A new intramedullary sustained dynamic compression nail for the treatment of long bone fractures: a biomechanical study

Objectives: We developed a new intramedullary interlocking nail (sustained dynamic compressive nail; SDCN) which can sustain a continuous dynamic compressive force on the fracture edges to overcome implant failure, screw loosening and nonunion complications encountered in the traditionally used static intramedullary nailing (SIMN)

Rates and Risk Factors of Diabetic Foot Reamputations

SUMMARY Aim: The aim of this study is to determine the reamputation rate in patients who had amputation surgery in our hospital with the diagnosis of diabetic foot and to analyze the comorbid factors. Material and Method: Of 131 patients with detailed information in their files 66 patients who had amputation surgery are included in the study. Age, gender, smoking habits, comorbid diseases, number, level, side and time period of amputation surgeries experienced, presence of infection, wound culture growth of microbes, presence of leukocytosis and method of treatment are recorded. Diabetic foot ulcers of the patients are graded with Wagner-Meggit classification depending on the depth of the wound. Wounds are also evaluated in three different pathophysiological groups as neuropathic, neuropathic-ischemic and ischemic. Levels of amputation were digital, ray, transmetatarsal, below-knee transtibial and above-knee transfemoral. Ipsilateral or contralateral reamputations in previosly amputated patients were investigated. Results: Of the 66 patients who experienced amputation or reamputation surgery 45 were males and 21 were females. Mean age was 63,2 ( 26-88 ). 11 patients had reamputation surgery. 7 patients had ipsilateral reamputations at a more proximal level, 2 patients had contralateral side amputations and ipsilateral more proximal level reampuations and 2 patients had contralateral side amputations. Wagner-Meggit classification of the wounds in amputated patients yielded 4 Grade3, 40 Grade4, 11 Grade5 wounds where as 7 Grade4, 4 Grade5 wounds in reampuatated patients. Pathophysiological classification yielded 6 neuropathic, 21 neuroischemic and 28 ischemic wounds in amputation group where as 4 neuroischemic and 7 ischemic wounds in reamputation group. Discussion: Evaluation of diabetes dependent and nondependent comorbid risk factors as well as the physiological capacity of the patients are important as much as selecting accurate level of amputation level with the aid of new diagnostic techniques in decreasing reamputation risk and rates. [Med-Science 2012; 1(4.000): 283-91

A Retrospective Analysis of Amputation Rates and Comorbidity in Patients with Diabetic Foot Ulcer

Abstract Diabetic foot ulcers cause elongated hospitalisations with high treatment costs and high rates of lower extremity amputations resulting with increased morbidity and decreased quality of life. The aim of this study was to determine amputation rate in patients admitted to our hospital with the diagnosis of diabetic foot and the most common risk factors in patients with diabetic foot ulcers. 131 patients admitted to outpatient clinics of Izmir Katip Celebi University Ataturk Training and Research Hospital between January 2011 and December 2011 with the diagnosis of diabetic foot ulcer were retrospectively analyzed. Of these 96 were males and 35 were females. Age, gender, smoking and alcohol habits, comorbid diseases, presence of infection, growth of microorganism in medium, presence of leukocytes, hypertension, method of treatment and regimes of antibiotics are recorded. Mean age was 61,1 ( 26-90). Patients are divided into two groups according to treatment protocols, first group was consist of debriated and medicaly treated patients, while the second group covered amputated patients. 66 were amputated and the rest 65 had debridement-wound care and antibiotherapy after they were evaluated in the diabetic foot council of our hospital. Rate of amputation was 50 %. 36 of the amputated patients had major and the others had minor amputations. Most common comorbidities that related and nonrelated to diabetes were peripheral arterial disease ( 102 out of 131; 77% ) and hypertension ( 50 out of 131; 38% ); respectively. Grading of diabetic ulcers according to Wagner-Meggit classification yielded that most commonly seen wounds were grade 4 in the amputation group and grade 2 in the debridement group. According to pathophysiological classification most common cause were ischemic wounds in both groups. Compared to the literature, our amputation rates are higher. This issue can be attributed to high rates of comorbid factors, higher age and irregular follow-up. Key words: diabetic foot, amputation, comorbidity [Med-Science 2012; 1(4.000): 331-40

Scapholunate dissociation associated with distal radius fractures

Objective: The exact prevalence of scapholunate dissociation (SLD) associated with distal radius fracture (DRF) and the effect of persistent SLD on the function of the wrist are not known. So, we examined the association between SLD and DRF and the effects of treatment on clinical outcomes. Methods: Eight hundred and twenty-nine patients with 839 DRF were included in the study. The radiographs of the patients were examined with special reference to SLD both in pre- and post-reduction period. Persistent SLD cases were evaluated by the scoring system of Green and O'Brien at least 2 years after the fracture. Results: Of the 839 fractures, 215 had SLD after the injury. When post-reduction radiographs were examined, SLD persisted in 98, but in 14 SLD was detected in the post-reduction period while not apparent in initial radiographs. So, a total of 112 patients (13.4 %) had persistent SLD. Nineteen patients were lost to follow-up and remaining 93 wrists examined clinically. Seventy-nine had pain on the scapholunate joint and 14 had not. When these patients were evaluated by Green and O'Brien system, symptomatic patients had fair or poor results but asymptomatic had good. The association between DRF and SLD is 13.4 %. Conclusions: Severity of the distal radius fractures is not associated with SLD. Intra-articular fractures were associated with significant increase in the prevalence of SLD. In some cases, SLD may appear after reduction in distal radius. Most cases with SLD are symptomatic, and this may be the reason of poor cases following distal radius fracture. © 2012 Springer-Verlag France

The effects of blood transfusion on renal functions in orthopaedic surgery

Objective: The effects of perioperative blood transfusion on renal functions have been studied in various studies. In this study, we investigated the effects of blood transfusion on postoperative kidney functions in patients who underwent orthopaedic surgeries

Assessment of Protective Effects of Pheniramine Maleate on Reperfusion Injury in Lung After Distant Organ Ischemia: A Rat Model

Objective: The aim of this study is to investigate the protective effects of methylprednisolone (MP) and pheniramine maleate (PM) on reperfusion injury of lungs developing after ischemia of the left lower extremity of rats. Materials and methods: A total of 28 randomly selected male rats were divided into 4 groups, each consisting of 7 rats. Group 1 was the control group. Group 2 was the sham group (ischemia/reperfusion [I/R]). Rats in group 3 were subjected to I/R and given PM (Ph group) and rats in group 4 were subjected to I/R and given MP (Pn group). Results: Malondialdehyde levels were significantly lower in Ph group than in I/R group (P < .05). Superoxide dismutase and glutathione peroxidase enzyme activities were found to be significantly higher in Ph group than in the I/R group (P < .05). Histological examination demonstrated that PM had protective effects against I/R injury. Conclusions: The PM has a protective effect against I/R injury in rat lung