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Zayd A. Eldadah MD PhD Amin Al-Ahmad MD T. Jared Bunch MD David B. Delurgio MD Rahul N. Doshi MD Bruce G. Hook MD Patrick M. Hranitzky MD Charles A. Joyner MD Suneet Mittal MD Christopher Porterfield MD Javier E. Sanchez MD Senthil K. Thambidorai MD Oussama M. Wazni MD H. Thomas McElderry MD 《Journal of cardiovascular electrophysiology》2023,34(2):348-355
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BackgroundSubtrochanteric fractures are challenging to treat because of their anatomical and biomechanical behaviours. Non-unions of this region become much more difficult to treat because of the previous surgical scar, fibrosis, mal-reduction, presence of an implant, compromised soft tissue, and osseous vascularity, bone-mass loss etc. The aim is to provide a stable mechanical environment by PF-LCP, augmented by LCP (dual plating) where biology can work uneventfully. Biology is re-initiated by decortication (shingling) and autologous cancellous bone graft.MethodsTwelve cases of failed aseptic subtrochanteric non-union either with intact or broken implant were included in this study in a period of 3 years from August 2016 to July 2019. The interposing fibrous tissue resected in patients with mal-aligned fragments. The mechanical stabilization is achieved by orthogonal dual plating. PF-LCP on lateral and 4.5 mm LCP anteriorly, decortication, and cancellous graft applied before applying for the anterior plate. Patients were encouraged for a toe-touch walk with walking-frame from 3rd post-operative day. Functional outcomes were assessed using Parker Mobility Score (PMS).ResultsAll fractures united in 7 ± 1.53 months. ROM at the knee remained unchanged but improved at the hip after revision surgery. Average PMS improved to 7.58 from pre-revision 1.75 validating the efficacy of this protocol.ConclusionAdequate stability by dual-plate construct and re-initiation of cellular and biochemical processes by decortication and cancellous bone-graft reunited ununited subtrochanteric fractures. This particular combination of plates and decortication has not been employed earlier as per our review of the literature.AimTo offer a new paradigm for the management of surgically failed subtrochanteric non-unions. 相似文献
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Karan S. Dewan Firas Hentati Tyler E. Greenlee Thais F. Conti Andrew X. Chen Grant L. Hom Rishi P. Singh 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2021,56(2):96-104
ObjectiveTo assess age-related differences at baseline and treatment outcomes in patients with retinal vein occlusion (RVO) and macular edema treated with anti-vascular endothelial growth factor (VEGF) therapyDesignSingle-centre retrospective chart review.Participants295 treatment-naïve RVO patients.Methods295 RVO patients included were separated into age quartiles: group A (22–61 years), group B (62–70 years), group C (71–79 years), and group D (80–95 years). Outcomes including central subfield thickness (CST), cubic volume, cubic average thickness, and visual acuity (VA) were collected at baseline and at 6 and 12 months after treatment. The primary outcome of the study was the CST at 12 months after anti-VEGF therapy.ResultsMean baseline CST for groups A, B, C, and D was 406.3 ± 161.2 μm, 463.4 ± 165.5 μm, 470.6 ± 187 μm, and 427.3 ± 187.2 μm, respectively. No significant differences in CST were observed between groups at baseline, 6 months, or 12 months (p ≥ 0.08). Mean baseline VA for groups A, B, C, and D was 55.8 ± 19.5, 54.4 ± 19.8, 54.7 ± 19, and 51.4 ± 20.4 Early Treatment Diabetic Retinopathy letters, respectively. VA did not differ significantly between age groups at baseline, 6 months, or 12 months (p ≥ 0.06).ConclusionsThe presentation of RVO and the visual outcomes of anti-VEGF therapy do not vary based on age. 相似文献
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