Injury
-
The capability for sustained and gradual release of pharmaceuticals is a major requirement in the development of a guided antimicrobial bacterial control system for clinical applications. In this study, PVA gels with varying constituents that were manufactured via a refreeze/thawing route, were found to have excellent potential for antimicrobial delivery for bone infections. ⋯ Our results indicate that the Cefuroxime Sodium released from poly(e-caprolactone) in PVA was tailored to a sustained release over more than 45 days, while the release from hydroxyapatite PVA reach burst maximum after 20 days. These PVA hydrogel-systems were also capable of controlled and sustained release of other biopharmaceuticals.
-
Review Case Reports
Simultaneous bilateral "floating arm" of the humeri: an uncommon presentation of a rare complex injury and review of the literature.
The timing of definitive fixation for simultaneous fractures of the humerus in polytrauma patient is controversial. We report on the management of a patient that sustained bilateral "floating arm" fractures of the humeri. ⋯ After seven years MEPS showed excellent and good results in the right and left arms, while UCLA scores proved excellent in both sides. We encountered no intraoperative and postoperative complications.
-
Review
Proximal femoral fractures and vascular injuries in adults: Incidence, aetiology and outcomes.
Vascular injuries (VI) presenting during internal fixation (IF) of proximal femoral fractures (PFF) are potentially limb- and life-threatening. The purpose of this systematic review of the literature is to report on their incidence, associated complications and to give special emphasis in their prevention. ⋯ The incidence of VIPFF-IF is low, though it will probably rise because of the increasing frequency of PFF. With few exceptions, these injuries, which are potentially limb and life-threatening, are iatrogenic, resulting of errors in IF, with different types of lesions to intra- and extrapelvic vessels running in close proximity to the bone. Although the surgeon should bear in mind this possibility and achieve early diagnosis and prompt accurate treatment, there is no consensus as to what is the best diagnostic or therapeutic modality. A precise diagnosis of the preoperative vascular status of the limb, monitoring of the displacement of the lesser trochanter fragment, careful and gentle reduction of the fracture, and precise handling of instruments and implant selection and placement during IF, are factors to consider in order to prevent this complication, which should never be underestimated.