Injury
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S-100 B protein was identified as a biomarker for traumatic brain injury, but studies suggest that extracranial injuries may also lead to increased S-100 B serum levels. In this study, we aim to quantify the impact of injury patterns on S-100 B levels in patients with suspected multiple trauma. ⋯ Fractures and thoracic injuries appeared as main factors associated with increased S-100 B levels. Head injury may only play a minor role in S-100 B protein elevation in multiple trauma patients. A normal S-100 B has a good negative predictive value for in-hospital mortality. S100-B levels were associated with trauma severity and might thus be of use as a prognostic marker in trauma patients.
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Osteosynthesis is recommended for Garden I and II femoral neck fracture treatment using parallel partially threaded cannulated screws. Postoperatively, excessive femoral neck shortening (FNS) and posterior tilt of the femoral neck (PTFN) are frequently encountered and are correlated with impaired quality of life and clinical outcomes. We hypothesized that stabilization by parallel partially threaded cannulated screws replacing a posterior partially threaded screw with a fully threaded positioning screw would improve fracture healing without further FNS and PTFN in femoral neck fractures. ⋯ Parallel cannulated screws replacing a posterior partially threaded screw with a fully threaded positioning screw as a length- and angle-stable construct for Garden I or II femoral neck fracture fixation can prevent femoral neck collapse in both the coronal and axial planes.
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Comparative Study
Comparison of histopathology and preoperative 18F-FDG-PET/CT of osteomyelitis aiming for image guided surgery: A preliminary trial.
There are currently no robust methods for accurately localizing the infection focus of osteomyelitis. Accumulation of fluorodeoxyglucose (FDG) is nonspecific, and it is well-known that it can indicate inflammatory cells and sites of inflammation, and its effectiveness in detecting osteomyelitis has been reported recently. However, the optimal cut-off value for the Standardized Uptake Value (SUV) in detecting the focus of osteomyelitis through 18F-FDG-PET/CT is not known. We investigated the optimal SUV cut-off values using 18F-FDG positron emission tomography (PET)computed tomography (CT) to visualize the infection focus of osteomyelitis accurately. ⋯ The infection focus of osteomyelitis was accurately visualized by setting the SUV cut-off lower level to 2.00 and upper level to 8.00. We believe that this 18F-FDG PET/CT technique is helpful for image guided surgery of osteomyelitis.
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The aim of this study is to assess the causes and rates of re-operation in olecranon fractures in adults treated with transosseous suture. ⋯ Transosseous suture with high strength thread is a valid alternative for treating Mayo IIA olecranon fractures in adult patients, decreasing re-operation rates for implant removal. There may be, in a moderate percentage of cases, radiologic diastasis of the posterior cortex at the fracture site, without causing pain nor limiting mobility LEVEL OF EVIDENCE: III.
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When a coronal fracture affects the capitellum and the trochlea, the Kocher lateral approach may be inadequate for the correct visualisation, reduction and fixation of the fracture. In such cases an associated medial elbow approach may be required, or a posterior transolecranon approach may be preferred. The anterior limited approach to the elbow (ALAE) could be a valid option when treating these types of fracture, as it does not involve the detachment of any muscle group or ligament, thereby facilitating the recovery process. ⋯ The presence of associated fractures does not seem to worsen the results. We believe that the ALAE is a technical option to consider for the open surgical treatment of a capitellar fracture with or without involvement of the trochlea. LEVEL OF EVIDENCEIS: Therapeutic Level III.