Reference radiologic measurements for the assessment of tibial pilon fractures

Objectives: The management of pilon fractures is a challenge and the outcome depends on multiple factors, one of which is the quality of reduction. In the literature, there is no assessment of anatomical reduction in pilon fractures. We also lack standard radiological parameters in large patient groups to measure the reduction. The main aim of this analysis was to define normal standard radiological values and identify potential specific types of ankle joint morphology (morphotypes) that might deserve special attention intraoperatively. Methods: We analyzed data of 103 healthy contralateral ankles collected within an observational and prospective multicenter study about tibial pilon fractures. We divided the patients according to their height into two groups, measured 11 radiological parameters, and compared them with each other and the literature. In addition, using cluster analysis, we could identify three morphotypes. Results: There is a statistically significant difference between the two groups in the lengths of three parameters: Mortise width, medial clear space, and length of the lateral malleolus, but not in the angles. The three morphotypes differ only in body mass index and the length of the lateral malleolus. Conclusion: Reference values from the literature are insufficient to assess a reduction after open reduction and internal fixation of tibial pilon fractures because they depend on the height. This does not apply to angles because they are independent of height. For clinical practice, a radiological control of the contralateral healthy ankle gives the best information about the reduction quality and should always be done, especially in normal weight males.

A clinical case of concurrent mycoplasma pneumonia and dengue hemorrhagic fever in a tourist from Thailand

The article describes a clinical case of concurrent infectious diseases - dengue hemorrhagic fever and mycoplasma pneumonia in a patient who came back from the area endemic for dengue fever. Further, the patient was diagnosed with clostridial colitis which was the complication. Clinical, laboratory, and radiological parameters used in the diagnosis of diseases were evaluated.

Associations between radiographic parameters in the reverse shoulder arthroplasty and patient outcomes

Background Various radiological parameters have been measured in the Reverse Shoulder Arthroplasty (RSA) and correlated to patient outcomes, to determine best baseplate position. Results remain unclear with respect to certain parameters such as inferior baseplate tilt. We have investigated our series of patients to clarify the relationship between radiological parameters and patient outcomes. Methods We conducted a UK based bi-centre retrospective review of 156 prostheses. Critical shoulder angle (CSA), RSA angle (RSAA), Overhang and Deltoid Lever Arm (DLA) were measured on preoperative and postoperative radiographs. Range of motion and Oxford Shoulder Score (OSS) (range 1–8 years) were obtained. We assessed for scapular notching at minimum 1 year follow up (n = 138). Results Decreased postoperative CSA and increased DLA were associated with higher OSSs (P = 0.001 and 0.019). Increased overhang and DLA were associated with increased flexion (P = 0.033 and 0.024 respectively). Multivariate analysis showed that CSA and DLA affected notching rate (P = 0.002 and 0.007). Conclusions Baseplate tilt in relation to the acromion (CSA) and DLA are the most predictive parameters for notching and OSS. We recommend considering a maximum CSA of 26 degrees to decrease notching rate and improve OSS. We recommend considering an Overhang of at least 6 mm to improve FF.

Monitoring of compliance of quality and safety of sunflower honey with the requirements of the national standard

Honey natural is one of unique booties of beekeeping. It is not only sweet addition to the ration but also valuable product that contains many important substances, in particular vitamins, micro-macronutrients, enzymes, irreplaceable amino acids and other, that must be in the food ration of everybody. For this reason for today honey is one of products, that occupies the not last place among commodity turnover. It touches not only markets but also trade network of shops and supermarkets. In recent year many producers that buy up honey on apiaries appeared in a trade network, buying honey in apiaries, package and will realize. Such honey needs careful veterinary control in relation to quality and unconcern, in fact he is one of food products, that sufficiently often yields to falsification, and to the consumer, it is almost impossible, independently to distinguish a quality product from an imitation. Therefore the aim of our research was to analyse accordance of indexes of quality and unconcern of honey natural of different producers, that will be realized in the trade network of city in relation to accordance to DSTU 4497:2005 “Natural honey. Specification”. The material of our research was samples of sunflower honey from several domestic producers, selected in the trade network. The research was conducted on the basis of Multidisciplinary Laboratory of Veterinary Medicine (Faculty of Veterinary Medicine and Biotecnologies of Odessa State Agrarian University) and on the basis of the laboratory of Department of Veterinary-Sanitary Inspection (Stepan Gzhytskyi National University of Veterinary Medicine and Biotechnologies, Lviv). Sampling, organoleptic and physicochemical analysis of natural honey, as well as determination of radiological parameters were performed in accordance with DSTU 4497:2005. According to the results of the analysis of the labeling, it is established that the packaging of all investigated products contains the basic production and consumer information in accordance with Article 6 of the Law of Ukraine “On information for consumers about food”. However, the labels of all test samples do not contain separate information provided by the requirements of DSTU 4497:2005 on labeling, namely: the labels of samples №№ 1 and 3 do not indicate the grade of honey, vitamin content and storage temperature of honey, and the expiration date from the date of packaging, not the day of manufacture; on the label of the sample № 2 – the date of packing is not indicated. The study of organoleptic, physicochemical and radiological parameters of sunflower honey samples demonstrates their compliance with the requirements of the regulated DSTU 4497:2005 “Natural honey. Specification”.

Evaluation of Radiological Parameters of the Spino-Pelvic Complex in Children with Hip Subluxation in Legg-Calve-Perthes Disease

Background. The natural course of Legg-Calve-Perthes disease (LCPD) in children with subtotal or total lesion, which correspond to group III-IV according to the Catterall classification, it often leads to hip subluxation. Any changes in the vertebral-pelvic complex lead to mutual transformation and aggravation of existing deformities. In the Russian literature, there are no data on the assessment of the state of the frontal and sagittal spino-pelvic ratios in children with hip subluxation in LCPD. Purpose to evaluate the radiological parameters of the frontal and sagittal spino-pelvic relations in children with hip subluxation in LCPD. Materials and Methods. The study is based on the results of radiometry of 20 patients (20 hip joints) at an average age of 8.90.6 years with LCPD. Radiometry of the main frontal and sagittal spino-pelvic indices was performed and the type of vertical posture was determined according to P. Rousoully, as well as correlations between the studied parameters. Results. All patients had a pelvic distortion in the frontal plane. The values of PI had insignificant changes in comparison with similar values in the asymptomatic child population, the values of SS and SSA exceeded them, and the values of PT were significantly lower, which indicates the presence of excessive pelvic anteversion. The GLL values significantly exceeded the average statistical indicators. The global sagittal balance indicator (SVA) had negative values. The correlation analysis showed the presence of a strong positive relationship between PI and SS, SS and GLL, SSA and SS, a moderately pronounced positive relationship between PI and PT and a moderately pronounced negative relationship between PO and SS, PO and GLL. Conslusion. In children with LCPD in the fragmentation stage with subtotal or total epiphysis lesion (Catterall group III-IV) and hip subluxation, excessive pelvic anteversion is characteristic, which is expressed in an increase in the angle of inclination of the sacrum (SS) in combination with hyperlordosis of the lumbar spine and negative imbalance, as well as a pelvic distortion towards the affected limb. The totality of these changes corresponds to the IV type of vertical posture according to R. Roussouly, which can contribute to the development of degenerative-dystrophic processes in the lumbar spine.

Changes in patellar morphology following surgical correction of recurrent patellar dislocation in children

Background The aim of this study was to evaluate patellar morphological changes following surgical correction of recurrent patellar dislocation in children. Methods A total of 35 immature children aged 5 to 10 years who suffered from bilateral recurrent patellar dislocation associated with abnormal patella morphology were enrolled in this study. The knees with the most frequent dislocations (treated with medial patellar retinacular plasty) were selected as the study group (SG), and those undergoing conservative treatment for the contralateral knee were selected as the control group (CG). Computed tomography (CT) scans were performed on all children preoperatively and at the last follow-up to evaluate morphological characteristics of the patella. Results All the radiological parameters of the patella showed no significant difference between the two groups preoperatively. At the last follow-up for CT scans, no significant differences were found for the relative patellar width (SG, 54.61%; CG, 52.87%; P = 0.086) and the relative patellar thickness (SG, 26.07%; CG, 25.02%; P = 0.243). The radiological parameters including Wiberg angle (SG, 136.25°; CG, 122.65°; P < 0.001), modified Wiberg index (SG, 1.23; CG, 2.65; P < 0.001), and lateral patellar facet angle (SG, 23.35°; CG, 15.26°; P < 0.001) showed statistical differences between the two groups. Conclusions The patellar morphology can be improved by early surgical correction in children with recurrent patellar dislocation. Therefore, early intervention is of great importance for children diagnosed with recurrent patellar dislocation.