Injury
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Comparative Study
Biomechanical cadaver testing of a fixed-angle plate in comparison to tension wiring and screw fixation in transverse patella fractures.
Operative treatment of patella fractures is frequently associated with implant failure and secondary dislocation which can be attributed to the employed hardware. Therefore, a 2.7 mm fixed-angle plate designed for the treatment of patella fractures was tested biomechanically against the currently preferred methods of fixation. It was hypothesized that under simulated cyclic loading fixed-angle plating would be superior to modified anterior tension wiring or cannulated lag screws with anterior tension wiring. ⋯ In contrast to modified anterior tension wiring and cannulated lag screws with anterior tension wiring the bilateral fixed-angle plate was the only fixation device to stabilize transverse patella fractures securely and sustainably.
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The treatment of a simple (AO/OTA classification 31A3.1) reverse oblique intertrochanteric hip fracture is a challenge for the orthopaedic surgeon. The surgical options include the use of side plates with various angled leg screws or intramedullary devices. The purpose of this study was to retrospectively assess our results of treating reverse oblique fracture with an expendable proximal femoral nail (EPFN) or with a dynamic condylar screw-plate (DCS: 95°) between January 2006 and July 2009. ⋯ Two ESPN patients and 5 DCS patients had malunions. Functional outcome scores showed better results in the EPFN group, but the difference was statistically significant only for the sitting subcategory (p=0.04). Based on our results and experience, we propose that the EPFN is at least as good as the DCS for treating reverse oblique fractures of the femur.
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N-acetylcysteine (NAC) suppresses the generation of reactive oxygen species (ROS) that are implicated in ventilator-induced lung injury (VILI). We thus hypothesised that NAC attenuates VILI. VILI was induced by mechanical ventilation with a tidal volume (Vt) of 15mlkg(-1) in isolated and perfused rat lung. ⋯ The administration of NAC increased GSH, attenuated ROS, cytokines, MPO, JNK, pAKT and caspase-3 and lung permeability associated with decreased activation of nuclear factor-κB. VILI is associated with inflammatory responses including the generation of ROS, cytokines and the activation of mitogen-activated protein kinase cascade. The administration of NAC attenuates the inflammatory responses, apoptosis and VILI in the isolated, perfused rat lung model.
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The purpose of this study was to investigate the radiographic and functional outcome of orthogonal plating (two plates at right angles) via a single volar approach for fixation of intra-articular distal radius fractures with an associated radial column fracture. ⋯ Therapeutic IV.
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Spinal injuries secondary to trauma are a major cause of patient morbidity and a source of significant health care expenditure. Increases in traffic safety standards and improved health care resources may have changed the characteristics and incidence of spinal injury. The purpose of this study was to review a single metropolitan Level I trauma centre's experience to assess the changing characteristics and incidence of traumatic spinal injuries and spinal cord injuries (SCI) over a 13-year period. ⋯ This study demonstrated a reduction in mortality attributable to spinal injury. There has been a marked reduction in SCI due to MVAs, which may be related to improvements in motor vehicle safety and traffic regulations. The elderly population was more likely to suffer SCI, especially by blunt injury, and at multiple levels. Underlying reasons may be anatomical, physiological or mechanism related.