Management of traumatic periprosthetic total ankle replacement fractures: A case report involving long-stemmed tibial components

Traumatic periprosthetic fractures around total ankle replacements (TARs) are not well documented in the literature, with less than 13 total cases described. These injuries present reconstructive challenges to the treating surgeon. TAR usage continues to rise, and thus traumatic periprosthetic ankle fractures will likely become more frequent. Current literature discussing the classification, treatment, and outcomes of this pathology is lacking and mostly discusses intra-operative and or stress fractures. The authors retrospectively reviewed 419 patients sustaining ankle fractures at a level 1 trauma center. Two (0.004 %) patients suffered a traumatic periprosthetic ankle fracture and were treated operatively via minimally invasive open reduction internal fixation (ORIF). These patients were followed for a year at the time of publication. Patient outcomes including the union rate, time to union and need for revision were reviewed. Results included 100 % (2/2) fracture union at an average of 5 months. The patients have returned to their pre-operative function level, ambulating unassisted. No re-operations or post-operative complications were noted. To the best of the authors’ knowledge, we report the first case report detailing patient outcomes of post-traumatic periprosthetic fractures after TAR, utilizing the INBONE Total Ankle System ( Wright Medical Group, Memphis, TN)

Substituent Effects on the Coordination Chemistry of Metal-Binding Pharmacophores

A combination of XAS, UV–vis, NMR, and EPR was used to examine the binding of a series of α-hydroxythiones to CoCA. All three appear to bind preferentially in their neutral, protonated forms. Two of the three clearly bind in a monodentate fashion, through the thione sulfur alone. Thiomaltol (TM) appears to show some orientational preference, on the basis of the NMR, while it appears that thiopyromeconic acid (TPMA) retains rotational freedom. In contrast, allothiomaltol (ATM), after initially binding in its neutral form, presumably through the thione sulfur, forms a final complex that is five-coordinate via bidentate coordination of ATM. On the basis of optical titrations, we speculate that this may be due to the lower initial p<i>K</i>_a of ATM (8.3) relative to those of TM (9.0) and TPMA (9.5). Binding through the thione is shown to reduce the hydroxyl p<i>K</i>_a by ∼0.7 pH unit on metal binding, bringing only ATM’s p<i>K</i>_a close to the pH of the experiment, facilitating deprotonation and subsequent coordination of the hydroxyl. The data predict the presence of a solvent-exchangeable proton on TM and TPMA, and Q-band 2-pulse ESEEM experiments on CoCA + TM suggest that the proton is present. ESE-detected EPR also showed a surprising frequency dependence, giving only a subset of the expected resonances at X-band

Crossing Borders and Criminalizing Identity: The Disintegrated Subjects of Administrative Sanctions

This paper draws on in-depth, qualitative interviews that examine individual experiences in two different legal contexts: deportation regimes and supermax prisons. Through putting these contexts and experiences into dialogue, we identify common legal processes of punishment experiences across both contexts. Specifically, the U.S. legal system re-labels immigrants (as deportable noncitizens) and supermax prisoners (as dangerous gang offenders). This re-labeling begins a process of othering, which ends in categorical exclusions for both immigrants and supermax prisoners. As individuals experience this categorical exclusion, they cross multiple borders and boundaries—often against their will—moving from prison to detention center to other countries beyond the U.S. border, and from isolation to prison to “free” society. In both cases, the state action that subjects experience as punishment is civil and, therefore, nominally not punitive. Ultimately, excluded individuals find themselves in a space of legal nonexistence. By examining these common processes and experiences, we argue that a new kind of subject is revealed: a disintegrating subject (as opposed to a juridical or disciplinary subject) whose exclusion reinforces the power of the state