Injury
-
Comparative Study
Locking versus non-locking one-third tubular plates for treating osteoporotic distal fibula fractures: a comparative study.
Ankle fractures represent the third most common fracture in elderly patients, after hip and wrist fractures. Distal fibula fractures in this population are closely related to osteoporosis, which renders commonly used methods of internal fixation technically demanding and prone to failure. Currently there is a tendency to fix osteoporotic metaphyseal and epiphyseal fractures with locking plates. However, published accounts about the use of this technology in osteoporotic distal fibula fractures are scarce. In this study we compare the results of two groups of patients who underwent surgery for these types of fracture, one group received locking and the other non-locking screws, both using one-third tubular plates. ⋯ Both locking and conventional non-locking plates achieved similar treatment outcomes in this group of osteoporotic patients aged over 64. However, locking plates may offer more benefits in cases that have to take into account immobilization time and concomitant soft-tissue damage.
-
Femoral shaft fractures are among the most severe injuries of the skeleton. They are associated with high morbidity and mortality. The most appropriate treatment depending on the type of fracture and location level should be chosen. ⋯ The obtained results between both nail materials (stainless steel and titanium alloy) show a higher mobility when using titanium nails, which produce a higher rate of strains at the fracture site, amplitude of micromotions and bigger global movements compared to stainless-steel nails. Steel nails provide stiffer osteosyntheses than the titanium nails. In conclusion, anterograde locked nail is particularly useful in the treatment of a wide range of supracondylar fractures with proximal extension into the femoral diaphysis.
-
Skin lesions are a significant public health problem, above all that wounds fail to heal properly and become chronic. Due to its reepithelization action, insulin has the potential to heal skin lesions, by stimulating the proliferation and migration of keratinocytes, angiogenic stimulus, and increasing collagen deposition. In the present study insulin was complexed with 2-hydroxypropyl-β-cyclodextrin (HPβCD) and its wound healing effect and inclusion complex (HPβCD-I) were evaluated in excisional wounds in the skin of rats. ⋯ Therefore, the slow release of complexed insulin modulated the reepithelialization process by stimulating cell proliferation and migration of keratinocytes, favoring greater concentration of serum insulin, modulating inflammatory response, matrix remodeling and promoting neovascularization. Angiogenesis extended by the steady release of insulin can be effective in the treatment of chronic wounds.
-
The possibility of diagnosis and prediction of multiple disorders in trabecular bone through nano-biomechanics and chemical analysis are summarized. Improvements to the understating of the compositional contributors of bone mineral and organic components to mechanical competence are crucial. Viscoelastic properties and Raman characterization have been used to evaluate possible alterations of the trabecular bone associated with aging, disease, or injury. ⋯ Complementary nano-morphological studies were done assessing roughness (SRa) and collagen fibrils width, on this trabecular bone. A general idea of the behavior of the viscoelastic performance can be obtained by the Tan δ (E″/E'), that achieved 0.98GPa of damping. 249nm and 0.898μm of SRa roughness and fibrils width were obtained, respectively. The relative presence of minerals, the carbonate-to-phosphate ratio, the crosslinking and the nature/secondary structure of collagen, between 700 and 1700cm-1, were also obtained, in order to propose a study protocol for trabecular bone characterization.