scholarly journals Comparison of Exposure in the Kaplan Versus the Kocher Approach in the Treatment of Radial Head Fractures

Hand ◽  
2018 ◽  
Vol 14 (2) ◽  
pp. 253-258 ◽  
Author(s):  
Leslie Fink Barnes ◽  
Joseph Lombardi ◽  
Thomas R. Gardner ◽  
Robert J. Strauch ◽  
Melvin P. Rosenwasser
Keyword(s):  
Surface Area ◽  
Radial Head ◽  
Lateral Collateral Ligament ◽  
Radial Head Fractures ◽  
3 Dimensional ◽  
Average Surface Area ◽  
The Mean ◽  
The Difference ◽  
Head Neck

Background: The aim of this study was to compare the complete visible surface area of the radial head, neck, and coronoid in the Kaplan and Kocher approaches to the lateral elbow. The hypothesis was that the Kaplan approach would afford greater visibility due to the differential anatomy of the intermuscular planes. Methods: Ten cadavers were dissected with the Kaplan and Kocher approaches, and the visible surface area was measured in situ using a 3-dimensional digitizer. Six measurements were taken for each approach by 2 surgeons, and the mean of these measurements were analyzed. Results: The mean surface area visible with the lateral collateral ligament (LCL) preserved in the Kaplan approach was 616.6 mm2 in comparison with the surface area of 136.2 mm2 visible in the Kocher approach when the LCL was preserved. Using a 2-way analysis of variance, the difference between these 2 approaches was statistically significant. When the LCL complex was incised in the Kocher approach, the average visible surface area of the Kocher approach was 456.1 mm2 and was statistically less than the Kaplan approach. The average surface area of the coronoid visible using a proximally extended Kaplan approach was 197.8 mm2. Conclusions: The Kaplan approach affords significantly greater visible surface area of the proximal radius than the Kocher approach.

scholarly journals Quantitative Anatomic Analysis of the Medial Ulnar Collateral Ligament Complex of the Elbow

2018 ◽  
Vol 6 (3) ◽  
pp. 232596711876275 ◽  
Author(s):  
Christopher L. Camp ◽  
Hamidreza Jahandar ◽  
Alec M. Sinatro ◽  
Carl W. Imhauser ◽  
David W. Altchek ◽  
...  
Keyword(s):  
Surface Area ◽  
Ulnar Collateral Ligament ◽  
Surgical Reconstruction ◽  
Collateral Ligament ◽  
3 Dimensional ◽  
Visual Center ◽  
Bony Landmarks ◽  
Fresh Frozen ◽  
Detailed Assessment ◽  
The Mean

Background: A more detailed assessment of the anatomy of the entire medial ulnar collateral ligament complex (MUCLC) is desired as the rate of medial elbow reconstruction surgery continues to rise. Purpose: To quantify the anatomy of the MUCLC, including the anterior bundle (AB), posterior bundle (PB), and transverse ligament (TL). Study Design: Descriptive laboratory study. Methods: Ten unpaired, fresh-frozen cadaveric elbows underwent 3-dimensional (3D) digitization and computed tomography with 3D reconstruction. Ligament footprint areas and geometries, distances to key bony landmarks, and isometry were determined. A surgeon digitized the visual center of each footprint, and this location was compared with the geometric centroid calculated from the outline of the digitized footprint. Results: The mean surface area of the AB was 324.2 mm2, with an origin footprint of 32.3 mm2 and an elongated insertional footprint of 187.6 mm2 (length, 29.7 mm). The mean area of the PB was 116.6 mm2 (origin, 25.9 mm2; insertion, 15.8 mm2), and the mean surface area of the TL was 134.5 mm2 (origin, 21.2 mm2; insertion, 16.7 mm2). The geometric centroids of all footprints could be predicted within 0.8 to 1.3 mm, with the exception of the AB insertion centroid, which was 7.6 mm distal to the perceived center at the apex of the sublime tubercle. While the PB remained relatively isometric from 0° to 90° of flexion ( P = .606), the AB lengthened by 2.2 mm ( P < .001). Conclusion: Contrary to several historical reports, the insertional footprint of the AB was larger, elongated, and tapered. The TL demonstrated a previously unrecognized expansive soft tissue insertion directly onto the AB, and additional analysis of the biomechanical contribution of this structure is needed. Clinical Relevance: These findings may serve as a foundation for future study of the MUCLC and help refine current surgical reconstruction techniques.

Interspecific differences in the burrow morphology between the sympatric mud shrimps, Austinogebia narutensis and Upogebia issaeffi (Crustacea: Thalassinidea: Upogebiidae)

2005 ◽  
Vol 85 (4) ◽  
pp. 943-947 ◽  
Author(s):  
Kyoko Kinoshita ◽  
Gyo Itani
Keyword(s):  
Size Effects ◽  
Interspecific Differences ◽  
The Family ◽  
The Mean ◽  
The Difference ◽  
Burrow Structure ◽  
Shaped Pattern ◽  
Burrow Morphology ◽  
Shaped Section

The morphology of burrows constructed by the upogebiid mud shrimps Austinogebia narutensis and Upogebia issaeffi was studied using resin castings of burrows in situ on Mukaishima Island, Seto Inland Sea, Japan, where the two species occurred sympatrically. The burrow structure of both shrimps is a relatively simple Y-shaped pattern, which is typical of the family Upogebiidae. Total burrow length, and length and overall width of the U-shaped section of A. narutensis were greater than those of U. issaeffi, possibly because A. narutensis is the larger species. When the ratios of the burrow measurements to the mean burrow diameter were compared to exclude possible size effects, the burrows of A. narutensis had a wider and shallower U-shaped section than those of U. issaeffi. Because the casts were made where the two species occurred sympatrically, the differences in the burrow morphology were not due to the differences in environmental factors but to the difference in the shrimp species, whether they are adaptive or not.

scholarly journals Use of Suture Anchors for Coronoid Fractures in the Terrible Triad of the Elbow

2009 ◽  
Vol 17 (1) ◽  
pp. 31-35 ◽  
Author(s):  
V Pai ◽  
V Pai
Keyword(s):  
Radial Head ◽  
Lateral Collateral Ligament ◽  
Lateral Condyle ◽  
Type I ◽  
Suture Anchors ◽  
Terrible Triad ◽  
Collateral Ligament ◽  
Range Of Movement ◽  
Flexion Extension ◽  
The Mean

Purpose. To report outcomes in 6 patients with the terrible triad of the elbow treated with our modified protocol. Methods. 6 men aged 26 to 54 years underwent surgery for the terrible triad of the elbow by a single surgeon. All the patients had a displaced comminuted fracture of the radius, posterior dislocation of the elbow, and Morrey type-I fracture of the coronoid. They all underwent replacement of the radial head and repair of the lateral collateral ligament to the isometric part of the lateral condyle using suture anchors. Five had an additional capsular fixation to the anterior coronoid using suture anchors; in patient 6 the coronoid was not repaired because it was stable. Functional outcomes were evaluated using the Hospital for Special Surgery (HSS) elbow assessment score. Bone union, implant loosening, heterotopic ossification, and degenerative changes were assessed using anteroposterior and lateral radiographs. Results. After a mean follow-up of 2.2 (range, 1–3) years, the mean arc of flexion-extension was 116 degrees and the mean flexion contracture was 15 degrees. All patients maintained a concentric reduction of both the ulnotrochlear and the radiocapitellar articulation, with isometric fixation of the lateral collateral ligament. No patient had dislocation of the radial-head prosthesis. All had good-to-excellent HSS elbow scores, and none required re-operation. Patient 2 had neuropraxia of the radial nerve, which recovered within 3 months. Patient 4 had a range of movement of only 20 to 100 degrees, but was satisfied with the outcome. Conclusion. Repair of the articular capsule using suture anchors in addition to replacement of the radial head and repair of the lateral collateral ligament achieves favourable outcome in patients with the terible triad of the elbow.

scholarly journals Short- to mid-term outcomes of radial head replacement for complex radial head fractures

2020 ◽  
Vol 23 (4) ◽  
pp. 183-189
Author(s):  
Chung-Sin Baek ◽  
Beom-Soo Kim ◽  
Du-Han Kim ◽  
Chul-Hyun Cho
Keyword(s):  
Heterotopic Ossification ◽  
Radial Head ◽  
Elbow Joint ◽  
Ulnar Neuropathy ◽  
Dash Score ◽  
Radial Head Fractures ◽  
Radial Head Replacement ◽  
The Mean ◽  
Quick Dash

Background: The purpose of the current study was to investigate short- to mid-term outcomes and complications following radial head replacement (RHR) for complex radial head fractures and to identify factors associated with clinical outcomes.Methods: Twenty-four patients with complex radial head fractures were treated by RHR. The mean age of the patients was 49.8 years (range, 19–73 years). Clinical and radiographic outcomes were evaluated for a mean follow-up period of 58.9 months (range, 27–163 months) using the visual analog scale (VAS) score for pain, the Mayo elbow performance score (MEPS), the quick disabilities of the arm, shoulder and hand (Quick-DASH) score, and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, the mean VAS score, MEPS, and Quick-DASH score were 0.6±1.1, 88.7±11.5, and 19.4±7.8, respectively. The mean range of motion was 132.7o of flexion, 4.7o of extension, 76.2o of pronation, and 77.5o of supination. Periprosthetic lucency was observed in six patients (25%). Heterotopic ossification was observed in four patients (16.7%). Arthritic change of the elbow joint developed in seven patients (29.2%). Capitellar wear was found in five patients (20.8%). Arthritic change of the elbow joint was significantly correlated with MEPS (P=0.047). Four cases of complications (16.6%) were observed, including two cases of major complications (one stiffness with heterotopic ossification and progressive ulnar neuropathy and one stiffness) and two cases of minor complications (two transient ulnar neuropathy).Conclusions: RHR for the treatment of complex radial head fractures yielded satisfactory short- to mid-term clinical outcomes, though radiographic complications were relatively high.

scholarly journals Functional Outcome of Elbow Kinematics in Radial Head Excision Versus Radial Head Replacement: A Comparative Study

2019 ◽  
Vol 7 (9) ◽  
pp. 1505-1508 ◽  
Author(s):  
Ayush Kumar Singh ◽  
Aswini Jidge ◽  
Ujwal Ramteke ◽  
Nivedhitha Venkateswaran ◽  
Hemlata Rokade ◽  
...  
Keyword(s):  
Comparative Study ◽  
Radial Head ◽  
Radial Head Fractures ◽  
Radial Head Arthroplasty ◽  
Radial Head Replacement ◽  
Prospective Comparative Study ◽  
The Difference ◽  
Type Of Injury ◽  
Radial Head Excision

BACKGROUND: Radial head fractures are quite common with incidence 1.5-4% of all adult fractures. The treatment for these fractures depends upon age, type of injury and whether the physics is closed or not. AIM: Comparison between radial head excision versus radial head replacement based on mayo elbow scoring in comminuted radial head fractures. MATERIAL AND METHODS: We did a prospective comparative study comprising 32 patients between age 22-60 years with Mason type II/III radial head fractures at Sir J.J Group of Hospitals, Mumbai. The patients were randomised using the admission day of the week placing 17 patients in the arthroplasty group and 15 patients in the excision group. The patients were followed up for 18-24 months (average 20 months) postoperatively. Results were analysed by the Mayo’s elbow performance score at 6 months and 18 months and were statistically evaluated by unpaired t-test. RESULTS: At 6 months, radial head arthroplasty gave excellent results in 2 patients, good in 5 patients and fair in 8 patients. In excision, there were 5 patients with excellent results at 6 months, 7 with good results and 2 with fair results. At 18 months, of the 17 patients who had undergone head arthroplasty, 2 had excellent results, and the same number had poor results. 7 (46.7%) of the 15 cases who had undergone radial head excision had excellent results. Good results were obtained in 7 cases of each. There was 6 cases (35.3%) of radial head arthroplasty which fell into the fair group. As per Mayo’s score at 6 months follow up, mean and standard deviation (SD) of the scores in arthroplasty was 68.82 and 18.66 respectively & for excision, it was 85.66 and 10.66. At 18 months follow up, it was 75 and 14.89 for arthroplasty & 90.66 and 7.98 for excision. The difference between the results was statistically significant (p < 0.01). CONCLUSION: Our study shows that long and short-term results of radial head excision are better as compared to arthroplasty in comminuted radial head fractures based on mayo elbow scoring, particularly for dominant upper limbs.

Pore size distribution and adsorption selectivity of sepiolite

Clay Minerals ◽  
1990 ◽  
Vol 25 (1) ◽  
pp. 99-105 ◽  
Author(s):  
S. Inagaki ◽  
Y. Fukushima ◽  
H. Doi ◽  
O. Kamigaito
Keyword(s):  
Surface Area ◽  
Outer Surface ◽  
Adsorbed Water ◽  
Total Surface Area ◽  
Effective Size ◽  
Adsorption Selectivity ◽  
Surface Areas ◽  
Bet Method ◽  
The Mean ◽  
The Difference

AbstractMicropore distribution and effective size of the channels of natural sepiolite from Turkey were measured by the BET method. Before the BET measurement, the samples were treated under a water vapour atmosphere at various pressures to fill progressively the sepiolite micropores with water. The surface areas measured by means of N2 adsorption decreased with increased vapour pressures of water. The outer surface area was estimated by comparison of the surface area of the vacuum-dried sepiolite with that filled with adsorbed water. The total surface area was ∼290 m2/g, and the outer surface area was 170 m2/g, the difference being attributed to the structural micropores of the sepiolite. The ratio of the surface areas possessed by the channels and that of the outer surface suggest that the mean thickness of the sepiolite fibre was ∼12 nm. The effective size of the channels was estimated from the number of various-sized molecules sorbed by the sepiolite, the results showing that molecules larger than benzene could not migrate into the channels.

scholarly journals Mid-term results after in situ pinning and hip arthroscopy for mild slipped capital femoral epiphysis: a minimum five-year follow-up

2020 ◽  
Vol 14 (6) ◽  
pp. 521-528
Author(s):  
Stefan Rahm ◽  
Lukas Jud ◽  
Anna Jungwirth-Weinberger ◽  
Timo Tondelli ◽  
Anna L. Falkowski ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Slipped Capital Femoral Epiphysis ◽  
Consecutive Series ◽  
The Mean ◽  
In Situ Pinning ◽  
Head Neck ◽  
Neck Junction ◽  
Over Time

Purpose In situ pinning of mild slipped capital femoral epiphysis (SCFE) results in an aspherical head–neck junction and arthroscopic osteochondroplasty can successfully correct the head–neck junction. However, whether the correction stays stable over at least five years remains unknown. Methods In a retrospective and consecutive series, 11 patients with a mean age of 12 years (range, 10 years to 15 years) were included. All patients were treated for mild SCFE with in situ pinning and staged hip arthroscopy correcting the head–neck junction. All patients were assessed clinically and radiographically (radiograph and magnetic resonance imaging (MRI)) pre-operatively, 12 weeks and at least five years’ post-operatively. Results The mean range of motion (ROM) for flexion and internal rotation was stable over time with 100° (sd 4) and 21° (sd 6), respectively at the last follow-up. The mean alpha angle decreased from pre-operative 64° (range 61° to 68°) to 12 weeks post-operative 49° (range 46° to 52°; p = 0.001) and stayed stable over time. New superficial cartilage damage on either the acetabular or femoral side was seen in each three patients. Progressive labral degeneration was present in two patients. Conclusion In situ pinning and staged hip arthroscopy for the correction of mild SCFE is safe, restores normal alpha angles and reveals stable morphological correction at mid-term follow-up. Furthermore, the clinical results were excellent with almost normalized internal hip rotation at mid-term follow-up in patients who had reached adulthood. However, there was some joint deterioration, but without negative impact on subjective and clinical outcome after at least five years. Level of evidence IV

Epidemiology of malignant melanoma (Clinical experience at the National Institute of Oncology in Hungary)

2011 ◽  
Vol 152 (25) ◽  
pp. 1000-1006 ◽  
Author(s):  
Tímea Balatoni ◽  
Gabriella Liszkay ◽  
Zoltánné Miklós ◽  
Miklós Kásler
Keyword(s):  
Malignant Melanoma ◽  
Early Recognition ◽  
Neck Region ◽  
Lower Limbs ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Test Results ◽  
The Mean ◽  
The Difference

The National Cancer Registry, which has been running since 1999 in Hungary, supplies more and more precise data about the growing incidence of malignant melanoma although nationwide melanoma database currently does not exist. As in the National Institute of Oncology a notable percentage of patients (20-25%) were treated with newly diagnosed melanoma, conclusions may be drawn for the efficacy of primary prevention for the whole country. Methods: The recent study compares the data of patients presented in the Institute with cutaneous malignant melanoma in 1998 and ten years later, in 2008. The histology parameters of tumors were also analyzed. The two groups were compared according to age, gender, localization and histology parameters (histological types Breslow and Clark numbers). In case of continuous variables the Mann-Whitney test were used to determine significant differences. Categorical variables were checked by χ2 test. Results: 149 and 377 cutaneous melanomas were diagnosed in 1998 and in 2008, respectively, which accounts for 153% increase in ten years. The mean age of patients was 56.3 and 57.2 years in 1998 and in 2008, respectively. The per cent of males was 43% in 1998 and 49% in 2008. Trunk was the most frequent localization in both years: 39% and 46%, then lower limbs (28% and 22%), upper limbs (21% and 18%) and the head and neck region (12% and 14%). Superficial melanoma was found the most frequent histological type (52 and 54%) followed by nodular melanoma (31% and 23%). Rate of in situ melanoma changed from 10% to 15%. The mean of Breslow numbers was 2.2 mm in 1998 and 1.6 mm in 2008, the difference was highly significant (p = 0.0002). Clark numbers were also decreasing, although the difference was not significant (p = 0.08). The majority of patients were presented with Clark III depth melanoma in both years (38% and 32%). Conclusions: It seems that forces emphasizing the importance of early recognition in medical education and in media are not futile considering that principally the early diagnosis can improve the melanoma’s prognosis – which is represented mainly by Breslow tumor depth. Orv. Hetil., 2011, 152, 1000–1006.

The Effect of Vocabulary Intervention on Text Comprehension: Who Benefits?

2019 ◽  
Vol 50 (4) ◽  
pp. 562-578 ◽  
Author(s):  
Dawna Duff
Keyword(s):  
Middle School ◽  
Reading Comprehension ◽  
Text Comprehension ◽  
Classroom Instruction ◽  
Vocabulary Instruction ◽  
Clinical Intervention ◽  
Vocabulary Knowledge ◽  
Vocabulary Intervention ◽  
The Mean ◽  
The Difference

Purpose Vocabulary intervention can improve comprehension of texts containing taught words, but it is unclear if all middle school readers get this benefit. This study tests 2 hypotheses about variables that predict response to vocabulary treatment on text comprehension: gains in vocabulary knowledge due to treatment and pretreatment reading comprehension scores. Method Students in Grade 6 ( N = 23) completed a 5-session intervention based on robust vocabulary instruction (RVI). Knowledge of the semantics of taught words was measured pre- and posttreatment. Participants then read 2 matched texts, 1 containing taught words (treated) and 1 not (untreated). Treated texts and taught word lists were counterbalanced across participants. The difference between text comprehension scores in treated and untreated conditions was taken as a measure of the effect of RVI on text comprehension. Results RVI resulted in significant gains in knowledge of taught words ( d RM = 2.26) and text comprehension ( d RM = 0.31). The extent of gains in vocabulary knowledge after vocabulary treatment did not predict the effect of RVI on comprehension of texts. However, untreated reading comprehension scores moderated the effect of the vocabulary treatment on text comprehension: Lower reading comprehension was associated with greater gains in text comprehension. Readers with comprehension scores below the mean experienced large gains in comprehension, but those with average/above average reading comprehension scores did not. Conclusion Vocabulary instruction had a larger effect on text comprehension for readers in Grade 6 who had lower untreated reading comprehension scores. In contrast, the amount that children learned about taught vocabulary did not predict the effect of vocabulary instruction on text comprehension. This has implications for the identification of 6th-grade students who would benefit from classroom instruction or clinical intervention targeting vocabulary knowledge.

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