Biomedical zirconia was introduced in 1969 into medicine to solve the problem of alumina brittleness in hip replacement procedures and has since been used for various joint replacement appliances in orthopedic surgery. The most frequently-studied material is yttrium-stabilized zirconia, which is also known as tetragonal zirconia polycrystal (TZP). Y-TZP presents various interesting characteristics, such as low porosity, high density and high bending and compression strength, proving that it is suitable for biomedical application. UV-treated zirconia surfaces exhibited an enhanced osteoblast response, which was characterized by an accelerated and augmented cell attachment, accelerated cell spread and cytoskeletal development with increased proliferation. The purpose of this paper is to identify which method of treatment of zirconia material implant & ultraviolet stimulation effect for bone healing is the most effective and efficient based on literature review. Bone grafts are available in a variety of substances. These bone substitutes can be biological (natural) or synthetic. Re-absorption is also essential for bone growth. Specific cells continuously break down bones and rebuild them. Substitutes that break down too quickly are not suitable for bone grafts, as they do not allow enough time for the new bone to grow. From our literature review, Zirconia is one of the biomaterials that have a bright future because of its high mechanical strength and fracture toughness. Zirconia ceramics have several advantages over other ceramic materials due to the transformation toughening mechanisms operating in their microstructure that can be expressed in components made out of them. UV treatment substantially enhances the osteogenesis process, resulting in a greater amount of peri-implant bone, as well as an increased strength of bone-zirconia integration.
Background: Quadriceps muscle rupture is second common cause of disrupted extensor mechanism by directly affect lower limb function by hinders knee extension drastically. Ideally, patient with quadriceps tendon rupture and undergo primary surgical repair in first 48–72 hours after injury to achieve good outcome then decrease morbidity and disability. Chronic untreated quadriceps tendon rupture with adverse progression of gap cause by muscle contraction, scarred muscle body, degenerative calcification, or decreased tendon end vascularity lead to pain in contraction, worsening morbidity and disability as well makes surgical repair more technically challenging. We report one case of chronic untreated quadriceps muscle rupture, our management, and outcomes. Clinical case: 27 years old male with right quadriceps rupture that occurred accidently while he was descending stairs. The patient then went to bonesetter and just went to the hospital after a long time of complaints of pain and are not getting better. In the right knee, the neglected quadriceps rupture was managed with polypropylene mesh and collacure to shorthen the gap. Discussion: Management goal is to reduce large gap at quadriceps tendon to reach both end of the muscle in tension free manner and not only increasing regeneration of tendon but also increasing the strength of the tissues after healing by polypropylene mesh and collacure. Conclusion: Quadriceps reconstruction with polypropylene mesh and collacure have a fair result for extensor mechanism. Further research is required to determine best approach to quadriceps reconstruction in reducing gap.
Supracondylar fractures of the humerus are common in children and the advocated treatments for these fractures include closed reduction and percutaneous pinning. There are numerous debates on the intervention period selection for delayed treatment in children. This phenomenon is prevalent in regions with limited healthcare support. The objective of this study was to compare the outcome of early and late treatment groups, including preliminary presentations and the management of failed treatment. This was a prospective comparative study on early and late open reduction, featuring Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 18 years. Patients from January 2018 to January 2019 were categorized into early and late groups (n=22 and n=26), consisting of 33 (86.8%) males and 15 (31.25%) females. Flynn’s criteria were used to evaluate them. The average time from injury to surgery was 50.24±23.5 hours in the early group and 373.79±89.23 hours in the late group (p<0.002). While the Bauman’s angle recorded after 12 weeks presented the values of 82.04 ± 5.18 and 77.38±6.43 (p=0.622) for the early and late groups, respectively. Pre-operative nerve injuries were observed only in 4 (8.33%) cases from the early group. The functional outcomes of both categories were not significantly different statistically (p=0.242). The outcome for children with supracondylar humerus fracture Gartland type III was satisfactory in both groups. In conclusion, treatment delay does not result in a difference in the outcome according to Flynn's criteria.
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