Displaced femoral neck fractures are associated with a high revision rate. The new femoral neck system(FNS) offers advantages in fixation stability, potentially reducing the need for revision. The purpose of this study was to compare the revision rate of patients with different reduction quality treated with the FNS and cannulated screws (CS).
OBJECTIVE: To compare the effectiveness of two minimally invasive methods: minimally invasive plating osteosynthesis (MIPO) and expandable intramedullary nailing technique in treatment of middle third humeral shaft fractures. METHODS: The clinical data were retrospectively analyzed and compared from 33 cases with middle third humeral shaft fractures between May 2004 and December 2008. All the patients were divided into 2 groups: 14 patients were treated with MIPO technique (group A) and 19 with expandable intramedullary nailing technique (group B). In group A, there were 10 males and 4 females with an average age of 35 years (range, 21-51 years). The disease cause was traffic accident in 5 cases, tumbling in 6 cases, machine related trauma in 2 cases, crushed by a heavy object in 1 case. Six fractures were classified as AO type A, 6 as type B, and 2 as type C. The time from injury to operation was 3 to 11 days with an average of 5.9 days. In group B, there were 12 males and 7 females with an average age of 40 years (range, 19-68 years). The disease cause was traffic accident in 7 cases, tumbling in 8 cases, falling from height in 3 cases, crush injury in 1 case. Ten fractures were classified as AO type A, 8 as type B, and 1 as type C. The time from injury to operation was 2 to 6 days with an average of 4.2 days. There was no significant difference in general data between 2 groups (P > 0.05). RESULTS: The operation time was (104.6 +/- 25.8) minutes in group A and (85.0 +/- 35.7) minutes in group B, showing no significant difference (P > 0.05). Incision healed by first intention without iatrogenic radial nerve palsy in 2 groups. The patients were followed up 21.4 months on average (range, 12-37 months) in group A and 20.5 months on average (range, 22-35 months) in group B. The X-ray films showed bony healing in all patients. The fracture union time was (16.4 +/- 6.1) weeks in group A and (15.0 +/- 2.5) weeks in group B, showing no significant difference (P > 0.05). The University of California Los Angeles (UCLA) End-Result scores were 34.1 +/- 1.1 in group A and 31.8 +/- 2.6 in group B and the Mayo Elbow Performance scores were 100 in group A and 97.6 +/- 3.9 in group B; all showing significant differences (P < 0.05). CONCLUSION: Good clinical outcomes could be obtained when middle third humeral shaft fractures are treated by either MIPO or expandable intramedullary nailing techniques. However, MIPO technique could offer better shoulder and elbow functional results.
To investigate the feasibility and therapeutic effect of subcutaneous pedicle screw-rod system with modified placement in treatment of Tile B pelvic fractures.From June 2014 to August 2015, 14 patients with Tile B pelvic fractures were treated by subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle. There were 8 males and 6 females, aged from 23 to 65 years with an average of 42 years. Operative time, intraoperative blood loss, fracture healing and postoperative complication were observed and clinical effects were evaluated by Matta reduction standard and Majeed score.All patients were followed up from 8 to 15 months with an average of 10.5 months. Operative time was 25 to 45 min with an average of 32 min;intraoperative blood loss was 10 to 35 ml with an average of 18 ml. All fractures got primary healing and healed time was 9 to 14 weeks with an average of 12.5 weeks. No postoperative incision infection, internal fixation failure and ectopic ossification were found, 4 cases occurred unilateral lateral femoral cutaneous nerve injury and 1 case occurred unilateral femoral nerve paralysis, but all restored finally. According to Matta criteria, reduction was excellent in 7 cases, good in 5 cases, fair in 2 case. According to Majeed score system, the functional evaluation at last follow-up was excellent in 5 cases, good in 7 cases, fair in 2 cases with the average score of 81.50±8.05.Subcutaneous pedicle screw-rod system with modified placement in the anterior inferior iliac spine and pubic tubercle have advantages of strong reduction, less trauma and complications, and is a promising surgical method in the treatment of Tile B pelvic fractures.
Tobacco alkaloids in tobacco-cultivated soils pose potential risks for succeeding crops, due to their allelopathy and toxicity. Effects of biochar on the dissipation of tobacco alkaloids in soil-crop systems remain poorly understood. In this study, a 40-day pot experiment was conducted to explore the effect of cow dung biochar (CDBC) and maize straw biochar (MSBC) on the uptake of nicotine and nornicotine by pea (Pisum sativum L.) and their dissipation in an agricultural soil. The results revealed that the bioaccumulation of nicotine and nornicotine by pea shoots in the soils added with CDBC and MSBC at 1.5% and –3.0% significantly decreased by 46.97–79.13% and 33.64–71.59%, respectively. Compared with MSBC, CDBC more effectively decreased the uptake and bioaccumulation of nicotine and nornicotine by pea shoots than MSBC result from the higher soil pH, and nutrients. The decreased bioavailability in the soils due to the increased adsorption was the key factor for the reduced bioaccumulation of tobacco alkaloids. The enhanced relative abundances of soil nicotine-degrading bacteria belonging to the genera Arthrobacter and Gemmatimonas decreased the uptake of nicotine by pea plants. This study firstly provides guidance to protect subsequent crops in tobacco-cultivated soil from tobacco alkaloids with biochar.
Abstract Background Several methods have been proposed to reduce plate construct stiffness and promote secondary bone healing. In this study, we explored the stiffness and strength of the new carbon fiber-reinforced poly-ether-ether-ketone (CF 50) plate compared with the titanium alloy plate (Ti6Al4V). Methods Titanium and CF-PEEK locking plates were tested in a tibial non-osteoporotic diaphyseal comminuted fracture model to determine construct stiffness in axial compression, torsion, and bending. Subsequently, constructs were loaded until construct failure to determine construct strength. Results Relative to the titanium locking plate, the stiffness of the CF-PEEK locking plate was 6.8% and 30.8% lower in 200 N and 700 N axial compression, respectively ( P < 0.05), 64.9% lower in torsion ( P < 0.05), and 48.9% lower in bending ( P < 0.05). The strength of the CF-PEEK locking plate was only 2.6% lower under axial compression, 7.8% lower in torsion, and 4.8% lower in bending than the titanium locking plate ( P > 0.05). Conclusions The CF-PEEK locking plate significantly reduced axial, torsion, and bending stiffness compared with the titanium locking plate. Nonetheless, axial, torsional, and bending strength showed only a modest reduction. Considering its other advantages, which include radiolucency and artifact-free imaging, the CF-PEEK locking plate therefore deserves further clinical investigation.
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