Combined Techniques for the Characterization of Polyfluorene Copolymers and Correlation with their Optical Properties.

New red- and green-emitting copolymers, hereafter <i>core</i>-copolymers, bearing a 4,7-bis­(thiophen-2-yl)­benzothiadiazole and a benzothiadiazole residue respectively as bridging <i>core</i> between two identical polymeric arms were synthesized by Suzuki coupling reaction of the dibromine derivative of such chromophores and essentially borolane-ended alternating copolymers [namely <b>P­(TPAF)</b>] of triphenylammine disubstituted fluorene and dialkylsubstituted fluorene. All polymer samples were characterized by ¹H NMR and in particular by MALDI–TOF MS. MALDI mass spectra allow the identification of many end groups of the initial blue-emitting macromers and therefore of the side reactions occurring during Suzuki polycondensation. The average molar masses were determined by two different SEC apparatus, one calibrated with conventional polystyrene narrow standards and the other with an absolute calibration curve built up by SEC/MALDI–TOF MS analysis of selected SEC fractions of polydisperse red and green <i>core</i>-copolymers. MALDI mass spectra of these fractions give reliable information on their composition, which combined with their integrated area calculated from the corresponding normalized SEC curves, enable the estimation, for the first time, of the percentage of macromolecules containing the dyes composing the neat <i>core</i>-copolymers. Optical characterization, performed by UV–visible absorption and photoluminescence measurements, of the same SEC fractions gives results in agreement with the different compositions determined by their MALDI mass spectra

Combination of low-contact cerclage wiring and osteosynthesis in the treatment of femoral fractures

Background and purpose: Objectives were (1) to evaluate results after cerclage wiring technique for femoral primary and periprosthetic fracture (PPF); (2) to report the incidence of complications and their treatment; (3) to analyze possible prognostic factors. Patients and methods: We analyzed 54 patients treated with different techniques associated with low-contact cerclage wires for femoral fracture. Fractures were stratified according to AO, Vancouver or Rorabeck classification. Cerclage was used as an exclusive implant in four PPFs or combined with internal devices in 50 cases. Comorbidities were assessed using Charlson Comorbidity Index. The Glasgow Outcome Scale was used to compare activities of daily living pre/postoperatively. Results: Cerclage wires with three or four spacers were used in 22 and 32 cases, respectively. Nine patients died within 6\ua0months. Mean follow-up of the remaining 42 patients was 10.5\ua0months. Fracture healing was achieved in 38/42 patients (71\ua0%), with a mean time to callus formation of 57\ua0days and to radiographic union of 3\ua0months (1.5\u20139\ua0months). Four patients had nonunion. Survival to major complications was 92 and 70\ua0% at 1 and 2\ua0years, respectively, significantly better in cerclage wires with three spacers than those with four spacers (p\ua0=\ua00.0188). No other statistical correlations were found. Conclusion: Cerclage wiring in difficult femoral fractures offers minimally invasive reduction and fixation technique, low cost and early holding. We reinforce the concept of \u201creduce with cerclage cables first, then nail\u201d for displaced long subtrochanteric fractures and support the use of cerclage wiring for challenge PPF using low-contact wires. Level of evidence: Therapeutic study, Level IV

Consensus for management of sacral fractures: from the diagnosis to the treatment, with a focus on the role of decompression in sacral fractures

Abstract Background There is no evidence in the current literature about the best treatment option in sacral fracture with or without neurological impairment. Materials and methods The Italian Pelvic Trauma Association (A.I.P.) decided to organize a consensus to define the best treatment for traumatic and insufficiency fractures according to neurological impairment. Results Consensus has been reached for the following statements: When complete neurological examination cannot be performed, pelvic X-rays, CT scan, hip and pelvis MRI, lumbosacral MRI, and lower extremities evoked potentials are useful. Lower extremities EMG should not be used in an acute setting; a patient with cauda equina syndrome associated with a sacral fracture represents an absolute indication for sacral reduction and the correct timing for reduction is “as early as possible”. An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an indication for laminectomy after reduction in the case of a displaced sacral fracture in a high-energy trauma, while a worsening and progressive radicular neurological deficit represents an indication. In the case of a displaced sacral fracture and neurological deficit with imaging showing no evidence of nerve root compression, a laminectomy after reduction is not indicated. In a patient who was not initially investigated from a neurological point of view, if a clinical investigation conducted after 72 h identifies a neurological deficit in the presence of a displaced sacral fracture with nerve compression on MRI, a laminectomy after reduction may be indicated. In the case of an indication to perform a sacral decompression, a first attempt with closed reduction through external manoeuvres is not mandatory. Transcondylar traction does not represent a valid method for performing a closed decompression. Following a sacral decompression, a sacral fixation (e.g. sacroiliac screw, triangular osteosynthesis, lumbopelvic fixation) should be performed. An isolated and complete radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. An isolated and incomplete radicular neurological deficit of the lower limbs does not represent an absolute indication. A worsening and progressive radicular neurological deficit of the lower limbs represents an indication for laminectomy after reduction in the case of a displaced sacral fracture in a low-energy trauma associated with imaging suggestive of root compression. In the case of a displaced sacral fracture and neurological deficit in a low-energy trauma, sacral decompression followed by surgical fixation is indicated. Conclusions This consensus collects expert opinion about this topic and may guide the surgeon in choosing the best treatment for these patients. Level of Evidence: IV. Trial registration: not applicable (consensus paper)

Past and present of the use of cerclage wires in orthopedics

Cerclage wiring is a simple technique that has been practiced widely since the advent of surgical treatment of fractures. Many studies have reported the use of various cerclage technologies with a wide range of results and clinical applications. The increasing numbers of periprosthetic fractures have led to a revival of interest for this simple technique. When cerclages function as implants, they may be used alone or together with a protecting device such as external or internal splints (such as plates, nails, stems of prosthesis or a combination of thereof). This article presents a review of the available literature relating cerclage-wiring techniques and updates the recommendations for clinical use