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Galli M, Laborante R, Occhipinti G, Zito A, Spadafora L, Biondi-Zoccai G, Nerla R, Castriota F, D'Amario D, Capodanno D, Jeong YH, Kimura T, Mehran R, Angiolillo DJ. Impact of ethnicity on antiplatelet treatment regimens for bleeding reduction in acute coronary syndromes: a systematic review and pre-specified subgroup meta-analysis. Eur Heart J Cardiovasc Pharmacother 2024; 10:158-169. [PMID: 37960983 DOI: 10.1093/ehjcvp/pvad085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/01/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023]
Abstract
AIMS Randomized controlled trials (RCTs) testing bleeding reduction strategies using antiplatelet treatment regimens (BRATs) in acute coronary syndromes (ACS) have shown promising results, but the generalizability of these findings may be significantly influenced by the ethnicity of the patients enrolled, given that East Asian (EA) patients show different ischaemic-bleeding risk profile compared to non-EA patients. METHODS AND RESULTS RCTs comparing a BRAT vs. standard 12-month dual antiplatelet therapy (DAPT) in patients with ACS undergoing percutaneous coronary intervention (PCI) were selected. The primary efficacy endpoint was major adverse cardiovascular events (MACE) as defined in each trial and the primary safety endpoint was minor or major bleeding. Twenty-six RCTs testing seven different BRATs were included. The only strategy associated with a trade-off in MACE was 'upfront unguided de-escalation' in the subgroup of non-EAs (risk ratio 1.16, 95% confidence interval 1.09-1.24). All but aspirin monotherapy-based strategies (i.e. 'short and very short DAPT followed by aspirin') were associated with reduced bleeding compared with standard DAPT in both EA and non-EA patients. There were no significant differences between subgroups, but the lack of RCTs in some of the included strategies and the difference in the certainty of evidence between EA and non-EA patients revealed that the evidence in support of different BRATs in ACS undergoing PCI is influenced by ethnicity. Moreover, absolute risk reduction estimation revealed that some BRATs might be more effective than others in reducing bleeding according to ethnicity. CONCLUSION The majority of BRATs are associated with reduced bleeding without any trade-off in hard ischaemic endpoints regardless of ethnicity. However, the supporting evidence and relative safety profiles of different BRATs might be significantly affected by ethnicity, which should be taken into account in clinical practice. STUDY REGISTRATION This study is registered in PROSPERO (CRD42023416710).
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Affiliation(s)
- Mattia Galli
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | | | - Giovanni Occhipinti
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Catania, Italy
| | - Andea Zito
- Catholic University of the Sacred Heart, Rome, Italy
| | - Luigi Spadafora
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Roberto Nerla
- Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
| | | | - Domenico D'Amario
- Dipartimento Universitario di Medicina Traslazionale, Università Piemonte Orientale, Azienda Ospedaliero-Universitaria Maggiore della Carità di Novara, Novara, Italy
| | - Davide Capodanno
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico 'G. Rodolico-San Marco', University of Catania, Catania, Italy
| | - Young-Hoon Jeong
- CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Takeshi Kimura
- Division of Cardiology, Hirakata Kohsai Hospital, Osaka, Japan
| | - Roxana Mehran
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dominick J Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
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Gökçe Y, Danisman B, Akcay G, Derin N, Yaraş N. L-Carnitine improves mechanical responses of cardiomyocytes and restores Ca 2+ homeostasis during aging. Histochem Cell Biol 2023; 160:341-347. [PMID: 37329457 DOI: 10.1007/s00418-023-02215-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/19/2023]
Abstract
L-Carnitine (β-hydroxy-γ-trimethylaminobutyric acid, LC) is a crucial molecule for the mitochondrial oxidation of fatty acids. It facilitates the transport of long-chain fatty acids into the mitochondrial matrix. The reduction in LC levels during the aging process has been linked to numerous cardiovascular disorders, including contractility dysfunction, and disrupted intracellular Ca2+ homeostasis. The aim of this study was to examine the effects of long-term (7 months) LC administration on cardiomyocyte contraction and intracellular Ca2+ transients ([Ca2+]i) in aging rats. Male albino Wistar rats were randomly assigned to either the control or LC-treated groups. LC (50 mg/kg body weight/day) was dissolved in distilled water and orally administered for a period of 7 months. The control group received distilled water alone. Subsequently, ventricular single cardiomyocytes were isolated, and the contractility and Ca2+ transients were recorded in aging (18 months) rats. This study demonstrates, for the first time, a novel inotropic effect of long-term LC treatment on rat ventricular cardiomyocyte contraction. LC increased cardiomyocyte cell shortening and resting sarcomere length. Furthermore, LC supplementation led to a reduction in resting [Ca2+]i level and an increase in the amplitude of [Ca2+]i transients, indicative of enhanced contraction. Consistent with these results, decay time of Ca2+ transients also decreased significantly in the LC-treated group. The long-term administration of LC may help restore the Ca2+ homeostasis altered during aging and could be used as a cardioprotective medication in cases where myocyte contractility is diminished.
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Affiliation(s)
- Yasin Gökçe
- Faculty of Medicine, Department of Biophysics, Harran University, Sanliurfa, Turkey.
| | - Betul Danisman
- Faculty of Medicine, Department of Biophysics, Ataturk University, Erzurum, Turkey
| | - Guven Akcay
- Faculty of Medicine, Department of Biophysics, Hitit University, Corum, Turkey
| | - Narin Derin
- Faculty of Medicine, Department of Biophysics, Akdeniz University, Antalya, Turkey
| | - Nazmi Yaraş
- Faculty of Medicine, Department of Biophysics, Akdeniz University, Antalya, Turkey
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Pradel S, Brunaud M, Coulomb R, Kouyoumdjian P, Marès O. Less than 1.5cm shortening in clavicle midshaft fracture has long-term functional impact. Orthop Traumatol Surg Res 2023; 109:103590. [PMID: 36905957 DOI: 10.1016/j.otsr.2023.103590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 12/11/2022] [Accepted: 01/23/2023] [Indexed: 03/11/2023]
Abstract
INTRODUCTION Mediolateral shortening is a risk in treatment of clavicle shaft fracture, and can lead to scapular dyskinesis and shoulder dysfunction. Many studies advocated surgical treatment if shortening exceeds 15mm. HYPOTHESIS Clavicle shaft shortening of less than 15mm has negative impact on shoulder function at more than 1 year's follow-up. MATERIALS AND METHODS A retrospective case-control comparative study was performed, with assessment by an independent observer. Clavicle length was measured on frontal radiographs showing both clavicles, and the ratio between the healthy and affected sides was calculated. Functional impact was assessed on Quick-DASH. Scapular dyskinesis was analyzed by global antepulsion on Kibler's classification. In total, 217 files were retrieved for a 6-year period. Clinical assessment was performed for 20 patients managed non-operatively and 20 patients managed by locking plate fixation, at a mean 37.5months' follow-up (range: 12-69months). RESULTS Mean Quick-DASH score was significantly higher in the non-operated group: 11.363 [0-50] versus 2.045 [0-11.36] (p=0.0092). Pearson ρ correlation between percentage shortening and Quick-DASH score was -0.3956 [95% CI: -0.6295; -0.0959] (p=0.012). Clavicle length ratio differed significantly between groups: operated group, +2.2% [-5.1%; +17%] for 0.34cm; non-operated group, -8.28% [-17.3%; -0.7%] for 1.38cm (p<0.0001). Shoulder dyskinesis was significantly more frequent non-operated patients: 10 versus 3 (p=0.018). A threshold of 1.3cm shortening was found for functional impact. CONCLUSION Restoring scapuloclavicular triangle length is an important aim in management of clavicular fracture. Surgery by locking plate fixation is therefore to be recommended in case of>8% radiological shortening (1.3cm) to avoid medium- and long-term complications in shoulder function. LEVEL OF EVIDENCE III; case-control study.
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Affiliation(s)
- Sarah Pradel
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalo-Universitaire de Nîmes, Nîmes, France.
| | - Maxime Brunaud
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalo-Universitaire de Nîmes, Nîmes, France
| | - Rémy Coulomb
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalo-Universitaire de Nîmes, Nîmes, France
| | - Pascal Kouyoumdjian
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalo-Universitaire de Nîmes, Nîmes, France
| | - Olivier Marès
- Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalo-Universitaire de Nîmes, Nîmes, France
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Mejia A, Lichtig AE, Ghosh A, Balasubramaniyan A, Mass D, Amirouche F. The Effect of Metacarpal Shortening on Finger Strength and Joint Motion: A Cadaveric Biomechanical Study. J Hand Surg Glob Online 2023; 5:407-412. [PMID: 37521540 PMCID: PMC10382880 DOI: 10.1016/j.jhsg.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/07/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Discrepancies exist between previous biomechanical and clinical studies when determining acceptable metacarpal shortening after metacarpal fractures. This study aimed to determine the amount of acceptable shortening after a metacarpal fracture before finger motion and strength is compromised. Methods We defrosted ten fresh-frozen cadaveric hands. A screw-driven external fixator was placed to stabilize the metacarpal, then a 15.0-mm section of the index metacarpal was excised and replaced with a three dimensional-printed, custom-designed polyethylene insert. The hand was then mounted on a custom testing rig, and the index finger was flexed using the flexor digitorum profundus tendon. Joint angles and fingertip force were recorded as the finger was flexed. Incrementally smaller inserts were placed, and testing was repeated. Results The average joint angles of the intact condition for the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were (54 [SD = 13], 79 [SD = 21], and 73 [SD = 10]), respectively. There were no statistically significant changes to any joint angle with any amount of shortening. The maximal fingertip contact pressures were 41 N (17), 31 N (12), 24 N (14), 19 N, (11), and 14 N (8) for the 15 mm, 12.5 mm, 10 mm, 7.5 mm, and 5 mm inserts, respectively. All changes in fingertip force by insert size were statistically significant. Conclusion Metacarpal shortening does not affect flexion range of motion regardless of the amount of shortening, but it significantly affects finger strength. The loss of strength after shortening was approximately 6.5% per mm of shortening for the fractured metacarpal. Clinical Relevance When viewed in the context of the hand as a whole and the contribution of the index finger to grip being only 23.5%, it is unlikely that any shortening will significantly affect the average patient regarding grip strength. However, for a patient who requires fine motor strength, any amount of shortening may affect their finger function and needs to be addressed.
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Affiliation(s)
- Alfonso Mejia
- Chicago Department of Orthopaedics, University of Illinois, Chicago, IL
| | - Asher Eli Lichtig
- Chicago Department of Orthopaedics, University of Illinois, Chicago, IL
| | - Arnab Ghosh
- Chicago Department of Mechanical and Industrial Engineering, University of Illinois, Chicago, IL
| | - Akshay Balasubramaniyan
- Chicago Department of Mechanical and Industrial Engineering, University of Illinois, Chicago, IL
| | - Daniel Mass
- Chicago Department of Orthopaedics, University of Illinois, Chicago, IL
| | - Farid Amirouche
- Chicago Department of Orthopaedics, University of Illinois, Chicago, IL
- Department of Orthopaedic Surgery, NorthShore University Health System, Evanston, IL
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Bui G, Rogers MJ, Shigley C, Huang JI. Staple Fixation in Ulnar- Shortening Osteotomies. J Hand Surg Glob Online 2023; 5:477-482. [PMID: 37521548 PMCID: PMC10382933 DOI: 10.1016/j.jhsg.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/25/2023] [Indexed: 08/01/2023] Open
Abstract
Ulnar-sided wrist pain is commonly caused by the ulnar impaction syndrome. Ulnar-shortening osteotomy is a surgical treatment that is used to address ulnar impaction syndrome that fails conservative management. Unfortunately, hardware irritation and nonunion are well-known complications of this procedure. This case report details the course of two patients with nonunion after ulnar-shortening osteotomy who were treated with a combination of a nitinol compression staple and neutralization plate. Further investigation is required to determine the long-term outcomes and indications for nitinol-staple fixation for nonunion after ulnar-shortening osteotomy.
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Affiliation(s)
- Gabrielle Bui
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA
| | - Miranda J. Rogers
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA
| | - Christian Shigley
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA
| | - Jerry I. Huang
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA
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Chao YH, Chou YC, Lin CL. The deformities of acute diaphyseal clavicular fractures: a three-dimensional analysis. Biomed Eng Online 2023; 22:42. [PMID: 37161417 PMCID: PMC10170817 DOI: 10.1186/s12938-023-01112-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/02/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Although minimally invasive surgeries have gained popularity in many orthopaedic fields, minimally invasive approaches for diaphyseal clavicular fracture have not been widely performed, which is attributed to difficulties in performing a closed reduction of fracture deformities of a curved bone in a three-dimensional space. The goal of this study was to investigate the radiographic parameters of fracture deformities in a three-dimensional space and to identify the risk factors for deformities. METHODS The computed tomography images of 100 patients who sustained a clavicle fracture were included. Five parameters were used to analyze the deformities: change in clavicle length, fracture displacement, and fragment rotation around the X, Y, Z axes. The change in length was assessed using the length of the endpoint line. The displacement was assessed using the distance between the fracture midpoints. The rotation deformities were assessed using the Euler angles. The correlation between the parameters was evaluated with the Pearson correlation coefficient. The risk factors were evaluated using univariable analysis and multiple regression analysis. RESULTS The average change in length was - 5.3 ± 8.3 mm. The displacement was 11.8 ± 7.1 mm. The Euler angles in the Z-Y-X sequences were -1 ± 8, 1 ± 8, and - 8 ± 13 degrees. The correlation coefficient between the change in length and the displacement was - 0.724 (p < 0.001). The variables found to increase the risk of shortening and displacement were right-sided fracture (p = 0.037), male sex (p = 0.015), and multifragmentary type (p = 0.020). The variables found to increase the risk of rotation deformity were the number of rib fractures (p = 0.001) and scapula fracture (p = 0.025). CONCLUSIONS There was a strong correlation between shortening and displacement. The magnitude of anterorotation around the X axis was greater than the magnitude of retraction around the Z axis and depression around the Y axis. The risk factors for shortening and displacement included right-sided fracture, male sex, and multifragmentary type. The risk factor for retraction around the Z axis was the number of rib fractures, and the risk factor for depression around the Y axis was scapula fracture. These results could be useful adjuncts in guiding minimally invasive surgical planning for diaphyseal clavicular fractures.
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Affiliation(s)
- Yi-Hsuan Chao
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan
- Department of Orthopaedic Surgery, Taipei City Hospital, No. 10, Sec. 4, Ren'ai Rd., Da'an Dist., Taipei, 106, Taiwan
- Innovation & Translation Center of Medical Device, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan
| | - Ying-Chao Chou
- Department of Orthopedics, Chang Gung Memorial Hospital, No. 5, Fuxing St., Guishan Dist., Taoyuan, 333, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan.
- Innovation & Translation Center of Medical Device, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan.
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Bhardwaj P, Malokar D, Sankaran A, Varadharajan V, Venkatramani H, Sabapathy SR. Does the Functional Status of the Upper Limb Influence Limb Length Discrepancy in a Child with Birth Brachial Plexus Palsy? J Hand Surg Asian Pac Vol 2023; 28:5-12. [PMID: 36803474 DOI: 10.1142/s2424835523500121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background: Limb length discrepancy (LLD) is a frequent observation in children with birth brachial plexus palsy (BBPP) and a common concern among parents. A common assumption is that the LLD decreases if the child is using the involved limb more. However, there is no literature evidence for this assumption. The present study was conducted to assess the correlation between the functional status of the involved limb and the LLD in children with BBPP. Methods: One hundred consecutive patients (age > 5 years) with unilateral BBPP seen at our institute underwent measurements of limb lengths to assess the LLD. The arm, forearm and hand segments were measured separately. The functional status of the involved limb was assessed using modified House's Scoring system (Scores 0-10). The correlation between limb length and functional status was assessed using the one-way Analysis of Variance (ANOVA) test. Post-hoc analyses were performed as required. Results: A length difference was observed in 98% of the limbs with brachial plexus lesions. The average absolute LLD was 4.6 cm with a standard deviation of 2.5 cm. We found a statistically significant difference in LLD among the patients with a House score of <7 ('Poor function') and 7 and above ('Good function'; p < 0.001) with later indicative of independent use of the involved limb. We found no correlation between age and LLD. More extensive plexus involvement resulted in higher LLD. The maximal relative discrepancy was found in the hand segment of the upper extremity. Conclusions: LLD was seen in most of the patients with BBPP. The functional status of the involved upper limb in BBPP was found to be significantly associated with LLD. Though causation cannot be assumed. We found that children using the involved limb independently tend to have the least LLD. Level of Evidence: Level IV (Therapeutic).
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Affiliation(s)
- Praveen Bhardwaj
- Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
| | - Dipak Malokar
- Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
| | - Ajeesh Sankaran
- Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
| | | | | | - S Raja Sabapathy
- Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
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Cherian N, Oladeji L, Ohnoutka C, Touhey D, Sauer M, Schweser KA, Kfuri M, Cook JL, Rocca GJD, Crist BD. Risk of shortening in operatively treated proximal femur fractures with cephalomedullary nails with dynamically versus statistically locked helical blades. Injury 2023; 54:669-676. [PMID: 36539309 DOI: 10.1016/j.injury.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/28/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Cephalomedullary nails (CMN) have proven to be effective for the fixation of unstable pertrochanteric hip fractures, but limited data exists regarding the degree of shortening that occurs with nailing systems that offer "dynamically" versus "statistically" locked helical blades. This study aimed to determine the incidence, timing, and amount of postoperative fracture shortening in patients with pertrochanteric hip fractures treated with "dynamically" versus "statistically" locked helical blades. METHODS A retrospective review was performed on patients requiring operative fixation of pertrochanteric fractures. Inclusion criteria were patients aged 55 or older, low energy mechanism of injury, primary surgical open reduction and internal fixation of the injury, surgery performed by a fellowship-trained orthopaedic traumatologist, and radiographic follow up until healing or failure (minimum of 3 months). Quantification of fracture shortening was determined using the lateral screw protuberance method. Fracture shortening measurements were calculated from immediate post-operative films and subsequent radiographs at each follow-up visit. RESULTS 222 patients met inclusion criteria (123 using Depuy Synthes Trochanteric Fixation Nail proximal femoral nailing system (TFN) with static locking; 65 TFN with dynamic locking; 23 using Depuy Synthes Trochanteric Fixation Nail-Advanced proximal nailing system (TFNA) with static locking; and 11 TFNA with dynamic locking). When comparing the final screw protuberance, the TFN dynamic (10.31 mm), TFNA static (9.52 mm), and TFNA dynamic (7.02 mm) groups were found to be significantly less compared to the TFN static cohort (11.67 mm; p < 0.001). The distribution of fracture shortening was found to be significant (p < 0.01). Interval measurements of fracture shortening by repeated measures of ANOVA within groups showed statistically significant increases in screw protuberance for the TFN static (p < 0.001), TFN dynamic (p < 0.001), and TFNA static (p < 0.01) cohorts within the first 60 days postoperatively. The TFNA with dynamic locking group was found to have statistically significant increases until the first 100 days post-operatively (p < 0.02). DISCUSSION The incidence of fracture shortening remains high even with the use of cephalomedullary nails, regardless of dynamization status. Current pertrochanteric fixation constructs continue to favor fracture healing at the direct expense of fracture shortening.
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Affiliation(s)
- Nathan Cherian
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Lasun Oladeji
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Cole Ohnoutka
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Dan Touhey
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Madeline Sauer
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Kyle A Schweser
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Mauricio Kfuri
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - James L Cook
- Missouri Orthopaedic Institute, University of Missouri, Columbia, MO, United States
| | - Gregory J Della Rocca
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States
| | - Brett D Crist
- Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, 1 Hospital Drive, Columbia, MO 65212, United States.
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Fan C, Yushan M, Liu Y, Bahesutihan Y, Liu K, Yusufu A. Treatment outcome of tardy ulnar nerve palsy associated with traumatic cubitus valgus by supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release. BMC Musculoskelet Disord 2022; 23:369. [PMID: 35443650 PMCID: PMC9022348 DOI: 10.1186/s12891-022-05324-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background Tardy ulnar nerve palsy is a common late complication of traumatic cubitus valgus. At present, the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus is still controversial, whether these two problems can be corrected safely and effectively in one operation is still unclear. To investigate the supracondylar shortening wedge rotary osteotomy combined with in situ tension release of the ulnar nerve in the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus. Methods Between 2012 and 2019, 16 patients who had traumatic cubitus valgus deformities with tardy ulnar nerve palsy were treated with simultaneous supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release. we compared a series of indicators of preoperative and postoperative follow-up for at least 24 months, (1) elbow range of motion; (2) the radiographic correction of the preoperative and postoperative humerus-elbow-wrist angles; (3) the static two-point discrimination and grip strength; and (4) the preoperative and postoperative DASH scores of upper limb function. The minimum follow-up was 24 months postoperative (mean, 33 months; range, 24 ~ 44 months). Results The mean ROM was improved from 107 ° preoperatively to 122 ° postoperatively (P = 0.001). The mean preoperative elbow wrist angle was 24.6 °, and the mean postoperative humerus-elbow wrist angle was 12.1 ° (P < 0.001). The average grip strength and static two-point discrimination improved from 21 kgf and 8 mm to 28 kgf and 4.0 mm (P < 0.001 and P < 0.001, respectively). The ulnar nerve symptoms were improved in all patients except one. The mean HASH score improved from 29 to 16 (P < 0.001). Conclusion Supracondylar shortening wedge rotary osteotomy combined with in situ tension release of ulnar nerve is an effective method for the treatment of traumatic cubitus valgus with tardy ulnar nerve palsy, which restored the normal biomechanical characteristics of the affected limb and improved the elbow joint function. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05324-7.
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Affiliation(s)
- Chenchen Fan
- Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Maimaiaili Yushan
- Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yanshi Liu
- Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yemenlehan Bahesutihan
- Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Kai Liu
- Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Aihemaitijiang Yusufu
- Department of Trauma and Microreconstructive Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
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Öztürk M, Paulin E, Charbonnier C, Dupuis-Lozeron E, Holzer N. Three-dimensional reconstruction and virtual reposition of fragments compared to two dimensional measurements of midshaft clavicle fracture shortening. BMC Musculoskelet Disord 2022; 23:216. [PMID: 35255891 PMCID: PMC8903646 DOI: 10.1186/s12891-022-05173-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Midshaft clavicle fracture shortening measurement is a reported key element for indication to surgical management and reporting of clinical trials. Determination of pre-fracture clavicle length for shortening measurement remains an unresolved issue. The purpose of the study was to assess accuracy of a novel technique of three-dimensional reconstruction and virtual reposition of bone fragments (3D-VR) for determination of pre-fracture clavicle length and measurement of shortening. Methods Accuracy of 3D-VR measurements was assessed using 5 synthetic bone clavicle fracture models. Measurements were compared between caliper and 3D-VR technique measurements. Correlation between 3D-VR and 2D measurements on standard radiographs was assessed on a cohort of 20 midshaft fractures. Four different methods for 2D measurements were assessed. Results Mean difference between caliper measurements and 3D-VR was 0.74 mm (95CI = − 2.51;3.98) (p = 0.56) on synthetic fracture models. Mean differences between 3D-VR and standard radiograph shortening measurement methods were 11.95 mm (95CI = 7.44;16.46) for method 1 (Jeray et al.) and 9.28 mm (95CI = 4.77;13.79) for method 2 (Smekal et al.) (p < 0.05). Differences were − 1.02 mm (95CI = − 5.53;3.48) for method 3 (Silva et al.) and − 2.04 mm (95CI = − 6.55;2.47) for method 4 (own method). Interobserver correlation ranged between 0.85 and 0.99. A false positive threshold of 20 mm was measured by the two observers in 25% of the case according to method of method 1, 30–35% with method 2, 15% with method 3 et al. and 5–10% with the method 4. Conclusion 3D VR is accurate in measuring midshaft clavicle fracture length and shortening. Two dimensional measurements may be used for approximation of clavicular shortening.
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Affiliation(s)
- Mehmet Öztürk
- Division of Orthopedic and Trauma Surgery, Geneva University Hospital, Geneva, Switzerland.
| | - Emilie Paulin
- Department of Radiology, Geneva University Hospital, Geneva, Switzerland
| | | | - Elise Dupuis-Lozeron
- Department of Clinical Epidemiology, Geneva University Hospital, Geneva, Switzerland
| | - Nicolas Holzer
- Division of Orthopedic and Trauma Surgery, Geneva University Hospital, Geneva, Switzerland
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Naeli MH, Milani JM, Farmani J, Zargaraan A. Developing and optimizing low-saturated oleogel shortening based on ethyl cellulose and hydroxypropyl methyl cellulose biopolymers. Food Chem 2022; 369:130963. [PMID: 34479005 DOI: 10.1016/j.foodchem.2021.130963] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022]
Abstract
Oleogels,gels in which the continuous liquid phase is oil, have been suggested as promising low-saturated alternatives to the conventional shortenings. In this study, we aimed to develop and optimize low saturated oleogel shortenings using ethylcellulose or ethylcellulose/hydroxypropyl methylcellulose biopolymers (as oleogelators), sunflower oil (as the base oil), and palm stearin (as the source of saturated fatty acids). Using the response surface-d-optimal method, oleogel formulations containing saturated fatty acids as low as 15.19 % could be developed. As compared to the commercial shortening samples, oleogel shortenings had much lower saturation levels (15.19-17.02 vs 47.87-58.65 %) but a comparable melting point, firmness, and rheological properties. However, oleogel samples had lower solid fat content and induction period of oxidation than commercial ones. Oleogel made using ethylcellulose/hydroxypropyl methylcellulose biopolymers contained lower saturation level, solid fat content, induction period of oxidation, and firmness but a higher melting point, as compared to that made using ethylcellulose.
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Affiliation(s)
- Mohammad Hossein Naeli
- Department of Food Science and Technology, Faculty of Agricultural Engineering, Sari Agricultural Sciences and Natural Resources University, P.O. Box: 578, Sari 4818166996, Iran
| | - Jafar M Milani
- Department of Food Science and Technology, Faculty of Agricultural Engineering, Sari Agricultural Sciences and Natural Resources University, P.O. Box: 578, Sari 4818166996, Iran
| | - Jamshid Farmani
- Department of Food Science and Technology, Faculty of Agricultural Engineering, Sari Agricultural Sciences and Natural Resources University, P.O. Box: 578, Sari 4818166996, Iran.
| | - Azizollaah Zargaraan
- Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition and Food Science, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences and Health Services, Iran
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12
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Bozon O, Chammas M, Degeorge B, Coroian F, Lafont I, Coulet B. Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture. Hand Surg Rehabil 2021:S2468-1229(21)00597-1. [PMID: 34688950 DOI: 10.1016/j.hansur.2021.10.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
Total wrist arthrodesis in severe wrist flexion deformities (greater than 60°) due to spasticity represents a valid therapeutic option. It aims to improve the hand's appearance, hygiene, function and to prevent the deformity from getting worse. The objective of this study is to evaluate the clinical and anatomical results of wrist shortening arthrodesis using a classic volar plate in the dorsal position in functional surgery for central spastic hands. We conducted a single-center analysis of a series of patients who underwent this shortening arthrodesis. The review at a minimum 1-year follow-up included a clinical evaluation (House score, INOM score, patient satisfaction and complications), and anatomical evaluation (arthrodesis position, bone healing and carpometacarpal arthropathy). Twenty-eight patients with a mean age of 40.6 years (18-74) were included at a mean follow-up of 30.6 months (12-75). The fusion rate was 100%. No carpometacarpal arthropathy was noted. The mean position of the fused wrist was 11° extension and 15° ulnar tilt. There were two complications (7%): one postoperative hematoma and one case of discomfort due to impingement that required plate removal. The House score was significantly improved postoperatively (2.4 (0-5) versus 1.8 (0-4), p < 0.001), as was the INOM score (45 (12-64) versus 63 (36-84), p < 0.001). The patient satisfaction rate was 93%. The use of a simple and common material (volar plate in dorsal position) during this challenging surgery (spastic wrist contracture), provides good anatomical results and high patient satisfaction. LEVEL OF EVIDENCE: Level 4, case series, therapeutic study.
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Lovasz G, Aros A, Toth F, Va Faye J, La Malfa M. Introduction of day case hip and knee replacement programme at an inpatient ward is safe and may expedite shortening of hospital stays of traditional arthroplasties. J Orthop Surg Res 2021; 16:585. [PMID: 34635122 PMCID: PMC8504781 DOI: 10.1186/s13018-021-02737-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE We investigated the safety of primary hip and knee replacements with same day discharge (SDD) and their effect on length of stay (LOS) of traditional inpatient arthroplasties at our elective orthopaedic ward. METHODS 200 patients underwent elective, unilateral primary day case total hip (THA, n = 94), total knee (TKA, n = 60) and unicondylar knee replacements (UKA, n = 46). SDD rates, reasons for failure to discharge, readmission, complication and satisfaction rates were recorded at 6-week follow up. Changes in LOS of inpatient arthroplasties (n = 6518) and rate of patients discharged with only one night stay treated at the same ward were tracked from 1 year prior to introduction of day case arthroplasty (DCA) program to the end of observation period. RESULTS 166 patients (83%) had SDD while 34 (17%) needed overnight stay. Main reasons for failure to discharge were lack of confidence (4%) fainting due to single vasovagal episode (3.5%), urine retention (3%) and late resolution of spinal anaesthesia (3%). 5 patients (3%) had readmission within 6 weeks, including 1 (0.6%) with a partial and treated pulmonary embolism. 163 patients were satisfied with SDD (98%). After launching the DCA program, average LOS of inpatients was reduced from 2.3 days to 1.8 days and rate of discharge with only 1-night stay increased from 12% to around 60%. CONCLUSION Introduction of routine SDD hip and knee arthroplasty programme at an elective orthopaedic centre is safe and also may confer wider benefits leading to shorter inpatient hospital stays.
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Affiliation(s)
- Gyorgy Lovasz
- Practice Plus Group Hospital Barlborough, 2 Lindrick Way, Barlborough, S43 4XE, Chesterfield, UK.
| | - Attila Aros
- Practice Plus Group Hospital Barlborough, 2 Lindrick Way, Barlborough, S43 4XE, Chesterfield, UK
| | - Ferenc Toth
- Practice Plus Group Hospital Barlborough, 2 Lindrick Way, Barlborough, S43 4XE, Chesterfield, UK
| | - John Va Faye
- The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Marco La Malfa
- Practice Plus Group Hospital Barlborough, 2 Lindrick Way, Barlborough, S43 4XE, Chesterfield, UK
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Polat A, Misir A, Buyukkuscu MO, Basilgan S, Basar H. Factors Associated with Femoral Neck Shortening After Closed or Open Reduction and Screw Fixation. Indian J Orthop 2022; 56:303-11. [PMID: 35140862 DOI: 10.1007/s43465-021-00484-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/07/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE This study aimed to evaluate the incidence of femoral neck shortening (FNS) after the treatment of displaced and non-displaced femoral neck fractures with closed or open reduction internal fixation, and determine the independent factors associated with this condition. METHOD The study included 81 patients who underwent internal fixation by closed or open reduction with multiple screws between 2013 and 2018 due to femoral neck fracture (FNF) and were followed up for at least 1 year. Patients were divided into two groups as with and without FNS. The patient, fracture, and surgical parameters compared between the two groups, and the factors affecting development of FNS were investigated. RESULTS Internal fixation was applied by closed reduction in 56 patients (69.1%) and open in 25 (30.9%). FNS was detected in 41 patients (50.6%), with the mean shortening 6.3 ± 6.4 mm. Fracture union achieved in 72 patients (89%). The mean time to fracture union was 4.3 ± 2.3 months.No statistically significant relationship found between FNS and the parameters of gender, age, smoking, reduction type, number, type and orientation of screws, Singh index, and Garden fix index (p > 0.05).However, there was significant difference between two groups regarding energy of the fracture, fragmentation, coronal angulation, Garden type, and fixation with medial buttress plate (p < 0.05). CONCLUSION FNS is an expected condition in FNF fixed by screws. Patients with high-energy traumas and advanced Garden types are more likely to have FNS. The use of medial plate may be effective in preventing FNS.
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Wirth SH, Fuernstahl Fürnstahl P, Meyer DC, Viehoefer Viehöfer AF. Planning tool for first metatarsal length in hallux valgus surgery. Foot (Edinb) 2021; 46:101774. [PMID: 33516117 DOI: 10.1016/j.foot.2020.101774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 11/25/2020] [Accepted: 12/26/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND The precise planning of metatarsal (MT) I length in hallux valgus surgery is important. However, currently no tool exists which allows the surgeon to reliably predict this parameter. METHODS 30 virtual 3-dimensional hallux valgus surgeries were performed on varied deformation models based on cadaveric feet scans. The shortening of the first ray during distal metatarsal I osteotomy for different osteotomy angles were measured. An algebraic 2-dimensional calculation was done and compared to the results obtained from the 3-dimensional models. RESULTS Inadvertent shortening of the first metatarsal bone can be as much as 8 mm depending on the amount of intermetatarsal angle (IMA) correction and osteotomy angle. Comparison of the 3 dimensional simulations and the 2 dimensional model resulted in a very strong correlation (R > 0.99 p < 0.00001). Based on our findings an anterior pointing osteotomy of approximately 10° is necessary to restore the length in distal metatarsal I hallux valgus surgery. CONCLUSION A slight misdirection of the osteotomy plane in distal hallux valgus surgery may result in relevant unwanted alterations in first metatarsal bone length and triangulation by eye is insufficient in this complex geometrical situation without appropriate planning. The present study provides surgeons a practical tool to plan and control the change of first metatarsal length during hallux valgus procedure through exact orientation of the osteotomy angle. If no alteration of length is intended, it may be generalized that an anterior direction of the cut relative to the second metatarsal bone will preserve the length of the first metatarsal bone.
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Affiliation(s)
- Stephan H Wirth
- Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
| | | | - Dominik C Meyer
- Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
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16
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Lenz CG, Niehaus R, Knych I, Eid K, Borbas P. Scarf osteotomy for hallux valgus deformity: Radiological outcome, metatarsal length and early complications in 118 feet. Foot Ankle Surg 2021; 27:20-24. [PMID: 31980384 DOI: 10.1016/j.fas.2020.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/25/2019] [Accepted: 01/03/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Scarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia. METHODS We enrolled 106 patients (118 feet) and assessed patients' pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Three different methods of measuring metatarsal length were compared and early postoperative complications noted. RESULTS Hallux valgus angle decreased significantly by an average of 18.7 degrees and the intermetatarsal angle by 7.8 degrees. Using three methods of measuring metatarsal length, all showed significant shortening of the first metatarsal. Mean relative lengthening of the second metatarsal averaged 0.45mm. The Coughlin method showed the highest interrater reliability (ICC=0.96). CONCLUSIONS Significant reduction of the hallux valgus angle and intermetatarsal angle was demonstrated with a low complication rate. There was significant shortening of the first metatarsal. The Coughlin method clearly demonstrated an excellent interrater reliability. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Christopher G Lenz
- Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland.
| | - Richard Niehaus
- Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland
| | - Ivo Knych
- Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland
| | - Karim Eid
- Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland
| | - Paul Borbas
- Cantonal Hospital Baden, Department of Orthopaedics and Traumatology, Im Ergel 1, 5404 Baden, Switzerland
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Benjamin B, Haddad FS. Management of limb length problems during total hip arthroplasty for patients with developmental dysplasia of the hip. Br J Hosp Med (Lond) 2020; 81:1-7. [PMID: 32730164 DOI: 10.12968/hmed.2019.0362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The anatomy of the acetabulum and femur is usually significantly altered in people with developmental dysplasia of the hip and this leads to secondary osteoarthritis of the hip joint. Ideal positioning of implants and reduction of the joint is technically demanding during arthroplasty. Lengthening may result in nerve palsies and therefore procedures may have to be undertaken to shorten the femur. Other complications include dislocation and non-union at the shortening osteotomy site. Thorough preoperative planning and templating is required before surgery to assess the need for shortening. Shortening osteotomies can be performed at the proximal femur, diaphysis or distal femoral levels, with subtrochanteric being the most common level. The procedure should be customised for each patient after extensive planning and detailed counselling.
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Affiliation(s)
- Biju Benjamin
- Department of Trauma and Orthopaedics, Forth Valley Royal Hospital, NHS Forth Valley, Larbert, UK
| | - Fares S Haddad
- Department of Trauma and Orthopaedics, University College London Hospital, London, UK Conflicts of interest
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Riemma G, La Verde M, Schiattarella A, Cobellis L, De Franciscis P, Colacurci N, Morlando M. Efficacy of hyoscine butyl-bromide in shortening the active phase of labor: Systematic review and meta-analysis of randomized trials. Eur J Obstet Gynecol Reprod Biol 2020; 252:218-224. [PMID: 32629224 DOI: 10.1016/j.ejogrb.2020.06.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Prolonged labor increases the risk of maternal and fetal complications. The active management of labor has been proven effective in lowering neonatal and maternal morbidity by shortening the duration of labor. Several pharmaceutical and non-pharmaceutical approaches are currently being used in the active management of labor. Hyoscine Butyl-bromide (HBB) is an antispasmodic and anticholinergic drug that acts as a cervical spasmolytic agent. It has been widely used in everyday practice for shortening the active phase of labor. Nonetheless, only a few trials have been conducted on the topic. OBJECTIVE This review aimed to evaluate whether HBB is effective in decreasing the mean duration of the active phase of labor. STUDY DESIGN An electronic search was conducted on Medline (through PubMed), Scopus, ClinicalTrials.gov, EMBASE, PROSPERO, and Cochrane Library from the beginning of all databases to December 2019. Results were limited to randomized trials. Restriction for English language was applied. Inclusion criteria were: randomized clinical trials regarding primiparae or multiparae women with a singleton vertex pregnancy at term who were randomized to HBB versus placebo or other drugs. Primary outcome evaluated was the mean reduction of the active phase of labor. DATA COLLECTION AND ANALYSIS Eight randomized clinical trials, including 1159 pregnant women, were analyzed. Significant heterogeneity (I2 = 99 %) between studies was noted for the primary outcome. The active phase of labor duration was significantly reduced in the treatment arm compared to controls [mean difference (MD) -83.93 min (95 % confidence interval (CI) -163.61, -4.25)]. Achieved reduction in primiparae women was -55.09 min [95 % CI -68.83, -41.35; I2 = 37 %]. CONCLUSION HBB is an effective treatment to shorten the duration of the active phase of labor in primiparae and multiparae women.
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Affiliation(s)
- Gaetano Riemma
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Marco La Verde
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Schiattarella
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Cobellis
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Pasquale De Franciscis
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Colacurci
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maddalena Morlando
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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Jose CG, Jacob RH, Gardner GE. Alternative cutting methods and dry aging reduce the shear force of hot boned beef striploin in Bos indicus cattle. Meat Sci 2019; 163:108036. [PMID: 31951922 DOI: 10.1016/j.meatsci.2019.108036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/29/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
Hot boning (HB) is an economical processing technique often resulting in poorer meat quality and tenderness. This study tested a method of partial HB, where the short loin section was removed from the hot carcass and chilled, with the striploin remained in the skeletal system. Thirty six yearling Bos indicus steers carcasses were subjected to either low, high or no electrical stimulation and each side allocated to a cutting treatment of HB, partial HB and conventional (Achillies hung). Striploins were divided into 3 and aged for 5, 14 and 28 days. Warner Bratzler Shear force (WBSF) and sarcomere length were tested. Partial HB resulted in greater tenderization without aging compared to HB. However, optimized electrical stimulation was a requirement. Treatment did not influence sarcomere length. The study also tested the impact of Dry aging of HB striploins, which resulted in further increases in tenderness at 28 days of aging compared to wet aged product, reducing WBSF by 9 N.
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Affiliation(s)
- Cameron G Jose
- School of Health, Engineering and Education, Murdoch University, Murdoch, Western Australia 6150, Australia.
| | - Robin H Jacob
- Department of Primary Industries and Regional Development, South Perth, Western Australia 6151, Australia
| | - Graham E Gardner
- School of Health, Engineering and Education, Murdoch University, Murdoch, Western Australia 6150, Australia
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Lopez-Vigil M, Suarez-Garnacho S, Martín V, Naranjo-Ruiz C, Rodriguez C. Evaluation of results after distal metatarsal osteotomy by minimal invasive surgery for the treatment of metatarsalgia: patient and anatomical pieces study. J Orthop Surg Res 2019; 14:121. [PMID: 31068197 DOI: 10.1186/s13018-019-1159-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 04/17/2019] [Indexed: 12/05/2022] Open
Abstract
Background Metatarsalgia of the lesser toes is a common cause of consultation in the podiatric clinic. However, there continues to be a controversy with respect to which is the best surgical technique, and there is few information in the literature regarding objectively comparable results in percutaneous surgery. Methods The second metatarsal bones of 30 feet belonging to patients who had attended the podiatric clinic were studied before and after distal metatarsal pecutaneous osteotomy. The degree of shortening of the second metatarsal (RX) and the degree of functional recovery and perception of the well-being of the patient (AOFAS) were evaluated retrospectively. The same bones of 10 cadaveric feet were also studied. The surgical procedure was identical to that used on patients, and electronic callipers were employed to take measurements of the second metatarsal. The integrity of the plantar plate was checked visually. Results The mean shortening of the second metatarsal bone, as determined by the radiological study, was 2.76 mm. After an average follow-up period of 1.5 years, the final mean score on the AOFAS scale was 95.26 points. In none of the cases was the mobility of the metatarsophalangeal (MTP) joint affected. The mean shortening in the cadaveric feet was 2.10 mm, and in all cases, the plantar plate and flexor apparatus were perfectly preserved. Conclusions Percutaneous osteotomy achieved, in our study, a lower degree of shortening than Weil’s surgery, according to the data published in the literature. However, it shows good clinical results without causing problems of consolidation or rigidity in the MTP joint. Neither, with the caution that should be taken due to the use of experimental cadaver models, damage of the flexor apparatus of the foot is observed. These results suggest that this could be a safe and effective surgical procedure to be considered for metatarsalgias of the lesser rays.
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Sandoval S, Kierkowicz M, Pach E, Ballesteros B, Tobias G. Determination of the length of single-walled carbon nanotubes by scanning electron microscopy. MethodsX 2018; 5:1465-1472. [PMID: 30505700 PMCID: PMC6249399 DOI: 10.1016/j.mex.2018.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/03/2018] [Indexed: 01/01/2023] Open
Abstract
A methodology is presented to determine the length of well individualized single-walled carbon nanotubes (SWCNTs) by means of scanning electron microscopy (SEM). Accurate measurements on wide areas of the sample can be achieved in an easy, fast and trustworthy manner. We have tested several supports and solvents to optimize the dispersion of SWCNTs, as well as the SEM imaging conditions. The optimal methodology goes via dispersion of the sample in ortho-dichlorobenzene, deposition onto a continuous carbon film supported on a copper TEM grid, and SEM imaging at 2 kV in secondary electrons mode using a through-in-lens detector. Individualization of SWCNTs is achieved by dispersion of SWCNTs in ortho-dichlorobenzene and deposition onto TEM grids Individual SWCNTs are imaged by SEM Length determination by SEM is as precise as AFM
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Affiliation(s)
- Stefania Sandoval
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), 08193, Bellaterra, Barcelona, Spain
| | - Magdalena Kierkowicz
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), 08193, Bellaterra, Barcelona, Spain
| | - Elzbieta Pach
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - Belén Ballesteros
- Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
- Corresponding authors.
| | - Gerard Tobias
- Institut de Ciència de Materials de Barcelona (ICMAB-CSIC), 08193, Bellaterra, Barcelona, Spain
- Corresponding authors.
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Brainin P, Biering-Sørensen SR, Møgelvang R, de Knegt MC, Olsen FJ, Galatius S, Gislason GH, Jensen JS, Biering-Sørensen T. Post-systolic shortening: normal values and association with validated echocardiographic and invasive measures of cardiac function. Int J Cardiovasc Imaging 2018; 35:327-337. [PMID: 30341672 DOI: 10.1007/s10554-018-1474-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/12/2018] [Indexed: 01/14/2023]
Abstract
Post-systolic shortening (PSS) does not contribute to the ejection of blood and may inhibit diastolic filling. We determined normal values of PSS in healthy subjects and investigated associations with echocardiographic and invasive measures of systolic and diastolic function. We prospectively analyzed participants from the general population (n = 620, mean age 47 ± 14 years) with no cardiovascular disease. Participants underwent echocardiography, including speckle tracking assessment of the post-systolic index (PSI), strain and time. We defined the PSI as: 100 × [(peak global longitudinal strain - peak systolic longitudinal strain)/(peak global longitudinal strain)]. We also included stable patients (n = 44) referred for left ventricle (LV) catheterization and echocardiography. Normal values: median PSI 2.0% (IQR 0.7, 4.8), post-systolic strain 0.4% (IQR 0.2, 0.8) and post-systolic time 22.6 ms (IQR 10.7, 40.8). Sex modified the relationship between PSI and age (P interaction = 0.037), such that PSI increased with age in women but not in men. PSI was associated with diastolic function (e', E/e' and E/A) (P < 0.05 for all), but not with LV ejection fraction (P = 0.08). PSI was associated with invasively measured LV pressure decline in early diastole, dP/dt min ([Formula: see text] = 0.12, P = 0.010), but not with LV pressure rise in early systole, dP/dt max ([Formula: see text]= - 0.05, P = 0.30). A PSI > 5% had 82% specificity and 99% sensitivity for identifying impaired LV systolic and/or diastolic function. Normal values of PSS are modified by sex. The PSI is associated with most validated echocardiographic and invasive measures of cardiac systolic and diastolic function.
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Affiliation(s)
- Philip Brainin
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark.
| | - Sofie Reumert Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Rasmus Møgelvang
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Martina Chantal de Knegt
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Flemming Javier Olsen
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Søren Galatius
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Gunnar Hilmar Gislason
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Jan Skov Jensen
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
| | - Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark
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Wang Z, Yin Y, Li Q, Sun G, Peng X, Yin H, Ye Y. Comparison of early complications between the use of a cannulated screw locking plate and multiple cancellous screws in the treatment of displaced intracapsular hip fractures in young adults: a randomized controlled clinical trial. J Orthop Surg Res 2018; 13:201. [PMID: 30103792 PMCID: PMC6090639 DOI: 10.1186/s13018-018-0901-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/30/2018] [Indexed: 11/19/2022] Open
Abstract
Background The incidence of early postoperative complications of displaced intracapsular hip fractures is high. The purpose of this study was to compare the early postoperative complications and assess the incidence of femoral neck shortening on using a newly designed proximal femoral cannulated screw locking plate (CSLP) versus multiple cancellous screws (MCS) in the treatment of displaced intracapsular hip fractures in young adults. Methods Sixty-eight young adult patients with displaced intracapsular hip fractures were randomly assigned to either the CSLP group or the MCS group and treated routinely by internal fixation with either the CSLP or the MCS. Harris Hip Score, nonunion, failure of fixation, overall complications, and femoral neck shortening were recorded and compared. Results Two patients (5.88%) in the CSLP group and eight (23.53%) in the MCS group had postoperative nonunion (P < 0.05). There was one case (2.94%) of fixation failure in the CSLP group and three cases (8.82%) in the MCS group (P > 0.05). Three patients (8.82%) in the CSLP group and 11 (32.35%) in the MCS group had overall complications (P < 0.05). Mean femoral neck shortening was 5.10 mm in the vertical plane and 5.11 mm in the horizontal plane in the CSLP group and 11.14 mm in the vertical plane and 10.51 mm in the horizontal plane in the MCS group. Severe femoral neck shortening (≥ 10 mm) did not occur in either the vertical or the horizontal plane in any patient of the CSLP group but occurred in 10 patients (28.57%) in the vertical plane and in 8 (22.86%) patients in the horizontal plane in the MCS group. Conclusions Compared with MCS, the use of CSLP in the treatment of displaced intracapsular hip fractures in young adults can reduce the rates of postoperative nonunion and overall complications and minimize femoral neck shortening. Trial registration ChiCTR1800016032. Registered 8 May 2018. Retrospectively registered.
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Affiliation(s)
- Zhiqiang Wang
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Yi Yin
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Qingshan Li
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Guanjun Sun
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Xu Peng
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Hua Yin
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China
| | - Yongjie Ye
- Department of Orthopaedics Surgery, Suining Central Hospital, Suining, 629000, Sichuan, China.
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Mandal P. Recent advances of Blood telomere length (BTL) shortening: A potential biomarker for development of cancer. Pathol Oncol Res 2019; 25:1263-5. [PMID: 29948614 DOI: 10.1007/s12253-018-0425-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 05/28/2018] [Indexed: 10/14/2022]
Abstract
Telomeres, the specific DNA-protein structures remains at both ends of each chromosome and are crucial in the maintenance of chromosome integrity and genomic stability with protection of the chromosome from damage and degradation.. Increasing evidences suggest the correlation between telomere length and the development of cancers, but the findings remain obscure. Generally, the average length of telomere repeats at the ends of chromosomes that gives a clue in providing indirect information about their mitotic history. It plays immense role in preventing genome from nucleolytic degradation, unnecessary recombination, repair, and interchromosomal fusion. It has major role in storing the information in the genome. Telomere attrition during successive cell divisions induces chromosomal instability and contributes significantly to genomic rearrangements that can result in tumorigenesis. Convincing evidence documented that a meagre portion of telomeric DNA is expelled out during mitotic stage of cell division. But accelerated shortening telomere length at critical level triggers senescence and/or apoptosis. Various harmful agents with bad lifestyles are responsible in inducing shortening of telomere length with damage of DNA resulting to occurrence of disease with shortening of lifespan. Besides, telomerases, the specialized polymerase that synthesizes new telomere repeats and is strongly associated with cancer facilitating malignant transformation. Therefore, in the study, it is highlighted that the telomeres may play diverse roles in different cancers whereas shortening of telomere length may be risk factors for the development of tumors.
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Škarabot J, Ansdell P, Brownstein C, Howatson G, Goodall S, Durbaba R. Differences in force normalising procedures during submaximal anisometric contractions. J Electromyogr Kinesiol 2018; 41:82-88. [PMID: 29857263 DOI: 10.1016/j.jelekin.2018.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/22/2018] [Accepted: 05/25/2018] [Indexed: 11/27/2022] Open
Abstract
Eccentric contractions are thought to require a unique neural activation strategy. However, due to greater intrinsic force generating capacity of muscle fibres during eccentric contraction, the understanding of neural modulation of different contraction types during submaximal contractions may be impeded by the force normalisation procedure employed. In the present experiment, subjects performed maximal isometric dorsiflexion at shorter (80°), intermediate (90°) and longer (100°) muscle lengths, and maximal concentric and eccentric contractions. Thereafter, submaximal concentric and eccentric contractions were performed normalised to either isometric maximum at 90° (ISO), contraction type specific maximum (CTS) or muscle length specific maximum (MLS). When using ISO or MLS for normalisation, mean submaximal eccentric torque levels were significantly lower when compared to CTS normalisation (11 and 7% lower compared to CTS; p = 0.003 and p = 0.018 for ISO and MLS, respectively). These experimentally observed differences closely matched those expected from the predictive model. During submaximal concentric contraction, mean torque levels were similar between ISO and CTS normalisation with similar discrepancies noted in EMG activity. These findings suggest that normalising to ISO and MLS might not be accurate for assessment and prescription of submaximal eccentric contractions.
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Affiliation(s)
- Jakob Škarabot
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom.
| | - Paul Ansdell
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
| | - Callum Brownstein
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
| | - Glyn Howatson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom; Water Research Group, School of Environmental Sciences and Development, Northwest University, Potchefstroom, South Africa
| | - Stuart Goodall
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
| | - Rade Durbaba
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England, United Kingdom
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Abstract
Healing in continuity with lengthening of the Achilles tendon is a disabling complication after Achilles tendon rupture. This results in weakness of ankle plantarflexion and a non-propulsive gait on the affected side. The elongated tendon may have to be shortened or reconstructed to re-establish the length and the physiologic tension in triceps surae muscle and allow restoration of push off. This technical note describes the details of endoscopic shortening of the Achilles tendon.
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Affiliation(s)
- T H Lui
- Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Road, Sheung Shui, NT, Hong Kong, China.
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Rosa DP, Borstad JD, Pogetti LS, Camargo PR. Effects of a stretching protocol for the pectoralis minor on muscle length, function, and scapular kinematics in individuals with and without shoulder pain. J Hand Ther 2017; 30:20-29. [PMID: 27769843 DOI: 10.1016/j.jht.2016.06.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 05/09/2016] [Accepted: 06/17/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Parallel-group intervention with repeated measures. INTRODUCTION Shortening of the pectoralis minor (PM) may contribute to alterations in scapular kinematics. PURPOSE OF THE STUDY To evaluate the effects of a stretching protocol on function, muscle length, and scapular kinematics in subjects with and without shoulder pain. METHODS A sample of 25 patients with shoulder pain and 25 healthy subjects with PM tightness performed a daily stretching protocol for 6 weeks. Outcome measures included Disabilities of the Arm, Shoulder, and Hand questionnaire, PM length, and scapular kinematics. RESULTS Disabilities of the Arm, Shoulder, and Hand scores decreased (P < .05) in the patient group at post-intervention. No differences (P > .05) were found for PM length in both groups. Scapular anterior tilt increased (P < .05) at 90° of flexion in the healthy group. DISCUSSION This study demonstrated that a daily home stretching protocol significantly decreases pain and improves function in subjects with shoulder pain. The mechanism responsible for these improvements does not appear directly related to PM muscle length or scapula kinematics, suggesting that other neuromuscular mechanisms are involved. CONCLUSION The PM stretching protocol did not change the PM length or scapular kinematics in subjects with or without shoulder pain. However, pain and function of the upper limbs improved in patients with shoulder pain. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Dayana P Rosa
- Physical Therapist, Master of Physical Therapy Program, Methodist University of Piracicaba, Piracicaba, SP, Brazil
| | - John D Borstad
- Associate Professor, Physical Therapy Division, The Ohio State University, Columbus, OH, USA
| | - Lívia S Pogetti
- Physical Therapist, Adjunct Professor, Physical Therapy Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Paula R Camargo
- Physical Therapist, Adjunct Professor, Physical Therapy Department, Federal University of São Carlos, São Carlos, SP, Brazil.
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Abstract
BACKGROUND The objective of this systematic review was to evaluate the reliability and reproducibility of measurements of shortening in midshaft clavicle fractures (MSCF) using any available imaging technique. METHODS Electronic databases (PubMed, EMBASE, and Cochrane) were searched. The 4-point-scale COSMIN checklist was used to evaluate the methodological quality of studies. RESULTS Four studies on reliability of measurement of MSCF were identified. These studies were of fair and poor quality. The reported intrarater reliability varied between none to fair, and intrarater reliability was minimal. CONCLUSION No definite conclusions could be drawn. In order to optimize future studies and the realization of comparable results, more research is necessary to identify a standardized method of imaging and measuring. Level of Evidence III.
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Affiliation(s)
- Paul Hoogervorst
- Department of Orthopedics, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Gerjon Hannink
- Department of Orthopedics, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | | | - Albert van Kampen
- Department of Orthopedics, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Slobogean GP, Stockton DJ, Zeng BF, Wang D, Ma B, Pollak AN. Femoral neck shortening in adult patients under the age of 55 years is associated with worse functional outcomes: Analysis of the prospective multi-center study of hip fracture outcomes in China (SHOC). Injury 2017; 48:1837-42. [PMID: 28651782 DOI: 10.1016/j.injury.2017.06.013] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/07/2017] [Accepted: 06/19/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Young femoral neck fracture patients require surgical fixation to preserve the native hip joint and accommodate increased functional demands. Recent reports have identified a high incidence of fracture shortening and this may have negative functional consequences. We sought to determine if fracture shortening is associated with poor functional outcome in young femoral neck fracture patients. PATIENTS AND METHODS One hundred and forty-two patients with femoral neck fractures age 18-55 were recruited in this prospective cohort study across three Level 1 trauma hospitals in Mainland China. Patient-reported and objective functional outcomes were measured with the Harris Hip Score (HHS), Timed Up and Go (TUG), and SF-36 Physical Component Summary (SF-36 PCS) at 12 months. Radiographic fracture shortening was measured along the long axis of the femoral neck and corrected for magnification. Severe shortening was defined as ≥10mm. The primary analysis measured associations between severe radiographic shortening and HHS at one-year post-fixation. RESULTS One hundred and two patients had complete radiographic and functional outcomes available for analysis at one year. The mean age of participants was 43.7±10.8years and 53% were male. Fifty-five percent of fractures were displaced and 37% were vertically orientated (Pauwels Type 3). The mean functional outcome scores were: HHS 90.0±10.8, TUG 12.0±5.1s, and PCS 48.5±8.6. Severe shortening occurred in 13% of patients and was associated with worse functional outcome scores: HHS mean difference 9.9 (p=0.025), TUG mean difference 3.2s (p=0.082), and PCS mean difference 5.4 (p=0.055). CONCLUSIONS Severe shortening is associated with clinically important decreases in functional outcome as measured by HHS following fixation of young femoral neck fractures, occurring in 13% of patients in this population. The principle of fracture site compression utilized by modern constructs may promote healing; however, excessive shortening is associated with worse patient-reported outcomes and objective functional measures.
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Schotola H, Sossalla ST, Renner A, Gummert J, Danner BC, Schott P, Toischer K. The contractile adaption to preload depends on the amount of afterload. ESC Heart Fail 2017; 4:468-478. [PMID: 29154423 PMCID: PMC5695189 DOI: 10.1002/ehf2.12164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 02/27/2017] [Accepted: 03/15/2017] [Indexed: 11/21/2022] Open
Abstract
Aims The Frank–Starling mechanism (rapid response (RR)) and the secondary slow response (SR) are known to contribute to increases contractile performance. The contractility of the heart muscle is influenced by pre‐load and after‐load. Because of the effect of pre‐load vs. after‐load on these mechanisms in not completely understood, we studied the effect in isolated muscle strips. Methods and results Progressive stretch lead to an increase in shortening/force development under isotonic (only pre‐load) and isometric conditions (pre‐ and after‐load). Muscle length with maximal function was reached earlier under isotonic (Lmax‐isotonic) compared with isometric conditions (Lmax‐isometric) in nonfailing rabbit, in human atrial and in failing ventricular muscles. Also, SR after stretch from slack to Lmax‐isotonic was comparable under isotonic and isometric conditions (human: isotonic 10 ± 4%, isometric 10 ± 4%). Moreover, a switch from isotonic to isometric conditions at Lmax‐isometric showed no SR proving independence of after‐load. To further analyse the degree of SR on the total contractile performance at higher pre‐load muscles were stretched from slack to 98% Lmax‐isometric under isotonic conditions. Thereby, the SR was 60 ± 9% in rabbit and 51 ± 14% in human muscle strips. Conclusions This work shows that the acute contractile response largely depends on the degree and type of mechanical load. Increased filling of the heart elevates pre‐load and prolongs the isotonic part of contraction. The reduction in shortening at higher levels of pre‐load is thereby partially compensated by the pre‐load‐induced SR. After‐load shifts the contractile curve to a better ‘myofilament function’ by probably influencing thin fibers and calcium sensitivity, but has no effect on the SR.
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Affiliation(s)
- Hanna Schotola
- Department of Anesthesiology, Georg-August-University, Goettingen, Germany
| | - Samuel T Sossalla
- Department of Cardiology and Pneumology, Georg-August-University, Goettingen, Germany
| | - André Renner
- Department of Cardiothoracic Surgery, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - Jan Gummert
- Department of Cardiothoracic Surgery, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - Bernhard C Danner
- Department of Thoracic and Cardiovascular Surgery, Georg-August-University, Goettingen, Germany
| | - Peter Schott
- Department of Cardiology and Pneumology, Georg-August-University, Goettingen, Germany
| | - Karl Toischer
- Department of Cardiology and Pneumology, Georg-August-University, Goettingen, Germany.,DZHK (German Center for Cardiovascular Research) partnersite Göttingen, Germany
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Eralp L, Bilen FE, Rozbruch SR, Kocaoglu M, Hammoudi AI. External fixation reconstruction of the residual problems of benign bone tumours. Strategies Trauma Limb Reconstr 2016; 11:37-49. [PMID: 26873644 PMCID: PMC4814386 DOI: 10.1007/s11751-016-0244-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 01/26/2016] [Indexed: 12/13/2022] Open
Abstract
The mechanical features of and biologic response to using distraction osteogenesis with the circular external fixator are the unique aspects of Ilizarov’s contribution that allows deformity correction and reconstruction of bone defects. We present a retrospective study of 20 patients who suffered from a variety of benign tumours for which external fixators (EF) were used to treat deformity, bone loss, and limb-length discrepancy. A total of 26 bony segments in twenty patients (10 males, 10 females; mean age 17 years; range 7–58 years) were treated with EF for residual problems from the tumour itself (primary treatment) in 8 patients and for complications related to the primary surgery (secondary treatment) in 12 patients. Histological diagnoses were Ollier’s disease (n = 4), Fibrous Dysplasia (n = 5), Congenital multiple exostosis (n = 5), giant cell tumour (n = 2) and one case for chondromyxoid fibroma, desmoid fibroma, chondroma and unicameral bone cyst. Various types of external fixators used to treat these problems. These were Ilizarov, unilateral fixator, multiaxial correction frame (Biomet, Parsippany, NJ), Taylor spatial frame (Memphis, TN) and smart correction multiaxial frame. The mean follow-up time was 69.5 months (range 35–108 months). The mean external fixation time was 159.5 days (range 27–300 days). The mean external fixation index was 67.4 days/cm (12–610) in 26 limbs who underwent distraction osteogenesis. The mean length of distraction was 4.9 cm (range 0.2–14 cm). At final follow-up, all patients had returned to normal activities. Complications were in the form of knee arthrodesis in one patient, pin tract infection in six and residual shortening in eight patients. The use of EF and the principles of distraction osteogenesis, in the management of problems associated with benign bone tumours and related surgery yields successful results especially in young patients. With this approach, the risk for recurrence of shortening and deformity may be minimized with overcorrection or over-lengthening as dictated by preoperative planning.
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Affiliation(s)
- Levent Eralp
- Department of Orthopaedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, 34390, Topkapi, Istanbul, Turkey
| | - F Erkal Bilen
- Department of Orthopaedics and Traumatology, Memorial Health Group, 34385, Okmeydani, Istanbul, Turkey.
| | - S Robert Rozbruch
- Hospital for Special Surgery, Limb Lengthening and Complex Reconstruction Service (LLCRS), Weill Cornell Medical College, Cornell University, 535 East 70th Street, New York, NY, 10021, USA
| | - Mehmet Kocaoglu
- Department of Orthopaedics and Traumatology, Memorial Health Group, 34385, Okmeydani, Istanbul, Turkey
| | - Ahmed I Hammoudi
- Orthopedic Department, Faculty of Medicine, Al-Azhar University Hospitals, Nasr City, Cairo, 11884, Egypt
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Wojnicki FHE, Johnson DS, Charny G, Corwin RLW. Development of bingeing in rats altered by a small operant requirement. Physiol Behav 2015; 152:112-8. [PMID: 26375821 PMCID: PMC4633377 DOI: 10.1016/j.physbeh.2015.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 08/25/2015] [Accepted: 09/09/2015] [Indexed: 12/28/2022]
Abstract
Previous studies have shown that providing an optional food for a brief period of time to non-food deprived rats on an intermittent basis in the home cage engenders significantly more intake (binge-type behavior) than when the optional food is provided for a brief period on a daily basis. Experiment 1 examined the effects of placing a small operant response requirement on access to an optional food (vegetable shortening) on the establishment of binge-type behavior. Experiment 2 examined the effects of different schedules of reinforcement, a period of abstinence from shortening, and 24h of food deprivation on established binge-type behavior. In Experiment 1 the group of rats with 30-min access to shortening on an intermittent basis in their home cages (IC) consumed significantly more shortening than the group with 30-min daily access in the home cage (DC). The group with 30-min intermittent access in an operant chamber (IO group) earned significantly more reinforcers than the group with 30-min daily access in an operant chamber (DO). In Experiment 2, the IO group earned significantly more reinforcers than the DO group regardless of the response cost, the period of shortening abstinence, and overnight food deprivation. These results demonstrate that while intermittent access generates binge-type eating, the size of the binge (intake) can be altered by different contingency arrangements.
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Affiliation(s)
- F H E Wojnicki
- Pennsylvania State University, Nutritional Sciences, 110 Chandlee Laboratory, University Park, PA 16802, United States
| | - D S Johnson
- University of Pennsylvania, School of Medicine, Department of Pathology and Laboratory Medicine, Virology, Philadelphia, PA 19104, United States
| | - G Charny
- Womack Army Medical Center, Department of Emergency Medicine, 2817 Reilly Street, Fort Bragg, NC 28310, United States
| | - R L W Corwin
- Pennsylvania State University, Nutritional Sciences, 110 Chandlee Laboratory, University Park, PA 16802, United States.
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Kovoor CC, George VV, Jayakumar R, Guild AJ, Bhaskar D, Cyriac A. Total and subtotal amputation of lower limbs treated by acute shortening, revascularization and early limb lengthening with ilizarov ring fixation - a retrospective study. Injury 2015; 46:1964-8. [PMID: 26256784 DOI: 10.1016/j.injury.2015.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/09/2015] [Accepted: 07/13/2015] [Indexed: 02/02/2023]
Abstract
We present the results of 15 patients who sustained total or subtotal traumatic amputation of the lower limbs who were treated by acute limb shortening and stabilisation with external fixator, revascularization and early lengthening with Ilizarov ring fixator. The mean age of the patients was 28 years [5-38]. There were three females and 12 males. The mean Mangled Extremity Severity Score was 8.5 [range 6-11]. The mean amount of shortening done was 6.9cm [range 3-12.5] to enable revascularization and soft tissue repair. Three cases had to be amputated early because of failure of vascular repair. In the remaining 12 patients who were followed up the mean interval between revascularization and application of Ilizarov ring fixator was 4.7 weeks [range 3-10]. The mean follow up was 6.5 years [3-16 years]. Union occurred in all patients. Ten of the 12 patients returned to work and residual shortening was present in two cases. We conclude that whenever possible lower limb salvage should be undertaken.
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Affiliation(s)
- C C Kovoor
- Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India.
| | - V V George
- Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India
| | - R Jayakumar
- Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India
| | - A J Guild
- Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India
| | - D Bhaskar
- Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India
| | - A Cyriac
- Departments of Micro-Vascular Surgery & Orthopaedics, Specialists Hospital, North, Kochi, Kerala, Pin Code 682018, India
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Stegeman SA, de Witte PB, Boonstra S, de Groot JH, Nagels J, Krijnen P, Schipper IB. Measurement of clavicular length and shortening after a midshaft clavicular fracture: Spatial digitization versus planar roentgen photogrammetry. J Electromyogr Kinesiol 2015; 29:74-80. [PMID: 26371869 DOI: 10.1016/j.jelekin.2015.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 05/14/2015] [Accepted: 07/18/2015] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Clavicular shortening after fracture is deemed prognostic for clinical outcome and is therefore generally assessed on radiographs. It is used for clinical decision making regarding operative or non-operative treatment in the first 2weeks after trauma, although the reliability and accuracy of the measurements are unclear. This study aimed to assess the reliability of roentgen photogrammetry (2D) of clavicular length and shortening, and to compare these with 3D-spatial digitization measurements, obtained with an electromagnetic recording system (Flock of Birds). PATIENTS AND METHODS Thirty-two participants with a consolidated non-operatively treated two or multi-fragmented dislocated midshaft clavicular fracture were analysed. Two observers measured clavicular lengths and absolute and proportional clavicular shortening on radiographs taken before and after fracture consolidation. The clavicular lengths were also measured with spatial digitization. Inter-observer agreement on the radiographic measurements was assessed using the Intraclass Correlation Coefficient (ICC). Agreement between the radiographic and spatial digitization measurements was assessed using a Bland-Altman plot. RESULTS The inter-observer agreement on clavicular length, and absolute and proportional shortening on trauma radiographs was almost perfect (ICC>0.90), but moderate for absolute shortening after consolidation (ICC=0.45). The Bland-Altman plot compared measurements of length on AP panorama radiographs with spatial digitization and showed that planar roentgen photogrammetry resulted in up to 37mm longer and 34mm shorter measurements than spatial digitization. CONCLUSION Measurements of clavicular length on radiographs are highly reliable between observers, but may not reflect the actual length and shortening of the clavicle when compared to length measurements with spatial digitization. We recommend to use proportional shortening when measuring clavicular length or shortening on radiographs for clinical decision making.
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Affiliation(s)
- Sylvia A Stegeman
- Department of Surgery-Trauma Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
| | - Pieter Bas de Witte
- Department of Orthopaedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; Laboratory for Kinematics and Neuromechanics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Sjoerd Boonstra
- Department of Surgery-Trauma Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Jurriaan H de Groot
- Department of Rehabilitation Medicine, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands; Laboratory for Kinematics and Neuromechanics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Jochem Nagels
- Department of Orthopaedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Pieta Krijnen
- Department of Surgery-Trauma Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
| | - Inger B Schipper
- Department of Surgery-Trauma Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands
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Abstract
Pain and reduced function caused by disorders of either the plantar fascia or the Achilles tendon are common. Although heel pain is not a major public health problem it affects millions of people each year. For most patients, time and first-line treatments allow symptoms to resolve. A proportion of patients have resistant symptoms. Managing these recalcitrant cases is a challenge. Gastrocnemius contracture produces increased strain in both the Achilles tendon and the plantar fascia. This biomechanical feature must be properly assessed otherwise treatment is compromised.
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Affiliation(s)
- Matthew C Solan
- Department of Trauma and Orthopaedic Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 5XX, UK; University of Surrey, Guildford, UK; Surrey Foot and Ankle Clinic, Guildford, UK; London Foot and Ankle Centre, London, UK.
| | - Andrew Carne
- Department of Trauma and Orthopaedic Surgery, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 5XX, UK
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Cai J, Jang JY, Kim J, Shin K, Kim KS, Park D, Kim TS, Lee SP, Ahn B, Choi EK, Lee J, Kim YB. Comparative effects of plant oils on the cerebral hemorrhage in stroke-prone spontaneously hypertensive rats. Nutr Neurosci 2014; 19:318-26. [PMID: 24856006 DOI: 10.1179/1476830514y.0000000132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Since oils and fats can induce metabolic syndrome, leading to cardiovascular and cerebrovascular diseases, the present study was performed to find out whether the plant oils affect the cerebral hemorrhage in stroke-prone spontaneously hypertensive (SHR-SP) rats. METHODS From 47 days of age, male SHR-SP rats were given drinking water containing 1% NaCl to induce hypertension, and simultaneously fed semi-purified diets containing 10% perilla oil, canola oil, or shortening. The onset time of convulsion following cerebral hemorrhage was recorded, and the areas of hemorrhage and infarction were analyzed in the stroke brains. RESULTS In comparison with 58-day survival of SHR-SP rats during feeding NaCl alone, perilla oil extended the survival time to 68.5 days, whereas canola oil shortened it to 45.7 days. Feeding perilla oil greatly reduced the total volume of cerebral hemorrhage from 17.27% in the control group to 4.53%, while shortening increased the lesions to 21.23%. In a microscopic analysis, perilla oil also markedly decreased the hemorrhagic and infarction lesions to 1/10 of those in control rats, in contrast to an exacerbating effect of shortening. In blood analyses, perilla oil reduced blood total cholesterol and low-density lipoproteins which were increased in SHR-SP, but canola oil further increased them and markedly lowered platelet counts. DISCUSSION Perilla oil delayed and attenuated cerebral hemorrhage by improving hyperlipidemia in hypertensive stroke animals, in contrast to the aggravating potential of canola oil and shortening. It is suggested that perilla oil should be the first choice oil for improving metabolic syndrome in hypertensive persons at risk of hemorrhagic stroke.
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Affiliation(s)
- Jingmei Cai
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Ja-Young Jang
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Jihyun Kim
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Kyungha Shin
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Kwang Sei Kim
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Dongsun Park
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | | | | | - Byeongwoo Ahn
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Ehn-Kyoung Choi
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
| | - Junsoo Lee
- c Department of Food Science and Technology , Chungbuk National University , Cheongju , Korea
| | - Yun-Bae Kim
- a College of Veterinary Medicine, Chungbuk National University , Cheongju , Korea
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Dinç S, Javidipour I, Ozbas OÖ, Tekin A. Utilization of zero-trans non-interesterified and interesterified shortenings in cookie production. J Food Sci Technol 2014; 51:365-70. [PMID: 24493897 DOI: 10.1007/s13197-011-0506-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 08/03/2011] [Accepted: 08/15/2011] [Indexed: 01/16/2023]
Abstract
The effects of zero-trans chemically interesterified (in-es) and non-interesterified (non-in-es) cottonseed (CO), hazelnut (HO) and olive oil (OO) and their blends (25, 50 and 75%) with palm oil (PO) were studied in the production of cookies. All the experimental shortenings had zero-trans fatty acids (TFA) while the shortening contained 14.20% TFA. Incorporation of CO in PO considerably increased the linoleic acid content whereas the raising of HO and OO ratio in the blend increased the oleic acid content. Zero-TFA and lower saturated /unsaturated fatty acid ratio (SFA/UFA) of some of the experimental shortenings indicated an important in nutritional properties of cookies produced from these experimental shortenings. Cookies with in-es shortenings showed significantly higher (p < 0.05) spread ratios and L Hunter color than their non-in-es shortenings added counterparts. It can be concluded that chemical interesterification is a promising method to produce cookie shortenings with zero-TFA.
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Tallent J, Goodall S, Hortobágyi T, St Clair Gibson A, Howatson G. Corticospinal responses of resistance-trained and un-trained males during dynamic muscle contractions. J Electromyogr Kinesiol 2013; 23:1075-81. [PMID: 23722116 DOI: 10.1016/j.jelekin.2013.04.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 04/26/2013] [Accepted: 04/26/2013] [Indexed: 11/15/2022] Open
Abstract
Little is known regarding the modulation and the plasticity of the neural pathway interconnecting elements of the central nervous system and skeletal muscle in resistant-trained individuals. The aim of the study was to compare corticospinal and spinal responses measured during dynamic muscle contractions of the tibialis anterior in resistance trained (RT) and un-trained (UT) males. Nine UT and 10 RT male volunteers reported to the laboratory 24h following a familiarisation session. Motor evoked potentials (MEPs) and the cortical silent period were evoked using transcranial magnetic stimulation at a range of contraction intensities and was delivered as the ankle passed 90° during shortening and lengthening contractions. The Hoffmann reflex (H-reflex) and V-waves were evoked with peripheral nerve stimulation. Despite the RT group being significantly stronger during shortening (28%; P=0.023: CI=1.27-15.1Nm), lengthening (25%; P=0.041: CI=0.27-17.0Nm) and isometric muscle actions (20%; P=0.041; CI=0.77-14.9Nm), no differences between the groups existed for corticospinal or spinal variables. Lack of detectable differences between RT and UT individuals may be linked to minimal exposure to task specific, isolated high intensity resistance training of the TA muscle.
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Affiliation(s)
- J Tallent
- Faculty of Health and Life Sciences, Northumbria University, Newcastle, UK
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Kaur A, Jassal V, Thind SS, Aggarwal P. Rice bran oil an alternate bakery shortening. J Food Sci Technol 2012; 49:110-4. [PMID: 23572833 DOI: 10.1007/s13197-011-0259-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 04/16/2010] [Accepted: 04/22/2010] [Indexed: 10/18/2022]
Abstract
Studies were carried out to replace bakery shortening with refined rice bran oil in bread preparation. Physico-chemical properties of bakery shortening and rice bran oil were studied. Rice bran oil was found to have a higher content of essential fatty acid linoleic acid (34.98%) as compared to that of bakery shortening (5.14%). Chemical composition of wheat flour used was also evaluation. Bread samples were prepared by replacing bakery shortening with rice bran oil at 0, 25, 50, 75 and 100% levels. Breads were examined for bread making quality i.e. loaf weight, loaf height, loaf volume and specific volume and organoleptic quality i.e. appearance, crust colour, crumb colour, aroma, texture, taste and overall acceptability on a 9 point hedonic scale. Statistical analysis regarding bread making quality and organoleptic quality of bread revealed that bread making and organoleptic quality of breads prepared after replacing bakery shortening with rice bran oil at 50% level varied significantly from that of control. Statistically significant variations were observed in the texture of breads prepared with shortening from that prepared after replacing bakery shortening with rice bran oil at 50% level.
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Abstract
Ulnar shortening osteotomy is the standard treatment for the condition of ulnocarpal impaction. Traditionally ulnar shortening osteotomy has been performed in the diaphysis and secured with a 3.5 mm plate. Delayed union, nonunion, and symptomatic hardware have been cited as detractors of this technique. A number of alternatives have consequently been proposed that range from different hardware to different patterns of osteotomy to resection of the distal portion of the ulnar head. This article describes one method for ulnar shortening osteotomy that seeks to draw upon the advantages of several of these variations in order to minimize complications.
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