Pullout reattachment of tibial avulsion fractures of the anterior cruciate ligament: a firm,effective suture-tying method using a tensioner

We describe a firm, effective suture-tying method using a tensioner for reattaching tibial avulsion fractures of the anterior cruciate ligament. Our simple method achieves strong, firm reattachment of the fracture. In addition, it prevents fixation loosening during suture tying effectively. Since pullout repair using nonabsorbable sutures is commonly used to fix various avulsion fractures, the tensioner helps attain strong, firm reattachment of avulsion fractures simply and effectively.     

转移瘤致股骨近端病理骨折的治疗

目的　探讨转移瘤致股骨近端病理骨折的治疗方法。方法　分析 1995年 5月至 2 0 0 2年 5月手术治疗的 16例的临床资料。结果　无手术并发症 ,术后疼痛明显缓解 ,伤口除 1例浅层感染外 ,余愈合良好。所有病例均存活在 3个月以上 ,14例术后继续原发肿瘤治疗。结论　股骨近端转移瘤所致的病理骨折应积极行手术治疗 ,内固定以带锁髓内钉加骨水泥为好。     

Teriparatide in the management of osteoporosis

Fracture of the hip is frequently a catastrophic event in the elderly, often resulting in death within a year and of the survivors, few regain pre-fracture quality of life. Although less appreciated, fractures of the spine result in significant morbidity and are also associated with increased mortality compared with individuals without a fracture. In recent years there has been an explosion in the development of new drugs for the treatment of osteoporosis. Recombinant human parathyroid hormone (1–34) (20 μg/day) is a recent addition to this armamentarium with a novel mechanism of action, which was approved by the US FDA for the treatment of post-menopausal osteoporosis and male osteoporosis secondary to hypogonadism in November 2002. It is the first osteoporosis treatment that leads to the formation of new bone with architecture similar to normal bone. Intense efforts have been made to understand the effect of teriparatide on antiresorptive therapy and vice versa. Although these relationships are not completely understood, the results of recent studies allow clinicians to begin to optimize therapeutic gains in bone mineral density and improve anti-fracture efficacy.     

Arthroscopic Assisted Fixation of Juvenile Intra-articular Epiphyseal Ankle Fractures

The purpose of this study was to present the long-term follow-up of a case series of arthroscopically assisted fixation of juvenile intraarticular epiphyseal ankle fractures. The functional and radiographic outcomes of 6 patients with a range of follow-up of 1 to 5 years were evaluated. Five of the 6 patients had triplane injuries, whereas the remaining patient sustained a juvenile Tillaux fracture. All of the patients returned to full activity within 14 weeks of surgery, and none of the patients had any restriction in the ankle range of motion at the time of last follow-up. The results of this small series of patients suggest that arthroscopic-assisted, percutaneous fixation of intraarticular juvenile epiphyseal ankle fractures is an effective, less invasive surgical technique. Several surgical maneuvers that are helpful in the consistent execution of this technique are also mentioned.     

不同鼠龄小鼠骨折愈合过程中钙沉积变化

本实验采用~(45)Ca液闪技术,测定骨折后不同天数的幼年小鼠和成年小鼠在注射~(45)Ca-氯化钙后24 h,各骨段~(45)Ca沉积量,发现:1.幼年小鼠各骨段中钙的沉积量均高于成年小鼠;2.右股骨中段骨折后,骨折股骨中段的钙沉积量急剧升高;健侧股骨上、中、下三段,骨折股骨上段及左右胫骨上段的钙沉积量则逐渐下降而骨折股骨下段的骨转换增加。说明骨折部位以外的各骨段均最大限度地调动了一切可以调动的钙,以满足骨折修复的需要。     

The influence of support conditions in the loading fixture on failure mechanisms in the push-out test: a finite element study

The usefulness of the push-out test as an indicator of interface strength was evaluated using finite element models of intact and partially failed cylindrical push-out specimens loaded against a rigid annular support. The irregular stress distributions that were found in intact specimens depended more on interface conditions at the loading fixture than on a 35% increase in interface area. The maximum stress at the interface was a tensile stress. Critical energy release rates for interface failure were calculated for flawed specimens in which flaw size was either 10 or 100 microns, and for boundary conditions at the loading fixture that were either fixed or slipping in the radial direction. The critical energy release rates depended heavily on the support boundary conditions. Thus, the results of parametric push-out tests can be reasonably compared only for specimens that are very similar in geometry and that are loaded in very carefully controlled fixtures.     

Concomitant intrusive luxation and root fracture of a central incisor - report of a case

Abstract A case of a 9-year-old boy who presented with intruded maxillary central incisors, one of which had also sustained a middle third root fracture, is reported. The root fracture was diagnosed after orthodontic extrusion was started, which resulted in separation of the apical and coronal fragments. The hypermobile coronal fragment was stabilised by passing a K file through a palatal access cavity into the root canal of the apical fragment. Orthodontic alignment was completed and the fractured incisors were restored with the file left in situ. At a 10-year follow-up, the incisors were clinically healthy and continued to satisfy aesthetic and functional demands.     

Clinical significance of 201Tl reverse redistribution in patients with aorto-coronary bypass surgery

Detection of myocardial ischemia by the stress thallium scan has traditionally been performed using transient defect analysis on exercise, followed by redistribution studies. Worsening of the ²⁰¹Tl myocardial image from exercise to redistribution is referred to as reverse redistribution. In this study, we found reverse redistribution in 10 (21%) of 48 angina pectoris patients who had undergone aortocoronary bypass surgery. The clinical significance of this phenomenon in these patients was investigated in relation to angiographic and surgical findings. Reverse redistribution was found to occur in regions which were supplied by bypass grafts. These areas showed increased coronary blood flow and rapid thallium washout. Our results indicate that a perfusion defect in the bypass region of the redistribution image might be caused by relatively rapid washout in the bypass graft region compared to the adjacent normal myocardium. These results should be considered in the clinical interpretation of stress thallium scans.