The timing of surgery for patients sustaining traumatic lower cervical spine injury with neurological involvement did not affect neurological recovery. Early surgical intervention was associated with a higher incidence of mortality and neurological deterioration compared with late surgical intervention, indicating that surgery after the first 72 hours might be relatively safe.

Background The treatment of vertical femoral neck fractures (vFNFs) in young patients remains challenging, with a high complication rate by using traditional techniques. The use of cannulated screws (CSs) combined with a buttress plate represents an alternative approach for treating vFNFs. However, the biomechanical influence of the use or non-use of the proximal screws of buttress plates on vFNFs stability remains unclear. This study aims to analyse the biomechanics of buttress plate fixation with or without the use of proximal screws through finite element analysis (FEA) to further understand this approach. Methods We built five vFNFs (Pauwels angle 70°) finite element models treated using three cannulated screws (CS group) or three cannulated screws plus a locking buttress plate (buttress group). In the buttress group, use or non-use of proximal screws was carried out on two types of plates (4-hole & 6-hole). The following seven parameters were analysed to compare biomechanical properties of the five models: the stiffness; the maximal stress of the plate system (plate and screws), CSs and bone (MPS, MCS, MBS); the maximal displacement of internal fixations (plate system & CSs) and bone (MIFD, MBD); and the maximal relative displacement of interfragments (MID). Results Compared with CS model, the buttress models exhibited improved biomechanical properties, with increased stiffness and decreased MCS, MBS, MIFD, MBD and MID. The models fixed using buttress plates combined with a proximal screw showed greater stiffness (+ 3.75% & + 8.31% vs + 0.98% & + 4.57%) and MPS (795.6 & 947.2 MPa vs 294.9 & 556.2 MPa) values, and smaller MCS, MBS, MIFD, MBD and MID (− 3.41% to − 15.35% vs − 0.07% to − 4.32%) values than those using the same length plates without a proximal screw. Conclusions Based on the FEA results, buttress plates can improve construct mechanics, help to resist shear force and prevent varus collapse; under the modelling conditions, the use of a proximal screw on buttress plate may be a key technical feature in improving anti-shearing ability; additionally, this screw may be essential to reduce stress and prevent re-displacement of cannulated screws and fracture fragments.

This study was conducted to assess the levels of trace elements and their relationship with growth and development of children in Shanghai, China, to offer scientific evidence for supplementing trace elements in children. A stratified, clustered, random sampling method was used in the study. Blood samples were taken from 2141 Shanghai children from 0 to 6.0 years old, and the concentrations of zinc (Zn), calcium (Ca), iron (Fe), copper (Cu), and magnesium (Mg) were measured using inductively coupled plasma mass spectrometry (ICP-MS). Nutritional status was determined and Z-scores of anthropometric parameters, such as height for age (HFA), weight for age (WFA), and body mass index (BMI) were calculated, indicated by HAZ, WAZ, and BMIZ, respectively. The overall median blood levels of Zn, Ca, Fe, Cu, and Mg were 8.83, 79.02, 9.49, 1.04, and 15.45 mg/L, respectively. Fe, Cu, and Mg increased with age and Zn, Fe, and Cu differed by sex. HAZ and WAZ were positively correlated with Zn (r (2) = 0.072 and 0.053, respectively; P < 0.05). Trace elements were significantly related to children's growth and development. Dietary supplementation and screening of nutritional states are potential solutions to improve children's growth and development.