Straight versus S-shaped sternotomy: a histologic study in the sheep model

INTRODUCTION: Straight sternotomy is the most common access for open heart surgery. Techniques have been proposed for maximizing sternal stability in high-risk patients. This trend implies a growing need for newer surgical techniques. The aim of this experimental study in the sheep model is to evaluate median vs. S shaped sternotomy the feasibility of using a special device to accelerate the sternal instability and bone healing. MATERIALS AND METHODS: We enrolled 31 sheep, weighing 18–30 kg. For all animals a midline skin incision was made. In group I (n = 16 animals), straight median sternotomy and in group II (n = 15 animals), S-shaped incision was marked on the periosteum of the sternum by new created device for standard S-shaped sternotomy. Sternum biopsies were performed on second surgery month for all survived animals from the sternum and the surrounding soft tissue. RESULTS: No early superficial wound complications were observed. Overall mortality in the initial approach group was 19.3% (6 sheep). In group I; 3 sheep had died on first surgery day, the reason may be hemorrhage and in group II; 3 sheep developed intractable VF during surgery procedure or immediately afterwards so died. There were statistically significant differences in the scores of bone healing between group 1 and group 2 (4.2 vs.7.3, ANOVA, p < 0.001). DISCUSSION: Our work is based on the use of a standard S-shaped sternotomy procedure on sheep sternum. In our experience with the sternal healing in the sheep model, the process of new bone formation was accelerated with S- shaped cut than straight sternotomy procedure. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-014-0173-x) contains supplementary material, which is available to authorized users

Red Cell Distribution Width: an Unacknowledged Predictor of Mortality and Length of Stay following Revision Arthroplasty

Introduction Red blood cell distribution width (RDW), a measure of variability in size of circulating erythrocytes, is routinely reported in complete blood cell analysis, and together with mean cell volume (MCV) has conventionally been used to distinguish the cause of anemia. It is calculated by (Standard deviation of MCV÷ mean MCV) x 100, with normal range being 11.5%-14.5%. Several recent publications have described RDW as an independent predictor of adverse outcome and mortality in patients with different underlying medical conditions such as acute and chronic heart failure, peripheral artery disease, chronic pulmonary disease and acute kidney injury1. The purposes of this study were 1) to investigate possible relationship between RDW levels and length of stay (LOS) and mortality following revision total joint arthroplasty (TJA), and if that correlation existed, 2) to develop predictive models for LOS and mortality based on preoperative patient-related factors including RDW values

Transpedicular decancellation osteotomy in the treatment of posttuberculous kyphosis

Objective: Although the transpedicular decancellation osteotomy is a salvage technique for reconstruction of complex spinal deformities, it is not a procedure used exclusively for patients with kyphosis occurring as a sequel of treated tuberculosis. In this study, 16 adult patients with kyphosis underwent transpedicular decancellation osteotomy between 1993 and 1999. Pain, kyphosis angle, sagittal balance, and functional and neurologic status were the main parameters used for the clinical and radiologic assessment. Methods: Sixteen patients with angular kyphotic deformity underwent transpedicular decancellation osteotomy between 1993 and 1999 with at least 5 years of follow-up. There were 6 male and 10 female patients with a mean age of 51.0. The radiologic involvement included the angle of kyphosis and plumb line on the anteroposterior and lateral radiographs. The preoperative and postoperative clinical assessment was performed by the using Oswestry Disability Index. All patients were asked to rate their preoperative and postoperative pain measurement using a pain visual analog scale. Fusion was evaluated on flexion-extension lateral radiographs. Results: There were significant corrections in the kyphosis angle and the sagittal balance whereas no radiologic correction loss was observed in any of the patients during follow-ups. When the preoperative and the last follow-up pain visual analog scale and Oswestry Disability Index scores were compared, decrease was documented in both of them. Bony fusion was achieved in all patients and no neurologic complications were detected. Conclusions: The transpedicular decancellation osteotomy effectively corrected the sagittal balance and improved pain and functional status. It was a safe and reliable technique in the treatment of posttuberculosis kyphosis

Morphometry of the medial tibial plateau in Turkish knees: correlation to the current tibial components of unicompartmental knee arthroplasty

Objective: The objective of this study was to measure the resected surfaces of the tibia in knees of Turkish patients and to compare these measurements with the dimensions of tibial implants in current use

Congenital Insensitivity to Pain with Anhidrosis (CIPA) Manifested with Chronic Osteomyelitis; A Case Report

Chronic osteomyelitis is a very rare entity among children. Also congenital insen-sitivity to pain with anhidrosis (CIPA) is a very rare autosomal-recessive disease of the nervous system which is one of the hereditary sensory and autonomic neuropathies (HSAN). Loss of pain, fever due to anhidrosis, recurrent fractures, chronic osteomyelitis, mental retardation, self mutilation, wound ulcers can be seen. We present a 10-year-old boy with loss of generalized pain sensation, chronic osteomyelitis on his right distal femur, bilateral corneal opacities, and decreased mental capacity

A PILOT STUDY ABOUT QUALITY OF INFORMATION AT HEALTH RELATED IN TURKISH WEB SITES: MENISCUS TEAR

Objective: The aim of this study is to evaluate the reliability of health related data available to patients at Turkish websites. For this purpose, meniscus tear was chosen as a subject for the pilot study

Olecranon anatomy: Use of a novel proximal interlocking screw for intramedullary nailing, a cadaver study

AIM: To define the optimum safe angle of use for an eccentrically aligned proximal interlocking screw (PIS) for intramedullary nailing (IMN)