The purpose of this study is to analyze the clinical results of patients with scaphoid nonunion treated with arthroscopic bone grafting and K (Kirschner)-wires fixation.We retrospectively reviewed the records of 27 patients with scaphoid nonunion who had been treated with arthroscopic bone grafting and K-wires fixation method from November 2008 to February 2014. The average patient age was 35 years. The time from injury to treatment averaged 45 months. The average follow-up period was 18 months. Bone union was assessed using serial plain radiographs. The functional outcome was evaluated by comparing the modified Mayo wrist score with the visual analog scale (VAS) for pain, which were measured at the time of preoperation and at final follow-up.Union was achieved in 26 of the 27 nonunions (96.29%). The average radiologic union time was 10 weeks. The average VAS score decreased from 6.38 (range, 3–10) preoperatively to 1.59 (range, 0–3) at the final follow-up. The average modified Mayo wrist score improved from 60.19 preoperatively to 83.46 at the final follow-up. According to this score, there were 12 excellent, 6 good, and 9 fair results at the final follow-up.Arthroscopic bone grafting and percutaneous K-wires fixation is an effective treatment method for a scaphoid nonunion and has the advantages of allowing thorough assessment, enabling a comprehensive management approach for scaphoid nonunion in a minimally invasive manner, and this method can also be used for the scaphoid nonunion with SNAC stage I.
Paenibacillus lentimorbus strain WJ5, a soil isolate showed in vitro antagonistic activity against several fungal phytopathogens belonging to the ascomycetes, basidiomycetes and oomycetes. The antifungal metabolite was extracellular and could be extracted with n-butanol. Its production was initiated at the end of the exponential phase, reaching a maximum after 5 days incubation at 30°C. Crude extract of the antifungal metabolite was thermostable (121°C for 3 h) and no loss of activity was recorded when exposed to proteinase K, sodium dodecyl sulphate (1%), Tween-80 (1%) and glycerol (1%). However, cationic hexadecyltrimethylammonium bromide and lysozyme inactivated the metabolite. The antifungal metabolite was purified by silica gel thin layer chromatography and Sephadex LH-20 size exclusion chromatography. Loss of activity during acid hydrolysis indicated the peptide nature of the antifungal metabolite. The FT-IR spectrum of the antifungal metabolite confirmed the presence of the peptide and glycosidic bonds.
A free ALT composite flap with the vascularized fascia lata, was successfully used for the treatment of infected Achilles tendinitis with overlying soft tissue defect even in an elderly patient. Furthermore, it provided satisfactory functional and cosmetic outcomes. Hence, the use of free ALT composite flap is highly recommended in such patients.
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