiya, Tadayoshi

    2018-01-01

    To study the effect of the internal fixation lamp on anterior chamber width measured by anterior segment optical coherence tomography. In a prospective cross sectional observational study, consecutive 22 right eyes of 22 patients (4 men and 18 women) with suspected primary angle closure underwent swept source domain anterior segment optical coherence tomography (AS-OCT), (CASIA SS-1000, Tomey, Nagoya, Japan). Anterior chamber parameters of angle opening distance (AOD), trabecular-iris angle (TIA), angle recess area (ARA) at 500 or 750 µm from scleral spur and pupil diameter were measured by AS-OCT in a three-dimensional mode in 4 quadrants (superior, inferior, temporal and nasal) in dark room setting both with and without internal fixation lamp. Anterior segment parameters of AOD 500 in superior, inferior and temporal quadrants, AOD 750 at superior and nasal, TIA 500 at superior, and inferior and TIA 750 at superior and nasal, and ARA 500 or 750 at superior and inferior with internal fixation lamp were greater and the pupil diameter was significantly (all P chamber angle is narrow but open, it is recommended that the internal fixation lamp be turned off to ensure a clear indication as to whether the angle is open or closed in the dark.

  12. A biomechanic comparison of an internal radiocarpal-spanning 2.4-mm locking plate and external fixation in a model of distal radius fractures.

    Science.gov (United States)

    Wolf, Jonathon C; Weil, Wayne M; Hanel, Douglas P; Trumble, Thomas E

    2006-12-01

    To compare the biomechanic stability of distal radius fracture fixation with a new internal radiocarpal-spanning 2.4-mm locking plate, which acts as an internal distal radius fixator, versus a standard distal radius external fixator. The number of locking screws necessary for adequate fracture fixation was also assessed. Ten cadaveric specimens were mounted in a loading fixture with cables attached to the 2 flexor and 3 extensor wrist tendons. A 1-cm osteotomy was created to simulate an unstable distal radius fracture. The radiocarpal-spanning locking plate was fixed to the radius and index metacarpal with 4 screws proximally and 4 distally. The specimen was incrementally loaded through the tendons. Motion at the fracture site was determined. Screws were sequentially removed from the construct, the specimen was again incrementally loaded, and fracture motion was measured. The fixation was then changed to an external fixator, and the loading tests were repeated. Fracture fixation with the radiocarpal-spanning 2.4-mm locking plate was significantly more stable with 4 screws proximally and 4 screws distally (4 x 4) and with the 3 x 3 configuration than with the external fixator in both flexion and extension. The 4 x 4 screw configuration was not significantly different from the 3 x 3 screw configuration. The 4 x 4 screw configuration was significantly more stable than the 2 x 2 and 1 x 1 screw configurations in both flexion and extension. All internal fixator configurations and the external fixator showed more fracture displacement at increasingly higher loads. Fracture fixation with the new internal radiocarpal-spanning 2.4-mm locking plate is more stable than with a standard distal radius external fixator. Only three 2.4-mm locking screws proximally and three 2.4-mm locking screws distally are required for adequate fixation of the locking spanning plate.

  13. International Issues. Paper Presentations: Session C.

    Science.gov (United States)

    2000

    This document contains eight papers from the international issues section of an international conference on vocational education and training (VET) for lifelong learning in the information era. The following papers are included: "The Impact of Globalisation and the Changing Nature of Work on Vocational Education and Training" (Chris…

  14. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    Directory of Open Access Journals (Sweden)

    D D Baksi

    2016-01-01

    Full Text Available Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG were excluded. Thus, out of 244 patients, 208 (85.3% untreated nonunion and 36 (14.7% following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN femoral head was found histologically in 135 (54.3% and radiologically in 48 (19.7% patients. The patients were operated by open reduction of fracture

  15. Present status and prospects of internal radiotherapy

    International Nuclear Information System (INIS)

    Chatal, J.F.

    1994-01-01

    The experience of the last 40 years has shown that internal radiotherapy generally produces palliative results for macroscopic tumor targets and curative results for the microscopic ones. The short-term prospects for internal radiotherapy concern essentially palliative treatment of painful bone metastases of osteophilic cancers (breast or prostate) for antalgic purposes. Radioimmunotherapy may ultimately play a determinant role in the curative treatment of microscopic residual disease resulting from several types of radiosensitive cancer (lymphoma, neuroblastoma or small-cell lung cancer). In all cases, internal radiotherapy should be integrated into a coherent strategy associating complementary therapeutic modalities. (author). 16 refs., 2 figs

  16. Ununited fracture neck of femur treated with closed reduction and internal fixation with cancellous screw and fibular strut graft

    Directory of Open Access Journals (Sweden)

    Singh Daria

    2006-01-01

    Full Text Available Background: Ununited fracture neck of femur in young adults has been tackled in various ways. Methods: Twenty five patients of ununited fracture neck of femur in age group 21-55 years were treated by closed reduction, cancellous screw fixation and fibular strut graft and followed up for 2-6 years. Time gap between injury and operation was 6 weeks to 58 weeks. Five cases were previously fixed with various fixation devices. Results: Osseous union was achieved in 24 cases with average time of 18.16 weeks. Main complication encountered in follow-up was avascular necrosis of femoral head, others were joint stiffness and shortening. Functional end results were good to excellent in 24 cases. Conclusion: Closed reduction with internal fixation by cancellous screw and fibular strut grafting is easy and useful procedure.

  17. Fractures of the posterior wall of the acetabulum: treatment using internal fixation of two parallel reconstruction plates.

    Science.gov (United States)

    Li, Heng; Yang, Honghang; Wang, Dan; Xu, Yi; Min, Jikang; Xu, Xuchun; Li, Zhanchun; Yuan, Yongjian

    2014-04-01

    Our aim was to evaluate the efficacy of the treatment method using internal fixation of parallel reconstruction plates for the posterior wall of the acetabulum fractures. Randomised, prospective. Level I trauma centre. 57 patients with posterior wall fractures of the acetabulum in our department from 2007 to 2010 were treated operatively using this technique. internal fixation of two parallel reconstruction plates was used in this study. One of the plates was near the border of acetabulum. The other was parallel to the former one and was located to stress concentrated area. The clinical outcome was evaluated using the clinical grading system and radiological outcome was evaluated according to the criteria described by Matta. In addition, complications were researched in this study. The percentages of the clinical excellent-to-good and fair-to-poor results were 93.0% and 7%, respectively. We found that clinical outcome had no correlation with age, operation time from injury to operation, nor had correlation with hip dislocation, comminuted fracture condition and marginal compression fracture. Anatomical reduction was significantly correlated with excellent-to-good clinical outcome. Necrosis of the femoral head and heterotopic ossification were prone to decline the outcome of acetabular fractures despite good fracture reduction. the internal fixation of two parallel reconstruction plates facilitated rigid fixation and avoided fracture fragment injury, was an effective and reliable alternative method to treat fractures of the posterior wall of the acetabulum. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Quality of life in treatment of mandibular fractures using closed reduction and maxillomandibular fixation in comparison with open reduction and internal fixation--a randomized prospective study.

    Science.gov (United States)

    Omeje, Kevin U; Rana, Majeed; Adebola, Adetokunbo R; Efunkoya, Akinwale A; Olasoji, Hector O; Purcz, Nicolai; Gellrich, Nils-Claudius; Rana, Madiha

    2014-12-01

    Treatment of mandibular fractures by open reduction and internal fixation (ORIF) is often assumed to be superior to treatment by close reduction and maxillomandibular fixation (MMF) because patients managed by ORIF seem to be rehabilitated earlier according to functional and social aspects. This assumption is often from surgeon's perspective, not taking into account patient's view point. This study highlights a comparative assessment between ORIF and MMF from the patients' perspective. Fifty six patients with mandibular fractures within the tooth bearing areas of the mandible were prospectively studied in a randomized controlled pattern for postoperative Quality of Life (QoL) after ORIF versus MMF. Both groups were analyzed preoperatively, at 1 day, 6 and 8 weeks regarding their QoL using the General Oral Health Assessment Index questionnaire (GOHAI). No significant statistical difference was found between the groups regarding overall QoL. Patients managed by MMF were more affected by psychosocial and physical domains whereas patients managed by ORIF were more affected by the pain domain. The results demonstrate that the treatment affects the psychosocial, physical and pain domain differentially. When both treatments are possible the patient's should be enlightened on the advantages and disadvantages of both treatment modalities to guide their choice of treatment. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  19. Is arthroscopic assisted percutaneous screw fixation as good as open reduction and internal fixation for the treatment of displaced intra-articular calcaneal fractures?

    Science.gov (United States)

    Yeap, Ewe Juan; Rao, Jaynesthra; Pan, Chee Huan; Soelar, Shahrul Aiman; Younger, Alistair S E

    2016-09-01

    This study compares the outcomes of calcaneal fracture surgery after open reduction internal fixation and plating (ORIF) versus arthroscopic assisted percutaneous screw fixation (APSF). Group I (N=12) underwent ORIF. Group II (N=15) underwent APSF. Anthropometric data, pre and post-operative stay, complications and duration off work were recorded in this retrospective case cohort study. Radiographs were analyzed for Bohler's, Gissane's angle and Sanders' classification. AOFAS Hindfoot and SF 36 scores were collected at final follow-up. Anthropometric data, Bohler's and Gissane's angles, AOFAS and SF 36 scores were not significantly different. Pre-operative duration was 12.3 days in ORIF and 6.9 days in APSF. Post-operative duration was 7.3 days vs 3.8 days. Duration off work was 6.2 months vs 2.9 months. The APSF group was able to have surgery earlier, go home faster, and return to work earlier. This study was not powered to demonstrate a difference in wound complication rates. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  20. [Nylon fixation at the internal and external canthus combined with skin graft for recurrent lower eyelids ectropion].

    Science.gov (United States)

    Yu, Li; Wang, Jiaqi

    2015-01-01

    To investigate the long-time effects of nylon fixation at the internal and external canthus combined with skin graft for recurrent lower eyelids ectropion. Under local anesthesia, the cicatricial contraction was released to repostion the lower eyelid. Then nylon thread was implanted in the fascial tissue at the upper margin of tarsus and was fixed on the periosteum at the internal and external canthus. The skin graft was applied on the wound of lower eyelids. 12 patients with lower eyelids ectropion at 19 sides were treated with primary healing. The patients were followed up for 6-24 months. All cases were satisfied with functional and cosmetic results. No complication and no recurrence happened. The technique of nylon fixation at the internal and external canthus combined with skin graft is an effective method for recurrent lower eyelids ectropion.

  1. Open reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel T-Plate

    Directory of Open Access Journals (Sweden)

    Hussain S

    2014-03-01

    Full Text Available Background: Proximal humeral fractures are considered the last unsolved fractures in orthopaedics. The treatment is controversial and various operative modalities have been reported in the literature. The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal humerus AO stainless steel Tplate. Twenty-five (25 patients with displaced proximal humerus fractures treated with proximal humerus T-plate between May 2005 and June 2008 were included in the study. Fractures were classified according to the Neer classification into displaced 2-part, 3-part, and 4-part fractures. Patients were followed-up for a minimum period of two years. Functional evaluation was done according to the Neer scoring system. Scores were compared with other studies in the literature using similar implant. Twenty patients had 2-part fracture, four had 3-part fracture, and one had 4-part fracture. Eighty-eight [88% (n = 22] patients had good to excellent result, eight [8% (n = 2] had fair, and four [4% (n = 1] had poor result. Difference in Neer’s score between 2-part and 3-part fractures was not significant. Complications encountered in this series were screw backout in 8% (n = 2, superficial infection in 12% (n= 3, and avascular necrosis in 4% (n = 1 of cases. We conclude that proximal humerus AO T- plate is a cheap and easily available implant, aspects which are particularly relevant in third world countries like India. It gives reliable fixation for 2-part and 3-part fractures. Its use in more complicated fracture patterns of 4-part fractures is not recommended.

  2. [Healing of spiral fractures in the sheep tibia comparing different methods--osteosynthesis with internal fixation, interlocking nailing and dynamic compression plate].

    Science.gov (United States)

    Seibold, R; Schlegel, U; Kessler, S B; Cordey, J; Perren, S M; Schweiberer, L

    1995-12-01

    The healing process of spiral fractures of the sheep tibia was investigated in an experiment with simulated clinical conditions. The effects of conventional internal fixation techniques with the DCP and the intramedullary nail are compared with those of internal fixation with the spine fixator. The internal fixation techniques are described in terms of their bending stiffness when mounted on the fractured bone. The in vivo investigation was documented clinically and radiographically and the post mortem specimens were evaluated histologically. The bending stiffness of the healed bone was assessed in relation to the contralateral side. After application of the DCP, primary healing took place and extensive transcortical necrosis occurred in the implant bed. Intramedullary nailing led to secondary healing and to necrosis of the inner cortex close to the endosteum. After internal fixation with the spine fixator, gap healing took place and no cortical necrosis was observed. The clinical course was generally good after all procedures. The histological evaluation shows that damage to the vascularity of the bone can only be avoided by using the spine fixator. This principle seems to be appropriate for the purposes of biological internal fixation.

  3. Bio-Environment-Induced Degradation and Failure of Internal Fixation Implants

    Directory of Open Access Journals (Sweden)

    Yan Zhou

    2015-10-01

    Full Text Available Internal fixations provide fast healing but their failure remains problematic to patients. Here, we report an experimental study in failure of three typical cases of metals: a bent intramedullary stainless steel nail, a broken exterior pure Ti plate, and a broken intramedullary stainless steel nail. Characterization of the bent nail indicates that those metals are vulnerable to corrosion with the evidence of increased surface roughness and embrittlement. Depredated surface of the Ti plate resulted debris particles in the surrounding tissue of 15.2 ± 6.5 μm in size. Nanoparticles were observed in transmission electron microscope. The electron diffraction pattern of the debris indicates a combination of nanocrystalline and amorphous phases. The failure mode of the broken nail made of stainless steel was found to be fatigue initiated from the surface. This study clearly shows the biological-attack induced surface degradation resulting in debris and fatigue. Future design and selection of implant materials should consider such factors for improvement.

  4. Multiple Rib Nonunion: Open Reduction and Internal Fixation and Iliac Crest Bone Graft Aspirate.

    Science.gov (United States)

    Kaplan, Daniel J; Begly, John; Tejwani, Nirmal

    2017-08-01

    Rib fractures are a common chest injury that can typically be treated nonoperatively. However, a percentage of these will go on to nonunion, either because of unique characteristics of the fracture itself or because of a variety of poor healing factors of the host. If a patient has continued symptomology beyond 3 months, surgeons may consider operative management. Although isolated resection of fibrous scar tissue from the nonunion site may be sufficient in some cases, it may also be necessary to provide additional structural integrity to the rib depending on the extent of the fracture pattern and resection. This goal can be achieved operatively with rib plating and bone grafting to promote healing. This video demonstrates the use of plating in the treatment of rib nonunion. It begins with relevant background information on rib fractures and nonunions, then details the approach, open reduction and internal fixation of 3 ribs using plates and bone graft aspirate. Pearls and pitfalls are included during the surgical technique aspect of the video to both help guide surgeons new to the procedure and provide potentially advantageous technical details to more experienced surgeons.

  5. Posterior Cruciate Ligament Tibial Avulsion treated with Open Reduction and Internal Fixation

    Directory of Open Access Journals (Sweden)

    Lee WXP

    2015-07-01

    Full Text Available The optimal treatment for thoracolumbar fractures (TLF without neurological deficit remains controversial. Majority of the systematic reviews and meta-analyses have evaluated open operative approaches but have yet to compare the outcomes of minimally invasive percutaneous pedicle fixation (MIPPF versus non-operative treatment. A retrospective cohort study was performed to compare clinical and radiological outcomes between MIPPF and conservative groups for TLF AO Type A1 to Type B2 during a 2-year follow-up period. Pre-operative plain and CT films were evaluated and decision made for short segment (non-fusion MIPPF. Patients who refused operation were treated conservatively with three months of body cast, brace, or corset. MIPPF group showed earlier Visual Analog Score (VAS improvement at six months post-injury (0 vs 6.0- p0.050. MIPPF as a method of internal bracing can be pursued in the treatment of TLF, with larger future cohorts and RCTs being called for to support and explore new findings.

  6. Short-Term Therapeutic Efficacy of the Isobar TTL Dynamic Internal Fixation System for the Treatment of Lumbar Degenerative Disc Diseases.

    Science.gov (United States)

    Qian, Jiale; Bao, Zhaohua; Li, Xuefeng; Zou, Jun; Yang, Huilin

    2016-07-01

    At present, posterior interbody fusion surgery with pedicle internal fixation is the gold standard for the treatment of lumbar degenerative disc diseases. However, an increasing number of studies have shown that because fused lumbar vertebrae lose their physiological activity, the compensatory range of motion (ROM) of the adjacent levels increases. To address this issue, dynamic internal fixation systems have been developed. Our goal was to investigate the short-term therapeutic efficacy of the Isobar TTL dynamic internal fixation system for the treatment of lumbar degenerative disc diseases and its effect on the ROM of the surgical segments. Retrospective Evaluation. Tertiary hospital setting in China. Twenty-four lumbar degenerative disc disease patients who underwent posterior lumbar decompression and single-segment Isobar TTL dynamic internal fixation at our hospital between January 2013 and July 2014 were retrospectively analyzed. The preoperative and one month, 3 month, and 12 month postoperative visual analog scale (VAS) pain scores, Japanese Orthopedic Association (JOA) scores, and Oswestry Disability Index (ODI) scores were observed and recorded to assess the clinical therapeutic effect; the lumbar ROM was measured preoperatively and at the last follow-up to evaluate the preservation of functional movement in the dynamically stabilized segment. All patients underwent the operation successfully without complications during hospitalization and were followed for 12 to 27 months, with an average of 18 months. The patients' preoperative and one month, 3 month, and 12 month postoperative VAS scores were 6.42 ± 0.72, 1.71 ± 0.86, 1.38 ± 0.65, and 1.37 ± 0.58, respectively, and their JOA scores were 9.54 ± 1.89, 21.21 ± 1.98, 22.50 ± 1.47, and 23.46 ± 1.32, respectively. The preoperative ODI score was 42.04 ± 2.63; the one month, 3 month, and 12 month postoperative ODI scores were 22.79 ± 1.61, 18.63 ± 1.61, and 15.08 ± 1.21, respectively. These

  7. Internal dosimetry monitoring equipment: Present and future

    International Nuclear Information System (INIS)

    Selby, J.; Carbaugh, E.H.; Lynch, T.P.; Strom, D.J.; Lardy, M.M.

    1993-09-01

    We have attempted to characterize the current and future status of in vivo and in vitro measurement programs coupled with the associated radioanalytical methods and workplace monitoring. Developments in these areas must be carefully integrated by internal dosimetrists, radiochemists and field health physicists. Their goal should be uniform improvement rather than to focus on one specific area (e.g., dose modeling) to the neglect of other areas where the measurement capabilities are substantially less sophisticated and, therefore, the potential source of error is greatest

  8. ISO Results Presented at International Astronomical Union

    Science.gov (United States)

    1997-08-01

    Some of the work being presented is collected in the attached ESA Information Note N 25-97, ISO illuminates our cosmic ancestry. A set of six colour images illustrating various aspects have also been released and are available at http://www.estec.esa.nl/spdwww/iso1808.htm or in hard copy from ESA Public Relations Paris (fax:+33.1.5369.7690). These pictures cover: 1. Distant but powerful infrared galaxies 2. A scan across the milky way 3. Helix nebula: the shroud of a dead star 4. Supernova remnant Cassiopeia A 5. Trifid nebula: a dusty birthplace of stars 6. Precursors of stars and planets The International Astronomical Union provides a forum where astronomers from all over the world can develop astronomy in all its aspects through international co-operation. General Assemblies are held every three years. It is expected that over 1600 astronomers will attend this year's meeting, which is being held in Kyoto, Japan from 18-30 August. Further information on the meeting can be found at: www.tenmon.or.jp/iau97/ . ISO illuminates our cosmic ancestry The European Space Agency's Infrared Space Observatory, ISO, is unmatched in its ability to explore and analyse many of the universal processes that made our existence possible. We are children of the stars. Every atom in our bodies was created in cosmic space and delivered to the Sun's vicinity in time for the Earth's formation, during a ceaseless cycle of birth, death and rebirth among the stars. The most creative places in the sky are cool and dusty, and opaque even to the Hubble Space Telescope. Infrared rays penetrating the dust reveal to ISO hidden objects, and the atoms and molecules of cosmic chemistry. "ISO is reading Nature's recipe book," says Roger Bonnet, ESA's director of science. "As the world's only telescope capable of observing the Universe over a wide range of infrared wavelengths, ISO plays an indispensable part in astronomical discoveries that help to explain how we came to exist." This Information Note

  9. Review of techniques for monitoring the healing fracture of bones for implementation in an internally fixated pelvis.

    Science.gov (United States)

    Wong, Lydia Chwang Yuh; Chiu, Wing Kong; Russ, Matthias; Liew, Susan

    2012-03-01

    Sacral fractures from high-impact trauma often cause instability in the pelvic ring structure. Treatment is by internal fixation which clamps the fractured edges together to promote healing. Healing could take up to 12 weeks whereby patients are bedridden to avoid hindrances to the fracture from movement or weight bearing activities. Immobility can lead to muscle degradation and longer periods of rehabilitation. The ability to determine the time at which the fracture is stable enough to allow partial weight-bearing is important to reduce hospitalisation time. This review looks into different techniques used for monitoring the fracture healing of bones which could lead to possible methods for in situ and non-invasive assessment of healing fracture in a fixated pelvis. Traditional techniques being used include radiology and CT scans but were found to be unreliable at times and very subjective in addition to being non in situ. Strain gauges have proven to be very effective for accurate assessment of fracture healing as well as stability for long bones with external fixators but may not be suitable for an internally fixated pelvis. Ultrasound provides in situ monitoring of stiffness recovery but only assesses local fracture sites close to the skin surface and has only been tested on long bones. Vibration analysis can detect non-uniform healing due to its assessment of the overall structure but may suffer from low signal-to-noise ratio due to damping. Impedance techniques have been used to assess properties of non-long bones but recent studies have only been conducted on non-biological materials and more research needs to be done before it can be applicable for monitoring healing in the fixated pelvis. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  10. Os acromiale open reduction and internal fixation: a review of iliac crest autogenous bone grafting and local bone grafting.

    Science.gov (United States)

    Atinga, Mordicai; Gregor, Reinhold; Selvaraj, Karthik M; Hong, Thin F

    2018-01-17

    Symptomatic os acromiale are fairly uncommon, and treatment has included fragment excision, decompression, and open reduction and internal fixation. Nonunion rates as high as 40% have been reported after fixation of os acromiale. This study assessed whether union of an os acromiale could be reliably achieved without the use of an iliac crest bone graft. This was a retrospective study of 32 consecutive shoulders that were treated with screw fixation and a local bone graft or iliac crest bone graft. The mean age was 50.3 years (range, 21-74 years), and the mean follow-up was 46.9 months (range, 12-120 months). Fusion was assessed clinically and radiologically. All 32 os acromiale were fused by 3 months on x-ray imaging. There were 18 shoulders in the iliac crest bone graft group and 14 in the local bone graft group. Rotator cuff repairs were performed concomitantly in 25 patients. Hardware was removed in 4 patients, a seroma was drained in 1 patient, and a superficial infection occurred in 1 patient. This is the largest study of os acromiale fixation using screws and a tension band to our knowledge. We report a 100% union rate using this technique, with 13% requiring hardware removal and the occurrence of 1 superficial infection. This study shows a local bone graft is as effective as iliac crest bone graft in achieving fusion. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  11. Thirty cases of distal humerus intra-articular fractures treated by open reduction and internal fixation: A 3-year review

    Directory of Open Access Journals (Sweden)

    Ajit Swamy

    2012-01-01

    Full Text Available Introduction: Fractures of the distal humerus involving articular surface remains one of the challenging situations for any orthopedic surgeon. Congruent articular reconstruction is mandatory for an acceptable functional recovery. Materials and Methods: This was a case series of 30 patients of distal humeral intraarticular fractures treated by open reduction and internal fixation and followed up at the end of 3 years.Fractures were classified according to AO [Arbeitsgemeinschaft für Osteosynthesefragen] and the results were evaluated using Cassebaums rating system, and other parameters. Results: Majority of the patients had a favourable outcome.There was no neurovascular complications and majority had a sound union. One case developed postoperative infection. Two cases resulted in nonunion. Conclusion: Open reduction and internal fixation with congruent articular reconstruction in young patients resulted in acceptable and good functional recovery. This was achieved with the use of recent AO ASIF plates. [AO/ASIF - Arbeitsgemeinschaft fuer Osteosynthesefragen - Association for the Study of Internal Fixation].

  12. Open Reduction with Internal Fixation of Mandibular Angle Fractures: A Retrospective Study.

    Science.gov (United States)

    Bouchard, Carl; Mansouri, Masoud

    2017-01-01

    The goal of this project was to report the complications associated with mandibular angle fractures and identify variables affecting their occurrence. We retrospectively reviewed the charts of patients with a mandibular angle fracture treated at the Centre hospitalier universitaire de Québec between 2009 and 2013. Seventy-eight patients (73 males) aged 15-59 years (mean 25.2 years) met our inclusion criteria. A wisdom tooth was present in 85.9% (n = 67) of the cases and it was removed 62.7% (n = 42) of the time. Thirty-four patients (43.6%) had other mandibular fractures. Most fractures were fixated with a sagittal split osteotomy plate (n = 32; 41.0%) or a 2.0-mm plate on the lateral aspect of the mandible (n = 20; 25.6%). The overall complication rate was 42.3% (n = 33); of these 37.2% were infections, 26.9% involved plate removal and 6.4% were associated with non-union. Older patients had more infections (p = 0.03) and more plates removed (p = 0.03). When a wisdom tooth was extracted, more infections (p = 0.04) and overall complications (p = 0.02) were observed. This study confirms that, when treating a mandibular angle fracture in a healthy patient, it may be beneficial to leave a wisdom tooth in the line of fracture in place, if there is no indication to remove it.

  13. 7th International Immunoglobulin Conference: Poster presentations.

    Science.gov (United States)

    Warnatz, K; Ballow, M; Stangel, M; Bril, V

    2014-12-01

    The pan-European survey provides useful information on the accessibility and trends of intravenous and subcutaneous immunoglobulin (IVIg/SCIg) therapy, which is used to treat primary immunodeficiency disorders (PIDs). Although immunoglobulin (Ig) therapy is the first-line treatment for PIDs, the mechanisms of action of Ig therapy may differ according to the condition it is used to treat. Moreover, intriguing presentations suggest that further investigation is required to understand more clearly both the haematological and immunoregulatory effects of therapeutic immunoglobulin. This can ultimately provide more information on optimizing Ig therapy efficacy, and establish whether individualized dosing regimens for patients will be conducive to better clinical outcomes. In addition to treating autoimmune and inflammatory conditions, there is evidence to suggest that immunoglobulins can potentially play a role in transplantation, which warrants further investigation for future use. © 2014 British Society for Immunology.

  14. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    DEFF Research Database (Denmark)

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

    . Patients and methods - We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction......Background and purpose - During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation...... was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results - The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17 of 42 (0...

  15. Application of IMF screws to assist internal rigid fixation of jaw fractures: our experiences of 168 cases.

    Science.gov (United States)

    Bai, Zhenxi; Gao, Zhibiao; Xiao, Xia; Zhang, Wenjuan; Fan, Xing; Wang, Zhaoling

    2015-01-01

    Intermaxillary fixation (IMF) screws were first introduced to achieve IMF as a kind of bone borne appliance for jaw fractures in 1989. Because this method can overcome many disadvantages associated with tooth borne appliance, IMF screws have been popularly used for jaw fractures since then. From March 2011 to February 2014, we treated 168 cases with single or multiple jaw fractures by open reduction and a total of 705 IMF screws were intraoperatively applied in all the cases to achieve IMF and maintain dental occlusion as an adjuvant to open reduction. The numbers, implantation sites and complications of IMF screws were retrospectively analyzed. In our experience, we found that IMF screws were important to assist open reduction of jaw fractures but their roles should be objectively assessed and the reliability of open reduction and internal rigid fixation must be emphasized. Much attention should be paid when implanting.

  16. Outcome of Internal Fixation and Corticocancellous Grafting of Symphysis Pubis Diastasis Which Developed after Malunion of Pubic Rami Fracture.

    Science.gov (United States)

    Bombaci, Hasan

    2017-06-01

    We report a case of pubic symphysis diastasis, which was initially asymptomatic; however, it became symptomatic with urinary incontinence during pregnancy. The patient was treated with open reduction and internal fixation of the symphysis pubis. A corticocancellous autograft was used for filling the gap which remained despite bilateral compression of the iliac bones. We obtained satisfactory outcome in terms of symptoms at the 3 years' follow-up; however, there was instability findings in the X-rays with broken screws. We conclude that asymptomatic pubic symphysis diastasis might be symptomatic after additional trauma (such as pregnancy) in the following days, if it was unstable in the very beginning of injury. Fixation of old pubic symphysis diastasis with reconstruction plate by filling the gap by using corticocancellous autograft, might not prevent ultimate implant failure if the symphysis pubis diastasis is part of an unstable pelvic fracture in the very beginning.

  17. Ti-24Nb-4Zr-8Sn Alloy Pedicle Screw Improves Internal Vertebral Fixation by Reducing Stress-Shielding Effects in a Porcine Model.

    Science.gov (United States)

    Qu, Yang; Zheng, Shuang; Dong, Rongpeng; Kang, Mingyang; Zhou, Haohan; Zhao, Dezhi; Zhao, Jianwu

    2018-01-01

    To ensure the biomechanical properties of Ti-24Nb-4Zr-8Sn, stress-shielding effects were compared between Ti-24Nb-4Zr-8Sn and Ti-6Al-4V fixation by using a porcine model. Twelve thoracolumbar spines (T12-L5) of 12-month-old male pigs were randomly divided into two groups: Ti-24Nb-4Zr-8Sn (EG, n = 6) and Ti-6Al-4V (RG, n = 6) fixation. Pedicle screw was fixed at the outer edge of L4-5 vertebral holes. Fourteen measuring points were selected on the front of transverse process and middle and posterior of L4-5 vertebra. Electronic universal testing machine was used to measure the strain resistance of measuring points after forward and backward flexion loading of 150 N. Meanwhile, stress resistance was compared between both groups. The strain and stress resistance of measurement points 1, 2, 5, 6, 9, and 10-14 in Ti-24Nb-4Zr-8Sn fixation was lower than that of Ti-6Al-4V fixation after forward and backward flexion loading ( P Ti-24Nb-4Zr-8Sn fixation than that of Ti-6Al-4V fixation ( P Ti-24Nb-4Zr-8Sn internal fixation were less than that of Ti-6Al-4V internal fixation. These results suggest that Ti-24Nb-4Zr-8Sn elastic fixation has more biomechanical goals than conventional Ti-6Al-4V internal fixation by reducing stress-shielding effects.

  18. Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study.

    Science.gov (United States)

    Sawada, Hideyoshi; Shinohara, Takaaki; Natsume, Tadahiro; Hirata, Hitoshi

    2016-11-01

    Ulnar styloid fractures are often associated with distal radius fractures. However, controversy exists regarding whether to treat ulnar styloid fractures. This study aimed to evaluate clinical effects of internal fixation for ulnar styloid fractures after distal radius fractures were treated with the volar locking plate system. We used prospectively collected data of distal radius fractures. 111 patients were enrolled in this study. A matched case-control study design was used. We selected patients who underwent fixation for ulnar styloid fractures (case group). Three control patients for each patient of the case group were matched on the basis of age, sex, and fracture type of distal radius fractures from among patients who did not undergo fixation for ulnar styloid fractures (control group). The case group included 16 patients (7 men, 9 women; mean age: 52.6 years; classification of ulnar styloid fractures: center, 3; base, 11; and proximal, 2). The control group included 48 patients (15 men, 33 women; mean age: 61.1 years; classification of ulnar styloid fractures: center, 10; base, 31; and proximal, 7). For radiographic examination, the volar tilt angle, radial inclination angle, and ulnar variance length were measured, and the union of ulnar styloid fractures was judged. For clinical examination, the range of motions, grip strength, Hand20 score, and Numeric Rating Scale score were evaluated. There was little correction loss for each radiological parameter of fracture reduction, and these parameters were not significantly different between the groups. The bone-healing rate of ulnar styloid fractures was significantly higher in the case group than in the control group, but the clinical results were not significantly different. We revealed that there was no need to fix ulnar styloid fractures when distal radius fractures were treated via open reduction and internal fixation with a volar locking plate system. Copyright © 2016 The Japanese Orthopaedic Association

  19. Incidence and risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture: A systematic review and meta-analysis.

    Science.gov (United States)

    Shao, Jiashen; Chang, Hengrui; Zhu, Yanbin; Chen, Wei; Zheng, Zhanle; Zhang, Huixin; Zhang, Yingze

    2017-05-01

    This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture. Stata 11.0 software was used for this meta-analysis. Eight studies involving 2214 cases of tibial plateau fracture treated by open reduction and internal fixation and 219 cases of surgical site infection were included in this meta-analysis. The following parameters were identified as significant risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture (p operative time (OR 2.15; 95% CI 1.53-3.02), tobacco use (OR 2.13; 95% CI 1.13-3.99), and external fixation (OR 2.07; 95% CI 1.05-4.09). Other factors, including male sex, were not identified as risk factors for surgical site infection. Patients with the abovementioned medical conditions are at risk of surgical site infection after open reduction and internal fixation of tibial plateau fracture. Surgeons should be cognizant of these risks and give relevant preoperative advice. Copyright © 2017. Published by Elsevier Ltd.

  20. The biomechanical evaluation of polyester as a tension band for the internal fixation of patellar fractures.

    LENUS (Irish Health Repository)

    McGreal, G

    2012-02-03

    We use a braided polyester suture in place of cerclage wire in tension band fixations. The objective of this study was to test the biomechanical properties of this technique. Sixteen cadaveric patellae were fractured and repaired by modified tension band fixation. Eight were fixed using eighteen gauge stainless steel wire as a tension band and eight using braided polyester. All specimens were subjected to tensile testing. Polyester was 75.0% as strong as wire. For dynamic testing, the patellae of seven cadaveric knees were fractured and then fixed with polyester tension bands. These were mounted in a device capable of extending the knees from 90 degrees to neutral against an applied force. None of the fixations failed. Three of the specimens fixed using 18 gauge stainless steel wire were compared with three fixed using polyester over 2000 cycles of knee flexion and extension. Polyester performed as well as wire. We conclude that polyester is an acceptable alternative to wire in tension band fixation.

  1. Comparative study on three surgical techniques for intra-articular calcaneal fractures: open reduction with internal fixation using a plate, external fixation and minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Missa Takasaka

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate, compare and identify the surgical technique with best results for treating intra-articular calcaneal fractures, taking into account postoperative outcomes, complications and scoring in the Aofas questionnaire. METHODS: This was a retrospective study on 54 patients with fractures of the calcaneus who underwent surgery between 2002 and 2012 by means of the following techniques: (1 open reduction with extended L-shaped lateral incision and fixation with double-H plate of 3.5 mm; (2 open reduction with minimal incision lateral approach and percutaneous fixation with wires and screws; and (3 open reduction with minimal incision lateral approach and fixation with adjustable monoplanar external fixator. RESULTS: Patients treated using a lateral approach, with fixation using a plate had a mean Aofas score of 76 points; those treated through a minimal incision lateral approach with screw and wire fixation had a mean score of 71 points; and those treated through a minimal incision lateral approach with an external fixator had a mean score of 75 points. The three surgical techniques were shown to be effective for treating intra-articular calcaneal fractures, without any evidence that any of the techniques being superior. CONCLUSION: Intra-articular calcaneal fractures are complex and their treatment should be individualized based on patient characteristics, type of fracture and the surgeon's experience with the surgical technique chosen.

  2. Evaluation of Outcomes of Open Reduction and Internal Fixation Surgery in Patients with Type C Distal Humeral Fractures

    Directory of Open Access Journals (Sweden)

    Mohammadhadi Nouraei

    2018-01-01

    Full Text Available Background: In this study, functional state of patients with Type C distal humerus fractures undergone surgical plating was evaluated 6 and 12 months after the surgery in order to record postsurgical factors such as pain level and job/performance satisfaction. Materials and Methods: In this cross-sectional study, 46 patients with humerus fractures were recruited and their ability to do daily tasks, presence of degenerative changes, stability of elbow joint, and range of motion was evaluated. For assessment of response to surgery, Mayo score was used. Results: Among 46 patients, 45 (97.8% of them had joint stability. Evaluation of postsurgical complications showed that six subjects (13% had no complications, but superficial infection was observed in 12 (26.1% subjects. Neuromuscular disorders in ulnar nerve were present in 11 subjects (23.9%, recurrent articular bursitis of elbow joint in 6 subjects (13%, stiffness of elbow joint in 29 subjects (63%, nonunion of fracture in 3 subjects (6.5%, and myositis ossification in 4 (8.7% subjects. Furthermore, 18 (39.1% patients presented with more than one (2–4 complications. Conclusion: Open reduction and internal fixation surgery with dual plating is the method of choice for treatment of Type C distal humeral fractures. Evaluation of long-term outcomes of this surgery could be done via several different questionnaires as many studies suggest. This study demonstrated that the outcomes of this surgery in Isfahan, Iran, have been noticeably inferior compared to results of the studies in other parts of the world.

  3. Continuous lumbar plexus block for acute postoperative pain management after open reduction and internal fixation of acetabular fractures.

    Science.gov (United States)

    Chelly, Jacques E; Casati, Andrea; Al-Samsam, Tameem; Coupe, Kevin; Criswell, Allen; Tucker, Jeffery

    2003-05-01

    To assess the efficacy of postoperative continuous lumbar plexus blocks for postoperative pain control in patients undergoing open reduction and internal fixation of an acetabular fracture. Twenty-six patients who underwent open reduction and internal fixation of an acetabular fracture. DESIGN/PERSPECTIVE: According to a case-control study design, patients were divided into 2 groups: Group 1 (n = 13) received postoperatively a continuous lumbar plexus block with 0.2% ropivacaine (10 mL/hr for 48 hours), and group 2 (n = 13) received postoperatively patient-controlled analgesia with morphine (1 mg; lock-out time, 10 minutes; total 6 mg/hr). Postoperative morphine consumption, time to unassisted ambulation, and clinical and radiographic outcomes. No significant differences in demographics, surgical procedure, or duration of surgery were reported between the two groups. The lumbar plexus catheter group showed a lower requirement for morphine in the postanesthesia care unit (6 mg [0-14 mg]) and during the first 2 days (20 mg [6-55 mg] on day 1 and 29 mg [4-56 mg] on day 2) than the control group (51 mg [20-100 mg] on day 1 and 50 mg [10-93 mg] on day 2) (P = 0.001 and P = 0.021). Effective unassisted ambulation was recovered earlier in patients with the lumbar plexus catheter (3 days; range 2-4 days) than in the control group (4 days; range 3-7 days) (P = 0.015). Continuous lumbar plexus block represents an interesting alternative for postoperative pain control in patients undergoing open reduction and internal fixation of an acetabular fracture.

  4. A randomised prospective study of two different combined internal and external fixation techniques for distal tibia shaft fractures.

    Science.gov (United States)

    Sun, Liao-Jun; Yu, Xian-Bin; Dai, Cheng-Qian; Hu, Wei; Guo, Xiao-Shan; Chen, Hua

    2014-12-01

    External fixation combined with limited open reduction and internal fixation (EF + LORIF) is a well-accepted and effective method for distal tibia shaft fractures, but it was also related to complications. The objective of this study was to compare external fixation combined with closed reduction and internal fixation (EF + CRIF) with EF + LORIF in the treatment of distal tibia shaft fractures, and explore the benefits and defects of these two techniques. Fifty-six patients were randomised to operative stabilisation either by an external fixator combined with two closed titanium elastic nails or by external fixation combined with limited open reduction and internal fixation. Pre-operative variables included the patients’ age, sex, the affected side, cause of injury, Tscherne classification of soft tissue injury, fracture pattern, and time from injury to surgery. Peri-operative variables were the operating time and the radiation time. Postoperative variables were wound problems and other complications, union time, time of recovery to work, the functional American Orthopaedic Foot and Ankle surgery (AOFAS) score. There was no significant difference in the mean operating time (72.6 ± 11.5 vs. 78.5 ± 16.4 min, P = 0.125), the time to union (21.2 ± 11.0 vs. 22.5 ± 12.3 weeks, P = 0.678), the time of recovery to work (25.0 ± 14.5 vs. 26.4 ± 13.6 weeks, P = 0.711), pin track infection (3/28 vs. 4/28, P = 1.000), delayed union (2/28 vs. 3/28, P = 1.000), pain (38.3 ± 1.6 vs. 38.7 ± 1.5, P = 0.339), function (44.4 ± 6.0 vs. 45.0 ± 5.5, P = 0.698), and total AOFAS scores (91.5 ± 7.4 vs. 93.4 ± 6.8, P = 0.322) between the two groups. However, the mean radiation time was longer in the EF + CRIF group than in the EF + LORIF group (2.0 ± 1.2 vs. 0.3 ± 0.1 min, P alignment was obtained in 50 patients (22 in EF + CRIF vs. 28 in EF + LORIF, P = 0.023). Two cases with EF + CRIF had a 6 degrees of recurvatum deformity and four had 6–9 degrees of valgus deformity

  5. Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment

    DEFF Research Database (Denmark)

    Niemeyer, Philipp; Schmal, Hagen; Hauschild, Oliver

    2010-01-01

    PURPOSE: Our purpose was to evaluate the 3-year clinical results of patients with medial-compartment osteoarthritis of the knee and varus malalignment who underwent open-wedge high tibial osteotomy (HTO) with an internal plate fixator (TomoFix; Synthes, Solothurn, Switzerland). Clinical results...... of patients reported discomfort related to the implant at some point during the follow-up period (40.6%). CONCLUSIONS: Open-wedge osteotomy by use of the TomoFix system leads to reliable 3-year results. Results do not depend on the severity of medial cartilage defects, whereas partial-thickness defects...

  6. Posterior Decompression, Lumber Interbody Fusion and Internal Fixation in the Treatment of Upper Lumbar Intervertebral Disc Herniation

    Directory of Open Access Journals (Sweden)

    DONG Zhan

    2014-12-01

    Full Text Available Objective: To assess the clinical outcomes of posterior decompression, interbody fusion and internal fixationfor the treatment of the upper lumbar intervertebral disc herniation. Methods: Twelve patients with the upper lumbar intervertebral disc herniation were treated by posterior decompression, interbosy fusion and internal fixation. The time of the operation, the amount of bleeding and the clinical efficacy were evaluated. Results: The time of operation was (143±36 min and the amount of bleeding during operation was (331.5±47.9 mL. There was no spinal cord and injuries, nerve injury, epidural damage and leakage of cerebrospinal fluid. All patients were followed up for 10~19 months with the average being 12.6 months. The functional scoring of Japanese Orthopedic Association (JOA before the operation was (11.4±3.3 scores and final score after follow-up was (22.9±3.1 scores and there were statistical difference (P<0.01. Lumber interbody fusion of all patients completed successfully and the good rate after the operation was 91.7%. Conclusion: Posterior decompression, interbody fusion and internal fixation for the treatment of the upper lumbar intervertebral disc herniation was characterized by full exposure, safety and significant efficacy.

  7. Evaluation of the trauma and bone metabolism after internal absorbable screw and metal screw fixation treatment of tibia-fibula fracture

    Directory of Open Access Journals (Sweden)

    Guang-Bin Yuan

    2017-03-01

    Full Text Available Objective: To study the trauma and bone metabolism after internal absorbable screw and metal screw fixation treatment of tibia-fibula fracture. Methods: 78 patients with tibia-fibula fracture who received internal fixation surgery in our hospital between May 2013 and October 2015 were selected and randomly divided into absorbable group and metal group (n=39 who accepted internal absorbable screw fixation and internal metal screw fixation respectively. 3 d after operation, serum was collected to determine the levels of inflammatory factors, pain mediators, stress hormones and bone metabolism indexes. Results: Serum inflammatory mediators procalcitonin (PCT, Resistin, C-reactive protein (CRP, interleukin-6 (IL-6, and tumor necrosis factor-α (TNF-α, pain mediators substance P (SP, prostaglandin E2 (PGE2 and NPY, stress hormones norepinephrine (NE, epinephrine (E and cortisol (Cor as well as bone resorption marker molecules C-terminal telopeptides of type I collagen (CTX-I and C-terminal telopeptides of type II collagen (CTX-II levels of absorbable group were significantly lower than those of metal group (P<0.05 while bone formation marker molecules N-MID osteocalcin (N-MID and N-terminal propeptide of procollagen type I (PINP levels were significantly higher than those of metal group (P<0.05. Conclusions: The trauma degree of internal absorbable screw fixation treatment of tibia-fibula fracture is weaker than that of internal metal screw fixation, and the bone metabolism activity is better than that of internal metal screw fixation.

  8. Surgical site infection after open reduction and internal fixation of tibial plateau fractures.

    Science.gov (United States)

    Lin, Shishui; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2014-07-01

    The aim of this study was to identify risk factors for surgical site infections and to quantify the contribution of independent risk factors to the probability of developing infection after definitive fixation of tibial plateau fractures in adult patients. A retrospective analysis was performed at a level I trauma center between January 2004 and December 2010. Data were collected from a review of the patient's electronic medical records. A total of 251 consecutive patients (256 cases) were divided into two groups, those with surgical site infections and those without surgical site infections. Preoperative and perioperative variables were compared between these groups, and risk factors were determined by univariate analyses and multivariate logistic regression. Variables analyzed included age, gender, smoking history, diabetes, presence of an open fracture, presence of compartment syndrome, Schatzker classification, polytrauma status, ICU stay, time from injury to surgery, use of temporary external fixation, surgical approach, surgical fixation, operative time, and use of a drain. The overall rate of surgical site infection after ORIF of tibial plateau fractures during the 7 years of this study was 7.8% (20 of 256). The most common causative pathogens was Staphylococcus aureus (n=15, 75%). Independent predictors of surgical site infection identified by multivariate analyses were open tibial plateau fracture (odds ratio=3.9; 95% CI=1.3-11.6; p=0.015) and operative time (odds ratio=2.7; 95% CI=1.6-4.4; psite infection. Both open fracture and operative time are independent risks factors for postoperative infection.

  9. Development of biodegradable polycaprolactone film as an internal fixation material to enhance tendon repair: an in vitro study.

    Science.gov (United States)

    Hu, Jian-Zhong; Zhou, Yong-Chun; Huang, Li-Hua; Lu, Hong-Bin

    2013-08-19

    Current tendon repair techniques do not provide sufficient tensile strength at the repair site, and thus early active motion rehabilitation after tendon repair is discouraged. To enhance the post-operative tensile strength, we proposed and tested an internal fixation technique using a polycaprolactone (PCL) biofilm. PCL was chosen for its good biocompatibility, excellent mechanical strength, and an appropriate degradation time scale. PCL biofilms were prepared by a modified melt-molding/leaching technique, and the physical and mechanical properties and in vitro degradation rate were assessed. The pore size distribution of the biofilm and the paratenon of native tendons were observed using scanning electron microscopy. Next, we determined whether this biofilm could enhance the tensile strength of repaired tendons. We performed tensile tests on rabbit Achilles tendons that were first lacerated and then repaired: 1) using modified Kessler suture combined with running peripheral suture ('control' group), or 2) using biofilm to wrap the tendon and then fixation with sutures ('biofilm' group). The influence of different repair techniques on tendon tensile strength was evaluated by mechanical testing. The novel biofilm had supple texture and a smooth surface. The mean thickness of the biofilm was 0.25 mm. The mean porosity of the biofilm was 45.3%. The paratenon of the rabbit Achilles tendon had pores with diameters ranging from 1 to 9 μm, which were similar to the 4-12 μm diameter pores in the biofilm cross-section. The weight loss of the biofilms at 4 weeks was only 0.07%. The molecular weight of PCL biofilms did not change after immersion in phosphate buffered saline for 4 weeks. The failure loads of the biofilm were similar before (48 ± 9 N) and after immersion (47 ± 7 N, P > 0.1). The biofilm group had ~70% higher mean failure loads and 93% higher stiffness compared with the control group. We proposed and tested an internal fixation technique

  10. FUNCTIONAL OUTCOME OF SUPRACONDYLAR FRACTURES OF FEMUR MANAGED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Madhusudhana

    2015-10-01

    Full Text Available INTRODUCTION : Incidence of distal femur fractures is approximately 37 per 1 , 00,000 person - years.¹Distal femoral fractures has two different injury mechanisms, high energy trauma and low energy trauma. In high - energy trauma, the problem of restoring the function in a destroyed knee joint persists. Complex knee ligament injuries frequently occur additionally to extensive cartilage injuries. In elderly patients, extreme osteoporosis represents a particular problem for anchoring the implant. 2 Supracondylar and inter condylar fractures often are unstable and comminuted and tend to occur in the elderly or those with multiple injuries. Treatment options are many with varied results. The final outcome would depend upon the type of fracture, stabilization of fixation and and perhaps patient general condition. 3 The options for operative treatment are traditional plating techniques that require compression of the implant to the femoral shaft (blade plate, Dynamic Condylar Screw, non - locking condylar buttress plate, antegrade nailing fixation, retrograde nailing, sub muscular locked internal fixation and external fixation. 4 However, as the complexity of fractures needing treatment has changed from simple extra - articular supra - condylar types to inter - condylar and metaphyseal comminuted types, these implants may not be ideal. Double plating, and more recently, locked plating techniques have been advocated 5 . However with double plating there is often extensive soft tissue stripping on both sides of the femur, resulting in reduced blood supply and potential non - union and failure of the implants 6 . The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw - bone interfaces rather than a single screw’s axial stiffness or pullout resistance as seen in unlocked plates 7,8 . Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilization

  11. Open Reduction and Internal Fixation of displaced Supracondylar Fractures of Humerus with Crossed K-wires via Medial Approach

    Directory of Open Access Journals (Sweden)

    S Hussain

    2014-07-01

    Full Text Available This study aimed at evaluating the medial approach for open reduction and internal fixation of Gartland type 3 displaced supracondylar fractures of humerus in children. A prospective, single centre study of on displaced supracondylar humerus fractures in 42 children was carried out at our institute. All fractures were managed with open reduction and internal fixation with crossed K-wires via medial approach. The mean follow-up was 12 months and patients were assessed according to Flynn’s criteria. No patients had post-operative ulnar nerve injury. Cubitus varus was not seen in any patient. Superficial pin tract infection occurred in three patients that subsided with anti-septic dressings and antibiotics. No deep infection occurred. 88.09 % patients showed satisfactory results as per Flynn’s criteria. The medial approach provides an excellent view of the supracondylar area. The approach is convenient due to a lower risk for ulnar nerve injury and better acceptability of the medial incisional scar.

  12. [Case control study on therapeutic effects of dynamic external fixtor combined with limited internal fixation and cross K-wires fixation for the treatment of Pilon fractures of the proximal interphalangeal joint].

    Science.gov (United States)

    Miao, Dao-yi; Yang, Guo-jing; Zhang, Ling-zhou; Wu, Jian-wei

    2015-10-01

    To compare the clinical effects and safety of dynamic external fixtor combined with limited internal fixation and cross K-wires fixation for the treatment of close Pilon fractures of the proximal interphalangeal joint. From June 2012 to June 2014, totally 41 patients (45 fingers) with close interphalangeal joint Pilon fracture were treated by dynamic external fixtor combined with limited internal fixation or cross K-wires fixation, and all the patients were followed up. In the dynamic external fixtor combined with limited internal fixation group (group A), there were 21 patients with 22 fingers, including 12 males and 9 females, with an average of (30.6±5.6) years old. In the cross K-wires fixation group (group B), there were 20 patients with 23 fingers, including 11 males and 9 females, with an average of (30.1±5.3) years old. Regular re-examination of X-ray was performed to evaluate the active range of joint motion, fracture healing time, infection rate and postoperative joint motion pain. According to the evaluation criteria of upper extremity function issued by the Hand Surgery Society of Chinese Medical Association, the excellent and good cases of group A was up to 19 and 13 for group B. The evaluation results has significant differences (Z=2.558, P=0.011). The excellent and good rate of group A was obviously higher than that of group B. The average bone union time of group A was (7.9±2.1) weeks, and (8.1±2.3) weeks for group B. There was no significant difference on the mean healing time (t=-0.304, P=0.762). The infection fingers of group A was 5, and 1 for group B. The difference between the results was statistically significant (χ2=3.287, Pexternal fixtor combined with limited internal fixation is a reliable and effective method to treat Pilon fractures of the proximal interphalangeal joint. It allows early postoperative functional rehabilitation and restores the joint function.

  13. International Entrepreneurship Theory: Past, Present and Way Forward

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    Ikemefuna Allen

    2016-12-01

    Full Text Available Objective: This paper recounts the historical development of International Entrepreneurship as a study field, and demonstrates how concepts brought forth contribute to a broader understanding of fundamental international business and entrepreneurship theories. Research Design & Methods: The analytical work makes reference to the existing literature on International Entrepreneurship. Based on the categorisation of themes and sub-themes, the historical development of international entrepreneurship theory is recounted, creating a foundation for the assessment of its relationships and linkages with international business and entrepreneurship theories. Findings: The findings indicate that International Entrepreneurship is still in a developmental stage. However, the field is rich with novel ideas and concepts that can give an impetus to researchers as they strive to explore themes such as international entrepreneurial orientation and entrepreneurial internationalization. Implications & Recommendations: The lack of theoretical foundation presents challenges to researchers. Research must be directed at answering the fundamental questions that distinguish International Entrepreneurship from the two related, but more established fields; international business and entrepreneurship. Contribution & Value Added: The paper provides a point of reference for scholars that want to attain a comprehensive insight into the state of international entrepreneurial research, and distinctions from, and relevance to the fields of international business and entrepreneurship.

  14. The anterior subcutaneous internal fixator (ASIF) for unstable pelvic ring fractures: clinical and radiological mid-term results.

    Science.gov (United States)

    Müller, Franz Josef; Stosiek, Wolfgang; Zellner, Michael; Neugebauer, Rainer; Füchtmeier, Bernd

    2013-11-01

    The purpose of this study was to determine the outcome of unstable type C pelvic fractures treated with posterior stabilisation and the anterior subcutaneous internal fixator (ASIF). Altogether, 36 consecutive patients were treated for unstable type C pelvic ring fractures using posterior stabilisation and ASIF. After a minimum of 18 months, the clinical and radiological outcome was retrospectively investigated. Overall, three patients (8.3%) died, and 31 patients (86%) were available for follow-up after a mean of 4.5 years. Thirty of 31 patients (97%) showed radiographic bone consolidation of both the posterior and anterior pelvic ring. Only one non-union and two infections due to the anterior device were observed. The total German pelvic outcome score showed an excellent or good rating for 64.5% of the patients, and a fair or poor for 35.5%. The SF-12 questionnaire showed a significantly reduced total score for physical and mental health compared to a general reference population. The ASIF represents an innovative surgical procedure for the treatment of type C pelvic ring fractures. In the medium term, patient satisfaction was high and the complication rate was low, despite the small number of patients. More cases must be investigated before the procedure can be recommended in general, possibly replacing the external fixator for the treatment of pelvic ring fractures in the future.

  15. Open reduction and internal fixation aided by intraoperative 3-dimensional imaging improved the articular reduction in 72 displaced acetabular fractures

    Science.gov (United States)

    Eckardt, Henrik; Lind, Dennis; Toendevold, Erik

    2015-01-01

    Background and purpose — During acetabular fracture surgery, the acetabular roof is difficult to visualize with 2-dimensional fluoroscopic views. We assessed whether intraoperative 3-dimensional (3D) imaging can aid the surgeon to achieve better articular reduction and improve implant fixation. Patients and methods — We operated on 72 acetabular fractures using intraoperative 3D imaging and compared the operative results, duration of surgery, and complications with those for 42 consecutive acetabular fracture operations conducted using conventional fluoroscopic imaging. Postoperative reduction was evaluated on reconstructed coronal and sagittal images of the acetabulum. Results — The fracture severity and patient characteristics were similar in the 2 groups. In the 3D group, 46 of 72 patients (0.6) had a perfect result after open reduction and internal fixation, and in the control group, 17 of 42 (0.4) had a perfect result. The mean difference in postoperative articular incongruity was 0.5 mm (95% CI: 0.4–0.7). In 29 of 72 operations, the intraoperative 3D scans led to intraoperative correction of the reduction and an improved result. The duration of surgery and infection rate were similar in the 2 groups. Interpretation — Intraoperative 3D imaging, which is not time-consuming, allowed the surgeon to correct malreductions and screw placement in 29 of 72 operations, leading to better articular reduction and more precise screw placement than in operations where conventional fluoroscopic imaging was used to control the reduction. PMID:26012545

  16. Recently released EIA report presents international forecasting data

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This report presents information from the Energy Information Administration (EIA). Articles are included on international energy forecasting data, data on the use of home appliances, gasoline prices, household energy use, and EIA information products and dissemination avenues.

  17. Clinical efficacy of open reduction and semirigid internal fixation in management of displaced pediatric mandibular fractures: A series of 10 cases and surgical guidelines

    Directory of Open Access Journals (Sweden)

    Samir Joshi

    2015-01-01

    Full Text Available Aim: To evaluate the efficacy of open reduction and semirigid internal fixation in the management of displaced pediatric mandibular fractures. Method: Ten patients with displaced mandibular fractures treated with 1.5 mm four holed titanium mini-plate and 4 mm screws which were removed within four month after surgery. Results: All cases showed satisfactory bone healing without any growth disturbance. Conclusion: Open reduction and rigid internal fixation (ORIF with 1.5 mm titanium mini- plates and 4 mm screws is a reliable and safe method in treatment of displaced paediatric mandibular fractures.

  18. Percutaneous internal fixation of proximal fifth metatarsal jones fractures (Zones II and III) with Charlotte Carolina screw and bone marrow aspirate concentrate: an outcome study in athletes.

    Science.gov (United States)

    Murawski, Christopher D; Kennedy, John G

    2011-06-01

    Internal fixation is a popular first-line treatment method for proximal fifth metatarsal Jones fractures in athletes; however, nonunions and screw breakage can occur, in part because of nonspecific fixation hardware and poor blood supply. To report the results from 26 patients who underwent percutaneous internal fixation with a specialized screw system of a proximal fifth metatarsal Jones fracture (zones II and III) and bone marrow aspirate concentrate. Case series; Level of evidence, 4. Percutaneous internal fixation for a proximal fifth metatarsal Jones fracture (zones II and III) was performed on 26 athletic patients (mean age, 27.47 years; range, 18-47). All patients were competing at some level of sport and were assessed preoperatively and postoperatively using the Foot and Ankle Outcome Score and SF-12 outcome scores. The mean follow-up time was 20.62 months (range, 12-28). Of the 26 fractures, 17 were traditional zone II Jones fractures, and the remaining 9 were zone III proximal diaphyseal fractures. The mean Foot and Ankle Outcome Score significantly increased, from 51.15 points preoperatively (range, 14-69) to 90.91 at final follow-up (range, 71-100; P fixation of proximal fifth metatarsal Jones fractures, with a Charlotte Carolina screw and bone marrow aspirate concentrate, provides more predictable results while permitting athletes a return to sport at their previous levels of competition, with few complications.

  19. A biomechanical experiment and clinical study of the use of figure of eight plus circular wiring fixation for the treatment of olecranon fractures

    OpenAIRE

    WANG, WULIAN; WU, GUANGWEN; SHEN, FUER; ZHANG, YIYUAN; LIU, XIANXIANG

    2012-01-01

    The aim of the present study was to evaluate the stability of the figure of eight plus circular wiring fixation technique compared with four common internal fixation techniques and to provide experimental data for the selection of internal fixation techniques clinically. A total of 20 fresh cadaveric elbow joints were used as transverse, oblique and comminuted olecranon fracture models. Five techniques of internal fixation were investigated: circular wiring, figure of eight wiring, circular p...

  20. Percutaneous internal fixation with Y-STRUT® device to prevent both osteoporotic and pathological hip fractures: a prospective pilot study.

    Science.gov (United States)

    Cornelis, François H; Tselikas, Lambros; Carteret, Thibault; Lapuyade, Bruno; De Baere, Thierry; Le Huec, Jean Charles; Deschamps, Frédéric

    2017-02-09

    We studied Y-STRUT® (Hyprevention, France), a new percutaneous internal fixation device, in combination with bone cementoplasty to prevent hip fracture. Between February 2013 and February 2015, a total of 16 femoral necks in 4 osteoporotic and 12 oncologic patients have been considered for prophylactic consolidation in this prospective multicentre pilot study involving 4 different hospitals. These consolidations were performed percutaneously under fluoroscopic guidance using Y-STRUT®, a dedicated internal fixation device. For osteoporotic patients, orthopaedic surgeons performed the prophylactic consolidations immediately after surgical treatment of a hip fracture (same anaesthesia) in the opposite side. For oncologic patients, without current hip fracture but considered at risk (Mirels score ≥8), interventional radiologists performed the procedures. We report the preliminary results of feasibility, safety and tolerance of these preventive consolidations using Y-STRUT®. Four patients (mean 83 years old) had prophylactic consolidation because of a severe osteoporosis (mean T-score -3.30) resulting in first hip fractures. Ten patients (mean 61 years old) were treated because of impending pathological fractures (mean Mirels score 9) related to femoral neck osteolytic metastases. All the procedures were performed with success. Wound healing was achieved in all cases with no access site complication. Radiographic exams performed at 3 months follow-up revealed that Y-STRUT® was well integrated in the bone. For the osteoporotic cohort, mean pain was 0.9 ± 0.7 at 3 weeks. For the oncologic cohort, it decreases from 3.6 ± 2.9 at baseline to 2.4 ± 0.9 at 2 months. Preliminary results demonstrate the feasibility and safety of Y-STRUT® implantation as well as the tolerance of the device.

  1. Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury

    Directory of Open Access Journals (Sweden)

    Li Baoliang

    2015-07-01

    Full Text Available Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years. Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases, fall from height (5 cases and hit by heavy object (2 cases. All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6e10 days (average 6.6 days. Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS and American Orthopaedic Foot and Ankle Society (AOFAS Scales. Healing time and complications were observed. Results: All patients were followed up for 18e24 months (average 20 months. Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (7.89 ± 0.34 and score at postoperative 8 weeks (0.67 ± 0.13. According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Conclusion: Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.

  2. Internal fixation versus conservative treatment for elderly patients with a trochanteric hip fracture in conjunction with post-stroke hemiplegia.

    Science.gov (United States)

    Li, Kainan; Zheng, Yingjie

    2016-10-01

    To retrospectively evaluated Gamma nail internal fixation in the treatment of elderly patients with post-stroke hemiplegia experiencing trochanteric hip fracture. The patients were obtained consecutively from January 2005 to December 2010 with inclusion criteria. The total number was 138 and allocated to two groups: treated with the Gamma nail (n=72,group A) and continuous skin traction (n=66,group B). Preoperative variables including patient age, gender, duration of cerebrovascular accident, duration of hypertension, ASA risk score, Harris hip score and fracture type were recorded and compared. After treatment, time of patients activity on the bed, ambulation time, Harris hip score, mortality, complications were recorded and used to compare the outcomes. (1) Follow-up was undertaken from 3 to 10 years, with an average of 5.8 years. (2) No statistical difference in preoperative variables was found between the 2 groups. (3) two groups had statistical significance (P=0.000) in the time of patients activity on the bed and ambulation time and group A can activities on the bed and ambulates earlier. (4) There were significant differences between 2 groups in Harris hip score at 1 and 3 years and group A was significantly higher than group B. (5) there were statistically significant differences in mortality of 3 years, 5 years and 10 years and the group B was significantly higher than the group A. (6) There was a statistical significance in complications between 2 groups and group B was higher than group A. Major complications in group A were pain, lag screw cut out, implant infection and distal femoral fractures caused by fall after the surgery. On elderly patients with trochanteric hip fracture on the hemiplegic lower side, Gamma nail internal fixation treatment can achieve better effect, patients can be early activity, fewer complications, and less mortality. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury.

    Science.gov (United States)

    Li, Bao-Liang; Zhao, Wen-Bo; Liu, Lei; Huang, Fu-Guo; Wang, Guang-Lin; Fang, Yue

    2015-01-01

    To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years). Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases), fall from height (5 cases) and hit by heavy object (2 cases). All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6-10 days (average 6.6 days). Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Scales. Healing time and complications were observed. All patients were followed up for 18-24 months (average 20 months). Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (7.89 ± 0.34) and score at postoperative 8 weeks (0.67 ± 0.13). According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.

  4. The treatment of intra-articular calcaneus fractures with severe soft tissue damage with a hinged external fixator or internal stabilization: long-term results.

    Science.gov (United States)

    Besch, Lutz; Waldschmidt, Jan Soeren; Daniels-Wredenhagen, Mark; Varoga, Deike; Mueller, Michael; Hilgert, Ralf-Erik; Mathiak, Guenther; Oestern, Stefanie; Lippross, Sebastian; Seekamp, Andreas

    2010-01-01

    We developed a hinged external fixator for the treatment of dislocated intra-articular calcaneus fractures with severe soft tissue damage. The external fixation was performed with a known external fixator system. The screw insertion points were biomechanically tested by defining a virtual rotation axis through the center of the talus to allow early active motion in the ankle joint. Long-term follow-up was performed after an average of 7.3 years. Results were graded with the American Orthopaedic Foot and Ankle Society (AOFAS) score. Radiographs were reviewed according to Sanders classification. Four open fractures and 33 cases with extremely swollen soft tissue, blisters, or compartment syndromes were treated. In 24 cases (64.9%), the hinged fixator was the final method of treatment (group I). A change to open reduction with internal fixation was performed in 13 fractures (35.1%) when soft tissue problems were minimal (group II). There were no late amputations, osteomyelitis, or malunions. According to Sanders classification, group I consisted of 14 type II, 8 type III, and 2 type IV fractures. Pin loosening or pin infection was seen in 4 cases, but there was no redislocation. The Böhler's angle improved in 43%, gaps in the posterior facet were closed in 41%, and any shortening or deviation of the axis was corrected in 82% of the cases. The AOFAS score for the group averaged 66.5. According to Sanders classification, group II consisted of 8 type II and 5 type III fractures. The Böhler's angle improved in 88%, and gaps in the posterior facet were closed in 87%. Any shortening or deviation of the axis was corrected in 95%, and the AOFAS score averaged 61.3. Significant differences in patient outcome scores between open reduction with internal fixation and hinged fixator were not found. P value was > .05. The hinged external fixator frame can be used in all calcaneus fracture types without soft tissue limitation. The hinged fixator allows early movement in the ankle

  5. Pitfalls associated with open reduction and internal fixation of fractured ribs.

    Science.gov (United States)

    Sarani, Babak; Schulte, Leah; Diaz, Jose J

    2015-12-01

    Rib fracture is exceedingly common and remains a leading cause of death in patients with chest injury. Probability of death increases by 19% with each broken rib, and the probability of death increases further with age. Treatment is centered on pain control and early mobilization to provide adequate pulmonary hygiene. Multimodality interventions, such as incentive spirometry, postural changes, and coughing, are pivotal in minimizing the risk of pneumonia and death. Recently, many studies have found mortality benefit to operation fixation (ORIF) of ribs in select patients. However, this procedure remains underutilized partly due to lack of familiarity with its technique and pitfalls by trauma surgeons, in particular. Whereas there are publications on operative technique, there are no studies describing pitfalls associated with this procedure. The purpose of this paper is to describe pitfalls on the technical aspects of ORIF of the ribs based on the medical literature where possible and based on our experience in instances where peer reviewed evidence is lacking. The paper is not meant to serve as a protocol for managing rib fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. DEGRADATION OF AND TISSUE REACTION TO BIODEGRADABLE POLY(L-LACTIDE) FOR USE AS INTERNAL-FIXATION OF FRACTURES - A STUDY IN RATS

    NARCIS (Netherlands)

    BOS, RRM; ROZEMA, FR; BOERING, G; NIJENHUIS, AJ; PENNINGS, AJ; NIEUWENHUIS, P; JANSEN, HWB; Verweij, A.B.

    Samples of high-molecular-weight poly (L-lactide) (PLLA) (MBAR(v) = 9.0 x 10(5)), a biomaterial developed for plates and screws used in internal fixation of jaw fractures, were implanted subcutaneously in the backs of rats to study tissue reaction to PLLA and to follow the degradation process. The

  7. Effects of three-dimensional navigation on intraoperative management and early postoperative outcome after open reduction and internal fixation of displaced acetabular fractures

    DEFF Research Database (Denmark)

    Oberst, Michael; Hauschild, Oliver; Konstantinidis, Lukas

    2012-01-01

    BACKGROUND: This study was conducted to evaluate whether intraoperative procedure and/or early postoperative results after open reduction and internal fixation (ORIF) of displaced acetabulum fractures are influenced by the use of a three-dimensional (3D) image intensifier in combination with a na...

  8. Internal fixation of mandibular angle fractures using one miniplate in Greek children: a 5-year retrospective study.

    Science.gov (United States)

    Iatrou, Ioannis; Theologie-Lygidakis, Nadia; Tzermpos, Fotios; Kamperos, Georgios

    2015-01-01

    Treatment modalities of mandibular angle fractures (MAFs) have been analyzed in several studies mainly referring to adult populations. The aim of this study was to retrospectively present and discuss our experience and literature findings regarding the treatment of MAFs in children. Data were retrieved from the files of the Oral and Maxillofacial department, at the Children's Hospital ''P. & A. Kyriakou'' of Athens, during a 5 years period (2009-2013). Demographic features, treatment methods, outcome and follow-up of all patients with mandibular angle fractures were recorded. 6 boys, 5-14 years old (mean age 10 years), were included in the study. They were all treated intraorally with open reduction and fixation via one monocortical titanium plate osteosynthesis at the external oblique line of the mandible, followed by 1 week of intermaxillary fixation (IMF). Plates were removed 3-12 months post-operatively. Follow-up period ranged from 12 to 18 months (mean 14.7 months). All fractures healed uneventfully and the patients tolerated well both the operation and the post-operative period. Osteosynthesis via intraoral approach combined with short duration IMF is adequate in treating MAFs in children. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. CLINICAL AND FUNCTIONAL OUTCOME OF DISTAL RADIUS FRACTURES MANAGED BY LIGAMENTOTAXIS AND/OR PERCUTANEOUS PINNING VERSUS OPEN REDUCTION & INTERNAL FIXATION BY BUTTRESS PLATES

    Directory of Open Access Journals (Sweden)

    Biju

    2015-05-01

    Full Text Available INTRODUCTI ON: We studied the clinical and functional outcome of distal radius fractures managed by ligamentotaxis and/or percutaneous pinning versus open reduction & internal fixation by buttress plates. METHODS : This prospective study was conducted during Aug 2012 to October 2014. All skeletally matured patients were having both Intra articular and extra articular Closed Distal Radius fractures were studied. Treatment was done either external fixator supplemented with k wires or internal fixation with plate and screws. The radiographic evaluation included radial length, palmar tilt, any evidence of jointincongruity and radio ulnar joint instability and arthritis. The assessments that were made includes Subjective assessment – pain, numbness, weakness of hand, stiffness, OBJECTIVE : R ange of motion measured by hand held goniometer, Measurement of grip strength done by commercially available hand dynamometer. Unaffected hand served as control. RESULTS : Male patients (85.46% outnumbered female patients (14.54% in incidence. The incidence of distal ra dius fractures was common between the ages of 20 to 40 years. Left sided fractures were more common (52.73%. Type III was most common type of fracture (Frykman’s Classification, accounting for 29% of all fractures.25 cases were treated by external fixati on and 30 cases were treated by open reduction and buttress plating. The results were evaluated by using STEWART ET AL anatomical and functional scoring system. The average range of movement at the knee joint was Dorsiflexion 70*, Palmar Flexion 65*, Ulnar Deviation 25*, Radial Deviation 15*, Supination 70*, Pronation 65*. Most common early complication was pin tract infection. Based on the stewar et al scoring, 4(7.27% had excellent, 43(78.18% had good, 7(12.72% had fair, 1(1.81% had poor results. CONC LUSION : We observed that both fixations were equally same, there is no superiority with over the other. The incidence of complications in

  10. [Clinical and radiographic evaluation of open reduction and internal fixation with headless compression screws in treatment of lisfranc joint injuries].

    Science.gov (United States)

    Zhang, Hui; Min, Li; Wang, Guanglin; Liu, Lei; Fang, Yue; Tu, Chongqi

    2013-10-01

    To evaluate the clinical and radiographic outcomes of headless compression screws for Lisfranc joint injuries. A retrospective analysis was made on clinical data of 34 patients (36 feet) with Lisfranc joint injuries who underwent open reduction and internal fixation with headless compression screws between January 2006 and January 2012. There were 22 males (24 feet) and 12 females (12 feet), aged 21-73 years (mean, 38.9 years). The causes of injury included traffic accident in 16 cases (17 feet), falling from height in 11 cases (12 feet), crushing in 5 cases (5 feet), and sports in 2 cases (2 feet). Of them, there were 19 cases (20 feet) of closed injury and 15 cases (16 feet) of open injury; there were 7 cases (8 feet) of pure dislocations of tarsometatarsal joints and ligamentous Lisfranc injuries (LD), 22 cases (23 feet) of Lisfranc joint fracture dislocations (LFD), 5 cases (5 feet) of combined Chopart-LFD (CLFD). According to Myerson classification, 5 cases (5 feet) were rated as type A, 7 cases (8 feet) as type B1, 14 cases (15 feet) as type B2, 5 cases (5 feet) as type C1, and 3 cases (3 feet) as type C2. Associated fractures included 12 cases (13 feet) of metatarsal shaft fracture, 4 cases (4 feet) of cuboid fracture, 4 cases (4 feet) of navicular bone fracture, 6 cases (7 feet) of coneiform bone fracture/dislocation, 8 cases (10 feet) of ipsilateral lower limb multiple fracture, and 4 cases (4 feet) of contralateral lower limb multiple fracture. The clinical outcomes were evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) score. Postoperative X-ray films were taken to assess the reduction, internal fixation, and the foot arch height. All patients were followed up 1 year to 5 years and 2 months (mean, 3.5 years). X-ray films showed anatomical reduction in 31 cases (33 feet, 91.7%). At last follow-up, AOFAS score and VAS score averaged 80.6 (range, 60-100) and 2.3 (range, 0-6), respectively; the

  11. Present status of nuclear development in Japan and international cooperation

    International Nuclear Information System (INIS)

    Oyama, Akira

    1994-01-01

    An overview of the current status of nuclear research in Japan is presented. The importance of research and developments in the fields of nuclear fuel recycling by means of fast breeders and nuclear fusion is emphasised. Nonproliferation, nuclear disarmament and international cooperation are also promoted. 2 figs

  12. International Arctic Research Collaborations: Past, Present and Future

    Science.gov (United States)

    Kintisch, E. S.

    2015-12-01

    International cooperation on Arctic research has a long and storied history, predating even the first International Polar Year in 1881. But scientists want to improve and expand current efforts to conduct international Arctic research, despite politcal and legal barriers that can hamper it. A review of the past and present aspects of such research can inform that effort. As part of a six month fellowship at the Center for Science Diplomacy at the American Association for the Advancement of Science I studied the history and current status of international cooperation in the Arctic. I will report on my findings, which include the fact that some of the first substantial international environmental research and regulatory cooperation began in the far North. My session will identify the elements that make international research collaborations successful, for example more than a century of cooperative work by Russian and Norwegian fishery scientists to monitor and regulate the cod trade in the Barents Sea. And it will explore the challenges that can threaten such collaborations. These can include rules that stymie data collection, block the import of certain analytical equipment across national boundaries, and bar the export of soil or water samples. I will mention specific complications to recent international arctic research projects. These include the SWERUS cruise, a joint effort between Sweden, Russia and the US, an effort to study carbon fluxes over the East Siberian Arctic Shelf in 2014. The session will also review progress towards a new international agreeement, first proposed by the US, on improving arctic research cooperation. That deal is focused on removing the bureacratic and legal barriers to scientists seeking to conduct arctic research on foreign waters and land.

  13. FUNCTIONAL OUTCOME OF INTERNAL FIXATION FOR DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Saket Jati

    2016-12-01

    Full Text Available BACKGROUND There are always difference of opinion in the importance of Bohler’s angle in evaluating the severity of displaced intra-articular calcaneal fractures and predicting the functional outcome following surgical fixation. The purpose of this research, the relationship exists between Bohler’s angle and the injury severity of displaced calcaneal fractures and between surgical improvement of Bohler’s angle and its practical outcome. MATERIALS AND METHODS Patients were treated surgically for unilateral closed displaced intra-articular calcaneal fractures from May 2014 to October 2016 were identified. The Bohler’s angles of bilateral calcaneus were measured and was compared to the dimension of the uninjured foot was used as its normal control. The difference in the value of Bohler’s angle measured preoperatively or after surgery between the angle of the damaged foot and that of the contralateral calcaneus was calculated, respectively. The change in Bohler’s angle by ratio was calculated by dividing the variation in the value of Bohler’s angle between bilateral calcaneus by its typical control. The injury severity was assessed according to Sanders classification. The functional outcomes were assessed using American Orthopaedic Foot and Ankle Society hindfoot scores. RESULTS 30 patients were included into the study with a mean follow-up duration of 30 months. According to Sanders classification, the fracture pattern included 12 type II, 10 type III and 8 type IV fractures. According to American Orthopaedic Foot and Ankle Society hindfoot scoring system, the excellent, good, fair and poor results were achieved in 10, 8, 4 and 2 patients, respectively. The preoperative Bohler’s angle, difference value of Bohler’s angle between bilateral calcaneus and change in Bohler’s angle by ratio each has a significant relationship with Sanders classification (P=0.003; P=0.004; P=0.005, respectively, however, is not correlated with

  14. Open reduction and internal fixation of mandibular angle fractures: does the transbuccal technique produce fewer complications after treatment than the transoral technique?

    Science.gov (United States)

    Wan, Kenneth; Williamson, Raymond A; Gebauer, Dieter; Hird, Kathryn

    2012-11-01

    The study's purpose was to answer the following clinical question: in patients with mandibular angle fractures requiring open reduction and internal fixation, do those who have fixation screws inserted using a transbuccal approach compared with those with fixation screws inserted using a transoral approach have fewer complications after treatment? The investigators hypothesized that the transoral approach was associated with a higher risk of complications. A multicenter retrospective cohort study was performed in patients who had open reduction and internal fixation of mandibular angle fractures from 2008 to 2010 within Western Australia. Patients were divided into transbuccal and transoral groups and then further subdivided into groups with and without fixation failures (primary outcome variable) and statistically compared. Binary logistic regression was used to control for possible confounders, which included patient gender, age, a wisdom tooth within the fracture not extracted, dental caries, partial dentition, bilateral/unilateral fractures, and smoking. In total 597 patients were in the study. Sixteen percent of patients in the transoral group had complications after treatment versus 10% in the transbuccal group. For the transoral technique, the odds of having fixation failure was 1.71 times greater than with the transbuccal technique (95% confidence interval, 1.02 to 2.93; P = .04). Incidences of all complication variables (hardware loosening/fracturing, wound dehiscence, secondary infection, surgery redo, nonunion/malunion of fracture, and removal of plate) were lower in the transbuccal group apart from plate fracture. The transbuccal technique was associated with fewer complications after treatment compared with the transoral technique. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  15. [Treatment of open tile type C pelvic fractures by open reduction and internal fixation through anterior and posterior approaches at early stage].

    Science.gov (United States)

    Li, Baichuan

    2014-05-01

    To explore the effectiveness of open reduction and internal fixation through anterior and posterior approaches in treatment of open Tile type C pelvic fractures at early stage. Between January 2009 and April 2012, 12 patients with open Tile C pelvic fractures were treated. There were 7 males and 5 females, aged 6-53 years (median, 31 years). Of 12 cases, 4 were classified as Tile type C1, 6 as Tile type C2, and 2 as Tile type C3; 5 were rated as Gustilo type II and 7 as Gustilo type III. The injury severity score was 18-57 (mean, 37.2). The interval of injury and admission ranged from 15 minutes to 3 days (median, 50 minutes). The debridement and external fixation were performed at first stage; then open reduction and internal fixation were used through anterior approach (reconstruction plate) and posterior approach (cannulated lag screws). The vacuum sealing drainage was performed during treatment until the wounds healed. Delayed healing of incison was obtained in 12 cases because of wound infection. Anatomical reduction or approximate anatomical reduction was achieved in all 12 cases. The patients were followed up 3-39 months (median, 18 months). No loosening of internal fixation or fracture displacement was observed during follow-up. The fracture healing time was 7-13 weeks (mean, 9.7 weeks). At last follow-up, according to the Matta standard, the outcome was excellent in 10 cases and good in 2 cases; according to Majeed score, the results were excellent in 9 cases, good in 1, and poor in 2. Early internal fixation operation of open Tile type C pelvic fractures can effectively restore the pelvic anatomical structure and stability, reduce the complication, and achieve satisfactory effectiveness.

  16. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Nauth, A. (Aaron); Creek, A.T. (Aaron T.); Zellar, A. (Abby); Lawendy, A.-R. (Abdel-Rahman); Dowrick, A. (Adam); Gupta, A. (Ajay); Dadi, A. (Akhil); A. van Kampen (A.); Yee, A. (Albert); A.C. de Vries (Alexander); de Mol van Otterloo, A. (Alexander); Garibaldi, A. (Alisha); Liew, A. (Allen); McIntyre, A.W. (Allison W.); Prasad, A.S. (Amal Shankar); Romero, A.W. (Amanda W.); Rangan, A. (Amar); Oatt, A. (Amber); Sanghavi, A. (Amir); Foley, A.L. (Amy L.); Karlsten, A. (Anders); Dolenc, A. (Andrea); Bucknill, A. (Andrew); Chia, A. (Andrew); Evans, A. (Andrew); Gong, A. (Andrew); Schmidt, A.H. (Andrew H.); Marcantonio, A.J. (Andrew J.); Jennings, A. (Andrew); Ward, A. (Angela); Khanna, A. (Angshuman); Rai, A. (Anil); Smits, A.B. (Anke B.); Horan, A.D. (Annamarie D.); Brekke, A.C. (Anne Christine); Flynn, A. (Annette); Duraikannan, A. (Aravin); Stødle, A. (Are); van Vugt, A.B. (Arie B.); Luther, A. (Arlene); Zurcher, A.W. (Arthur W.); Jain, A. (Arvind); Amundsen, A. (Asgeir); Moaveni, A. (Ash); Carr, A. (Ashley); Sharma, A. (Ateet); Hill, A.D. (Austin D.); Trommer, A. (Axel); Rai, B.S. (B. Sachidananda); Hileman, B. (Barbara); Schreurs, B. (Bart); Verhoeven, B. (Bart); Barden, B.B. (Benjamin B.); Flatøy, B. (Bernhard); B.I. Cleffken (Berry); Bøe, B. (Berthe); Perey, B. (Bertrand); Hanusch, B.C. (Birgit C.); Weening, B. (Brad); B. Fioole (Bram); Rijbroek, B. (Bram); Crist, B.D. (Brett D.); Halliday, B. (Brett); Peterson, B. (Brett); Mullis, B. (Brian); Richardson, C.G. (C. Glen); Clark, C. (Callum); Sagebien, C.A. (Carlos A.); C. van der Pol (Carmen); Bowler, C. (Carol); Humphrey, C.A. (Catherine A.); Coady, C. (Catherine); Koppert, C.L. (Cees L.); Coles, C. (Chad); Tannoury, C. (Chadi); DePaolo, C.J. (Charles J.); Gayton, C. (Chris); Herriott, C. (Chris); Reeves, C. (Christina); Tieszer, C. (Christina); Dobb, C. (Christine); Anderson, C.G. (Christopher G.); Sage, C. (Claire); Cuento, C. (Claudine); Jones, C.B. (Clifford B.); Bosman, C.H.R. (Coks H.R.); Linehan, C. (Colleen); C.P. van der Hart (Cor P.); Henderson, C. (Corey); Lewis, C.G. (Courtland G.); Davis, C.A. (Craig A.); Donohue, C. (Craig); Mauffrey, C. (Cyril); Sundaresh, D.C. (D. C.); Farrell, D.J. (Dana J.); Whelan, D.B. (Daniel B.); Horwitz, D. (Daniel); Stinner, D. (Daniel); Viskontas, D. (Darius); Roffey, D.M. (Darren M.); Alexander, D. (David); Karges, D.E. (David E.); Hak, D. (David); Johnston, D. (David); Love, D. (David); Wright, D.M. (David M.); Zamorano, D.P. (David P.); Goetz, D.R. (David R.); Sanders, D. (David); Stephen, D. (David); Yen, D. (David); Bardana, D. (Davide); Olakkengil, D.J. (Davy J); Lawson, D. (Deanna); Maddock, D. (Deborah); Sietsema, D.L. (Debra L.); Pourmand, D. (Deeba); D. den Hartog (Dennis); Donegan, D. (Derek); D. Heels-Ansdell (Diane); Nam, D. (Diane); Inman, D. (Dominic); Boyer, D. (Dory); Li, D. (Doug); Gibula, D. (Douglas); Price, D.M. (Dustin M.); Watson, D.J. (Dylan J.); Hammerberg, E.M. (E. Mark); Tan, E.T.C.H. (Edward T.C.H.); E.J.R. de Graaf (Eelco); Vesterhus, E.B. (Elise Berg); Roper, E. (Elizabeth); Edwards, E. (Elton); E.H. Schemitsch (Emil); E.R. Hammacher (Eric); Henderson, E.R. (Eric R.); Whatley, E. (Erica); Torres, E.T. (Erick T.); Vermeulen, E.G.J. (Erik G.J.); Finn, E. (Erin); E.M.M. van Lieshout (Esther); Wai, E.K. (Eugene K.); Bannister, E.R. (Evan R.); Kile, E. (Evelyn); Theunissen, E.B.M. (Evert B.M.); Ritchie, E.D. (Ewan D.); Khan, F. (Farah); Moola, F. (Farhad); Howells, F. (Fiona); F. de Nies (Frank); F.H.W.M. van der Heijden (Frank); de Meulemeester, F.R.A.J. (Frank R.A.J.); F. Frihagen (Frede); Nilsen, F. (Fredrik); Schmidt, G.B. (G. Ben); Albers, G.H.R. (G.H. Robert); Gudger, G.K. (Garland K.); Johnson, G. (Garth); Gruen, G. (Gary); Zohman, G. (Gary); Sharma, G. (Gaurav); Wood, G. (Gavin); G.W.M. Tetteroo (Geert); Hjorthaug, G. (Geir); Jomaas, G. (Geir); Donald, G. (Geoff); Rieser, G.R. (Geoffrey Ryan); Reardon, G. (Gerald); Slobogean, G.P. (Gerard P.); G.R. Roukema (Gert); Visser, G.A. (Gijs A.); Moatshe, G. (Gilbert); Horner, G. (Gillian); Rose, G. (Glynis); Guyatt, G. (Gordon); Chuter, G. (Graham); Etherington, G. (Greg); Rocca, G.J.D. (Gregory J. Della); Ekås, G. (Guri); Dobbin, G. (Gwendolyn); Lemke, H.M. (H. Michael); Curry, H. (Hamish); H. Boxma (Han); Gissel, H. (Hannah); Kreder, H. (Hans); Kuiken, H. (Hans); H.L.F. Brom; Pape, H.-C. (Hans-Christoph); H.M. van der Vis (Harm); Bedi, H. (Harvinder); Vallier, H.A. (Heather A.); Brien, H. (Heather); Silva, H. (Heather); Newman, H. (Heike); H. Viveiros (Helena); van der Hoeven, H. (Henk); Ahn, H. (Henry); Johal, H. (Herman); H. Rijna; Stockmann, H. (Heyn); Josaputra, H.A. (Hong A.); Carlisle, H. (Hope); van der Brand, I. (Igor); I. Dawson (Imro); Tarkin, I. (Ivan); Wong, I. (Ivan); Parr, J.A. (J. Andrew); Trenholm, J.A. (J. Andrew); J.C. Goslings (Carel); Amirault, J.D. (J. David); Broderick, J.S. (J. Scott); Snellen, J.P. (Jaap P.); Zijl, J.A.C. (Jacco A.C.); Ahn, J. (Jaimo); Ficke, J. (James); Irrgang, J. (James); Powell, J. (James); Ringler, J.R. (James R.); Shaer, J. (James); Monica, J.T. (James T.); J. Biert (Jan); Bosma, J. (Jan); Brattgjerd, J.E. (Jan Egil); J.P.M. Frölke (Jan Paul); J.C. Wille (Jan); Rajakumar, J. (Janakiraman); Walker, J.E. (Jane E.); Baker, J.K. (Janell K.); Ertl, J.P. (Janos P.); de Vries, J.P.P.M. (Jean Paul P.M.); Gardeniers, J.W.M. (Jean W.M.); May, J. (Jedediah); Yach, J. (Jeff); Hidy, J.T. (Jennifer T.); Westberg, J.R. (Jerald R.); Hall, J.A. (Jeremy A.); van Mulken, J. (Jeroen); McBeth, J.C. (Jessica Cooper); Hoogendoorn, J. (Jochem); Hoffman, J.M. (Jodi M.); Cherian, J.J. (Joe Joseph); Tanksley, J.A. (John A.); Clarke-Jenssen, J. (John); Adams, J.D. (John D.); Esterhai, J. (John); Tilzey, J.F. (John F.); Murnaghan, J. (John); Ketz, J.P. (John P.); Garfi, J.S. (John S.); Schwappach, J. (John); Gorczyca, J.T. (John T.); Wyrick, J. (John); Rydinge, J. (Jonas); Foret, J.L. (Jonathan L.); Gross, J.M. (Jonathan M.); Keeve, J.P. (Jonathan P.); Meijer, J. (Joost); J.J. Scheepers (Joris J.); Baele, J. (Joseph); O'Neil, J. (Joseph); Cass, J.R. (Joseph R.); Hsu, J.R. (Joseph R.); Dumais, J. (Jules); Lee, J. (Julia); Switzer, J.A. (Julie A.); Agel, J. (Julie); Richards, J.E. (Justin E.); Langan, J.W. (Justin W.); Turckan, K. (Kahn); Pecorella, K. (Kaili); Rai, K. (Kamal); Aurang, K. (Kamran); Shively, K. (Karl); K.J.P. van Wessem; Moon, K. (Karyn); Eke, K. (Kate); Erwin, K. (Katie); Milner, K. (Katrine); K.J. Ponsen (Kees-jan); Mills, K. (Kelli); Apostle, K. (Kelly); Johnston, K. (Kelly); Trask, K. (Kelly); Strohecker, K. (Kent); Stringfellow, K. (Kenya); Kruse, K.K. (Kevin K.); Tetsworth, K. (Kevin); Mitchell, K. (Khalis); Browner, K. (Kieran); Hemlock, K. (Kim); Carcary, K. (Kimberly); Jørgen Haug, K. (Knut); Noble, K. (Krista); Robbins, K. (Kristin); Payton, K. (Krystal); Jeray, K.J. (Kyle J.); Rubino, L.J. (L. Joseph); Nastoff, L.A. (Lauren A.); Leffler, L.C. (Lauren C.); L.P. Stassen (Laurents); O'Malley, L.K. (Lawrence K.); Specht, L.M. (Lawrence M.); L. Thabane (Lehana); Geeraedts, L.M.G. (Leo M.G.); Shell, L.E. (Leslie E.); Anderson, L.K. (Linda K.); Eickhoff, L.S. (Linda S.); Lyle, L. (Lindsey); Pilling, L. (Lindsey); Buckingham, L. (Lisa); Cannada, L.K. (Lisa K.); Wild, L.M. (Lisa M.); Dulaney-Cripe, L. (Liz); L.M.S.J. Poelhekke; Govaert, L. (Lonneke); Ton, L. (Lu); Kottam, L. (Lucksy); L.P.H. Leenen (Luke); Clipper, L. (Lydia); Jackson, L.T. (Lyle T.); Hampton, L. (Lynne); de Waal Malefijt, M.C. (Maarten C.); M.P. Simons; M. van der Elst (Maarten); M.W.G.A. Bronkhorst (Maarten); Bhatia, M. (Mahesh); M.F. Swiontkowski (Marc ); Lobo, M.J. (Margaret J.); Swinton, M. (Marilyn); Pirpiris, M. (Marinis); Molund, M. (Marius); Gichuru, M. (Mark); Glazebrook, M. (Mark); Harrison, M. (Mark); Jenkins, M. (Mark); MacLeod, M. (Mark); M.R. de Vries (Mark); Butler, M.S. (Mark S.); Nousiainen, M. (Markku); van ‘t Riet, M. (Martijne); Tynan, M.C. (Martin C.); Campo, M. (Martin); M.G. Eversdijk (Martin); M.J. Heetveld (Martin); Richardson, M. (Martin); Breslin, M. (Mary); Fan, M. (Mary); Edison, M. (Matt); Napierala, M. (Matthew); Knobe, M. (Matthias); Russ, M. (Matthias); Zomar, M. (Mauri); de Brauw, M. (Maurits); Esser, M. (Max); Hurley, M. (Meghan); Peters, M.E. (Melissa E.); Lorenzo, M. (Melissa); Li, M. (Mengnai); Archdeacon, M. (Michael); Biddulph, M. (Michael); Charlton, M. (Michael); McDonald, M.D. (Michael D.); McKee, M.D. (Michael D.); Dunbar, M. (Michael); Torchia, M.E. (Michael E.); Gross, M. (Michael); Hewitt, M. (Michael); Holt, M. (Michael); Prayson, M.J. (Michael J.); M.J.R. Edwards (Michael); Beckish, M.L. (Michael L.); Brennan, M.L. (Michael L.); Dohm, M.P. (Michael P.); Kain, M.S.H. (Michael S.H.); Vogt, M. (Michelle); Yu, M. (Michelle); M.H.J. Verhofstad (Michiel); Segers, M.J.M. (Michiel J.M.); M.J.M. Segers (Michiel); Siroen, M.P.C. (Michiel P.C.); M.R. Reed (Mike); Vicente, M.R. (Milena R.); M.M.M. Bruijninckx (Milko); Trivedi, M. (Mittal); M. Bhandari (Mohit); Moore, M.M. (Molly M.); Kunz, M. (Monica); Smedsrud, M. (Morten); Palla, N. (Naveen); Jain, N. (Neeraj); Out, N.J.M. (Nico J.M.); Simunovic, N. (Nicole); Simunovic, N. (Nicole); N.W.L. Schep (Niels); Müller, O. (Oliver); Guicherit, O.R. (Onno R.); O.J.F. van Waes (Oscar); Wang, O. (Otis); P. Doornebosch (Pascal); Seuffert, P. (Patricia); Hesketh, P.J. (Patrick J.); Weinrauch, P. (Patrick); Duffy, P. (Paul); Keller, P. (Paul); Lafferty, P.M. (Paul M.); Pincus, P. (Paul); P. Tornetta III (Paul); Zalzal, P. (Paul); McKay, P. (Paula); Cole, P.A. (Peter A.); de Rooij, P.D. (Peter D.); Hull, P. (Peter); Go, P.M.N.Y.M. (Peter M.N.Y.M.); P. Patka (Peter); Siska, P. (Peter); Weingarten, P. (Peter); Kregor, P. (Philip); Stahel, P. (Philip); Stull, P. (Philip); P. Wittich (Philippe); P.A.R. Rijcke (Piet); P.P. Oprel (Pim); Devereaux, P.J. (P. J.); Zhou, Q. (Qi); Lee Murphy, R. (R.); Alosky, R. (Rachel); Clarkson, R. (Rachel); Moon, R. (Raely); Logishetty, R. (Rajanikanth); Nanda, R. (Rajesh); Sullivan, R.J. (Raymond J.); Snider, R.G. (Rebecca G.); Buckley, R.E. (Richard E.); Iorio, R. (Richard); Farrugia, R.J. (Richard J); Jenkinson, R. (Richard); Laughlin, R. (Richard); R.P.R. Groenendijk (Richard); Gurich, R.W. (Richard W.); Worman, R. (Ripley); Silvis, R. (Rob); R. Haverlag (Robert); Teasdall, R.J. (Robert J.); Korley, R. (Robert); McCormack, R. (Robert); Probe, R. (Robert); Cantu, R.V. (Robert V.); Huff, R.B. (Roger B.); R.K.J. Simmermacher; Peters, R. (Rolf); Pfeifer, R. (Roman); Liem, R. (Ronald); Wessel, R.N. (Ronald N.); Verhagen, R. (Ronald); Vuylsteke, R. (Ronald); Leighton, R. (Ross); McKercher, R. (Ross); R.W. Poolman (Rudolf); Miller, R. (Russell); Bicknell, R. (Ryan); Finnan, R. (Ryan); Khan, R.M. (Ryan M.); Mehta, S. (Samir); Vang, S. (Sandy); Singh, S. (Sanjay); Anand, S. (Sanjeev); Anderson, S.A. (Sarah A.); Dawson, S.A. (Sarah A.); Marston, S.B. (Scott B.); Porter, S.E. (Scott E.); Watson, S.T. (Scott T.); S. Festen (Sebastiaan); Lieberman, S. (Shane); Puloski, S. (Shannon); Bielby, S.A. (Shea A.); Sprague, S. (Sheila); Hess, S. (Shelley); MacDonald, S. (Shelley); Evans, S. (Simone); Bzovsky, S. (Sofia); Hasselund, S. (Sondre); Lewis, S. (Sophie); Ugland, S. (Stein); Caminiti, S. (Stephanie); Tanner, S.L. (Stephanie L.); S.M. Zielinski (Stephanie); Shepard, S. (Stephanie); Sems, S.A. (Stephen A.); Walter, S.D. (Stephen D.); Doig, S. (Stephen); Finley, S.H. (Stephen H.); Kates, S. (Stephen); Lindenbaum, S. (Stephen); Kingwell, S.P. (Stephen P.); Csongvay, S. (Steve); Papp, S. (Steve); Buijk, S.E. (Steven E.); S. Rhemrev (Steven); Hollenbeck, S.M. (Steven M.); van Gaalen, S.M. (Steven M.); Yang, S. (Steven); Weinerman, S. (Stuart); Subash, (); Lambert, S. (Sue); Liew, S. (Susan); S.A.G. Meylaerts (Sven); Blokhuis, T.J. (Taco J.); de Vries Reilingh, T.S. (Tammo S.); Lona, T. (Tarjei); Scott, T. (Taryn); Swenson, T.K. (Teresa K.); Endres, T.J. (Terrence J.); Axelrod, T. (Terry); van Egmond, T. (Teun); Pace, T.B. (Thomas B.); Kibsgård, T. (Thomas); Schaller, T.M. (Thomas M.); Ly, T.V. (Thuan V.); Miller, T.J. (Timothy J.); Weber, T. (Timothy); Le, T. (Toan); Oliver, T.M. (Todd M.); T.M. Karsten (Thomas); Borch, T. (Tor); Hoseth, T.M. (Tor Magne); Nicolaisen, T. (Tor); Ianssen, T. (Torben); Rutherford, T. (Tori); Nanney, T. (Tracy); Gervais, T. (Trevor); Stone, T. (Trevor); Schrickel, T. (Tyson); Scrabeck, T. (Tyson); Ganguly, U. (Utsav); Naumetz, V. (V.); Frizzell, V. (Valda); Wadey, V. (Veronica); Jones, V. (Vicki); Avram, V. (Victoria); Mishra, V. (Vimlesh); Yadav, V. (Vineet); Arora, V. (Vinod); Tyagi, V. (Vivek); Borsella, V. (Vivian); W.J. Willems (Jaap); Hoffman, W.H. (W. H.); Gofton, W.T. (Wade T.); Lackey, W.G. (Wesley G.); Ghent, W. (Wesley); Obremskey, W. (William); Oxner, W. (William); Cross, W.W. (William W.); Murtha, Y.M. (Yvonne M.); Murdoch, Z. (Zoe)

    2017-01-01

    textabstractBackground Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled

  17. Fracture fixation in the operative management of hip fractures (FAITH) : an international, multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Nauth, Aaron; Creek, Aaron T.; Zellar, Abby; Lawendy, Abdel Rahman; Dowrick, Adam; Gupta, Ajay; Dadi, Akhil; van Kampen, Albert; Yee, Albert; de Vries, Alexander C.; de Mol van Otterloo, Alexander; Garibaldi, Alisha; Liew, Allen; McIntyre, Allison W.; Prasad, Amal Shankar; Romero, Amanda W.; Rangan, Amar; Oatt, Amber; Sanghavi, Amir; Foley, Amy L.; Karlsten, Anders; Dolenc, Andrea; Bucknill, Andrew; Chia, Andrew; Evans, Andrew; Gong, Andrew; Schmidt, Andrew H.; Marcantonio, Andrew J.; Jennings, Andrew; Ward, Angela; Khanna, Angshuman; Rai, Anil; Smits, Anke B; Horan, Annamarie D.; Brekke, Anne Christine; Flynn, Annette; Duraikannan, Aravin; Stødle, Are; van Vugt, Arie B.; Luther, Arlene; Zurcher, Arthur W.; Jain, Arvind; Amundsen, Asgeir; Moaveni, Ash; Carr, Ashley; Sharma, Ateet; Hill, Austin D.; Trommer, Axel; Rai, B. Sachidananda; Hileman, Barbara; Schreurs, Bart; Verhoeven, Bart A N; Barden, Benjamin B.; Flatøy, Bernhard; Cleffken, Berry I.; Bøe, Berthe; Perey, Bertrand; Hanusch, Birgit C.; Weening, Brad; Fioole, Bram; Rijbroek, Bram; Crist, Brett D.; Halliday, Brett; Peterson, Brett; Mullis, Brian; Richardson, C. Glen; Clark, Callum; Sagebien, Carlos A.; van der Pol, Carmen C.; Bowler, Carol; Humphrey, Catherine A.; Coady, Catherine; Koppert, Cees L.; Coles, Chad; Tannoury, Chadi; DePaolo, Charles J.; Gayton, Chris; Herriott, Chris; Reeves, Christina; Tieszer, Christina; Dobb, Christine; Anderson, Christopher G.; Sage, Claire; Cuento, Claudine; Jones, Clifford B.; Bosman, Coks H.R.; Linehan, Colleen; van der Hart, Cor P.; Henderson, Corey; Lewis, Courtland G.; Davis, Craig A.; Donohue, Craig; Mauffrey, Cyril; Sundaresh, D. C.; Farrell, Dana J.; Whelan, Daniel B.; Horwitz, Daniel; Stinner, Daniel; Viskontas, Darius; Roffey, Darren M.; Alexander, David; Karges, David E.; Hak, David; Johnston, David; Love, David; Wright, David M.; Zamorano, David P.; Goetz, David R.; Sanders, David; Stephen, David; Yen, David; Bardana, Davide; Olakkengil, Davy J.; Lawson, Deanna; Maddock, Deborah; Sietsema, Debra L.; Pourmand, Deeba; Den Hartog, Dennis; Donegan, Derek; Heels-Ansdell, Diane; Nam, Diane; Inman, Dominic; Boyer, Dory; Li, Doug; Gibula, Douglas; Price, Dustin M.; Watson, Dylan J.; Hammerberg, E. Mark; Tan, Edward C T H; de Graaf, Eelco J.R.; Vesterhus, Elise Berg; Roper, Elizabeth; Edwards, Elton; Schemitsch, Emil H.; Hammacher, Eric R.; Henderson, Eric R.; Whatley, Erica; Torres, Erick T.; Vermeulen, Erik G.J.; Finn, Erin; Van Lieshout, Esther M M; Wai, Eugene K.; Bannister, Evan R.; Kile, Evelyn; Theunissen, Evert B.M.; Ritchie, Ewan D.; Khan, Farah; Moola, Farhad; Howells, Fiona; de Nies, Frank; van der Heijden, Frank H.W.M.; de Meulemeester, Frank R.A.J.; Frihagen, Frede; Nilsen, Fredrik; Schmidt, G. Ben; Albers, G. H.Robert; Gudger, Garland K.; Johnson, Garth; Gruen, Gary; Zohman, Gary; Sharma, Gaurav; Wood, Gavin; Tetteroo, Geert W.M.; Hjorthaug, Geir; Jomaas, Geir; Donald, Geoff; Rieser, Geoffrey Ryan; Reardon, Gerald; Slobogean, Gerard P.; Roukema, Gert R.; Visser, Gijs A.; Moatshe, Gilbert; Horner, Gillian; Rose, Glynis; Guyatt, Gordon; Chuter, Graham; Etherington, Greg; Rocca, Gregory J.Della; Ekås, Guri; Dobbin, Gwendolyn; Lemke, H. Michael; Curry, Hamish; Boxma, Han; Gissel, Hannah; Kreder, Hans; Kuiken, Hans; Brom, Hans L.F.; Pape, Hans Christoph; van der Vis, Harm M.; Bedi, Harvinder; Vallier, Heather A.; Brien, Heather; Silva, Heather; Newman, Heike; Viveiros, Helena; van der Hoeven, Henk; Ahn, Henry; Johal, Herman; Rijna, Herman; Stockmann, Heyn; Josaputra, Hong A.; Carlisle, Hope; van der Brand, Igor; Dawson, Imro; Tarkin, Ivan; Wong, Ivan; Parr, J. Andrew; Trenholm, J. Andrew; Goslings, J Carel; Amirault, J. David; Broderick, J. Scott; Snellen, Jaap P.; Zijl, Jacco A.C.; Ahn, Jaimo; Ficke, James; Irrgang, James; Powell, James; Ringler, James R.; Shaer, James; Monica, James T.; Biert, Jan; Bosma, Jan; Brattgjerd, Jan Egil; Frölke, Jan Paul M.; Wille, Jan; Rajakumar, Janakiraman; Walker, Jane E.; Baker, Janell K.; Ertl, Janos P.; De Vries, Jean-Paul P. M.; Gardeniers, Jean W.M.; May, Jedediah; Yach, Jeff; Hidy, Jennifer T.; Westberg, Jerald R.; Hall, Jeremy A.; van Mulken, Jeroen; McBeth, Jessica Cooper; Hoogendoorn, Jochem M; Hoffman, Jodi M.; Cherian, Joe Joseph; Tanksley, John A.; Clarke-Jenssen, John; Adams, John D.; Esterhai, John; Tilzey, John F.; Murnaghan, John; Ketz, John P.; Garfi, John S.; Schwappach, John; Gorczyca, John T.; Wyrick, John; Rydinge, Jonas; Foret, Jonathan L.; Gross, Jonathan M.; Keeve, Jonathan P.; Meijer, Joost; Scheepers, Joris J.G.; Baele, Joseph; O'Neil, Joseph; Cass, Joseph R.; Hsu, Joseph R.; Dumais, Jules; Lee, Julia; Switzer, Julie A.; Agel, Julie; Richards, Justin E.; Langan, Justin W.; Turckan, Kahn; Pecorella, Kaili; Rai, Kamal; Aurang, Kamran; Shively, Karl; van Wessem, Karlijn; Moon, Karyn; Eke, Kate; Erwin, Katie; Milner, Katrine; Ponsen, Kees Jan; Mills, Kelli; Apostle, Kelly; Johnston, Kelly; Trask, Kelly; Strohecker, Kent; Stringfellow, Kenya; Kruse, Kevin K.; Tetsworth, Kevin; Mitchell, Khalis; Browner, Kieran; Hemlock, Kim; Carcary, Kimberly; Jørgen Haug, Knut; Noble, Krista; Robbins, Kristin; Payton, Krystal; Jeray, Kyle J.; Rubino, L. Joseph; Nastoff, Lauren A.; Leffler, Lauren C.; Stassen, Laurents P.S.; O'Malley, Lawrence K.; Specht, Lawrence M.; Thabane, Lehana; Geeraedts, Leo M.G.; Shell, Leslie E.; Anderson, Linda K.; Eickhoff, Linda S.; Lyle, Lindsey; Pilling, Lindsey; Buckingham, Lisa; Cannada, Lisa K.; Wild, Lisa M.; Dulaney-Cripe, Liz; Poelhekke, Lodewijk M.S.J.; Govaert, Lonneke; Ton, Lu; Kottam, Lucksy; Leenen, Luke P.H.; Clipper, Lydia; Jackson, Lyle T.; Hampton, Lynne; de Waal Malefijt, Maarten C.; Simons, Maarten P.; van der Elst, Maarten; Bronkhorst, Maarten W.G.A.; Bhatia, Mahesh; Swiontkowski, Marc; Lobo, Margaret J.; Swinton, Marilyn; Pirpiris, Marinis; Molund, Marius; Gichuru, Mark; Glazebrook, Mark; Harrison, Mark; Jenkins, Mark; MacLeod, Mark; de Vries, Mark R.; Butler, Mark S.; Nousiainen, Markku; van ‘t Riet, Martijne; Tynan, Martin C.; Campo, Martin; Eversdijk, Martin G.; Heetveld, Martin J.; Richardson, Martin; Breslin, Mary; Fan, Mary; Edison, Matt; Napierala, Matthew; Knobe, Matthias; Russ, Matthias; Zomar, Mauri; de Brauw, Maurits; Esser, Max; Hurley, Meghan; Peters, Melissa E.; Lorenzo, Melissa; Li, Mengnai; Archdeacon, Michael; Biddulph, Michael; Charlton, Michael R; McDonald, Michael D.; McKee, Michael D.; Dunbar, Michael; Torchia, Michael E.; Gross, Michael; Hewitt, Michael; Holt, Michael; Prayson, Michael J.; Edwards, Michael J R; Beckish, Michael L.; Brennan, Michael L.; Dohm, Michael P.; Kain, Michael S.H.; Vogt, Michelle; Yu, Michelle; Verhofstad, Michiel H J; Segers, Michiel J M; Segers, Michiel J M; Siroen, Michiel P.C.; Reed, Mike; Vicente, Milena R.; Bruijninckx, Milko M.M.; Trivedi, Mittal; Bhandari, Mohit; Moore, Molly M.; Kunz, Monica; Smedsrud, Morten; Palla, Naveen; Jain, Neeraj; Out, Nico J.M.; Simunovic, Nicole; Simunovic, Nicole; Schep, Niels W. L.; Müller, Oliver; Guicherit, Onno R.; Van Waes, Oscar J.F.; Wang, Otis; Doornebosch, Pascal G.; Seuffert, Patricia; Hesketh, Patrick J.; Weinrauch, Patrick; Duffy, Paul; Keller, Paul; Lafferty, Paul M.; Pincus, Paul; Tornetta, Paul; Zalzal, Paul; McKay, Paula; Cole, Peter A.; de Rooij, Peter D.; Hull, Peter; Go, Peter M.N.Y.M.; Patka, Peter; Siska, Peter; Weingarten, Peter; Kregor, Philip; Stahel, Philip; Stull, Philip; Wittich, Philippe; de Rijcke, Piet A.R.; Oprel, Pim; Devereaux, P. J.; Zhou, Qi; Lee Murphy, R.; Alosky, Rachel; Clarkson, Rachel; Moon, Raely; Logishetty, Rajanikanth; Nanda, Rajesh; Sullivan, Raymond J.; Snider, Rebecca G.; Buckley, Richard E.; Iorio, Richard; Farrugia, Richard J.; Jenkinson, Richard; Laughlin, Richard; Groenendijk, Richard P R; Gurich, Richard W.; Worman, Ripley; Silvis, Rob; Haverlag, Robert; Teasdall, Robert J.; Korley, Robert; McCormack, Robert; Probe, Robert; Cantu, Robert V.; Huff, Roger B.; Simmermacher, Rogier K J; Peters, Rolf; Pfeifer, Roman; Liem, Ronald; Wessel, Ronald N.; Verhagen, Ronald; Vuylsteke, Ronald J C L M; Leighton, Ross; McKercher, Ross; Poolman, Rudolf W; Miller, Russell; Bicknell, Ryan; Finnan, Ryan; Khan, Ryan M.; Mehta, Samir; Vang, Sandy; Singh, Sanjay; Anand, Sanjeev; Anderson, Sarah A.; Dawson, Sarah A.; Marston, Scott B.; Porter, Scott E.; Watson, Scott T.; Festen, Sebastiaan; Lieberman, Shane; Puloski, Shannon; Bielby, Shea A.; Sprague, Sheila; Hess, Shelley; MacDonald, Shelley; Evans, Simone; Bzovsky, Sofia; Hasselund, Sondre; Lewis, Sophie; Ugland, Stein; Caminiti, Stephanie; Tanner, Stephanie L.; Zielinski, Stephanie M.; Shepard, Stephanie; Sems, Stephen A.; Walter, Stephen D.; Doig, Stephen; Finley, Stephen H.; Kates, Stephen; Lindenbaum, Stephen; Kingwell, Stephen P.; Csongvay, Steve; Papp, Steve; Buijk, Steven E.; Rhemrev, Steven J.; Hollenbeck, Steven M.; van Gaalen, Steven M.; Yang, Steven; Weinerman, Stuart; Lambert, Sue; Liew, Susan; Meylaerts, Sven A.G.; Blokhuis, Taco J.; de Vries Reilingh, Tammo S.; Lona, Tarjei; Scott, Taryn; Swenson, Teresa K.; Endres, Terrence J.; Axelrod, Terry; van Egmond, Teun; Pace, Thomas B.; Kibsgård, Thomas; Schaller, Thomas M.; Ly, Thuan V.; Miller, Timothy J.; Weber, Timothy; Le, Toan; Oliver, Todd M.; Karsten, Tom M.; Borch, Tor; Hoseth, Tor Magne; Nicolaisen, Tor; Ianssen, Torben; Rutherford, Tori; Nanney, Tracy; Gervais, Trevor; Stone, Trevor; Schrickel, Tyson; Scrabeck, Tyson; Ganguly, Utsav; Naumetz, V.; Frizzell, Valda; Wadey, Veronica; Jones, Vicki; Avram, Victoria; Mishra, Vimlesh; Yadav, Vineet; Arora, Vinod; Tyagi, Vivek; Borsella, Vivian; Willems, W. Jaap; Hoffman, W. H.; Gofton, Wade T.; Lackey, Wesley G.; Ghent, Wesley; Obremskey, William; Oxner, William; Cross, William W.; Murtha, Yvonne M.; Murdoch, Zoe

    2017-01-01

    Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we

  18. Stabilization of the lower thoracic and lumbar spine with the internal spinal skeletal fixation system. Indications, techniques, and first results of treatment.

    Science.gov (United States)

    Aebi, M; Etter, C; Kehl, T; Thalgott, J

    1987-01-01

    Since 1984, 30 patients with burst fractures of the lower thoracic and lumbar spine were treated with AO internal spinal skeletal fixation system. All patients in this series had a minimum follow-up of 12 months. This new instrumentation is a posterior intrapedicular system developed by Dick in 1982. It allows stable fixation that is limited only to adjacent spinal segments. The internal fixator permits reduction in all three planes. Independently, it is possible to add distraction or compression to the involved segments. It also is able to reduce effectively the "middle column" which is thought to be accomplished by "ligamentotaxis." In this series there were 16 neurologically intact patients and 14 with partial or complete neurologic injury. There were two minor instrumentation loosenings early in the series. Most patients in this series had a near-anatomic reduction of all three columns in the involved segment. It was also possible to re-establish the normal lordosis of the lumbar spine. The device provided sufficient rigid fixation for rapid postoperative mobilization in a light external orthosis.

  19. Abstracts and papers presented at the 2004 international RERTR meeting

    International Nuclear Information System (INIS)

    2005-01-01

    Oral and poster presentations of the Meeting covered the following topics: National and international programs related to Reduced Enrichment for Research and Test Reactors (RERTR). Development of new fuel types, testing, fabrication, modelling. Studies of reactor cores conversion from highly enriched to low enriched fuel, including licensing. New and converted reactors. Spent fuel management including storage and transportation. Production of Molybdenum 99 under converted core conditions

  20. Biomechanical comparison of three types of internal fixation in a type C zone II pelvic fracture model

    Science.gov (United States)

    Wu, Tao; Chen, Wei; Li, Xu; Zhang, Qi; Lv, Hong-Zhi; Zhang, Ying-Ze

    2015-01-01

    Objective: This study aimed to compare the stability of Tile C pelvic fractures fixed with two iliosacral (IS) screws, tension band plate (TBP), and minimally invasive adjustable plate (MIAP). Methods: Six embalmed specimens of adult pelvis were used. The soft tissue was removed from the specimens, but spines from the fourth lumbar vertebra to the proximal one-third of both femurs were retained. The pubic symphysis, bilateral sacroiliac joints and ligaments, bilateral hip joints, bilateral sacrotuberous ligaments, and bilateral sacrospinous ligaments were intact. Tile C pelvic fractures were created on the specimens. The symphysis pubis was fixed with a plate, and the fracture on the posterior pelvic ring was fixed with three types of internal fixation in a randomized block design. The specimens were placed in a biomechanical machine at a standing neutral posture. A cyclic vertical load of up to 500N was applied, and displacement was recorded. Shifts in the fracture gap were measured by a grating displacement sensor. Results: Under different vertical loads, the shift in the fracture gap and displacement of the pelvic fractures fixed with two IS screws were similar to those in fractures fixed with MIAP. However, the shift in the fracture gap and displacement of fractures fixed with MIAP was significantly smaller than those of fractures fixed with TBP. Conclusion: The stability of the Tile C pelvic fractures fixed with MIAP was similar to that of fractures fixed with IS screws. MIAP performed better than TBP under vertical load. PMID:25932113

  1. Wedgeless 'V' shaped distal femoral osteotomy with internal fixation for genu valgum in adolescents and young adults.

    Science.gov (United States)

    Gupta, Vikas; Kamra, Gaurav; Singh, Davinder; Pandey, Ketan; Arora, Sumit

    2014-06-01

    The treatment of angular malalignment includes restoration of normal mechanical axis alignment and joint orientation.The supracondylar wedgeless distal femoral 'V' osteotomy, as a treatment modality, is sparsely explored in the literature. This study was conducted at a tertiary level teaching referral hospital from October 2010 to September 2012. Forty six lower limbs (in 30 patients) were operated with a wedgeless 'V' osteotomy that was fixed with a buttress 'L' plate. The pre-operative deformity, post-operative correction and knee range of movement were noted. Mobilisation was started at 3 weeks after surgery and full weight-bearing was allowed at 3 months. The knee score by Bostman et al. was used for functional outcome. The mean age of the patients in our study was 16.9 years (range: 15 years to 23 years). The patients were followed up for a mean period of 19.8 months (range, 15 months to 29 months). The mean radiological tibiofemoral angle was 22.2 degrees (range, 16 degrees to 29 degrees) before surgery, that improved to a mean postoperative value of 5.1 degrees (range, 0 degrees to 10 degrees) (p p p V' shaped osteotomy is a simple procedure for the correction of genu valgum in individuals nearing skeletal maturity and is easy to perform. It has the advantage of being wedgeless as it does not cause limb length discrepancy. Internal fixation helps in early rehabilitation after surgery.

  2. Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Qing-Hua, E-mail: ddqinghua-tian@163.com; He, Cheng-Jian, E-mail: tianhechengjian@163.com; Wu, Chun-Gen, E-mail: 649514608@qq.com; Li, Yong-Dong, E-mail: tianliyongdong@163.com; Gu, Yi-Feng, E-mail: tianyifenggu@163.com; Wang, Tao, E-mail: tianandwangtao@163.com; Xiao, Quan-Ping, E-mail: tianxiaoquanping@163.com; Li, Ming-Hua, E-mail: tianminghuali@163.com [Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Department of Diagnostic and Interventional Radiology (China)

    2016-01-15

    PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

  3. Antimicrobial prophylaxis in open reduction and internal fixation of compound mandibular fractures: a collaborative regional audit of outcome.

    Science.gov (United States)

    Singh, Rabindra P; Carter, Lachlan M; Whitfield, Paul H

    2013-07-01

    We conducted a regional 2-stage prospective audit involving 5 different maxillofacial units in the Yorkshire region of the UK to evaluate the effectiveness of perioperative antimicrobial prophylaxis in the treatment of mandibular fractures. In the first stage (145 patients) we surveyed current practice concerning antimicrobial prophylaxis and found out the current infection rate after open reduction and internal fixation (ORIF) of mandibular fractures. In the second stage (157 patients) we implemented a common antimicrobial protocol in all units and recorded the infection rates using the new regimen. In the first stage a wide range of antimicrobial prophylaxis was used in different units. The agreed perioperative antimicrobial protocol in the second stage was to begin amoxicillin or clarithromycin and metronidazole intravenously on admission and include 2 postoperative doses. The infection rates were 10.3% and 8.9%, respectively, and the difference between the two groups was not significant (χ(2)=0.051, df=1, p=0.83). The infection rate in the Yorkshire region was similar to results from other centres. We recommend short perioperative antimicrobial prophylaxis with a maximum of 2 postoperative doses after ORIF of mandibular fractures. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Low complications after minimally invasive fixation of calcaneus fracture.

    Science.gov (United States)

    Ene, R; Popescu, D; Panaitescu, C; Circota, G; Cirstoiu, M; Cirstoiu, C

    2013-03-15

    Calcaneus fractures are still a delicate point regarding the indication for osteosynthesis. Knowing the skin's poor vascularisation of the back foot, the purpose of this study is to present the benefits of proper surgical options between an open and invasive osteosynthesis with anatomical reduction and internal fixation or minimally invasive approach preserving the quality of the soft parts. 66 interventions that targeted reduction and internal fixation of calcaneus fractures were performed between 2009-2012, in the Orthopaedic and Traumatology Department of Bucharest Emergency University Hospital. 29 cases underwent open reduction and internal fixation with plates and screws or Kirschner wires, and 37 cases underwent a minimally invasive reduction and Essex Lopresti osteosynthesis technique. No patient who underwent a minimally invasive reduction had skin lesions, but showed pain due to osteoarthritis lesions that appeared in the subtalar joint. 4 of them, who underwent open reduction and internal fixation had postoperative wound infections and skin necrosis.

  5. EVALUATION OF FUNCTIONAL OUTCOME AFTER OPEN REDUCTION AND INTERNAL FIXATION OF DISTAL FEMUR FRACTURES BY LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    L. Lokanadha Rao

    2016-09-01

    Full Text Available BACKGROUND In the supra and intercondylar fractures of femur particularly with intra articular extension, patient may develop stiffness of knee, shortening, rotational deformities, internal derangement of knee with instability, varus and valgus deformities which affect patient’s routine lifestyle. If these cases were treated with locking compression plate, the results obtained were successful, superior, timesaving providing early ambulation and least disability improving the functional outcome. MATERIALS AND METHODS This is a prospective interventional study. This study includes 25 supracondylar and intercondylar fractures of femur (both Muller’s Type ‘A’, Type B and Type ‘C’ fractures treated with open reduction and internal fixation by Locking Compression Plate in the Department of Orthopaedics, King George Hospital, Visakhapatnam from September 2013 to September 2015. There are 16 males and 9 females with age ranging from 20 to 80 years with an average of 44.6 years. Average age for males is 28.9 years and average age for females is 25 years. 18 fractures were due to road traffic accidents and 6 cases are due to fall from significant heights, 1 case due to simple fall from standing (osteoporosis. 15 cases were in right femur (60% and 10 cases were in left femur (40%. RESULTS 25 cases were included in the study. There is an increase in the rate of union, decreased time taken for union, increased knee range of motion, decreased time for weight-bearing, postoperative complications and duration for hospital stay. CONCLUSION LCP proved to be a good implant which could take the challenges like poor bone stock, severe comminution both metaphyseal and articular and prove successful. The locking head screws distally have prevented varus collapse, even in cases of osteoporosis. The Condylar LCP can be used in either an open or a minimally invasive manner.

  6. In vitro biomechanical evaluation of internal fixation techniques on the canine lumbosacral junction.

    Science.gov (United States)

    Early, Peter; Mente, Peter; Dillard, Stacy; Roe, Simon

    2015-01-01

    Few biomechanical studies have evaluated the effect of internal stabilization techniques after decompressive surgery on the stability of the canine lumbosacral junction. The purpose of this canine cadaver study is to evaluate the stability of the canine lumbosacral (LS) spine in flexion and extension following laminectomy and discectomy and then stabilization with each of the three techniques: pins and polymethylmethacrylate (P/PMMA), two dorsal locking plates (SOP) or bilateral transarticular facet screws (FACET).Using a cantilever biomechanical system, bending moments were applied to the LS and range of motion (ROM) was recorded via a rotational potentiometer. With 3 Nm, the ROM (n = 4 in each group) for P/PMMA, SOP and FACET were 1.92 ± 0.96°, 2.56 ± 0.55°and 3.18 ± 1.14°, respectively. With moments up to 35 Nm, the P/PMMA specimens appeared stable. Sacroiliac motion in the SOP and FACET groups invalidated further comparisons. Each of the stabilization techniques (P/PMMA, SOP, and FACET) significantly decreased the range of motion in flexion and extension for low bending moments.

  7. Aberrant internal carotid artery presenting as a retrotympanic vascular mass

    International Nuclear Information System (INIS)

    Nicolay, Simon; De Foer, Bert; Bernaerts, Anja; Van Dinther, Joost; Parizel, Paul M

    2014-01-01

    We report a case of a young woman with an aberrant right internal carotid artery (ICA) presenting as a retrotympanic reddish mass. This variant of the ICA represents the collateral pathway that is formed as a result of an embryological agenesis of the cervical segment of the ICA. The embryonic inferior tympanic artery is recruited to bypass the absent carotid segment. This hypertrophied vessel may be seen otoscopically and wrongfully considered to be a vascular middle ear tumor. Informing the otorhinolaryngologist of this important vascular variant not only obviates biopsy but also helps in careful preoperative planning of eventual middle ear procedures

  8. Presentations from the 13th International Magnetic Measurement Workshop

    International Nuclear Information System (INIS)

    Wolf, Zachary R

    2003-01-01

    The 13th International Magnetic Measurement Workshop was held at the Stanford Linear Accelerator Center from Monday, May 19 through Thursday, May 22, 2003. All professionals in the field of magnetic measurements were encouraged to attend. The workshop was primarily concerned with equipment and techniques for measuring and fiducializing accelerator magnets and insertion devices, although other relevant topics were also welcome. The program consisted of presentations by the workshop participants followed by discussions. During the workshop, there was an industrial exhibit and a tour of the SLAC magnetic measurement facilities

  9. Effects of Low-Dose Microwave on Healing of Fractures with Titanium Alloy Internal Fixation: An Experimental Study in a Rabbit Model

    Science.gov (United States)

    Zhang, Han; Fu, Tengfei; Jiang, Lan; Bai, Yuehong

    2013-01-01

    Background Microwave is a method for improving fracture repair. However, one of the contraindications for microwave treatment listed in the literature is surgically implanted metal plates in the treatment field. The reason is that the reflection of electromagnetic waves and the eddy current stimulated by microwave would increase the temperature of magnetic implants and cause heat damage in tissues. Comparing with traditional medical stainless steel, titanium alloy is a kind of medical implants with low magnetic permeability and electric conductivity. But the effects of microwave treatment on fracture with titanium alloy internal fixation in vivo were not reported. The aim of this article was to evaluate the security and effects of microwave on healing of a fracture with titanium alloy internal fixation. Methods Titanium alloy internal fixation systems were implanted in New Zealand rabbits with a 3.0 mm bone defect in the middle of femur. We applied a 30-day microwave treatment (2,450MHz, 25W, 10 min per day) to the fracture 3 days after operation. Temperature changes of muscle tissues around implants were measured during the irradiation. Normalized radiographic density of the fracture gap was measured on the 10th day and 30th day of the microwave treatment. All of the animals were killed after 10 and 30 days microwave treatment with histologic and histomorphometric examinations performed on the harvested tissues. Findings The temperatures did not increase significantly in animals with titanium alloy implants. The security of microwave treatment was also supported by histology of muscles, nerve and bone around the implants. Radiographic assessment, histologic and histomorphometric examinations revealed significant improvement in the healing bone. Conclusion Our results suggest that, in the healing of fracture with titanium alloy internal fixation, a low dose of microwave treatment may be a promising method. PMID:24086626

  10. Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population: a meta-analysis.

    Science.gov (United States)

    Xu, Jiaming; Zhang, Changqing

    2014-04-11

    This meta-analysis aimed to compare the therapeutic effect of mini-plate versus Kirschner wire (K-wire) internal fixation on the treatment of metacarpal and phalangeal fractures among Chinese Han population. Databases of China National Knowledge Infrastructure (CNKI), Wanfang, Chinese VIP, PubMed, and Embase were retrieved for studies on mini-plate (case group) versus K-wire (control group) internal fixation for the treatment of metacarpal and phalangeal fractures among Chinese Han population. The odds ratio (OR) and standardized mean difference (SMD) at 95% confidence interval (CI) were used for estimating the effects of dichotomous data and continuous data, respectively. All statistical analyses were performed by Review Manager 5.2 software. A total of 18 studies involving 1,375 metacarpal or phalangeal fracture patients (709 cases and 666 controls) were included in the meta-analysis. There were significant differences in fracture healing time (SMD = -1.28; 95% CI: -1.81, -0.76), postoperative infection rate (OR = 0.25; 95% CI: 0.16, 0.39), complication incidence (OR = 0.24; 95% CI: 0.15, 0.38), and surgery time (SMD = 1.57; 95% CI: 0.76, 2.37) between the case and the control group, while no significant difference was found in hospital stays between these two groups (SMD = 0.43; 95% CI: -0.34, 1.20; P = 0.27). For the treatment of metacarpal or phalangeal fracture among Chinese Han population, mini-plate has advantages of shorter healing time and lower infection rate and complication incidence compared with K-wire internal fixation, while a longer surgery time than K-wire. In conclusion, mini-plate is prior than K-wire internal fixation for the treatment of metacarpal or phalangeal fracture among Chinese Han population.

  11. Single‑incision technique for the internal fixation of distal fractures of the tibia and fibula: a combined anatomic and clinical study.

    Science.gov (United States)

    Yu, Baoqing; Huang, Gan; George, Josiah T; Li, Wenrui; Pan, Sihua; Zhou, Haiyan

    2013-12-01

    To present a novel single anterior-lateral approach for the treatment of distal tibia and fibula fracture via anatomical study and primary clinical application in order to minimize soft tissue complications. Both a gross anatomic cadaver and retrospective studies of the single-incision technique in patients recruited between June 2004 and January 2010. Level I trauma center. Twenty-six legs of 14 adult human cadavers and clinical recruitment of 49 patients (29 males, 20 females) with a mean age of 37.6 years (range 11-68) with fracture of distal 1/3 tibia and fibula. A single anterior-lateral incision technique for open reduction and internal fixations of distal tibia and fibula fractures. To identify the anatomic structures at risk in the anterolateral aspect of the lower leg and explicit the safe dissection distance from the extensor digitorum longus (EDL) to tibia and fibula, 26 legs of 14 adult human embalmed specimens were recruited in the anatomical study with the distance between the EDL and the anterior edge of the distal thirds of the tibia, as well as the distance between the EDL and the anterior edge of the distal thirds of the fibula were measured, and their mutual relationships to the surrounding anatomical structures described. Mean average standard deviations were also calculated. As for the clinical study, the quality of bone union and soft tissue healing were noted. The mean distances between the distal tibia and the EDL were measured to be 2.96 ± 0.46 cm (proximal), 1.85 ± 0.25 cm (middle), and 2.15 ± 0.30 cm (distal), and that between the fibula and the EDL were 1.82 ± 0.28 cm (proximal), 2.09 ± 0.31 cm (middle), and 2.30 ± 0.27 cm (distal), which means the safe gap from the distal tibia to EDL was 1.6-3.4 cm and from the EDL to fibula was 1.5-2.6 cm. The anterior tibial vein and artery and the deep fibular nerve lie on the anterior interosseous membrane over the lateral surface of the distal tibia were excellently visualized. Review of

  12. In vitro evaluation of allogeneic bone screws for use in internal fixation of transverse fractures created in proximal sesamoid bones obtained from equine cadavers.

    Science.gov (United States)

    Sasaki, Naoki; Takakuwa, Jun; Yamada, Haruo; Mori, Ryuji

    2010-04-01

    To evaluate effectiveness of allogeneic bone screws and pins for internal fixation of midbody transverse fractures of equine proximal sesamoid bones (PSBs) in vitro. 14 forelimbs from cadavers of 3-year-old Thoroughbreds. Allogeneic cortical bone fragments were collected from the limbs of a male Thoroughbred, and cortical bone screws were prepared from the tissue by use of a precision desktop microlathe programmed with the dimensions of a metal cortical bone screw. A midbody transverse osteotomy of each PSB was performed by use of a bone-shaping oscillating saw and repaired via 1 of 3 internal fixation techniques: 1 allogeneic bone screw with 1 allogeneic bone pin (type I; n = 6 PSBs), 2 allogeneic bone screws (type II; 8), or 1 stainless steel cortical bone screw (control repair; 6). Mechanical tension measurements were obtained by use of a commercially available materials testing system. Mean +/- SD tensile strength (TS) was 668.3 +/- 216.6 N for type I repairs, 854.4 +/- 253.2 N for type II repairs, and 1,150.0 +/- 451.7 N for control repairs. Internal fixation of PSB fractures by the use of allogeneic bone screws and bone pins was successful. Although mean TS of control repairs with stainless steel cortical bone screws was greater than the mean TS of type I and type II repairs, the difference between type II and control repairs was not significant. Allogeneic screws may advance healing and result in fewer complications in a clinical setting.

  13. Early to mid-term outcomes of patients with complex elbow dislocations following internal fixation

    Directory of Open Access Journals (Sweden)

    Yunus Guzel

    2015-08-01

    Results: In 19 of 29 patients evaluated in the emergency department, related fractures were detected. According to the Roberts criteria, the results were excellent in 6 patients (31.5%, good in 7 patients (36.8%, fair in 5 patients (26%, and poor in 1 patient (5%. Younger age and lack of ligament lesions were associated with good results. Ligament and cartilage lesions, older age and a longer period of immobilization were associated with worse results. Conclusions: The primary goal of surgery is to restore stability to initiate early range of motion, which is the key factor for a successful outcome. The patient's age and the presence of ligament and cartilage injury have prognostic value. Pure dislocation is uncommon, so it is recommended that radiographs are evaluated carefully for associated fractures around the elbow, especially on first presentation in the emergency department. [Hand Microsurg 2015; 4(2.000: 32-38

  14. Internal fixation for the treatment of the thoracic spine fractures - Multicentric experience

    International Nuclear Information System (INIS)

    Maria Ibarra, Javier Ernesto; Arrieta Maria, Victor Elias; Chaparro Rondon, Walker

    2003-01-01

    Thoracic spine fractures has a high social impact because of its frequent association with neurological deficit. There is much controversy about the way to treat them: using transpedicular screws (Roy Camille), books (Harrington) or sublaminar wires (Luque) systems. Forty patients were reviewed in time span from 1993 to 2002; average age 37 years, average follow up 54 months. The analyzed variables were: technique used, diagnostic, mechanism of trauma, neurological deficit, additional injuries, decompressive procedures, anatomic level and complications. There were 28 (70%) luxofractures. The causes of the injuries found were 21 (52%) cases of vehicle motor accidents. 24 patients (60%) had neurological deficit and seven of them required decompression procedures, the mean of levels fixed per patient were seven. the modified Harrington-Luque technique was used in 26 patients and the modular technique was used in 14. The complications presented were two acute infections

  15. [Auxiliary cerclage-wiring in internal fixation of displaced acetabular fractures].

    Science.gov (United States)

    Erichsen, C J; von Rüden, C; Hierholzer, C; Bühren, V; Woltmann, A

    2015-01-01

    Displaced fractures of the acetabulum involving the quadrilateral plate continue to be a surgical challenge. In this study, we describe our operation technique of auxiliary acetabular cerclage-wiring combined with plate osteosynthesis and present our results as well as short-term outcome. All patients aged 18 years and older treated with auxiliary cerclage-wiring between 2007 and 2012 were included in this study. Fractures were classified according to Letournel. Cerclage wiring was used when reposition and retention of the fracture was insufficient with plates and screws alone. Short-term outcome was evaluated by the German Short Musculoskeletal Functional Assessment (SMFA-D) questionnaire. Data from 23 patients were collected. The follow-up period was 7 months (range 2-23 months). Of the 23 patients, 22 showed excellent fracture reduction and retention. One patient had to undergo revision surgery due to loss of reposition. Patients showed good functional outcome. Auxiliary acetabular cerclage-wiring is a safe and effective method for fracture reduction and retention especially in displaced acetabular fractures involving the quadrilateral plate.

  16. Surgical site infection in orthopedic implants and its common bacteria with their sensitivities to antibiotics, in open reduction internal fixation

    International Nuclear Information System (INIS)

    Shah, M.Q.; Zardad, M.S.; Khan, A.; Ahmed, S.; Awan, A. S.; Mohammad, T.

    2017-01-01

    Surgical site infection in orthopaedic implants is a major problem, causing long hospital stay, cost to the patient and is a burden on health care facilities. It increases rate of non-union, osteomyelitis, implant failure, sepsis, multiorgan dysfunction and even death. Surgical site infection is defined as pain, erythema, swelling and discharge from wound site. Surgical site infection in orthopaedic implants is more challenging to the treating orthopaedic surgeon as the causative organism is protected by a biofilm over the implant's surface. Antibiotics cannot cross this film to reach the bacteria's, causing infection. Method: This descriptive case series study includes 132 patients of both genders with ages between 13 years to 60 years conducted at Orthopaedic Unit, Ayub Medical College, Abbottabad from 1st October 2015 to 31st March 2016. Patients with close fractures of long bones were included in the study to determine the frequency of surgical site infection in orthopaedic implants and the type of bacteria involved and their sensitivity to various antibiotics. All implants were of stainless steel. The implants used were Dynamic hip screws, Dynamic compression screws, plates, k-wires, Interlocking nails, SIGN nails, Austin Moore prosthesis and tension band wires. Pre-op and post-op antibiotics used were combination of Sulbactum and Cefoperazone which was given 1 hour before surgery and continued for 72 hours after surgery. Patients were followed up to 4 weeks. Pus was taken on culture stick, from those who developed infection. Results were entered in the pro forma. Results: A total of 132 patients of long bone fractures, who were treated with open reduction and internal fixation, were studied. Only 7 patients developed infection. Staphylococcus Aureus was isolated from all 7 patients. Staphylococcus aureus was sensitive to Linezolid, Fusidic Acid, and vancomycin. Cotrimoxazole, tetracycline, Gentamycin and Clindamycin were partially effective

  17. Single-Incision Carpal Tunnel Release and Distal Radius Open Reduction and Internal Fixation: A Cadaveric Study.

    Science.gov (United States)

    Gaspar, Michael P; Sessions, Blane A; Dudoussat, Bryan S; Kane, Patrick M

    2016-08-01

    The safety of surgical approaches for single- versus double-incision carpal tunnel release in association with distal radius open reduction and internal fixation remains controversial. The purpose of this study was to identify critical structures to determine if a single-incision extension of the standard flexor carpi radialis (FCR) approach can be performed safely. Nine cadaveric arms with were dissected under loupe magnification, utilizing a standard FCR approach. After the distal radius exposure was complete, the distal portion of the FCR incision was extended to allow release of the carpal tunnel. Dissection of critical structures was performed, including the recurrent thenar motor branch of the median nerve, the palmar cutaneous branch of the median nerve (PCBm), the palmar carpal and superficial palmar branches of the radial artery, and proximally the median nerve proper. The anatomic relationship of these structures relative to the surgical approach was recorded. Extension of the standard FCR approach as described in this study did not damage any critical structure in the specimens dissected. The PCBm was noted to arise from the radial side of the median nerve an average of 6.01cm proximal to the proximal edge of the transverse carpal ligament. The PCBm became enveloped in the layers of the antebrachial fascia and the transverse carpal ligament at the incision site, protecting it from injury. The recurrent motor branch of the median nerve, branches of the radial artery and the median nerve proper were not at risk during extension of the FCR approach to release the carpal tunnel. Extension of the standard FCR approach to include carpal tunnel release can be performed with minimal risk to the underlying structures. This exposure may offer benefits in both visualization and extent of carpal tunnel release.

  18. [Surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation].

    Science.gov (United States)

    Yang, Qi-Yua; Feng, Jing; Luo, Xiao-Li; Yang, Wen-Dong; Li, Ying-Bo; Fan, Bin; Feng, Zhi; Lai, Xian-Jin

    2016-10-25

    To explore the clinical effects of surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation. The clinical data of 12 patients with odontoid fracture associated with atlantoaxial dislocation from January 2008 to December 2013 were retrospectively analyzed. There were 8 males and 4 females, ranging in age from 21 to 53 years with an average of 37.2 years. Eleven cases were fresh fracture and 1 case was old fracture, all patients complicated with atlantoaxial anterior dislocation. According to Anderson-D' Alonzo typing method modified by Grauer, 3 cases were type IIA, 5 cases were type IIB, 3 cases were type IIC, and 1 case was type IIIA. All patients underwent surgical treatment with cable dragged reduction and cantilever beam internal fixation by posterior approach. JOA score and ADI method were respectively used to evaluate the nerve function and reductive condition of atlantoaxial dislocation. All patients were followed up from 6 months to 2 years with an average of 1 year and 3 months. At 1 week, 6 months after operation, and final follow up, JOA scores were 13.2±1.3, 13.5±1.4, 14.3±1.5, respectively, and these data were obviously better than that of preoperative 8.3±1.4( P dragged reduction and cantilever beam internal fixation by posterior approach for odontoid fracture associated with atlantoaxial dislocation is a good method, with advantage of firm fixation and high safety. It could obtain good clinical effects.

  19. Treatment of type II odontoid fracture with a novel technique: Titanium cable-dragged reduction and cantilever-beam internal fixation.

    Science.gov (United States)

    Zhu, Ce; Wang, Lei; Liu, Hao; Song, Yueming; Liu, Limin; Li, Tao; Gong, Quan

    2017-11-01

    Surgical methods for type II odontoid fracture can be classified into 2 main groups: anterior or posterior approach. A more effective way to achieve bone fusion with the lowest possible surgical risk is needed. Therefore, the aim of our study was to describe and evaluate a novel technique, cable-dragged reduction/cantilever beam internal fixation for the treatment of type II odontoid fracture.This was a retrospective study enrolled 34 patients underwent posterior cable-dragged reduction/cantilever-beam internal fixation surgery. Medical records, rates of reduction, the location of the instrumentation and fracture healing during follow-up were analyzed. Once fracture healing was obtained, instrumentation was removed. Neck pain (scored using a visual analog scale [VAS]), neck stiffness, patient satisfaction, and neck disability index (NDI) were recorded before and after removing the instrumentation during follow-up.The mean duration of follow up was 22.8 ± 5.3 months. There was no iatrogenic damage to nerves or blood vessels. Radiographic evaluation showed complete reduction in the 20 patients with fracture displacement and satisfactory fracture healing in all 34 cases. Titanium cable breakage was observed in 4 patients after fracture healing. After removal of instrumentation, significant improvements were seen in neck-pain VAS score, neck stiffness, patient satisfaction, and NDI (all P dragged reduction/cantilever-beam internal fixation was an optimal salvage maneuver to conventional surgical methods such as anterior screw fixation and C1-C2 screw-rod system. The operative difficulty and incidence of nerve and vascular injury were reduced. Its major disadvantage is the exposure and screw-setting at C3, which is left intact in traditional surgery, and it is suitable only for patients with intact C1 posterior arches.

  20. Primary open reduction and internal fixation with headless compression screws in the treatment of Chinese patients with acute Lisfranc joint injuries.

    Science.gov (United States)

    Zhang, Hui; Min, Li; Wang, Guang-Lin; Huang, Qiang; Liu, Kai; Liu, Lei; Tu, Chongqi; Pei, Fu-Xing

    2012-05-01

    Although primary open anatomic reduction and stable internal fixation has become a standard treatment principle of Lisfranc joint injuries, there are still some debates existed among surgeons as to the most appropriate treatment of this injury. The aim of this cohort study was to analyze the early (mean, 3.2 years) clinical and radiographic outcomes of one surgeon's experience associated with a standardized protocol of open reduction and internal fixation using headless compression screws (HCS) in a consecutive series of Chinese patients with Lisfranc joint injuries. This study is to retrospectively evaluate the clinical and radiographic outcomes of a series of Chinese patients with Lisfranc joint injuries that underwent open reduction and internal fixation with HCS. There were 29 patients (30 feet) included in our study. The average score of American Orthopaedic Foot and Ankle Society Midfoot score and the Visual Analog Pain Scale were 80.6 and 2.4 points at the final follow-up point, respectively. Anatomic initial reduction was obtained in 26 patients (27 feet, 90%). At the last follow-up point, only one case had the loss of reduction. Posttraumatic osteoarthritis was observed in 10 patients (10 feet, 33%), and 2 of them (2 feet, 7%) were scheduled for arthrodesis because of persistent pain. Our results have shown that fixation of an unstable tarsometatarsal joint with AO 3.0 mm HCS can provide the firm stability, the precise reduction of the joint, and satisfactory short-term clinical and radiographic outcomes without any screw breakage, although posttraumatic osteoarthritis in the midfoot is still a significant challenge for orthopedic surgeons.

  1. A biomechanical experiment and clinical study of the use of figure of eight plus circular wiring fixation for the treatment of olecranon fractures.

    Science.gov (United States)

    Wang, Wulian; Wu, Guangwen; Shen, Fuer; Zhang, Yiyuan; Liu, Xianxiang

    2012-12-01

    The aim of the present study was to evaluate the stability of the figure of eight plus circular wiring fixation technique compared with four common internal fixation techniques and to provide experimental data for the selection of internal fixation techniques clinically. A total of 20 fresh cadaveric elbow joints were used as transverse, oblique and comminuted olecranon fracture models. Five techniques of internal fixation were investigated: circular wiring, figure of eight wiring, circular plus figure of eight wiring, Kirschner wire (K-wire) and screw fixation. The elbow joints were flexed at 90°. The fixation performance was tested using a high-precision displacement sensor. Displacement-load curves revealed that the strength of internal fixation was weakest when using circular wiring alone and that circular wiring plus figure of eight wiring fixation was stronger than that of figure of eight wiring or screw fixation. The difference was statistically significant (Pwiring plus figure of eight wiring fixation and K-wire fixation in the transverse and oblique fracture models (P>0.05). However, figure of eight plus circular wiring fixation was superior to K-wire fixation in the comminuted fracture model, with a tensile force of 67.42±2.17 vs. 58.52±2.17 N, respectively (Pwiring plus figure of eight wiring fixation recovered and 108 were included in the follow-up for an average of 12 months. The rate of excellent/fairly good recovery was 98.10%. Due to its reliability, simple surgery, lower invasiveness and lower cost, figure of eight plus circular wiring fixation is an ideal choice for the internal fixation of olecranon fractures, particularly comminuted fractures, compared with circular wiring, figure of eight wiring or screw fixation.

  2. International Entrepreneurship Theory: Past, Present and Way Forward

    OpenAIRE

    Ikemefuna Allen

    2016-01-01

    Objective: This paper recounts the historical development of International Entrepreneurship as a study field, and demonstrates how concepts brought forth contribute to a broader understanding of fundamental international business and entrepreneurship theories. Research Design & Methods: The analytical work makes reference to the existing literature on International Entrepreneurship. Based on the categorisation of themes and sub-themes, the historical development of international entrepren...

  3. International conference on past, present and future climate. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Heikinheimo, P. [ed.

    1995-12-31

    This publications contains the proceedings of the International Conference on Past, Present and Future Climate, held in Helsinki, Finland, on 22-25 August 1995. Conference was organized to serve at least two purposes. First, it was the fourth meeting in a series of Nordic climate conferences. Earlier Nordic meetings had been held in Copenhagen (1978), Stockholm (1983) and Tromsoe (1990). Secondly, the conference formed part of the integration activities of the Finnish Research Programme on Climate Change (SILMU). Four central themes were selected for the conference: (1) climatic changes since the last glaciation inferred from proxy data,(2) detection of climate change from the instrumental record,(3) changes in atmospheric composition, (4) predicting future climate. The Finnish Research Programme on Climate Change was in its sixth and final year at the time of the conference. One of the aims of the meeting was to foster the communication of SlLMU`s results to the scientific community at large. On the other hand, feedback from overseas colleagues was expected to be beneficial for the final reporting of the results of the research programme. Altogether 117 scientific contributions were submitted and more than 140 scientists attended the conference

  4. Theory of condensed matter. Lectures presented at an international course

    International Nuclear Information System (INIS)

    1968-01-01

    The International Centre for Theoretical Physics, since its inception, has striven to maintain an interdisciplinary character in its research and training programme as far as different branches of theoretical physics are concerned. in pursuance of this aim the Centre has followed a policy of organizing extended research seminars with a comprehensive and synoptic coverage on varying disciplines. The first of these — lasting over a month — was held in 1964 on fluids of ionized particles and plasma physics; the second, lasting for two months, was concerned with physics of elementary particles and high-energy physics; the third, of three months’ duration, October — December 1966, covered nuclear theory; the fourth, bringing the series through a complete cycle, was a course on condensed matter held from 3 October to 16 December 1967. The present volume records the proceedings of this research seminar. The publication is divided into four parts containing 29 papers. Part I — General Courses, Part II - Dynamical lattice properties; Part III — Liquids and molecules; Part IV — Electronic properties

  5. Economics and Comparative and International Education: Past, Present, Future

    Science.gov (United States)

    Wolhuter, Charl

    2017-01-01

    The aim of this paper is to map this place of economics in the field of study of Comparative and International Education. Interrelationship between economy and education is concerned, two broad lines of enquiry lie within the scope of Comparative and International Education: economy as shaping force of education systems and the effect of education…

  6. Skeletal stability in orthognathic surgery: evaluation of methods of rigid internal fixation after counterclockwise rotation in patients with class II deformities.

    Science.gov (United States)

    Rocha, Vanessa Álvares de Castro; Neto, Antonio Irineu Trindade; Rebello, Iêda Margarida Crusoé Rocha; de Souza, Gustavo Mota Mascarenhas; Esteves, Lucas Senhorinho; dos Santos, Jean Nunes; Zanetta-Barbosa, Darceny; do Prado, Célio Jesus

    2015-10-01

    Our aim was to assess the influence of internal fixation in skeletal stability on patients who had had counterclockwise rotation of the maxillomandibular complex and mandibular advancement procedures. We studied 60 records of 20 patients (14 female, 6 male), mean (range) age at operation 29 (16-50) years. The mean (range) postoperative follow-up was 15 (8-24) months. Sixty standard lateral cephalometric radiographs were randomly traced and digitised by one senior radiologist to estimate surgical and postoperative changes. Patients were divided into two groups, the first group (n=10) of which had fixation with only 2.0 system plates (2 plates with monocortical screws alone) and the second (n=10) of which had hybrid fixation (1 plate with monocortical screws and 2 or 3 bicortical bone screws). During operation the change in the mean occlusal plane with counterclockwise rotation was 9.4° (range -17.3 to -2.5mm). The maxilla moved forward and upward. All the anterior mandibular measurements had advanced horizontally, the mean (range) being 17 (6.4 to 9.9) mm for the pogonion, and 17.6 (6.0 to 30.7) mm for the menton. At the longest follow-up period, there were significant long-term changes, but these were clinically acceptable (stability or in the magnitude of the advancement and stability. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Features of Three- and Four-Part Proximal Humeral Fractures and Outcome of Internal Fixation Using the Philos® Locking Plate

    Directory of Open Access Journals (Sweden)

    Ali Sadighi

    2017-03-01

    Full Text Available Background: Proximal humeral fractures are among common types of fractures and remain a challenging issue for surgical management. This study aimed to assess the clinical outcomes and complication rates of three- vs. four-part proximal humeral fractures, treated with internal fixation using the Philos® plate. Material and Methods: In this cohort study, a total of 30 consecutive patients with three-part or four-part proximal humeral fractures based on the Neer classification were included. Surgical treatment was performed with open reduction and internal fixation using the Philos® plate. The constant score was evaluated 6 months later in follow-up. The P<0.05 was considered significant. Results: Four-part fractures were mainly caused by trauma from above, while insults of opposite direction were responsible for more than half of 3 part fractures (P=0.01. Open fractures were only observed in patients with a four-part fracture (P=0.018. No significant differences were noticed regarding gender, cause, and side of the fracture. The presence of other fractures, fracture of the implant, reduction loss, avascular necrosis (AVN of humerus head, rotator cuff injury, and revision surgery were significantly higher in patients with four-part fractures. The mean constant score was 81.40±11.61 and 65.09±16.09 for three-part and four-part fractures, respectively (P=0.006. Conclusion: Open reduction and internal fixation with Philos® plate yield acceptable results in both types of fractures, however, the prognosis of this intervention is poorer four-part fractures.

  8. Risk stratification for avascular necrosis of the femoral head after internal fixation of femoral neck fractures by post-operative SPECT/CT

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sang Won; Oh, Min Young; Yoon, Seok Ho; Kim, Jin Soo; Chang, Jae Suk; Ryu, Jin Sook [Asan Medical CenterUniversity of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Ji Wan [Dept. of Orthopedic Surgery, Haeundae Paik Hospital, Inje University, Busan (Korea, Republic of)

    2017-03-15

    Avascular necrosis (AVN) of the femoral head is a major complication after internal fixation of a femoral neck fracture and determines the functional prognosis. We investigated postoperative bone single-photon emission computed tomography/computed tomography (SPECT/CT) for assessing the risk of femoral head AVN. We retrospectively reviewed 53 consecutive patients who underwent bone SPECT/CT within 2 weeks of internal fixation of a femoral neck fracture and follow-up serial hip radiographs over at least 12 months. Nine patients developed femoral head AVN. In 15 patients who showed normal uptake on immediate postoperative SPECT/CT, no AVN occurred, whereas 9 of 38 patients who showed cold defects of the femoral head later developed AVN. The negative predictive value of immediate postoperative SPECT/CT for AVN was 100 %, whereas the positive predictive value was 24 %. Among 38 patients with cold defects, 1 developed AVN 3 months postoperatively. A follow-up bone SPECT/CT was performed in the other 37 patients at 2–10 months postoperatively. The follow-up bone SPECT/CT revealed completely normalized femoral head uptake in 27, partially normalized uptake in 8, and persistent cold defects in 2 patients. AVN developed in 3.7 % (1/27), 62.5 % (5/8), and 100 % (2/2) of each group, respectively. According to the time point of imaging, radiotracer uptake patterns of the femoral head on postoperative bone SPECT/CT indicate the risk of AVN after internal fixation of femoral neck fractures differently. Postoperative bone SPECT/CT may help orthopedic surgeons determine the appropriate follow-up of these patients.

  9. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis: A retrospective case-control study.

    Science.gov (United States)

    Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

    2017-07-01

    The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery.In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared.The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively.PELD operation was superior in terms of operation time, bleeding volume, recovery period, and financial

  10. Comprehensive comparing percutaneous endoscopic lumbar discectomy with posterior lumbar internal fixation for treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis

    Science.gov (United States)

    Sun, Yapeng; Zhang, Wei; Qie, Suhui; Zhang, Nan; Ding, Wenyuan; Shen, Yong

    2017-01-01

    Abstract The study was to comprehensively compare the postoperative outcome and imaging parameter characters in a short/middle period between the percutaneous endoscopic lumbar discectomy (PELD) and the internal fixation of bone graft fusion (the most common form is posterior lumbar interbody fusion [PLIF]) for the treatment of adjacent segment lumbar disc prolapse with stable retrolisthesis after a previous lumbar internal fixation surgery. In this retrospective case-control study, we collected the medical records from 11 patients who received PELD operation (defined as PELD group) for and from 13 patients who received the internal fixation of bone graft fusion of lumbar posterior vertebral lamina decompression (defined as control group) for the treatment of the lumbar disc prolapse combined with stable retrolisthesis at Department of Spine Surgery, the Third Hospital of Hebei Medical University (Shijiazhuang, China) from May 2010 to December 2015. The operation time, the bleeding volume of perioperation, and the rehabilitation days of postoperation were compared between 2 groups. Before and after surgery at different time points, ODI, VAS index, and imaging parameters (including Taillard index, inter-vertebral height, sagittal dislocation, and forward bending angle of lumbar vertebrae) were compared. The average operation time, the blooding volume, and the rehabilitation days of postoperation were significantly less in PELD than in control group. The ODI and VAS index in PELD group showed a significantly immediate improving on the same day after the surgery. However, Taillard index, intervertebral height, sagittal dislocation in control group showed an immediate improving after surgery, but no changes in PELD group till 12-month after surgery. The forward bending angle of lumbar vertebrae was significantly increased and decreased in PELD and in control group, respectively. PELD operation was superior in terms of operation time, bleeding volume, recovery period

  11. Presentations

    International Nuclear Information System (INIS)

    2007-01-01

    The presented materials consist of presentations of international workshop which held in Warsaw from 4 to 5 October 2007. Main subject of the meeting was progress in manufacturing as well as research program development for neutron detector which is planned to be placed at GANIL laboratory and will be used in nuclear spectroscopy research

  12. History of internal fixation with plates (part 2): new developments after World War II; compressing plates and locked plates.

    Science.gov (United States)

    Hernigou, Philippe; Pariat, Jacques

    2017-07-01

    The first techniques of operative fracture with plates were developed in the 19th century. In fact, at the beginning these methods consisted of an open reduction of the fracture usually followed by a very unstable fixation. As a consequence, the fracture had to be opened with a real risk of (sometimes lethal) infection, and due to unstable fixation, protection with a cast was often necessary. During the period between World Wars I and II, plates for fracture fixation developed with great variety. It became increasingly recognised that, because a fracture of a long bone normally heals with minimal resorption at the bone ends, this may result in slight shortening and collapse, so a very rigid plate might prevent such collapse. However, as a consequence, delayed healing was observed unless the patient was lucky enough to have the plate break. One way of dealing with this was to use a slotted plate in which the screws could move axially, but the really important advance was recognition of the role of compression. After the first description of compression by Danis with a "coapteur", Bagby and Müller with the AO improved the technique of compression. The classic dynamic compression plates from the 1970s were the key to a very rigid fixation, leading to primary bone healing. Nevertheless, the use of strong plates resulted in delayed union and the osteoporosis, cancellous bone, comminution, and/or pathological bone resulted in some failures due to insufficient stability. Finally, new devices represented by locking plates increased the stability, contributing to the principles of a more biological osteosynthesis while giving enough stability to allow immediate full weight bearing in some patients.

  13. The evolution of international cooperation up to the present time

    International Nuclear Information System (INIS)

    Goldschmidt, Bertrand

    1978-01-01

    This paper delivered at the Symposium organised on the XXth anniservary of the OECD Nuclear Energy Agency recalls the historical background of nuclear cooperation which went through three stages : European collaboration, U.S. isolationist policy and finally, openness. Cooperation took place at three levels: bilateral and multilateral technical cooperation; creation of joint multinational undertakings; trade relations. The paper then examines three particular areas which illustrate the evolution of international nuclear cooperation, i.e., organisation of the uranium market, uranium enrichment and the International Nuclear Fuel Cycle Evaluation. (NEA) [fr

  14. Hong Kong as international banking center: present and future

    OpenAIRE

    Alicia Garcia-Herrero

    2011-01-01

    The banking industry is key for Hong Kong’s economy but Hong Kong is not a big international banking center, at least not when compared with other centers belonging to large economic areas, such as New York and, to a lesser extent, Tokyo. Within Asia, Hong Kong has a larger banking sector as a whole but similar if we focus on the off-shore side of it and growing faster than in Hong Kong. Furthermore, Singapore is being more active as a banking platform for international corporates while...

  15. Finite element analysis of a bone healing model: 1-year follow-up after internal fixation surgery for femoral fracture.

    Science.gov (United States)

    Jiang-Jun, Zhou; Min, Zhao; Ya-Bo, Yan; Wei, Lei; Ren-Fa, Lv; Zhi-Yu, Zhu; Rong-Jian, Chen; Wei-Tao, Yu; Cheng-Fei, Du

    2014-03-01

    Finite element analysis was used to compare preoperative and postoperative stress distribution of a bone healing model of femur fracture, to identify whether broken ends of fractured bone would break or not after fixation dislodgement one year after intramedullary nailing. Method s: Using fast, personalized imaging, bone healing models of femur fracture were constructed based on data from multi-slice spiral computed tomography using Mimics, Geomagic Studio, and Abaqus software packages. The intramedullary pin was removed by Boolean operations before fixation was dislodged. Loads were applied on each model to simulate a person standing on one leg. The von Mises stress distribution, maximum stress, and its location was observed. Results : According to 10 kinds of display groups based on material assignment, the nodes of maximum and minimum von Mises stress were the same before and after dislodgement, and all nodes of maximum von Mises stress were outside the fracture line. The maximum von Mises stress node was situated at the bottom quarter of the femur. The von Mises stress distribution was identical before and after surgery. Conclusion : Fast, personalized model establishment can simulate fixation dislodgement before operation, and personalized finite element analysis was performed to successfully predict whether nail dislodgement would disrupt femur fracture or not.

  16. [Femoral and sciatic nerve blocks for open reduction and internal fixation of a femoral condylar fracture in a patient with post-polio syndrome].

    Science.gov (United States)

    Nagaoka, Takehiko; Mizuno, Ju; Ino, Kentaro; Yoshimura, Tatsuya; Sakamoto, Hidetoshi; Morita, Shigeho

    2011-08-01

    The post polio symdrome (PPS) refers to the development of delayed neuromuscular symptoms among survivors, years after the initial presentation of acute poliomyelitis. The symptoms of PPS vary widely and include flaccid palsy, muscle weakness, scoliosis, osteoarthritis, gait disturbance, sleep apnea syndrome (SAS), dysphagia, chronic lung dysfunction, and others. We report the successful combination of peripheral nerve blocks, femoral and sciatic nerve blocks, for surgery on the lower extremity in a patient with PPS. A 51-year-old man with continuous positive airway pressure therapy for restrictive ventilatory impairment due to scoliosis and SAS as part of the PPS was scheduled for open reduction and internal fixation (OR-IF) for a right femoral condylar fracture. Respiratory function tests demonstrated a vital capacity (VC) 1.41l (41% predicted). Arterial blood gas analysis on room air was; pH 7.376, PaCO2 55.0 mmHg, and PaO2 77.9 mmHg. With the patient in the supine position, ultrasound-guided right femoral nerve block in the infra-inguinal region was performed using 1.5% mepivacaine 10 ml and 0.75% ropivacaine 5 ml, followed by sciatic nerve block in the popliteal fossa using 1.5% mepivacaine 8 ml and 0.75% ropivacaine 4 ml in the prone position. OR-IF of the fractured femoral condyle was then successfully performed with propofol under spontaneous ventilation. Postoperatively, there were no adverse events; respiratory function was adequate, and his pain was within manageable bounds. Femoral and sciatic nerve blocks are safe and effective anesthetic methods for lower extremity surgery in patients with restrictive ventilatory impairment and hypercapnia due to scoliosis and SAS as PPS.

  17. The application of closed reduction internal fixation and iliac bone block grafting in the treatment of acute displaced femoral neck fractures.

    Directory of Open Access Journals (Sweden)

    Zhiyong Li

    Full Text Available OBJECTIVE: This study aimed to evaluate the preliminary clinical and radiographic outcomes of acute displaced femoral neck fracture treated by closed reduction and internal fixation (CRIF with free iliac bone block grafting with comparison to a routine protocol of CRIF without bone grafting. METHODS: From December 2008 to February 2010, 220 adult patients with acute displaced femoral neck fractures were enrolled in this study. In study group, there were 124 patients (57 males, 67 females with a mean age of 44.8 years (range, 20-64 years. There were 70 transcervical fractures and 54 subcapital fractures. The patients were treated by CRIF and free iliac bone block grafting. The control group consisted of 96 adult patients (46 males, 50 females with a mean age of 46.3 years (range, 23-64 years. There were 61 transcervical fractures and 35 subcapital fractures. The patients in control group were treated by CRIF without bone grafting. RESULTS: In study group, 112 patients were followed up for an average of 27.4 months (range, 24-34 months. All fractures healed within 5 months. However, 10 patients presented AVN of the femoral heads. The mean Harris score was 88.6 (range, 41-100. In control group, 68 patients were followed up for an average of 31.2 months (range, 24-42 months. The rates of AVN of the femoral head and fracture nonunion in control group were 26.5% (18/68 and 16.2% (11/68, respectively, significantly higher than those in study group (both P<0.05. The mean Harris score in control group was 83.8 (41-100, significantly lower than that in study group (P<0.05. CONCLUSION: Acute displaced femoral neck fractures can be treated by CRIF and free iliac bone block grafting in a minimally invasive manner. This technique can guarantee uneventful fracture healing and significantly reduce the rate of femoral head osteonecrosis.

  18. Present status of International Criticality Safety Benchmark Evaluation Project (ICSBEP)

    International Nuclear Information System (INIS)

    Miyoshi, Yoshinori

    2000-01-01

    The International Criticality Safety Evaluation Project, ICSBEP was designed to identify and evaluate a comprehensive set of critical experiment benchmark data. Compilation of the data into a standardized format are made by reviewing original and subsequently revised documentation for calculating each experiment with standard criticality safety codes. Five handbooks of evaluated criticality safety benchmark experiments have been published since 1995. (author)

  19. International Telemedicine/Disaster Medicine Conference: Papers and Presentations

    Science.gov (United States)

    1991-01-01

    The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

  20. Economics and Comparative and International Education: Past, Present, Future

    Directory of Open Access Journals (Sweden)

    Charl Wolhuter

    2017-05-01

    Full Text Available The aim of this paper is to map this place of economics in the field of study of Comparative and International Education. Interrelationship between economy and education is concerned, two broad lines of enquiry lie within the scope of Comparative and International Education: economy as shaping force of education systems and the effect of education on the economy. In the interwar “factors and forces” stage of Comparative Education, the economy as a shaping force of national education systems came to the fore. In the social science phase of the 1960s the focus shifted to a study of the effect of education on the economy. This was reversed again in the 1970s, when socio-economic reproduction theories assigned a deterministic place to socio-economic stratification of society. In recent years neo-liberal economics dictated the research agenda of Comparative Education. In conclusion recommendations for a future research agenda in the field are made.

  1. Contemporaneous International Asthma Guidelines Present Differing Recommendations: An Analysis

    Directory of Open Access Journals (Sweden)

    Samir Gupta

    2016-01-01

    Full Text Available Background. Several international groups develop asthma guidelines. Conflicting recommendations across guidelines have been described in several disease areas and may contribute to practice variability. Accordingly, we compared the latest Canadian Thoracic Society (CTS asthma guideline with contemporaneous international asthma guidelines to evaluate conflicting recommendations and their causes. Methods. We identified the latest CTS asthma guideline update (2012 and the following societies which also updated their guidelines in 2012: the British Thoracic Society and Scottish Intercollegiate Guidelines Network and the Global Initiative for Asthma. We compared these three guidelines on (1 key methodological factors and (2 adult pharmacotherapy recommendations. Results. Methods used and documentation provided for literature search strategy and dates, evidence synthesis, outcomes considered, evidence appraisal, and recommendation formulation varied between guidelines. Criteria used to define suboptimal asthma control varied widely between guidelines. Inhaled corticosteroid dosing recommendations diverged, as did recommendations surrounding use of budesonide/formoterol as a reliever and controller and recommendations in the subsequent step. Conclusions. There are important differences between recommendations provided in contemporaneous asthma guidelines. Causes include differences in methods used for interpreting evidence and formulating recommendations. Adopting a common set of valid and explicit methods across international societies could harmonize recommendations and facilitate guideline implementation.

  2. Relationship between screw sagittal angle and stress on endplate of adjacent segments after anterior cervical corpectomy and fusion with internal fixation: a Chinese finite element study.

    Science.gov (United States)

    Zhang, Yu; Tang, Yibo; Shen, Hongxing

    2017-12-01

    In order to reduce the incidence of adjacent segment disease (ASD), the current study was designed to establish Chinese finite element models of normal 3rd~7th cervical vertebrae (C3-C7) and anterior cervical corpectomy and fusion (ACCF) with internal fixation , and analyze the influence of screw sagittal angle (SSA) on stress on endplate of adjacent cervical segments. Mimics 8.1 and Abaqus/CAE 6.10 softwares were adopted to establish finite element models. For C4 superior endplate and C6 inferior endplate, their anterior areas had the maximum stress in anteflexion position, and their posterior areas had the maximum stress in posterior extension position. As SSA increased, the stress reduced. With an increase of 10° in SSA, the stress on anterior areas of C4 superior endplate and C6 inferior endplate reduced by 12.67% and 7.99% in anteflexion position, respectively. With an increase of 10° in SSA, the stress on posterior areas of C4 superior endplate and C6 inferior endplate reduced by 9.68% and 10.22% in posterior extension position, respectively. The current study established Chinese finite element models of normal C3-C7 and ACCF with internal fixation , and demonstrated that as SSA increased, the stress on endplate of adjacent cervical segments decreased. In clinical surgery, increased SSA is able to play important role in protecting the adjacent cervical segments and reducing the incidence of ASD.

  3. Presentation of the International Building Physics Toolbox for Simulink

    DEFF Research Database (Denmark)

    Weitzmann, Peter; Sasic Kalagasidis, Angela; Nielsen, Toke Rammer

    2003-01-01

    The international building physics toolbox (IBPT) is a software library specially constructed for HAM system analysis in building physics. The toolbox is constructed as a modular structure of the standard building elements using the graphical programming language Simulink. Two research groups have...... participated in this project. In order to enable the development of the toolbox, a common modelling platform was defined: a set of unique communication signals, material database and documentation protocol. The IBPT is open source and publicly available on the Internet. Any researcher and student can use...

  4. PRESENT AND FUTURE PERSPECTIVES IN INTERNATIONAL MEDICAL ASSISTANCE

    Directory of Open Access Journals (Sweden)

    Carmen Stadoleanu

    2012-12-01

    Full Text Available Paneuropean development of patients’ rights represent a relatively recent concern, the legislative norms of which aim at granting to patients real-time access to all sorts of medical services. To this end, the European Union implemented a unitary normative professional and juridical background: Directive 2011/24/U.E. on the rights of patients to international treatments. Consequently, the patients are free to choose themselves the suppliers of medical services which do not include hospitalization, without a previous authorisation (country, doctor and medical institution while, in the case of long-term treatments, a principial authorisation will be necessary. In both cases, the carrier of the therapeutic service receives the payment for his actions at the level of those established at national level, the difference being usually payed by the patient.

  5. Surgical Site Infections after Open Reduction Internal Fixation for Trauma in Low and Middle Human Development Index Countries: A Systematic Review.

    Science.gov (United States)

    McQuillan, Thomas J; Cai, Lawrence Z; Corcoran-Schwartz, Ian; Weiser, Thomas G; Forrester, Joseph D

    2018-01-17

    Musculoskeletal trauma represents a large source of morbidity in low and middle human development index countries (LMHDICs). Open reduction and internal fixation (ORIF) of traumatic long bone fractures definitively manages these injuries and restores function when conducted safely and effectively. Surgical site infections (SSIs) are a common complication of operative fracture fixation, although the risks of infection are ill-defined in LMHDIC. This study reviewed systematically all studies describing SSI after ORIF in LMDHICs. Studies were reviewed based on their qualitative characteristics, after which a quantitative synthesis of weighted pooled infection rates based on available patient-level data was performed to estimate published incidence of SSI. Forty-two studies met criteria for qualitative review and 32 studies comprising 3,084 operations were included in the quantitative analysis. Among 3,084 operations, the weighted pooled SSI rate was 6.4 infections per 100 procedures (95% confidence interval [CI] 4.6-8.2 infections per 100 procedures). Higher rates of infection were noted among the sub-group of open fractures (95% CI 13.9-23.0 infections per 100 procedures). Lower extremity injuries and procedures utilizing intra-medullary nails also had slightly higher rates of infection versus upper extremity procedures and other fixation devices. Reported rates of SSI after ORIF are higher in LMHDICs, and may be driven by high rates of infection in the sub-group of open fractures. This study provides a baseline SSI rate obtained from literature produced from LMHDICs. Infection rates are highly dependent on fracture sub-types.

  6. The international Argo data infrastructure; past, present, and future.

    Science.gov (United States)

    Buck, J. J. H.; Pouliquen, S.; Thresher, A.; Schmechtig, C.; Ignaszewski, M.; Carval, T.; Scanderbeg, M.; Frost, M.

    2016-12-01

    The Argo array is composed of over 3,000 autonomous profiling floats that measure the temperature and salinity of the upper 2,000 m of the global deep ocean every ten days. Argo is a key component of the global ocean observing system and the data addresses crucial questions such as quantifying the heat content of the upper ocean and steric sea level change. Further to this data are routinely assimilated into operational ocean forecast models. Argo is underpinned by an international data system that was founded in the year 2,000 at the first meeting of the Argo data management team. The Argo data system is built on principles of open data and supplying data to both operational ocean models and research communities within 24 hours of collection. The data system served as a template for the established international OceanSITES community and the emerging Everyones Glider Observatories initiative. The Argo data system is composed of national Data Assembly Centers (DAC) that supply data to two mirrored Global Data Assembly Centres (GDAC). GDAC data exchanges are based on File Transfer Protocol (FTP). A significant recent data system development is the assignment of a single dynamic DOI to GDAC holdings enabling time dependent unambiguous data citation at a monthly granularity. The on-going evolution of Argo to address new global questions requires deeper data, shallower data, biogeochemical sampling and increased spatial coverage. These enhancements are increasing data complexity and volumes necessitating significant recent data format adaptation. The challenge and achievement was to preserve data formats and quality for existing established users while still allowing the integration of new data streams. The implementation of these adaptations is currently in progress within DACs. Argo data have been traditionally delivered via FTP protocol with developments are on-going to facilitate new users and emerging expectations on data delivery mechanisms. These experimental

  7. Biologic and biomechanic evaluation of posterior lumbar fusion in the rabbit. The effect of fixation rigidity.

    Science.gov (United States)

    Feighan, J E; Stevenson, S; Emery, S E

    1995-07-15

    The histologic and biomechanic characteristics of posterior lumbar fusion with varying rigidity of a novel internal fixation construct in the rabbit were analyzed. To evaluate this rabbit model for future studies of fusion augmentation. Previous studies in goats and dogs showed internal fixation enhances spinal arthrodesis. Twenty eight New Zealand white rabbits underwent a posterior midline fusion from L4 to L6. Some animals received autogenous iliac crest bone graft, stabilized by wiring the superior facets bilaterally, and supplementation with polymethylmethacrylate. The experimental groups were iliac crest bone graft with either no fixation, wire fixation, or wire and polymethylmethacrylate fixation; and no graft and either no fixation, wire fixation, or wire and polymethylmethacrylate fixation. Animals were killed 2 months after surgery, and the specimens were nondestructively tested biomechanically for stiffness in six modes (flexion, extension, left and right bending, compression, and torsion) and histologically for evidence of fusion, revascularization, and new bone formation. Fusions with either wire or wire and polymethylmethacrylate fixation were significantly stiffer than those without fixation (P < 0.05). There was no statistical difference between the iliac crest bone graft and wire group and the iliac crest bone graft, wire, and polymethylmethacrylate group in the modes tested. Nine of 14 motion segments receiving the stiffest construct (iliac crest bone graft, wire, and polymethylmethacrylate) had evidence of solid bony fusion. None of the 12 motion segments receiving iliac crest bone graft and wire had evidence of bony fusion, but five had a fibrocartilage union with some ossification present. Eight of 12 motion segments receiving iliac crest bone graft and no fixation had predominantly fibrous unions with some fibrocartilage, and only one motion segment of 12 showed bony fusion. This study suggests that more rigid fixation produces more successful

  8. Three phase bone scintigraphy with (99m)Tc-MDP and serological indices in detecting infection after internal fixation in malunion or nonunion traumatic fractures.

    Science.gov (United States)

    Yang, Fang; Yang, Zheng; Feng, Jin; Zhang, Lianna; Ma, Daqing; Yang, Jigang

    2016-01-01

    To evaluate the diagnostic efficacy of technetium-99m-methylene diphosphonate ((99m)Tc-MDP) three phase bone scintigraphy in detecting infection in malunion or nonunion traumatic fractures after internal fixation. One hundred and eighty four patients with malunion or nonunion fractures after internal fixation (130 men and 54 women; age range, 16-79 years) underwent (99m)Tc-MDP three phase bone scintigraphy (3PBS). They were divided into the infection group (n=96) and the control group without infection (n=88) based on the final diagnosis after operation. The sensitivity, specificity, accuracy, positive prediction value (PPV) and negative prediction value (NPV) were calculated and compared. All patients carried out other laboratory tests related to infection such as complete serum blood cells count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). The (99m)Tc-MDP 3PBS for the blood flow phase showed sensitivity, specificity, accuracy, positive predictive value and negative predictive value, 91.7% (88/96), 72.7% (64/88), 82.6% (152/184), 78.6% (88/112) and 88.9% (64/72), respectively and for the blood pool phase, 93.8% (90/96), 61.4% (54/88), 78.3% (144/184), 72.6% (90/124) and 90.0% (54/60) respectively. The semiquantitative indices of the ratio between the abnormal and the normal region of interest (ROI), called by us the A/N ratio, for both blood flow and blood pool phases as estimated between the infection group and the control group were statistically different. It is the opinion of the authors that (99m)Tc-MDP 3PBS provided high predictive values in diagnosing infection in patients with malunion or nonunion traumatic fractures after internal fixation. The diagnostic value of blood flow and blood pool phases estimated of the 3PBS was better than the laboratory indices: white blood cell counts, CRP, and ESR.

  9. Treatment of Atypical Ulnar Fractures Associated with Long-Term Bisphosphonate Therapy for Osteoporosis: Autogenous Bone Graft with Internal Fixation

    Directory of Open Access Journals (Sweden)

    Yohei Shimada

    2017-01-01

    Full Text Available Long-term bisphosphonate use has been suggested to result in decreased bone remodelling and an increased risk of atypical fractures. Fractures of this nature commonly occur in the femur, and relatively few reports exist to show that they occur in other bones. Among eight previous reports of atypical ulnar fractures associated with bisphosphonate use, one report described nonunion in a patient who was treated with cast immobilization and another described ulna nonunion in one of three patients, all of whom were treated surgically with a locking plate. The remaining two surgical patients achieved bone union uneventfully following resection of the osteosclerotic lesion and iliac bone grafting before rigid fixation. We hypothesized that the discontinuation of bisphosphonate therapy, the use of teriparatide treatment, and low-intensity pulsed ultrasound (LIPUS might have been associated with fracture healing.

  10. Wrong capital? Problems with recognition of knowledge presented by non-native students in international education

    DEFF Research Database (Denmark)

    Wilken, Lisanne

    This paper presents research on problems of knowledge recognition among students of various nationalities at an international organisation......This paper presents research on problems of knowledge recognition among students of various nationalities at an international organisation...

  11. Arterial Injury to the Profunda Femoris Artery following Internal Fixation of a Neck of Femur Fracture with a Compression Hip Screw

    Directory of Open Access Journals (Sweden)

    Simon Craxford

    2013-01-01

    Full Text Available We report the case of an 82-year-old woman who developed extensive proximal thigh swelling and persistent anaemia following internal fixation of an extracapsular neck of femur fracture with a dynamic hip screw (DHS. This was revealed to be a pseudoaneurysm of a branch of profunda femoris artery on angiography. Her case was further complicated by a concurrent pulmonary embolism (PE. She underwent endovascular coil embolisation of the pseudoaneurysm. An IVC filter was inserted and the patient was fully anticoagulated once it had been ensured that there was no active bleeding. In this case, we review the potential for anatomical variations in the blood supply to this region and discuss treatment options for a complicated patient. We recommend that a pseudoaneurysm should be part of a differential diagnosis for postoperative patients with anaemia refractory to blood transfusion so as not to miss this rare but potentially serious complication.

  12. Axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures through an extended lateral deltoid-split approach: electrophysiological findings.

    Science.gov (United States)

    Westphal, Thomas; Woischnik, Stephan; Adolf, Daniela; Feistner, Helmut; Piatek, Stefan

    2017-03-01

    Axillary nerve injuries after shoulder surgery are rare. In most studies, the frequency of injury is usually determined using clinical examinations, but results from intraoperative neuromonitoring studies have revealed higher than expected rates. Few studies have investigated this topic. Our aim was to determine the frequency of axillary nerve lesions after open reduction and internal fixation of proximal humeral fractures by using electrophysiological assessments and to provide a review of the relevant literature. This was a retrospective cohort study of 76 consecutive patients who received open reduction and internal fixation of a proximal humeral fracture using a locking plate through a deltoid-splitting approach. We performed a clinical and electrophysiological examination at a minimum follow-up time of 12 months. Functional results were assessed according to the Constant-Murley and Disabilities of the Arm, Shoulder and Hand scores. Electrophysiological examinations comprised electromyography, electroneurography, and motor and somatosensory evoked potentials. The main outcome was the frequency of axillary nerve lesions. Forty patients were monitored for an average of 28 months. The mean raw Constant-Murley score was 61 points, the age- and gender-adjusted score was 71%, and the mean Disabilities of the Arm, Shoulder and Hand score was 33 points. Neurapraxia occurred in 1 patient, axonotmesis with incomplete reinnervation occurred in 3, and complete reinnervation occurred in 3. The latter group was classified as having a temporary axillary nerve lesion. The 10% rate of permanent axillary nerve lesions in our cohort is higher than expected based on the clinical examination. Electrophysiological assessment is therefore more appropriate to detect axillary nerve injuries. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia

    Directory of Open Access Journals (Sweden)

    HU Peng

    2012-08-01

    Full Text Available Background Chiari malformation type Ⅰ(CM-Ⅰ is one of the soft tissue anomalies in craniovertebral junction (CVJ. This kind of soft tissue anomaly usually develops with bone anomaly, such as atlantoaxial subluxation, basilar invagination, platybasia, C1 assimilation, etc. For these complex combined anomalies, the treatment remains unaddressed. This study was performed to evaluate the effect of posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression for Chiari malformation type Ⅰ with basilar invagination, atlantoaxial subluxation, and syringomyelia. Methods Patients with basilar invagination and atlantoaxial subluxation treated from July 2004 to September 2011 were reviewed. Including criterions were made to screen matching patients. Including patients were retrospectively analyzed on both clinical outcomes and radiographical results. Japanese Orthopaedic Association (JOA score was used to evaluate the clinical outcomes, while the syrinx maximum size was measured on transverse view of MRI T2 image. The results were analyzed by SPSS 17.0 using t -text. Significant difference was considered when P ≤ 0.05. Results Fourteen patients met the including criterions, including 4 male patients and 10 female patients, with a mean age of 31.86 ± 11.36 (standard deviation, range: 17-51 years. Mean JOA score preoperatively of 14 patients was 13.07 ± 1.59 (standard deviation, while that was 15.57 ± 1.02 (standard deviation postoperatively (t = 9.946, P = 0.000. The mean syrinx size was (7.05 ± 1.98 mm (standard deviation, while that was (2.21 ± 1.91 mm (standard deviation postoperatively (t = 7.271, P = 0.000. There were no procedure-related morbidity or mortality happened. Conclusion Direct posterior reduction and internal fixation with posterior cranial fossa cranioectomy decompression can obviously improve the clinical outcomes and shrink syrinx for patients suffered from Chiari malformation typeⅠ with

  14. Internal fixation of S1-S3 iliosacral screws and pubic screw as the best configuration for unstable pelvic fracture with unilateral vertical sacral fracture (AO type C1.3).

    Science.gov (United States)

    Dilogo, Ismail Hadisoebroto; Satria, Oryza; Fiolin, Jessica

    2017-01-01

    Although internal fixation is the definitive treatment in unstable pelvic fractures with disruption of the anterior arch and a vertical fracture of the sacrum (AO type C1.3), there have been no agreement of the best technique of internal fixation yet. We aimed to derive comparable objective data on stiffness and load to failure in this type of fracture fixations. Synbone was modified into AO type C1.3 fracture model, while treatments were divided into six internal fixation treatment groups using tension band plate (TBP), symphysis pubis plate (SP) with iliosacral screw at S1 and S2 (IS S1-S2), pubic screw (PS) with iliosacral TBP, PS and IS S1-S2, SP and IS S1-S3, PS and S1-S3 and finally PS and IS S1-S3. Sensor was applied to detect the shifting and rotation of fracture fragments. Mechanical strength test conducted with the application of axial force on the sacrum vertebra (S1). The highest translational stiffness was observed in the group IS S1-S3 + PS (830.36 N/mm, p = 0.031) and there was no difference on the rigidity of the rotation between the groups posterior fixation using IS S1-S2 and IS S1-S3 ( p = 0.51). Meanwhile the highest load to failure was found in group IS S1-S3 + PS (1522.20 N). PS provided advantages compared to the use of plate. Group of PS and S1-S3 IS is the configuration of internal fixation with best translational and rotational stiffness and the largest load to failure compared to other techniques in AO type C1.3 fracture.

  15. Presentations

    International Nuclear Information System (INIS)

    2007-01-01

    The PARIS meeting held in Cracow, Poland from 14 to 15 May 2007. The main subjects discussed during this meeting were the status of international project dedicated to gamma spectroscopy research. The scientific research program includes investigations of giant dipole resonance, probe of hot nuclei induced in heavy reactions, Jacobi shape transitions, isospin mixing and nuclear multifragmentation. The mentioned programme needs Rand D development such as new scintillations materials as lanthanum chlorides and bromides as well as new photo detection sensors as avalanche photodiodes - such subjects are also subjects of discussion. Additionally results of computerized simulations of scintillation detectors properties by means of GEANT- 4 code are presented

  16. Treatment of complex osteoarticular injuries of the elbow with external unilateral articulated fixator

    International Nuclear Information System (INIS)

    Cuellar Gallo, Lazaro; Portilla Carrillo, Armando; Calderon Uribe, Oscar; Calvache Currea, Gustavo Adolfo; Satizabal Azuero, Carlos Arnulfo

    2001-01-01

    Previous observations suggest that conventional treatment of complex injuries about the elbow such as open; reduction and internal Fixation might lead, to bad functional outcome. The authors present a descriptive, observational and prospective study of a series of cases, on 8 patients, average age 37.8 years (25-28 years) 6 men and 2 women with complex injury of the elbow. Due to trauma which etiology is summarized as follows intraarticular comminuted open fracture secondary to gunshot wound 5 patients (62.5%); luxofracture 2 patients (25%), lntraarticular comminuted closed fracture 1 patient (12.5%). The patients where followed for 8 to 20 months. Were performed en 75% of patients open reduction, internal fixation of radial resection of radial head en 25% when comminute fracture of the head was found. All patients were treated with an external unilateral articulated fixation on the elbow, in order to protect the internal fixation, allow early joint motion and give early mobility. All patients were evaluated with Mayo scale, obtaining good results, with externals fixation treatment. In one case (12.5%) a dyaphiseal fracture of the humerus, occurred as an inherent complication secondary to the use of the external fixation, after it's withdrawal. This patient was treated with open reduction and internal fixation of the fracture, without significant impairment of the final result. Early results suggest that the use of unilateral articulated external fixator for the treatment of complex fractures about the elbow has great advantages over the other treatment techniques, such as the early motion of the elbow, dynamic protection of the internal fixation and preservation of the articulate stability, even when ligament injury is present

  17. Present status and prospects of internal radiotherapy; Etat actuel et perspectives de la radiotherapie interne

    Energy Technology Data Exchange (ETDEWEB)

    Chatal, J.F. [Institut de Cancerologie, 44 - Nantes (France)

    1994-12-31

    The experience of the last 40 years has shown that internal radiotherapy generally produces palliative results for macroscopic tumor targets and curative results for the microscopic ones. The short-term prospects for internal radiotherapy concern essentially palliative treatment of painful bone metastases of osteophilic cancers (breast or prostate) for antalgic purposes. Radioimmunotherapy may ultimately play a determinant role in the curative treatment of microscopic residual disease resulting from several types of radiosensitive cancer (lymphoma, neuroblastoma or small-cell lung cancer). In all cases, internal radiotherapy should be integrated into a coherent strategy associating complementary therapeutic modalities. (author). 16 refs., 2 figs.

  18. Open reduction and internal fixation of acetabulum fractures: does timing of surgery affect blood loss and OR time?

    Science.gov (United States)

    Dailey, Steven K; Archdeacon, Michael T

    2014-09-01

    The purpose of this study was to investigate the timing of surgical intervention for fractures of the acetabulum and its influence on perioperative factors. Retrospective review. Level I trauma center. Two hundred eighty-eight consecutive patients who sustained either posterior wall (PW), associated both column (ABC), or anterior column posterior hemitransverse (ACPHT) acetabulum fractures were included in the study. One hundred seventy-six PW fractures were treated through a Kocher-Langenbeck approach, and 112 ABC/ACPHT fractures were treated through an anterior intrapelvic approach. Estimated blood loss (EBL), operative time. EBL (800 vs. 400 mL), operative time (270 vs.154 minutes), and hospital stay (11 vs. 7 days) were greater for the ABC/ACPHT fractures compared with the PW fractures. When comparing early (≤48 hours) versus late (>48 hours) treatment of PW fractures, there was no difference in EBL (400 vs. 400 mL, P = 0.37) or operative time (150 vs. 156 minutes, P = 0.50). In comparison of early versus late treatment of ABC/ACPHT fractures, no significant difference was noted in EBL (725 vs. 800 mL, P = 0.30) or operative time (258.5 vs. 272 minutes, P = 0.21). We found no advantage or disadvantage in terms of EBL or operative time for early (≤48 hours) versus late (>48 hours) fixation for either PW or ABC/ACPHT acetabular fractures. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  19. Presentation of Local and International Culture in Current International English-Language Teaching Textbooks

    Science.gov (United States)

    Shin, Jeeyoung; Eslami, Zohreh R.; Chen, Wen-Chun

    2011-01-01

    The place of culture in teaching English as an international language (EIL) is a complex issue, given the diversity of contexts in which English is currently being used globally. Building on a sociocultural perspective that language use is open to negotiation and is context-dependent, this paper argues that the design and content of…

  20. Open reduction and internal fixation of OTA type C2-C4 fractures of the calcaneus with a triple-plate technique.

    Science.gov (United States)

    Brunner, Alexander; Müller, Jochen; Regazzoni, Pietro; Babst, Reto

    2012-01-01

    The purpose of this study was to present a surgical technique of open reduction and internal fixation of displaced intra-articular calcaneal fractures with 3 AO mini-fragment plates and to evaluate the clinical and radiological outcome of a consecutive group of patients after a mean follow-up of 41.7 months. A series of 54 patients (16 women and 38 men) with 62 calcaneal fractures were treated over a period of 6.5 years. Forty-five patients with 50 calcaneal fractures were completely clinically and radiologically followed up. Clinical follow-up included assessment of range of motion, pain according to a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score, and the short-form 36 health survey. Radiological follow-up included plain axial and lateral radiographs and measurement of the Böhler's angle and Gissane's angle. Independent Student's t test and paired Student's t test were used alongside the chi-square test to compare clinical and radiological data and score values between different groups of patients. Eleven patients showed breakage of the osteosynthesis material during the healing process and 2 patients sustained deep wound infection requiring revision surgery. At the final follow-up all fractures had healed. The average range of motion was supination 26.4° (range 0° to 50°; SD 11.6°), pronation 15.4° (range 0° to 30°; SD 6.4°), dorsal extension 14.3° (range -10° to 30°; SD 8.0°), and plantarflexion 39.6° (range 20° to 65°; SD 11.7°). Patients with OTA type C4 fractures achieved significantly lower supination (p fracture types. The mean visual analog scale pain score was 3.6 (range 0 to 8; SD 2.3) points, average American Orthopaedic Foot and Ankle Society hindfoot score was 70.8 (range 33 to 100; SD 17.1) points, and the mean short-form 36 score was 60.98 (range 22.9 to 93.0; SD 18.4) points. The mean postoperative Böhler's angle was 28.9° (range 8° to 38°; SD 7.1°), which decreased to 23.6° (range 4

  1. [One-stage operation for pelvis and acetabular fractures combined with Morel-Lavallée injury by internal fixation associated with vacuum sealing drainage].

    Science.gov (United States)

    Wei, Dan; Wang, Yue; Yuan, Jiabin; Tang, Xiaoming; Zhang, Bin; Lu, Bing; Tan, Bo

    2014-01-01

    To investigate the methods and effectiveness of one-stage operation for pelvis and acetabular fractures combined with Morel-Lavallée injury by internal fixation associated with vacuum sealing drainage (VSD). Between June 2008 and October 2012, 15 cases of pelvis and acetabular fractures combined with Morel-Lavallée injury were treated. There were 5 males and 10 females, aged from 18 to 67 years (mean, 36.8 years). Fractures were caused by traffic accident in 11 cases and crashing injury of heavy object in 4 cases. The time from injury to hospitalization was 3 hours to 9 days (mean, 5.4 days). Morel-Lavallée injury located in the above posterior superior iliac spine in 4 cases, greater trochanter in 7 cases, and anterior proximal thigh in 4 cases. In 10 cases complicated by pelvic fracture, there were 1 case of anteroposterior compression type, 3 cases of lateral compression type, 5 cases of vertical shear type, and 1 case of compound injury type; in 5 cases complicated by acetabular fracture, there were 1 case of transverse fracture, 1 case of posterior wall and posterior column fracture, 1 case of transverse acetabulum plus posterior wall fracture, and 2 cases of both columns fracture. Open reduction and internal fixation were used to treat pelvic and acetabular fractures, and VSD to treat Morel-Lavallée injury. When the drainage volume was less than 20 mL/d, interrupted wound suture or free skin grafting was performed. The hospitalization time was 16-31 days (mean, 20.8 days). Thirteen cases were followed up 4-16 months (mean, 7.8 months). The healing time of Morel-Lavallée injury was 16-36 days after operation (mean, 21.3 days). All the wounds had primary healing, and no infection occurred. The X-ray films showed that all fractures healed, with a mean healing time of 13.6 weeks (range, 11-18 weeks). At 6.5 months after operation, according to Majeed function scoring system in 8 cases of pelvic fracture, the results were excellent in 5 cases, good in 2 cases

  2. [Comparision of clinical effects between one-stage anterior and posterior approach in treating thoracolumbar tuberculosis with debridement and internal fixation].

    Science.gov (United States)

    Lin, Bin; Dai, Li-Lin; Chen, Zhi-da; Zheng, Yong

    2017-09-25

    To compare the outcomes of surgical operation by posterior or anterior approach only for thoracolumbar tuberculosis. The clinical data of 97 patients with thoracolumbar tuberculosis underwent debridement and internal fixation from January 2005 to December 2014 were retrospectively analyzed. The study included 59 males and 38 females, with a mean age of 53.7 years ranged from 20 to 68 years. The course of disease was from 1 to 13 months with an average of (6.9±2.3) months. Among these patients, 43 cases were treated through one-stage anterior approach (anterior approach group) and 54 cases were treated through posterior approach (posterior approach group). The clinical data and imaging data of 97 cases were analyzed, including the operation time, intraoperative and postoperative blood loss, postoperative hospitalization time, complications, visual analogue scale(VAS), Oswestry Disability Index(ODI), Frankle grade, bone fusion time, and corrective rate of Cobb angle. Operation time, intraoperative and postoperative blood loss, postoperative hospitalization time, complication rate, and corrective rate of Cobb angle were(174.4±9.9) min, (885.0±95.7) ml, (103.2±11.5) ml, (15.1±0.7) d, 9.3%, (73.4±3.2)% in posterior group respectively, while in anterior approach group were(229.5±15.2) min, (1326.0±113.5) ml, (153.2±16.7) ml, (19.0±0.8) d, 16.3%, (62.3±2.5)%, respectively, and there was significant difference between two groups. There was no significant difference in graft bone fusion between two groups. Postoperative VAS, ODI, Frankel grade of all patients were obviously improved, but there was no significant difference between two groups. Thoracolumbar tuberculosis could be cured by one-stage anterior or posterior approach with debridement, bone grafting and internal fixation, but posterior approach has advantages of less trauma and better deformity correction.

  3. Therapeutic efficacy of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting for tuberculosis of lumbar vertebra

    Directory of Open Access Journals (Sweden)

    Jia-ming LIU

    2015-11-01

    Full Text Available Objective To evaluate the efficacy and safety of pedicle screw-rod internal fixation after one-stage posterior transforaminal lesion debridement and non-structural bone grafting in the treatment of tuberculosis of mono-segmental lumbar vertebra. Methods From January 2010 to April 2013, 21 patients (9 males and 12 females with an average age of 49.1 years with mono-segmental tuberculosis of lumbar vertebra underwent surgery in our hospital were included. Eight patients had neurological deficit. The focus of tuberculosis was located on one side of the vertebral body, and all the patients had obvious signs of bone destruction on CT and MRI. All the patients were given anti-tuberculosis chemotherapy for 2-3 weeks before surgery. The local bone chips and autologous iliac cancellous bone were used as the intervertebral bone graft. Postoperative plain radiographs and CT were obtained to evaluate the fusion rate and degree of lumbar lordosis. The visual analogue scale score (VAS, erythrocyte sedimentation rate (ESR, and C-reactive protein (CRP before and after operation, and at final follow-up date were recorded. Results All the patients were followed up for 25.3±4.2 months. The mean operation time was 157±39 minutes, and the average blood loss was 470±143ml. The fusion rate of the interbody bone graft was 95.2%, with an average fusion period of 6.1±2.5 months. The neurological function was improved by 100%, and no severe complication or neurological injury occured. The preoperative and postoperative lordosis angles of the lumbar spine were 21.4°±5.7° and 33.6°±3.1°, respectively, and it was 31.3°±2.7° at the final follow up. The preoperative and postoperative VAS scores were 7.8±2.6 and 2.4±1.7 respectively, and it was 0.9±0.7 at the final follow up. The ESR and CRP were significantly decreased 3 months after surgery, and they became normal at 6 months. Conclusion Pedicle screw-rod internal fixation after one-stage posterior

  4. Assessment of the influence of Laser phototherapy on the bone repair process of complete fractures in tibiae of rabbits stabilized with semi-rigid internal fixation treated with or without MTA graft: a histological study

    Science.gov (United States)

    Soares, Luiz G. P.; Silva, Aline C. P.; Silva, Anna Paula L. T.; Neves, Bruno Luiz R. C.; Santos, Nicole R. S.; dos Santos, Jean N.; Pinheiro, Antonio L. B.

    2016-03-01

    Beside biomaterials, Laser phototherapy has shown positive effects as auxiliary therapy in bone repair process, especially when involving large bone losses. The aim of this histological study was to evaluate, by light microscopy, the influence of laser phototherapy on the repair of complete tibial fractures in rabbits treated or not with semi-rigid internal fixation and Mineral Trioxide Aggregate - MTA graft. Twelve Rabbits were randomly divided into four groups with three animals each. After general anesthesia, complete fractures were created in one tibia with a carborundum disk. All animals (groups I-IV) had the fracture stabilized with semi-rigid fixation (wire osteosynthesis - WO). Group I was routinely fixed with WO; groups II and IV fracture was filled by blood clot and MTA implant. In Groups III and IV fracture was filled by blood clot and further irradiated with laser (λ780 nm, 70 mW, CW, Φ = 0.04 cm2, 20.4 J/cm2, per session, t = 300s, 142.8 J/cm2 per treatment). The phototherapy protocol was applied immediately after the surgery and repeated each 48 hours during 15 days. Animal death occurred on the 30th postoperative day. After removal of the specimens, the samples were routinely processed, stained with HE and evaluated by light microscopy. Histologically, the group treated with MTA graft and irradiated with laser showed the fracture filled by a more organized and mature trabecular bone, when compared with all other groups. From the results of the present study, it may be concluded that the association of Laser phototherapy + MTA graft in fractures treated with WO improved bone repair when compared with fractures treated only with WO.

  5. Ruptured internal iliac artery aneurysm presenting as Cullen’s sign

    Directory of Open Access Journals (Sweden)

    Choon K. Gan

    2010-11-01

    Full Text Available Cullen’s sign or periumbilical ecchymosis, is classically considered as an indicator of acute hemorrhagic pancreatitis or ruptured ectopic pregnancy. Internal iliac artery aneurysms are rare and are usually asymptomatic. We present a case of a contained rupture of the internal iliac artery aneurysm presenting with Cullen’s sign.

  6. Closed External Fixation for Failing or Failed Femoral Shaft Plating in a Developing Country.

    Science.gov (United States)

    Aliakbar, Adil; Witwit, Ibrahim; Al-Algawy, Alaa A Hussein

    2017-08-01

    Femoral shaft fractures are one of the common injuries that is treated by open reduction, with internal fixation by plate and screws or intramedullary nailing, which can achieve a high union rate. To evaluate the outcome of using closed external fixation to augment a failing plate; with signs of screw loosening and increasing bone/plate gap; a failed plate; broken plate; screws completely out of bone with redisplacement of fracture. A retrospective study on 18 patients, aged between 17-42 years, who presented between 6-18 weeks after initial surgical fixation, with pain, difficulty in limb function, deformity and abnormal movement at fracture site, was done. X-Rays showed plating failure with acceptable amount of callus, which unfortunately had refractured. Cases associated with infection and no radiological evidence of callus formation were excluded from this study. Closed reduction was done by manipulation, then fracture fixation by AO external fixator. The patients were encouraged for full weight bearing as early as possible with dynamization later on. Of the 18 patients who underwent external fixation after close reduction, 15 cases showed bone healing in a period between 11-18 weeks (mean of 14.27 weeks) with good alignment (Radiologically). Removal of external fixator was done followed by physical therapy thereafter. Closed external fixation for treatment of failing or failed femoral plating, achieves good success rate and has less complications, is a short time procedure, especially in a hospital with limited resources.

  7. The cement-augmented transiliacal internal fixator (caTIFI): an innovative surgical technique for stabilization of fragility fractures of the pelvis.

    Science.gov (United States)

    Schmitz, Paul; Baumann, Florian; Grechenig, Stephan; Gaensslen, Axel; Nerlich, Michael; Müller, Michael B

    2015-10-01

    Analyzing the different age groups in a population who suffered a pelvic ring fracture it becomes obvious that there are important differences between the pelvic ring lesions of an elderly patient compared to a young adult concerning trauma mechanism, fracture pattern and therapeutic options. In the elderly patient it is very important to achieve maximum of stability if surgery is necessary in order to avoid early failure of the ostheosynthesis under mobilization with full weight bearing. 15 patients (14 female) with fragility fractures of the pelvis that required surgical stabilization were eligible to participate in this study from December 2012 to December 2014. Such details were documented and analysed as patient demographics, mechanism of injury, fracture classification, operative treatment and postoperative radiological parameters of achieved bone-implant interface. The average age of the patients was 79.9 years (SD 9.0 years). According to Rommens five patients had a fragility fracture of the pelvis Type II-c, one a Type III-c, six a Type IV-b and three a Type IV-c. Four patients were treated by a cement augmented transiliac internal fixation (caTIFI). Seven patients received a cement augmented iliolumbar fixation. In all these patients the Schanz screws applied to the ilium were placed in an oblique dorsoventral direction into the supraacetabular bone canal (mean length of screws 100 ± 20mm, max. 135 mm, min. 70 mm). Even though in four patients the iliosacral joint was hit tangential and one cortex perforation without any cement leakage appeared no revision surgery was necessary. Overall the clinical findings including mobilisation with full weight bearing showed a sufficient mechanically stability in all patients. The focus of this study was to describe the modified surgical technique of the caTIFI with placing the Schanz screws from the posterior superior iliac spine to the anterior inferior iliac spine into the supraacetabular bone canal. Usage of

  8. Latarjet Fixation

    Science.gov (United States)

    Alvi, Hasham M.; Monroe, Emily J.; Muriuki, Muturi; Verma, Rajat N.; Marra, Guido; Saltzman, Matthew D.

    2016-01-01

    Background: Attritional bone loss in patients with recurrent anterior instability has successfully been treated with a bone block procedure such as the Latarjet. It has not been previously demonstrated whether cortical or cancellous screws are superior when used for this procedure. Purpose: To assess the strength of stainless steel cortical screws versus stainless steel cannulated cancellous screws in the Latarjet procedure. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen matched-pair shoulder specimens were randomized into 2 separate fixation groups: (1) 3.5-mm stainless steel cortical screws and (2) 4.0-mm stainless steel partially threaded cannulated cancellous screws. Shoulder specimens were dissected free of all soft tissue and a 25% glenoid defect was created. The coracoid process was osteomized, placed at the site of the glenoid defect, and fixed in place with 2 parallel screws. Results: All 10 specimens failed by screw cutout. Nine of 10 specimens failed by progressive displacement with an increased number of cycles. One specimen in the 4.0-mm screw group failed by catastrophic failure on initiation of the testing protocol. The 3.5-mm screws had a mean of 274 cycles (SD, ±171 cycles; range, 10-443 cycles) to failure. The 4.0-mm screws had a mean of 135 cycles (SD, ±141 cycles; range, 0-284 cycles) to failure. There was no statistically significant difference between the 2 types of screws for cycles required to cause failure (P = .144). Conclusion: There was no statistically significant difference in energy or cycles to failure when comparing the stainless steel cortical screws versus partially threaded cannulated cancellous screws. Clinical Relevance: Latarjet may be performed using cortical or cancellous screws without a clear advantage of either option. PMID:27158630

  9. Feasibility study of international cooperation on the chemical CO2 fixation and effective utilization technology in FY 1996; 1996 nendo kagakuteki CO2 koteika yuko riyo gijutsu ni kakawaru kokusai kyoryoku kanosei chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    In this survey, candidate organizations to cooperate internationally in the development of chemical CO2 fixation technologies have been selected, and possible forms of the cooperation each organization would participate in have been examined. The chemical CO2 fixation technology project of RITE (Research Institute of Innovation Technology for the Earth) involves the essential themes of CO2 separation membrane technology, catalytic hydrogenation reaction technology, and hydrogen production/supply technology, as well as the overall system. Through the arrangement, 19 international research institutes were selected as the potential candidates for international research cooperation. Either direct visit or questionnaire by mail was conducted to these institutes. The purposes of international cooperation in each of essential study theme are to review the possibility of improving technologies in each theme by introducing new technologies, and to review the possibilities of promoting practical implementation of chemical CO2 fixation system. The research institutes to be reviewed as partners for joint research are summarized. 10 figs., 16 tabs.

  10. Report on survey of international cooperation possibility on chemical CO2 fixation and utilization technology in FY 1997; 1997 nendo chosa hokokusho (kagakuteki CO2 koteika yuko riyo gijutsu ni kakawaru kokusai kyoryoku kanosei chosa)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    This survey focused on the end of the more promising companion and promoting the international cooperation on chemical CO2 fixation and utilization technology. As a result, the way of the carrying-forward of the international cooperation with more than one companion could be arranged beforehand. It led to getting an arrangement about a secrecy agreement respectively with Lurgi company and ABB company in Europe, and to providing a catalyst sample developed by RITE to implement an examination by the other party and to show related technical information. In addition, it concluded a cooperation agreement about a total system of the chemical CO2 fixation and utilization technology and methanol synthesis with ZSW. In Australia, negotiation about international cooperation with CSIRO which is a federal research organization and CRC (Cooperative Research Centre) for renewable energy has been started. The ideal circumstances are being ready for the chemical CO2 fixation project for which the international cooperation with the country where the natural energy is rich like Australia is essential when coming to practical use. To do alternating current with further high density in the following year it is desired to build a concrete study cooperation system. 1 fig., 4 tabs.

  11. Flexible fixation and fracture healing

    DEFF Research Database (Denmark)

    Schmal, Hagen; Strohm, Peter C; Jaeger, Martin

    2011-01-01

    External and internal fixators use bone screws that are locked to a plate or bar to prevent periosteal compression and associated impairment of blood supply. Both osteosynthesis techniques rely on secondary bone healing with callus formation with the exception of compression plating of simple...

  12. NASA Physical Sciences - Presentation to Annual Two Phase Heat Transfer International Topical Team Meeting

    Science.gov (United States)

    Chiaramonte, Francis; Motil, Brian; McQuillen, John

    2014-01-01

    The Two-phase Heat Transfer International Topical Team consists of researchers and members from various space agencies including ESA, JAXA, CSA, and RSA. This presentation included descriptions various fluid experiments either being conducted by or planned by NASA for the International Space Station in the areas of two-phase flow, flow boiling, capillary flow, and crygenic fluid storage.

  13. Femoral artery thrombosis after internal fixation of a transverse acetabular fracture in a patient with osteogenesis imperfecta type I

    Directory of Open Access Journals (Sweden)

    Morgan Steven J

    2008-01-01

    Full Text Available Abstract Osteogenesis imperfecta is a genetic disorder characterized by increased susceptibility to fractures and vascular injuries due to connective tissue fragility. In this case report, we present a patient with osteogenesis imperfecta type I who sustained a transverse fracture of the right acetabulum while transferring from bed to chair. The fracture was repaired through an ilioinguinal approach. During the surgery, an iatrogenic injury to the femoral artery and vein occurred. This intraoperative complication was salvaged by immediate vascular repair. We discuss the possible causes of iatrogenic vascular injuries in patients with osteogenesis imperfecta. Orthopaedic surgeons should be aware of this potentially devastating complication in this particular patient cohort.

  14. Lithium-Ion Battery Safety Study Using Multi-Physics Internal Short-Circuit Model (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, G-.H.; Smith, K.; Pesaran, A.

    2009-06-01

    This presentation outlines NREL's multi-physics simulation study to characterize an internal short by linking and integrating electrochemical cell, electro-thermal, and abuse reaction kinetics models.

  15. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  16. Traumatic intracranial internal carotid artery pseudoaneurysm presenting as epistaxis treated by endovascular coiling

    Science.gov (United States)

    Al-Jehani, Hosam M.; Alwadaani, Hassan A.; Almolani, Fadhel M.

    2016-01-01

    Traumatic intracranial pseudoaneurysm is a rare complication of blunt trauma. It is even more rare when it presents as epistaxis. Massive epistaxis of a ruptured intracranial internal carotid artery pseudoaneurysm is a major cause of mortality, which requires emergency intervention. We report a case of traumatic intracranial internal carotid artery pseudoaneurysm secondary to skull base fracture, which presented with delayed onset of epistaxis. This was successfully treated by primary endovascular coil embolization. We discuss endovascular treatment options and review the literature. PMID:26818170

  17. High failure rate after internal fixation and beneficial outcome after arthroplasty in treatment of displaced femoral neck fractures in patients between 55 and 70 years.

    Science.gov (United States)

    Bartels, Stefan; Gjertsen, Jan-Erik; Frihagen, Frede; Rogmark, Cecilia; Utvåg, Stein Erik

    2018-02-01

    Background and purpose - The treatment of patients between 55 and 70 years with displaced intracapsular femoral neck fracture remains controversial. We compared internal fixation (IF), bipolar hemiarthroplasty (HA) and total hip arthroplasty (THA) in terms of mortality, reoperations and patient-reported outcome by using data from the Norwegian Hip Fracture Register. Patients and methods - We included 2,713 patients treated between 2005 and 2012. 1,111 patients were treated with IF, 1,030 with HA and 572 patients with THA. Major reoperations (defined as re-osteosynthesis, secondary arthroplasty, exchange, or removal of prosthesis components and Girdlestone procedure), patient-reported outcome measures (satisfaction, pain, and health-related quality of life (EQ5D) after 4 and 12 months), 1-year mortality, and change in treatment methods over the study period were investigated. Results - Major reoperations occurred in 27% after IF, 3.8% after HA and 2.8% after THA. 549 patients (20% of total study population) answered both questionnaires. Compared with IF, patients treated with THA were more satisfied after 4 and 12 months, reported less pain after 4 months and 12 months, had a higher EQ5D-index score after 4 months and 12 months, and EQ-VAS score after 4 months. Compared with IF, patients treated with HA were more satisfied and reported less pain after 4 months. EQ5D-index and EQ-VAS were similar. Patients treated with HA had higher 1-year mortality and had more comorbidities than both the THA and IF group. All these differences were statistically and clinically significant. Interpretation - This study showed high reoperation rate after IF and better patient-reported outcome after both THA and HA with medium follow-up. Patients selected for HA represented a frailer group than patients treated with THA or IF.

  18. Overcoming fixation with repeated memory suppression.

    Science.gov (United States)

    Angello, Genna; Storm, Benjamin C; Smith, Steven M

    2015-01-01

    Fixation (blocks to memories or ideas) can be alleviated not only by encouraging productive work towards a solution, but, as the present experiments show, by reducing counterproductive work. Two experiments examined relief from fixation in a word-fragment completion task. Blockers, orthographically similar negative primes (e.g., ANALOGY), blocked solutions to word fragments (e.g., A_L_ _GY) in both experiments. After priming, but before the fragment completion test, participants repeatedly suppressed half of the blockers using the Think/No-Think paradigm, which results in memory inhibition. Inhibiting blockers did not alleviate fixation in Experiment 1 when conscious recollection of negative primes was not encouraged on the fragment completion test. In Experiment 2, however, when participants were encouraged to remember negative primes at fragment completion, relief from fixation was observed. Repeated suppression may nullify fixation effects, and promote creative thinking, particularly when fixation is caused by conscious recollection of counterproductive information.

  19. Intrascleral IOL Fixation.

    Science.gov (United States)

    Jacob, Soosan

    2017-01-01

    Intrascleral sutureless intraocular lens (IOL) fixation utilizes direct haptic fixation within the sclera in eyes with deficient capsular support. This has advantages of long-term stability, good control of tilt and decentration, and lesser pseudophakodonesis. This review summarizes various techniques for intrascleral haptic fixation, results, complications, adaptations in special situations, modifications of the technique, combination surgeries, and intrascleral capsular bag fixation techniques (glued capsular hook). Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  20. International seminar on the safety research needs for Russian-designed reactors: material presented at the international seminar 1997

    International Nuclear Information System (INIS)

    1997-01-01

    This seminar on international, national and bilateral cooperation programmes on the safety research needs for Russian-designed reactors was held in Tokyo, Japan (1997) and hosted by the OECD Nuclear Energy Agency and the Science and Technology Agency (STA) of Japan. More than 70 participants attended the seminar. Represented were experts from OECD/NEA member countries and Russia, the International Atomic Energy Agency (IAEA), the ISTC, the INSC and the Russian INSC. Eighteen papers were presented in five sessions. The seminar was structured around four main areas of cooperation: cooperative programmes of the OECD/NEA, programmes of international organisations, bi-lateral programmes, and national programmes of OECD/NEA member countries having reactors of the VVER type. General conclusions, followed by specific technical conclusions are included

  1. Polymeric media for tritium fixation. Supplement I

    International Nuclear Information System (INIS)

    Franz, J.A.; Burger, L.L.

    1976-01-01

    Procedures for the fixation of tritium as TH or THO in two different polymeric media are described. The complete procedure for THO fixation in a polyureylene-polyurethane polumer, including polymer molding procedures and leach tests is presented. The catalytic tritiation of polystyrene under very mild conditions using a rhodium catalyst is also described. Thermal stabilities and cost estimates for the polymers examined under this program are discussed. Organic polymers were found to have attractive features for the fixation and storage of concentrated tritium wastes due to the convenience of fixation procedures and favorable properties of the resulting media

  2. Selective transport of internalized antigens to the cytosol for MHC class I presentation in dendritic cells

    NARCIS (Netherlands)

    Rodriguez, A; Regnault, A; Kleijmeer, M; Ricciardi-Castagnoli, P; Amigorena, S

    1999-01-01

    In order for cytotoxic T cells to initiate immune responses, peptides derived from internalized antigens must be presented to the cytotoxic T cells on major histocompatibility complex (MHC) class I molecules. Here we show that dendritic cells, the only antigen-presenting cells that initiate immune

  3. Teacher Strategies for Effective Intervention with Students Presenting Social, Emotional and Behavioural Difficulties: An International Review

    Science.gov (United States)

    Cooper, Paul

    2011-01-01

    A review of international research literature on teacher strategies for effective intervention with students presenting social, emotional and behavioural difficulties (SEBD) is presented. Particular attention is given to evidence defining the qualities and skills of effective teachers and the value of behavioural and cognitive behavioural…

  4. Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification.

    LENUS (Irish Health Repository)

    Naqvi, Gohar A

    2012-06-01

    Ankle syndesmotic injuries are complex and require anatomic reduction and fixation. Tightrope fixation is a relatively new technique and we present the largest series of syndesmosis fixation using Arthrex Tightrope™ (Naples, FL, USA).

  5. Full text publication rates of studies presented at an international emergency medicine scientific meeting.

    Science.gov (United States)

    Chan, Jannet W M; Graham, Colin A

    2011-09-01

    The publication rate of full text papers following an abstract presentation at a medical conference is variable, and few studies have examined the situation with respect to international emergency medicine conferences. This retrospective study aimed to identify the publication rate of abstracts presented at the 2006 International Conference on Emergency Medicine (ICEM) held in Halifax, Canada. The full text publication rate was 33.2%, similar to previous emergency medicine meetings. English language barriers may play a role in the low publication rate seen.

  6. Accelerated rehabilitation compared with a standard protocol after distal radial fractures treated with volar open reduction and internal fixation: a prospective, randomized, controlled study.

    Science.gov (United States)

    Brehmer, Jess L; Husband, Jeffrey B

    2014-10-01

    There are relatively few studies in the literature that specifically evaluate accelerated rehabilitation protocols for distal radial fractures treated with open reduction and internal fixation (ORIF). The purpose of this study was to compare the early postoperative outcomes (at zero to twelve weeks postoperatively) of patients enrolled in an accelerated rehabilitation protocol with those of patients enrolled in a standard rehabilitation protocol following ORIF for a distal radial fracture. We hypothesized that patients with accelerated rehabilitation after volar ORIF for a distal radial fracture would have an earlier return to function compared with patients who followed a standard protocol. From November 2007 to November 2010, eighty-one patients with an unstable distal radial fracture were prospectively randomized to follow either an accelerated or a standard rehabilitation protocol after undergoing ORIF with a volar plate for a distal radial fracture. Both groups began with gentle active range of motion at three to five days postoperatively. At two weeks, the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises, whereas the standard group initiated passive range of motion and strengthening at six weeks postoperatively. Patients were assessed at three to five days, two weeks, three weeks, four weeks, six weeks, eight weeks, twelve weeks, and six months postoperatively. Outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) scores (primary outcome) and measurements of wrist flexion/extension, supination, pronation, grip strength, and palmar pinch. The patients in the accelerated group had better mobility, strength, and DASH scores at the early postoperative time points (zero to eight weeks postoperatively) compared with the patients in the standard rehabilitation group. The difference between the groups was both clinically relevant and statistically significant. Patients who follow an accelerated rehabilitation

  7. Bohler's angle's role in assessing the injury severity and functional outcome of internal fixation for displaced intra-articular calcaneal fractures: a retrospective study.

    Science.gov (United States)

    Su, Yanling; Chen, Wei; Zhang, Tao; Wu, Xingwang; Wu, Zhanpo; Zhang, Yingze

    2013-09-24

    Controversy exits over the role of Böhler's angle in assessing the injury severity of displaced intra-articular calcaneal fractures and predicting the functional outcome following internal fixation. This study aims to investigate whether a correlation exists between Böhler's angle and the injury severity of displaced calcaneal fractures, and between surgical improvement of Böhler's angle and functional outcome. Patients treated operatively for unilateral closed displaced intra-articular calcaneal fractures from January 1, 2004 to March 31, 2008 were identified. The Böhler's angles of both calcaneus were measured, and the measurement of the uninjured foot was used as its normal control. The difference in the value of Böhler's angle measured preoperatively or postoperatively between the angle of the injured foot and that of the contralateral calcaneus were calculated, respectively. The change in Böhler's angle by ratio was calculated by dividing the difference value of Böhler's angle between bilateral calcaneus by its normal control. The injury severity was assessed according to Sanders classification. The functional outcomes were assessed using American Orthopaedic Foot & Ankle Society hindfoot scores. 274 patients were included into the study with a mean follow-up duration of 71 months. According to Sanders classification, the fracture pattern included 105 type II, 121 type III and 48 type IV fractures. According to American Orthopaedic Foot & Ankle Society hindfoot scoring system, the excellent, good, fair and poor results were achieved in 104, 132, 27, and 11 patients, respectively. The preoperative Böhler's angle, difference value of Böhler's angle between bilateral calcaneus, and change in Böhler's angle by ratio each has a significant correlation with Sanders classification (rs=-0.178, P=0.003; rs=-0.174, P=0.004; rs=-0.172, P=0.005, respectively), however, is not correlated with functional outcome individually. The three postoperative measurements

  8. Bohler’s angle’s role in assessing the injury severity and functional outcome of internal fixation for displaced intra-articular calcaneal fractures: a retrospective study

    Science.gov (United States)

    2013-01-01

    Background Controversy exits over the role of Böhler’s angle in assessing the injury severity of displaced intra-articular calcaneal fractures and predicting the functional outcome following internal fixation. This study aims to investigate whether a correlation exists between Böhler’s angle and the injury severity of displaced calcaneal fractures, and between surgical improvement of Böhler’s angle and functional outcome. Methods Patients treated operatively for unilateral closed displaced intra-articular calcaneal fractures from January 1, 2004 to March 31, 2008 were identified. The Böhler’s angles of both calcaneus were measured, and the measurement of the uninjured foot was used as its normal control. The difference in the value of Böhler’s angle measured preoperatively or postoperatively between the angle of the injured foot and that of the contralateral calcaneus were calculated, respectively. The change in Böhler’s angle by ratio was calculated by dividing the difference value of Böhler’s angle between bilateral calcaneus by its normal control. The injury severity was assessed according to Sanders classification. The functional outcomes were assessed using American Orthopaedic Foot & Ankle Society hindfoot scores. Results 274 patients were included into the study with a mean follow-up duration of 71 months. According to Sanders classification, the fracture pattern included 105 type II, 121 type III and 48 type IV fractures. According to American Orthopaedic Foot & Ankle Society hindfoot scoring system, the excellent, good, fair and poor results were achieved in 104, 132, 27, and 11 patients, respectively. The preoperative Böhler’s angle, difference value of Böhler’s angle between bilateral calcaneus, and change in Böhler’s angle by ratio each has a significant correlation with Sanders classification (rs=−0.178, P=0.003; rs=−0.174, P=0.004; rs=−0.172, P=0.005, respectively), however, is not correlated with functional outcome

  9. Open reduction and internal fixation of displaced intraarticular fractures of the calcaneus - influence of type of fracture and congruency of the subtalar joint upon functional result

    Directory of Open Access Journals (Sweden)

    Matej Andoljšek

    2005-11-01

    Full Text Available Background: More and more, open reduction and internal fixation (ORIF followed by early motion are advocated for displaced intraarticular fractures of the calcaneus. In prospective study the author asked, what are the results of ORIF with the calcaneal plate in intraarticular fractures of the calcaneus, and whether type of fracture and/or congruity in the subtalar joint influence these results.Methods: Forty-three intraarticular fractures of the calcaneus (30 Type II, 10 Type III and 3 Type IV according to Sanders classification were operated through extensile lateral approach. After reduction of the subtalar joint and restoration of the calcaneus shape, the fracture was fixed with the calcaneal plate. Mostly, surgery was delayed for a few days until soft tissues recuperate. Motion of the ankle and the subtalar joint was encouraged immediately, partial weight bearing after 6–8 weeks and full weight bearing after 3–4 month. After surgery, subtalar joint was found congruent in 33 (77% and non-congruent (within 2 mm in ten fractures.Results: Functional results of 36 fractures with a representative type distribution were evaluated 12 to 61 months postinjury. Functional results were satisfactory in 31 fractures (86% and not satisfactory in five (14%. All fractures with unsatisfactory results were comminutive (Type III or IV. Four fractures with congruent joint had unsatisfactory, and eight of nine fractures with uncongruent joint had satisfactory result. Statistically, functional results of the comminuted fractures were significantly worse. However, functional results of fractures with non-congruent joint were comparable to the results of fractures with congruent joint and analysis of variance showed that interaction of these two factors was not important.Conclusions: This prospective study confirms that ORIF enables satisfactory results in majority of displaced intraarticular fractures of the calcaneus. It also confirms that comminution in the

  10. High incidence of osteochondral lesions after open reduction and internal fixation of displaced ankle fractures: Medium-term follow-up of 100 cases.

    Science.gov (United States)

    Regier, Marc; Petersen, Jan Philipp; Hamurcu, Ahmet; Vettorazzi, Eik; Behzadi, Cyrus; Hoffmann, Michael; Großterlinden, Lars G; Fensky, Florian; Klatte, Till Orla; Weiser, Lukas; Rueger, Johannes M; Spiro, Alexander S

    2016-03-01

    The incidence of osteochondral lesions (OCLs) in association with displaced ankle fractures has only been examined in two previous studies. In both studies magnetic resonance imaging (MRI) was performed prior to open reduction and internal fixation (ORIF). Because MRI may overdiagnose or overestimate the extent of OCLs in an acute trauma setting the aim of this study was to determine the incidence of OCLs after ORIF of displaced ankle fractures using MRI at medium-term follow-up, and to analyse if the severity of fracture or the clinical outcome correlates with the incidence of OCLs. Following institutional review board approval a total of 100 patients (mean age, 41.3 years; range, 17.9-64.3 years) with a displaced ankle fracture who had undergone ORIF according to the AO principles were included in this study. The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was used to quantify the clinical outcome and MR images were evaluated for OCLs of the talus and distal tibia after a mean of 34.5 months (range, 17.5-54.1 months). OCLs were found in 40.4% of the patients. Logistic regression revealed a significant correlation between the severity of fracture and the incidence of OCLs. Patients with a trimalleolar fracture (p=0.04) or an ankle fracture dislocation (p=0.003) had a significantly higher risk for developing an OCL compared to those with a type B fracture. Logistic regression also demonstrated a significant correlation between the clinical outcome (AOFAS score) and the incidence of OCLs (p=0.01). The risk for developing an OCL increases up to 5.6% when the AOFAS score decreases by one point. OCLs were frequently found in association with acute ankle fractures at medium-term follow-up, and the severity of fracture was associated with an increased number of OCLs. Considering the disadvantages of MRI including the high cost and limited availability, the results of this study may help to explain why anatomic surgical realignment of displaced

  11. Giant aneurysm of internal carotid artery presenting features of retrobulbar neuritis

    Directory of Open Access Journals (Sweden)

    Misra Madhumati

    1991-01-01

    Full Text Available We report the case of a man who presented with in the features of left optic nerve compression. CT scan and carotid angiography demonstrated an unruptured giant aneurysm of the left internal carotid artery possibly kinking the optic nerve. Carotid ligation in the neck saved both life and vision.

  12. Presentation

    Directory of Open Access Journals (Sweden)

    Eduardo Vicente

    2013-06-01

    Full Text Available In the present edition of Significação – Scientific Journal for Audiovisual Culture and in the others to follow something new is brought: the presence of thematic dossiers which are to be organized by invited scholars. The appointed subject for the very first one of them was Radio and the invited scholar, Eduardo Vicente, professor at the Graduate Course in Audiovisual and at the Postgraduate Program in Audiovisual Media and Processes of the School of Communication and Arts of the University of São Paulo (ECA-USP. Entitled Radio Beyond Borders the dossier gathers six articles and the intention of reuniting works on the perspectives of usage of such media as much as on the new possibilities of aesthetical experimenting being build up for it, especially considering the new digital technologies and technological convergences. It also intends to present works with original theoretical approach and original reflections able to reset the way we look at what is today already a centennial media. Having broadened the meaning of “beyond borders”, four foreign authors were invited to join the dossier. This is the first time they are being published in this country and so, in all cases, the articles where either written or translated into Portuguese.The dossier begins with “Radio is dead…Long live to the sound”, which is the transcription of a thought provoking lecture given by Armand Balsebre (Autonomous University of Barcelona – one of the most influential authors in the world on the Radio study field. It addresses the challenges such media is to face so that it can become “a new sound media, in the context of a new soundscape or sound-sphere, for the new listeners”. Andrew Dubber (Birmingham City University regarding the challenges posed by a Digital Era argues for a theoretical approach in radio studies which can consider a Media Ecology. The author understands the form and discourse of radio as a negotiation of affordances and

  13. KEY FACTORS OF TRANSFORMATION OF THE INTERNATIONAL MARKET AT THE PRESENT STAGE OF GLOBAL ECONOMY

    Directory of Open Access Journals (Sweden)

    A. Starostina

    2013-11-01

    Full Text Available The main conditions of transformation of the world market in modern conditions of globalization are determined. The main transformation’s factors of the international services market at the present stage of the world’s economy development are singled out. The impacts of the global market for the growth of productivity are investigated. The features for increase of export potential of developing countries in international trade in services are explored. The main characteristic features of the subject structure of the modern world market are showed.

  14. Use of the TRPV1 Agonist Capsaicin to Provide Long-Term Analgesia in a Rat Limb Fracture/Open Repair, Internal Fixation Model

    Science.gov (United States)

    2012-10-01

    model for acute traumatic femoral fracture followed by repair via intramedullary nail fixation that closely mimics what happens in real-world...Y, Friedman RJ, Parent T, Draughn RA. Production of a standard closed fracture in the rat tibia . J Orthop Trauma 8 (2004): 687-95. 2. Anand U, Otto...comminuted, or too distal of a fracture , or if the fracture was not able to be reduced and fixed via an intramedullary nail . Methods: 30 male Sprague

  15. Kennedy Space Center Fixation Tube (KFT)

    Science.gov (United States)

    Richards, Stephanie E.; Levine, Howard G.; Romero, Vergel

    2016-01-01

    Experiments performed on the International Space Station (ISS) frequently require the experimental organisms to be preserved until they can be returned to earth for analysis in the appropriate laboratory facility. The Kennedy Fixation Tube (KFT) was developed to allow astronauts to apply fixative, chemical compounds that are often toxic, to biological samples without the use of a glovebox while maintaining three levels of containment (Fig. 1). KFTs have been used over 200 times on-orbit with no leaks of chemical fixative. The KFT is composed of the following elements: a polycarbonate main tube where the fixative is loaded preflight, the sample tube where the plant or other biological specimens is placed during operations, the expansion plug, actuator, and base plug that provides fixative containment (Fig. 2). The main tube is pre-filled with 25 mL of fixative solution prior to flight. When actuated, the specimen contained within the sample tube is immersed with approximately 22 mL (+/- 2 mL) of the fixative solution. The KFT has been demonstrated to maintain its containment at ambient temperatures, 4degC refrigeration and -100 C freezing conditions.

  16. Abstracts and available papers presented at the 2005 International RERTR Meeting

    International Nuclear Information System (INIS)

    2005-01-01

    Oral and poster presentations of the Meeting covered the following topics: National and international programs related to Reduced Enrichment for Research and Test Reactors (RERTR). Development of new fuel types, testing, fabrication, modelling. Studies of reactor cores conversion from highly enriched to low enriched fuel, including licensing. New and converted reactors. Spent fuel management including storage and transportation. Production of Molybdenum 99 under converted core conditions

  17. Posttraumatic pseudoaneurysm of the intracavernous internal carotid artery presenting with massive epistaxis.

    Science.gov (United States)

    Fontela, Patricia S; Tampieri, Donatella; Atkinson, Jeffrey D; Daniel, Sam J; Teitelbaum, Jeanne; Shemie, Sam D

    2006-05-01

    To report a case of posttraumatic pseudoaneurysm of the intracavernous internal carotid artery presenting with massive epistaxis and to discuss its pathophysiology and management. Case report and literature review. Pediatric intensive care unit in a tertiary-care center. Twelve days after a motor vehicle accident causing a head injury and facial fractures, this patient presented with massive epistaxis due to a pseudoaneurysm of the intracavernous internal carotid artery . Nasal packing was performed and subsequent angiography demonstrated the vascular lesion that had dissected into the sphenoid sinus. Endovascular stent and coil occlusion of the vascular lesion was performed, and the patient's condition improved without any ischemic or thromboembolic sequelae. Posttraumatic aneurysms of the intracavernous internal carotid artery can be associated with delayed and sometimes lethal massive epistaxis. This vascular lesion should be considered in patients with traumatic brain injury presenting with basal skull fractures in the region of the carotid canal or cavernous sinus and/or orbital fractures and compromise of the optical nerves. Knowledge of these risk factors and early diagnosis can minimize the high mortality risk.

  18. Internal Carotid Artery Aneurysms Presenting with Epistaxis - Our Experience and Review of Literature.

    Science.gov (United States)

    Garg, Kanwaljeet; Gurjar, Hitesh Kumar; Singh, Pankaj Kumar; Singh, Manmohan; Chandra, P Sarat; Sharma, Bhawani Shankar

    Intracranial internal carotid artery aneurysms are an extremely rare cause of spontaneous epistaxis, with a few documented cases. The management of such cases is challenging due to the relative anatomical inaccessibility of the bleeding point. The aim of the present study was to acquaint the readers with this rare type of aneurysm presenting with epistaxis and to report our experience of treating cases of severe epistaxis due to internal carotid artery (ICA) aneurysms. Data of 4 patients with İCA aneurysms presenting with epistaxis from June 2011 to July 2013 was retrospectively reviewed. The age of patients ranged from 16 to 62 years. Duration of epistaxis ranged from 3 months to 3 years. Two patients had severe epistaxis following transnasal biopsy. Two patients had a history of trauma. Two patients developed hemodynamically instability. All the patients were managed with trapping of the aneurysm. Complete exclusion of aneurysm from circulation was achieved in all the patients. ICA aneurysms can rarely present as life-endangering epistaxis. In patients presenting with a history of craniocerebral trauma, traumatic pseudoaneurysm must be considered as a differential diagnosis. Trapping of the aneurysm is a good option if there is good cross circulation.

  19. Summary of papers presented at the 2012 seventh international cough symposium

    Science.gov (United States)

    2013-01-01

    Twenty six papers were presented as posters in the Seventh International Symposium on Cough; 12 papers were presented in the Basic Science of Cough session, and 14 papers presented in the Clinical Science of Cough session. These papers explored a wide spectrum of cough-related areas including pathophysiological mechanisms, treatment and detection of cough, and symptom assessment and perception, and were grouped into several general themes for facilitate the discussion. Studies presented in these posters have provided new information that should improve our knowledge on the basic physiology and pharmacology of cough, and the peripheral and central neural mechanisms involved in the generation of the cough motor pattern. In addition, in the clinical science section, studies reporting potential new anti-tussive agents and further characterisation of cough symptoms and perception have provided a base for the fruitful strategies for the development of novel anti-tussive therapies and cough management. PMID:23639195

  20. Guide to radiation fixatives

    International Nuclear Information System (INIS)

    Tawil, J.J.; Bold, F.C.

    1983-11-01

    This report identifies and then characterizes a variety of substances available in the market place for potential effectiveness as a fixative on radiologically contaminated surfaces. The substances include both generic chemicals and proprietary products. In selecting a fixative for a particular application, several attributes of the fixative may be relevant to the choice. These attributes include: toxicity, durability, and cleanliness and removability. In addition to the attributes of the fixative, one should also take into account certain characteristics of the site to be treated. These characteristics relate to climate, nature of the surface, use to which the treated surface will be put, subsequent cleanup operations, and type of neighboring surfaces. Finally, costs and potential environmental effects may influence the decision. A variety of fixatives are evaluated with respect to these various attributes and summarized in a reference table

  1. Guide to radiation fixatives

    Energy Technology Data Exchange (ETDEWEB)

    Tawil, J.J.; Bold, F.C.

    1983-11-01

    This report identifies and then characterizes a variety of substances available in the market place for potential effectiveness as a fixative on radiologically contaminated surfaces. The substances include both generic chemicals and proprietary products. In selecting a fixative for a particular application, several attributes of the fixative may be relevant to the choice. These attributes include: toxicity, durability, and cleanliness and removability. In addition to the attributes of the fixative, one should also take into account certain characteristics of the site to be treated. These characteristics relate to climate, nature of the surface, use to which the treated surface will be put, subsequent cleanup operations, and type of neighboring surfaces. Finally, costs and potential environmental effects may influence the decision. A variety of fixatives are evaluated with respect to these various attributes and summarized in a reference table.

  2. Theory of Imperfect Crystalline Solids: Trieste Lectures 1970. Lectures Presented at an International Course

    International Nuclear Information System (INIS)

    1971-01-01

    The International Centre for Theoretical Physics has maintained an interdisciplinary character in its research and training program so far as different branches of theoretical physics are concerned. In pursuance of this aim the Centre has organized extended research courses with a comprehensive and synoptic coverage in varying disciplines. The first of these - on Plasma Physics — was held in 1964; the second, in 1965, was concerned with the physics of particles; the third, in 1966, covered nuclear theory; the fourth, in 1967, dealt with condensed matter; the fifth, in 1969, was a course on nuclear structure. The proceedings of all these courses were published by the International Atomic Energy Agency. The present volume records the proceedings of the sixth course, held from 12 January to 10 April 1970, which was concerned with the study of the theory of imperfect crystalline solids

  3. Papers presented at the fourteenth international conference on plasma physics and controlled nuclear fusion research

    International Nuclear Information System (INIS)

    1994-01-01

    This report contains the contributions of the CIEMAT's Fusion Unit to the 14th International Conference on Plasma Physics and Controlled Nuclear Fusion Research that was held by the International Atomic Energy Agency in Wurzburg, Germany from 30 September to 7 October 1992. Three papers were presented that summarized the main lines of work done in the Unit during the previous two years: The first one on the theoretical advances in the understanding of the Flexible Heliac TJ-II under construction, the second on the confinement studies performed in the operating TJ-I Tokamak and the third one on the description of the physical properties of the soon to be started TJ-IU Torsatron. (Author) 25 refs

  4. Comparison of lag screw versus buttress plate fixation of posterior malleolar fractures.

    Science.gov (United States)

    Erdem, Mehmet Nuri; Erken, H Yener; Burc, Halil; Saka, Gursel; Korkmaz, Mehmet Fatih; Aydogan, Mehmet

    2014-10-01

    The goal of this study was to report the results of selective open reduction and internal fixation of fractures of the posterior malleolus with a posterolateral approach and to compare the results of the 2 techniques. We prospectively evaluated 40 patients who underwent posterior malleolar fracture fixation between 2008 and 2012. The patients were treated with a posterolateral approach. We assigned alternating patients to receive plate fixation and the next screw fixation, consecutively, based on the order in which they presented to our institution. Fixation of the posterior malleolus was made with lag screws in 20 patients and a buttress plate in 20 patients. We used American Orthopaedic Foot and Ankle Society (AOFAS) scores, range of motion (ROM) of the ankle, and radiographic evaluations as the main outcome measurements. The mean follow-up was 38.2 (range, 24-51) months. Full union without any loss of reduction was obtained in 38 of the 40 patients. We detected a union with a step-off of 3 mm in 1 patient in the screw group and a step-off of 2 mm in 1 patient in the plate group. At the final follow-up, the mean AOFAS score of the patients regardless of fixation type was 94.1 (range, 85-100). The statistical results showed no significant difference between the patients regardless of the fixation type of the posterior malleolus in terms of AOFAS scores and ROM of the ankle (P > .05). Good (AOFAS score of 94/100) and equivalent (within 3 points) results were obtained using the 2 techniques (screws or plate) for fixation after open reduction of posterior malleolar fragments. Level II, prospective case series. © The Author(s) 2014.

  5. Self-organization in Complex Systems The Past, Present, and Future of Synergetics : International Symposium

    CERN Document Server

    Pelster, Axel

    2016-01-01

    This proceedings volume contains talks and poster presentations from the International Symposium "Self-Organization in Complex Systems: The Past, Present, and Future of Synergetics", which took place at Hanse-Wissenschaftskolleg, an Institute of Advanced Studies, in Delmenhorst, Germany, during the period November 13 - 16, 2012. The Symposium was organized in honour of Hermann Haken, who celebrated his 85th birthday in 2012. With his fundamental theory of Synergetics he had laid the mathematical-physical basis for describing and analyzing self-organization processes in a diversity of fields of research. The quest for common and universal principles of self-organization in complex systems was clearly covered by the wide range of interdisciplinary topics reported during the Symposium. These extended from complexity in classical systems and quantum systems over self-organisation in neuroscience even to the physics of finance. Moreover, by combining a historical view with a present status report the Symposium con...

  6. Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID: protocol for a randomized clinical multi-center trial

    Directory of Open Access Journals (Sweden)

    Seiler Christoph

    2011-03-01

    Full Text Available Abstract Background Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation. Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. Methods/Design ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool. The primary objective is to determine differences in the Short Form 36 (SF-36 Physical Component Score (PCS between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery, as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture

  7. Technical Management Oversight Framework for International Defense Acquisition: Presentation, Application, and Analysis

    National Research Council Canada - National Science Library

    Hoyt, Sidney

    2001-01-01

    ... data, Programs considered were HAWK, ROLAND, LANCE, MEADS, the International Space Station, and MLRS TGW. These programs had various degrees of international participation and various degrees of international coupling...

  8. External fixation of the pelvic ring: an experimental study on the role of pin diameter, pin position, and parasymphyseal fixator pins

    NARCIS (Netherlands)

    Ponsen, Kees-Jan; Joosse, Pieter; Hoek van Dijke, Gilbert A.; Snijders, Chris J.

    2007-01-01

    BACKGROUND: The mechanical properties of current external fixator systems for unstable (type C) pelvic ring fractures are inferior to internal fixation, and are not optimal for definitive treatment. We explored methods to increase stability of external fixator constructs. METHODS: An experimental

  9. Biomechanical study of posterior wall acetabular fracture fixation using acetabular tridimensional memory alloy-fixation system.

    Science.gov (United States)

    Xin-wei, Liu; Shuo-gui, Xu; Chun-cai, Zhang; Qing-ge, Fu; Pan-feng, Wang

    2010-05-01

    We developed the acetabular tridimensional memory alloy-fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, nitinol alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Six formalin-preserved cadaveric pelvis were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelvis were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40-90 degrees about the acetabular rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1422N) as compared to the intact condition (762N, P=0.007). Following reduction and internal fixation, the load distributed to the superior acetabulum (1486N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (936N) was less than fixation with reconstruction plate and was not different from intact state (P=0.4). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. Artrodese do punho com fixação mínima preservando as articulações carpometacarpianas Wrist arthrodesis with minimal internal fixation preserving the carpometacarpal joints

    Directory of Open Access Journals (Sweden)

    Arlindo Gomes Pardini Júnior

    2010-01-01

    structures. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques are described, with different methods of internal fixation, most of which include the carpometacarpal joints (CMJ in the fusion. The objective of this study is to evaluate the results of wrist arthrodesis through a technique which is simpler, more biological, more inexpensive, and does not involve the carpometacarpal joints. METHODS: 15 patients with wrist arthrodesis were evaluated (6 with sequelae of trauma, 4 Rheumatoid Arthritis, 3 Kienbock's grade IV, 1 Preiser and 1 panarthrosis. The technique consisted of the use of an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints. RESULTS: The evaluation was based on consolidation time (93% in 7 weeks; movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH questionnaire, pain and patient satisfaction. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result. CONCLUSION: wrist arthrodesis with fixation using Kirschner wires and the use of an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results which are similar to those of other techniques described. However it presents major advantages over other methods: it is less aggressive, less expensive, and does not have the inconvenience and complications associated the use of plates and screws.

  11. [Ilizarov fixation of supramalleolar fractures].

    Science.gov (United States)

    Mseddi, M B E; Mseddi, M; Siala, A; Dahmene, J; Ben Hamida, R; Ben Ayeche, M

    2005-02-01

    Supramalleolar fractures are generally considered to be a difficult surgical challenge because they occur in a area where the tibia lies superficially with a precarious blood supply to the skin, exposing to the risk of infection and necrosis after internal fixation. These fractures are also situated close to the tibiotalar joint making centromedullary nailing difficult, even with distal locking. The Ilizarov external fixator could be an attractive alternative in this indication. We report a series of 17 supramalleolar fractures in 17 patients, 14 men and 3 women, treated with the Ilizarov external fixator between 1991 and 2001. Most were traffic accident victims and most had complex fractures resulting from high-energy trauma. There were many associated lesions. Fractures were open in ten patients. The Ilizarov fixator was used as the first intention treatment in seven patients and as a second line treatment in ten. The system allowed early weight bearing in all patients. Tolerance was generally good with a relatively low rate of superficial pin track infections (two cases). There was one case of osteitis which developed in a patient with an open fracture. There were no thromboembolic complications and no nerve involvement. Bone healing was achieved within three months in thirteen patients. There were three cases of late healing which were treated by the ascension technique using a cancellous graft and fibular osteotomy. The overall healing rate with this method was 94%. The one case of nonunion was successfully treated with an inter tibiofibular graft. The overall functional outcome was satisfactory in 76% of the patients, based on the Alho-Klemm criteria. Axial deformation predominated in the frontal plane: three patients had > 10 degrees varus in one case. These results could be improved by better operative technique. We advocate installing the patient in the supine position with transcalcaneal traction allowing good restitution of the leg axis. The assembly

  12. Collection and presentation of animal data relating to internally distributed radionuclides

    International Nuclear Information System (INIS)

    Lathrop, K.A.

    1981-01-01

    Data obtained from laboratory animals on the distribution of an internally administered radionuclide may be put to use by various people in ways quite different from the one for which the original observations were made. Consideration for these other scientists, sometimes in unrelated fields, can be shown by attention to a few details in the method of data collection and reporting that may improve the author's credibility, the reader's comprehension, and the value of the data. Briefly stated, two rules should be followed: (1) Account for 100% of the administered radioactivity; and (2) Report data as fraction of administered activity per organ. The first rule serves as an internal check on the proper functioning of counting equipment, and may disclose excretion, contamination of counting tubes, or failure to inject the desired amount of activity. The second rule allows anyone to make use of the raw data. Adherence to these two principles will permit the reader to follow through on any permutations of the data that the author may make, and to apply the data in unrelated situations. In addition to the above, reality testing should be carried out continuously, especially when presenting data graphically. Techniques used to account for all of the administered activity are discussed in detail, and illustrations of pitfalls to avoid and examples to follow are given for presentation of data

  13. Rare presentation of an arteriovenous malformation within the internal auditory canal

    Directory of Open Access Journals (Sweden)

    Noor Sulieman

    2018-03-01

    Full Text Available While cerebral arteriovenous malformations (AVM are common, a presentation of this vascular lesion involving the internal auditory canal (IAC is rare. We describe a case of an un-ruptured AVM within the right IAC of a 55-year-old male who presented following a whiplash injury and left-ear (contralateral to the lesion unilateral non-pulsatile tinnitus. On magnetic resonance imaging (MRI, an incidental atypical linear enhancement suspicious for a vascular lesion within the right IAC was identified and investigated further using magnetic resonance angiography and venography (MRA/MRV, which illustrated serpentine flow voids that confirmed the presence of an AVM. Given the patient's intact hearing and rare location of the AVM, treatment options including watchful waiting, stereotactic radiosurgery, embolization, and microsurgery were discussed, of which observation was chosen.

  14. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation.

    Science.gov (United States)

    Sabat, Dhananjaya; Dabas, Vineet; Dhal, Anil

    2014-07-01

    Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  15. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation

    Directory of Open Access Journals (Sweden)

    Dhananjaya Sabat

    2014-01-01

    Full Text Available Late rupture of extensor pollicis longus (EPL tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP. He was managed with extensor indicis proprius (EIP transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  16. Fixação interna de fragmento osteocondral originado de osteocondrite dissecante do joelho Internal fixation of osteochondral fragment originated fro dissecting knee osteochondritis

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Sanches Vaz

    2008-01-01

    Full Text Available O tratamento da osteocondrite dissecante do joelho com lesão tipo cratera associada a corpo livre intra-articular pode ser realizado pela fixação do fragmento osteocondral no seu local de origem. No entanto, existem controvérsias quanto à indicação e eficácia deste procedimento, principalmente quando o corpo livre está solto por tempo prolongado, já que existem relatos na literatura demonstrando deterioração do revestimento condral do mesmo diretamente relacionado com o intervalo decorrente de sua soltura. Relatamos um caso em que, apesar do fragmento osteocondral estar livre na articulação por aproximadamente cinco semanas, a sua fixação não trouxe complicações e resultou em cicatrização completa da lesão. Nós concluímos que, principalmente nos casos onde a lesão osteocondral no côndilo femoral envolve a superfície de carga, quando então o descarte do fragmento geralmente resultaria em mau prognóstico, as possíveis complicações da fixação tardia são compensadas pelos benefícios obtidos pela redução do fragmento osteocondral no local de origem, resultando na recuperação da congruência articular e possivelmente evitando um processo degenerativo articular precoce.The treatment of dissecting knee osteochondritis with crater-like lesion associated to intra-articular loose body can be provided by fixating the osteochondral fragment on its original site. However, there is some concern about the efficacy of this approach, since some reports have shown that the cartilage layer in osteochondral loose bodies that have been detached for a long time becomes deteriorated. We report a case where while the osteochondral loose body was detached for as long as five weeks, the fixation to the osteochondral defect was uneventful and resulted in a completely healed lesion. We concluded that, especially in cases in which the lesion involves a weight-bearing area of the knee with a detached osteochondral fragment, when the

  17. Current Issues in the Presentation of Asymptomatic Primary Hyperparathyroidism: Proceedings of the Fourth International Workshop

    Science.gov (United States)

    Clarke, Bart L.; Peacock, Munro; Bandeira, Francisco; Boutroy, Stephanie; Cusano, Natalie E.; Dempster, David; Lewiecki, E. Michael; Liu, Jian-Min; Minisola, Salvatore; Rejnmark, Lars; Silva, Barbara C.; Walker, Marcella D.; Bilezikian, John P.

    2014-01-01

    Objective: This report summarizes data on traditional and nontraditional manifestations of primary hyperparathyroidism (PHPT) that have been published since the last International Workshop on PHPT. Participants: This subgroup was constituted by the Steering Committee to address key questions related to the presentation of PHPT. Consensus was established at a closed meeting of the Expert Panel that followed. Evidence: Data from the 5-year period between 2008 and 2013 were presented and discussed to determine whether they support changes in recommendations for surgery or nonsurgical follow-up. Consensus Process: Questions were developed by the International Task Force on PHPT. A comprehensive literature search for relevant studies was undertaken. After extensive review and discussion, the subgroup came to agreement on what changes in the recommendations for surgery or nonsurgical follow-up of asymptomatic PHPT should be made to the Expert Panel. Conclusions: 1) There are limited new data available on the natural history of asymptomatic PHPT. Although recognition of normocalcemic PHPT (normal serum calcium with elevated PTH concentrations; no secondary cause for hyperparathyroidism) is increasing, data on the clinical presentation and natural history of this phenotype are limited. 2) Although there are geographic differences in the predominant phenotypes of PHPT (symptomatic, asymptomatic, normocalcemic), they do not justify geography-specific management guidelines. 3) Recent data using newer, higher resolution imaging and analytic methods have revealed that in asymptomatic PHPT, both trabecular bone and cortical bone are affected. 4) Clinically silent nephrolithiasis and nephrocalcinosis can be detected by renal imaging and should be listed as a new criterion for surgery. 5) Current data do not support a cardiovascular evaluation or surgery for the purpose of improving cardiovascular markers, anatomical or functional abnormalities. 6) Some patients with mild PHPT

  18. CSF coccidioides complement fixation

    Science.gov (United States)

    Skip navigation U.S. National Library of Medicine The navigation menu has been collapsed. ... of this page: //medlineplus.gov/ency/article/003526.htm CSF coccidioides complement fixation test To use the sharing features ...

  19. Histoplasma complement fixation

    Science.gov (United States)

    Skip navigation U.S. National Library of Medicine The navigation menu has been collapsed. ... this page: //medlineplus.gov/ency/article/003527.htm Histoplasma complement fixation To use the sharing features on this page, ...

  20. Units of measurement past, present and future international system of units

    CERN Document Server

    Gupta, S V

    2010-01-01

    It is for the first time that the subject of quantities and their respective units is dealt this much in detail a glimpse of units of measurements of base quantities of length, time, mass and volume is given for ancient India three and four dimensional systems of measurement units are critically examined establishment of the fact that only four base units are needed to describe a system of units the basics to arrive at the unit of a derived quantity are explained basic, derived and dimensionless quantities including quantity calculus are introduced life history of scientists concerned with measurements units are presented to be inspiring to working metrologists and students. The International System of Units including, Metre Convention Treaty and its various organs including International National of Weights and Measure are described. The realisation of base units is given in detail. Classes of derived units within the SI, units permitted for time to come, units outside SI but used in special fields of measur...

  1. Collet-Sicard syndrome: a rare but important presentation of internal jugular vein thrombosis.

    Science.gov (United States)

    Neo, Shermyn; Lee, Kim En

    2017-01-01

    We describe a rare neurological presentation of internal jugular vein thrombosis induced by central venous catheter placement in a patient with cancer. A 71-year-old man gave a 3-week history of dysphagia and dysarthria with left-sided neck pain and headache. He was receiving chemotherapy for appendiceal adenocarcinoma. On examination, he had left 9th-12th cranial neuropathies, manifesting as voice hoarseness, decreased palatal movement, absent gag reflex, weakness of scapular elevation and left-sided tongue wasting. CT scan of neck showed the left subclavian central venous catheter tip was in the left internal jugular vein. Skull base MRI showed thrombus within the left jugular foramen extending intracranially. We diagnosed Collet-Sicard syndrome secondary to thrombosis in the sigmoid-jugular venous complex. His headache and neck pain resolved 2 days after removing the catheter and starting anticoagulation. Collet-Sicard syndrome is an unusual syndrome of lower cranial nerve palsies, often signifying disease at the skull base, including malignancy, trauma or vascular causes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Examination of the International Scope of Papers Presented at the International Society for Music Education Research Commission Seminars, 1988-2006

    Science.gov (United States)

    Price, Harry E.; Madsen, Clifford K.; Cornacchio, Rachel; Webb, Marie

    2010-01-01

    The authors classified citations included in papers presented at 10 International Society for Music Education (ISME) biennial International Research Commission Seminars across an 18-year period (1988-2006) based on the six world regions as specified by the ISME Research Commission. Citations (N = 4,535) were examined from 238 papers presented at…

  3. Investigating the Effective Factors on Entering into International Markets by Presenting the Local Islamic Model

    Directory of Open Access Journals (Sweden)

    Sayyed Mohammad Ali Alamolhodaei

    2015-03-01

    Full Text Available The internationalization of small and medium size businesses is regarded as one of the most leading general policies in many of the world’s countries. The reason is that it is often the small and medium size companies which have a vital role in industrial innovation and gain profit for their societies through economic development. This research has investigated and identified the effective factors (organizational factors and business etiquette in Islam on entering into international markets by presenting local Islamic model in the companies of incubator of Science and Technology Park. The statistical population of the research includes the existing companies of Incubator of Mashhad Science and Technology Park. The statistical sample was investigated through simple random sampling from managers of active companies in export in Science and Technology Park. AMOS and SPSS software were applied for data analysis to identify the effects among variables survey research methodology and questionnaire tools were used.

  4. Left Internal Mammary Artery Injury Requiring Resuscitative Thoracotomy: A Case Presentation and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ammar Al Hassani

    2012-01-01

    Full Text Available Background. Penetrating injuries to the chest and in particular to the heart that results in pericardial tamponade and cardiac arrest requires immediate resuscitative thoracotomy as the only lifesaving technique and should be performed without delay. Objective. To describe an external cardiac tamponade caused by massive tension hemothorax from penetrating injury of the left internal mammary artery (LIMA. Method. A case presentation treated at the Level I trauma center at Hamad General Hospital, in Doha, Qatar and review of the literature on LIMA injuries reported cases. Results. LIMA injury as a cause of hemothorax is not uncommon, but to our knowledge our case is the first massive tension hemothorax with witnessed cardiac arrest reported in the literature requiring emergency thoracotomy, performed in trauma room, with full recovery. Conclusion. Injury to the LIMA with massive tension hemothorax requires immediate resuscitative thoracotomy.

  5. International Seminar on Nuclear policy in Argentina and the world: present and perspectives

    International Nuclear Information System (INIS)

    2012-01-01

    The 25 and April 26, 2013 was held in Buenos Aires the International Seminar 'Nuclear Politics in Argentina and the world: present and perspectives', organized by the Nuclear Regulatory Authority (ARN), the National University of San Martin (UNSAM) and University of San Andres (UdeSA). With the main objective of creating an area for reflection and discussion on the state of the global nuclear policy, its impact on the region and in our country, and raised as an area of interaction between the academic and those working in the sector policies. The seminar consisted of six thematic panels, in addition to the opening session, in which academics and researchers exposed renowned in dialogue with officials and professionals of the nuclear sector. In this seminar were presented some papers of the following topics: historical approaches to nuclear policy in emerging contexts; nuclear policy and civil society; discussion and perspectives on proliferation and non-proliferation, security in the post-Fukushima: discussion and perspectives; Argentina-Brazil: from competition to cooperation, present and prospects for the nuclear industry.

  6. Congenital agenesis of internal carotid artery with ipsilateral Horner presenting as focal neurological symptoms

    Directory of Open Access Journals (Sweden)

    Hosseini H

    2011-01-01

    Full Text Available Wassim Farhat, Rechdi Ahdab, Hassan HosseiniService de Neurologie, Hôpital Henri Mondor, APHP, Faculté de Médecine, Université Paris XII, Créteil, FranceAbstract: Internal carotid artery (ICA agenesis is a rare developmental anomaly and is most frequently asymptomatic, but it may also present as cerebrovascular accidents. The association with Horner’s syndrome is exceptional. We present three cases of agenesis of ICA associated with Horner’s syndrome and hypochromia iridum presenting as focal neurological symptoms. A system of collaterals develops as a consequence of agenesis of the ICA, making the majority of cases asymptomatic. Three types of collateral circulations have been described. These collaterals increase the risk of aneurysm formation and the occurrence of life-threatening subarachnoid hemorrhages. The association of congenital Horner’s syndrome and hypochromia iridum without anhidrosis is highly suggestive of sympathetic pathway injury early in life. Such signs should prompt further diagnostic evaluation to demonstrate the presence of the agenesis of the carotid canal. Early diagnosis is essential to rule out potentially life-threatening associated vascular anomalies.Keywords: carotid artery agenesis, Horner’s syndrome, heterochromia iridum

  7. SIGN HIP CONSTRUCT: ACHIEVING HIP FRACTURE FIXATION ...

    African Journals Online (AJOL)

    elderly has made stable reduction and internal fixation the preferred treatment. .... anaemia, 1 had concomitant spine injury, and another had widespread ... infection (1.5%) and 8 cases of varus collapse (11.8%). (Table 4). Table 3. Stable versus unstable fracture and mechanism of injury. Type of fracture. MTA. No. (%). Fall.

  8. Presentations of the GeoExchange 2005 international conference and trade show

    Energy Technology Data Exchange (ETDEWEB)

    Ross, L. (comp.) [GeoExchange BC, Burnaby, BC (Canada)

    2005-07-01

    This international conference provided a forum to discuss the status of geoexchange technology and industry. Advances in geoexchange system innovations have provided a sustainable option for space heating, cooling and hot water heating for buildings at typically less than 50 per cent of the cost of conventional gas and electric heating, ventilation and air conditioning (HVAC) systems. Major constraints on North American gas production were reviewed to provide a strong case for a sustainable geoexchange industry. Geoexchange systems offer the largest greenhouse gas mitigation opportunity worldwide. In addition to lasting for years, they require minimum maintenance. The unique environment of the Pacific West Coast provides the geoexchange industry with new opportunities to promote a sustainable energy plan for the 2010 Winter Olympics Athletes Village. Some presentations outlined professional design guidelines for evaluating geoexchange proposals, conducting site evaluations and completing proper designs for successful installations. Program developers from CANMET Energy Technology Centre presented the latest version of the RETScreen Ground Source Heat Pump Project model for evaluating the design of geoexchange proposals. An overview of the new refrigeration action program for buildings was also presented. The conference featured 32 presentations in various sessions that focused on system performance, monitoring and innovations in design and technology; issues associated with geoexchange and aquifer/open loop system characteristics, performance and design; earth heat fundamentals, HVAC designs and LEED points; market potential for geoexchange and financial considerations; innovative deployment of geoexchange systems and technology; deep sea and wastewater design applications for geoexchange technology; case studies of innovations in design for commercial and institutional geoexchange system installations; and, the business potential for geoexchange. tabs., figs.

  9. International Fusion Materials Irradiation Facility conceptual design activity. Present status and perspective

    International Nuclear Information System (INIS)

    Kondo, Tatsuo; Noda, Kenji; Oyama, Yukio

    1998-01-01

    For developing the materials for nuclear fusion reactors, it is indispensable to study on the neutron irradiation behavior under fusion reactor conditions, but there is not any high energy neutron irradiation facility that can simulate fusion reactor conditions at present. Therefore, the investigation of the IFMIF was begun jointly by Japan, USA, Europe and Russia following the initiative of IEA. The conceptual design activities were completed in 1997. As to the background and the course, the present status of the research on heavy irradiation and the testing means for fusion materials, the requirement and the technical basis of high energy neutron irradiation, and the international joint design activities are reported. The materials for fusion reactors are exposed to the neutron irradiation with the energy spectra up to 14 MeV. The requirements from the users that the IFMIF should satisfy, the demand of the tests for the materials of prototype and demonstration fusion reactors and the evaluation of the neutron field characteristics of the IFMIF are discussed. As to the conceptual design of the IFMIF, the whole constitution, the operational mode, accelerator system and target system are described. (K.I.)

  10. The Cognitive Behavioral Assessment (CBA Project: Presentation and Proposal for International Collaboration

    Directory of Open Access Journals (Sweden)

    Ezio Sanavio

    2013-11-01

    Full Text Available Aims: The main aim of this paper is to describe almost 30 years of work on psychological assessment using CBA, a research team, and to propose collaboration with Latin countries. Methods: The acronym CBA stands for Cognitive Behavioural Assessment and indicates both an overall approach to clinical assessment and a series of tests. Five general principles formed the basis on which the team developed their questionnaires: (1 assessment is not a passive collection of information, but an active process similar to problem-solving; (2 horizontal integration of questionnaires with other assessment methods; (3 vertical integration and hierarchical structure of assessment questionnaires; (4 idiographic perspective; (5 computer support. Results: The paper briefly presents the most important tests: CBA-2.0, a broad-spectrum Battery for patients who need counselling and/or psychotherapy; CBA-H (Hospital for both in-patients and out-patients suffering from physical illnesses; CBA-SPORT for professional athletes; CBA-Y (young people for adolescents and young adults; CBD-VE (treatment benefits to assess the effectiveness of psychological treatment. Conclusion: These questionnaires have produced over 100 research works, published in Italian journals or presented in conferences. In the near future, we expect important, radical changes and hope to create an international research milieu.

  11. Unstable fragility fractures of the ankle in the elderly; Transarticular Steinmann pin or external fixation

    NARCIS (Netherlands)

    Meijer, R. P. J.; Halm, J. A.; Schepers, T.

    2017-01-01

    Because of poor skin conditions and comorbidity, open reduction and internal fixation in ankle fractures is frequently contra-indicated in the elderly. This study reports the results of two temporary fixation types in fragility fractures in the older patient: transarticular Steinmann pin fixation

  12. Intermittent internal fixation with a locking plate to preserve epiphyseal growth function during limb-salvage surgery in a child with osteosarcoma of the distal femur: a case report.

    Science.gov (United States)

    Mei, Jiong; Ni, Ming; Jia, Guang-Yao; Chen, Yan-Xi; Zhu, Xiao-Zhong

    2015-05-01

    Limb shortening is a problem associated with surgery for osteosarcoma of the lower extremity in adolescents, as the tumors frequently occur near the epiphysis. Herein we report the use of a less invasive stabilization system (LISS) and an intermittent fixation method to preserve the growth function of epiphysis in an 11-year-old patient with an osteosarcoma of the distal femur.The 11-year-old male presented with left knee enlargement and pain for 2 weeks, and magnetic resonance imaging (MRI) and biopsy were consistent with osteosarcoma of the left distal femur. After preoperative chemotherapy, en bloc tumor resection was performed with margins based on MRI findings preserving the epiphyseal growth plate, the tumor cavity was filled with inactivated bone and bone cement, and a LISS was used to stabilize the femur. Aggressive postoperative chemotherapy was given. Approximately 105 weeks after surgery radiography showed that the distal end of the plate had moved superior to the epiphysis along with bone growth. Locking screws were placed in the distal part of the LISS plate to stabilize the re-implanted bone, and external fixation was not needed.The patient was able to walk with the crutches 1 week postoperatively, and bear weight on the extremity 6 weeks postoperatively. At 6 years after surgery, the patient's height had increased 52 cm, shortening of the affected limb was only 1 cm, and the circumference of the affected limb was 2 cm smaller than that of the contralateral limb. There was no significant discomfort in the affected limb, and there was no gait abnormality. The patient could jump and run, and could participate in sports including basketball and badminton to the same degree as his peers.In summary, the novel method of bone reconstruction and fixation provided good results in a child with an osteosarcoma of the distal femur. This fixation method preserves the osteogenic function of the epiphysis and restored bone integrity simultaneously, and

  13. Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China

    Science.gov (United States)

    Liu, Xinwei; Xu, Shuogui; Su, Jiacan; Yu, Baoqing

    2009-01-01

    Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of acetabular fractures by using shape-memory alloy designed by the authors. This is a retrospective review conducted at a level 1 trauma centre. From October 1999 to July 2009, 19 patients with acetabular fractures were treated with our patented Ni-Ti shape-memory alloy acetabular tridimensional memory alloy-fixation system (ATMFS). The ATMFS device was cooled with ice before implantation and then warmed to 40–50°C after implantation to produce balanced axial and compression forces that would stabilise the fracture three dimensionally. Our results are as follows; according to the D’Aubigne−Postel scoring system: Fifteen cases out of 19 (79%) achieved excellent or good clinical results. In two patients, late complications included avascular necrosis of the femoral head (ANFH) associated with posterior dislocation of the hip joint two years after the operation. We also observed two cases of grade II or III ectopic ossification, with good hip function, and one case of traumatic arthritis. In conclusion, these results demonstrate the effectiveness of the ATMFS device for the management of acetabular fracture. The device provides continuous compression of the fracture with minimal disruption to the local blood supply. PMID:20012433

  14. Mesenteric defect with internal herniation in the pediatric emergency department: an unusual presentation of acute abdomen.

    Science.gov (United States)

    Hu, Mei-Hua; Huang, Go-Shine; Chen, Jeng-Chang; Wu, Chang-Teng

    2014-04-01

    Internal herniation is a rare cause of intestinal obstruction, especially in the emergency department. We report a child with acute abdomen resulting from transmesenteric internal herniation of the small bowel. Radiographic findings revealed gaseous distension of the bowel loops in the upper abdominal area with a paucity of gas in the lower abdomen. Operative finding showed gangrenous small bowel due to mesenteric defect with an internal herniation. The gangrenous bowel was resected and the patient was discharged with an uneventful outcome. We emphasize that early recognition of internal herniation warrants further evaluation and appropriate management. Copyright © 2012. Published by Elsevier B.V.

  15. Ilizarov fixator in management of nonunited and infected tibial shaft fractures

    Directory of Open Access Journals (Sweden)

    Abhinay Singh

    2015-01-01

    Full Text Available Background: Management of nonunion with bony defect and infection in long bones is a challenging problem for orthopedic surgeons. Objectives: Evaluation of Ilizarov circular fixation method of treatment for the management of nonunited and infected fractures of tibia. Materials and Methods: This prospective study was conducted in a tertiary care hospital of eastern region of India on 30 subjects in a time span of 3 years after taking clearance of the Institutional Ethical Committee and informed consent of the patients. Results: All the patients had infected nonunion before undergoing Ilizarov procedure. Following initial injury, 22 patients were treated with external fixation and 8 cases were treated with internal fixation. At the time of presentation, 18 patients had infected gap nonunion, 5 patients had infected hypertrophic and 2 patients had atrophic nonunion. The Ilizarov fixator was kept for an average period of 303.7 days. Based on Association for the Study and Application of Methods of Ilizarov scoring system, bony and functional results were assessed. The bony result was excellent in 16 patients, good in eight, fair in four and poor in two. The functional result was excellent in 10 patients, good in 16, fair in two, poor in two. Conclusion: Ilizarov ring fixator still remains an excellent treatment modality for tibial nonunion with a defect, regarding bone union, deformity correction, infection eradication, limb-length achievement, and limb function.

  16. Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses.

    Science.gov (United States)

    Frei, Sina; Fürst, Anton E; Sacks, Murielle; Bischofberger, Andrea S

    2016-05-18

    Three horses that were presented with supraglenoid tubercle fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP). Placing the DFLP caudal to the scapular spine in order to preserve the suprascapular nerve led to a stable fixation, however, it resulted in infraspinatus muscle atrophy and mild scapulohumeral joint instability (case 1). Placing the DFLP cranial to the scapular spine and under the suprascapular nerve resulted in a stable fixation, however, it resulted in severe atrophy of the supraspinatus and infraspinatus muscles and scapulohumeral joint instability (case 2). Placing the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage site resulted in the best outcome (case 3). Only a mild degree of supraspinatus and infraspinatus muscle atrophy was apparent, which resolved quickly and with no effect on scapulohumeral joint stability. In all cases, fixation of supraglenoid tubercle fractures using DFLP in slightly different techniques led to stable fixations with good long-term outcome. One case suffered from a mild incisional infection and plates were removed in two horses. Placement of the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage prevented major nerve damage. Further cases investigating the degree of muscle atrophy following the use of the DFLP placed in the above-described technique are justified to improve patient outcome.

  17. Temporising external fixation of calcaneus fractures prior to definitive plate fixation: a case series.

    Science.gov (United States)

    Farrell, Brian M; Lin, Carol A; Moon, Charles N

    2015-09-01

    Surgical management of calcaneus fractures is technically demanding and has a high risk of wound complications. These fractures are traditionally managed with splinting until swelling has subsided, which can take weeks and leaves the fracture fragments displaced. We describe a novel protocol for the management of displaced intraarticular calcaneus fractures that utilises a temporising external fixator and staged conversion to plate fixation through a sinus tarsi approach. The goal of this technique was to enable earlier treatment with open reduction and internal fixation, minimise the amount of manipulation required at the time of definitive fixation and reduce the wound complication rate seen with the traditional extensile approach. The records of patients with displaced calcaneus fractures from 2010-2014 were reviewed retrospectively. A total of nine patients with 10 calcaneus fractures were treated using this protocol. All patients underwent ankle-spanning medial external fixation within 48 hours after injury. Patients underwent conversion to open plate fixation through a sinus tarsi approach when skin turgor had returned to normal. Time to surgery, infection rate, wound complications, radiographic alignment, and time to radiographic union were recorded. The average Bohler's angle improved from 13.2 (range -2 to 34) degrees preoperatively to 34.3 (range 26 to 42) degrees postoperatively. The average time from external fixation to conversion to internal fixation was 4.8 (range 3 to 7) days. There were no immediate post-surgical complications. The average time to weight-bearing was 8.5 weeks. The average time to radiographic union was 9.5 (range 8 to 12) weeks. There were no infections or wound complications at the time of last follow-up. Early temporising external fixation for the acute management of displaced calcaneus fractures is a safe and effective method to reduce and stabilise the foot and may decrease the time to definitive fixation. There were no

  18. International Symposium on Isotopes in Hydrology, Marine Ecosystems, and Climate Change Studies. Presentations

    International Nuclear Information System (INIS)

    2011-01-01

    Human activities have had a far-reaching impact on the aquatic environments - both marine and freshwater systems. The protection of these systems against further deterioration and the promotion of sustainable use are vital. In order to deepen understanding about the main processes affecting the present situation, as well as possible developments in the future, further investigation is required. The oceans play a major role in climate change, for example, and ocean acidification by increased CO2 release is one major threat to the world's oceans. Isotope methods can play a critical role in identifying and quantifying key processes within aquatic environments. Addressing the problems of global water resources has become a matter of urgency. Water resources are subject to multiple pressures for various reasons, including increasing populations, climate change, rising food and energy costs, the global economic crisis and pollutant loading. Isotope hydrology provides the unique and critical tools required to address complex water problems and helps managers and policy makers understand the closely intertwined relationship between water resources and the various pressures affecting them, as well as the issue of sustainability. The symposium will be an important forum for the exchange of knowledge on the present state of marine and freshwater environments, use of isotopes in water resources investigations and management, and climate change studies. The meeting will involve leading scientists in the field of climate change and hydrology, as well as representatives from other United Nations bodies and international organizations that focus on climate change and other important environmental issues. TOPICS: The role of isotopes in understanding and modelling climate change, marine ecosystems and the water cycle; Carbon dioxide sequestration and related aspects of the carbon cycle, such as ocean acidification; Isotopes in groundwater flow modelling for large aquifers

  19. External fixation of “intertrochanteric” fractures

    Directory of Open Access Journals (Sweden)

    Naseem ul Gani

    2009-08-01

    Full Text Available In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with “intertro-chanteric” fractures remain unsuitable for open reduction and internal fixation. The aim of this study was to analyze the results of external fixation of “intertro-chanteric” fractures in high-risk geriatric patients in a developing country. The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58-90 years with “intertrochanteric” fractures, in whom external fixation was performed, are reported. Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet’s point system. Good to excellent results were achieved in 44 patients. This study demonstrated that external fixation of “intertrochantric” fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country.

  20. External skeletal fixation of the tibial shaft fractures

    OpenAIRE

    Milenković Saša; Mitković Milorad B.; Radenković Mile

    2005-01-01

    Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitković’s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16−84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitković’s external fixator type M 20. Results. The results of exter...

  1. Analysis and an overview of fixators in medicine and the methods of processing materials for producing fixators

    Directory of Open Access Journals (Sweden)

    Dalibor Milojko Đenadić

    2013-06-01

    Full Text Available The fixator is a medical device that provides support to fractured biological structures. Metal biomaterials are mainly used for replacing broken or damaged hard tissues such as bones because of their high strenght, toughness and corrosion resistance. Materials such as stainless steel, titanium and aluminium alloys (Ti-6Al-4V, cobalt and chromium alloys, composite materials and other biocompatible materials are used in orthopedy for the stabilization of connective tissue injuries or as a substitute for the bone tissues. Fixators are classified according to the place of installation to external and internal fixators. Widely used medical fixators are pins, rods plates, screws, pipes, wires, nails and external fixators. Conventional and non-conventional methods of processing are used in the production process for all types of fixators. Introduction Fixators are medical devices manufactured to support damaged biological structures. In the field of orthopedic surgery that deals with skeletal disorders such as bone, spine, joints, muscles and tendons injuries and diseases, various metals, titanium and cobalt alloys etc. are used to stabilize the supporting tissue injuries or as a substitute for bone tissues. Metallic implants are frequently used in orthopedic surgery as joint prosthesis (hip, knee and elbow fracture fixation devices (plates, screws, external fixators and devices for the fixation of the spine. In principle, fixators are devided into external and internal ones, depending on the place of installation (outside or inside the body. The most common types of medical fixators are pins, rods and plates. This paper presents some of the most common materials used for the production of fixators, their processing and possibilties of use in medicine for various purposes. Types of fixators and materials used for their production Nowadays, biocompatible materials are usually used for the production of fixators and implants. These materials show good

  2. Improving carbon fixation pathways

    Energy Technology Data Exchange (ETDEWEB)

    Ducat, DC; Silver, PA

    2012-08-01

    A recent resurgence in basic and applied research on photosynthesis has been driven in part by recognition that fulfilling future food and energy requirements will necessitate improvements in crop carbon-fixation efficiencies. Photosynthesis in traditional terrestrial crops is being reexamined in light of molecular strategies employed by photosynthetic microbes to enhance the activity of the Calvin cycle. Synthetic biology is well-situated to provide original approaches for compartmentalizing and enhancing photosynthetic reactions in a species independent manner. Furthermore, the elucidation of alternative carbon-fixation routes distinct from the Calvin cycle raises possibilities that novel pathways and organisms can be utilized to fix atmospheric carbon dioxide into useful materials.

  3. Bilateral Internal Carotid Artery Segmental Agenesis: Embryology, Common Collateral Pathways, Clinical Presentation, and Clinical Importance of a Rare Condition.

    Science.gov (United States)

    Alexandre, Andrea M; Visconti, Emiliano; Schiarelli, Chiara; Frassanito, Paolo; Pedicelli, Alessandro

    2016-11-01

    Bilateral segmental agenesis of the internal carotid artery is a rare congenital anomaly. We present a case of bilateral internal carotid artery segmental agenesis in an asymptomatic 18-year-old man. Embryology, common collateral pathways, clinical presentation, and clinical importance of this condition are discussed. According to our review of the literature, this report is the first to describe bilateral internal carotid artery segmental agenesis in a patient studied with magnetic resonance imaging, computed tomography, Doppler ultrasonography, and digital subtraction angiography. An 18-year-old man presented to our hospital complaining of occasional mild headaches. Neurologic examination was unremarkable. Imaging findings consisted of bilateral segmental agenesis of the internal carotid arteries. Bilateral segmental agenesis of internal carotid artery may be completely asymptomatic and harmless, but associated conditions, such as cerebral aneurysms or abnormal collateral circulation, should alert clinicians to the possibilities of subarachnoid hemorrhage or cerebral ischemia. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Envisioning World Citizens? Self-Presentations of an International School in Germany and Related Orientations of Its Pupils

    Science.gov (United States)

    Keßler, Catharina; Krüger, Heinz-Hermann; Schippling, Anne; Otto, Ariane

    2015-01-01

    Against the backdrop of changes in global education, the German education system has undergone immense diversification. Many private schools are being founded, among them international schools catering both to an international clientele and to growing numbers of Germans. This article presents results from part of a qualitative longitudinal study…

  5. Improvement of security techniques and protection of biometric data in biometric systems: Presentation of International Standard ISO 24745

    OpenAIRE

    Milinković, Milorad

    2017-01-01

    This paper presents the International Standard ISO 24745 as a potential security tool for biometric information protection, more precisely as a tool for privacy protection in biometric systems. This is one of the latest internationally accepted standards that address the security issues of biometric systems.

  6. Characteristics of Successful Internal Medicine Resident Research Projects: Predictors of Journal Publication Versus Abstract Presentation.

    Science.gov (United States)

    Atreya, Auras R; Stefan, Mihaela; Friderici, Jennifer L; Kleppel, Reva; Fitzgerald, Janice; Rothberg, Michael B

    2018-02-06

    To identify the characteristics of successful research projects at an internal medicine residency program with an established research curriculum. The authors collected data about all research projects initiated by or involving medicine residents from 2006 to 2013 at Baystate Medical Center, using departmental files and institutional review board applications. Resident and mentor characteristics were determined using personnel files and Medline searches. Using multivariable models, the authors identified predictors of successful completion of projects using adjusted prevalence ratios (PRs). The primary outcome was manuscript publication by resident and secondary outcome was either publication or regional/national presentation. Finally, residents were surveyed to identify barriers and/or factors contributing to project completion. Ninety-four research projects were identified: 52 (55.3%) projects achieved the primary outcome and 72 (76.5%) met the secondary outcome, with overlap between categories. Most study designs were cross-sectional (41, 43.6%) or retrospective cohort (30, 31.9%). After adjustment, utilization of the epidemiology/biostatistical core (PR = 2.09; 95% CI: 1.36, 3.21), established publication record of resident (PR = 1.54, 95% CI: 1.14, 2.07), and resident with U.S. medical education (PR = 1.39, 95% CI: 1.02, 1.90) were associated with successful completion of projects. Mentor publication record (PR = 3.13) did not retain significance due to small sample size. Most respondents (65%) cited "lack of time" as a major project barrier. Programs seeking to increase resident publications should consider an institutional epidemiology/biostatistical core available to all residency research projects, and residents should choose experienced mentors with a track record of publications.

  7. Fixation of displaced subcapital femoral fractures. Compression screw fixation versus double divergent pins.

    Science.gov (United States)

    Christie, J; Howie, C R; Armour, P C

    1988-03-01

    One hundred and twenty-seven consecutive patients with displaced subcapital fractures of the femoral neck (Garden Grade III or IV) all under 80 years of age and independently mobile, were randomly allocated to fixation with either double divergent pins or a single sliding screw-plate device. The incidence of non-union and infection in the sliding screw-plate group was significantly higher, and we believe that when internal fixation is considered appropriate multiple pinning should be used. Mobility after treatment was disappointing in about half of the patients, and we feel that internal fixation can only be justified in patients who are physiologically well preserved and who maintain a high level of activity.

  8. Update: Biological Nitrogen Fixation.

    Science.gov (United States)

    Wiseman, Alan; And Others

    1985-01-01

    Updates knowledge on nitrogen fixation, indicating that investigation of free-living nitrogen-fixing organisms is proving useful in understanding bacterial partners and is expected to lead to development of more effective symbioses. Specific areas considered include biochemistry/genetics, synthesis control, proteins and enzymes, symbiotic systems,…

  9. Benthic N2 fixation in coral reefs and the potential effects of human-induced environmental change

    Science.gov (United States)

    Cardini, Ulisse; Bednarz, Vanessa N; Foster, Rachel A; Wild, Christian

    2014-01-01

    Tropical coral reefs are among the most productive and diverse ecosystems, despite being surrounded by ocean waters where nutrients are in short supply. Benthic dinitrogen (N2) fixation is a significant internal source of “new” nitrogen (N) in reef ecosystems, but related information appears to be sparse. Here, we review the current state (and gaps) of knowledge on N2 fixation associated with coral reef organisms and their ecosystems. By summarizing the existing literature, we show that benthic N2 fixation is an omnipresent process in tropical reef environments. Highest N2 fixation rates are detected in reef-associated cyanobacterial mats and sea grass meadows, clearly showing the significance of these functional groups, if present, to the input of new N in reef ecosystems. Nonetheless, key benthic organisms such as hard corals also importantly contribute to benthic N2 fixation in the reef. Given the usually high coral coverage of healthy reef systems, these results indicate that benthic symbiotic associations may be more important than previously thought. In fact, mutualisms between carbon (C) and N2 fixers have likely evolved that may enable reef communities to mitigate N limitation. We then explore the potential effects of the increasing human interferences on the process of benthic reef N2 fixation via changes in diazotrophic populations, enzymatic activities, or availability of benthic substrates favorable to these microorganisms. Current knowledge indicates positive effects of ocean acidification, warming, and deoxygenation and negative effects of increased ultraviolet radiation on the amount of N fixed in coral reefs. Eutrophication may either boost or suppress N2 fixation, depending on the nutrient becoming limiting. As N2 fixation appears to play a fundamental role in nutrient-limited reef ecosystems, these assumptions need to be expanded and confirmed by future research efforts addressing the knowledge gaps identified in this review. PMID:24967086

  10. The present status of International Nuclear Cooperation of Korea and the expectations from PNC's role

    International Nuclear Information System (INIS)

    Kim, S.C.

    1992-01-01

    The international cooperation activities for peaceful uses of nuclear energy in Korea started with the cooperation and assistance provided by advanced countries in the early 1960s when a feasibility study for a nuclear power reactor was carried out for its introduction into the Korean power system. Currently, we have 9 nuclear energy cooperation agreements concluded with foreign governments and also maintain cooperation relations with power companies, research institutes, A/E companies, manufacturers, etc. in 15 countries. The international cooperation activities cover a wide range of nuclear industries from design of nuclear power plant to nuclear fuel cycle, but need to expand into exchange of co-operation for noncommercial nuclear safety and cultural aspects. It is relatively simple and easy to realize international nuclear cooperation on commercial base such as nuclear reactor procurement contract, but unfavorable result can be expected from noncommercial transactions

  11. Distal tibial fractures: evaluation of different fixation techniques.

    Science.gov (United States)

    Jöstl, Julian; Tiefenböck, Thomas Manfred; Hofbauer, Marcus; Winnisch, Markus; Lang, Nikolaus; Hajdu, Stefan; Sarahrudi, Kambiz

    2017-03-01

    The purpose of this study was the comparison of the most commonly used surgical techniques (external fixation, intramedullary nailing, and plate fixation) for the treatment of distal tibial fractures (AO/OTA classification 42-A, B, C or 43-A, B1). A retrospective cohort study of patients who underwent surgical treatment for distal tibial fractures between 1992 and 2011 was performed. A total of 93 patients (52 male/41 female) met inclusion criteria. Statistically significant differences were found regarding the consolidation time of the intramedullary-nailing (147.32 ± 91.16 days) and the plate-fixation group (135.75 ± 110.75 days) versus the external-fixation group (163.12 ± 96.79 days; P = 0.001; P = 0.01). Significant differences were also observed in the range of motion (ROM) of the ankle joint in the intramedullary-nailing and plate-fixation group versus the ROM in the external-fixation group (P = 0.044; P = 0.025). The overall complication rate was 13/93 (14 %). Out of 66 patients treated with intramedullary nailing, 8 (12 %) suffered from complications. Out of the 15 patients treated with plate and 12 patients with external fixation, 2 (13 %) and 3 (25 %) showed complications, respectively. Our results demonstrate advantages in terms of shorter mobilization time and a better ROM of the ankle joint for intramedullary nailing and plate fixation compared with external fixation. Due to our results, we suggest internal fixation (intramedullary nailing or plate fixation) whenever patient's condition and the local fracture situation allow it.

  12. Posterior transodontoid fixation: A new fixation (Kotil technique

    Directory of Open Access Journals (Sweden)

    Kadir Kotil

    2011-01-01

    Full Text Available Anterior odontoid screw fixation or posterior C1-2 fusion techniques are routinely used in the treatment of Type II odontoid fractures, but these techniques may be inadequate in some types of odontoid fractures. In this new technique (Kotil technique, through a posterior bilateral approach, transarticular screw fixation was performed at the non-dominant vertebral artery (VA side and posterior transodontoid fixation technique was performed at the dominant VA side. C1-2 complex fusion was aimed with unilateral transarticular fixation and odontoid fixation with posterior transodontoid screw fixation. Cervical spinal computed tomography (CT of a 40-year-old male patient involved in a motor vehicle accident revealed an anteriorly dislocated Type II oblique dens fracture, not reducible by closed traction. Before the operation, the patient was found to have a dominant right VA with Doppler ultrasound. He was operated through a posterior approach. At first, transarticular screw fixation was performed at the non-dominant (left side, and then fixation of the odontoid fracture was achieved by directing the contralateral screw (supplemental screw medially and toward the apex. Cancellous autograft was scattered for fusion without the need for structural bone graft or wiring. Postoperative cervical spinal CT of the patient revealed that stabilization was maintained with transarticular screw fixation and reduction and fixation of the odontoid process was achieved completely by posterior transodontoid screw fixation. The patient is at the sixth month of follow-up and complete fusion has developed. With this new surgical technique, C1-2 fusion is maintained with transarticular screw fixation and odontoid process is fixed by concomitant contralateral posterior transodontoid screw (supplemental screw fixation; thus, this technique both stabilizes the C1-2 complex and fixes the odontoid process and the corpus in atypical odontoid fractures, appearing as an

  13. International Symposium to assess present and future promise of world's most powerful particle colliders

    CERN Multimedia

    Goshaw, Alfred

    2006-01-01

    "An international group of researchers will meet May 22-26 at Duke University for this year's Hadron Collider Physics Symposium. Participants will review the latest results from what is now the world's most powerful subatomic particle smasher and review final planning for its even more powerful successor now nearing completion."

  14. PRESENTED AT: TURNOVO, BULGARIA: LANDSCAPE SCIENCES FOR ENVIRONMENTAL ASSESSMENT: A NATO FRAMEWORK FOR INTERNATIONAL COOPERATION

    Science.gov (United States)

    An international pilot study has been developed to explore the possibility of quantifying and assessing environmental condition, processes of land degradation, and subsequent impacts on natural and human resources. The purpose of the study is to foster a framework for scientific...

  15. Evolution of Ukraine’s economy international specialization: from neolithic age to present time

    Directory of Open Access Journals (Sweden)

    Natalia Grushchynska

    2015-05-01

    Full Text Available The paper is a brief notice of a series of WORKS covering the topic of Ukraine’s economy international specialization, Ukraine’s evolution since the pre-state period in its history, formation of the first states within the territory of Ukraine (the Scythian culture, Greek states within Ukraine, the tribal Antes Alliance and Huts Empire, the origin of Slavs and the Ukrainian people, the period from the foundation of Kyiv through liquidation of Kyiv Principality, the Cossack Era in the history of Ukraine, the Ukrainian People’s Republic, declaration of Ukraine’s independence, Famine-Genocide, and the place and role of Ukraine’s international specialization as part of the USSR

  16. International Conference on Human Resource Development for Nuclear Power Programmes: Building and Sustaining Capacity. Presentations

    International Nuclear Information System (INIS)

    2014-01-01

    The objectives of the conference are to: • Review developments in the global status of HRD since the 2010 international conference; • Emphasize the role of human resources and capacity building programmes at the national and organizational level for achieving safe, secure and sustainable nuclear power programmes; • Discuss the importance of building competence in nuclear safety and security; • Provide a forum for information exchange on national, as well as international, policies and practices; • Share key elements and best practices related to the experience of Member States that are introducing, operating or expanding nuclear power programmes; • Highlight the practices and issues regarding HRD at the organizational and national level; • Highlight education and training programmes and practices; • Emphasize the role of nuclear knowledge management for knowledge transfer and HRD; and • Elaborate on the role and scope of various knowledge networks

  17. Features of the International Cooperation in Nuclear Power at the Present Stage

    Directory of Open Access Journals (Sweden)

    Dmitry S. Panteley

    2017-01-01

    Full Text Available Purpose: in article the author raises the aspects of the international cooperation in nuclear power. The author wants to analyse the multiplefactor analysis of the international regulation in the field of peaceful use of atomic energy and to reveal competitive advantages of the Russian Federation in this area.Methods: the methodological base of the research was made by set of general scientific methods and methods of the economic analysis. In particular, such methods of the scientific analysis were used as system approach, method of the comparative analysis, synthesis and analysis. From economic methods was used the method of the analysis of the branch competitiveness.Results: the author, raises the aspects of the international cooperation in nuclear power, comes to the conclusion that the specifics of branch cause need of comprehensive and close international interaction for prevention of distribution of dual-use technologies, for ensuring global and regional ecological and energy security, for ensuring the rights to use peaceful atom for needs of national economies and for observance of rules of the free market competition in such a complex branch of the world economy.Conclusions and Relevance: nuclear power is a high-tech and innovative branch of the Russian economy. Today it is one of the most dynamically developing in the country, and also plays a significant role in the world energy. Among the competitive advantages of the national nuclear power industry is the development of new technologies, flexible price offers in foreign markets, etc. The development of the branch and the sustainability of Russia's competitive position in this area on foreign markets require the development of new proposals for different regional markets and the implementation of planned measures to support the level of competitiveness.Сonclusions can be used as recommendations for developing programs to increase the competitiveness of the Rosatom State Corporation

  18. Proceedings of papers presented at the 2nd international symposium on applications of biotechnology to tree culture, protection, and utilization.

    Science.gov (United States)

    Charles H. Michler; Michael R. Becwar; Daniel Cullen; Warren L. Nance; Ronald R. Sederoff; James M. Silvicek

    1994-01-01

    Contains 38 oral presentation abstracts, 34 poster abstracts, and 18 manuscripts on applications of biotechnology to tree research in the areas of stress resistance, protection, and wood utilization presented at an international conference in Bloomington, Minnesota, October 2-6, 1994.

  19. TREATMENT OF POST-TRAUMATIC HUMERAL FRACTURES AND COMPLICATIONS USING THE OSTEOLINE(®) EXTERNAL FIXATOR: A TREATMENT OPTION.

    Science.gov (United States)

    de Azevedo, Marcos Coelho; de Azevedo, Gualter Maldonado; Hayashi, Alexandre Yoshio; Dourado Nascimento, Paulo Emilio

    2011-01-01

    To evaluate the results obtained from treatment of humeral shaft fractures and their complications using the Osteoline(®) uniplanar external fixator. The radiographic and functional results from 78 patients with humeral shaft fractures treated using the uniplanar external fixation technique were retrospectively assessed. The patients' ages ranged from 23 to 71 years, with a mean of 47 years. Male patients predominated (79%). Out of the 78 patients, 45 presented open fractures, 14 presented pseudarthrosis and six presented synthesis failure. There were no losses during the follow-up and all the patients were discharged after fracture consolidation and functional recovery. The results were evaluated based on the studies by Catagni, as good, fair or poor. Fracture consolidation was observed in 98% of the cases treated with uniplanar external fixation. Only one pseudarthrosis case required conversion to rigid internal fixation and autologous bone grafting. At the end of the treatment, all the patients were discharged with consolidated fractures, without pain, and good limb function. The external fixation described in this paper was shown to be an efficient and safe method for treating humeral shaft fractures and their complications. It preserved the local biological status and enabled passive and active movement immediately after surgery.

  20. Improving carbon fixation pathways.

    Science.gov (United States)

    Ducat, Daniel C; Silver, Pamela A

    2012-08-01

    A recent resurgence in basic and applied research on photosynthesis has been driven in part by recognition that fulfilling future food and energy requirements will necessitate improvements in crop carbon-fixation efficiencies. Photosynthesis in traditional terrestrial crops is being reexamined in light of molecular strategies employed by photosynthetic microbes to enhance the activity of the Calvin cycle. Synthetic biology is well-situated to provide original approaches for compartmentalizing and enhancing photosynthetic reactions in a species independent manner. Furthermore, the elucidation of alternative carbon-fixation routes distinct from the Calvin cycle raises possibilities that novel pathways and organisms can be utilized to fix atmospheric carbon dioxide into useful materials. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. PRESENTATION OF SPORTING PLAYER’S RIGHTS IN HUNGARIAN AND INTERNATIONAL ACCOUNTING

    Directory of Open Access Journals (Sweden)

    Szoke Reka

    2015-07-01

    Full Text Available Incipiently, sport had been a civil activity then sports organizations, clubs, leagues and societies appeared in growing numbers throughout Europe in the 19th century. It had launched only for purposes of pastime and entertainment but it moved to social, political and economic levels later. After the Second World War, sports done in form of civil and private activity become equal to the public interest. The right to do sports is a constitutional right. In the 21st century, the demand on sport makes great strides and it pulls the development of the economic fields of sports as well. Today, sport is already considered as an independent industry, several countries have developed sport markets. According to estimates, sport accounts for 4% of the EU’s GDP. The actuality of research is given by the fact that the economic branch of sports develops continuously which is due to that more and more amounts already stream into sports in our days. In Hungary, sport is mainly state aided and has mostly financing problems while the sport businesses existing in the more developed Western Europe are principally sponsored by the private sector. The government considers sport as a strategic branch and manages as such because they see the international breakthrough potencies in sport as well. All this can explain the substantial contribution to this segment.The research covers an economic subject. The purpose of this research is to examine the differences of the accounting systems applied by a domestic and an international sport business; how they demonstrate the available player roster in their books; how they account for the incomes and expenditures incurred with the players. For the leaders of the businesses to be able to make quick and appropriate economic decisions in this intensively changing world, it is essential that an enterprise should have a well-functioning accounting system based on up-to-date information. International Financial Reporting

  2. Brow lift fixation.

    Science.gov (United States)

    Gold, Alan H; Bernard, Robert W; Hamas, Robert S; McKinney, Peter; Paul, Malcolm D

    2003-05-01

    One of the more difficult and controversial aspects of forehead and brow lift is fixation with control and stabilization of the result. Aesthetic Surgery Journal has invited Robert W. Bernard, MD; Robert S. Hamas, MD; Peter McKinney, MD; and Malcolm D. Paul, MD to share their preferred brow lift techniques. Here are their responses to questions posed by "Comparing Notes" editor, Alan H. Gold, MD. (Aesthetic Surg J 2003;23:217-219.).

  3. Improving Carbon Fixation Pathways

    OpenAIRE

    Ducat, Daniel C.; Silver, Pamela A.

    2012-01-01

    A recent resurgence in basic and applied research on photosynthesis has been driven in part by recognition that fulfilling future food and energy requirements will necessitate improvements in crop carbon-fixation efficiencies. Photosynthesis in traditional terrestrial crops is being reexamined in light of molecular strategies employed by photosynthetic microbes to enhance the activity of the Calvin cycle. Synthetic biology is well-situated to provide original approaches for compartmentalizing...

  4. CARBON DIOXIDE FIXATION.

    Energy Technology Data Exchange (ETDEWEB)

    FUJITA,E.

    2000-01-12

    Solar carbon dioxide fixation offers the possibility of a renewable source of chemicals and fuels in the future. Its realization rests on future advances in the efficiency of solar energy collection and development of suitable catalysts for CO{sub 2} conversion. Recent achievements in the efficiency of solar energy conversion and in catalysis suggest that this approach holds a great deal of promise for contributing to future needs for fuels and chemicals.

  5. Biometric recognition via fixation density maps

    Science.gov (United States)

    Rigas, Ioannis; Komogortsev, Oleg V.

    2014-05-01

    This work introduces and evaluates a novel eye movement-driven biometric approach that employs eye fixation density maps for person identification. The proposed feature offers a dynamic representation of the biometric identity, storing rich information regarding the behavioral and physical eye movement characteristics of the individuals. The innate ability of fixation density maps to capture the spatial layout of the eye movements in conjunction with their probabilistic nature makes them a particularly suitable option as an eye movement biometrical trait in cases when free-viewing stimuli is presented. In order to demonstrate the effectiveness of the proposed approach, the method is evaluated on three different datasets containing a wide gamut of stimuli types, such as static images, video and text segments. The obtained results indicate a minimum EER (Equal Error Rate) of 18.3 %, revealing the perspectives on the utilization of fixation density maps as an enhancing biometrical cue during identification scenarios in dynamic visual environments.

  6. A comparative study in fixation methods of medial malleolus fractures between tension bands wiring and screw fixation.

    Science.gov (United States)

    Mohammed, Ayyoub A; Abbas, Khalid Ahmed; Mawlood, Ammar Salah

    2016-01-01

    The aim of this study is to compare two methods of internal fixations of fractured medial malleolus which are simple screw fixation and tension band wiring. Over 5 years we grouped 20 patients with fractured medial malleolus into two groups of operative treatments, group1 treated by malleolar screw fixation and group2 by tension band wiring. The patients were with same age group, gender, fracture type, and etiology. We use statistical analysis for make a comparative study between the two ways of surgical treatment. The mean time for radiologic bone union was 11.8 weeks in group1 patients and 9.4 weeks in group2 patients (P = 0.03). No patients had any sign of fixation failure or Kirschner wires migration. According to the modified ankle scoring system of Olerud and Molander, excellent and good results were achieved in 80 % in group1 patients and 90 % in group2 patients (P = 0.049). Tension-band wiring may be better treatment option for internal fixation of medial malleolar fractures than screw fixation. From these findings we recommend a further randomized clinical trial of larger number of cases and longer follow-up duration in order to regard tension-band wiring a better operative option for fixation of medial malleolar fractures.

  7. Peculiarities of International Migration of Population in Europe at the Present Stage

    Directory of Open Access Journals (Sweden)

    Iurchenko Svitlana A.

    2017-06-01

    Full Text Available Under conditions of globalization, international migration of population is steadily growing and significantly affects the socio-economic development of countries and regions. The aim of the article is to identify the features of international migration of population in Europe. The migration trends in the region and its subregions are analyzed. It is shown that Western Europe is leading according to the number of migrants residing on its territory, but the maximum growth of migrants for the period of 1990-2015 is observed in Southern Europe. The proportion of women and population of active age groups is increasing in the structure of migrants. In recent years the flow of refugees has increased. The impact of the migration crisis on the economies of the host countries is analyzed. Calculations of coefficients of multiple correlation demonstrated the level of dependence between the indicators of migration and GDP, population size, share of urban population. It is concluded that it is necessary to develop migration policies at different hierarchical levels.

  8. Second International MELODI Workshop on Low Dose Risk Research - Slides of the presentations

    International Nuclear Information System (INIS)

    Repussard, J.; Weiss, W.; Quintana Trias, O.; Rosario Perez, M. del; Andersen, M.; Rudiger Trott, K.; Ottolenghi, A.; Smyth, V.; Graw, J.; Little, M.P.; Yonai, S.; Barcellos-Hoff, M.H.; Bouffler, S.; Chevillard, S.; Jeggo, P.; Sabatier, L.; Baatout, S.; Niwa, O.; Oesch, F.; Atkinson, M.; Averbeck, D.; Lloyd, D.; O'Neill, P.

    2011-01-01

    The MELODI (Multidisciplinary European Low Dose Initiative) mission is to impulse low dose risk research in Europe through a strategic research agenda (SRA) and road-map of priorities. The last presentation is dedicated to the SRA and its preference research programs. The other presentations deal principally with the low-dose exposure in medical uses of ionizing radiations, radiosensitivity, radiation-induced cataracts, or epidemiology and radiobiology of cardiovascular disease. This document is composed of the slides of the presentations

  9. Biomechanical Study of Acetabular Tridimensional Memoryalloy Fixation System

    Science.gov (United States)

    Liu, Xin-Wei; Xu, Shuo-Gui; Zhang, Yun-Tong; Zhang, Chun-Cai

    2011-07-01

    We developed the acetabular tridimensional memoryalloy fixation system (ATMFS), which is made of NiTi shape memory alloy, according to the specific mechanical properties of biological memory material, NiTi shape memory alloy and measured distribution of contact area and pressure between the acetabulum and the femoral head of cadaveric pelvis. Seven formalin-preserved cadaveric pelves were used for this investigation. Pressure-sensitive film was used to measure contact area and pressure within the anterior, superior, and posterior regions of the acetabulum. The pelves were loaded under the following four conditions: (1) intact; (2) following a creation posterior wall fracture defect; (3) following reduction and standard internal fixation with reconstruction plate; and (4) following reduction and internal fixation with a new shape memory alloy device named ATMFS. A posterior wall fracture was created along an arc of 40° to 90° about the acetabulur rim. Creation of a posterior wall defect resulted in increased load in the superior acetabulum (1485 N) as compared to the intact condition (748 N, P = 0.009). Following reduction and internal fixation, the load distributed to the superior acetabulum (1545 N) was not statistically different from the defect condition. Following the fixation with ATMFS, the load seen at the superior region of the actabulum (964 N) was familiar with fixation with reconstruction plate and was not different from intact state ( P = 0.45). These data indicate that the use of ATMFS as a fracture internal fixation device resulted a partial restoration of joint loading parameters toward the intact state. ATMFS fixation may result in a clinical benefit.

  10. A Nearly Lethal Screw: An Unusual Cause of Recurrent Bradycardia and Asystole Episodes after Fixation of the Cervical Spine

    Directory of Open Access Journals (Sweden)

    Amit Frenkel

    2017-01-01

    Full Text Available We present a case of a 51-year-old man who was injured in a bicycle accident. His main injury was an unstable fracture of the cervical and thoracic vertebral column. Several hours after his arrival to the hospital the patient underwent open reduction and internal fixation (ORIF of the cervical and thoracic spine. The patient was hospitalized in our critical care unit for 99 days. During this time patient had several episodes of severe bradycardia and asystole; some were short with spontaneous return to sinus and some required pharmacological treatment and even Cardiopulmonary Resuscitation (CPR. Initially, these episodes were attributed to the high cervical spine injury, but, later on, CT scan suggested that a fixation screw abutted on the esophagus and activated the vagus nerve by direct pressure. After repositioning of the cervical fixation, the bradycardia and asystole episodes were no longer observed and the patient was released to a rehabilitation ward. This case is presented in order to alert practitioners to the possibility that, after operative fixation of cervical spine injuries, recurrent episodes of bradyarrhythmia can be caused by incorrect placement of the fixation screws and might be confused with the natural history of the high cervical cord injury.

  11. International Legal Framework for Denuclearization and Nuclear Disarmament -- Present Situation and Prospects

    Energy Technology Data Exchange (ETDEWEB)

    Gastelum, Zoe N. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); OECD NEA International School of Nuclear Law, Paris (France)

    2012-12-01

    This thesis is the culminating project for my participation in the OECD NEA International School of Nuclear Law. This paper will begin by providing a historical background to current disarmament and denuclearization treaties. This paper will discuss the current legal framework based on current and historical activities related to denuclearization and nuclear disarmament. Then, it will propose paths forward for the future efforts, and describe the necessary legal considerations. Each treaty or agreement will be examined in respect to its requirements for: 1) limitations and implementation; 2) and verification and monitoring. Then, lessons learned in each of the two areas (limitations and verification) will be used to construct a proposed path forward at the end of this paper.

  12. [A 70-year-old woman presenting with restless shoulder following posterior internal capsule infarction].

    Science.gov (United States)

    Matsubara, Takeo; Suzuki, Keisuke; Okamura, Madoka; Shiina, Tomohiko; Miyamoto, Masayuki; Nakamura, Toshiki; Hirata, Koichi

    2017-11-25

    A 70-year-old woman noticed difficulty in speech and weakness of the left upper and lower limb upon awakening. Neurological examination showed dysarthria and left hemiparesis. No sensory disturbance was observed. Brain MRI revealed acute infarction in the right posterior limb of the internal capsule. On the hospital day 1, she developed the abnormal sensations restricted to the bilateral shoulders, resulting in difficulty initiating sleep. On laboratory data, renal function and serum hemoglobin and ferritin levels were normal. When four essential features of restless legs syndrome (RLS) were applied to her shoulders, the patient met RLS criteria. Following low dose pramipexole treatment, the abnormal sensation of the shoulders and insomnia significantly improved. We should be aware of the possibility of RLS or its variant, including "restless shoulder" of our patient, for the cause of insomnia following acute ischemic infarction.

  13. Osteomyelitis in burn patients requiring skeletal fixation

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    Deep and severe burns often present with the exposure of musculoskeletal structures and severe deformities. Skeletal fixation, suspension and/or traction are part of their comprehensive treatment. Several factors put burn patients at risk for osteomyelitis, osteosynthesis material being one of them.

  14. 15N in biological nitrogen fixation studies

    International Nuclear Information System (INIS)

    Faust, H.

    1986-05-01

    A bibliography with 298 references on the use of the stable nitrogen isotope 15 N in the research on the biological fixation of dinitrogen is presented. The literature pertaining to this bibliography covers the period from 1975 to the middle of 1985. (author)

  15. External skeletal fixation of the tibial shaft fractures

    Directory of Open Access Journals (Sweden)

    Milenković Saša

    2005-01-01

    Full Text Available Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitković’s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3% and 33 females (28.7%, average age 43.92 years (16−84. Open tibial shaft fractures were present in 37 (31.36%. All the fractures were treated with Mitković’s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93% patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08% patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85% patient with closed fracture. Malunion was found in 2 (1.69% patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

  16. [External skeletal fixation of the tibial shaft fractures].

    Science.gov (United States)

    Milenković, Sasa; Mitković, Milorad; Radenković, Mile

    2005-01-01

    To present the possibility of a succesfful use of external skelatal fixation in treating the open and closed tibial shaft fractures with Mitković's external fixator. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16-84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitković's external fixator type M 20. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

  17. International Workshop on Gauge Theories, Supersymmetry, and Mathematical Physics - Slides of the presentations

    International Nuclear Information System (INIS)

    Wit, B. de; Morier-Genoud, S.; Ovsienko, V.; Lopes Cardoso, G.; Mahapatra, S.; Sundell, P.; Boulanger, N.; Gava, E.; Karndumri, P.; Narain, K.S.; Theis, U.; Tomasiello, A.; Slizovskiy, S.; Roytenberg, D.; Voronov, T.

    2011-01-01

    This workshop was dedicated to supersymmetry, supergravity, topological field theories and their mathematical formulations. This document is composed of a large part of the slides presented at the workshop

  18. Present international patterns of foreign direct investment: underlying causes and some policy implications for Brazil

    Directory of Open Access Journals (Sweden)

    François Chesnais

    2013-12-01

    Full Text Available An important feature of the 1980s has been the substantial fall in the flow of foreign direct investment (FDI to the developing countries and also, with the limited exception of the Asian NIE (Korea, Taiwan, Malaysia, Singapore and China, to the newly industrialized countries, in particular those in Latin America. FDI has been concentrated more than ever among the advanced industrialized countries of OECD. The same period has witnessed a number of extremely important changes, both in the nature and location of basic or key technologies, the role of technology in industrial competitiveness; the most appropriate industrial management paradigm following the difficulties of the "Fordist" one; the nature of predominant international supply or market structures; and the relationships between productive and financial capital. Today a number of governments in developing countries and in NIC, among them the new government of Brazil, are again engaged in an attempt to attract FDI and to make foreign capital one of the major pillars of industrial revival and future growth. This paper argues that this policy objective is both fairly illusory and largely mistaken. It is fairly illusory in that it seriously underestimates the nature and strength of the structural factors which have been at work since the mid-1970s and seriously modified the strategies and investment priorities of the TNC which under took the brunt of the investment in developing countries and NICs in the earlier "golden age" of the 1960s and 1970s . The objective of luring foreign capital again to Brazil in ways and on a level similar to the 1960s is also largely mistaken in that it fails to recognize that the change in technological paradigms has modified the parameters of international technology transfers (cf. Ernst and O'Connor, 1989 and made indigenous and endogenous industrial growth dependent to a much higher degree than in the previous period (19601975 on factors which foreign capital

  19. Treating singularities present in the Sutcliffe-Tennyson vibrational Hamiltonian in orthogonal internal coordinates

    Science.gov (United States)

    Czakó, Gábor; Szalay, Viktor; Császár, Attila G.; Furtenbacher, Tibor

    2005-01-01

    Two methods are developed, when solving the related time-independent Schrödinger equation (TISE), to cope with the singular terms of the vibrational kinetic energy operator of a triatomic molecule given in orthogonal internal coordinates. The first method provides a mathematically correct treatment of all singular terms. The vibrational eigenfunctions are approximated by linear combinations of functions of a three-dimensional nondirect-product basis, where basis functions are formed by coupling Bessel-DVR functions, where DVR stands for discrete variable representation, depending on distance-type coordinates and Legendre polynomials depending on angle bending. In the second method one of the singular terms related to a distance-type coordinate, deemed to be unimportant for spectroscopic applications, is given no special treatment. Here the basis set is obtained by taking the direct product of a one-dimensional DVR basis with a two-dimensional nondirect-product basis, the latter formed by coupling Bessel-DVR functions and Legendre polynomials. With the basis functions defined, matrix representations of the TISE are set up and solved numerically to obtain the vibrational energy levels of H3+. The numerical calculations show that the first method treating all singularities is computationally inefficient, while the second method treating properly only the singularities having physical importance is quite efficient.

  20. SET-bullying: presentation of a collaborative project and discussion of its internal and external validity.

    Science.gov (United States)

    Chalamandaris, Alexandros-Georgios; Wilmet-Dramaix, Michèle; Eslea, Mike; Ertesvåg, Sigrun Karin; Piette, Danielle

    2016-04-12

    Since the early 1980s, several school based anti-bullying interventions (SBABI) have been implemented and evaluated in different countries. Some meta-analyses have also drawn conclusions on the effectiveness of SBABIs. However, the relationship between time and effectiveness of SBABIs has not been fully studied. For this aim, a collaborative project, SET-Bullying, is established by researchers from Greece, Belgium, Norway and United Kingdom. Its primary objective is to further understand and statistically model the relationship between the time and the sustainability of the effectiveness of SBABI. The secondary objective of SET-Bullying is to assess the possibility of predicting the medium-term or long-term effectiveness using as key information the prior measurement and the short-term effectiveness of the intervention. Researchers and owners of potentially eligible databases were asked to participate in this effort. Two studies have contributed data for the purpose of SET-Bullying. This paper summarizes the main characteristics of the participating studies and provides a high level overview of the collaborative project. It also discusses on the extent to which both study and project characteristics may pose threats to the expected internal and external validity of the potential outcomes of the project. Despite these threats, this work represents the first effort to understand the impact of time on the observed effectiveness of SBABIs and assess its predictability, which would allow for better planning, implementation and evaluation of SBABIs.

  1. Centre-of-Gravity Fixations in Visual Search: When Looking at Nothing Helps to Find Something

    Directory of Open Access Journals (Sweden)

    Dustin Venini

    2014-01-01

    Full Text Available In visual search, some fixations are made between stimuli on empty regions, commonly referred to as “centre-of-gravity” fixations (henceforth: COG fixations. Previous studies have shown that observers with task expertise show more COG fixations than novices. This led to the view that COG fixations reflect simultaneous encoding of multiple stimuli, allowing more efficient processing of task-related items. The present study tested whether COG fixations also aid performance in visual search tasks with unfamiliar and abstract stimuli. Moreover, to provide evidence for the multiple-item processing view, we analysed the effects of COG fixations on the number and dwell times of stimulus fixations. The results showed that (1 search efficiency increased with increasing COG fixations even in search for unfamiliar stimuli and in the absence of special higher-order skills, (2 COG fixations reliably reduced the number of stimulus fixations and their dwell times, indicating processing of multiple distractors, and (3 the proportion of COG fixations was dynamically adapted to potential information gain of COG locations. A second experiment showed that COG fixations are diminished when stimulus positions unpredictably vary across trials. Together, the results support the multiple-item processing view, which has important implications for current theories of visual search.

  2. Nitrogen fixation apparatus

    Science.gov (United States)

    Chen, Hao-Lin

    1984-01-01

    A method and apparatus for achieving nitrogen fixation includes a volumetric electric discharge chamber. The volumetric discharge chamber provides an even distribution of an electron beam, and enables the chamber to be maintained at a controlled energy to pressure (E/p) ratio. An E/p ratio of from 5 to 15 kV/atm of O.sub.2 /cm promotes the formation of vibrationally excited N.sub.2. Atomic oxygen interacts with vibrationally excited N.sub.2 at a much quicker rate than unexcited N.sub.2, greatly improving the rate at which NO is formed.

  3. ITER JCT presentation at the International Conference on Fusion Reactor Materials (ICFRM-9)

    International Nuclear Information System (INIS)

    Kalinin, G.; Barabash, V.; Ioki, K.

    1999-01-01

    During this conference four invited papers and one poster paper were presented on behalf of the ITER Joint Central Team with the review of latest achievements. The results of the comprehensive materials R and D program in support of the ITER design were extensively reported the ITER Home Teams

  4. Individual cathepsins degrade immune complexes internalized by antigen-presenting cells via Fcgamma receptors.

    NARCIS (Netherlands)

    Driessen, C.A.G.G.; Lennon-Dumenil, A.M.; Ploegh, H.L.

    2001-01-01

    We have analyzed the intracellular degradation of an immune complex after its FcgammaR-mediated uptake in antigen-presenting cells (APC). Mice that lack the cathepsins (Cat) S, L, B and D allowed us to assess the direct contribution of these individual proteases to the processing events observed.

  5. Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment

    Directory of Open Access Journals (Sweden)

    Lyudmila Andreevna Kalashnikova

    2013-01-01

    Full Text Available The paper gives the data available in the literature and the author’s results of an examination of almost 140 patients with dissection of the internal carotid and vertebral arteries (ICA and VA. Dissection is blood penetration through an intimal tear from the lumen of an artery into its wall to develop intramural hematoma (IMH. The cause of dissection is the weakness of the arterial wall presumably due to mitochondrial cytopathy. IMH narrows/occludes the arterial lumen or is a source of arterioarterial embolism, which in turn leads to ischemic stroke. Stroke as a result of dissection generally develops in young patients, who are not prone to traditional vascular risk factors, frequently after the influence of provocative factors (mild head/neck injury, head jerks, physical strain, contraceptives, etc.. The characteristics of stroke are head/neck pain on the side of dissection that appears a few days prior to stroke or simultaneously with the latter; quite often a good recovery of impaired functions; and low recurrence rates. Another major manifestation, isolated cervicocephalic pain, is encountered in PA dissection more frequently (in almost a third of cases and in ICA dissection less frequently (about 5%. Magnetic resonance (MR angiography and fat-saturated T1-weighted MR imaging play a leading role in the verification of dissection. Dissection should be treated with anticoagulants/antiaggregants in its acute phase, as well as with trophic drugs, primarily actovegin, in both acute and chronic phases.

  6. Microgravity Science Glovebox (MSG), Space Science's Past, Present and Future Aboard the International Space Station (ISS)

    Science.gov (United States)

    Spivey, Reggie; Spearing, Scott; Jordan, Lee

    2012-01-01

    The Microgravity Science Glovebox (MSG) is a double rack facility aboard the International Space Station (ISS), which accommodates science and technology investigations in a "workbench' type environment. The MSG has been operating on the ISS since July 2002 and is currently located in the US Laboratory Module. In fact, the MSG has been used for over 10,000 hours of scientific payload operations and plans to continue for the life of ISS. The facility has an enclosed working volume that is held at a negative pressure with respect to the crew living area. This allows the facility to provide two levels of containment for small parts, particulates, fluids, and gases. This containment approach protects the crew from possible hazardous operations that take place inside the MSG work volume and allows researchers a controlled pristine environment for their needs. Research investigations operating inside the MSG are provided a large 255 liter enclosed work space, 1000 watts of dc power via a versatile supply interface (120, 28, + 12, and 5 Vdc), 1000 watts of cooling capability, video and data recording and real time downlink, ground commanding capabilities, access to ISS Vacuum Exhaust and Vacuum Resource Systems, and gaseous nitrogen supply. These capabilities make the MSG one of the most utilized facilities on ISS. MSG investigations have involved research in cryogenic fluid management, fluid physics, spacecraft fire safety, materials science, combustion, and plant growth technologies. Modifications to the MSG facility are currently under way to expand the capabilities and provide for investigations involving Life Science and Biological research. In addition, the MSG video system is being replaced with a state-of-the-art, digital video system with high definition/high speed capabilities, and with near real-time downlink capabilities. This paper will provide an overview of the MSG facility, a synopsis of the research that has already been accomplished in the MSG, and an

  7. Fixation and escape times in stochastic game learning

    International Nuclear Information System (INIS)

    Realpe-Gomez, John; Szczesny, Bartosz; Galla, Tobias; Dall’Asta, Luca

    2012-01-01

    Evolutionary dynamics in finite populations is known to fixate eventually in the absence of mutation. We here show that a similar phenomenon can be found in stochastic game dynamical batch learning, and investigate fixation in learning processes in a simple 2×2 game, for two-player games with cyclic interaction, and in the context of the best-shot network game. The analogues of finite populations in evolution are here finite batches of observations between strategy updates. We study when and how such fixation can occur, and present results on the average time-to-fixation from numerical simulations. Simple cases are also amenable to analytical approaches and we provide estimates of the behaviour of so-called escape times as a function of the batch size. The differences and similarities with escape and fixation in evolutionary dynamics are discussed. (paper)

  8. Monitoring in vivo load transmission through an external fixator.

    Science.gov (United States)

    Grasa, J; Gómez-Benito, M J; González-Torres, L A; Asiaín, D; Quero, F; García-Aznar, J M

    2010-03-01

    This work presents a portable non-invasive external fixator to assess and monitor fracture healing in real time. To evaluate the potential of this fixator, a transverse osteotomy was performed in the tibia of six adult sheep (mean age 3+/-0.5 years and weight 63+/-5 kg). The fractures were stabilized by a specially designed unilateral external fixator, which was instrumented by means of a set of strain gauges. Strains in the external surface of the fixator were monitored during all the healing process. A wireless, remote monitoring of the implant was developed through a specially designed external telemetric device. The strain gauges were arranged in two different half-bridge Wheatstone configurations, allowing easy post-processing of the signal. Thus, bending loads were measured in two planes of the external fixator acting as a load cell. The load through the fixator was evaluated for the gait cycle during all the healing process. Full weight bearing of the injured leg was observed from the beginning. The load transmission mechanism in the fixator was quite similar in all operated tibias and radiographic images showed a successful healing in all animals. Although the fixator has only been tested in an animal model, after further testing this system may have clinical potential.

  9. Viscosity Measurement at the International Conferences on Molten Slags and Fluxes from 1980 to the Present

    Science.gov (United States)

    Wright, Steven; Kim, Wan-Yi

    Many papers have been presented, and the sessions well attended, on the viscosity measurements of silicate and calcium ferrite based slag systems since this conference series inception in 1980 in Halifax. Over the years, the emphasis has been spent on developing reliable measurement techniques of pure liquids, trustworthy datasets, extending the slag systems and the number of components in the liquids, understanding the behaviour of amphoteric oxides, and extending measurements to two phase systems.

  10. Management of subtrochanteric femur fractures with internal fixation and recombinant human bone morphogenetic protein-7 in a patient with osteopetrosis: a case report

    Science.gov (United States)

    2010-01-01

    Introduction Osteopetrosis is a group of conditions characterized by defects in the osteoclastic function of the bone resulting in defective bone resorption. Clinically, the condition is characterized by a dense, sclerotic, deformed bone which, despite an increased density observable by radiography, often results in an increased propensity to fracture and delayed union. Case Presentation We report the case of a 27-year-old Asian man presenting with bilateral subtrochanteric femur fractures. He had a displaced right subtrochanteric femur fracture after a low-energy fall, which was treated surgically. The second fracture that our patient endured was diagnosed as a stress fracture ten weeks later when he complained of pain in the contralateral left thigh. By that time, the right-sided fracture exhibited no radiographic evidence of healing, and when the left-sided stress fracture was being treated surgically, bone grafting with recombinant human bone morphogenetic protein-7 was also performed on the right side. Conclusion While there are no data supporting the use of bone morphogenic proteins in the management of delayed healing in patients with osteopetrosis, no other reliable osteoinductive grafting options are available to treat this condition. Both fractures in our patient healed, but based on the serial radiographic assessment it is uncertain to what degree the recombinant human bone morphogenetic protein-7 may have contributed to the successful outcome. It may have also contributed to the formation of heterotopic bone around the fracture site. Further investigation of the effectiveness and indications of bone morphogenic protein use for the management of delayed fracture healing in patients with osteopetrosis is warranted. PMID:20482845

  11. Semi-present Approachfor Intern Qualificationin Clinical Biochemistry Laboratory of UFPE

    Directory of Open Access Journals (Sweden)

    J.M. Martins

    2011-04-01

    Full Text Available This study has arisenfrom the experience in the discipline “Estágio Curricular" from Biomedicine,  Pharmacy and Laboratory Technique  courses in ULAB/HC/UFPE. The goal of this study wasto use a semi-present environment (50 hours to the qualification of the incoming students in 2011-1. Conventional classes were given through present approaches (theoretical-practical classes and the students were inscribed and trained in the virtual environment to accomplish the distant learning  course: “Capacitaçãodos Estagiários daULAB em Biossegurança e Coleta”, in which classes, debates, links, scientificstudies, tests and videoconferences were available. The presence phase was evaluated by the attendance (assiduity 98%, while the online phase was the result ofthe access reports (6,221, the progress of the exercises (95%, and the final evaluations grades available in thesystem (8.2. Theoretical-practical classes have provided interaction between content/teacher/student.Didactical model, quality contents and multidisciplinary  present approach remarkably contribute to diminish difficulties in using the tools and applications: 80% of students have never taken a distant learning coursebefore; 23% haven’t had a computer; 95% have declared that presential training helped them to conclude the course and 100%have stated non-restricted contents available online have facilitated their access. Current challenges in education is to conciliate technology and learningin favor of ensuring that the students take advantage on their potentialities.

  12. VLASOVIA 2013 - International workshop on the theory and applications of Vlasov equation - Slides of the presentations

    International Nuclear Information System (INIS)

    Aunai, N.; Belmont, G.; Smets, R.; Chandre, C.; Tassi, E.; Morrison, P.J.; Back, A.; Guillebon, L. de; Qin, H.; Squire, J.; Tang, W.M.; Garbet, X.; Esteve, D.; Sarazin, Y.; Abiteboul, J.; Bourdelle, C.; Dif-Pradalier, G.; Ghendrih, P.; Grandgirard, V.; Latu, G.; Smolyakov, A.; Hervieux, P.A.; Manfredi, G.; Jasiak, R.; Kraus, M.; Mora, P.; Morel, P.; Dreydemy Ghiro, F.; Berionni, V.; Gurcan, O.D.; Morrison, P.J.; Negulescu, C.; Pegoraro, F.; Bulanov, S.V.; Califano, F.; Fedeli, L.; Grassi, A.; Macchi, A.; Petri, J.; Pezzi, O.; Valentini, F.; Perrone, D.; Veltri, P.; Taccogna, F.; Minelli, P.; Thide, B.; Tamburini, F.; Throumoulopoulos, G.; Tasso, H.

    2014-01-01

    The Vlasov equation is used for the modelling of a wide range of phenomena occurring in natural and man-made plasmas, as well as in other many-particle systems displaying a collective behaviour. The purpose of this workshop is to bring together scientists to discuss the latest results on Vlasov theory and related applications. The topics discussed include: space plasmas, inertial confinement plasmas, magnetic confinement plasmas, quantum effects in collisionless plasmas, gravitational systems, Hamiltonian Vlasov dynamics, and computational and numerical approaches. This document gathers the slides of the presentations.

  13. Book of presentations of the International Workshop on High Temperature Heat Pumps

    DEFF Research Database (Denmark)

    Modern society moves towards an electrifed energy system based on wind, solarand other renewable sources. Utilizing these sources effciently by heat pumps ishighly attractive and a significant potential for improving the energy system byextensive adaptation of heat pumping technology in all fields...... exists. However, challenges are present for heat pump technology. In particular for high temperature applications like industrial processes and to some extent district heating, heat pumps are not yet commercially available. In some countries the expansion already occurs, but other places the development...... is much more limited. Some obstacles relate to regulations and boundary conditions which may not be favorablefor heat pumps and electrification. But, the level of the technology willprobably also improve with regards to temperature limits, efficiency, capacity, and economy, and hence inherently become...

  14. Improvement of external fixator performance in type C pelvic ring injuries by plating of the pubic symphysis: An experimental study on 12 external fixators

    NARCIS (Netherlands)

    Ponson, K. J.; Hoek van Dijke, G. A.; Joosse, Pieter; Snijders, C. J.; Agnew, Samuel G.

    2002-01-01

    Background: In an earlier study, we introduced a pelvic ring stability criterion for weightbearing stabilization. In a loading test, however, current external fixation systems alone did not meet this criterion. Internal fixation of the dorsal ring can significantly increase stability, but the

  15. External transpedicular spine fixation in severe spondylodiscitis – salvage procedure

    Directory of Open Access Journals (Sweden)

    Spalteholz, Matthias

    2013-11-01

    Full Text Available Specific and non-specific infections of the spine are rare. Due to their potential for severe instabilities, deformities and the impairment of neurological structures, the treatment is often prolonged and needs an interdisciplinary management. The clinical presentation is uncharacteristic, therefore diagnosis is often delayed. There are no prospective randomized studies for therapy recommendation. The surgical concept includes eradication of the infection and the reliable stabilization of involved segments. This concept is successful in most cases of endogenous vertebral osteomyelitis. The therapy of the exogenous spine infections after macro and micro surgery is more difficult, due to the critical wound situation and the involvement of the posterior parts of the spine. In these cases, infection-associated instability of the anterior part is complicated by critical posterior wound conditions.We present three cases of severe exogenous vertebral infections, where temporary external transpedicular spine fixation was used for salvage procedure, till soft tissue conditions have permitted a definitive internal stabilization.

  16. Fixation Time for Evolutionary Graphs

    Science.gov (United States)

    Nie, Pu-Yan; Zhang, Pei-Ai

    Evolutionary graph theory (EGT) is recently proposed by Lieberman et al. in 2005. EGT is successful for explaining biological evolution and some social phenomena. It is extremely important to consider the time of fixation for EGT in many practical problems, including evolutionary theory and the evolution of cooperation. This study characterizes the time to asymptotically reach fixation.

  17. Complement fixation test to C burnetii

    Science.gov (United States)

    ... complement fixation test; Coxiella burnetii - complement fixation test; C burnetii - complement fixation test ... a specific foreign substance ( antigen ), in this case, C burnetii . Antibodies defend the body against bacteria, viruses, ...

  18. Abstracts of contributions presented in the VII. International Conference on the Conservation of the Eastern Imperial Eagle, Bratislava, Slovakia, 2013

    Directory of Open Access Journals (Sweden)

    Deutschová Lucia

    2014-01-01

    Full Text Available VII. International Conference on the Conservation of the Eastern Imperial Eagle (Aquila heliaca was held on October 2-5, 201 3 in Barónka hotel in Bratislava, Slovakia and it was organised by Raptor Protection of Slovakia (RPS in cooperation with the Czech Society for Ornithology and MME/BirdLife Hungary, under the auspices of the Ministry of Environment, supported by the International Visegrad Fund. Results of 43 experts from ten countries, including three countries of Visegrad region (Slovakia, Czech Republic and Hungary were presented in 20 presentations and five posters. Six contributions are published in Slovak Raptor Journal volume 8, issue 1 (2014 as full papers, further twelve contributions are published here as conference abstracts.

  19. Defect internalization and tyrosine kinase activation in Aire deficient antigen presenting cells exposed to Candida albicans antigens.

    Science.gov (United States)

    Brännström, Johan; Hässler, Signe; Peltonen, Leena; Herrmann, Björn; Winqvist, Ola

    2006-12-01

    Patients with Autoimmune polyendocrine syndrome type I (APS I) present with multiple endocrine failures due to organ-specific autoimmune disease, thought to be T-cell-mediated. Paradoxically, APS I patients suffer from chronic mucocutaneous candidiasis. The mutated gene has been identified as the Autoimmune regulator (AIRE). Aire is expressed in medullary epithelial cells of the thymus and in antigen presenting cells in the periphery. T cells from Aire deficient mice and men displayed an enhanced proliferative response against Candida antigen in vitro, suggesting that Aire deficient T cells are competent in recognizing Candida albicans. In contrast, monocytes from APS I patients displayed a decreased and delayed internalization of zymosan. Furthermore, Candida antigen activated monocytes from APS I patients show decreased and altered phoshotyrosine kinase activation. In conclusion, Aire deficient APCs have a defect receptor mediated internalization of Candida which affects kinase activation, likely altering the innate Candida immune response.

  20. Cross-cultural management and language studies within international business research: past and present paradigms and suggestions for future research

    OpenAIRE

    Pudelko, Markus; Tenzer, Helene; Harzing, Anne-Wil

    2015-01-01

    Our contribution seeks to (1) outline how cross-cultural management and, more recently, language studies developed as two interrelated subareas within international business research; (2) discuss the changing paradigms and orthodoxies under which empirical research in cross-cultural management and language studies has been executed, focusing in particular on what we consider shortcomings in past and present research; and (3) formulate our suggestions how research should develop in the future....

  1. Proceedings of the CISDEN meeting on present problems in Community and international law in the nuclear field

    International Nuclear Information System (INIS)

    1981-06-01

    These proceedings of the meeting of the Italian Nuclear Law Study Centre reproduce in full the three papers presented, together with the ensuing discussions. The papers respectively deal with the recent Constitutional Court Decision opposing a referendum on nuclear power plant site selection; international contracts -private autonomy and State law- and the incidence of recent trends on nuclear contracts; problems in relation to the entry into force of the 1980 Euratom radiation protection directive and the revision of relevant Italian regulations. (NEA) [fr

  2. Mini-Open Sinus Tarsi Approach with Percutaneous Screw Fixation of Displaced Calcaneal Fractures: A Prospective Computed Tomography-Based Study

    NARCIS (Netherlands)

    Nosewicz, Tomasz; Knupp, Markus; Barg, Alexej; Maas, Mario; Bolliger, Lilianna; Goslings, J. Carel; Hintermann, Beat

    2012-01-01

    Background: Open reduction and internal fixation (ORIF) of calcaneal fractures using an extended lateral approach results in soft tissue disruption and theoretically subtalar joint stiffness. A minimally invasive sinus tarsi approach for posterior facet exposure and percutaneous screw fixation of

  3. Papers presented at the Fourteenth International conference on Plasma Physics and Controlled Nuclear Fusion Research. Organization International de la Energia Atomica Wuerzberg, Alemania 30 September - 7 October 1992

    International Nuclear Information System (INIS)

    1994-01-01

    This report contains the contributions of the CIEMAT's Fusion Unit to the 14th International Conference on Plasma Physics and Controlled Nuclear Fusion Research that was held by the International Atomic Energy Agency in Wuerzberg, Germany from 30 September to 7 October 1992. Three papers were presented that summarized the, main lines of work done in the Unit during the previous two years: The first one on the theoretical advances in the understanding of the Fexible Heliac TJ-II under construction, the second on the confinement studies performed in the operating TJ-I Tokamak and the third one on the description of the physical properties of the soon to be started TJ-IU Torsatron. (Author) 25 refs

  4. Influência do suporte e fixação anterior na resistência mecânica do fixador interno vertebral Influencia del soporte y de la fijación anterior sobre la resistencia mecánica del fijador interno vertebralartrodesis cervical anterior por hernia del disco cervica The influence of anterior reconstruction and fixation on the mechanical performance of an internal fixator

    Directory of Open Access Journals (Sweden)

    Gisele Cristina Ale dos Santos

    2009-03-01

    momento-flexor, la torción y la rigidez obtenidas a partir de la curva carga x deflexión de cada ensayo mecánico. RESULTADOS: fue observado que la colocación del soporte y de la fijación anterior aumentaron la resistencia mecánica en los ensayos de flexo-compresión. En los ensayos de flexión lateral fue observado aumento de la resistencia mecánica solamente con la fijación anterior. CONCLUSIÓN: en los ensayos de torción, el soporte anterior y la fijación anterior no aumentaron la resistencia mecánica del sistema de fijación vertebral.OBJECTIVE: evaluation of the mechanical stability of the internal vertebral fixation through the influence of the anterior load bearing reconstruction and stabilization. METHODS: cylindrical woods blocks were utilized as test bodies and were stabilized by an internal fixation. Three experimental groups were set according to the anterior reconstruction and fixation: group I - without anterior support; group II - with anterior support and group III - with support and anterior fixation. In an universal assay machine the wood block underwent to flexion-compression, lateral flexion and torsion mechanical assays, until ten assays of each modality were performed (flexion-compression, lateral compression and torsion in each experimental group, in a total of 90 mechanical assays. The studied mechanical proprieties were the flex moment, torsion moment and the stiffness, obtained through the load x deflection of each mechanical trial. RESULTS: it was observed that utilizing a support and anterior fixation there has been na increased mechanical stiffness in the flexion-compression mechanical assays. In the lateral flexion tests it was observed an increased rigidity only with the anterior fixation. CONCLUSION: with the torsion tests the anterior support and fixation did not increase the mechanical rigidity of the vertebral fixation system.

  5. Complications Using Bioabsorbable Cross-Pin Femoral Fixation: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Saqib Hasan

    2011-01-01

    Full Text Available The use of bioabsorbable cross-pin transcondylar fixation has remained a viable option for femoral fixation in anterior cruciate ligament reconstruction. Although numerous biomechanical studies have demonstrated high fixation strength and minimal slippage with use of this method of fixation, there have been increasing reports of a variety of clinical complications associated with these implants. We reviewed the literature for all complications associated with the Bio-TransFix implant and present a case report of a patient status after ACL reconstruction using Bio-TransFix cross-pin femoral fixation with iliotibial band friction syndrome from a broken cross-pin four month post-operatively.

  6. Comparison of intermaxillary fixation screw versus eyelet interdental wiring for intermaxillary fixation in minimally displaced mandibular fracture: a randomized clinical study.

    Science.gov (United States)

    Ingole, Pranav D; Garg, Anoop; Shenoi, S Ramakrishna; Badjate, Samprati J; Budhraja, Nilima

    2014-05-01

    The aim of the present randomized study was to evaluate the efficacy of intermaxillary fixation screw (IMFS) versus eyelet interdental wiring for intermaxillary fixation (IMF) in minimally displaced mandibular fractures. A total of 50 patients with a minimally displaced mandibular fracture were enrolled, with 25 patients randomly selected for each group. In group I (study group, n = 25), the patients were treated using IMFS, and in group II (control group, n = 25), they received eyelet interdental wiring. Both techniques were assessed for the following parameters: time required for placement and removal of each type of IMF technique, time required for placement of IMF wires, postoperative occlusion, stability of the IMF wire, local anesthesia requirement during removal of each fixation type, oral hygiene status, glove perforation rate, and complications associated with both techniques. The collected data were analyzed using Student's unpaired t test or χ2 test. P wire in group I was 2.1 minutes and in group II was 6 minutes. The oral hygiene status was assessed, and the mean plaque index score for groups I and II was 1.44 and 2.12, respectively (P = .00). The glove perforation rate was much less in group I than in group II. Finally, the most common complication in both groups was mucosal growth. The results established the supremacy of IMFS compared with eyelet interdental wiring. Thus, we have concluded that IMFS, in the present scenario, is a safe and time-saving technique. IMFS is a cost-effective, straightforward, and viable alternative to cumbersome eyelet interdental and other wiring techniques for providing IMF, with satisfactory occlusion during closed reduction or intraoperative open reduction internal fixation of fractures. In addition, oral hygiene can be maintained, and the glove perforation rate was very low using IMFS. The relatively small sample size and limited follow-up period were the study limitations. Copyright © 2014 American Association of

  7. [Evaluation of the degree of compliance of Spanish scientific biomedical journals with international standards of presentation of periodicals].

    Science.gov (United States)

    Delgado López-Cózar, E

    1997-01-01

    Because standardization is important to ensure the successful transfer of scientific information, compliance with international standards for the presentation of periodicals in 205 Spanish biomedical journals, with the aim of improving their quality as instruments of information transfer, is evaluated. Journals were identified by consulting five printed bibliographies and four electronic databases. A total of 136 parameters of evaluation for the presentation of periodicals derived from ISO (International Standardization Organization) standards (86%) and recommendations published by UNESCO, the International Committee of Medical Journal Editors, The Council of Biology Editors, and EJ Huth (14%) were evaluated. Three features (inclusion, presentation and location) were recorded for most data item, and the total number of items studied was 342. The rate of compliance with standards in Spanish biomedical journals was 33.5% +/- 8.5 (DE). Compliance was highest for items related with the identification of the journal in the text pages and the issue contents list. The lowest rates of compliance were found for items related the volume and the abstract sheet. The worst standardized journals were those published by private firms and public administration organizations. As a group, journals published annually were the best standardized. The low rate of compliance with standards did not reflect inadequate compliance with all items, but was rather the result of complete noncompliance with particular standards, especially those relating to the abstract sheet, volume front cover, volume contents list and volume index. To improve compliance a change in the policies governing the availability of standards, the preparation of guides and manuals for scientific periodical publishing, and the development of training programs aimed at authors, editors, publishers, librarians and information scientists, is suggested.

  8. Loss of Proliferation and Antigen Presentation Activity following Internalization of Polydispersed Carbon Nanotubes by Primary Lung Epithelial Cells

    Science.gov (United States)

    Kumari, Mandavi; Sachar, Sumedha; Saxena, Rajiv K.

    2012-01-01

    Interactions between poly-dispersed acid functionalized single walled carbon nanotubes (AF-SWCNTs) and primary lung epithelial (PLE) cells were studied. Peritoneal macrophages (PMs, known phagocytic cells) were used as positive controls in this study. Recovery of live cells from cultures of PLE cells and PMs was significantly reduced in the presence of AF-SWCNTs, in a time and dose dependent manner. Both PLE cells as well as PMs could take up fluorescence tagged AF-SWCNTs in a time dependent manner and this uptake was significantly blocked by cytochalasin D, an agent that blocks the activity of acto-myosin fibers and therefore the phagocytic activity of cells. Confocal microscopic studies confirmed that AF-SWCNTs were internalized by both PLE cells and PMs. Intra-trachially instilled AF-SWCNTs could also be taken up by lung epithelial cells as well as alveolar macrophages. Freshly isolated PLE cells had significant cell division activity and cell cycling studies indicated that treatment with AF-SWCNTs resulted in a marked reduction in S-phase of the cell cycle. In a previously standardized system to study BCG antigen presentation by PLE cells and PMs to sensitized T helper cells, AF-SWCNTs could significantly lower the antigen presentation ability of both cell types. These results show that mouse primary lung epithelial cells can efficiently internalize AF-SWCNTs and the uptake of nanotubes interfered with biological functions of PLE cells including their ability to present BCG antigens to sensitized T helper cells. PMID:22384094

  9. Midterm results of biologic fixation or mosaicplasty and drilling in osteochondritis dissecans

    Directory of Open Access Journals (Sweden)

    Tuluhan Yunus Emre

    2011-01-01

    Conclusion: Biologic fixation or mosaicplasty and drilling as a technique to treatment of the lesion in OCD by osteochondral autograft transfer has resulted in good and excellent clinical outcomes in our patients and it is considered that providing blood flow to subchondral bone by circumferencial drilling leads to an increase in the robustness of biological internal fixation and shortens the duration of recovery.

  10. Percutaneous Intramedullary Screw Fixation of Distal Fibula Fractures: A Case Series and Systematic Review

    NARCIS (Netherlands)

    Loukachov, Vladimir V.; Birnie, Merel F. N.; Dingemans, Siem A.; de Jong, Vincent M.; Schepers, Tim

    2017-01-01

    The current reference standard for unstable ankle fractures is open reduction and internal fixation using a plate and lag screws. This approach requires extensive dissection and wound complications are not uncommon. The use of intramedullary screw fixation might overcome these issues. The aim of our

  11. Failure of volar locking plate fixation of an extraarticular distal radius fracture: A case report

    Directory of Open Access Journals (Sweden)

    Ozer Kagan

    2010-11-01

    Full Text Available Abstract Background Volar locking plates provide significant structural stability to the distal radius. Failure of a volar locked plating is a rarely reported complication in the literature. Case Presentation A 40 year-old, obese female patient who presented with a displaced extraarticular distal radius fracture, underwent open reduction and internal fixation of the fracture using a volar locking plate. Radiographs taken at 10 weeks postoperatively showed failure of fixation with breakage of the four distal locking screws. A hardware removal was performed at 6 months, and the patient was then lost to follow-up. She presented again at 18 months after the first surgery, with significant pain, and radiographic signs of a radial collapse and a fracture-nonunion. A total wrist fusion was performed as the method of choice at that point in time. Conclusion Volar locked plating represents the new "gold standard" of distal radius fracture fixation. However, despite the stability provided by locking plates, hardware failure may occur and lead to a cascade of complications which will ultimately require a wrist fusion, as outlined in this case report. Additional structural support by bone grafting may be needed in selected cases of volar locked plating, particularly in patients with a high risk of developing a fracture-nonunion.

  12. The principles of interference screw fixation: application to foot and ankle surgery.

    Science.gov (United States)

    Feldman, Kent A

    2005-01-01

    Based on the success of the anterior cruciate ligament model, interference screw fixation is now being applied to a wide variety of orthopedic conditions that require the fixation of tendon or ligament to bone. The primary focus of this article is to present the principles of interference screw fixation. By understanding the principles of interference screw fixation, the foot and ankle surgeon will be able to apply this fixation technique to a wide variety of surgical applications for tendon transfers or ligament repairs. The surgical technique, history, principles of fixation, studies of fixation strength, tissue healing, and foot and ankle indications are reviewed. A modified Girdlestone digital flexor tendon transfer procedure description is included to illustrate how interference screw techniques may be applied to foot surgery.

  13. Nitrogen supply of crops by biological nitrogen fixation. 2

    International Nuclear Information System (INIS)

    Jensen, E.S.; Andersen, A.J.; Soerensen, H.; Thomsen, J.D.

    1985-02-01

    In the present work the contributions from combined N-sources and symbiotic nitrogen fixation to the nitrogen supply of field-grown peas and field beans were evaluated by means of 15 N fertilizer dilution. The effect of N-fertilizer, supplied at sowing and at different stages of plant development, on nitrogen fixation, yield and protein production in peas, was studied in pot experiments. (author)

  14. Cultural Diplomacy and its Presentation in International Affairs Textbooks, 1945-1971. A Study of the Treatment Accorded International Education and Cultural Relations in 171 Textbooks on International Relations, Foreign Policy, and International Organization.

    Science.gov (United States)

    Flack, Michael J.; And Others

    International education and cultural relations (IEC) are surveyed in the content of books from three areas of political science--international relations, foreign policy, and international organizations. One hundred seventy one texts published in the U.S. from 1945-mid 1971 are statistically analyzed in terms of amount of consideration of IEC;…

  15. Present trends in radioactive waste management policies in OECD countries and related international co-operative efforts

    International Nuclear Information System (INIS)

    Olivier, J.P.

    1977-01-01

    In recent years waste management has received increased attention not only at the national level but also internationally in order to harmonise to some extent the policies and practices to be followed and to continue to achieve a high safety standard in this field. In particular, discussions are taking place between OECD Member countries on the definition of objectives, concepts and strategies for radioactive waste management with a view to presenting coherent overall systems covering not only the treatment and storage aspects for the short term but also the longer term problems of disposal in the context of a rapidly developing nuclear fuel cycle. The technical, administrative, legal and financial aspects of the waste management problems are being discussed and various approaches are envisaged for the future. In addition to the discussion of policies and practices, a significant effort is also being initiated on research and development. The disposal problem has been given priority particularly as far as high level waste and alpha bearing wastes are concerned. Close international co-operation has been initiated in this sector as well as on the conditioning of high level radioactive waste. As a result of these efforts an international R and D programme is being established at the site of the Eurochemic reprocessing plant on the incorporation of high level waste into metal matrices. Increased co-operation is also taking place concerning other waste management problems such as the management of gaseous waste, alpha waste and cladding hulls and the question of dismantling and decommissioning of obsolete nuclear facilities. The paper describes in detail the results achieved so far through this co-operation between OECD Member countries and presents current plans for future activities [fr

  16. Frequency of infection after extraction of involved third molar in mandibular angle fractures treated with rigid fixation

    International Nuclear Information System (INIS)

    Chatha, A.A.; Tahir, S.; Warraich, R.A.; Hanif, S.

    2013-01-01

    Objective: To determine the frequency of post-operative infection in patients with mandibular angle fractures treated with rigid fixation after extraction of involved third molar. Materials and Methods: In a total of 100 patients undergoing open reduction and internal fixation of mandibular angle fractures in which involved third molar will be extracted were included from Department of Oral and Maxillofacial Surgery, Mayo Hospital, Lahore. Procedure was performed by the same consultant and post operatively patients were assessed by two post graduate trainees who were trained previously to check Infection, on 1st, 2nd, 4th and 6th weeks post operatively. All the observations were entered on preformed proforma. Data was entered and analyzed by using SPSS version 10.0 Results: According to this study, the mean age of patients was 33.22 + 9.155 years. Minimum and maxi-mum age of patients was 18 years and 50 years with range of 32 years. There were 83 (83.0%) male patients while only 17 (17%) female patients presented with mandibular angle fractures. The rate of infection at week 1 was higher (9 (9.0%) cases), but gradually decreased in next follow up. 8 (8.0%) at 2nd week, 7 (7.0%) at week 4 and only 6 (6.0%) in last follow up at week 6 after open reduction and internal fixation of mandibular angle fractures with extraction of third molar. Conclusion: The frequency of post-operative infection in patients with mandibular angle fractures treated with rigid fixation after extraction of third molar was 30% at different follow ups in which 9% patients had infection at first week, 8 patients had at 2nd week, 7 patients had at 6th week and 6% patients presented with infection at last follow up. Overall the infection rate is lower in patients with mandibular angle fractures treated with rigid fixation after extraction of third molar. (author)

  17. Present trends in radioactive waste management policies in OECD countries, and related international co-operative efforts

    International Nuclear Information System (INIS)

    Olivier, J.P.

    1977-01-01

    In recent years, waste management has received increased attention at the national level and also internationally, to harmonize to some extent the policies and practices to be followed and to continue to achieve a high safety standard. In particular, discussions are taking place between OECD Member countries on the definition of objectives, concepts and strategies for radioactive waste management with a view to presenting coherent overall systems, covering not only the treatment and storage aspects for the short-term but also the longer-term problems of disposal in the context of a rapidly developing nuclear fuel cycle. The technical, administrative, legal and financial aspects of the waste management problems are being discussed and various approaches are envisaged for the future. In addition, a significant effort is also being initiated on research and development. The disposal problem has been given priority, particularly regarding high-level waste and alpha-bearing wastes. Close international co-operation has been initiated in this sector as well as on the conditioning of high-level radioactive waste. Increased co-operation is also taking place concerning other waste management problems such as the management of gaseous waste, alpha waste and cladding hulls and the question of dismantling and decommissioning of obsolete nuclear facilities. The paper describes the results achieved so far through this co-operation between OECD Member countries and presents current plans for future activities. (author)

  18. International conference on challenges faced by technical and scientific support organizations in enhancing nuclear safety. Contributed papers and presentations

    International Nuclear Information System (INIS)

    2007-01-01

    conclusions apply equally to TSOs, since their expertise is an integral part of supporting the regulatory decision making process over the entire life cycle of facilities and activities for the continuous improvement of safety. On the basis of the presentations and discussions, the conference developed conclusions as well as recommendations for consideration by TSOs, regulatory authorities, national governments, relevant international and regional organizations, the nuclear industry and other stakeholders. This CD-ROM contains the unedited contributed papers and the presentations that were submitted with some of the invited papers. A record of the conference including a summary, the opening speeches, the invited papers, and the conclusions and summary of the conference by the President are available in the printed STI/PUB-1301

  19. Combined Percutaneous Iliosacral Screw Fixation With Sacroplasty Using Resorbable Calcium Phosphate Cement for Osteoporotic Pelvic Fractures Requiring Surgery.

    Science.gov (United States)

    Collinge, Cory A; Crist, Brett D

    2016-06-01

    Osteoporotic sacral fractures, including acute and chronic insufficiency fractures, are increasing in frequency and present a number of management problem. Many of these patients are treated nonoperatively with relative immobility (eg, bedrest, wheelchair, or weight-bearing restrictions) and analgesics, which likely make the osteoporotic component worse. Surgery in this patient population may be desirable in some cases with the goals of improving mobility, relieving pain, and healing in an aligned position while minimizing deformity progression. However, internal fixation of the osteoporotic pelvis can be difficult. Large unicortical lag screws are the workhorse of posterior pelvic fixation, and yet fixation in cancellous bone corridors of an osteoporotic sacrum seems unlikely to achieve optimal fixation. As a result, the operative management and clinical results of these difficult injuries may not be uniformly successful. The authors present a technique for treating osteoporotic patients with a sacral fracture when operative treatment is indicated using percutaneous screw fixation combined with screw augmentation using a resorbable calcium phosphate bone substitute or "cement." The guide wire for a 7.3-mm or other large cannulated lag screw is fully inserted along the desired bony sacral corridor as is standard. The lag screw is then inserted over the wire to the depth where cement is desired. The guide wire is removed, and the aqueous calcium phosphate is injected through the screw's cannulation. For acute fractures, cement was applied to the areas distant to the fracture; whereas in insufficiency fractures, the cement was inserted along most of the screw path. The guide wire then can be reinserted and the lag screw fully inserted. The rationale for using these 2 modalities is their synergistic effect: the cannulated screw provides typical screw fixation and also a conduit for cement application. The cement augments the lag screw's purchase in osteoporotic bone

  20. Report of International Workshop on tracing isotopic composition of past and present precipitation - opportunities for climate and water studies

    International Nuclear Information System (INIS)

    1995-01-01

    The Workshop on Tracing Isotopic Composition of Past and Present Precipitation - Opportunities for Climate and Water Studies, was jointly organized by the World Meteorological Organization (WMO), the International Atomic Energy Agency (IAEA), Past Global Changes (PAGES) - a core project of the International Geosphere - Biosphere Programme (IGBP), and the International Association of Hydrological Sciences (IAHS). The Global Network ''Isotopes in Precipitation'' (GNIP) was initiated by IAEA in 1958 and became operational in 1961. The main objective was to collect systematic data on isotopic content of precipitation on a global scale and to establish temporal and spatial variations of environmental isotopes in precipitation. The network is now expected to serve additional purposes, namely as a benchmark for the interpretation of paleo-records, as a validation tool for Global Circulation Models, and for establishing large-scale regional (and continental-scale) waster balances. Furthermore, the structure of GNIP should be strengthened. This includes the build-up of: stations located close to major natural climatic archives (e.g. Greenland, mountain areas); stations which represent climatically sensitive areas (indicated by GCM's and biome models). Isotope monitoring of river outflow from major continental basins should be initiated. This could be realized in co-operation with the UNEP/WHO Global Environmental Monitoring System-Water (GEMS-Water). The deuterium excess parameter (δ) is of particular importance in climate modelling and in the understanding of hydro-meteorological pathways. The use of the deuterium excess imposes strict requirements on the accuracy of deuterium and oxygen-18 analysis. A GNIP-based worldwide documentation of quality control regarding sampling, shipping and measurements is needed. The IAEA/WMO database and other isotope data sets should be included in the World Data Center A for palaeo-climatology. Refs, figs, tabs

  1. Flexible 3D laparoscopic assisted reduction and percutaneous fixation of acetabular fractures: Introduction to a new surgical option.

    Science.gov (United States)

    Mauffrey, C; Hake, M; Kim, F J

    2016-10-01

    The gold standard for fractures of the acetabulum is to perform an open reduction and internal fixation in order to achieve anatomical reduction. In a well-defined subset of patients, percutaneous techniques may be employed but achieving reduction by closed means can be challenging especially for fractures with large degrees of displacement. Such patient may include elderly patients who may not have the physiologic reserve to withstand open approaches. In our paper, we present a new option using laparoscopic assisted reduction of the acetabular fracture and percutaneous fixation. The young obese patient refused all forms of blood products transfusion and presented with a displaced transverse posterior wall fracture. While we do not recommend routine use of such technique and recognize its numerous limitations, we present it as an alternative strategy in a small subset of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Preliminary experience with biodegradable implants for fracture fixation

    Directory of Open Access Journals (Sweden)

    Dhillon Mandeep

    2008-01-01

    Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

  3. Biomechanics of intramedullary fracture fixation.

    Science.gov (United States)

    Kyle, R F

    1985-11-01

    Intramedullary rodding allows excellent control of bending forces on long bone fractures when adequate sized rods are used. This is made possible by reaming when necessary. Torsional stability is poor if adequate bone nail contact is not obtained and there is little bone fragment interdigitation. This can be optimized with the interlocking system, especially with proximal and distal fractures. Intramedullary rods allow transmission of compressive load so there must be adequate bone to bone contact without comminution to prevent shortening. If a great deal of comminution is present, an interlocking system must be used to resist compressive loads. The interlocked devices have not been proven to be a detriment to union and indeed are a semi-rigid fixation system when used in comminuted shaft fractures. The strength of an osteosynthesis with an intramedullary rod depends on the geometry of the rod and the geometry of the fracture complex. Both locked and nonlocked intramedullary rods perform extremely well when one understands the mechanical principles involved in intramedullary rodding and pays close attention to detail.

  4. Abstracts of contributions presented at the International Conference on the Conservation of the Lesser Spotted Eagle, Slovakia, 2014

    Directory of Open Access Journals (Sweden)

    Dravecký Miroslav

    2015-06-01

    Full Text Available The International Conference on the Conservation of the Lesser Spotted Eagle (Aquila pomarina was held on September 25-27, 2014 in Lesanka Guesthouse at Košická Belá, Slovakia. The Conference was organized within the framework of the project LIFE09NAT/SK/000396 Conservation of Aquila pomarina in Slovakia, implemented by Raptor Protection of Slovakia, Východoslovenská energetika, a.s., Stredoslovenská energetika, a.s., and Stredoslovenská energetika - Distribúcia, a.s. This project was cofinanced by EU-LIFE and the Ministry for the Environment of the Slovak Republic. A total of 59 participants from 14 countries attended the conference. The conference agenda included 17 presentations and 7 posters. Some of the contributions are published in Slovak Raptor Journal volume 9 (2015 as full papers, and a further 23 contributions are published here as conference abstracts.

  5. Endovascular treatment of radiation-induced petrous internal carotid artery aneurysm presenting with acute haemorrhage. A report of two cases

    International Nuclear Information System (INIS)

    Cheng, K.-M.; Chiu, H.-M.; Chan, C.-M.; Cheung, Y.-L.; Tang, K.-W.; Law, C.-K.

    2001-01-01

    Hemorrhage from rupture of petrous ICA aneurysm can be life threatening and emergency treatment is required. We report 2 cases of radiation-induced petrous internal carotid artery (ICA) aneurysm presenting with acute hemorrhage (epistaxis and otorrhagia) after radiotherapy (RT) for nasopharyngeal carcinoma (NPC). Both patients had a history of RT treatment for NPC. The first patient, a 54-year-old man, presented with sudden severe epistaxis and hemorrhagic shock. The second patient, a 35-year-old man, presented with episodes of severe otorrhagia. The first patient was immediately resuscitated. Obliteration of the aneurysm was performed by endovascular occlusion of the ICA with Guglielmi detachable coils and fibered platinum coils. For the second patient, the aneurysm was treated by deploying a self-expandable stent across the aneurysm neck. In an emergency situation, ruptured petrous ICA aneurysm can be treated with endovascular occlusion of the ICA with micro-coils if there is a good collateral blood flow. Alternatively, the aneurysm can be treated by deployment of a stent, which can induce stasis and eventual thrombosis of the aneurysm. (author)

  6. The retinal locus of fixation in simulations of progressing central scotomas.

    Science.gov (United States)

    Barraza-Bernal, Maria J; Rifai, Katharina; Wahl, Siegfried

    2018-01-01

    Patients with central scotoma use a preferred retinal locus (PRL) of fixation to perform visual tasks. Some of the conditions that cause central scotoma are progressive, and as a consequence, the PRL needs to be adjusted throughout the progression. The present study investigates the peripheral locus of fixation in subjects under a simulation of progressive central scotoma. Five normally sighted subjects participated in the study. A foveally centered mask of varying size was presented to simulate the scotoma. Initially, subjects developed a peripheral locus of fixation under simulation of a 6° scotoma, which was used as a baseline. The progression was simulated in two separate conditions: a gradual progression and an abrupt progression. In the gradual progression, the diameter of the scotoma increased by a fixed amount of either 1° or 2° of visual angle, thus scotomas of 8°, 10°, and 11° of visual angle were simulated. In the abrupt progression, the diameter was adjusted individually to span the area of the visual field used by the current peripheral locus of fixation. Subjects located the peripheral locus of fixation along the same meridian under simulation of scotoma progression. Furthermore, no differences between the fixation stability of the baseline locus of fixation and the incremental progression locus of fixation were found whereas, in abrupt progression, the fixation stability decreased significantly. These results provide first insight into fixation behavior in a progressive scotoma and may contribute to the development of training tools for patients with progressive central maculopathies.

  7. The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years.

    Science.gov (United States)

    Keene, David J; Mistry, Dipesh; Nam, Julian; Tutton, Elizabeth; Handley, Robert; Morgan, Lesley; Roberts, Emma; Gray, Bridget; Briggs, Andrew; Lall, Ranjit; Chesser, Tim Js; Pallister, Ian; Lamb, Sarah E; Willett, Keith

    2016-10-01

    Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study. Trauma and orthopaedic departments of 24 NHS hospitals. Adults aged over 60 years with unstable ankle fracture. Those with serious limb or concomitant disease or substantial cognitive impairment were excluded. CCC was conducted under anaesthetic in theatre by surgeons who attended training. ORIF was as per local practice. Participants were randomised in 1 : 1 allocation via remote telephone randomisation. Sequence generation was by random block size, with stratification by centre and fracture pattern. Follow-up was conducted at 6 weeks and, by blinded outcome assessors, at 6 months after randomisation. The primary outcome was the Olerud-Molander Ankle Score (OMAS), a patient-reported assessment of ankle function, at 6 months. Secondary outcomes were quality of life (as measured by the European Quality of Life 5-Dimensions, Short Form questionnaire-12 items), pain, ankle range of motion and mobility (as measured by the timed up and go test), patient satisfaction and radiological measures. In accordance with equivalence trial US Food and Drug Administration guidance, primary analysis was per protocol. We recruited 620 participants, 95 from the pilot and 525 from the multicentre phase, between June 2010 and November 2013. The majority of participants, 579 out of 620 (93%), received the allocated treatment; 52 out of 275 (19%) who received CCC later converted to ORIF because of loss of fracture reduction. CCC resulted in equivalent ankle

  8. Axial loading cross screw fixation for the Austin bunionectomy.

    Science.gov (United States)

    Rigby, Ryan B; Fallat, Lawrence M; Kish, John P

    2011-01-01

    The Austin procedure has become a common method of osteotomy for the correction of hallux abductovalgus when indicated. The V-type configuration is intrinsically stable but not without complications. One complication encountered is rotation and/or displacement of the capital fragment. We present the use of an axial loading screw in conjunction with a dorsally placed compression screw. The benefit to this technique lies in the orientation of the axial loading screw, because it is directed to resist the ground reactive forces while also providing a second point of fixation in a crossing screw design. In a head-to-head biomechanical comparison, we tested single dorsal screw fixation versus double screw fixation, including both the dorsal and the axial loading screws in 10 metatarsal Sawbones(®) (Pacific Research Laboratories Inc, Vashon, WA). Five metatarsals received single dorsal screw fixation and five received the dorsal screw and the additional axial loading screw. The metatarsals were analyzed on an Instron compression device for comparison; 100% of the single screw fixation osteotomies failed with compression at an average peak load of 205 N. Four of five axial loading double screw fixation osteotomies did not fail. This finding suggests that the addition of an axial loading screw providing cross screw orientation significantly increases the stability of the Austin osteotomy, ultimately decreasing the likelihood of displacement encountered in the surgical repair of hallux abductovalgus. Copyright © 2011 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

    LENUS (Irish Health Repository)

    Ong, J C Y

    2012-06-01

    The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

  10. Delayed Union of a Sacral Fracture: Percutaneous Navigated Autologous Cancellous Bone Grafting and Screw Fixation

    International Nuclear Information System (INIS)

    Huegli, R. W.; Messmer, P.; Jacob, A. L.; Regazzoni, P.; Styger, S.; Gross, T.

    2003-01-01

    Delayed or non-union of a sacral fracture is a serious clinical condition that may include chronic pain, sitting discomfort, gait disturbances, neurological problems, and inability to work. It is also a difficult reconstruction problem. Late correction of the deformity is technically more demanding than the primary treatment of acute pelvic injuries. Open reduction, internal fixation (ORIF), excision of scar tissue, and bone grafting often in a multi-step approach are considered to be the treatment of choice in delayed unions of the pelvic ring. This procedure implies the risk of neurological and vascular injuries, infection, repeated failure of union, incomplete correction of the deformity, and incomplete pain relief as the most important complications. We report a new approach for minimally invasive treatment of a delayed union of the sacrum without vertical displacement. A patient who suffered a Malgaigne fracture (Tile C1.3) was initially treated with closed reduction and percutaneous screw fixation (CRPF) of the posterior pelvic ring under CT navigation and plating of the anterior pelvic ring. Three months after surgery he presented with increasing hip pain caused by a delayed union of the sacral fracture. The lesion was successfully treated percutaneously in a single step procedure using CT navigation for drilling of the delayed union, autologous bone grafting, and screw fixation

  11. The biomechanics of ipsilateral intertrochanteric and femoral shaft fractures: a comparison of 5 fracture fixation techniques.

    Science.gov (United States)

    McConnell, Alison; Zdero, Rad; Syed, Khalid; Peskun, Christopher; Schemitsch, Emil

    2008-09-01

    The aim of the present study was to examine biomechanically 5 different construct combinations for fixation of ipsilateral intertrochanteric and femoral shaft fractures. Twenty-five fresh-frozen adult human femora (age range = 58-91 years, average age = 75.4 years) were tested in physiological bending and in torsion to characterize initial bending and torsional stiffness and stiffness following fixation of combined intertrochanteric and femoral shaft fractures. Five fracture fixation device constructs were assessed-construct A: long dynamic hip screw (long DHS); construct B: reconstruction nail; construct C: DHS plus low-contact dynamic compression plate; construct D: DHS plus retrograde intramedullary nail; and construct E: long intramedullary hip screw. Axial stiffness, torsional stiffness, and axial load-to-failure were the main measurements recorded. There were no differences between constructs in terms of axial stiffness (P = 0.41), external rotation stiffness (P = 0.13), and axial load-to-failure (P = 0.16). However, there was a borderline statistically significant difference in internal rotation stiffness between the constructs (P = 0.048). Specifically, construct C was significantly stiffer than construct E (P = 0.04). All constructs showed no statistical differences when compared with one another, with the exception of construct E, which provided the least torsional stiffness. However, the current in vitro model did not simulate fracture healing or support offered by soft tissues, both of which would affect the stiffness and load-to-failure levels reached.

  12. Analysis of quench-vent pressures for present design of ITER [International Thermonuclear Experimental Reactor] TF [toroidal field] coils

    International Nuclear Information System (INIS)

    Slack, D.S.

    1989-01-01

    The International Thermonuclear Experimental Reactor (ITER) is a new tokamak design project with joint participation from Japan, the European Community, the Union of the Soviet Union, and the United States. This paper examines the effects of a quench within the toroidal field (TF) coils based on current ITER design. It is a preliminary, rough analysis. Its intent is to assist ITER designers while more accurate computer codes are being developed and to provide a check against these more rigorous solutions. Rigorous solutions to the quench problem are very complex involving three-dimensional heat transfer, extreme changes in heat capacities and copper resistivity, and varying flow dynamics within the conductors. This analysis addresses all these factors in an approximate way. The result is much less accurate than a rigorous analysis. Results here could be in error as much as 30 to 40 percent. However, it is believed that this paper can still be very useful to the coil designer. Coil pressures and temperatures vs time into a quench are presented. Rate of helium vent, energy deposition in the coil, and depletion of magnetic stored energy are also presented. Peak pressures are high (about 43 MPa). This is due to the very long vent path length (446 m), small hydraulic diameters, and high current densities associated with ITER's cable-in-conduit design. The effects of these pressures as well as the ability of the coil to be self protecting during a quench are discussed. 3 refs., 3 figs., 1 tab

  13. Percutaneous reduction and screw fixation of fracture neck talus.

    Science.gov (United States)

    Abdelgaid, Sherif Mohamed; Ezzat, Farid Fouad

    2012-12-01

    Fracture neck talus is a rare fracture represents about 1% of all fractures and usually due to high energy trauma. These fractures are usually associated with compromised soft tissues, concomitant skeletal fractures, or life threatening injuries. Talus has a tenuous blood supply which is affected by fracture displacement. Urgent fracture reduction±fracture fixation is mandatory. The associated injuries may make the conventional open reduction and internal fixation is impossible to be done in urgent base as it may impacts the already tenuous blood supply of talus increasing the risk of AVN and non union. Percutaneous fracture reduction and fixation can overcome this problem, and decrease complications associated with conventional open reduction and internal fixation. Between 2006 and 2008, 16 patients with talar neck fractures were operated on by percutaneous reduction of fracture and percutaneous fixation with 3.5mm cannulated screws. Injuries were classified according to modified Hawkins classification system. Patients were followed up over an average of 48 months. 87.5% of the patients were satisfied and resumed their preoperative activities. The mean AOFAS Hind Foot Scale was 89.25 points (range: 74-100) and no poor outcomes. Although the number of patients in this study is small, the results showed that, percutaneous reduction and fixation is a good treatment modality in treatment of fracture neck talus, especially in cases with increased risk of soft tissue complications and open reduction should be resort only when percutaneous reduction was failed. Copyright © 2012 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  14. Outcome of double bundle anterior cruciate ligament reconstruction using crosspin and aperture fixation

    Directory of Open Access Journals (Sweden)

    Deepak Joshi

    2014-01-01

    Full Text Available Background: Double bundle anterior cruciate ligament (DBACL reconstruction is said to reproduce the native anterior cruciate ligament (ACL anatomy better than single bundle anterior cruciate ligament, whether it leads to better functional results is debatable. Different fixation methods have been used for DBACL reconstruction, the most common being aperture fixation on tibial side and cortical suspensory fixation on the femoral side. We present the results of DBACL reconstruction technique, wherein on the femoral side anteromedial (AM bundle is fixed with a crosspin and aperture fixation was done for the posterolateral (PL bundle. Materials and Methods: Out of 157 isolated ACL injury patients who underwent ACL reconstruction, 100 were included in the prospective study. Arthroscopic DBACL reconstruction was done using ipsilateral hamstring autograft. AM bundle was fixed using Transfix (Arthrex, Naples, FL, USA on the femoral side and bio interference screw (Arthrex, Naples, FL, USA on the tibial side. PL bundle was fixed on femoral as well as on tibial side with a biointerference screw. Patients were evaluated using KT-1000 arthrometer, Lysholm score, International Knee Documentation Committee (IKDC Score and isokinetic muscle strength testing. Results: The KT-1000 results were evaluated using paired t test with the P value set at 0.001. At the end of 1 year, the anteroposterior side to side translation difference (KT-1000 manual maximum showed mean improvement from 5.1 mm ± 1.5 preoperatively to 1.6 mm ± 1.2 ( P < 0.001 postoperatively. The Lysholm score too showed statistically significant ( P < 0.001 improvement from 52.4 ± 15.2 (range: 32-76 preoperatively to a postoperative score of 89.1 ± 3.2 (range 67-100. According to the IKDC score 90% patients had normal results (Category A and B. The AM femoral tunnel initial posterior blow out was seen in 4 patients and confluence in the intraarticular part of the femoral tunnels was seen in 6

  15. Report About the Design of External Fixator for Treatment of Pelvis and Acetabulum Fractures

    Directory of Open Access Journals (Sweden)

    Martin JANEČKA

    2012-06-01

    Full Text Available Main point in this contribution is the design of external fixators applied in traumatology and orthopaedics. These fixators can be used in the treatment of open and unstable (i.e. complicated fractures of pelvis and its acetabulum. Numerical modelling (i.e. Finite Element Method, together with CAD modelling, experiments, material engineering, and nanotechnology are presented as a support for developing of a new design of external fixators.

  16. Intraosseous fixation compared to plantar plate fixation for first metatarsocuneiform arthrodesis: a cadaveric biomechanical analysis.

    Science.gov (United States)

    Roth, Klaus Edgar; Peters, Jennifer; Schmidtmann, Irene; Maus, Uwe; Stephan, Daniel; Augat, Peter

    2014-11-01

    Metatarsocuneiform (MTC) fusion is a treatment option for management of hallux valgus. We compared the biomechanical characteristics of an internal fixation device with plantar plate fixation. Seven matched pairs of feet from human cadavers were used to compare the intramedullary (IM) device plus compression screw to plantar plate combined with a compression screw. Specimen constructs were loaded in a cyclic 4-point bending test. We obtained initial/final stiffness, maximum load, and number of cycles to failure. Bone mineral density was measured with peripheral quantitative computed tomography. Performance was compared using time to event analysis with number of cycles as time variable, and a proportional hazard model including shared frailty model fitted with treatment and bone mineral density as covariates. On average the plates failed after 7517 cycles and a maximum load of 167 N, while the IM-implants failed on average after 2946 cycles and a maximum load of 69 N. In all pairs the 1 treated with IM-implant failed earlier than the 1 treated with a plate (hazard ratio for IM-implant versus plate was 79.9 (95% confidence interval [6.1, 1052.2], P = .0009). The initial stiffness was 131 N/mm for the plantar plate and 43.3 N/mm for the IM implant. Initial stiffness (r = .955) and final stiffness (r = .952) were strongly related to the number of cycles to failure. Bone mineral density had no effect on the number of cycles to failure. Plantar plate fixation created a stronger and stiffer construct than IM fixation. A stiffer construct can reduce the risk of nonunion and shorten the period of non-weight-bearing. © The Author(s) 2014.

  17. [Three-dimensional finite element investigation of lateral mass screw fixation and transarticular screw fixation in lower cervical spine].

    Science.gov (United States)

    Duan, Yang; Jin, Anmin; Zhang, Hui; Min, Shaoxiong; Hu, Konghe

    2010-12-01

    To establish sophisticated three-dimensional finite element model of the lower cervical spine and reconstruct lower cervical model by different fixation systems after three-column injury, and to research the stress distribution of the internal fixation reconstructed by different techniques. The CT scan deta were obtained from a 27-year-old normal male volunteer. Mimics 10.01, Geomagic Studio10.0, HyperMesh10.0, and Abaqus 6.9.1 softwares were used to obtain the intact model (C3-7), the model after three-column injury, and the models of reconstructing the lower cervical spine after three-column injury through different fixation systems, namely lateral mass screw fixation (LSF) and transarticular screw fixation (TSF). The skull load of 75 N and torsion preload of 1.0 N*m were simulated on the surface of C3. Under conditions of flexion, extension, lateral bending, and rotation, the Von Mises stress distribution regularity of internal fixation system was evaluated. The intact model of C3-7 was successfully established, which consisted of 177 944 elements and 35 668 nodes. The results of the biomechanic study agreed well with the available cadaveric experimental data, suggesting that they were accord with normal human body parameters and could be used in the experimental research. The finite element models of the lower cervical spine reconstruction after three-column injury were established. The stress concentrated on the connection between rod and screw in LSF and on the middle part of screw in TSF. The peak values of Von Mises stress in TSF were higher than those in LSF under all conditions. For the reconstruction of lower cervical spine, TSF has higher risk of screw breakage than LSF.

  18. Understanding Nitrogen Fixation

    Energy Technology Data Exchange (ETDEWEB)

    Paul J. Chirik

    2012-05-25

    synthesis of ammonia, NH{sub 3}, from its elements, H{sub 2} and N{sub 2}, via the venerable Haber-Bosch process is one of the most significant technological achievements of the past century. Our research program seeks to discover new transition metal reagents and catalysts to disrupt the strong N {triple_bond} N bond in N{sub 2} and create new, fundamental chemical linkages for the construction of molecules with application as fuels, fertilizers and fine chemicals. With DOE support, our group has discovered a mild method for ammonia synthesis in solution as well as new methods for the construction of nitrogen-carbon bonds directly from N{sub 2}. Ideally these achievements will evolve into more efficient nitrogen fixation schemes that circumvent the high energy demands of industrial ammonia synthesis. Industrially, atmospheric nitrogen enters the synthetic cycle by the well-established Haber-Bosch process whereby N{sub 2} is hydrogenated to ammonia at high temperature and pressure. The commercialization of this reaction represents one of the greatest technological achievements of the 20th century as Haber-Bosch ammonia is responsible for supporting approximately 50% of the world's population and serves as the source of half of the nitrogen in the human body. The extreme reaction conditions required for an economical process have significant energy consequences, consuming 1% of the world's energy supply mostly in the form of pollution-intensive coal. Moreover, industrial H{sub 2} synthesis via the water gas shift reaction and the steam reforming of methane is fossil fuel intensive and produces CO{sub 2} as a byproduct. New synthetic methods that promote this thermodynamically favored transformation ({Delta}G{sup o} = -4.1 kcal/mol) under milder conditions or completely obviate it are therefore desirable. Most nitrogen-containing organic molecules are derived from ammonia (and hence rely on the Haber-Bosch and H{sub 2} synthesis processes) and direct synthesis from

  19. A new treatment for avulsion fracture of the calcaneus using an Ilizarov external fixator.

    Science.gov (United States)

    Takahashi, Masayasu; Noda, Mitsuaki; Saegusa, Yasuhiro

    2013-11-01

    In the treatment of avulsion fractures of the posterior calcaneal tuberosity, open reduction and internal fixation are prone to several complications. We describe a new treatment using an Ilizarov external fixator, which can minimise the complications and achieve sufficient stability of the displaced fragment. A 55-year-old woman sustained an avulsion fracture of the calcaneus. Examination revealed the development of bruising with extremely taut skin over the posterior prominence of the displaced bone. Radiographs demonstrated grossly proximal displacement of the tuberosity fragment. Surgery was exclusively percutaneous using an Ilizarov external fixator. The displaced fragment was adequately reduced and stabilised. Progressive weight bearing in the equinus position was initiated at the third week after surgery and the external fixator was removed at the seventh week. There was no skin necrosis or loss of reduction while the fixator was maintained. Postoperative follow-up for 2 years revealed full recovery. Major postoperative complications after conventional open reduction and internal fixation include skin necrosis, skin irritation by metal implants and re-displacement of the reduced fragment. Our method of using an external fixator may decrease the incidence of these three complications. Skin incision and the risk of skin necrosis are inevitable during internal fixation. On the other hand, the use of an external fixator reduces or eliminates skin necrosis, as it is applied percutaneously for reduction and stabilisation of the fragment. External fixation is mostly recommended in cases of poor vascularity or bruising. In addition, skin irritation can be avoided upon removal of the external fixator. Re-displacement occurs occasionally as a serious complication in lag screw fixation, particularly in cases with poor purchase of the osteoporotic bone. Tension band wiring and application of an Ilizarov external fixator in avulsion fractures of the calcaneus can

  20. Distal fingertip replantation without skeletal fixation.

    Science.gov (United States)

    Sabapathy, S Raja; Venkatramani, Hari; Bharathi, R Ravindra; Sebastin, Sandeep J

    2005-01-01

    The replantation of fingertip amputation (through the nail bed) requires repair of the artery and vein on the palmar side. These structures are present in different planes, with the artery being deeper and the veins superficial. The authors believe that vascular repair in such cases is facilitated by stabilization of the amputated part by nail-bed repair alone. This provides a certain degree of flexibility, which allows for easier placement of clamps in the limited space available. Although Kirschner wires were not used for bony fixation, bony union was achieved in all five cases in which this technique was used.

  1. The use of computers for the registration, presentation and analysis of operation data and for the improvement of internal communication

    International Nuclear Information System (INIS)

    Lamarre, J.C.; Depigny-Huet, C.; Ghertman, F.

    1988-01-01

    Internal communication is discussed. It is shown that its improvement leads to a quality improvement throughout the whole company. Communication improvement is possible through the employment of computers; the organization of security rounds is given as an example

  2. Endovascular treatment of a ruptured internal mammary artery pseudoaneurysm presenting as massive hemothorax in a patient with type I neurofibromatosis

    International Nuclear Information System (INIS)

    Yeh, Dae Wook; Kim, Soo Jin; Kim, Chang Won; Kim, Suk; Lee, Tae Hong; Moon, Tae Yong; Chung, Sung Woon

    2005-01-01

    We report a case of an acute hemothorax caused by a rupture of a left internal mammary artery pseudoaneurysm in a 45-year-old woman with a type I neurofibromatosis, which was successfully treated using endovascular coil embolization

  3. Endovascular treatment of a ruptured internal mammary artery pseudoaneurysm presenting as massive hemothorax in a patient with type I neurofibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, Dae Wook; Kim, Soo Jin; Kim, Chang Won; Kim, Suk; Lee, Tae Hong; Moon, Tae Yong; Chung, Sung Woon [Pusan National University Hospital, Pusan (Korea, Republic of)

    2005-07-15

    We report a case of an acute hemothorax caused by a rupture of a left internal mammary artery pseudoaneurysm in a 45-year-old woman with a type I neurofibromatosis, which was successfully treated using endovascular coil embolization.

  4. 7th International Topical Meeting on High Temperature Reactor Technology: The modular HTR is advancing towards reality. Papers and Presentations

    International Nuclear Information System (INIS)

    2014-01-01

    HTR2014 aimed at providing an international platform for researchers, engineers and industrial professionals to share their innovative ideas, valuable experience and recent progresses on high temperature gas-cooled reactor (HTR) and its application technologies.

  5. Abstracts presented at the International Society of Addiction Medicine (ISAM) 19th Annual Meeting, Abu Dhabi, United Arab Emirates, October 2017.

    Science.gov (United States)

    Gordon, Adam J

    2018-01-02

    The 19th Annual Meeting of the International Society of Addiction Medicine (ISAM) was held in Abu Dhabi, United Arab Emirates, in October 2017. Contained in this paper are the abstracts of scientific work presented at the conference.

  6. [Biomechanical study on the posterior screw fixation in the lower cervical spine].

    Science.gov (United States)

    Lin, Hua-jie; Xu, Rong-min; Liu, Guan-yi

    2011-06-01

    So far, the fixation in the lower cervical spine through posterior approach technology has commonly been used, besides the lateral screw and pedicle screw techniques, transarticular screw and laminar screw techniques have being paid more attention recently. This article introduced four screw fixation ways in the lower cervical spine through posterior approach and reviewed the recent biomechanics studies of four screw fixation techniques. The biomechanics study includes stabilization, pollout strength, insertion technique, and screw characteristic and so on. Lateral screw and pedicle screw techniques have become an effective internal fixation way for the lower cervical spine instability because of their superior stabilization and higher pollout strength. Transarticular screw fixation has become a new way to fix the lower cervical spine through posterior approach, which has widely surgical indications. Besides, this technique is relatively safe, simple and has achieved favorable curative effect in clinic. Laminar screw fixation technique is rarely used in clinic, but the study of anatomy and biomechanics confirmed that this technique can be applied as a salvage technique in clinic. Above four techniques of the screw fixation in the lower cervical spine through posterior approach have advantages and disadvantages, respectively, and the application in clinic is different. Through the biomechanics study of these techniques will contribute to the development of the techniques of the screw fixation in the lower cervical spine through posterior approach and guide the clinical work effectively.

  7. A Comparison of Screw Fixation and Suture-Button Fixation in a Syndesmosis Injury in an Ankle Fracture.

    Science.gov (United States)

    Kim, Jung-Han; Gwak, Heui-Chul; Lee, Chang-Rack; Choo, Hye-Jeung; Kim, Jeon-Gyo; Kim, Dae-Yoo

    2016-01-01

    The present study compared the quality of reduction and the clinical assessment between screw fixation and suture-button fixation with an ankle fracture accompanied by syndesmosis injury. We studied the clinical and radiologic findings 1 year postoperatively through retrospective examination of 24 patients who had undergone screw fixation from January 2011 to December 2012 and prospective examination of 20 patients who had undergone suture button fixation from January 2013 to May 2014. Regarding the tibiofibular clear space, tibiofibular overlap, and medial clear space, the screw fixation group had improvement from a preoperative mean of 6.97 (range 2.79 to 15.81) mm, 4.43 (range 0 to 7.87) mm, 7.90 (range 4.24 to 19.50) mm to a postoperative mean of 4.95 (range 2.72 to 9.08) mm, 6.29 (range 0 to 10.37) mm, and 4.32 (range 1.98 to 6.57) mm, respectively. The corresponding improvement for the suture-button fixation group was from a preoperative mean of 6.65 (range 3.94 to 13.73) mm, 5.39 (range 0 to 9.44) mm, 7.27 (range 4.04 to 16.00) mm to a postoperative mean of 5.15 (range 2.93 to 7.30) mm, 7.21 (range 2.15 to 10.30) mm, and 4.25 (range 2.97 to 5.71) mm. No statistically significant difference was found between the 2 techniques. Both suture-button and metal screw fixation are effective treatment methods for an ankle fracture accompanied by syndesmosis injury. However, a long-term and prospective analysis is needed. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. A Baltic bio-bibliography - international lawyers of the Baltic region, past and present / Peter Macalister-Smith

    Index Scriptorium Estoniae

    Macalister-Smith, Peter

    2005-01-01

    Eestist: Küllike Jürimäe (s. 1962, Euroopa Ühenduste Kohtu esimese astme kohtu kohtunik alates 12. maist 2004) ; Uno Lõhmus (s. 1952, Euroopa Kohtu kohtunik alates 11. maist 2004) ; Rait Maruste (s. 1953, Euroopa Inimõiguste Kohtu kohtunik) ; Rein Müllerson (s. 1944, Institut de droit international liige, valiti aastal 1995) ; Ants Piip (1884-1942, rahvusvahelise õiguse uurija) ; Kaarel Robert Pusta (1883-1964, Institut de droit international liige, valiti aastal 1932) ; Otto Strandman (1875-1941, Permanent Court of International Justice - kohtunik 1938, 1939) ; Henn-Jüri Uibopuu (s. 1929, rahvusvahelise õiguse uurija) ; Abner T. Uustal (1915-1985, rahvusvahelise õiguse uurija). Lisatud: A note on F. F. Martens (1845-1909), lk. 159-164 (Friedrich Frommhold Martens, Frederic de Martens, Fjodor Fjodorovitsh Martens)

  9. Scleral Fixation of a One-Piece Toric Intraocular lens

    Science.gov (United States)

    Emanuel, Matthew E.; Randleman, J. Bradley; Masket, Samuel

    2013-01-01

    Purpose To describe a novel technique for toric intraocular lens (IOL) repositioning and fixation in the absence of adequate capsular support Methods Case report and literature review Results Two cases are presented with scleral fixation of a one-piece toric IOL (SN6AT series, Alcon Inc.) In both cases, toric IOLs initially placed within the capsular bag became decentered due to poor capsular support and/or posterior capsule rupture. To avoid the potential complications of lens explantation and maintain the astigmatic benefits of the toric IOL, scleral fixation of the lenses was performed. The Hoffman technique was used to create reverse scleral pockets without conjunctival dissection. A 10-0 suture was used to capture and then secure the lens haptics in a lasso-type fashion. Sutures were then buried within the previously created scleral pockets. Both patients had well centered lenses postoperatively and have remained stable at last follow-up, up to thirty months postoperatively. Conclusion In the absence of adequate capsular support, scleral fixation is a viable option for one-piece toric IOL fixation to avoid IOL explanation PMID:23380416

  10. Plate fixation of paediatric fractures of the distal tibia and fibula.

    Science.gov (United States)

    He, Bingshu; Wang, Jun

    2012-10-01

    The role of surgery in the management of paediatric long-bone shaft fractures remains a matter of debate. We present a series of paediatric patients with unstable fractures of the distal tibia and fibula, treated with titanium plate fixation. Excellent results were obtained after plate fixation.

  11. The role of eye fixation in memory enhancement under stress - An eye tracking study.

    Science.gov (United States)

    Herten, Nadja; Otto, Tobias; Wolf, Oliver T

    2017-04-01

    In a stressful situation, attention is shifted to potentially relevant stimuli. Recent studies from our laboratory revealed that participants stressed perform superior in a recognition task involving objects of the stressful episode. In order to characterize the role of a stress induced alteration in visual exploration, the present study investigated whether participants experiencing a laboratory social stress situation differ in their fixation from participants of a control group. Further, we aimed at shedding light on the relation of fixation behaviour with obtained memory measures. We randomly assigned 32 male and 31 female participants to a control or a stress condition consisting of the Trier Social Stress Test (TSST), a public speaking paradigm causing social evaluative threat. In an established 'friendly' control condition (f-TSST) participants talk to a friendly committee. During both conditions, the committee members used ten office items (central objects) while another ten objects were present without being used (peripheral objects). Participants wore eye tracking glasses recording their fixations. On the next day, participants performed free recall and recognition tasks involving the objects present the day before. Stressed participants showed enhanced memory for central objects, accompanied by longer fixation times and larger fixation amounts on these objects. Contrasting this, fixation towards the committee faces showed the reversed pattern; here, control participants exhibited longer fixations. Fixation indices and memory measures were, however, not correlated with each other. Psychosocial stress is associated with altered fixation behaviour. Longer fixation on objects related to the stressful situation may reflect enhanced encoding, whereas diminished face fixation suggests gaze avoidance of aversive, socially threatening stimuli. Modified visual exploration should be considered in future stress research, in particular when focussing on memory for a

  12. The CSNI International Standard Problem Programme: Overall Presentation on Objectives; Rationale and Lessons Learnt: a Joint Venture of the Thermalhydraulic International Community

    International Nuclear Information System (INIS)

    Reocreux, M.

    2008-01-01

    The CSNI International Standard Problems have been one of the key activities of the CSNI thermal hydraulics groups during the last 25 years. After recalling the way the international standard problems were initiated in the late 1970 years -they were called at that time CSNI LOCA Standard Problem- the process which has led to make from the ISPs a full CSNI activity, is described. Rules have been defined which formalized the way experimental results were provided and the way the comparison exercise were performed. The long series of ISPs from 1975 up to nowadays is described, explaining the different trends in the ISPs choices. The findings which have been obtained are reviewed on both technical and programmatic aspects.

  13. Displaced avulsion fractures of the posterior cruciate ligament: Treated by stellate steel plate fixation.

    Science.gov (United States)

    Li, Lijun; Tian, Wei

    2015-01-01

    The open reduction with internal fixation is an effective approach for treatment of avulsion fracture of posterior cruciate ligament. The previously used internal fixation materials including hollow screws, absorbable screw, tension bands and sutures have great defects such as insufficient fixation strength, susceptibility to re-fracture, etc. Stellate steel plate is novel material for internal fixation which has unique gear-like structure design. We used stellate steel plate for treatment of displaced avulsion fractures of posterior cruciate ligament in this study. 14 patients (9 men, 5 women; aged, 19-35 years; mean age, 28 years) with displaced avulsion fractures of the tibial insertion of the posterior cruciate ligament were retrospectively analyzed between June 2009 and June 2011. The mean duration from injury to the operation was 8.3 days (range 6-15 days). All the patients were treated with open reduction and internal fixation of a stellate steel plate (DePuy, Raynham, MA 02767, USA). The Lysholm-Tegner knee function score criteria were used to analyze results. The mean followup was 24.6 months (range 18-32 months). After 6 months, all the fractures healed and knee joint activity was normal, with no knee stiffness or instability. The Lysholm-Tegner scores were 97.1 ± 1.7 points at the final followup. Owing to its unique gear structure, the stellate steel plate design can effectively fix an avulsion fracture block and it is a simple operation with short postoperative rehabilitation time and firm fixation.

  14. Phase-Contrast Hounsfield Units of Fixated and Non-Fixated Soft-Tissue Samples.

    Directory of Open Access Journals (Sweden)

    Marian Willner

    Full Text Available X-ray phase-contrast imaging is a novel technology that achieves high soft-tissue contrast. Although its clinical impact is still under investigation, the technique may potentially improve clinical diagnostics. In conventional attenuation-based X-ray computed tomography, radiological diagnostics are quantified by Hounsfield units. Corresponding Hounsfield units for phase-contrast imaging have been recently introduced, enabling a setup-independent comparison and standardized interpretation of imaging results. Thus far, the experimental values of few tissue types have been reported; these values have been determined from fixated tissue samples. This study presents phase-contrast Hounsfield units for various types of non-fixated human soft tissues. A large variety of tissue specimens ranging from adipose, muscle and connective tissues to liver, kidney and pancreas tissues were imaged by a grating interferometer with a rotating-anode X-ray tube and a photon-counting detector. Furthermore, we investigated the effects of formalin fixation on the quantitative phase-contrast imaging results.

  15. Smaller Fixation Target Size Is Associated with More Stable Fixation and Less Variance in Threshold Sensitivity.

    Directory of Open Access Journals (Sweden)

    Kazunori Hirasawa

    Full Text Available The aims of this randomized observational case control study were to quantify fixation behavior during standard automated perimetry (SAP with different fixation targets and to evaluate the relationship between fixation behavior and threshold variability at each test point in healthy young participants experienced with perimetry. SAP was performed on the right eyes of 29 participants using the Octopus 900 perimeter, program 32, dynamic strategy. The fixation targets of Point, Cross, and Ring were used for SAP. Fixation behavior was recorded using a wearable eye-tracking glass. All participants underwent SAP twice with each fixation target in a random fashion. Fixation behavior was quantified by calculating the bivariate contour ellipse area (BCEA and the frequency of deviation from the fixation target. The BCEAs (deg2 of Point, Cross, and Ring targets were 1.11, 1.46, and 2.02, respectively. In all cases, BCEA increased significantly with increasing fixation target size (p < 0.05. The logarithmic value of BCEA demonstrated the same tendency (p < 0.05. A positive correlation was identified between fixation behavior and threshold variability for the Point and Cross targets (ρ = 0.413-0.534, p < 0.05. Fixation behavior increased with increasing fixation target size. Moreover, a larger fixation behavior tended to be associated with a higher threshold variability. A small fixation target is recommended during the visual field test.

  16. Workshops of the Sixth International Brain–Computer Interface Meeting : brain–computer interfaces past, present, and future

    NARCIS (Netherlands)

    Huggins, Jane E.; Guger, Christoph; Ziat, Mounia; Zander, Thorsten O.; Taylor, Denise; Tangermann, Michael; Soria-Frisch, Aureli; Simeral, John; Scherer, Reinhold; Rupp, Rüdiger; Ruffini, Giulio; Robinson, Douglas K.R.; Ramsey, Nick F.; Nijholt, Anton; Müller-Putz, Gernot R.; McFarland, Dennis J.; Mattia, Donatella; Lance, Brent J.; Kindermans, Pieter-Jan; Iturrate, Iñaki; Herff, Christian; Gupta, Disha; Do, An H.; Collinger, Jennifer L.; Chavarriaga, Ricardo; Chasey, Steven M.; Bleichner, Martin G.; Batista, Aaron; Anderson, Charles W.; Aarnoutse, Erik J.

    2017-01-01

    The Sixth International Brain–Computer Interface (BCI) Meeting was held 30 May–3 June 2016 at the Asilomar Conference Grounds, Pacific Grove, California, USA. The conference included 28 workshops covering topics in BCI and brain–machine interface research. Topics included BCI for specific

  17. Potential for nitrogen fixation in fungus-growing termite symbiosis

    DEFF Research Database (Denmark)

    Sapountzis, Panagiotis; de Verges, Jane; Rousk, Kathrin

    2016-01-01

    Termites host a gut microbiota of diverse and essential symbionts that enable specialization on dead plant material; an abundant, but nutritionally imbalanced food source. To supplement the severe shortage of dietary nitrogen (N), some termite species make use of diazotrophic bacteria to fix...... atmospheric nitrogen (N2). Fungus-growing termites (subfamily Macrotermitinae) host a fungal exosymbiont (genus Termitomyces) that provides digestive services and the main food source for the termites. This has been thought to obviate the need for N2-fixation by bacterial symbionts. Here, we challenge...... this notion by performing acetylene reduction assays of live colony material to show that N2 fixation is present in two major genera (Macrotermes and Odontotermes) of fungus-growing termites. We compare and discuss fixation rates in relation to those obtained from other termites, and suggest avenues...

  18. How Life History Can Sway the Fixation Probability of Mutants

    Science.gov (United States)

    Li, Xiang-Yi; Kurokawa, Shun; Giaimo, Stefano; Traulsen, Arne

    2016-01-01

    In this work, we study the effects of demographic structure on evolutionary dynamics when selection acts on reproduction, survival, or both. In contrast to the previously discovered pattern that the fixation probability of a neutral mutant decreases while the population becomes younger, we show that a mutant with a constant selective advantage may have a maximum or a minimum of the fixation probability in populations with an intermediate fraction of young individuals. This highlights the importance of life history and demographic structure in studying evolutionary dynamics. We also illustrate the fundamental differences between selection on reproduction and selection on survival when age structure is present. In addition, we evaluate the relative importance of size and structure of the population in determining the fixation probability of the mutant. Our work lays the foundation for also studying density- and frequency-dependent effects in populations when demographic structures cannot be neglected. PMID:27129737

  19. Abnormal Fixational Eye Movements in Amblyopia.

    Science.gov (United States)

    Shaikh, Aasef G; Otero-Millan, Jorge; Kumar, Priyanka; Ghasia, Fatema F

    2016-01-01

    Fixational saccades shift the foveal image to counteract visual fading related to neural adaptation. Drifts are slow eye movements between two adjacent fixational saccades. We quantified fixational saccades and asked whether their changes could be attributed to pathologic drifts seen in amblyopia, one of the most common causes of blindness in childhood. Thirty-six pediatric subjects with varying severity of amblyopia and eleven healthy age-matched controls held their gaze on a visual target. Eye movements were measured with high-resolution video-oculography during fellow eye-viewing and amblyopic eye-viewing conditions. Fixational saccades and drifts were analyzed in the amblyopic and fellow eye and compared with controls. We found an increase in the amplitude with decreased frequency of fixational saccades in children with amblyopia. These alterations in fixational eye movements correlated with the severity of their amblyopia. There was also an increase in eye position variance during drifts in amblyopes. There was no correlation between the eye position variance or the eye velocity during ocular drifts and the amplitude of subsequent fixational saccade. Our findings suggest that abnormalities in fixational saccades in amblyopia are independent of the ocular drift. This investigation of amblyopia in pediatric age group quantitatively characterizes the fixation instability. Impaired properties of fixational saccades could be the consequence of abnormal processing and reorganization of the visual system in amblyopia. Paucity in the visual feedback during amblyopic eye-viewing condition can attribute to the increased eye position variance and drift velocity.

  20. Abnormal fixational eye movements in strabismus.

    Science.gov (United States)

    Ghasia, Fatema F; Otero-Millan, Jorge; Shaikh, Aasef G

    2018-02-01

    Fixational saccades are miniature eye movements that constantly change the gaze during attempted visual fixation. Visually guided saccades and fixational saccades represent an oculomotor continuum and are produced by common neural machinery. Patients with strabismus have disconjugate binocular horizontal saccades. We examined the stability and variability of eye position during fixation in patients with strabismus and correlated the severity of fixational instability with strabismus angle and binocular vision. Eye movements were measured in 13 patients with strabismus and 16 controls during fixation and visually guided saccades under monocular viewing conditions. Fixational saccades and intersaccadic drifts were analysed in the viewing and non-viewing eye of patients with strabismus and controls. We found an increase in fixational instability in patients with strabismus compared with controls. We also found an increase in the disconjugacy of fixational saccades and intrasaccadic ocular drift in patients with strabismus compared with controls. The disconjugacy was worse in patients with large-angle strabismus and absent stereopsis. There was an increase in eye position variance during drifts in patients with strabismus. Our findings suggest that both fixational saccades and intersaccadic drifts are abnormal and likely contribute to the fixational instability in patients with strabismus. Fixational instability could be a useful tool for mass screenings of children to diagnose strabismus in the absence of amblyopia and latent nystagmus. The increased disconjugacy of fixational eye movements and visually guided saccades in patients with strabismus reflects the disruption of the fine-tuning of the motor and visual systems responsible for achieving binocular fusion in these patients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. The Jules Horowitz Reactor - A new High Performance European Material Testing Reactor open to International Users Present Status and Objectives

    International Nuclear Information System (INIS)

    Iracane, Daniel; Bignan, Gilles; Lindbaeck, Jan-Erik; Blomgren, Jan

    2010-01-01

    The development of sustainable nuclear energy requires R and D on fuel and material behaviour under irradiation with a high level of performance in order to meet the needs and challenges for the benefit of industry, research and public bodies. These stakes require a sustainable and secured access to an up-to-date high performance Material Testing Reactor. Following a broad survey within the European Research Area, the international community agreed that the need for Material Test Reactors in support of nuclear power plant safety and operation will continue in the context of sustainable nuclear energy. The Jules Horowitz Reactor project (JHR) copes with this context. JHR is designed as a user facility addressing the needs of the international community. This means: - flexibility with irradiation loops able to reproduce a large variation in operation conditions of different power reactor technologies, - high flux capacity to address Generations II, III, and IV needs. JHR is designed, built and operated as an international user facility because: - Given the maturity and globalization of the industry, domestic tools have no more the required level of economic and technical efficiency. Meanwhile, countries with nuclear energy need an access to high performance irradiation experimental capabilities to support technical skill and guarantee the competitiveness and safety of nuclear energy. - Many research items related to safety or public policy (waste management, etc.) require international cooperation to share costs and benefits of resulting consensus. JHR design is optimised for offering high performance material and fuel irradiation capability for the coming decades. This project is driven and funded by an international consortium gathering vendors, utilities and public stakeholders. This consortium has been set up in March 2007 when the construction began. The construction is in progress and the start of operation is scheduled for 2014. The JHR is a research

  2. The Jules Horowitz Reactor - A new High Performance European Material Testing Reactor open to International Users Present Status and Objectives

    Energy Technology Data Exchange (ETDEWEB)

    Iracane, Daniel; Bignan, Gilles [CEA Atomic Energy Commission Saclay Batiment 121- 91191 Gif Sur Yvette (France); Lindbaeck, Jan-Erik; Blomgren, Jan [VATTENFALL AB Nuclear Power Jaemtlandsgatan 99 SE-16287 Stockholm (Sweden)

    2010-07-01

    The development of sustainable nuclear energy requires R and D on fuel and material behaviour under irradiation with a high level of performance in order to meet the needs and challenges for the benefit of industry, research and public bodies. These stakes require a sustainable and secured access to an up-to-date high performance Material Testing Reactor. Following a broad survey within the European Research Area, the international community agreed that the need for Material Test Reactors in support of nuclear power plant safety and operation will continue in the context of sustainable nuclear energy. The Jules Horowitz Reactor project (JHR) copes with this context. JHR is designed as a user facility addressing the needs of the international community. This means: - flexibility with irradiation loops able to reproduce a large variation in operation conditions of different power reactor technologies, - high flux capacity to address Generations II, III, and IV needs. JHR is designed, built and operated as an international user facility because: - Given the maturity and globalization of the industry, domestic tools have no more the required level of economic and technical efficiency. Meanwhile, countries with nuclear energy need an access to high performance irradiation experimental capabilities to support technical skill and guarantee the competitiveness and safety of nuclear energy. - Many research items related to safety or public policy (waste management, etc.) require international cooperation to share costs and benefits of resulting consensus. JHR design is optimised for offering high performance material and fuel irradiation capability for the coming decades. This project is driven and funded by an international consortium gathering vendors, utilities and public stakeholders. This consortium has been set up in March 2007 when the construction began. The construction is in progress and the start of operation is scheduled for 2014. The JHR is a research

  3. Nitrogen fixation and nitrogenase activity of Azotobacter chroococcum

    NARCIS (Netherlands)

    Brotonegoro, S.

    1974-01-01

    The purpose of the present investigation was to study the effect of some chemical, physical and biological factors on growth, efficiency of nitrogen fixation and nitrogenase activity of Azotobacter chroococcum.

    From biochemical studies with cell-free

  4. Influence of Target Parameters on Fixation Stability in Normal and Strabismic Monkeys.

    Science.gov (United States)

    Pirdankar, Onkar H; Das, Vallabh E

    2016-03-01

    The purpose of this study was to assess the effect of fixation target parameters on fixation instability in strabismic monkeys. One normal and three exotropic monkeys were presented with four differently shaped fixation targets, with three diameters, during monocular or binocular viewing. Fixation targets were white on a black background or vice versa. Binocular eye movements were recorded using the magnetic search coil technique and fixation stability quantified by calculating the bivariate contour ellipse area (BCEA). Fixation instability was greater in all the strabismic monkeys compared with the normal monkey. During monocular viewing, strabismic monkeys showed significantly greater instability in the covered eye compared to the fixating eye. Multifactorial ANOVA suggested statistically significant target parameter influences, although effect sizes were small. Thus, a disk-shaped target resulted in greater instability than other target shapes in the viewing eyes of the normal monkey and two of three strabismic monkeys. A similar target-shape effect was also observed in the covered eye. Least instability was elicited with a 0.5° target in the normal monkey and a 1.0° target in the strabismic monkeys, both in the viewing and the covered eye. Target/background polarity effects were idiosyncratic. In strabismic monkeys, stability of the fixating eye during binocular viewing was not different from the stability of the same eye during monocular viewing. Abnormal drifts and nystagmus contribute to increased fixation instability in strabismic monkeys. Target parameters (shape and size) that influence fixation stability in a normal animal also affected fixation stability in our sample of strabismic monkeys.

  5. Information report presented by the Commission of European Affairs about the international negotiations relative to climate change - No. 2391

    International Nuclear Information System (INIS)

    Deflesselles, Bernard; Lambert, Jerome; Leroy, Arnaud

    2014-01-01

    The conclusion put forward by scientists is clear-cut and alarming: the current efforts to limit the increase in global temperature to 2 deg. C are insufficient. This was the aim which the international community set itself in order to avoid the catastrophic effect of climate change. In their fifth report, the experts of the IPCC recommend the limitation, before the end of the century, of the concentration of greenhouse gases in the atmosphere, to 450 parts per million. This level is equivalent, according to the scientists, to a rise in global temperature of 2 deg. C and would imply a reduction of between 40 % and 70 % of global emissions between now and 2050 and would envisage decreasing them to an 'almost zero level' before the end of the century. The last Conference of the United Nations on Climate Change which was held in Warsaw at the end of 2013 (COP19) was a 'stepping-stone' conference according to the very words of its participants. In order to remain on track concerning the global agreement on climate for 2015, two types of decision were taken there: - the notion of bringing nations together in the framework of a global initiative aiming to reduce emissions quite quickly so as to allow humanity to avoid, in the long term, the dangerous threshold concerning climate change, whilst, at the same time, strengthening the capabilities for adaptation; - the idea of moving so as to speed up and bolster the current plan of action. The Warsaw Conference managed to chart the way towards the Paris Conference on Climate in 2015 during which a new world agreement on climate should be signed. However, it also showed that the road will be long and difficult. Basic questions remain unanswered and require a high level of political commitment. The negotiations on climate change of the 20. Climate Change Conference or COP, will take place in Lima between December 1 - 12, 2014. The Conference will thus be the last within the United Nations Framework Convention on Climate Change

  6. The United Nations Population Fund and Planned Parenthood proudly present the International Conference on Population and Development.

    Science.gov (United States)

    Corey, W

    1994-01-01

    The 1994 International Conference on Population and Development (ICPD) was orchestrated and largely controlled by such pro-choice groups as the UN Population Fund, Planned Parenthood, and radical American feminists. Efforts to promote abortion in parts of the world where it is illegal were couched in such terms as "safe motherhood" and "reproductive health." These efforts failed, however, with inclusion of the clause stating that abortion shall not be promoted as a means of family planning. However, the seeds of abortion, in the form of unnatural contraception, continue to be spread throughout the world. On the other hand, in the nongovernmental organization forum, which ran concurrently with the ICPD, pro-life organizations attracted a great deal of attention at the International Right to Life Federation booth. A workshop on natural family planning was attended by only a few people, but interest was high and the attendees followed-up by requesting more information during the Forum. A press conference held by Catholics for a Free Choice backfired because the mostly Moslem audience left angry at the women's apparent lack of obedience to the Pope. Other American feminists were confronted with the sight of women from the Third World picketing the conference with signs like "2 cars for every family in the North; one child for every family in the South." The pro-choice activists succeeded in bolstering the esteem of the Pope by making it evident that he is carrying the burden of family values almost singlehandedly.

  7. The Jules Horowitz reactor, a new high performance European material testing reactor open to international users: present status and objectives

    International Nuclear Information System (INIS)

    Iracane, D.; Bignan, G.

    2010-01-01

    The development of nuclear power as a sustainable and competitive energy source will continue to require research and development of fuel and material behaviour under irradiation. This necessitates a high performance material testing reactor (MTR). Facing the obsolescence of most of the existing MTR in Europe, France decided a few years ago the construction of the RJH (Jules Horowitz reactor). RJH is designed, built and will be operated as an international user facility. A first set of experimental hosting devices is being designed. For instance, there are the in-core CALIPSO Nak integrated loop for material studies and other loops for fuel studies under nominal or off-normal or accidental conditions. The RJH international program will focus on the following subjects: -) fuel reliability, assessed through power ramps tests and post-irradiation examination; -) Loss of coolant tests done out-of-pile in a first phase and in-pile in a possible second phase; and -) source term tests addressing fission products release. The paper reports also the point of view of VATTENFALL (a Swedish power utility), as a potential European RJH user. (A.C.)

  8. Papers presented at the IAEA specialists' meeting on the development of an international nuclear decay data and cross-section database

    International Nuclear Information System (INIS)

    Lemmel, H.D.

    1994-12-01

    The present report contains 20 papers presented at the IAEA meeting on the Development of an International Nuclear Decay Data and Cross-Section Database, Vienna, 24-28 October 1994, covering the following topics: Wall-charts of nuclides, PC systems presenting nuclear data, nuclear decay-data and uncertainties, nuclear spectroscopy, thermal neutron cross-sections and resonance-integrals, reactor-neutron activation analysis, nuclear data standards. (author). Refs, figs and tabs

  9. International conference on fast reactors and related fuel cycles (FR09): Challenges and opportunities. CN-176 presentations

    International Nuclear Information System (INIS)

    2009-01-01

    Renewed interest in nuclear energy is driven by the need to develop carbon free energy sources, by demographics and development in emerging economies, as well as by security of supply concerns. It is expected that nuclear energy will deliver huge amounts of energy to both emerging and developed economies. However, acceptance of large scale contributions would depend on satisfaction of key drivers to enhance sustainability in terms of economics, safety, adequacy of natural resources, waste reduction, non-proliferation and public acceptance. Fast spectrum reactors with recycle enhance the sustainability indices significantly. This has led to the focus on fast spectrum reactors with recycle in the Generation IV International Forum (GIF) and the International Project on Innovative Nuclear Reactors and Fuel Cycles (INPRO) initiative of the IAEA. It is expected that 2009 will register major events in the domain of fast spectrum reactors, that is, the restart of Monju in Japan, the first criticality of the China Experimental Fast Reactor in China, as well as new insights through end-of-life studies in Phenix, France. New fast reactors are expected to be commissioned in the near future: the 500 MW(e) Prototype Fast Breeder Reactor in India and the BN-800 unit in the Russian Federation. Moreover, China, France, India, Japan, Republic of Korea and the United States of America are preparing advanced prototypes/ demonstrations and/or commercial reactors for the 2020-2030 horizon. The necessary condition for successful fast reactor deployment in the near and mid-term is the understanding and assessment of innovative technological and design options, based on both past knowledge and experience, as well as on ongoing research and technology development efforts. In this respect, the need for in-depth international information exchange is underscored by the fact that the last large international fast reactor conference was held as far back as 1991. Since then, progress in research

  10. Nitrogen fixation method and apparatus

    Science.gov (United States)

    Chen, H.L.

    1983-08-16

    A method and apparatus for achieving nitrogen fixation includes a volumetric electric discharge chamber. The volumetric discharge chamber provides an even distribution of an electron beam, and enables the chamber to be maintained at a controlled energy to pressure (E/p) ratio. An E/p ratio of from 5 to 15 kV/atm of O[sub 2]/cm promotes the formation of vibrationally excited N[sub 2]. Atomic oxygen interacts with vibrationally excited N[sub 2] at a much quicker rate than unexcited N[sub 2], greatly improving the rate at which NO is formed. 1 fig.

  11. Percutaneous Fixation of Displaced Calcaneal Fracture

    Directory of Open Access Journals (Sweden)

    Yeung Yip-Kan

    2011-06-01

    Conclusion: Percutaneous fixation of displaced tongue-type calcaneal fractures is an effective treatment with acceptable clinical outcome, short hospital stay, minimal skin complications, and quick recovery.

  12. International Workshop on Exotic Hadronic Atoms, Deeply Bound Kaonic Nuclear States and Antihydrogen : Present Results, Future Challenges

    CERN Document Server

    Widmann, E; Curceanu, C; Trento 2006; Trento06

    2006-01-01

    These are the miniproceedings of the workshop "Exotic hadronic atoms, deeply bound kaonic nuclear states and antihydrogen: present results, future challenges," which was held at the European Centre for Theoretical Nuclear Physics and Related Studies (ECT*), Trento (Italy), June 19-24, 2006. The document includes a short presentation of the topics, the list of participants, and a short contribution from each speaker.

  13. Nitrogen Fixation in the Intertidal Sediments of the Yangtze Estuary: Occurrence and Environmental Implications

    Science.gov (United States)

    Hou, Lijun; Wang, Rong; Yin, Guoyu; Liu, Min; Zheng, Yanling

    2018-03-01

    Nitrogen fixation is a microbial-mediated process converting atmospheric dinitrogen gas to biologically available ammonia or other molecules, and it plays an important role in regulating nitrogen budgets in coastal marine ecosystems. In this study, nitrogen fixation in the intertidal sediments of the Yangtze Estuary was investigated using nitrogen isotope tracing technique. The abundance of nitrogen fixation functional gene (nifH) was also quantified. The measured rates of sediment nitrogen fixation ranged from 0.37 to 7.91 nmol N g-1 hr-1, while the abundance of nifH gene varied from 2.28 × 106 to 1.28 × 108 copies g-1 in the study area. The benthic nitrogen fixation was correlated closely to the abundance of nifH gene and was affected significantly by salinity, pH, and availability of sediment organic carbon and ammonium. It is estimated that sediment nitrogen fixation contributed approximately 9.3% of the total terrigenous inorganic nitrogen transported annually into the Yangtze estuarine and coastal environment. This result implies that the occurrence of benthic nitrogen fixation acts as an important internal source of reactive nitrogen and to some extent exacerbates nitrogen pollution in this aquatic ecosystem.

  14. Monoaxial external fixation of the calcaneus: An anatomical study assessing the safety of monoaxial pin insertion.

    Science.gov (United States)

    Thomson, Callum M; Esparon, Tom; Rea, Paul M; Jamal, Bilal

    2016-10-01

    The use of external fixation for intra-articular calcaneal fractures is increasing in popularity. Studies have shown fine wire and monoaxial external fixation to be a viable surgical alternative to more invasive methods of open reduction and internal fixation of the calcaneus. However, there is an absence of literature that quantifies the risk of pin insertion for monoaxial fixation. This study aimed to determine the safety of inserting monoaxial pins within the calcaneus to house the Orthofix Calcaneal Mini-Fixator. Five formalin embalmed cadaveric ankle and lower leg specimens were inserted with six monoaxial pins. Careful dissection then revealed the presence of the tendons of peroneus longus and brevis, the sural nerve and the small saphenous vein in relation to these pins. Measurements from each pin to each of these structures were made as the structures transected lines drawn from each pin to two palpable bony landmarks: the inferior tip of the lateral malleolus and the posterosuperior calcaneus. In doing this, the risk posed by each pin could be evaluated. We found that two particular pins, those used to hold the articular surface of the subtalar joint in a reduced position, posed a larger risk of injury to surrounding structures than the remaining pins. These findings therefore suggest that monoaxial fixation of the calcaneus using a six pin approach is a relatively safe method of rectifying calcaneal fractures and thus may serve as a welcome alternative to other methods of calcaneal fixation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Workshops of the Sixth International Brain–Computer Interface Meeting: brain–computer interfaces past, present, and future

    Science.gov (United States)

    Huggins, Jane E.; Guger, Christoph; Ziat, Mounia; Zander, Thorsten O.; Taylor, Denise; Tangermann, Michael; Soria-Frisch, Aureli; Simeral, John; Scherer, Reinhold; Rupp, Rüdiger; Ruffini, Giulio; Robinson, Douglas K. R.; Ramsey, Nick F.; Nijholt, Anton; Müller-Putz, Gernot; McFarland, Dennis J.; Mattia, Donatella; Lance, Brent J.; Kindermans, Pieter-Jan; Iturrate, Iñaki; Herff, Christian; Gupta, Disha; Do, An H.; Collinger, Jennifer L.; Chavarriaga, Ricardo; Chase, Steven M.; Bleichner, Martin G.; Batista, Aaron; Anderson, Charles W.; Aarnoutse, Erik J.

    2017-01-01

    The Sixth International Brain–Computer Interface (BCI) Meeting was held 30 May–3 June 2016 at the Asilomar Conference Grounds, Pacific Grove, California, USA. The conference included 28 workshops covering topics in BCI and brain–machine interface research. Topics included BCI for specific populations or applications, advancing BCI research through use of specific signals or technological advances, and translational and commercial issues to bring both implanted and non-invasive BCIs to market. BCI research is growing and expanding in the breadth of its applications, the depth of knowledge it can produce, and the practical benefit it can provide both for those with physical impairments and the general public. Here we provide summaries of each workshop, illustrating the breadth and depth of BCI research and highlighting important issues and calls for action to support future research and development. PMID:29152523

  16. End-of-life vehicle recycling and international cooperation between Japan, China and Korea: Present and future scenario analysis.

    Science.gov (United States)

    Che, Jia; Yu, Jeong-Soo; Kevin, Roy Serrona

    2011-06-01

    In the area of end-of-life vehicle (ELV) recycling, Japan passed the Automobile Recycling Law in January 2005, the first in Asia. Korea followed suit with the passage of the resource circulation method in 2009. China is expected make a new recycling law in 2011. In contribution to these initiatives, Tohoku University made a comparative analysis of ELV recycling laws, advance dismantling experiments and scenario analysis to promote international cooperation. This is envisioned to introduce ELV recycling system in Japan, China and Korea and in developing countries as well. Copyright © 2011 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.

  17. International Conference on Fast Reactors and Related Fuel Cycles: Safe Technologies and Sustainable Scenarios (FR13). Presentations

    International Nuclear Information System (INIS)

    2013-01-01

    The conference, which was held from 4 to 7 of March 2013 in Paris, provided a forum to exchange information on national and international programmes, and more generally new developments and experience, in the field of fast reactors and related fuel cycle technologies. A first goal was to identify and discuss strategic and technical options that have been proposed by individual countries or companies. Another goal was to promote the development of fast reactors and related fuel cycle technologies in a safe, proliferation resistant and economic way. A third goal was to identify gaps and key issues that need to be addressed in relation to the industrial deployment of fast reactors with a closed fuel cycle. A fourth goal was to engage young scientists and engineers in this field, in particular with sustainability, innovation, simulation, safety, economics and public acceptance

  18. Biomechanical analysis on transverse tibial fixation in anterior cruciate ligament reconstructions

    Directory of Open Access Journals (Sweden)

    Edmar Stieven Filho

    2015-04-01

    Full Text Available OBJECTIVE: To verify whether the combination of tibial cross pin fixation and femoral screw fixation presents biomechanical advantages when compared to femoral cross pin fixation and tibial screw fixation for the reconstruction of the anterior cruciate ligament (ACL.METHODS: Thirty-eight porcine knees and bovine extensor digitorum tendons were used as the graft materials. The tests were performed in three groups: (1 standard, used fourteen knees, and the grafts were fixated with the combination of femoral cross pin and a tibial screw; (2 inverted, used fourteen knees with an inverted combination of tibial cross pin and a femoral screw; (3 control, ten control tests performed with intact ACL. After the grafts fixation, all the knees were subjected to tensile testing to determine yield strength and ultimate strength.RESULTS: There was no statistically significant difference in survival techniques in regard to strength, yield load and tension. There was a higher survival compared in the standard curves of yield stress (p < 0.05.CONCLUSION: There is no biomechanical advantage, observed in animal models testing, in the combination of tibial cross pin fixation and femoral screw when compared to femoral cross pin fixation and tibial screw.

  19. An integer programming model for distal humerus fracture fixation planning.

    Science.gov (United States)

    Maratt, Joseph D; Peaks, Ya-Sin A; Doro, Lisa Case; Karunakar, Madhav A; Hughes, Richard E

    2008-05-01

    To demonstrate the feasibility of an integer programming model to assist in pre-operative planning for open reduction and internal fixation of a distal humerus fracture. We describe an integer programming model based on the objective of maximizing the reward for screws placed while satisfying the requirements for sound internal fixation. The model maximizes the number of bicortical screws placed while avoiding screw collision and favoring screws of greater length that cross multiple fracture planes. The model was tested on three types of total articular fractures of the distal humerus. Solutions were generated using 5, 9, 21 and 33 possible screw orientations per hole. Solutions generated using 33 possible screw orientations per hole and five screw lengths resulted in the most clinically relevant fixation plan and required the calculation of 1,191,975 pairs of screws that resulted in collision. At this level of complexity, the pre-processor took 104 seconds to generate the constraints for the solver, and a solution was generated in under one minute in all three cases. Despite the large size of this problem, it can be solved in a reasonable amount of time, making use of the model practical in pre-surgical planning.

  20. Fixação interna de fratura de epífise proximal de tíbia em potro Internal fixation of the tibial proximal epiphyses fracture in a foal

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Maciel Brunner

    2006-02-01

    Full Text Available A fratura Salter Harris tipo II ocorre comumente na epífise proximal de tíbia em potros e tem reparação difícil mas com o advento das técnicas de fixação interna, o prognóstico tem melhorado. No caso descrito, em um potro da raça árabe de 26 dias de idade, com fratura proximal de tíbia direita tipo Salter Harris II, foram utilizadas as placas de compressão para garantirem estabilização e aproximação dos fragmentos fraturados, porém com risco de ocasionar distúrbios no desenvolvimento esquelético. No caso relatado, através do controle radiológico, não foi evidenciada diminuição da radioluscência na região correspondente à cartilagem de conjugação proximal da tíbia. O artigo tem como objetivo discutir o tratamento empregado que se mostrou como alternativa viável pelo resultado favorável com bons resultados.The most frequent fracture is tibia’s proximal epiphysis in foals is Salter Harris type II although its difficult to repair. The development of the inner fixation technique has been made the prognosis better. The dynamic compression bone plate allow guaranteed reduction and stabilization of the bone’s fragments, but it can promote development disturbs. In this case, by the radiological control, it has not shown less radiolucency in the proximal tibia’s growth plate. The treatment used showed itself as a feasible alternative because of the favourable good results.

  1. COMBINATION OF FIXATION TECHNIQUES IN THE MANAGEMENT OF COMPLEX DISTAL RADIUS FRACTURE- OUR EXPERIENCES

    Directory of Open Access Journals (Sweden)

    Isaac Sunder Sen

    2016-10-01

    Full Text Available BACKGROUND The aim of the study is to categorically suggest the apt method of surgical technique for a particular type of distal radius fracture (Frykman’s type III-VI. Distal radius fracture are among the most common fractures of the upper extremity inspite of increased focus on regular prevention of osteoporosis, early identification and its prompt management. Most distal radius fractures are the result of low energy mechanisms that can be successfully treated either nonoperatively or with a variety of operative techniques if indicated. Complex distal radius fractures occur most commonly in high-energy injuries with extensive comminution or bone loss and associated soft tissue or vascular injuries. These high-energy fractures can present challenges in reconstructing the distal radius. Effective restoration of the bony architecture requires a thorough knowledge of distal radius anatomy, understanding of the goals of treatment, versatility in surgical approaches and familiarity with multiple fixation options. Although, majority of the extra-articular fracture without signs of instability can be successfully managed with POP immobilisation for a period of 4-5 weeks followed by active physiotherapy, other types (Frykman’s III-VI need surgical management that too with combination of surgical techniques namely augmented spanning external fixator with supplemented K-wire fixation or external fixation followed by fragment specific volar locking compression plate osteosynthesis. MATERIALS AND METHODS I have studied 50 cases of distal radius fractures classified using Frykman’s classification using combination of techniques namely augmented spanning external fixator application with K-wire supplementation and spanning external fixator application followed by volar LCP fixation in which external fixator had been used as a reduction tool in majority of the cases and external fixator had been removed after plate osteosynthesis. In some cases retained

  2. Is prophylactic fixation a cost-effective method to prevent a future contralateral fragility hip fracture?

    Science.gov (United States)

    Faucett, Scott C; Genuario, James W; Tosteson, Anna N A; Koval, Kenneth J

    2010-02-01

    : A previous hip fracture more than doubles the risk of a contralateral hip fracture. Pharmacologic and environmental interventions to prevent hip fracture have documented poor compliance. The purpose of this study was to examine the cost-effectiveness of prophylactic fixation of the uninjured hip to prevent contralateral hip fracture. : A Markov state-transition model was used to evaluate the cost and quality-adjusted life-years (QALYs) for unilateral fixation of hip fracture alone (including internal fixation or arthroplasty) compared with unilateral fixation and contralateral prophylactic hip fixation performed at the time of hip fracture or unilateral fixation and bilateral hip pad protection. Prophylactic fixation involved placement of a cephalomedullary nail in the uninjured hip and was initially assumed to have a relative risk of a contralateral fracture of 1%. Health states included good health, surgery-related complications requiring a second operation (infection, osteonecrosis, nonunion, and malunion), fracture of the uninjured hip, and death. The primary outcome measure was the incremental cost-effectiveness ratio estimated as cost per QALY gained in 2006 US dollars with incremental cost-effectiveness ratios below $50,000 per QALY gained considered cost-effective. Sensitivity analyses evaluated the impact of patient age, annual mortality and complication rates, intervention effectiveness, utilities, and costs on the value of prophylactic fixation. : In the baseline analysis, in a 79-year-old woman, prophylactic fixation was not found to be cost-effective (incremental cost-effectiveness ratio = $142,795/QALY). However, prophylactic fixation was found to be a cost-effective method to prevent contralateral hip fracture in: 1) women 71 to 75 years old who had 30% greater relative risk for a contralateral fracture; and 2) women younger than age 70 years. Cost-effectiveness was greater when the additional costs of prophylaxis were less than $6000. However, for

  3. Intramedullary versus extramedullary fixation in the management of subtrochanteric femur fractures: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Liu PC

    2015-04-01

    Full Text Available Pengcheng Liu,1,2,* Xing Wu,1,* Hui Shi,1,2 Run Liu,1 Hexi Shu,1 JinPeng Gong,1 Yong Yang,1 Qi Sun,1 Jiezhou Wu,1,2 Xiaoyang Nie,1 Ming Cai1 1Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai, 2First Clinical Medical College, Nanjing Medical University, Nanjing, People’s Republic of China *These authors contributed equally to this work Background: Intramedullary and extramedullary fixation methods are used in the management of subtrochanteric femur fractures. However, whether intramedullary or extramedullary fixation is the primary treatment for subtrochanteric femur fractures in adults remains debatable.Level of evidence: Meta-analyses of prospective studies, level I.Materials and methods: The Cochrane library, Embase, Google Scholar, and PubMed databases were searched separately for all relevant studies published before January 1, 2015. No language restriction was applied. Prospective randomized controlled trials that compared intramedullary or extramedullary internal fixation to repair subtrochanteric femur fractures in adults were included. We determined intraoperative data, postoperative complications, fracture fixation complications, wound infection, hospital stay days, and final outcome measures to assess the relative effects of different internal fixation methods for the treatment of subtrochanteric femur fractures in adults.Results: Six studies were included in our meta-analysis. The relative risks (RRs of revision rate was 83% lower (RR, 0.17, 95% confidence interval [CI], 0.05 to 0.60; P=0.006, fixation failure rate was 64% lower (RR, 0.36, 95% CI, 0.12 to 1.08; P=0.07, non-union rate was 77% lower (RR, 0.23, 95% CI, 0.07 to 0.81; P=0.02 in the intramedullary group compared with the extramedullary group. No significant differences were found between the intramedullary group and extramedullary group for intraoperative data, postoperative complications, wound infection

  4. PATRAM '92: 10th international symposium on the packaging and transportation of radioactive materials [Papers presented by Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    None

    1992-01-01

    This document provides the papers presented by Sandia Laboratories at PATRAM '92, the tenth International symposium on the Packaging and Transportation of Radioactive Materials held September 13--18, 1992 in Yokohama City, Japan. Individual papers have been cataloged separately. (FL)

  5. Feedstock recycling of plastics. Selected papers presented at the third International Symposium on Feedstock Recycling of Plastics, Karlsruhe, Sept. 25-29, 2005

    OpenAIRE

    Müller-Hagedorn, Matthias; Bockhorn, Henning [Hrsg.

    2005-01-01

    Feedstock Recycling of Plastics gives a survey of actual fundamental and applied research. It consists of selected contributions that were presented during the Third International Symposium on Feedstock Recycling of Plastics & other Innovative Plastics Recycling Techniques in Karlsruhe (Germany), 2005. The following fundamental issues of feedstock recycling are covered: - Pyrolysis or solvolysis - Pyrolysis: Processes - Strategies - Usages - Modelling - Py...

  6. Rhetorical Structure and Linguistic Features of Case Presentations in Case Reports in Taiwanese and International Medical Journals

    Science.gov (United States)

    Hung, Hsuan; Chen, Pi-Ching; Tsai, Jing-Jane

    2012-01-01

    The case presentation is the core section of a medical case report. Issues in the teaching of case report writing have recently been the subject of great interest in medical education, especially in the era of globalization. Given that Taiwanese medical students, residents and junior physicians are requested to write case reports in English and…

  7. In silico insights into the symbiotic nitrogen fixation in Sinorhizobium meliloti via metabolic reconstruction.

    Science.gov (United States)

    Zhao, Hansheng; Li, Mao; Fang, Kechi; Chen, Wenfeng; Wang, Jing

    2012-01-01

    Sinorhizobium meliloti is a soil bacterium, known for its capability to establish symbiotic nitrogen fixation (SNF) with leguminous plants such as alfalfa. S. meliloti 1021 is the most extensively studied strain to understand the mechanism of SNF and further to study the legume-microbe interaction. In order to provide insight into the metabolic characteristics underlying the SNF mechanism of S. meliloti 1021, there is an increasing demand to reconstruct a metabolic network for the stage of SNF in S. meliloti 1021. Through an iterative reconstruction process, a metabolic network during the stage of SNF in S. meliloti 1021 was presented, named as iHZ565, which accounts for 565 genes, 503 internal reactions, and 522 metabolites. Subjected to a novelly defined objective function, the in silico predicted flux distribution was highly consistent with the in vivo evidences reported previously, which proves the robustness of the model. Based on the model, refinement of genome annotation of S. meliloti 1021 was performed and 15 genes were re-annotated properly. There were 19.8% (112) of the 565 metabolic genes included in iHZ565 predicted to be essential for efficient SNF in bacteroids under the in silico microaerobic and nutrient sharing condition. As the first metabolic network during the stage of SNF in S. meliloti 1021, the manually curated model iHZ565 provides an overview of the major metabolic properties of the SNF bioprocess in S. meliloti 1021. The predicted SNF-required essential genes will facilitate understanding of the key functions in SNF and help identify key genes and design experiments for further validation. The model iHZ565 can be used as a knowledge-based framework for better understanding the symbiotic relationship between rhizobia and legumes, ultimately, uncovering the mechanism of nitrogen fixation in bacteroids and providing new strategies to efficiently improve biological nitrogen fixation.

  8. [Analysis of degradation failure of poly L-lactic acid fixators used in meniscus tears].

    Science.gov (United States)

    Ceyhan, Taşkin; Aşik, Mehmet; Atalar, Ata Can; Apohan, Nilhan Kayaman

    2008-01-01

    Biodegradable poly L-lactic acid (PLLA) fixators used in the repair of meniscal tears may cause adverse reactions inside the knee due to delayed degradation. This study was designed to determine the reasons for late degradation of PLLA fixators. Three unused and three used meniscal PLLA fixators (BioStinger) were analyzed. The latter were removed from three patients due to persisting symptoms within six months after knee arthroscopy. Fourier transform infrared (FTIR) spectroscopy was performed and external and internal surfaces of the samples were examined by scanning electron microscopy (SEM) and X-ray fluoroscopy (XRF). Chemical structural analyses of two samples (one from each group) were made by 1H-nuclear magnetic resonance (1H-NMR) spectroscopy. Degradation times of two samples (one from each group) by oxidative hydrolysis in hydrogen peroxide solution were recorded. Chemical structure of used and unused fixators did not differ in FTIR analysis. With increasing temperatures, unused and used fixators showed degradation with and without melt flow, respectively. In SEM analysis, inner sections of unused fixators were homogeneous, whereas those of the used ones exhibited crystals which were found to be sodium and potassium chloride salts in XRF analysis. The 1H-NMR spectrum of used and unused samples showed the normal pattern of lactic acid polymer. The unused and used fixators degraded in hydrogen peroxide solution in 10 days and 30 days, respectively. Both fixators had the same chemical structure in FTIR and NMR analyses. Formation of salt crystals seemed to be the most important cause of degradation failure, while changes in the physical properties of fixators were thought to be associated with delayed degradation.

  9. International conference on opportunities and challenges for water cooled reactors in the 21. century. PowerPoint presentations

    International Nuclear Information System (INIS)

    2009-01-01

    Water Cooled Reactors have been the keystone of the nuclear industry in the 20th Century. As we move into the 21st Century and face new challenges such as the threat of climate change or the large growth in world energy demand, nuclear energy has been singled out as one of the sources that could substantially and sustainably contribute to power the world. As the nuclear community worldwide looks into the future with the development of advanced and innovative reactor designs and fuel cycles, it becomes important to explore the role Water Cooled Reactors (WCRs) will play in this future. To support the future role of WCRs, substantial design and development programmes are underway in a number of Member States to incorporate additional technology improvements in