Injury
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This study investigates the relationship between plasma exosomal miRNAs and nonunion risk following open reduction and internal fixation (ORIF) of clavicle fractures, aiming to identify predictive molecule to enhance patient management and personalized orthopedic care. ⋯ The elevated preoperative levels of exosomal miR-21 were significantly associated with an increased risk of bone nonunion at three months ORIF in patients with clavicle fractures, indicating that miR-21 holds potential as a non-specific predictive molecule.
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This study aimed to apply a shock wave from the ventral side of a pig and examine its effect to use the results for new body armor production for humans. ⋯ None of the pigs exposed to shock waves from the ventral side died; however, most showed multiple bullae on the lung surface with lung contusion and splenic injury, which may have been greater than those exposed from the dorsal side. This may be due to the direct impact of the shock wave proceeding from the epigastrium and subcostal region, which are not protected by the skeletal structure of the thorax. These characteristics should be considered when producing new body armor for humans to protect the body from shock waves.
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This study aims to investigate the biomechanical characteristics of non-anatomical reduction and different screw positions on the stability of Pauwels type III femoral neck fractures. ⋯ For Pauwels type III femoral neck fractures, a positive support reduction with BDSF fixation exhibited superior biomechanical performance than negative reduction. Based on the finite element analysis conducted in this study, the positive support reduction with BDSF fixation can enhance fixation stability, suggesting that non-anatomical reduction is recommended.
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Fracture-related infections (FRIs) are a challenging complication in orthopaedics. Standard of care management for FRIs typically involves prolonged antibiotic therapies, irrigation and debridement (I&D) of the fracture site, and retention of fracture-fixation implants with or without exchange. Unfortunately, this treatment regimen is associated with treatment failure rates of up to 38 %, such that improved preventive and therapeutic interventions are needed. ⋯ This model consistently resulted in clinical signs of local infection, compromised wound healing, radiographic evidence for delayed bone healing and implant loosening, and implant-associated biofilm formation. Importantly, MRSA was isolated from deep tissue cultures in all dogs, and histological assessments detected bacteria and bacterial biofilms associated with all fracture-fixation implants at the study endpoint. These clinical, radiographic, bacteriologic, and histologic outcomes in conjunction with the capabilities for standard of care interventions, such as antibiotic treatment and I&D, verify that this preclinical canine model for early onset FRI effectively replicated the pathology associated with this commonly encountered complication of orthopaedic trauma.
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Surgical stabilization of rib fractures (SSRF) is a viable treatment option for rib fracture patients. Polyetheretherketone (PEEK) plates have become available for SSRF. The objective of this pilot study was to examine the use of PEEK plates for SSRF. ⋯ PEEK plates for SSRF are safe and effective, allowing for adequate rib fracture healing and are associated with positive patient reported outcomes.