scholarly journals The use of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 43-47
Author(s):  
A.V. Chuzhak
Keyword(s):  
Ankle Joint ◽  
High Efficiency ◽  
Point Of View ◽  
Tibial Fractures ◽  
Ankle Injuries ◽  
Treatment Results ◽  
Ao Classification ◽  
In Trans ◽  
Poor Outcomes ◽  
Elastic Fixation

The problem of complications and the frequency of poor outcomes in the surgical treatment of ankle fractures with ti-biofibular syndesmosis (TFS) rupture (4.8–36.8 % of cases) remains significant. It was interesting from a scientific and practical point of view to conduct a clinical study to determine the effectiveness of the newly developed method of metal osteosynthesis for tibial fractures with TFS rupture, which would combine stability of tibial fixation and not limit the elastic qualities of TFS. The aim of the study: to determine the effectiveness of combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia. Materials and methods. On the basis of own clinical researches and data of literature sources, the method of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia is developed. The effectiveness of the proposed technique was evaluated 6 months after surgery on the Kitaoka scale. We have examined 12 patients with tibial fractures type 44 B1, B2 and B3 according to the AO classification, who underwent surgery using our methods. Results. The high efficiency of using the technique of combined stable-elastic fixation for unstable injuries of the ankle joint due to trans-syndesmotic fractures of the tibia has been determined. Good and excellent treatment results 6 months after surgery were observed in all 12 people (100 %), with excellent outcomes observed in 75 % of cases. There were no satisfactory and unsatisfactory treatment results. Conclusions. The study proves the high efficiency of the proposed method for combined stable-elastic fixation of ankle injuries in unstable trans-syndesmotic fractures of the tibia with TFS damage. There were 75 % excellent and 25 % good results within 6 months after surgery. A wider introduction of this technique into the practice of traumatologists of Ukraine is proposed.

scholarly journals Multifunctional Cantilevers as Working Elements in Solid-State Cooling Devices

Actuators ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 58
Author(s):  
Andraž Bradeško ◽  
Lovro Fulanović ◽  
Marko Vrabelj ◽  
Aleksander Matavž ◽  
Mojca Otoničar ◽  
...  
Keyword(s):  
Heat Transfer ◽  
Ethylene Glycol ◽  
Contact Resistance ◽  
High Efficiency ◽  
Thermal Contact ◽  
Point Of View ◽  
Practical Implementation ◽  
Cooling Devices ◽  
Cascade Structure ◽  
Lead Magnesium

Despite the challenges of practical implementation, electrocaloric (EC) cooling remains a promising technology because of its good scalability and high efficiency. Here, we investigate the feasibility of an EC cooling device that couples the EC and electromechanical (EM) responses of a highly functionally, efficient, lead magnesium niobate ceramic material. We fabricated multifunctional cantilevers from this material and characterized their electrical, EM and EC properties. Two active cantilevers were stacked in a cascade structure, forming a proof-of-concept device, which was then analyzed in detail. The cooling effect was lower than the EC effect of the material itself, mainly due to the poor solid-to-solid heat transfer. However, we show that the use of ethylene glycol in the thermal contact area can significantly reduce the contact resistance, thereby improving the heat transfer. Although this solution is most likely impractical from the design point of view, the results clearly show that in this and similar cooling devices, a non-destructive, surface-modification method, with the same effectiveness as that of ethylene glycol, will have to be developed to reduce the thermal contact resistance. We hope this study will motivate the further development of multifunctional cooling devices.

Inadequate Selection and Treatment Results in Poor Outcomes and Lack of Cost-Effectiveness

2021 ◽  
Author(s):  
Johan Hambraeus ◽  
Reza Ehsanian ◽  
David S. Cheng ◽  
Michael J. McKenna ◽  
Zachary L. McCormick
Keyword(s):  
Cost Effectiveness ◽  
Treatment Results ◽  
Poor Outcomes

Experience of using chlorhexidine in obstetrics and gynecology

2018 ◽  
pp. 46-50
Author(s):  
O.V. Kravchenko ◽  
Keyword(s):  
Pregnant Women ◽  
Key Words ◽  
Functional Activity ◽  
High Efficiency ◽  
Reproductive Age ◽  
Obstetrics And Gynecology ◽  
Laboratory Examination ◽  
Control Groups ◽  
Treatment Results ◽  
Regenerative Activity

The objective: generalization of the experience of using chlorhexidine drugs in obstetric and gynecological practice. Materials and methods. The efficacy of using Depantol and Hexicon for non-specific colpitis in patients of adolescent, reproductive age, pregnant women, women in perimenopause, as well as in patients after cervical, vaginal and perineal operations was evaluated and generalized. The surveyed groups contained 30 to 50 patients. The diagnosis of nonspecific vaginitis was verified by clinical and laboratory examination. Criteria for recovery were complete clinical and bacterial sanation. The effectiveness of therapy was evaluated immediately after treatment and after 1 and 3 months. The data were compared with the appropriate control groups or with the condition prior to treatment. Results. High efficiency of chlorhexidine preparations in the treatment of nonspecific colpitis in patients of different age categories and conditions was noted. The experience of using Depantol and Gecikon in obstetrics and gynecology is generalized, priorities are determined in the application of these drugs. Conclusion. Preparations of chlorhexidine Geksikon and Depantol are highly effective against the main pathogens of inflammatory nonspecific vulvovaginitis. They do not interfere with the functional activity of lactobacilli, which helps maintain a normal vaginal biocenosis. The drug Geksikon with success can be recommended both for the treatment of gynecological patients of reproductive age, and pregnant women. The use of Depantol, due to the regenerative activity of the dexpanthenol component, is a priority in the treatment of infectious processes in adolescence, perimenopausal age and in patients after operations on the cervix, vagina and perineum. Key words: chlorhexidine preparations, obstetrics and gynecology, Depantol, Geksikon.

Role of ultrasonography in assessment of painful ankle

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Amin Nassef ◽  
Shaimaa El Metwaly El Diasty ◽  
Marina Sameh Lamei
Keyword(s):  
Ankle Joint ◽  
Joint Pain ◽  
Pathological Condition ◽  
Ankle Injuries ◽  
Ankle Pain ◽  
Cross Sectional ◽  
Screening Study ◽  
Underlying Causes ◽  
Post Traumatic

Abstract Background Ankle disorders are a relatively common pathological condition, and ankle injuries account for approximately 14% of sports-related orthopedic emergency visits. Various imaging modalities can be used to make a diagnosis in cases of ankle pain; however, ultrasound (US) has several benefits for the evaluation of ankle pain, especially in the tendons, ligaments, and nerves of the ankle. Aim of the work to assess the role of high resolution US as a valuable tool in the depiction of causes of ankle joint pain. Patient & methods our study is a cross sectional descriptive screening study including 25 patients with ankle joint pain (acute or chronic), post traumatic or not with no age or sex predilection. Results The study included 15 (60%) males and 10 (40%) females. Their age ranged from 10 to 60 years with a mean age of 33.84±13.31years. Chronic ankle pain was the most common presenting symptom in 15 patients (60%) whereas 10 (40%) patients presented with acute ankle pain after trauma. The posterior ankle compartment was the most common affected compartment (24%) of cases. About 7 cases (28%) were presented by ankle swelling with or without pain. Conclusion In conclusion, MSK US is useful in detecting the underlying causes of ankle pain and still it has the potential to offer more valuable data if it is well mastered by the sonographers.

scholarly journals Regulatory links between imprinted genes: evolutionary predictions and consequences

2016 ◽  
Vol 283 (1824) ◽  
pp. 20152760 ◽  
Author(s):  
Manus M. Patten ◽  
Michael Cowley ◽  
Rebecca J. Oakey ◽  
Robert Feil
Keyword(s):  
Gene Networks ◽  
Cellular Proliferation ◽  
Point Of View ◽  
Imprinted Genes ◽  
Imprinted Gene ◽  
Genome Wide ◽  
Proliferation And Differentiation ◽  
Evolutionary View ◽  
In Trans ◽  
Regulatory Effects

Genomic imprinting is essential for development and growth and plays diverse roles in physiology and behaviour. Imprinted genes have traditionally been studied in isolation or in clusters with respect to cis -acting modes of gene regulation, both from a mechanistic and evolutionary point of view. Recent studies in mammals, however, reveal that imprinted genes are often co-regulated and are part of a gene network involved in the control of cellular proliferation and differentiation. Moreover, a subset of imprinted genes acts in trans on the expression of other imprinted genes. Numerous studies have modulated levels of imprinted gene expression to explore phenotypic and gene regulatory consequences. Increasingly, the applied genome-wide approaches highlight how perturbation of one imprinted gene may affect other maternally or paternally expressed genes. Here, we discuss these novel findings and consider evolutionary theories that offer a rationale for such intricate interactions among imprinted genes. An evolutionary view of these trans -regulatory effects provides a novel interpretation of the logic of gene networks within species and has implications for the origin of reproductive isolation between species.

scholarly journals Chronic Myeloid Leukemia and Cesarean Section: The Anesthesiologist’s Point of View

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Houssam Rebahi ◽  
Mourad Ait Sliman ◽  
Ahmed-Rhassane El Adib
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Cesarean Section ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Hematologic Malignancy ◽  
Blast Crisis ◽  
Myeloproliferative Neoplasm ◽  
Point Of View ◽  
Poor Outcomes ◽  
Challenging Situation

Background. Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm related to chromosomal reciprocal translocation t(9;22). Tyrosine kinase inhibitors (TKIs) such as imatinib have drastically revolutionized the course and the prognosis of this hematologic malignancy. As we know, the association pregnancy-CML is an infrequent situation. Also the use of TKI in pregnant women is unsafe with a lack of alternatives and effective therapeutic options. Thus its cessation during gestation puts those patients at high risk of developing blast crisis characterized by poor outcomes.Case Report. A 37-year-old pregnant woman, gravida 2, para 2, with a previous cesarean section in 2011, presented to the obstetric unit. Her medical past revealed that she is a newly diagnosed patient with CML managed by TKI during her preconception period. Due to the perilous use of TKI during her pregnancy, a switch to interferon-αadministration was adopted. But after the completion of 36 weeks of gestation, disease progression (relapse with blast crisis), attested by biological worsening, a white blood cell count = 245000/mm3with 32% blasts in the peripheral blood, urged the medical team to opt for cesarean delivery. She underwent general endotracheal anesthesia without any perioperative incidents and gave birth to a healthy newborn. Ten days later, the patient was started on TKI.Discussion. Although data on this specific and challenging situation are limited, this case highlights the difficulties encountered by the anesthesiologists when choosing the accurate anesthetic strategy and how important it is to weigh the risks and benefits inherent to each technique. Above all, taking into consideration the possible central nervous system (CNS) contamination by circulating blast cells when performing spinal or epidural approach is primordial. This potential adverse event (CNS blast crisis) is extremely scarce but it is responsible for high rates of morbidity and mortality.

scholarly journals Magnetic resonance imaging in traumatic injuries of the ankle joint in children

2020 ◽  
Vol 24 (4) ◽  
pp. 266-271
Author(s):  
N. Yu. Serova ◽  
T. A. Akhadov ◽  
I. A. Melnikov ◽  
O. V. Bozhko ◽  
N. A. Semenova ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Soft Tissues ◽  
Diagnostic Value ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Traumatic Injuries ◽  
Sport Activities ◽  
Bone Fragments

Introduction. Sprain of the ankle joint is one of the most common injuries in children during sport activities. Purpose. To define MRI diagnostic value in ankle joint injuries. Material and methods. 30 patients , 18 boys and 12 girls aged 8-17 ( average age 14.6 years), were enrolled into the study. 20 of them (66.7%) were 12-14 years old, 3 (10%) - < 10 years old and 7 (23.3 %) - > 14 years old. A Philips AchievadStream 3.0 Tesla scanner was used for MRI examination. Results. MRI findings showed that 17 (56.7%) patients had damage of the anterior talofibular ligament; 8 patients had avulsion of bone fragments of the lateral ankle; 9 patients (30.0%) had partial deltoid ligament injuries. Complete rupture of ligaments was rare and was seen only in two patients (6.7%). Conclusion. MRI is a method of choice in assessing ankle injuries due to high contrast of soft tissues, high resolution and multi-planar potentials. MRI is especially useful in examining soft ankle tissue structures such as tendons, ligaments, nerves and fascia, as well as in revealing hidden / subtle bone damage.

scholarly journals A PROSPECTIVE ANALYSIS OF GUSTILLO-ANDERSON OPEN TYPE II AND TYPE III TIBIAL DIAPHYSEAL FRACTURES OF AO TYPE 42C1 AND 42C2; THAT WERE SURGICALLY INTERVENED UPON.

2021 ◽  
pp. 1-8
Author(s):  
Umale Rushikesh Hari ◽  
R K Guhan ◽  
Janhavi Thanigaivelu ◽  
Venkatachalam. K
Keyword(s):  
Tibial Fracture ◽  
Tibial Fractures ◽  
Soft Tissue Coverage ◽  
Type Ii ◽  
Open Type ◽  
Type Iii ◽  
Bone Trauma ◽  
Diaphyseal Fractures ◽  
The Mean ◽  
Poor Outcomes

Introduction: Segmental tibial fracture is characterized, as a distinguished kind of fracture type. They are portrayed by at least, two distinctive fracture lines, with a totally separate, inter-calary osseous section, either with intact cortical tubular or as a comminuted segment. AO type 42 C1 and C2 fractures of the tibia are generally, brought about by a high- velocity RTA. They have a high “taux de” of complications. AO type 42 C1 and C2 tibial fractures are considered, as a discrete clinico-surgical bone trauma and are in deep contrast, with the other variants of tibial fractures. Aim: To analyze the functional outcome of Gustillo- Anderson open type II and type III Tibial Diaphyseal fractures of AO Type 42C1 and 42C2; that were surgically intervened upon. Materials and Methods: 62 adult patients in the age bracket of 26-55 years having Gustillo-Anderson open type II and type III Tibial Diaphyseal fractures of AO Type 42C1 and 42C2, were surgically intervened in the form of reamed IMIL nailing. Results: We achieved 62.36% Excellent, 13.98% Good, 15.05% Fair and 4.84% Poor outcomes calculated by the mean of mean scores of Johner AND Wruhs Criteria, Modified Knee Society Score, Yokoyama Criteria scores. Conclusion: This study concludes that Gustillo- Anderson open type II and type III Tibial Diaphyseal fractures of AO Type 42C1 and 42C2 can be managed satisfactorily with IMIL nailing without the need of external fixator application, provided appropriate soft tissue coverage is given at the appropriate time.

scholarly journals Сomputed tomography for fractures of the ankle joint in children

2021 ◽  
Vol 25 (3) ◽  
pp. 119-130
Author(s):  
N. Yu. Serova ◽  
T. A. Akhadov ◽  
I. A. Mel'nikov ◽  
O. V. Bozhko ◽  
T. D. Kostikova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ankle Joint ◽  
Traffic Accidents ◽  
Correct Diagnosis ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Slice Thickness ◽  
Ray Method ◽  
Intraarticular Fractures ◽  
Fractures In Children

Introduction. Correct diagnosis is based on visualization and knowledge of fracture patterns characteristic of children. Traditionally, radiography is used to visualize bone damage. In fractures in children due to the high risk of damage to the germinal zones, it is necessary to have clear and reliable information about their condition, which cannot always be obtained by x-ray method. For these purposes and the requirements of modern surgery, CT is used, which with high diagnostic accuracy clarifies the degree of displacement of fragments, present a qualitative characteristic of fractures and reveals associated damage.Purpose: to show the capabilities of computed tomography in diagnosis of fractures of ankle joint.Materials and methods. The results of computed tomography (CT) are presented in 226 children and adolescents aged 3 to 17 years. There were 142 boys (62.8%), 84 girls (37.2%). Scanning was carried out depending on the weight and age of the patient with the minimum indicators of kV and mAS, a slice thickness of 0.75 mm.Results. Average time for seeking medical help was 32 hours from moment of injury. Among causes of injury in the first place was domestic injury (73, 8%), followed by sports injury (22, 3%) and traffic accidents (3.9%). Right-sided ankle fractures were found in 147 (65.1%), left-sided – in 79 (34.9%) children. The most common types of tibial fractures were metaepiphysiolysis of the distal tibia and metaepiphysiolysis of the distal tibia of both tibia, which together accounted for 67.7% (n = 153) of all tibial fractures.Conclusion. Computed tomography should be performed in all cases of intraarticular fractures of the ankle joint. It is especially important for evaluating fractures with damage to germ zones. Scanning must be carried out with a cutting thickness of not more than 1 mm. CT with multi-planar data reformatting is an important factor in determining whether a patient needs surgical treatment. As a result of CT, a final diagnosis was established and a decision was made on treatment tactics.

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