scholarly journals Possible factors for ankle fractures

2010 ◽  
Vol 67 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Dejan Tabakovic ◽  
Radovan Manojlovic ◽  
Marko Kadija ◽  
Mihailo Ille ◽  
Goran Turkovic ◽  
...  

Background/Aim. Classification of ankle fractures is commonly used for selecting an appropriate treatment and prognosing an outcome of definite management. One of the most used classifications is the Danis-Weber classification. To the best of our knowledge, in the available literature, there are no parameters affecting specific types of ankle fractures according to the Danis-Weber classification. The aim of this study was to analyze the correlation of the following parameters: age, body weight, body mass index (BMI), height, osteoporosis, osteopenia and physical exercises with specific types of ankle fractures using the Danis-Weber classification. Methods. A total of 85 patients grouped by the Danis-Weber classification fracture types were analyzed and the significance of certain parameters for specific types of ankle fractures was established. Results. The proportion of females was significantly higher (p < 0.001) with a significantly higher age (59.9 years, SD ? 14.2) in relation to males (45.1 years, SD ? 12.8) (p < 0.0001). Type A fracture was most frequent in the younger patients (34.2 years, SD ? 8.6), and those with increased physical exercises (p = 0.020). In type B fracture, the risk factor was osteoporosis (p = 0.0180), while in type C fracture, body weight (p = 0.017) and osteoporosis (p = 0.004) were significant parameters. Conclusion. Statistical analysis using the Danis-Weber classification reveals that there are certain parameters suggesting significant risk factors for specific types of ankle fractures.

Reproduction ◽  
2000 ◽  
pp. 43-48 ◽  
Author(s):  
S Meredith ◽  
G Dudenhoeffer ◽  
K Jackson

In the present study, follicles were classified according to the morphology of their granulosa cells. Type B follicles contained only flattened granulosa cells; type B/C follicles had a mixture of flattened and cuboidal granulosa cells in a single layer, and type C follicles had a single layer of cuboidal granulosa cells. The primary objectives of the study were to determine whether 5-bromo-2-deoxyuridine incorporation into type B/C follicles was a marker for initiation of growth and how long type B/C follicles could remain at the same stage before transformation to type C follicles. Female Holtzman rats received bromo-deoxyuridine for 7 days. After the infusion (day minipumps were removed = day 0), rats were ovariectomized on days 0 (n = 9), 30 (n = 8), 90 (n = 8) and 150 (n = 9). The numbers of type B, B/C and C follicles within one ovary were determined using modified fractionator counting. Analysis over all times demonstrated that there were more (P < 0.0001) type B/C (941 +/- 61 per ovary) than type C (140 +/- 18 per ovary) or type B (159 +/- 19 per ovary) follicles. The numbers of type B and type C follicles did not differ from each other at any time. Only one of 34 rats evaluated had bromo-deoxyuridine-labelled type B follicles. On day 150, 57% of the bromo-deoxyuridine-labelled type B/C follicles remained from day 0. It is concluded that (1) DNA synthesis in granulosa cells of type B/C follicles is not a reliable indicator of impending growth; and (2) type B and type B/C follicles are both components of the pool of primordial follicles.


2019 ◽  
Vol 130 (5) ◽  
pp. 1468-1477 ◽  
Author(s):  
David Hasan ◽  
Mario Zanaty ◽  
Robert M. Starke ◽  
Elias Atallah ◽  
Nohra Chalouhi ◽  
...  

OBJECTIVEThe overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%–7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can be used as a guide to determine the technical success and safety of endovascular recanalization for symptomatic COICA and to assess the changes in systemic blood pressure following successful revascularization.METHODSThe radiographic images of 100 consecutive subjects with COICA were analyzed. A new classification of COICA was proposed based on the morphology, location of occlusion, and presence or absence of reconstitution of the distal ICA. The classification was used to predict successful revascularization in 32 symptomatic COICAs in 31 patients, five of whom were female (5/31 [16.13%]). Patients were included in the study if they had a COICA with ischemic symptoms refractory to medical therapy. Carotid artery occlusion was defined as 100% cross-sectional occlusion of the vessel lumen as documented on CTA or MRA and confirmed by digital subtraction angiography.RESULTSFour types (A–D) of radiographic COICA were identified. Types A and B were more amenable to safe revascularization than types C and D. Recanalization was successful at a rate of 68.75% (22/32 COICAs; type A: 8/8; type B: 8/8; type C: 4/8; type D: 2/8). The perioperative complication rate was 18.75% (6/32; type A: 0/8 [0%]; type B: 1/8 [12.50%]; type C: 3/8 [37.50%], type D: 2/8 [25.00%]). None of these complications led to permanent morbidity or death. Twenty (64.52%) of 31 subjects had improvement in their symptoms at the 2–6 months’ follow-up. A statistically significant decrease in systolic blood pressure (SBP) was noted in 17/21 (80.95%) patients who had successful revascularization, which persisted on follow-up (p = 0.0001). The remaining 10 subjects in whom revascularization failed had no significant changes in SBP (p = 0.73).CONCLUSIONSThe pilot study suggested that our proposed classification of COICA may be useful as an adjunctive guide to determine the technical feasibility and safety of revascularization for symptomatic COICA using endovascular techniques. Additionally, successful revascularization may lead to a significant decrease in SBP postprocedure. A Phase 2b trial in larger cohorts to assess the efficacy of endovascular revascularization using our COICA classification is warranted.


2015 ◽  
Vol 20 (2) ◽  
pp. 90-101 ◽  
Author(s):  
Sung-Wook Jeong ◽  
Lee-Suk Kim

Objectives: The aims of this study were to introduce a new classification of cochleovestibular malformation (CVM) and to investigate how well this classification can predict speech perception ability after cochlear implantation in children with CVM. Methods: Fifty-nine children with CVM who had used a cochlear implant for more than 3 years were included. CVM was classified into 4 subtypes based on the morphology of the cochlea and the modiolus on temporal bone computed tomography (TBCT): normal cochlea and normal modiolus (type A, n = 16), malformed cochlea and partial modiolus (type B, n = 31), malformed cochlea and no modiolus (type C, n = 6), and no cochlea and no modiolus (type D, n = 6). Speech perception test scores were compared between the subtypes of CVM using analysis of covariance with post hoc Bonferroni test. Univariate and multivariate regression analyses were used to identify the significant predictors of the speech perception test scores. Results: The speech perception test scores after implantation were significantly better in children with CVM type A or type B than in children with CVM type C or type D. The test scores did not differ significantly between the implanted children with CVM type A or type B and those without CVM. In univariate regression analysis, the type of CVM was a significant predictor of the speech perception test scores in implanted children with CVM. Multivariate regression analysis revealed that the age at cochlear implantation, cochlear nerve size and preimplantation speech perception test scores were significant predictors of the postimplantation speech perception test scores. The chance of cochlear nerve deficiency increased progressively from CVM type A to type D. Conclusion: The new classification of CVM based on the morphology of the cochlea and the modiolus is simple and easy to use, and correlated well with postimplantation speech perception ability and cochlear nerve status. This simple classification of CVM using TBCT with cochlear nerve assessment by magnetic resonance imaging is helpful in the preoperative evaluation of children with CVM.


1926 ◽  
Vol 44 (1) ◽  
pp. 113-128 ◽  
Author(s):  
Louis A. Julianelle

A biological classification has been made of thirty strains of Friedländer's bacillus. This study reveals that there exist among these strains three sharply defined and specific types and one heterogeneous group. The three types are Type A, fifteen strains; Type B, six strains; Type C, three strains; and Group X, six strains. The agglutination, agglutinin adsorption, protection, thread, and precipitin reactions have been employed in the working out of this classification, and the types have been proved highly specific by means of each serological test.


Author(s):  
Gagandeep Mahi ◽  
Milind Atmaram Lokhande ◽  
Lokesh Kumar Yogi ◽  
Ankit Gawri

<p class="abstract"><strong>Background:</strong> Hemi-arthroplasty of hip for intracapsular fractures of femoral neck is one of the most commonly done surgical procedures in the low mobility older Indian population. Although there are numerous complications associated with the procedure, we want to study the types and management of peri-prosthetic fractures in patients treated with hip hemi-arthroplasty.</p><p class="abstract"><strong>Methods:</strong> A total of 26 patients were included in the study. A retrospective analysis of the radiological cum clinical diagnosis and management of peri-prosthetic fractures was performed. All patients were followed up till 1.5 years post-operatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to Vancouver classification of peri-prosthetic fractures, 10 fractures were classified as type A, 7 as type B1, 3 as type B2, 4 as type B3 and 2 as type C. Fractures were managed either by Open Reduction with Internal Fixation (ORIF) or Revision hemi-arthroplasty. Fractures type AG, B1 and C were managed with ORIF and type B2 and B3 fractures were managed with revision hemi-arthroplasty using longer stem.</p><p class="abstract"><strong>Conclusions:</strong> As evident in our study, majority of fractures occurred intra-operatively, a thorough evaluation of pre-operative x-rays of both hips should be done along with special focus on anatomical variations. Correct diagnosis based on radiological and intraoperative findings followed by appropriate treatment are of paramount importance in the management of peri-prosthetic fractures.</p>


2010 ◽  
Vol 297-301 ◽  
pp. 1226-1231 ◽  
Author(s):  
Irina V. Belova ◽  
Graeme E. Murch ◽  
Thomas Fiedler

Recently, the transition point between the Harrison Type-A and Type-B kinetics regimes as well as the emerging intermediate AB transition regime have been analysed in detail by making use of Lattice Monte Carlo (LMC) simulations of tracer depth concentration profiles as a function of diffusion time and distance between grain boundaries e.g. [1-3]. In the present study, we analyse Harrison Type-B to Type-C kinetics regimes in the transient grain boundary diffusion problem using the parallel slabs model and LMC numerical simulation. The transition point where the Harrison Type-B kinetics regime last occurs (transition point between the Harrison Type-B kinetics and the Type-BC kinetics) is estimated at  (= 0.5δ(Dlt)-1/2) = 0.1. The Harrison Type-C grain boundary diffusion kinetics regime is also analysed using LMC simulated concentration depth profiles. The transition point where the Harrison Type-C kinetics regime first occurs (transition point between the Type-BC kinetics and the Harrison Type-C kinetics) is estimated at  = 5.0. Therefore an intermediate Type-BC regime can be expected to occur between 0.1 <  < 5.0. Preliminary results for the cubic grain model show that the interval for the intermediate Type-BC regime is somewhat narrower for this model and occurs at 0.5 <  < 5.0.


2018 ◽  
Vol 132 (06) ◽  
pp. 489-492 ◽  
Author(s):  
N Jufas ◽  
A Rubini ◽  
D Soloperto ◽  
M Alnoury ◽  
M Tarabichi ◽  
...  

AbstractObjectivesAn anatomical study was performed to describe the endoscopic anatomy and variations of the protympanum, including classification of the protiniculum and subtensor recess.MethodsA retrospective review was conducted of video recordings of cadaveric dissections and surgical procedures, which included visualisation of the protympanum, across 4 tertiary university referral centres over a 16-month period. A total of 97 ears were used in the analysis.ResultsA quadrangular conformation of the protympanum was seen in 60 per cent of ears and a triangular conformation in 40 per cent. The protiniculum was type A (ridge) in 58 per cent, type B (bridge) in 23 per cent and type C (absent) in 19 per cent. The subtensor recess was type A (absent) in 30 per cent, type B (shallow) in 48 per cent and type C (deep) in 22 per cent.ConclusionThe protympanum is an area that has been ignored for many years because of difficulties in visualising it with an operating microscope. However, modern endoscopic equipment has changed this, providing detailed anatomical knowledge fundamental to ensuring the safety of endoscopic surgical procedures in the region.


2017 ◽  
Vol 158 (2) ◽  
pp. 358-363 ◽  
Author(s):  
Bin Li ◽  
Phi Doan ◽  
Robert R. Gruhl ◽  
Alessia Rubini ◽  
Daniele Marchioni ◽  
...  

Objectives The objectives of the study were to (1) study the anatomical variations of the tensor fold and its anatomic relation with transverse crest, supratubal recess, and anterior epitympanic space and (2) explore the most appropriate endoscopic surgical approach to each type of the tensor fold variants. Study Design Cadaver dissection study. Setting Temporal bone dissection laboratory. Subjects and Methods Twenty-eight human temporal bones (26 preserved and 2 fresh) were dissected through an endoscopic transcanal approach between September 2016 and June 2017. The anatomical variations of the tensor fold, transverse crest, supratubal recess, and anterior epitympanic space were studied before and after removing ossicles. Results Three different tensor fold orientations were observed: vertical (type A, 11/28, 39.3%) with attachment to the transverse crest, oblique (type B, 13/28, 46.4%) with attachment to the anterior tegmen tympani, and horizontal (type C, 4/28, 14.3%) with attachment to the tensor tympani canal. The tensor fold was a complete membrane in 20 of 28 (71.4%) specimens, preventing direct ventilation between the supratubal recess and anterior epitympanic space. We identified 3 surgical endoscopic approaches, which allowed visualization of the tensor fold without removing the ossicles. Conclusions The orientation of the tensor fold is the determining structure that dictates the conformation and limits of the epitympanic space. We propose a classification of the tensor fold based on 3 anatomical variants. We also describe 3 different minimally invasive endoscopic approaches to identify the orientation of the tensor fold while maintaining ossicular chain continuity.


2018 ◽  
Vol 159 (6) ◽  
pp. 1037-1042 ◽  
Author(s):  
Lukas Anschuetz ◽  
Matteo Alicandri-Ciufelli ◽  
Marco Bonali ◽  
Matteo Fermi ◽  
Marco Caversaccio ◽  
...  

Objective The aim of this study is to describe the endoscopic anatomy of the subtympanic sinus (STS), establish a classification according to its extension regarding the level of the facial nerve (FN), and assess the feasibility of the transcanal endoscopic approach to the STS. Study Design Experimental anatomic research. Setting Temporal bone laboratory. Methods We performed endoscopic dissection of 34 human whole head and ear block specimens. Of those, 29 underwent high-resolution computed tomography. The STS was classified according to its extension regarding the level of the FN: type A, no extension medial to the FN; type B, extension to the medial limit of the FN; type C, extension of the sinus medially and posteriorly from the FN into the mastoid cavity. Results The majority of cases (n = 21, 72%) showed a shallow type A STS. We observed a deep type B configuration in 6 cases (21%) and a type C in 2 cases (7%). The STS was completely exposable with a 0° endoscope in 44% of the specimens. Using a 45° endoscope, we gained complete insight in 79%. However, in 21% of the cases, the posteromedial extension of the STS was too deep to be completely explored by an endoscopic transcanal approach. Conclusion The majority of the STS is shallow and does not extend medially from the FN. This morphologic variant allows complete transcanal endoscopic visualization. In more excavated STS, a complete endoscopic exploration is not achievable, and a retrofacial approach may be adopted to completely access the STS.


2021 ◽  
pp. 194338752110225
Author(s):  
Kathia Dubron ◽  
Maarten Verbist ◽  
Eman Shaheen ◽  
Titiaan Jacob Dormaar ◽  
Reinhilde Jacobs ◽  
...  

Study Design: Retrospective study. Objective: Zygomaticomaxillary complex (ZMC) fractures are common facial injuries with heterogeneity regarding aetiologies, fracture types, infraorbital nerve (ION) involvement, and treatment methods. The aim of this study was to identify associations between aetiologies, fracture types, and neurological complications. Additionally, treatment methods and recovery time were investigated. Methods: Medical files of 272 patients with unilateral and bilateral ZMC fractures were reviewed, whose cases were managed from January 2014 to January 2019 at the Department of Oral and Maxillofacial Surgery, University hospitals Leuven, Belgium. History of ION sensory dysfunction and facial nerve motoric dysfunction were noted during follow-up. Results: ION hypoaesthesia incidence was 37.3%, with the main causes being fall accidents, road traffic accidents, and interpersonal violence. Significant predictors of ION hypoaesthesia were Zingg type B fractures ( P = 0.003), fracture line course through the infraorbital canal ( P < .001), orbital floor fracture ( P < 0.001), and ZMC dislocation or mobility ( P = 0.001). Conclusion: Of all ZMC fractures, 37.3% exhibited ION hypoaesthesia. Only ZMC Zingg type B fractures (74.0%) were significantly more associated with ION hypoaesthesia. ION hypoesthesia was more likely (OR = 2.707) when the fracture line course ran through the infraorbital canal, and was less dependent on the degree of displacement. Neuropathic pain symptoms developed after ZMC fractures in 2.2% patients, posing a treatment challenge. Neuropathic pain symptoms were slightly more common among women, and were associated only with type B or C fractures. No other parameters were found to predict the outcome of this post-traumatic neuropathic pain condition.


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