A case of fracture talus with medial malleolus treated with headless screws and cancellous cannulated screws using single anteromedial approach

<p>Talar fractures are complex injuries with an array of management options and complications. We present a case of talar fracture with medial malleolus fracture fixed via common anteromedial approach through the fracture site. The incidence of associated malleolar injury has ranged from 19% to 28% in prior studies. The skin condition is often poor and prone to swelling in such cases which makes the management challenging. Along with poor wound healing, joint stiffness, osteonecrosis and osteoarthritis of the ankle are complications affecting the outcome of the patient.</p>

Synthesis and study of oligohexamethyleneguanidine hydroiodide as a radiopaque substance

Diagnosis of complex injuries, such as splinter fractures and wounds, skull injuries accompanied by internal injuries that are inaccessible to visual control, presents the greatest difficulties during X-ray examination. Therefore, it is relevant to develop a drug that can help localize the site of a pathological lesion with high accuracy, relying only on the results of an X-ray study, which is possible when a reference point (substance) is applied to the patient’s skin. A radiopaque contrast compound based on an iodinated polymeric matrix with iodine as the contrasting component and polyguanidine as the carrier has been proposed to be used as a reference point substance. The choice of this class of polymers stemmed from the fact that a positive charge is localized to a greater extent on the carbon atom of the guanidine group, which allows loading iodine anions into it. Protonation of pure guanidine with hydroiodic acid has helped obtain guanidine hydroiodide. This finding was confirmed by IR spectroscopy methods (a decrease in the intensity of bands in the region of 1,380, 880 cm−1 in comparison with guanidine, as well as broadening of the band of stretching vibrations of amino groups characteristic of guanidine salts) and X-ray phase analysis. Polyhexamethylene guanidine hydroiodide was synthesized based on hexamethylenediamine and iodine-containing guanidine salt using melt polycondensation. The results show that the aqueous solutions of samples under study absorb X-radiation and are the X-ray-positive substances (exposure radiation dosage E = 0.04 mSV).

Aldolase A and carbonic anhydrase III, two new candidate biomarkers versus acknowledged parameters in the context of crushing syndrome

Introduction. Crushing syndrome can affect all structures of a limb and can cause unique or complex injuries. The clinical picture of the injuries is nonspecific and extremely varied, and is not characteristic of the mechanism that generated it. The aim of our study was to correlate the changes of ALD A (aldolase A) and CAIII (carbonic anhydrase III) in the appearance and evolution of the crushing syndrome. Material and methods. The present study included 22 patients with crushing syndrome. The control group consisted of 20 healthy subjects. IL-6 (interleukin-6), CK (creatine kinase), ALD A and CAIII blood levels were determined simultaneously from all the participants to the study. Statistical analysis was performed using IBM SPSS Statistics 25 and Microsoft Office Excel / Word 2013. Results. Our results showed significantly increased levels of ALD A, CAIII, IL-6 and CK in patients with crushing syndrome. However, no statistically significant correlations could be found between the studied biomarkers. Discussions. So far, in the medical literature, very few studies focused on the correlation between the occurrence of crushing syndrome and changes in ALD A and CA III levels. Conclusions. Our study showed that ALD A and CAIII may become important biomarkers for the rapid diagnosis of crushing syndrome in the future.