Multislice Spiral Computed Tomography Postprocessing Technology in the Imaging Diagnosis of Extremities and Joints

Objective. To improve the clinical detection rate of bone and joint fractures of the extremities and to explore the value and significance of the application of multislice spiral computed tomography (MSCT) postprocessing technology in diagnosis. Methods. 80 patients with bone and joint fractures of the extremities admitted to the hospital were selected as the research objects. The patients received X-ray digital radiography (DR) plain film examination and then MSCT examination. At the same time, multiplane reconstruction (MPR) and surface shadow display (SSD) and volume rendering three-dimensional imaging (VRT) technology and other postprocessing technologies compare the differences in the detection rate of limbs and joint fractures between the two inspection methods. Results. A total of 100 fractures were found in 80 patients. The detection rate of X-ray DR was 69%. After MSCT postprocessing technology, the detection rates of MPR, SSD, and VRT were 96%, 98%, and 99%, respectively. The accuracy of MSCT postprocessing technology in diagnosing extremity bone and joint fractures was significantly higher than that of DR, and the difference between groups was statistically significant. Conclusion. MSCT postprocessing technology for patients with extremity bone and joint fractures has a good effect. It is not only noninvasive but also has a high detection rate. It can significantly reduce the missed and misdiagnosed rate and provide detailed imaging data for the formulation of clinical treatment plans.

RESULTADOS CLINICOS Y RADIOLOGICOS POSTERIORES AL TRATAMIENTO QUIRURGICO DE FRACTURA DE MESETA TIBIAL EN PACIENTES MILITARES EN ACTIVO DEL CENTRO MEDICO NAVAL DE MEXICO

Objective: To lay foundations in the population of theNavy Secretary from Mexico on the frequency, surgical approach, and recovery time of tibial plateau fractures, which would help in the future to develop more efficient protocols for the treatment of these patients and achieve their faster recovery, incorporating into their daily activities of high impact without complications. Materials and methods: We evaluated the functional and radiographic recovery of 20 active military patients with tibial plateau fracture undergoing surgical treatment at the Naval Medical Center of Mexico (CEMENAV) during the period from 2018 to 2021. Results: Of the patients evaluated in this study, it was found that 70% were men, in addition, it was observed that the most frequent tibial plateau fracture was type III, based on the Schatzker scale. Highlighting that the surgical approach most frequently was the previous one >80% of patients. In addition, 45% of patients showed excellent functional recovery, but 15% were poor. However, 90% of the patients had a very good radiographic recovery. Conclusion: The management of proximal tibial joint fractures that occur in the military, which are treated surgically at the Naval Medical Center of Mexico, show favorable functional results accompanied by an adequate radiological evaluation.

Recovery of Post-Traumatic Temporomandibular Joint after Mandibular Fracture Immobilization: A Literature Review

Considered as one of the most common traumatic injuries of the maxillofacial region, mandibular fractures remain among the complex causes of temporomandibular joint disorders (TMDs). Due to the complexity of the temporomandibular joint, the management of TMDs represents a challenge in real-life practice; although many treatment modalities have already been proposed, ranging from conservative options to open surgical procedures, a consensus is still lacking in many aspects. Furthermore, despite continuous improvement of the management of mandible fractures, the duration of immobilization and temporary disability is not reduced, and the incidence of complications remains high. The aim of the present study is to (i) review anatomophysiological components of temporomandibular joint; (ii) review concepts of temporomandibular joint fractures; and (iii) describe methods of the recovery of the temporomandibular joint after mandibular fracture immobilization.

Medicinal importance of Kaempferia galanga L. (Zingiberaceae): A comprehensive review

Kaempferia galanga included in the Zingiberaceae family is one of the potential medicinal plants with aromatic rhizome. In traditional medicine in Asian countries, this plant is widely used by local practitioners. This plant is widely cultivated in most Southeast Asian countries such as Cambodia, Vietnam, Malaysia, Thailand, and Indonesia. Ethyl-para-methoxycinnamate and ethyl-cinnamate are found as the main compounds in hexane, dichloromethane, and methanol extracts of K. galanga. This plant is traditionally used as an expectorant, stimulant, diuretic, carminative, and antipyretic remedy. In addition, K. galanga is used for treatment of diabetes, hypertension, cough, asthma, joint fractures, rheumatism, urticaria, vertigo, and intestinal injuries. Therefore, this study aimed to give a sneak peek view on galangal’s ethnobotany, toxicology, pharmacology, and phytochemistry.

Hemihamate arthroplasties in pilon fractures: a modified approach and experience in 30 patients

Hemihamate arthroplasty is an established method of managing difficult Pilon fractures of the proximal interphalangeal (PIP) joint. We present our experience in 30 patients, whose injuries were further complicated by severe comminution and late presentations. Several modifications were utilized, including preoperative distraction, use of smaller size grafts and functional release of collaterals. The average follow-up period was 28 months (range 18 to 28). Postoperatively, the average range of flexion at the PIP joint improved from 30° (range 20° to 45°) preoperatively to 104° (90° to 110°) at the final follow-up. The average extension lag was 6° (0° to 20°). Five patients required secondary procedures and no patient had a recurrent dorsal dislocation. We propose these modifications in the use of hemihamate arthroplasty for the management of difficult PIP joint fractures. Level of evidence: IV

Vascular impulse technology versus elevation for the reduction of swelling of lower extremity joint fractures: results of a prospective randomized controlled study

Aims Complex joint fractures of the lower extremity are often accompanied by soft-tissue swelling and are associated with prolonged hospitalization and soft-tissue complications. The aim of the study was to evaluate the effect of vascular impulse technology (VIT) on soft-tissue conditioning in comparison with conventional elevation. Methods A total of 100 patients were included in this prospective, randomized, controlled monocentre study allocated to the three subgroups of dislocated ankle fracture (n = 40), pilon fracture (n = 20), and intra-articular calcaneal fracture (n = 40). Patients were randomized to the two study groups in a 1:1 ratio. The effectiveness of VIT (intervention) compared with elevation (control) was analyzed separately for the whole study population and for the three subgroups. The primary endpoint was the time from admission until operability (in days). Results The mean length of time until operability was 8.2 days (SD 3.0) in the intervention group and 10.2 days (SD 3.7) in the control group across all three fractures groups combined (p = 0.004). An analysis of the subgroups revealed that a significant reduction in the time to operability was achieved in two of the three: with 8.6 days (SD 2.2) versus 10.6 days (SD 3.6) in ankle fractures (p = 0.043), 9.8 days (SD 4.1) versus 12.5 days (SD 5.1) in pilon fractures (p = 0.205), and 7.0 days (SD 2.6) versus 8.4 days (SD 1.5) in calcaneal fractures (p = 0.043). A lower length of stay (p = 0.007), a reduction in pain (ppreop = 0.05; pdischarge < 0.001) and need for narcotics (ppreop = 0.064; ppostop = 0.072), an increased reduction in swelling (p < 0.001), and a lower revision rate (p = 0.044) could also be seen, and a trend towards fewer complications (p = 0.216) became apparent. Conclusion Compared with elevation, VIT results in a significant reduction in the time to achieve operability in complex joint fractures of the lower limb. Cite this article: Bone Joint J 2021;103-B(4):746–754.

Role and importance of posterior malleolus fixation in trimaleolar fractures

Introduction - ankle fractures are third when it comes to frequency, right after hip and wrist joint fractures. Posterior malleolus fractures are common, comprising 7% to 44% of all ankle fractures, and are very rare on their own; that is a Volkmann triangle fracture. Ankle is a supporting joint in the human body, and fractures generally occur within rotation of the body with different fixed foot positions. The posterior malleolus is a very important structure in distal tibiofibular joint. Material and methods - we retrospectively present a group of 21 patients who had a fracture of the ankle and were surgically treated at the Clinic for Orthopedics and Traumatology in Niš during the period from January 2013 to December 2015. The basic criterion for surgical treatment was the size of the fragment, > 25% from tibial joint surface and dislocation >2mm. We systemized all ankle fractures according to the Lauge Hansen system, which is based on the mechanism of injury. We evaluated treatment results according to the Olerud-Molander classification, followed by subjective and objective signs. We systemized posterior malleolus fractures into three types, according to the Haraguchi classification. Results - etiological causes of the fractures are: a fall at the same level - sport, skating in 11 (52.3%) patients, a fall from a height in 6 (28.6%) and traffic accident in 4 (21.1%) patients. According to the Lauge Hansen classification, there were 15 (71.4%) patients with a SER-type fracture, 4 (19%) of the PER type, and 2 (9.6%) of the PA type. End result of the treatment was excellent in 13 (61.9%) patients, good in 7 (33.4%) and poor in 1 (4.7%) patient. Post-traumatic arthritis (PTA) was assessed one year after the surgery and level 1 and 2 were present in 12 (57.1%) patients.