Objective Extensive bone defects remain a therapeutic challenge necessitating alternative surgical approaches with better outcomes. Can increase the effectiveness of PRP or EGF treatment in surgical treatment of large bone defects with Masquelet technique? Aim of this study examined potential therapeutic benefits of the Masquelet technique with induced membranes in combination with platelet-rich plasma (PRP) or epidermal growth factor (EGF) in a rat model of segmental femur defect. Methods Three groups each consisting of 20 Sprague-Dawley rats were defined as follows: EGF group, PRP group, and control group. A femoral bone defect was created and filled with antibiotic embedded polymethyl methacrylate. Half of the animals in each group were sacrificed at week 6 and the pseudo-membranes formed were analyzed. In the remaining half, the cement was removed and the space was filled with autograft. After another 6 weeks, the structures formed were examined radiologically, histologically, and biochemically. Results At week 6, both PRP and EGF groups had significantly higher membrane CD31, TGF-beta, and VEGF levels than controls. At week 12, when compared to controls, PRP and EGF groups had significantly higher membrane CD31 levels and the PRP group had significantly higher membrane TGF levels. Regarding bone tissue levels, PRP and EGF groups had significantly higher VEGF levels and the EGF group had significantly higher BMP levels. In addition, PRP and EGF groups had higher radiological scores than controls. However, the two experimental groups did not differ with respect to any parameter tested in this study. Conclusion Both PRP and EGF seem to be associated with histological, biochemical, and radiological improvements in experimental rat model of Masquelet technique, warranting in further clinical studies. Level of evidence Level 5
Background and objectives: Supracondylar humerus fractures are common in children andcan be surgically treated. However, the general surgical procedures involving reduction andfixation might lead to reduction loss, failure to direct the Kirschner (K)-wire toward the desiredposition, prolonged surgery, or chondral damage. This study aimed to show that temporaryfixation of closed reduction with a fabric adhesive bandage in pediatric supracondylar humerusfractures could maintain reduction so that surgical treatment can be easily performed by a singlephysician. Materials and Methods: Forty-six patients with Gartland type 3 supracondylar humerusfractures who underwent surgical treatment between May 2017 and June 2018 were retrospectivelyevaluated. Fluoroscopy-guided reduction and fixation were performed from the distal third of theforearm to the proximal third of the humerus using a fabric adhesive bandage. Two crossed pinswere applied on the fracture line by first inserting a lateral-entry K-wire and then inserting anotherK-wire close to the anterior aspect of the medial epicondyle and diverging from the ulnar nervetunnel. A tourniquet was not applied in any patient and no patients required open reduction.Results: The study included 32 boys (69.6%) and 14 girls (30.4%) (mean age, 7.1; range, 2–16 years).The mean hospital stay and follow-up duration were 4.3 ± 3.9 days and 48.1 ± 14.3 weeks,respectively. Heterotopic ossification was detected in one patient, and ulnar nerve neuropraxia wasdetected in another patient. Functional (according to Flynn criteria) and cosmetic outcomes wereexcellent in 95.6%, moderate in 2.2%, and poor in 2.2% of patients. The mean duration of fixation ofthe closed reduction with a fabric adhesive bandage was 8.1 ± 3.9 min, and the mean duration ofpinning was 7.9 ± 1.4 min. Conclusions: Temporary preoperative fixation of supracondylar humerusfractures that require surgical treatment with a fabric adhesive bandage may be significantlyconvenient in practice.
The management of displaced radial neck fractures in children is still a controversial topic. The objective of this study is to examine the outcomes of modified Metaizeau technique in the children with displaced radius neck fractures. The retrospective study included 15 children with displaced radial neck fracture with an angulation of more than 30° who were managed with the use of leverage technique by mosquito clamps and internal fixation with elastic stable intramedullary nailing (ESIN). Radiological and functional assessments were performed during follow-up. Additionally, the patients were evaluated using Mayo Elbow Per- formance Score (MEPS). All the children could be managed with clamp-assisted closed reduction. The average duration of follow up was 25.5 ± 6.1 months (15-36 months). An excellent elbow function was achieved in all but one patient. Based on Metaizeau classification, excellent, good, fair, and poor outcomes were achieved in 11, 1, 2, and 1 patients, respectively. The average postoperative MEPS score was 98.7 ± 5.1 (80-100). Clamp-assisted closed reduction and fixation with ESIN is a good choice in the children with displaced radial neck fractures. This technique is associated with good functional and radiologic outcomes in the medium-term. Further studies are warranted with larger sample sizes.
H uman orf infection is an uncommon zoonotic infection transmitted from infected sheep and goats. The causative agent is dermotropic Parapox virus. Although known as occupational infection, any person who directly contacts infected animals, meat or materials is prone to acquire the disease (1-4). We report an Orf lesion which occurred on the finger of a fifth-grade Medical student who had butchered a goat in Sacrifice Feast (also called Eid al-Adha).
Objectives:To present two cases who underwent cruciate ligament repair by nitinol wire synthetic allograft and to discuss outcomes.Methods:Although definitive incidence of anterior cruciate ligament injuries is unknown, it is estimated that annual 200.000 rupture occurs with 100.000 reconstructions in United States [1]. Therapeutic options include medical treatment, isolated or augmented anterior cruciate ligament repair and reconstruction with autograft, allograft and synthetic grafts. Debates on the treatment of such injury focus on selection of graft rather than need for surgery. Once anterior cruciate ligament reconstruction was decided, surgeon should have to select a graft. In general, an autograft is preferred. There are also allograft and synthetic grafts. Autograft have advantages of low risk for cross-inflammatory response and lack of risk for disease transmission. Nitinol is a material produced from nickel and titanium. It is more often used in vascular stents, orthodontic wires, implants used in mandible surgery and some orthopedic implants [2]. We presented 2 patients who underwent reconstruction with synthetic grafts produced from flexible nitinol wire.Results:Case 1: A 31-year old man presented to our clinic with pain at right knee. The patient underwent cruciate ligament surgery 10 years ago at another facility. His right knee was sprained again 12 months ago; thus, he was re-operated ad anterior cruciate reconstruction was performed in a facility. The patient had pain after surgery. On the physical examination, there was limitation in knee flexion by 100 degree and in knee extension by 10 degree at the right. It was seen that there was painful knee movements. It was found that there was tenderness at medial joint space and patellofemoral grind test was positive while Lachman and anterior drawer tests were negative. On the plain radiographs, it was observed that reconstruction was performed by using flexible nitinol wire synthetic graft and that occasional fractures in nitinol wire existed. The patient accepted removal of graft when he was informed. Thus, we removed flexible nitinol wire synthetic graft and interference screw. In the arthroscopic examination, it was seen that there was grade 4 cartilage defect in patellofemoral joint with occasional fracture in flexible nitinol wire synthetic graft. Endo-button was localized at suprapatellar pouch and removed via artrhroscopy. Micro-fracture procedure was performed for cartilage defect. The patient was scheduled for physical therapy after surgery. After 3 months, it was seen that complaints were resolved and he had almost full range of motion without instability signs. Case 2: A 23-year old man presented to our clinic with pain at right knee. He reported that his knee was injured during sports 9 months ago and he underwent anterior cruciate ligament reconstruction in another facility. However, he had persistent pain. On the physical examination, it was seen that there was full range of motion at knee but diffuse knee pain in hyperflexion. It was s...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.