BackgroundNeglected fracture of neck of femur in young adults is a major problem in developing countries. Existing treatment options varies from osteotomy to various graft techniques (muscle pedicle, vascularized and nonvascularized fibula etc.). There is paucity of literature regarding the use of double angle barrel plate and hip screw in such cases. We conducted a prospective longitudinal observational study with displaced, neglected fracture neck of femur in young adults and compared the results with literature.
ObjectivesThe aim of this study was to determine feasibility and effectiveness of 120° double angle barrel plate and hip screw fixation in neglected fracture neck of femur. Effectiveness of fixed 30 degree closed wedge osteotomy in neglected fracture neck of femur.
MethodsThirty cases of neglected (more than three weeks) femoral neck fracture (Pauwel II and III) of age 20-60 years were included in the study conducted at Postgraduate Institute Of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India in year 2004-06. Average age of the patient was 35.4 years (range, 22yrs-55yrs). In all cases internal fixation was done by 120° double angle barrel plate and hip Screw. At the end of follow-up, results were evaluated according to Askin Bryan Criteria and Harris-hip score.
ResultsUnion was achieved in 28 of 30 patients. Two patients that went into nonunion were later treated with hemireplacement arthroplasty. According to Askin Bryan Criteria at the end of study, 35% patients had excellent results, 50% patients had good results. Minimum follow-up in our study was 12 months and maximum was five years.
ConclusionThis study validates the use of double angled screw plate configuration for successful outcome in patients with neglected fracture neck of femur. Valgus osteotomy is also technically easy operation in hands of average trauma surgeon with the use of a fixed angle plate and hip screw.
Background: Percutaneous renal biopsy can result in serious complications. The study is aimed to compare the safety and yield between the two approaches of biopsy techniques: the conventional craniocaudal and the caudocranial trajectory of the biopsy needle under real-time ultrasound guidance. Methods: In this prospective observational study, a total of 80 serial kidney biopsies were performed, 40 with craniocaudal angulation and 40 with caudocranial angulation of the biopsy needle on the random allocation of 1:1 in each group. In the craniocaudal approach, the patient must hold the breath in deep inspiration to make a lower pole of the kidney approachable during unloading the biopsy gun, which was not required in caudocranial trajectory as the lower pole was approachable without holding the breath in deep inspiration. All kidney biopsies were performed percutaneously under real-time ultrasonogram guidance with a 16-cm-long, 16- or 18-gauge needles with a penetration depth of 22 mm and a sample notch of 18 mm. The yield and complications between the two groups were analyzed. Results: Both the groups were comparable in essential demographic characteristics. The study found that the caudocranial position of renal biopsy is equally suitable concerning tissue yield without any increase in the risk of complications and a smaller number of passes to obtain adequate tissue. Conclusion: Caudocranial trajectory of the biopsy needle using a probe needle guide is as safe as the craniocaudal approach. Both approaches have similar yield and complications; however, the caudocranial approach provides ease to the patient during the procedure.
I n d e x e d i n P u b M e d , W e b o f S c i e n c e a n d S c o p u s Yasemin Yuyucu Karabulut, et al.; The role of COL6A1 and PD-1 expressions in renal cell carcinoma.
The cardiovascular effects of ergometrine have been examined using animal models in vivo and in vitro. In rats in vivo the pressor effects of a standard dose of ergometrine were found to be dependent upon the anaesthetic used for the procedure. The pressor action of ergometrine was greater when urethane, an anaesthetic which produces both sympathetic and parasympathetic acitivity, was used. The in-vitro experiments, using isolated rabbit aorta and portal vein, failed to explain the phenomenon; they suggested that ergometrine has a direct action on the alpha-adrenoceptor in rabbits. No evidence was found to suggest that ergometrine inhibits noradrenaline uptake or its release from the nerve terminals.
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