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1.

Background

Intramedullary nailing is considered a “gold standard” for treatment of tibial shaft fractures. However, some types of fractures are typically considered as “difficult for nailing”. This group includes the periarticular fractures, fractures of both bones at the same level, comminuted and segmental fractures of the tibia. Fixator-assisted nailing (FAN) is an effective method treatment of these types of fractures. The main requirements for the ideal reduction device are an ease of its installation and an ability of multiplanar fracture reduction. Fixator-assisted nailing (FAN) with the use of two perpendicular to each other monolateral tubular frames perfectly meets these requirements. In this study we present this new surgical technique and the analysis of first 30 cases.

Methods

A prospective analysis was conducted for 30 patients with “difficult for nailing” tibial fractures treated with fixator-assisted nailing in our institution between September 1st, 2017, and March 1st, 2018. The duration of surgery and its different stages, the time of fluoroscopy, difficulties encountered during surgery, were analyzed. Clinical and radiological methods were used to evaluated reduction quality.

Results

In all 30 cases the acceptable reduction was achieved. The mean duration of the surgical procedure was 73.7?±?3?min. The mean duration of fluoroscopy 85.9?±?4.8?s. In 7 cases we faced with technical difficulties, which were successfully addressed.

Conclusion

The described technique of FAN is an effective method for the treatment of “difficult for nailing” tibial fractures. Future multi-centered studies with a larger number of patients are needed to validate our results.  相似文献   
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A new technique of scanning electron microscopy for visualization of hidden cellular surfaces in organs and tissue has been developed. It employs the sample incubation in 30% potassium hydroxide and 96% alcohol mixed in equal amounts and dissociation until single cells appear in the solution, this being checked under phase-contrast microscope. The method is beneficial in non-standard cases of three-dimensional organization of organs and tissues.  相似文献   
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An efficient procedure for finding parameters of multiexponential function from experimental data is described. All time-constants are determined by roots of the corresponding characteristic polynomial and weighting factors are then found from the system of linear equations. Due to the non-iterative character of the fitting procedure it is fast and does not need a guess about the initial values of parameters of multiexponential function. For single- or double-exponential fitting explicit algorithms are given, for which programming is straightforward.  相似文献   
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Three patients presented with giant aneurysms of the intracranial internal carotid artery that became symptomatic with expanding mass effects 4-10 years after severe head trauma accompanied by skull base injuries at the site of aneurysm formation. These aneurysms are therefore considered to be late manifestations of traumatic vessel disruption. Posttraumatic aneurysm growth was documented in one case of a supraclinoidal aneurysm. One intracavernous aneurysm was combined with a traumatic carotid-cavernous sinus fistula. Although the origin of intracranial aneurysms is usually considered to be traumatic only within a period of weeks or months after head injuries, giant aneurysms of the intracranial internal carotid may represent late complications of trauma in a number of cases.  相似文献   
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We performed 3-dimensional studies of vascular casts of the microvasculature of the cerebral cortex of rats that were exposed to three weeks of hypobaric hypoxia and of control rats. Scanning electron microscopy of the casts gave the qualitative impression of increased vascularity of the cerebral cortex, particularly the deeper layers, in hypoxic rats. Quantitative analysis of capillary segment lengths revealed a significant shift in the frequency distribution to longer lengths (from 77 ± 8 to 90 ± 14 μm) in the deep, but not in the superficial, layers of the cerebral cortex of hypoxic rats. These findings agree with previous results reporting increased capillary density in the brain after exposure to prolonged hypobaric hypoxia and suggest that capillary segment elongation plays a role in the increased capillary density in the deeper layers of the cerebral cortex.  相似文献   
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