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Almost all fractures healed in 2 to 3 weeks with excellent functional outcome. Knowledge of epidemiology and etiology of hand fractures can serve as an essential first step in devising strategies to reduce the incidence of these hand injuries. It is hoped that studies such as the present study may serve as a first step in planning measures to reduce the occurrence of hand fractures.

Various complications can result from titanium plate internal fixation, including infection, exposure, pain, cold intolerance, and palpability. The incidence of such complications has become a topic of recent interest with the advent of resorbable plating. We undertook a retrospective review to determine complication rates of titanium fixation in a facial fracture population. Out of 266 patients with operative management of traumatic facial fracture between 1991 and 2004, 135 patients had titanium plate fixation. We evaluated 16 panfacial fractures, 22 zygomatic-orbital complex fractures, 49 midface fractures, and 48 fractures of the mandible. Overall, 33.3% (45/135) of patients had plates removed; 64.4% (29/45) of plate removals were for complications, ie, discomfort, exposure, and infection; 35.6% (16/45) were removed during secondary reconstruction. The most common complication was discomfort related to palpability, cold intolerance, and pain. This constituted 72.4% (21/29) of all plate removals for complications. Higher rates of plate discomfort were noted near the supraorbital, infraorbital, and mental foramina.

We report on a molecular-dynamics study of the wetting state of a system of hard spheres near a planar hard wall. A direct simulation at the melting point of a two-phase system between two walls develops all the way from complete wetting by fluid via a partial wetting state to a final arrangement of complete wetting by crystal. This implies that a hard-sphere fluid closely approaching coexistence from below should spontaneously crystallize at a smooth hard wall, contrary to existing beliefs. PACS numbers: 61.20.Ja, 64.70.Dv, 68.10.Cr, 68.45.Gd The last decade has seen a large increase in activity in the traditional areas of wetting, adhesion, and heterogeneous nucleation. To a large extent the renewed efforts were stimulated by the work of Cahn [l], who first argued the existence of a wetting transition in fluid-fluid systems on the basis of an elegant scaling argument. Researchers have focused on the order of the wetting transition, looked for prewetting lines, and investigated the role of the interaction ranges and the role of fluctuations. A comprehensive review has been published by Dietrich [2]. Much of the focus has been on fluid-fluid systems near substrates or in contact with a noncritical spectator phase. Wetting studies involving the crystal phase are much smaller in number [2]. Of these most have focused on surface melting of single crystals and on adsorbed crystalline layers which constitutes an example of the approach of complete wetting along the sublimation curve. However, a few experimental studies have addressed wetting of He phases near the melting line [2], the topic of this Letter. Extending recent advances in describing fluid-fluid wetting phenomena (which have primarily been made with the use of density functional theory) is hindered by the difficulty of describing the symmetry and rapid spatial variations of density for the crystal and the crystal-fluid interface. Similarly, simulation of liquid-crystal coexistence is found to be more challenging than fluid-fluid coexistence. In this Letter we will present what we believe to be the first thorough simulation of wetting at coexistence by crystal on a substrate. We find that even a perfectly smooth wall can be wetted by crystal. This implies the existence of spontaneous heterogeneous nucleation when saturation is approached from below, a phenomenon which is often referred to as prefreezing. Prefreezing is sometimes observed when dense colloidal suspensions nucleate near smooth container walls. Our simulations closely mimic this case because the length scales of roughness on the container walls is such that the walls appear smooth to the large colloidal particles. Our results appear to be contrary to all previous speculations based on earlier simulation attempts [3][4][5]. We shall discuss these contradictions below.The molecular-dynamics (MD) simulations [6] were performed on a system of TV =2100 hard spheres. The initial calculations were started from a perfect fee crystal configuration with the (ill) planes in the x-y plane. By partially ...

The authors believe that all types of reconstruction should be an option for women older than 60 years of age and that age as an isolated factor should not deter physicians from offering these women the option of breast reconstruction.

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Background: Pierre Robin sequence (PRS) is a triad of micrognathia, glossoptosis, and respiratory distress. There is no standard clinical classification used in the management of neonatal airway in patients with PRS. The goal of our study was to review the presentation and management of patients with PRS and formulate a clinical grading system and treatment algorithm. Methods: A 10-year retrospective review of all neonates diagnosed with PRS was performed after obtaining institutional ethics approval. Patients were identified using our cleft lip and palate program database. Inclusion criteria were 2 of the following 3 clinical features-glossoptosis, retrognathia, or airway obstruction. We collected demographic data, clinical information (coexisting airway morbidity, maxillary-mandibular discrepancy, type of intervention used, complications, and outcomes (feeding, length of stay, and airway status) during the first year of life. Results: Sixty-three patients met our inclusion criteria. Of these, 55 (87%) had cleft palate and 17 (27%) were syndromic. Forty-eight (76%) patients were managed by prone positioning. Of the 15 surgically managed patients, the initial procedure was floor of mouth release in 7, mandibular distraction osteogenesis (MDO) in 4, and tongue-lip adhesion in 4. Five patients with coexisting airway morbidity needed a second surgery; 2 had MDO and 3 tracheostomies (one patient was later decannulated). Seven (47%) of the surgically managed patients required a gastrostomy tube. Conclusion: At present, there is no consensus on neonatal airway management in infants with PRS. From our review of 63 patients with PRS, we hereby propose a simple 4-point classification system and treatment algorithm, based on clinical features. Résumé Historique : Le syndrome de Pierre-Robin (SPR) désigne une triade de micrognathie, de glossoptose et de détresse respiratoire. Aucune classification clinique standard n'est utilisée pour assurer l'ouverture des voies respiratoires chez les nouveau-nés présentant un SPR. La présenteétude visait à examiner la présentation et la prise en charge des patients ayant un SPR ainsi qu'à formuler un système de classement clinique et un algorithme de traitement. Méthodologie : Après avoir obtenu l'approbation du comité d'éthique de leurétablissement, les chercheurs ont procédé à une analyse rétrospective sur dix ans de tous les nouveau-nés ayant reçu un diagnostic de SPR. Ils ont recensé les patients dans leur base de données de fentes labiales et palatines. Deux des trois caractéristiques cliniques suivantes constituaient les critères d'inclusion : glossoptose, rétrognatie ou obstruction