Hexose-monophosphate shunt (HMS) activity, myelo-peroxidase-(MPO)-mediated iodination and random mobility in human polymorphonuclear leukocytes (PMNs) were studied in the presence of lignocaine. Incubating the PMNs with 0.1% lignocaine during phagocytosis inhibited the 14CO2 produced from glucose-1-14-C via the HMS shunt by 33%. On increasing the concentration of lignocaine, a dose-dependent inhibition was noted. The MPO-mediated iodination was inhibited by 73% in the presence of 0.1% lignocaine, and complete inhibition took place when the concentration was increased to 0.5%. The random mobility of leukocytes was studied by an opto-electronic technique. In the presence of 0.5% lignocaine, all leukocytes examined were completely immobilized; in the presence of 0.1% lignocaine immobilization took place within 45-65 min.
The RAB-plate provided a more stable fixation, especially with regard to maintained postoperative alignment. However, positive predictors for fixation failure were identical for both devices. Here, the screw/neck angle deviation has had the strongest significance for prediction of fixation failure.
The stability of union following the conservative treatment of tibial shaft fractures has been examined in 157 patients by a non-invasive method. With this technique it is possible to ascertain when the fragments are united and whether the strength of union is sufficient for full weight-bearing without protection. The mean time required for union was 14.0 +/- 9.2 weeks, with a range of 4 to 48 weeks. In 31 cases union was judged to be delayed; in 22 of these, intended operations were avoided because repeated stability determinations indicated progressive union. Of nine fracture variables examined, the only ones which significantly affected the time required to achieve union were the age and the weight of the patient. Irrelevant factors were the type and level of the fracture, the energy of trauma, soft-tissue injury and the presence of multiple injuries.
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