Humerus distal kırıklarında çift plak osteosentezi, çift gergi bandı tekniğinden daha iyi biyomekanik stabilizasyon sağlar

Objectives: In this study we evaluated the stability and effectiveness of the double tension band osteosynthesis technique compared to the double plate osteosynthesis technique used for fixation of distal humerus fractures. Materials and methods: The study was performed on two groups, and in each group eight cadaveric, elderly (mean age 70-80) human humeri was used. An osteotomy was performed in the supracondylar region using a manual saw. The first group (group 1) was fixed with double 3.5 mm reconstruction plates, while the second group (group 2) was fixed with the double tension band technique, using crossing Kirschner wires. The osteotomy was designed so that the distal fragment would allow only a single screw per plate. The constructs were evaluated using a material testing machine. A linear non-cyclic load was applied until the failure of the constructs. The force which produced a 3 mm gap (3 mm gap strength), as detected visually with the aid of operating loupes, and the maximum load prior to failure of the fixation (maximum force) were measured from all tests. Results: The mean value for the 3 mm gap strength was 1356.29&plusmn;226.97 N for group 1 and 882.63&plusmn;305.21 N for group 2. The mean value of the maximum load strength was 1487.13&plusmn;298 N for group 1 and 1232&plusmn;107.62 N for group 2. There were significant differences in 3 mm gap strengths of the two groups (p=0.005). There was also a significant difference in the maximum load between the two groups (p=0.016). Conclusion: Double plate osteosynthesis technique is superior to double tension band osteosynthesis for the fixation of distal humerus fractures.Bu çalışmada Doğu Karadeniz bölgesi hamsilerinin avlama mevsimi süresince besin bileşenleri ve yağ asitleri komposizyonundaki aylık değişim incelenmesi amaçlanmıştır. Hamsilerin nem oranı ekim ayında en düşük (%64,93) iken nisan ayında ise en yüksek seviyeyede (%74,32) olduğu hesaplanmıştır (P<0,05). Buna bağlı olarak tüm aylardaki yağ seviyeleri ve aralık ve nisan aylarındaki kül miktarlarındaki değişim istatistiksel açıdan önemli bulunmuştur. İlaveten, avlanma mevsimi süresince doymuş yağ asitlerinden (SFA) C16:0, C14:0 ve C18:0, tekli doymamış yağ asitlerinden (MUFA) C18:1n9 ve çoklu doymamış yağ asitlerinden (PUFA) C22:6n-3 (DHA, dekosahekzanoik asit) ve C20:5n-3 (EPA, eikosapentanoik asit) en yüksek oranlarda bulunmuşlardır. Avlama mevsimi boyunca, ortalama omega–3 ve omega–6 değerleri sırası ile %30,33 ve %4,43 olarak hesaplanmıştır. EPA seviyesinde tedrici olarak bir azalma meydana gelirken, DHA seviyesinde ise ekim ayından nisan ayına kadar bir artış gözlenmiştir. Yağ asitlerinde av mevsimi boyunca yağ assitlerinde özellikle de DHA oranında belirgin bir şekilde bir değişimin olduğu gözlemlenmiştir

Humerus proksimal uç iki parçalı kırıklarının tek yönlü ve çok yönlü Kirschner teli ile tespitinin biyomekanik olarak karşılaştırılması

Objectives: The stability and effectiveness of uni-planar Kirschner wire (K-wires) was compared to multi-planar K-wires osteosynthesis combined with tension band wiring for fixation of two-part osteoporotic surgical neck fracture of the proximal humerus. Materials and methods: Two groups each with eight cadaveric elderly (mean age 72.6; range 70 to 80 year) frozen human humeri were used in the study. Transverse osteotomy of the proximal humerus was performed using a thin oscillating saw. The first group (group A) was fixed using two anterograde smooth K-wires, sent from lateral cortex, combined with tension band wiring. The second group (group B) was fixed using multi-planar (anterograde and retrograde) four smooth K-wires combined with tension band wiring on the lateral cortex. Biomechanical tensile properties for 3 mm displacement (gap load) and maximum load were assessed. Results: The mean value for the gap load was 1045.0&plusmn;45.4 N (Newton) for group A and 1238.1&plusmn;115.8 N for group B. Gap load values of groups were similar (p=0.01). The maximum load was 1261.8&plusmn;52.4 N in group A and 1471.1&plusmn;107.3 N in group B. The maximum load values were statistically higher in the multiplanar fixation technique (group B) when compared to that of the uniplanar fixation technique (group A), (p=0.004). Conclusion: Fixation in osteoporotic two-part surgical neck fractures of the proximal humerus using multiplanar K-wires combined with tension band wire provides substantially more effective stability compared to that of uniplanar fixation.Amaç: Humerus proksimal uç cerrahi boyun iki parçalı kırıklarında tek yönlü Kirschner teli (K-teli) ile tespit yönteminin stabilite ve etkinliği, çok yönlü K-teli ve gergi bandı yöntemi ile biyomekanik olarak karşılaştırıldı.Gereç ve yöntemler: Çalışma iki grup halinde düzenlendi. Her bir grupta sekizer adet dondurulmuş insan (ort. yaş 72.6; dağılım 70-80 yıl) kadavra humerus kemiği kullanıldı. Humerus proksimalinde ince el testeresi yardımı ile transvers osteotomi yapıldı. Birinci grupta (grup A) gergi bandı yöntemi ile güçlendirilen ve lateral korteksten antegrad olarak gönderilen iki adet düz K-teli ile tek yönlü tespit uygulandı. İkinci grupta ise lateral kortekste gergi bandı yöntemi ile güçlendirilmiş dört adet K-teli ile çok yönlü (antegrad ve retrograd) tespit uygulandı. Üç milimetre aralık oluşma sırasındaki yüklenme (ayrışma gücü) ve maksimum yüklenme miktarları biyomekanik olarak değerlendirildi. Bulgular: Ortalama ayrışma gücü, grup A’da 1045.0±45.4 N (Newton) ve grup B’de 1238.1±115.8 N olarak tespit edildi. Ayrışma gücü açısından, iki grup benzerdi (p=0.01). Maksimum yüklenme miktarı grup A’da 1261.8±52.4 N, grup B’de ise 1471.1±107.3 N olarak bulundu. Maksimum yükleme değerleri, çok yönlü tespit tekniğinde (grup B), tek yönlü tespit tekniğinden (grup A) istatiksel olarak yüksek bulundu (p=0.004). Sonuç: Humerus proksimal uç iki parçalı cerrahi boyun kırıklarının sabitlenmesinde, gergi bandı ve K-telleri ile güçlendirilmiş çok yönlü tespit yöntemi, tek yönlü tespit yöntemine göre daha etkilidir

Synchrotron Ft-Ir Microspectroscopic Analysis of Necrotic Bone

Avascular necrosis (osteonecrosis) is a disease that results from the temporary or permanent loss of blood supply to the bone. Synchrotron FT-IR microspectroscopy has been used to study the changes in mineral and matrix content of necrotic bone. FT-IR spectroscopic analysis revealed that in necrotic bone the relative mineral/matrix ratio decreased. Spectroscopic differences were observed between normal and necrotic bones. The noticeable differences may have important implications for analyzing and evaluating death bone.WoSScopu

Effect of Ankaferd Blood Stopper on muscle healing

Purpose: Ankaferd Blood Stopper (ABS), which is a standardized mixture of herbal extracts obtained from five plants, has been proven as an efficient hemostatic agent and is still used in emergency situations. It is not known exactly if decreased bleeding has positive or negative effects on muscle healing and fibrosis, so the purpose of this study was to test the effect of ABS on muscle healing and morphology. Methods: A total of 66 outbred Wistar rats were divided into three control and three experimental subgroups. In the experimental groups, ABS was sprayed on the cut surface of the soleus. In the control groups, a saline solution was sprayed on the cut surface of the soleus. Subgroups were euthanized after 2 weeks, 3 weeks and 4 weeks, respectively. In each subgroup, eight rats were used for the biomechanical study to determine muscle healing and three rats were used for the histopathological investigation. Results: Although muscle strength in the control groups was lower than that of the experimental groups in early weeks, no differences were found between the control and the experimental groups at 4 weeks. Conclusions: ABS has no negative effect on muscle healing. We also observed that ABS accelerated muscle healing compared to the control group. ABS could be used in hemostasis of open fractures and elective orthopedic surgeries

Handgun injuries with metacarpal and proximal phalangeal fractures: early definitive treatment

Most gunshot injuries to the hand involve a combination of tissue types. The goal of this study is to report the results of early definitive treatment in extra-articular metacarpal and proximal phalangeal fractures due to low velocity gunshot wounds and to analyse their outcomes. A retrospective analysis of 51 metacarpal and 41 proximal phalangeal fractures of 76 patients due to low velocity gunshot wounds treated between January 2001 and December 2004 was carried out. We applied acute fixation in the first 24 hours. The patients were evaluated with total active motion scores, radiographic control, complication rate and the need for revision surgery. The infection frequency was 10.5% and the need for a revision surgery was 7%. The plate fixation group had significantly higher total active motion scores than the external fixation group. The K wire group had the highest revision rate. The bone grafting group was associated with good total active motion scores and low complication rates. The majority of the low velocity gunshot injuries are surgically clean wounds which allow not only early fracture fixation, but also early bone grafting and soft tissue reconstruction. Plate and screw fixation is associated with significantly better functional outcomes than the minimal fixation group