形状记忆合金弓齿钉治疗腕舟状骨腰部骨折

正2013年10月~2015年3月,我科采用腕掌侧切开复位形状记忆合金弓齿钉治疗17例腕舟状骨腰部骨折患者,疗效满意,报道如下。1材料与方法1.1病例资料本组17例,男15例,女2例,年龄16~42岁。左侧1例,右侧16例,均为闭合骨折。新鲜骨折16例,陈旧性骨折1例,合并桡骨茎突骨折1例。1.2治疗方法臂丛麻醉下手术。取     

Serum levels of anti‐Fcγ receptor IIB/C antibodies are increased in patients with systemic sclerosis

Systemic sclerosis (SSc) is a systemic autoimmune disorder that results in fibrosis of the skin and multiple internal organs. Although the precise mechanism is unknown, it appears to result from the overproduction of extracellular matrix proteins and aberrant immune activations. Receptors for the Fc region of immunoglobulin (Ig)G (FcγR) are members of the Ig superfamily that modulate both activation and inhibition of immune responses. FcγRIIB is the sole inhibitory member, which has an intrinsic cytoplasmic immunoreceptor tyrosine‐based inhibitory motif. The present study was undertaken to investigate the circulating concentrations of anti‐FcγRIIB/C antibodies (Ab) in patients with SSc. Serum levels of anti‐FcγRIIB/C Ab were significantly increased in patients with SSc compared to those in controls and in patients with localized scleroderma. Serum levels of anti‐FcγRIIB/C Ab in patients with limited cutaneous SSc were similar to those in patients with diffuse cutaneous SSc. Among SSc patients, serum levels of anti‐FcγRIIB/C Ab were increased in those with nail‐fold bleeding and decreased in those with diffuse pigmentation and calcinosis. These findings support the notion that increased serum anti‐FcγRIIB/C Ab levels are involved in aberrant immune responses in SSc.     

Prediction of tibial nonunion at the 6-week time point

IntroductionIntramedullary (IM) nail fixation is a common operative treatment, yet concerns regarding the frequency of complications, such as nonunion, remain. Treatment of tibial shaft fractures remains a challenge, and little evidence of prognostic factors that increase risk of nonunion is available. The aim of this study was to develop a predictive model of tibial shaft fracture nonunion 6 weeks after reamed intramedullary (IM) nail fixation based on commonly collected clinical variables and the radiographic union score for tibial fractures (RUST).MethodsA retrospective case-control study was conducted. All tibial shaft fractures treated at our level I trauma center from 2007 to 2014 were retrospectively reviewed. Only patients with follow-up until fracture healing or secondary operation for nonunion were included. Fracture gaps ≥3 mm were excluded. A total of 323 patients were included for study.ResultsInfection within 6 weeks of operation, standard RUST, and the Nonunion Risk Determination (NURD) score had statistically significant associations with nonunion (odds ratio > or < 1.0; p < 0.01). The NURD score was increasingly predictive of nonunion with decreasing RUST. All patients in the high RUST group (RUST ≥ 10), achieved union regardless of NURD score. In the medium RUST group (RUST 6–9), 25% of patients with a NURD score ≥7 experienced nonunion. In the low RUST group (RUST <6 or infection within 6 weeks), 69% of patients with a NURD score ≥7 experienced nonunion.ConclusionThree variables predicted nonunion. Based on these variables, we created a clinical prediction tool of nonunion that could aid in clinical decision making and discussing prognosis with patients.     

Comparative Anatomy of Mouse and Human Nail Units

Recent studies of mice with hair defects have resulted in major contributions to the understanding of hair disorders. To use mouse models as a tool to study nail diseases, a basic understanding of the similarities and differences between the human and mouse nail unit is required. In this study we compare the human and mouse nail unit at the macroscopic and microscopic level and use immunohistochemistry to determine the keratin expression patterns in the mouse nail unit. Both species have a proximal nail fold, cuticle, nail matrix, nail bed, nail plate, and hyponychium. Distinguishing features are the shape of the nail and the presence of an extended hyponychium in the mouse. Expression patterns of most keratins are similar. These findings indicate that the mouse nail unit shares major characteristics with the human nail unit and overall represents a very similar structure, useful for the investigation of nail diseases and nail biology. Anat Rec, 296:521–532, 2013. © 2013 Wiley Periodicals, Inc.     

Regeneration of nails with artificial dermis

Abstract

We treated fingertips injured through the proximal half of the nail bed using artificial dermis in 22 patients from 2004 to 2009. We classified the injuries to the nail bed into three types according to where the wounds were. Type ? was localised to the nail bed with or without minor injury to the surrounding structure; type II was an avulsion and amputation of the fingertip including the nail bed, the finger pulp, and the distal phalanx at the level of the proximal nail bed; and type III was post-traumatic shortening of the nail, in which the pulp and distal phalanx were intact. Regeneration and elongation of the nail was achieved in every patient by applying artificial dermis. All patients were satisfied with the results.     

Accuracy analysis of computer-assisted surgery for femoral trochanteric fracture using a fluoroscopic navigation system: Stryker ADAPT®system

PurposeADAPT is a fluoroscopic computer-assisted surgery system which intraoperatively shows the distance from the tip of the screw to the surface of the femoral head, tip-to-head-surface distance (TSD), and the tip-apex distance (TAD) advocated by Baumgaertner et al. The study evaluated the accuracy of ADAPT.Patients and methodsA total of 55 patients operated with ADAPT between August 2016 and March 2017 were included as subjects. TSD and TAD were measured postoperatively using computed tomography (CT) and X-rays. The intraclass correlation coefficient (ICC) was checked in advance. The error was defined as the difference between postoperative and intraoperative measurement values of ADAPT. Summary statistics, root mean square errors (RMSEs), and correlations were evaluated.ResultsICC was 0.94 [95% CI: 0.90–0.96] in TSD and 0.99 [95% CI: 0.98–0.99] in TAD. The error was −0.35 mm (−1.83 mm to 1.12 mm) in TSD and +0.63 mm (−5.65 mm to 4.59 mm) in TAD. RMSE was 0.63 mm in TSD and 1.53 mm in TAD. Pearson’s correlation coefficient was 0.79 [95% CI: 0.66–0.87] in TSD and 0.83 [95% CI: 0.72–0.89] in TAD. There were no adverse events with ADAPT use.ConclusionADAPT is highly accurate and useful in guiding surgeons in properly positioning the screws.     

Characterization of indoor air contaminants in a randomly selected set of commercial nail salons in Salt Lake County,Utah, USA

Air samples were collected in 12 randomly selected commercial nail salons in Salt Lake County, Utah. Measurements of salon physical/chemical parameters (room volume, CO₂ levels) were obtained. Volatile organic compound (VOC) concentrations were collected using summa air canisters and sorbent media tubes for an 8-h period. Multivariate analyses were used to identify relationships between salon physical/chemical characteristics and the VOCs found in the air samples. The ACGIH^® additive mixing formula was also applied to determine if there were potential overexposures to the combined airborne concentrations of chemicals monitored. Methyl methacrylate was detected in 58% of the establishments despite having been banned for use in nail products by the state of Utah. Formaldehyde was found above the NIOSH REL^® (0.016?ppm) in 58% of the establishments. Given the assortment of VOCs to which nail salon workers are potentially exposed, a combination of engineering as well as personal protective equipment is recommended.     

股骨近端防旋髓内针治疗高龄不稳定性股骨转子间骨折

正2011年7月~2014年4月,我们采用股骨近端防旋髓内针(PFNA)治疗57例高龄不稳定性股骨转子间骨折患者,效果满意,报道如下。1材料与方法1.1病例资料本组57例,男20例,女37例,年龄80~94岁。骨折按Tronzo-Evans分型:Ⅲ型28例,Ⅳ型25例,Ⅴ型4例。患者均合并有内科疾病