Sir John Charnley en de totale heuparthroplastiek

John Charnley, grondlegger van de moderne totale heuparthroplastiek, wordt in 1911 geboren in Bury (Lancashire). Zijn vader, Arthur, is chemicus in het nabijgelegen Manchester en zijn moeder, Lily, verpleegkundige in het Crumpsall Hospital. In 1929 start Charnley de opleiding geneeskunde aan de Victoria Universiteit in Manchester. Op vijfentwintigjarige leeftijd wordt hij de jongste Fellow ooit van het Royal College of Surgeons..

Climate Change Mitigation in Practice: Ecosystem Restoration Around Lake Singkarak, Sumatra

An increasing important component of climate change mitigation is restoring degraded lands, while improving the economies of communities living in and around degraded forests. The national Low Emission Development Strategies (LEDS) in Indonesia have put ecosystem restoration and sustainable forest management (including social forestry) in degraded areas upfront.  In line with the Indonesian and global climate change policies, a Dutch-based social enterprise named CO2 Operate, has been running a Voluntary Carbon Mechanism (VCM) scheme in West Sumatra’s Singkarak Lake watershed since 2009. The scheme is entirely financed through private sector carbon offsetting. In close collaboration with the Provincial Forestry Department and local partners in education, the VCM scheme brings back tree cover to restore ecosystem functions on the degraded slopes of lake Singkarak. A combination of Assisted Natural Regeneration (ANR) and tree planting brings both significant environmental and livelihood improvements. The ecological and cost effective approach allows for even the poorest farmers to join and improve their livelihoods. It brings back a forested landscape and its associated biodiversity within 5 years, while significant carbon sequestration above and below ground fits the low emission development of the Indonesian government to mitigate climate change

Arthroplasty for Femoral Neck Fractures

The aim of this thesis is threefold. The first aim is to study the cumulative incidence of bilateral femoral neck fractures and the use of two types of arthroplasty for these fractures. The second aim is to investigate the reliability and validity of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in a femoral neck fracture population. Finally, the third aim is to evaluate health care costs and functional results after treatment with arthroplasty for femoral neck fractures

Rigidity of unilateral external fixators-A biomechanical study

Introduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS (R) Standard Fixator (4 joints) with the Orthofix ProCallus Fixator (R) (2 joints), which differ in possibilities for adapting the configuration for clinical needs. Materials and methods: Both devices were tested 10 times in a standardised model. In steps of 10 N, loading was increased to a maximum of 160 N in parallel, transversal and axial direction (distraction and compression). Translation resultant and rotation resultant were calculated. Results: With a force of 100 N in parallel direction the mean translation resultant (Tr(mean)) of the Dynafix DFS (R) Standard Fixator (6.65 +/- 1.43 mm) was significantly higher than the ProCallus Fixator (R) (3.29 +/- 0.83 mm, p < 0.001; Student's t-test). With a maximum load of 60 N in transverse direction the Tr(mean) of the Dynafix DFS (R) Standard Fixator was significantly lower (8.14 +/- 1.20 mm versus 9.83 +/- 0.63 mm, p < 0.005). Translation was significantly higher with the Dynafix DFS Conclusions: Both fixators were most sensitive to transverse forces. The Dynafix DFS (R) Standard Fixator was less rigid with parallel and axial forces, whereas transverse forces and rotation at distraction forces favoured the Dynafix DFS (R) Standard Fixator. Repeated heavy loading did not influence the rigidity of both devices. (C) 2011 Elsevier Ltd. All rights reserved

Rigidity of unilateral external fixators-A biomechanical study

Introduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS (R) Standard Fixator (4 joints) with the Orthofix ProCallus Fixator (R) (2 joints), which differ in possibilities for adapting the configuration for clinical needs. Materials and methods: Both devices were tested 10 times in a standardised model. In steps of 10 N, loading was increased to a maximum of 160 N in parallel, transversal and axial direction (distraction and compression). Translation resultant and rotation resultant were calculated. Results: With a force of 100 N in parallel direction the mean translation resultant (Tr(mean)) of the Dynafix DFS (R) Standard Fixator (6.65 +/- 1.43 mm) was significantly higher than the ProCallus Fixator (R) (3.29 +/- 0.83 mm, p < 0.001; Student's t-test). With a maximum load of 60 N in transverse direction the Tr(mean) of the Dynafix DFS (R) Standard Fixator was significantly lower (8.14 +/- 1.20 mm versus 9.83 +/- 0.63 mm, p < 0.005). Translation was significantly higher with the Dynafix DFS Conclusions: Both fixators were most sensitive to transverse forces. The Dynafix DFS (R) Standard Fixator was less rigid with parallel and axial forces, whereas transverse forces and rotation at distraction forces favoured the Dynafix DFS (R) Standard Fixator. Repeated heavy loading did not influence the rigidity of both devices. (C) 2011 Elsevier Ltd. All rights reserved

Restructuring space in the name of development: the sociocultural impact of the Forest Land Allocation Program on the indigenous Co Tu people in Central Vietnam

The Forest Land Allocation (FLA) program was introduced by the Vietnamese government in 1991 and it allowed communities, household groups and households to receive forest land for long term use (50 years). The main assumption of this program was that with ownership, households would have greater incentives to preserve forests. But the State, through its formal agencies, still decides how the forests will be used and managed. There have been unintended socio-cultural consequences of this program affecting Vietnam's forest-dependent indigenous communities. The study focused on two Co Tu villages in Central Vietnam. Their livelihoods and their culture, institutions, social life, customs, and religious beliefs are linked to surrounding forests. The FLA program has altered the traditional forest management practices and systems of the Co Tu people, as well as their traditional institutions, particularly the role of the village patriarch, and to a lesser extent their perceptions of 'nature'. The FLA program has consolidated the power of formal institutions in both villages. Keywords: Forest Land Allocation program, Indigenous forest management systems, Co Tu people of Central Vietnam, socio-cultural impact of development interventions, nature conservation, paradigms of nature

Rigidity of unilateral external fixators - A biomechanical study

Introduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS®Standard Fixator (4 joints) with the Orthofix ProCallus Fixator®(2 joints), which differ in possibilities for adapting the configuration for clinical needs. Materials and methods: Both devices were tested 10 times in a standardised model. In steps of 10 N, loading was increased to a maximum of 160 N in parallel, transversal and axial direction (distraction and compression). Translation resultant and rotation resultant were calculated. Results: With a force of 100 N in parallel direction the mean translation resultant (Trmean) of the Dynafix DFS®Standard Fixator (6.65 ± 1.43 mm) was significantly higher than the ProCallus Fixator®(3.29 ± 0.83 mm, p < 0.001; Student's t-test). With a maximum load of 60 N in transverse direction the Trmeanof the Dynafix DFS®Standard Fixator was significantly lower (8.14 ± 1.20 mm versus 9.83 ± 0.63 mm, p < 0.005). Translation was significantly higher with the Dynafix DFS®Standard Fixator, for both distraction (2.13 ± 0.32 mm versus 1.69 ± 0.44 mm, p < 0.05) and compression (1.55 ± 1.08 mm versus 0.15 ± 0.33 mm, p < 0.005). The mean rotation resultant (Rrmean) at 160 N distraction was lower for the Dynafix DFS®Standard Fixator (0.70 ± 0.17° versus 0.97 ± 0.21°, p < 0.005). Conclusions: Both fixators were most sensitive to transverse forces. The Dynafix DFS®Standard Fixator was less rigid with parallel and axial forces, whereas transverse forces and rotation at distraction forces favoured the Dynafix DFS®Standard Fixator. Repeated heavy loading did not influence the rigidity of both devices

Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: A meta-Analysis and systematic review of randomized trials

Purpose Displaced femoral neck fractures in healthy elderly patients have traditionally been managed with hemiarthroplasty (HA). Recent data suggest that total hip arthroplasty (THA) may be a better alternative. Methods A systematic review of the English literature was conducted. Randomized controlled trials comparing all forms of THA with HA were included. Three authors independently extracted articles and predefined data. Results were pooled using a random effects model. Results Eight trials totalling 986 patients were retrieved. After THA 4 % underwent revision surgery versus 7 % after HA. The one-year mortality was equal in both groups: 13 % (THA) versus 15 % (HA). Dislocation rates were 9 % after THA versus 3 % after HA. Equal rates were found for major (25 % in THA versus 24 % in HA) and minor complications (13 % THA versus 14 % HA). The weighted mean of the Harris hip score was 81 point