scholarly journals A study on patients treated with interlock nailing in the forearm fracture bones

Author(s):  
Shivakumar G. V. ◽  
Naveen P. R. ◽  
Manjunatha M. L.

<p class="abstract"><strong>Background:</strong> Fractures involving the bones of the forearm present unique problems not encountered with fractures of other long bones and may significantly affect the function of the upper limb. The purpose of the present study was to evaluate the functional outcome of patients treated with interlock nailing in the fracture forearm bones<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Thirty two patients included after their <span lang="EN-IN">consent. </span>With the patient supine on a radiolucent table, and under general or regional anesthesia the extremity was prepared and the surgery was performed using a standard procedure. If secure rigid fixation is achieved forearm POP splint is applied and kept in place for 2 weeks, thereafter a removable sugar-tong orthosis is worn until bridging callus is present, and the orthosis is removed frequently for exercise.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The average age of the patients was 38.90 years. The major mode of injury was RTA (59.09%) followed by assault (36.36%). 41% of patients were operated within week of injury, only three patients were operated after a week and one patient after 3 weeks. More than half of patients had closed fractures and rest was open fractures, of which Gustilo Anderson type II were in majority. In 3/5 of patients locking at nondriving end was not done cause of stable fixation. There was statistically significant difference in the surgical time (P &lt;0.05) and duration of postoperative immobilization differed statistically significantly (P &lt;0.001) between the group of patients in whom locking was done and not done. </span></p><p class="abstract"><strong>Conclusions:</strong> Advantages of Interlocking nail are high rate of bony consolidation along with minimized surgical approaches, cosmetically better suited and little risk of refracture after removal of the implant<span lang="EN-IN">.</span></p>

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 682-688 ◽  
Author(s):  
Kyle R. Sochacki ◽  
Robert A. Jack ◽  
Takashi Hirase ◽  
Patrick C. McCulloch ◽  
David M. Lintner ◽  
...  

Background: Forearm fractures are one of the most common upper extremity injuries requiring surgery in professional football. Surgical fixation of forearm fractures may speed recovery and decrease games missed in football. Methods: National Football League (NFL) players who underwent forearm fracture open reduction and internal fixation (ORIF) were identified. Matched controls (position, age, experience, performance) were identified. Control and case performance scores were calculated using a standardized scoring system. Return to sport (RTS) in the NFL was defined as playing in a single NFL game after surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired-samples Student t tests. Results: Thirty-six surgeries were analyzed following ORIF. Thirty-three were able to RTS in the NFL at an average of 152.1 + 129.8 days. Controls had a significantly longer NFL career ( P < .001) and played in significantly more games per season ( P = .026) than players who underwent surgery. There was a significant ( P = .013) decrease in games/season for DBs following surgery. No significant difference was seen in postoperative performance scores compared with preoperative scores among any positions, nor in postoperative and postindex performance scores compared with matched controls. Conclusion: There is a high rate of RTS in the NFL following forearm fracture ORIF. Following surgery, players’ careers were 1 year shorter and played nearly 2 fewer games per season than matched controls. Games per season following surgery was significantly lower among DBs when compared with presurgery. Postoperative performance scores were not significantly different compared with preoperative and when compared with matched controls.


2003 ◽  
Vol 42 (02) ◽  
pp. 71-77 ◽  
Author(s):  
I. Schreivogel ◽  
C. Angerstein ◽  
U. Siefker ◽  
K. Lehmann ◽  
G. Altenvoerde ◽  
...  

SummaryAim: Formal and clinical comparison of a new 3rd-gene-ration-Tg-IRMA (3-G-IRMA; Dynotest®Tg-plus) with a conventional Tg-IRMA (3-G-IRMA; SELco®Tg-assay) for patients with differentiated thyroid carcinoma. In addition we evaluated, if thyroglobulin (Tg) levels above a specific threshold concentration indicate the need for further investigations for residual disease. Patients, methods: Tg concentration of 105 sera of 93 consecutive patients with a differentiated thyroid cancer was determined with both assays and compared at different cut-off values (Dynotest®Tg-plus: 0.2, 1, 2 ng/ml; SELco®Tg-assay: 0.5, 1, 2 ng/ml) with the clinical results in respect to the corresponding TSH concentration. Results: Tg concentration did not show any significant difference (SELco®Tg-assay 0.5 ng/ml, Dynotest® Tg-plus 0.2 ng/ml). The Tg-values of both assays correlated with 97%. However, correlation of recovery in both assays was small (40%). The sensitivities and specificities of both assays at different cut-offs and TSH values did not reveal significant differences. In patients with TSH concentration >30 µU/ml the functional assay sensitivity was superior to arbitrary cut-offs in the decision to start further evaluations. Conclusions: In our study neither formal nor clinical significant differences between two Tg-assays were found. In a hypothyroid patient (TSH >30 µU/ml, Tg concentration exceeding the functional assay sensitivity) further investigations for residual disease are warranted. Higher thresholds are of limited value, due to a inacceptable high rate of false negative results.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shou-qian Dai ◽  
Rong-qing Qin ◽  
Xiu Shi ◽  
Hui-lin Yang

Abstract Background Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD. Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference. Conclusion PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.


2021 ◽  
pp. 1-10
Author(s):  
Anshu Siwach ◽  
Siddhartha Kaushal ◽  
Ratul Baishya

Abstract Mosses are one of the most important and dominant plant communities, especially in the temperate biome, and play a significant role in ecosystem function and dynamics. They influence the water, energy and element cycle due to their unique ecology and physiology. The present study was undertaken in three different temperate forest sites in the Garhwal Himalayas, viz., Triyuginarayan (Kedarnath Wildlife Sanctuary (KWLS)), Chakrata, and Kanasar forest range. The study was focused on understanding the influence of mosses on soil physical properties and nutrient availability. Different physico-chemical properties were analysed under two different substrata, that is, with and without moss cover in two different seasons, viz., monsoon and winter. We observed mosses to influence and alter the physical properties and nutrient status of soil in both seasons. All soil physical and chemical properties, except magnesium, showed significant difference within the substrates, among all the sites and across the two seasons. Besides the soil characteristics underneath the moss vegetation, the study also highlights the diversity of mosses found in the area. Mosses appear to create high nutrient microsites via a high rate of organic matter accumulation and retain nutrients for longer periods thus, maintaining ecosystem stability.


Author(s):  
Cristiano Termine ◽  
Enzo Grossi ◽  
Valentina Anelli ◽  
Ledina Derhemi ◽  
Andrea E. Cavanna

Abstract Background The association of stereotypies and tics is not rare in children with severe autism spectrum disorder (ASD). The differential diagnosis between stereotypies and tics in this patient population can be difficult; however, it could be clinically relevant because of treatment implications. Methods A total of 108 video recordings of repetitive behaviors in young patients with stereotypies in the context of ASD were reviewed by a movement disorders expert and a trainee, in order to assess the prevalence of possible co-morbid tics. The Modified Rush Videotape Rating Scale (MRVS) was used to rate tic frequency and severity. Results Out of 27 patients with stereotypies (24 males; mean age 14 years), 18 (67%) reported possible tics. The most frequently observed tics were eye blinking, shoulder shrugging, neck bending, staring, and throat clearing. The mean MRVS score was 5, indicating mild tic severity. The only significant difference between patients with tics and patients without tics was the total number of stereotypies, which was higher in the subgroup of patients without tics (p = 0.01). Conclusions Expert review of video-recordings of repetitive behaviors in young patients with ASD and stereotypies suggests the possibility of a relatively high rate of co-morbid tics. These findings need to be integrated with a comprehensive clinical assessment focusing on the diagnostic re-evaluation of heterogeneous motor manifestations.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Felix G. E. Dyrna ◽  
Daniel M. Avery ◽  
Ryu Yoshida ◽  
David Lam ◽  
Simon Oeckenpöhler ◽  
...  

Abstract Background Metacarpal shaft fractures are common and can be treated nonoperatively. Shortening, angulation, and rotational deformity are indications for surgical treatment. Various forms of treatment with advantages and disadvantages have been documented. The purpose of the study was to determine the stability of fracture fixation with intramedullary headless compression screws in two types of metacarpal shaft fractures and compare them to other common forms of rigid fixation: dorsal plating and lag screw fixation. It was hypothesized that headless compression screws would demonstrate a biomechanical stronger construct. Methods Five matched paired hands (age 60.9 ± 4.6 years), utilizing non-thumb metacarpals, were used for comparative fixation in two fracture types created by an osteotomy. In transverse diaphyseal fractures, fixation by headless compression screws (n = 7) and plating (n = 8) were compared. In long oblique diaphyseal fractures, headless compression screws (n = 8) were compared with plating (n = 8) and lag screws (n = 7). Testing was performed using an MTS frame producing an apex dorsal, three point bending force. Peak load to failure and stiffness were calculated from the load-displacement curve generated. Results For transverse fractures, headless compression screws had a significantly higher stiffness and peak load to failure, means 249.4 N/mm and 584.8 N, than plates, means 129.02 N/mm and 303.9 N (both p < 0.001). For long oblique fractures, stiffness and peak load to failure for headless compression screws were means 209 N/mm and 758.4 N, for plates 258.7 N/mm and 518.5 N, and for lag screws 172.18 N/mm and 234.11 N. There was significance in peak load to failure for headless compression screws vs plates (p = 0.023), headless compression screws vs lag screws (p < 0.001), and plates vs lag screws (p = 0.009). There was no significant difference in stiffness between groups. Conclusion Intramedullary fixation of diaphyseal metacarpal fractures with a headless compression screw provides excellent biomechanical stability. Coupled with lower risks for adverse effects, headless compression screws may be a preferable option for those requiring rapid return to sport or work. Level of evidence Basic Science Study, Biomechanics.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mary Nyangi ◽  
Elizabeth Kigondu ◽  
Beatrice Irungu ◽  
Margaret Nganga ◽  
Anthony Gachanja ◽  
...  

Abstract Background Vector control is an essential component in prevention and control of malaria in malaria endemic areas. Insecticide treated nets is one of the standard tools recommended for malaria vector control. The objective of the study was to determine physical integrity and insecticidal potency of long-lasting insecticidal nets (LLINs) used in control of malaria vector in Kirinyaga County, Kenya. Method The study targeted households in an area which had received LLINs during mass net distribution in 2016 from Ministry of Health. A total of 420 households were sampled using systematic sampling method, where the household heads consented to participate in the study. A semi-structured questionnaire was administered to assess care and use while physical examination was used to determine integrity. Chemical concentration was determined by gas chromatography mass spectroscopy (GC-MS). Data analysis was done using Statistical Package for Social Sciences (SPSS) version 19. Results After 18 months of use, 96.9% (95% CI: 95.2–98.6%) of the distributed nets were still available. Regarding net utilization, 94.1% of household heads reported sleeping under an LLIN the previous night. After physical examination, 49.9% (95% CI: 43–52.8%) of the bed nets had at least one hole. The median number of holes of any size was 2[interquartile range (IQR) 1–4], and most holes were located on the lower part of the nets, [median 3 (IQR 2–5)]. Only 15% of the nets with holes had been repaired. The median concentration for α-cypermethrin was 7.15 mg/m2 (IQR 4.25–15.31) and 0.00 mg/g (IQR 0.00–1.99) for permethrin. Based on pHI, Chi-square test varied significantly with the manufacturer (X (6, N = 389) = 29.14, p = 0.04). There was no significant difference between nets with different number of washes (X2(2) = 4.55, p = 0.103). Conclusion More than three-quarters of the nets supplied had survived and insecticidal potency was adequate in vector control. Standard procedure for field evaluation of surface insecticidal content available to a mosquito after landing on a net to rest is recommended.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18056-e18056
Author(s):  
Julie Elaine McGrath ◽  
Punita Grover ◽  
Joanne Xiu ◽  
Chadi Nabhan ◽  
Jennifer Hsing Choe ◽  
...  

e18056 Background: Adenoid cystic carcinoma (ACC) is a rare malignancy of glandular tissue with a high rate of local recurrence and metastatic disease. Despite being regarded as an indolent disease, the clinical course of recurrent and metastatic ACC (R/M ACC) is highly variable. Responses to chemotherapy (chemo) are uniformly poor. Several multi-targeted tyrosine-kinase inhibitors (mTKIs), EGFR inhibitors (EGFRi) and other targeted agents have been studied in single-arm early phase trials with response rates ranging from 0-16% and progression free survival ranging from 2.5-17 months. However, there have been no comparative clinical trials and it is not known if one treatment strategy is superior. We undertook this retrospective study to assess the real-world clinical outcomes in patients with adenoid cystic carcinoma using the Caris Life Sciences database. Methods: Real world overall survival (rwOS) for cases of ACC was obtained from insurance claims data and Kaplan-Meier estimates were calculated from the date of collection to the date of last contact. Cases were divided into subgroups based on treatment received – chemo (including platinum agents, taxanes, 5FU, topoisomerase inhibitors, anthracyclines), EGFRi (cetuximab, erlotinib, lapatinib), mTKIs (pazopanib, axitinib, sunitinib, cabozantinib, lenvatinib, sorafenib) and immune checkpoint inhibitors (ICIs) (atezolizumab, ipilimumab, pembrolizumab, nivolumab). Results: 368 patients (pts) were identified with ACC, 16 were locally recurrent and 216 tumors were taken from metastatic sites. 50 pts received chemo, 6 were treated with EGFRi and 15 with mTKIs. Pts who received combination EGFRi and chemo or mTKI and chemo were excluded. The median overall survival (mOS) all patients with metastatic ACC was 2.8 years (yrs). The mOS of pts with R/M ACC was 3 yrs for chemo, 2.9 yrs for EGFRi and 1.5 yrs for mTKIs. There was no significance in mOS between chemo vs mTKIs (HR 0.85, 95% CI 0.3 - 2, p = 0.72) and chemo vs EGFRi (HR = 0.88, 95% CI 0.3 - 2.5, p = 0.78). We further compared the outcomes of those treated with EGFRi (n = 8) with mTKIs (n = 19) in the entire cohort. For most pts, these agents were given as front line therapy. 25% (2/8) of patients had received treatment prior to EGFRi and 20% (4/9) prior to mTKIs (p = 1). There was no significant difference in mOS with HR 0.6 (95% CI 0.16 - 2.6), p = 0.6. We also compared the mOS of patients who received ICIs (n = 22) with those who did not (n = 346) but there was no significant difference (mOS 3.19 vs 3.17 yrs respectively, HR 0.87, 95% CI 0.47- 1.61, p = 0.65). Conclusions: There was no significant difference in the mOS between pts with R/M ACC who were treated with chemo, EGFRi or TKIs and in those who received ICIs compared to those who did not in our limited patient population. This highlights the need for predictive biomarkers for better patient selection with the goal of personalizing treatment strategies for this disease.


2016 ◽  
Vol 8 (4) ◽  
pp. 396-400 ◽  
Author(s):  
Bolaji Fatai OYEYEMI ◽  
John Oluwafemi ADEBAYO ◽  
Abass Toba ANIFOWOSHE ◽  
Oluyinka Ajibola IYIOLA

Digit ratio (2D:4D) denotes the relative length of the second and fourth digits. There are contradicting reports on its relationship with ethnicity/race, whereas convincing studies show it is related to obesity. This cross-sectional study was undertaken to demystify ethnic difference in 2D:4D ratio and to analyze its relationship with obesity among adults in Ilorin Nigeria. The cross-sectional study included 701 individuals. Finger lengths were measured with electronic calipers and other anthropometric traits were measured with standard procedure. Student t test and one-way ANOVA were used to detect differences among groups and relationship was computed with Pearson correlation. The receiver operator characteristic curves were used to detect the diagnostic effect of 2D:4D for obesity. The obtained results showed sexual dimorphism in 2D:4D ratio and other anthropometrics at p < 0.01. Obesity was associated with significantly higher mean of 2D:4D in both genders (female 0.9814 ± 0.012:0.9700 ± 0.012; male 0.9700 ± 0.010:0.9592 ± 0.010 at p < 0.001). The area under the curve was 0.753 (95% CI 0.677-0.829, p < 0.01) and 0.798 (95% CI 0.756-0.804, p < 0.01) in female and male R2D:4D respectively for obesity, implying that 2D:4D might be a surrogate marker for obesity in future.  No significant difference was found in 2D:4D among different ethnic groups studied (p >0.05); this result proved that there was no ethnic specificity in 2D:4D ratio among study’ participants. Thus, it can be reported that the digit ratio was related to high 2D:4D, but this cannot be said for different ethnic groups. The results imply that 2D:4D might be a good surrogate indicator for obesity, but not ethnicity.  


2018 ◽  
Vol 29 (2) ◽  
pp. 59-63
Author(s):  
AKM Akramul Haque ◽  
AHM Kazi Mostofa Kamal ◽  
Zinat De Laila ◽  
Luna Laila ◽  
Helal Uddin Ahmed ◽  
...  

Schizophrenia is a chronic psychiatric illness with high rate of relapse which is commonly associated with noncompliance of medicine, as well as stress and high expressed emotions. The objective of the study was to determine the factors of relapse among the schizophrenic patients attending in outpatient departments of three tertiary level psychiatric facilities in Bangladesh. This was a cross sectional study conducted from July, 2001 to June, 2002. Two hundred patients including both relapse and nonrelapse cases of schizophrenia and their key relatives were included by purposive sampling. The results showed no statistically significant difference in terms of relapse with age, sex, religion, residence, occupation and level of education (p>0.05), but statistically significant difference was found with marital status and economic status (p<0.01). The proportion of non-compliance was found to be 80% and 14%, of high expressed emotion was 17% and 2% and of the occurrence of stressful life events was 10% and 1% in relapse and non-relapse cases respectively which were statistically significant (p<0.001). The study indicated that stressful life events, high expressed emotion, and noncompliance with medication had a role in schizophrenic patients for its relapse.Bang J Psychiatry December 2015; 29(2): 59-63


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