Injury
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INTRODUCTION: Volar locking plates have revolutionised the treatment of distal radius fractures but complications are not uncommon. We present a cadaveric study and a technical tip to assist in the accurate and reproducible placement of one such plate. ⋯ Placing this next to needles in these joints can help pre-plan the most distal and ulnar extent of the plate allowing for reproducible optimal positioning of the DVR plate. TECHNIQUE: The technique developed uses the existing kit and is simple and easy to build into one's existing fixation technique.
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Acutrak 2 screws are commonly used for scaphoid fracture fixation. To our knowledge, the variation in compressive force along the screw has not been investigated before. The objectives of our study were to measure variance in compression along the length of the standard Acutrak 2 screw, to identify the region of the screw which produces the greatest compression and to discuss the clinical relevance of this to the placement of the screw for scaphoid fractures. ⋯ There is variation in compression along the length of the standard Acutrak 2 screw and the maximum compression was obtained at the mid-point of the screw. From this study, we would recommend when using an Acutrak 2 screw for internal fixation of scaphoid fractures, to attain maximum compressive force, place the fracture at the mid-point of the Acutrak screw. If this is not possible, then place the fracture towards the proximal half of the screw.
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Comparative Study
The interpretation of intra-abdominal pressures from animal models: the rabbit to human example.
The importance of the abdominal wall characteristics in intraabdominal pressure (IAP), intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are poorly understood. The applicability of laboratory research findings to human scenarios is unknown due to the potential differences in abdominal wall elastance (AWE) amongst species. The aims of the study are to describe the AWE curve in rabbits and to compare it to the available human data. ⋯ The AWE can vary amongst species. This study determined the relationship to allow the comparison of rabbit and human IAP. The proposed mathematical function is important for the advancement of interpretation and understanding of animal research into IAH and ACS. We recommend developing model-specific functions comparing individual animal models' IAP and that of humans.
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Today multiple trauma still is associated with a high mortality. Although severe open fractures and wounds can give rise to local infections and sepsis, the overall infection rate of multiply injured patients is surprisingly low. We have investigated serum of multiply injured patients with respect to antibacterial properties and screened for host defence peptides (HDP) that constitute a class of fast acting and rapidly available molecules preventing bacterial infection. ⋯ Similar patterns of concentration profiles were recorded for hBD-2/IL-6 and hBD-3/IFN-γ suggesting a stimulatory influence within their induction process. With this study we provide evidence, that serum of multiply injured patients has by far higher antibacterial capacity than that of healthy donors. As possible mediators we have detected the HDP hBD-2, hBD-3 and LL-37 and their inducers in serum of multiply injured patients.
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The purpose of this study was to determine whether a displaced dorsal rim fracture has an adverse effect on wrist function after volar plate fixation of a dorsally displaced distal radius fracture (DRF). ⋯ A displaced dorsal rim fracture does not appear to affect outcomes adversely after volar locking plate fixation of dorsally displaced DRFs.