No abstract

No abstract

The authors investigated the use of an anti-rotation screw with the dynamic hip screw (DHS) during internal fixation of Garden I and II femoral neck fractures. Sixty-five patients with Garden I and II femoral neck fractures (mean age, 70 years) were treated with internal fixation at the authors' institution. In 31 patients, a 2-hole DHS was used alone (group 1), and in 34 patients, the DHS was combined with an anti-rotation screw placed in the cranial part of femoral head and neck (group 2). Patients' preinjury function and mental level were assessed using the Barthel index and the Abbreviated Mental test, respectively. The outcome measures included cost implications, operative time, and intraoperative radiation dose. The modified Harris Hip Score and a radiological assessment were performed at a mean of 11 months (range, 8-24 months) postoperatively. The use of the anti-rotation screw was associated with a longer operative time (mean, 44.54 minutes in group 1 vs 51.52 minutes in group 2; P<.0001) and more fluoroscopy screening (mean dose area product, 28.39 cGy/cm(2) in group 1 vs 44.33 cGy/cm(2) in group 2; P=.03). The additional cost of using an anti-rotation screw was £106 ($170) per case. No difference existed between the 2 groups with regard to radiological union, onset of avascular necrosis, and rate of revision surgeries. An anti-rotation screw, used with the dynamic hip screw, involves extra costs, prolongs operative time, and requires more intraoperative fluoroscopy screening but offers no advantages with regard to fracture union.

Background: Ultimate repair of alveolar defects is a great challenge in practical field, many bone graft materials have been evolved in the literatures for alveolar defect reconstruction as autogenous, allogenic, xenogenic, and alloplastic grafts [1], autogenous iliac crest bone graft is the gold standard among other graft materials evaluated. However, the procedure associated with a potential risk of early complications such as graft resorption, graft leakage, infection, or graft failure, failure rate is about 30% [2].Objectives: To assess the efficacy of using Platelet Rich Plasma (PRP) in alveolar cleft reconstruction; in combination with Iliac Crest Bone Graft (ICBG) in comparison to the conventional Iliac Crest Bone Grafting (ICBG).Patients and Methods: 20 patients underwent alveolar cleft reconstruction at the age of mixed dentition over a 3year's period; their mean age was 8.8±2.3 years years and their mean post-operative follow-up was 13.4 months. Of these, 10 patients treated with ICBG combined with PRP (Group I), and 10 patients repaired by ICBG alone Group II (control group) results were assessed by rating the radiographs obtained 3, 6, and 12 months post-operatively according to cone beam CT (CBCT) volume and density assessment.Results: Alveolar cleft repairs using PRP combined cancellous bone (Group I) were 90 percent successful, alveolar cleft repairs using cancellous bone (Group I) were 70 percent successful as regard; bone resorption reduction, bone volume gaining and improved bone density in CBCT at 3, 6, and 12 months post-operative with decreased post-operative complication rates. Conclusion:Application of PRP enhances bone formation in alveolar clefts when admixed with autologous bone graft harvested from the iliac crest as it leads to early bone formation, increased bone density, decreases bone resorption, low infection rate and least post-operative complications.

No abstract