scholarly journals Percutaneous Treatment With Bridge Plate and Extra-articular Screws in Low-Energy and High-Energy Lisfranc Injuries

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Juan P. Randolino ◽  
Valeria López
Keyword(s):  
Percutaneous Treatment ◽  
High Energy ◽  
Low Energy ◽  
Bridge Plate ◽  
Lisfranc Injuries

scholarly journals Bridge Plate Fixation Results in Better Functional Outcomes Than Transarticular Screw Fixation for Low-Energy Lisfranc Injuries

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001
Author(s):  
Joseph Bellamy ◽  
Grant Cochran
Keyword(s):  
Plate Fixation ◽  
Low Energy ◽  
Categorical Variables ◽  
Complication Rates ◽  
Transarticular Screw ◽  
Plate Group ◽  
Bridge Plate ◽  
Lisfranc Injuries ◽  
Bridge Plating ◽  
Screw Group

Category: Midfoot/Forefoot, Sports, Trauma Introduction/Purpose: Open reduction and internal fixation (ORIF) with transarticular screws or bridge plating is the standard of care for unstable Lisfranc injuries. There are no studies comparing the clinical outcomes of fixation with transarticular screws or bridge plates in young, athletic patients who sustained low-energy injuries. Methods: All low-energy Lisfranc injuries that underwent ORIF between 2010 and 2015 were reviewed. Injuries were classified as low-energy if the occurred during athletic activity, ground level twisting, or a fall from less than three feet (typically stairs or curbs). Tarsometatarsal (TMT) joint fixation with transarticular screws or bridge plating was documented. Transarticular screws were typically removed between four and six months postoperatively. Injury characteristics, complication rates, pain scores, and Foot and Ankle Ability Measure (FAAM) scores were compared. All continuous variables were compared with a two-tailed Student t-test. All categorical variables were compared using the Chi Squared test. Results: Of the fifteen patients identified, nine were fixed with transarticular screws and six with bridge plates. Average patient age was 27 years old. 12 of 15 were primarily ligamentous injuries. Implant removal was performed in the entire transarticular screw group and three out of six in the bridge plate group (p=0.018). Secondary arthrodesis for arthritis was recommended in two of the transarticular screw group and none of the bridge plate group (p=0.21). Mean FAAM scores were significantly higher in all subscales (ADL 96.2 v 76.7 p=.035, ADL SANE 92.5 v 72.6 p=.055, Sport 89.5 v 62.5 p=.027, Sport SANE 90 v 58.7 p=.024) in the bridge plate group at an average of 43 months follow up. Conclusion: In this study, ORIF with bridge plate fixation of the TMT joints had a lower rate of HWR and higher medium term FAAM scores than fixation with transarticular screws. A statistically significant difference in rates of secondary arthritis could not be established in this small cohort. Prospective studies are necessary to confirm these findings.

Injury Characteristics of Low-Energy Lisfranc Injuries Compared With High-Energy Injuries

2017 ◽  
Vol 38 (9) ◽  
pp. 964-969 ◽  
Author(s):  
Christopher H. Renninger ◽  
Grant Cochran ◽  
Trevor Tompane ◽  
Joseph Bellamy ◽  
Kevin Kuhn
Keyword(s):  
Motor Vehicle ◽  
High Energy ◽  
Motor Vehicle Crash ◽  
Low Energy ◽  
Future Research ◽  
Injury Patterns ◽  
Lisfranc Joint ◽  
Lateral Column ◽  
Articular Fractures ◽  
Lisfranc Injuries

Background: Lisfranc injuries result from high- and low-energy mechanisms though the literature has been more focused on high-energy mechanisms. A comparison of high-energy (HE) and low-energy (LE) injury patterns is lacking. The objective of this study was to report injury patterns in LE Lisfranc joint injuries and compare them to HE injury patterns. Methods: Operative Lisfranc injuries were identified over a 5-year period. Patient demographics, mechanism of injury, injury pattern, associated injuries, missed diagnoses, clinical course, and imaging studies were reviewed and compared. HE mechanism was defined as motor vehicle crash, motorcycle crash, direct crush, and fall from greater than 4 feet and LE mechanism as athletic activity, ground level twisting, or fall from less than 4 feet. Thirty-two HE and 48 LE cases were identified with 19.3 months of average follow-up. Results: There were no differences in demographics or missed diagnosis frequency (21% HE vs 18% LE). Time to seek care was not significantly different. HE injuries were more likely to have concomitant nonfoot fractures (37% vs 6%), concomitant foot fractures (78% vs 4%), cuboid fractures (31% vs 6%), metatarsal base fractures (84% vs 29%), displaced intra-articular fractures (59% vs 4%), and involvement of all 5 rays (23% vs 6%). LE injuries were more commonly ligamentous (68% vs 16%), with fewer rays involved (2.7 vs 4.1). Conclusions: LE mechanisms were a more common cause of Lisfranc joint injury in this cohort. These mechanisms generally resulted in an isolated, primarily ligamentous injury sparing the lateral column. Both types had high rates of missed injury that could result in delayed treatment. Differences in injury patterns could help direct future research to optimize treatment algorithms. Level of Evidence: Level III, comparative series.

Primary Arthrodesis versus Open Reduction and Internal Fixation for Low-Energy Lisfranc Injuries in a Young Athletic Population

2017 ◽  
Vol 38 (9) ◽  
pp. 957-963 ◽  
Author(s):  
Grant Cochran ◽  
Christopher Renninger ◽  
Trevor Tompane ◽  
Joseph Bellamy ◽  
Kevin Kuhn
Keyword(s):  
Internal Fixation ◽  
Test Scores ◽  
Open Reduction ◽  
Removal Rate ◽  
High Energy ◽  
Low Energy ◽  
Implant Removal ◽  
Level Of Evidence ◽  
Fitness Test ◽  
Lisfranc Injuries

Background: There are 2 Level I studies comparing open reduction and internal fixation (ORIF) and primary arthrodesis (PA) in high-energy Lisfranc injuries. There are no studies comparing ORIF and PA in young athletic patients with low-energy injuries. Methods: All operatively managed low-energy Lisfranc injuries sustained by active duty military personnel at a single institution were identified from 2010 to 2015. The injury pattern, method of treatment, and complications were reviewed. Implant removal rates, fitness test scores, return to military duty rates, and Foot and Ankle Ability Measure (FAAM) scores were compared. Thirty-two patients were identified with the average age of 28 years. PA was performed in 14 patients with ORIF in 18. Results: The PA group returned to full duty at an average of 4.5 months whereas the ORIF group returned at an average of 6.7 months ( P = .0066). The PA group ran their fitness test an average of 9 seconds per mile slower than their preoperative average whereas the ORIF group ran it an average of 39 seconds slower per mile ( P = .032). There were no differences between the 2 groups in the FAAM scores at an average of 35 months. Implant removal was performed in 15 (83%) in the ORIF group and 2 (14%) in the PA group ( P = .005). Conclusions: Low-energy Lisfranc injuries treated with primary arthrodesis had a lower implant removal rate, an earlier return to full military activity, and better fitness test scores after 1 year, but there was no difference in FAAM scores after 3 years. Level of Evidence: Level III, comparative cohort study.

scholarly journals Functional Outcomes of Open Reduction and Internal Fixation Treatment of Lisfranc Injuries

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0017
Author(s):  
Daniel Corr ◽  
Trevor McBride ◽  
Ryan G. Rogero ◽  
Steven M. Raikin ◽  
Rachel J. Shakked
Keyword(s):  
Internal Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Case Series ◽  
High Energy ◽  
Low Energy ◽  
Foot And Ankle ◽  
Lisfranc Injury ◽  
Functional Scores ◽  
Lisfranc Injuries

Category: Midfoot/Forefoot; Sports; Trauma Introduction/Purpose: Prior reports have suggested that primary partial arthrodesis may be superior to open reduction and internal fixation (ORIF) for the ligamentous Lisfranc injury. Although this may be true for the high energy Lisfranc injury, little has been studied regarding outcomes after operative fixation of low energy Lisfranc injuries. The purpose of this study is to present a large case series of patients who underwent ORIF for low energy ligamentous Lisfranc injuries including functional outcomes, complications, and reoperation rates. Methods: We included adult patients who underwent ORIF for low-energy Lisfranc injuries with fellowship-trained foot and ankle surgeons at our institution within 6 weeks of injury. Patients were excluded if the mechanism of injury or initial radiographs were consistent with a high-energy mechanism such as significant subluxation of multiple tarsometatarsal joints rather than subtle diastasis with weight-bearing images. Patients were also excluded if there were any significant fractures aside from avulsion fractures, other associated injuries, or underlying neuropathic pathophysiology. Patients completed the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports subscales, Visual Analog Scale for Pain (VAS), and Short Form-12 questionnaires before their procedures and then at least 2 years post-operatively. Standard demographic data was collected. Spearman’s correlations and Student’s t-tests were performed to evaluate outcomes after surgery and any relationship between patient characteristics and functional scores. Results: Eighty-seven patients completed functional scores an average of 4.9 years following their procedure (range 2.0 - 8.9), with average age of 41 and average BMI of 27.5. Fifty-two patients (59.8%) were female, and average time from injury to procedure was 15.2 days (range 1-36). Average FAAM-ADL improved from 27.83 to 88.36 postoperatively (p<.001), average FAAM-Sports improved from 7.47 to 76.36 (p<.001), and average VAS pain rating was reduced from 62.83 to 21.78 (p<.001). Hardware removal was performed in 36 cases (41.4%). One patient required removal of hardware and revision ORIF 30 days after the index procedure as a result of hardware complication. Both age at the time of surgery and BMI were negatively correlated with followup SF-12 Physical Health scores (r=-0.254, p=0.018; r=-0.263, p=0.014 respectively). Conclusion: This study is one of the largest case series of low energy Lisfranc injuries. We demonstrate that ORIF for low- energy Lisfranc injuries results in significant functional improvement and pain reduction while maintaining low rates of loss of correction or reoperation. Further investigation is necessary to evaluate this subset of Lisfranc injuries in terms of optimal surgical treatment patient functional outcomes following the use of primary arthrodesis in the treatment of Lisfranc procedures, and to assess the efficacy of the various hardware choices available for the procedure. [Table: see text]

Low energy vs. high energy depositional settings and related sedimentary bodies in early Senenian rudist bearing carbonate shelves (central-southern Italy)

2001 ◽  
Vol 28 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Gabriele Carannante ◽  
A. Laviano ◽  
D. Ruberti ◽  
Lucia Simone ◽  
G. Sirna ◽  
...  
Keyword(s):  
Southern Italy ◽  
High Energy ◽  
Low Energy ◽  
Depositional Settings

Transportation: Fuel Energies

2017 ◽  
Author(s):  
Peter Rez
Keyword(s):  
Energy Density ◽  
Fossil Fuels ◽  
High Energy ◽  
Ease Of Use ◽  
Low Energy ◽  
High Energy Density ◽  
Nuclear Fuels ◽  
Liquid Hydrocarbons ◽  
Transportation Fuel ◽  
Journey Time

Transportation efficiency can be measured in terms of the energy needed to move a person or a tonne of freight over a given distance. For passengers, journey time is important, so an equally useful measure is the product of the energy used and the time taken for the journey. Transportation requires storage of energy. Rechargeable systems such as batteries have very low energy densities as compared to fossil fuels. The highest energy densities come from nuclear fuels, although, because of shielding requirements, these are not practical for most forms of transportation. Liquid hydrocarbons represent a nice compromise between high energy density and ease of use.

scholarly journals Low-Energy Electron Damage to Condensed-Phase DNA and Its Constituents

2021 ◽  
Vol 22 (15) ◽  
pp. 7879
Author(s):  
Yingxia Gao ◽  
Yi Zheng ◽  
Léon Sanche
Keyword(s):  
Condensed Phase ◽  
Genetic Material ◽  
High Energy ◽  
Dna Lesions ◽  
Low Energy ◽  
Experimental Investigations ◽  
Experimental Conditions ◽  
Strand Breaks ◽  
Sequence Of Events ◽  
Wide Range

The complex physical and chemical reactions between the large number of low-energy (0–30 eV) electrons (LEEs) released by high energy radiation interacting with genetic material can lead to the formation of various DNA lesions such as crosslinks, single strand breaks, base modifications, and cleavage, as well as double strand breaks and other cluster damages. When crosslinks and cluster damages cannot be repaired by the cell, they can cause genetic loss of information, mutations, apoptosis, and promote genomic instability. Through the efforts of many research groups in the past two decades, the study of the interaction between LEEs and DNA under different experimental conditions has unveiled some of the main mechanisms responsible for these damages. In the present review, we focus on experimental investigations in the condensed phase that range from fundamental DNA constituents to oligonucleotides, synthetic duplex DNA, and bacterial (i.e., plasmid) DNA. These targets were irradiated either with LEEs from a monoenergetic-electron or photoelectron source, as sub-monolayer, monolayer, or multilayer films and within clusters or water solutions. Each type of experiment is briefly described, and the observed DNA damages are reported, along with the proposed mechanisms. Defining the role of LEEs within the sequence of events leading to radiobiological lesions contributes to our understanding of the action of radiation on living organisms, over a wide range of initial radiation energies. Applications of the interaction of LEEs with DNA to radiotherapy are briefly summarized.

Fabrication of the narrow size nano curcuminoids emulsion by combining phase inversion temperature and ultrasonication: preparation and bioactivity

2021 ◽  
Author(s):  
Quang Hieu Tran ◽  
Thuy Thanh Ho ◽  
Tu Thanh Nguyen
Keyword(s):  
Energy Method ◽  
Phase Inversion ◽  
Curcuma Longa ◽  
High Energy ◽  
Low Energy ◽  
Inversion Temperature ◽  
Comprehensive Study ◽  
Phase Inversion Temperature

A comprehensive study from Curcuma longa to powder nano curcuminoids has been carried out. Combining of both low energy method (Phase Inversion Temperature) and high-energy method (Ultrasonication), a series of...

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