Greenrobertson7407
Dynamization has already been described as a secondary intervention for delay unions of tibial shaft fractures treated with intramedullary nailing. Although it's a common procedure, it is not widely supported in the literature. The purpose of this study was to determine the union rate of nail dynamization in cases of delayed union of diaphyseal tibial fractures, and assess the effect of fracture morphology on union rates.
We retrospectively analyzed a series of 199 consecutive tibial shaft fractures. We recorded the dynamization rate, period from nailing to dynamization, nailing to the union, the fracture pattern (according to AO/ASIF and whether it was closed or open), the callus diameter before dynamization (fracture healing index; FHI) and union/failure rates.
Out of a total of 199 fractures treated during the study period, 41 (20.6%) were dynamized. After applying inclusion and exclusion criteria, 39 patients with 39 fractures were included in the study. The mean time from nailing to dynamization was 18.4 ± 7.2weeks. The union rate was 92.3% (
= 36) over a mean time of 14.1 ± 5.6weeks as from dynamization. The overall failure rate was 6.7% (
= 3). There was no significant association between failure and AO/ASIF classification (
> 0.05) or fracture exposure (
= 0.19;
= 0.66). The pre-dynamization FHI of ≥ 1.17 was significantly associated with consolidation (
< 0.05).
In cases of delayed union of tibial fractures, dynamization offered a high union rate associated with pre-dynamization FHI, while fracture morphology did not affect the failure rate.
In cases of delayed union of tibial fractures, dynamization offered a high union rate associated with pre-dynamization FHI, while fracture morphology did not affect the failure rate.
The primary aim of this retrospective study was to assess the postoperative clinical, functional, and radiographic outcomes of patients with closed tibial plateau fractures (TPFs) surgically treated with proximal tibial locking compression plate (LCP) system with a focus on the use of preoperative CT scan.
Two hundred and sixteen patients with TPFs who underwent surgical treatment in our department between January 2010 and December 2019 were enrolled in this study. Ninety-five patients of 216 (44.0%) had preoperative CT examination in addition to plain radiographs to better evaluate the pattern of fracture and displacement of fragments. Clinical and functional outcomes were assessed using VAS, SF-36, Knee Society Score (KSS) and WOMAC score. Radiographic outcomes were evaluated according to the Kellgreen- Lawrence classification of the pre- and postoperative grades of valgus knee, articular displacement and gonarthrosis.
Patients with preoperative CT showed better clinical results than the X-ray group for the VAS, KSS, WOMAC and SF-36 score. Moreover, we found that the X-ray group had worse results than the CT group in the rate of varus-valgus alignment and step-off worsening, while the posterior tibial slope showed no significant changes between the two groups at the final follow-up. Finally, the group of patients who received preoperative CT scans displayed a better immediate postoperative reduction and less long-term arthritis.
CT has proved to be a good examination in preoperative planning of TPFs it can influence postoperative results thanks to an improvement in the surgical approach, a better evaluation of the morphology of fracture lines and the involvement of the Luo's three columns in axial CT scans.
CT has proved to be a good examination in preoperative planning of TPFs it can influence postoperative results thanks to an improvement in the surgical approach, a better evaluation of the morphology of fracture lines and the involvement of the Luo's three columns in axial CT scans.
To compare functional and radiological outcomes of transverse patella fractures treated with tension band wiring using either two 4.5mm cannulated screws or Kirshner wire.
This is a non-blinded prospective randomized study comprising of two groups (
= 30 each) with closed transverse patella fractures treated with tension band wiring using Kirschner wire (K wire group) and two 4.5mm cannulated screws (CCS group). Outcomes measured were radiological union, Knee Society score, range of motion and post-operative complications.
The CCS group showed a statistically significant higher range of motion than K wire group for each follow up (
< 0.001 in flexion and
< 0.005 in extension). A statistically significant higher percentage of patients in the CCS group showed signs of union at 6th and 12th post-operative week (
= 0.001 and 0.011 respectively) but no difference at 24th post-operative week (
= 0.313). The rate of hardware complications was significantly higher in K wire group (
= 0.001). No significant difference was noted in in the Knee society score and post-operative complications between the groups.
This study concludes that the fixation of closed transverse patella fractures using two 4.5mm cannulated screws is allows a faster rate of union, a better knee range of motion and lesser hardware complications as compared to Kirschner wires. However more studies with larger sample sizes and longer follow up are required.
This study concludes that the fixation of closed transverse patella fractures using two 4.5 mm cannulated screws is allows a faster rate of union, a better knee range of motion and lesser hardware complications as compared to Kirschner wires. However more studies with larger sample sizes and longer follow up are required.The current study's aim is to evaluate the dynamics of a Hepatitis B virus (HBV) model with the class of asymptomatic carriers using two different numerical algorithms and various values of the fractional-order parameter. We considered the model with two different fractional-order derivatives, namely the Caputo derivative and Atangana-Baleanu derivative in the Caputo sense (ABC). The considered derivatives are the most widely used fractional operators in modeling. We present some mathematical analysis of the fractional ABC model. The fixed-point theory is used to determine the existence and uniqueness of the solutions to the considered fractional model. For numerical results, we show a generalized Adams-Bashforth-Moulton (ABM) method for Caputo derivative and an Adams type predictor-corrector (PC) algorithm for Atangana-Baleanu derivatives. Finally, the models are numerically solved using computational techniques and obtained results graphically illustrated with a wide range of fractional-order values. We compare the numerical results for Caputo and ABC derivatives graphically. In addition, a new variable-order fractional network of the HBV model is proposed. Considering the fact that most communities interact with each other, and the rate of disease spread is affected by this factor, the proposed network can provide more accurate insight for the modeling of the disease.[This corrects the article DOI 10.18632/oncotarget.11515.].Multiple myeloma (MM) is a hematological malignancy of plasma cells that remains incurable despite significant progress with myeloablative regimens and autologous stem cell transplantation for eligible patients and, more recently with T cell redirected immunotherapy. Recently, we reported that ex vivo virotherapy with oncolytic myxoma virus (MYXV) improved MM-free survival in an autologous-transplant Balb/c mouse model. Here, we tested the Vk*MYC transplantable C57BL/6 mouse MM model that more closely recapitulates human disease. see more In vitro, the murine bortezomib-resistant Vk12598 cell line is fully susceptible to MYXV infection. In vivo results demonstrate (i) autologous bone marrow (BM) leukocytes armed ex vivo with MYXV exhibit moderate therapeutic effects against MM cells pre-seeded into recipient mice; (ii) Cyclophosphamide in combination with BM/MYXV delays the onset of myeloma in mice seeded with Vk12598 cells; (iii) BM/MYXV synergizes with the Smac-mimetics LCL161 and with immune checkpoint inhibitor α-PD-1 to control the progression of established MM in vivo, resulting in significant improvement of survival rates and decreased of tumor burden; (iv) Survivor mice from (ii) and (iii), when re-challenged with fresh Vk12598 cells, developed acquired anti-MM immunity. These results highlight the utility of autologous BM grafts armed ex vivo with oncolytic MYXV alone or in combination with chemotherapy/immunotherapy to treat drug-resistant MM in vivo.Recently an enhancement of the sensitivity of colorectal cancer (CRC) cells by 5-fluorouracil (5FU) due to the concurrent treatment with epigallocatechin-3-gallate (EGCG) has been found. In the present paper, to investigate on this aspect, adenocarcinoma cells HT29 were treated with 5FU, EGCG and an equimolar mixture of 5FU and EGCG ([5FU+EGCG]) and cell viability was determined. While 5FU exhibits a clear activity, EGCG alone does not express any activity. However by treating the cells with [5FU+EGCG] a strong effect of EGCG is evidenced the sensitivity of HT29 cells to 5FU was increased by 12-fold. A simulation of the behavior of [5FU+EGCG] in different compartments of the gastrointestinal digestion model was also performed. 5FU and EGCG solubilized into a mixture of digestive fluids analyzed by mass spectrometry did not lead to signals of 5FU, EGCG and the related complex, while by diluting the solution they become detectable. On the contrary, when 5FU and EGCG are submitted to the step-by-step digestion model procedure, the analysis did not show the presence of 5FU, EGCG and [5FU+EGCG]. This behaviour could be ascribed to the instability of these compounds due to the too severe digestion conditions and/or to the complexity of the matrix which could lead in ESI conditions to the suppression of the signals of the analytes of interest.In this study, the molecular profile of different BRCA-associated tumor types was assessed with regard to the classification and annotation of detected BRCA1/2 variants. The aim was to establish guidelines in order to facilitate the interpretation of BRCA1/2 alterations in routine diagnostics. Annotation of detected variants was evaluated compared to background mutations found in normal tissue samples and manually reviewed according to distinct online databases. This retrospective study included 48 samples (45 tumors, three non-tumors), which were sequenced with the GeneReader (QIAGEN). Thereof ten samples were additionally analyzed with the Ion S5™ (Thermo Fisher) and 20 samples with the MiSeq™ (Illumina®) to compare the different NGS devices, as well as the sequencing results and their quality. The analysis showed that the individual NGS platforms detected different numbers of BRCA1/2 alterations in the respective tumor sample. In addition, the GeneReader revealed variability in the detection and classification of pathogenic alterations within the platform itself as well as in comparison with the other platforms or online databases. The study concluded that the Ion S5™ in combination with the Oncomine™ Comprehensive Assay v3 is most recommendable for current and prospective requirements of molecular analysis in routine diagnostics. In addition to the two BRCA1/2 genes, a broad number of other genes (BRCAness genes and genes involved in the repair pathway) is covered by the panel, which may open up new treatment options for patients depending on the respective eligibility criteria.