Injury
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This study determines the relative effects of changes in osteoporosis condition, plate/screw design factors (plate angle/length/width/thickness and screw diameter) and fixation methods (screw number and screw length) on the biomechanical response of dorsal double plating (DDP) fixation at a distal radius fracture to determine the optimal design and evaluate its biomechanical strength using the dynamic fatigue test. Eighteen CAD and finite element (FE) models corresponding to a Taguchi L18 array were constructed to perform numerical simulations to simulate the mechanical responses of a DDP fixed in a simply distal radius fracture bone. The Taguchi method was employed to determine the significance of each design factor in controlling bone/plate/screw stress and distal fragment displacement under axial (100 N), bending (1 N m) and torsion (1 N m) loads. ⋯ The average stiffness in 20,000 test cycles was 425.7 N/mm, 461.1 N/mm and 532.1N/mm for the 0°, 30° and 60° constructs, respectively. No difference in stiffness was found in the same angled constructs throughout the 20,000 cycles of testing (p > 0.05). Lack of gross construct failures during cyclic testing and reasonable stiffness corroborated that our new constructs tested to date seem stable enough to support restricted post-operative loads.
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The objective was to assess the effect of topically administered dexamethasone on peripheral nerve regeneration and functional recovery. Sixty male healthy white Wistar rats were divided into four experimental groups (n = 15), randomly: in transected group (TC), left sciatic nerve was transected and stumps were fixed in the adjacent muscle. In treatment group defect was bridged using a silicone tube (SIL/Dexa) filled with 10 μL dexamethasone (0.1 mg/kg). ⋯ In immunohistochemistry, location of reactions to S-100 in SIL/Dexa was clearly more positive than that in SIL group. When loaded in a silicone tube, dexamethasone improved functional recovery and morphometric indices of sciatic nerve. Topical application of this readily available agent offers the benefit of cost savings as well as avoiding the complications associated with systemic administration.
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Considering the potential use of growth factors carried by liposomes for bone repair, this study aimed to assess the progress of bone healing process in injured alveoli of rats after administering EGF within liposomes. For this assessment we used 48 male Wistar rats that had their maxillary second molar extracted and separated into 5 groups: sockets filled with blood clot (BC), treated with empty liposome (L), PBS (P), EGF in PBS (EGF-P) and EGF in liposome (EGF-L). The animals were sacrificed after 3, 7, 14 and 21 days after surgery. ⋯ Nevertheless, groups BC, L, P and EGF-P followed a regular time for regeneration significantly different from the EGF-L group, which showed faster recovering. A higher expression of fibronectin and type III collagen in the group EGF-L after 3 and 7 days of surgery was observed and might be explained by the ability of the liposome to deliver EGF in a controlled manner, stimulating mesenchymal cells migration and osteoblast differentiation. As liposome efficiently regulated the availability of EGF without risks for its function and protected the factor from early absorption and degradation, the present work indicates that liposomes can be successful used as carriers for controlled delivery of growth factors in bone healing.
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Review Meta Analysis Comparative Study
External fixation versus open reduction with plate fixation for distal radius fractures: a meta-analysis of randomised controlled trials.
Both external fixation and open reduction with internal fixation (ORIF) using plates have been recommended for treatment of distal radius fractures. We conducted a systematic review and meta-analysis of randomised controlled trials comparing external fixation to ORIF. ⋯ ORIF with plate fixation provides lower DASH scores, better restoration of radial length and reduced infection rates as compared to external fixation for treatment of distal radius fractures.