Direct and indirect loading of the Ilizarov external fixator: the effect on the interfragmentary movements and compressive loads

The amount of weight bearing and the force transmission to the frame have an important influence on the results of treatment with an Ilizarov external fixator. The frame provides beneficial interfragmentary movements and compressive loads at the fracture site through elastic wires. Mobilisation can be achieved by applying a weight-bearing platform at the distal end of the fixator. The effect on the interfragmentary movements and the compressive loads in indirect and direct loading were analysed in this study using a composite tibia bone model. Displacement transducers were attached to measure the interfragmentary movements and to detect relative movements of the bone fragments and movements between the rings. The compressive loads in the osteotomy were measured with loading cells in the defect zone. The weight-bearing platform had a substantial effect on the biomechanical behaviour of the frame. It led to an indirect force transmission through the fixator with respect to the osteotomy, resulting in lower compressive loads, lower interfragmentary movements and higher mechanical stress on the frame

Additional external hinged fixator after open repositioning and internal fixation of acute elbow instability in non-compliant patients

This is a retrospective analysis of the clinical and radiological outcome in 11 patients with complex acute posttraumatic elbow instability after dislocation. These patients had also been treated with a hinged external fixator after open reduction, capsular and ligamentous reconstruction and internal fixation, because of an expected diminished compliance, to avoid a secondary dislocation of the internal fixation. Concentric stability and a sufficient range of motion of the elbow joint were achieved in all cases. Non-compliant patients were classified by the surgeon as not compliant or not able or not willing to cooperate post-operatively for various reasons, such as alcoholism, drug abuse, mental disability, cerebral trauma or senile dementia. Non-compliant patients had undergone open reduction and internal fixation of an acute posttraumatic unstable elbow. The addition of a hinged external fixator allows early intensive mobilization, and can protect and improve the clinical outcome after these complex elbow injuries. This evaluation remains, of course, largely subjective and decision making is not easy because in most cases, the patient was not known before surgery. Thus, the only patient exclusion criteria in this study was surgeon classification as “compliant”

A non-radioactive protein truncation test for the sensitive detection of all stop and frameshift mutations

A new method for mutation detection is described, which is a technical advancement of the protein truncation test. The new technique is non-radioactive and highly sensitive for detection of virtually all sequence mutations, which lead to a stop signal or to the shift of the translation frame. The method includes four steps: 1) capture of the interesting sequence copies out of the sample by binding to an immobilized complementary sequence, 2) PCR amplification of the gene fragment to be analyzed with primers coding both for amino. and carboxy-terminal tags, 3) in vitro transcription and translation, and 4) analysis of the translation products by Western blot. As an evaluation of the new method, we detected mutated gene copies at a dilution of 1 to 40 compared to the non,mutated gene. Using the method, we were able to detect a mutation in the adenomatous polyposis coli tumor suppressor gene (APC) in a stool sample of a colorectal cancer patient. This mutation could not be detected by direct sequencing of the amplified APC gene fragm