Locked intramedullary nailing of fractures of femur and tibia

The results of 194 consecutive interlocking nailings for 95 fractures in the tibia and 99 fractures in the femur with a median observation time of 22 months are presented. Three fractures were not consolidated radiologically at follow-up; three deep infections were recorded, all of which healed. Shortening > 1cm was recorded in 17 fractures, rotatory malalignment > 5 ° in 21, and angular malalignment > 5 ° occurred in 17. The end result was excellent in 121 fractures, good in 41, fair in 28, and poor in 4.     

Irritantcy Potential and Sub Acute Dermal Toxicity Study of Pistacia Lentiscus Fatty Oil as a Topical Traditional Remedy

The current study was undertaken to assess safety of Pistacia lentiscus fruits fatty oil (PLFO) as a topical traditional remedy. A primary skin and eye irritation tests were conducted with New Zealand white rabbits to determine the potential for PLFO to produce irritation from a single application. In addition, a sub acute dermal toxicity study was performed on 18 NZW rabbits to evaluate possible adverse effect following application of PLFO for 28 days. Based on the results of the current study, PLFO is classified as slightly irritating to the skin and the eye of rabbits (Primary Irritation Index (P.I.I.) = 1.037; Ocular Irritation Index (O.I.I.) = 5.33 at 1 h). In the sub-acute toxicity test, PLFO produced neither mortality nor significant differences in the body and organ weights between control group and treated rabbits. However, a reversible irritant contact dermatitis was observed in the treated areas from the end of the second week of application until the end of experiment. This local phenomenon was accompanied by a significant skin thickening (P≤0.01) since the 12^th day (ANOVA, F = 11, 07143, P = 0, 00765) which is confirmed with an inflammatory granuloma in histological study. Haematological analysis and blood chemistry values of the 2 groups showed no significant differences in any of the parameters examined. In summary, PLFO is minimally irritating to the eye and skin after a single exposure, but it may cause irritant contact dermatitis and a reversible thickening of skin after prolonged use.     

On-slope evaluation of release bindings for world-class alpine racers

The alpine release bindings are set as indicated by the scale given in deca N.m (DIN) to the wanted release torque. The actual release torque of the toe unit was measured and calculated in 89 World Cup and national class racers during the Norwegian national championship in 1992. The deviation of the actual release torque from the desired release torque was calculated. The actual release torque was higher than the wanted release torque, with a mean deviation of 24% and a large dispersion from -28% to 130%. For the second testing, this deviation was reduced to 15% The deviation of the actual release torque from the desired release torque was not related to age of the binding or class of skier (World Cup, European Cup or national class racers). Compared with a similar investigation 10 years ago, there was no significantly lower deviation.     

Muscle contribution to tibial fracture strength in rats

We studied the contribution of anesthetized and dead muscle to the loading capacity of the tibia in ventral three-point cantilever bending directly by a newly developed method in rats. Ketamine anesthesia, known to give poor muscle relaxation, did not increase the loading capacity more than Hypnorm®/Dormicum® anesthesia and dead muscle. The ultimate bending moment increased by about 40 percent and the ultimate absorbed energy by about 85 percent when the tibia was tested in situ compared to testing in the dissected state; the tibia could withstand approximately 50 percent more deflection when loaded intact with soft tissues. No differences were observed between the tibia of anesthetized and newly-killed rats. The results indicate that the soft tissues are quantitatively important for the strength of long bones, and for the understanding and prevention of fractures.     

Locked intramedullary nailing of femoral shaft fractures

One hundred twenty-three femoral shaft fractures were treated with Grosse-Kempf slotted, locked nails and followed for a median 20 (range, 12-60) months. There were eight intraoperative and 11 postoperative complications, among them two superficial and two deep infections. Most of the intraoperative complications and some postoperatively lost reductions could have been prevented by a better operative technique and judgment of stability. Seventy-eight results were graded as excellent, 24 as good, 19 as fair, and two as poor (one 9-cm shortening and one 40 degrees external malrotation). All fractures united without further procedures during the first year.     

Bone changes after castration in rats. A model for osteoporosis

Bone changes 6-12 weeks after castration have been studied in 25 female and 27 male middle-aged rats. Castrated female rats gained more weight than their controls, but had decreased bone density and calcium and hydroxyproline content per cm3 bone volume of tibia. Castrated male rats did not differ from controls regarding body weight and the bone parameters. No influence of castration on the mechanical strength of the femora could be detected in either sex. At 2 weeks after castration, the circulating levels of immunoreactive calcitonin (iCT) were decreased in female rats compared to controls. In contrast, iCT was increased both in castrated male and female rats 10 weeks later. We conclude that castration of 6-month-old female rats causes osteoporosis, and therefore represents a promising experimental model for studying postmenopausal bone loss.     

Good functional results following high tibial opening-wedge osteotomy of knees with medial osteoarthritis: A prospective study with a mean of 8.3 years of follow-up

Background

To report time dependent functional improvement and predictive risk factors for failure when the load in varus knees with medial osteoarthritis is shifted from the medial to the lateral knee compartment.

Time-dependent improvement in functional outcome following Oxford medial unicompartmental knee arthroplasty. A prospective longitudinal multicenter study involving 96 patients

Background and purpose

10-year survival rates after unicompartmental knee replacement (UKR) have been up to 97% in single-center studies, but they have been as low as 80% in studies from arthroplasty registers. Few studies have evaluated short-term functional outcome and its improvement with time. We determined the time course of functional outcome as evaluated by the knee injury and osteoarthritis outcome score (KOOS) over the first 2 years after Oxford medial UKR.

Patients and methods

In a prospective multicenter study, we included 99 unselected knees (96 patients, mean age 65 (51–80) years, 57 women) operated with Oxford medial UKR at 3 hospitals in the southeast of Norway between November 2003 and October 2006. Data were collected by independent investigators preoperatively and at 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively. KOOS and range of motion (ROM) were determined at all follow-ups.

Results

Mean KOOS values for pain and activities of daily living were improved already after 6 weeks, and increased between each time point up to 2 years postoperatively. However, no statistically significant improvements were seen after 6 months. Mean active and passive ROM gradually improved up to 2 years after UKR, and were then better than before surgery.

Interpretation

Most of the expected improvements in pain and function after UKR are achieved within 6 months of surgery. Only minimal improvement can be expected beyond this time.Unicompartmental knee replacement (UKR) has regained popularity in recent years. Studies comparing UKR to total knee replacement (TKR) have shown faster recovery, shorter hospital stay, more normal kinematics, better range of motion, less blood loss, fewer thromboembolic incidents, and fewer surgical site infections (Li et al. 2006, Walton et al. 2006, Furnes et al. 2007, Lombardi et al. 2009, Newman et al. 2009). Survival rates as high as 96–98% at 10 years have been reported in single-center studies (Murray et al. 1998, Pandit et al. 2011), whereas in studies from national arthroplasty registers 10-year survival rates have been reported to be as low as 80% (Furnes et al. 2007, Koskinen et al. 2008).With a possible higher revision risk for UKR than for TKR (Furnes et al. 2007), more information on pain and function following knee arthroplasty is needed. During the last decade, several authors have emphasized the importance of measuring the patient''s own experience of disability using self-reported questionnaires (Garratt et al. 2004, Tanner et al. 2007) such as the Oxford knee score, the knee injury and osteoarthritis outcome score (KOOS), and the International Knee Documentation Committee (IKDC) standard evaluation form.We determined (1) the time course of patient-relevant functional outcome evaluated by the KOOS, and (2) the time course of range of motion (ROM) during the first 2 years following UKR using the Oxford medial unicompartmental knee prosthesis. Improvements in patients'' self-reported pain and daily function during the study period were of particular interest.