Utility of three-dimensional printing in the surgical management of intra-articular distal humerus fractures: a systematic review and meta-analysis of randomized controlled trials

Background Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures. Methods A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software. Results Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74–19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45–60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance. Conclusions Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes. Level of evidence I

Knock knee deformity and body mass index among the male school students of 9 to 13 years old of chandigarh, India

Study aim: To study knock knee deformity and the body mass index among male school students of Chandigarh, India. The study also intended to evaluate the association of knock knee deformity with BMI

Neglected, semimembranosus osteochondral avulsion fracture of the posteromedial tibial plateau

Semimembranosus avulsion fracture is infrequently reported and is easy to miss on plain radiographs; the mechanism of injury is highly controversial. Initial reports linked it to anterior cruciate ligament and medial meniscal tears. We report an osteochondral semimembranosus avulsion fracture of the posteromedial tibial plateau with associated posterior cruciate ligament rupture. Also described is a novel surgical fixation technique for such osteochondral fractures where the surgical exposure is limited due to the obliquity of the fracture line resulting in a greater involvement of the articular cartilage than the small bony component. The fixation technique described may be used for osteochondral fractures where the application of a conventional compression screw may not be feasible. Keywords: Osteochondral fracture, Semimembranosus avulsion fracture, Posteromedial tibial plateau, Neglected, Nonunio

Neem: a magical herb in endodontics

For thousands of years, humans have been using herbal remedies to cure and prevent various illnesses. Out of many herbal products, neem has numerous properties which have promoted its use in both the medical and dental fields. Use of neem has been mentioned in alternative medical specialties, such as Ayurveda, Unani and Homeopathic medicine. Endodontic therapy aims to eliminate microorganisms from the root canal system. In endodontics, irrigating solutions play a significant role because of their antimicrobial activity. Their use becomes even more significant when handling infected endodontic cases where a plethora of microbes is invading the root canal system. However, one has to be extremely cautious while using irrigating chemicals in endodontics, owing to their toxic effects, in case they extrude into periradicular tissue. For this very reason, the use of herbal irrigating solutions such as neem is being advocated worldwide. This article highlights the origin, taxonomy, chemical composition, and medicinal properties of the neem tree and its potential use as an irrigating solution in the field of endodontics

Evolution of restorative dentistry from past to present

The history of operative dentistry dates back to the era when Babylonians, Assyrians, and Egyptians (4500–4000 BC) were familiar with gold, and Etruscans and Phoenicians (2700 BC) were practising gold crowns. Since then, there have been numerous advances, developments, and researches which have proceeded continuously. These inventions have transformed the practice of operative dentistry into one which is more efficient and more comfortable for the patients as well as for the operating team. This article highlights the significant advancements in the field of operative dentistry which have occurred over a period of time and have helped us to serve our patients better

Reconstruction of chronic acromioclavicular joint disruption with artificial ligament prosthesis

【Abstract】Objective: Management of Rockwood type 3 acromioclavicular disruptions is a matter of debate. Should we adopt conservative or operative measures at first presentation? It is not clear but most of the evidences are in favour of conservative management. We present our expe-rience in managing these patients surgically. Methods: We present a prospective series of eight cases of chronic Rockwood type 3 acromioclavicular joint disruptions treated surgically. Anatomical reconstruction of the coracoclavicular ligament was done by artificial braided polyester ligament prosthesis. Results: All the patients were able to perform daily activities from an average of the 14th postoperative day. All patients felt an improvement in pain, with decrease in ave-rage visual analogue scale from preoperative 6.5 points (range 3-9 points) to 2.0 points (range 0-5 points), Constant score from 59% to 91% and American Shoulder and Elbow Surgeons shoulder score from 65 to 93 points postoperatively. These results improved or at least remained stationary on midterm follow-up, and no deterioration was recorded at an average follow-up of 46 months. Conclusion: This midterm outcome analysis of the artificial ligament prosthesis is the first such follow-up study with prosthesis. Our results are encouraging and justify the further use and evaluation of this relatively new and easily reproducible technique. Key words: Acromioclavicular joint; Prostheses and implants; Reconstructive surgical procedures; Ligament

Evaluating the Effects of Sclerotinia Rot Resistant Genotypes on Different Indian Mustard Traits and Yield Using Generation Analysis

Sclerotinia stem rot caused by the pathogen Sclerotinia sclerotiorum is a serious threat to Indian mustard cultivation and causes up to 90% loss in seed yield. The present investigation was conducted to understand the inheritance pattern of Sclerotinia stem rot resistance through generation mean analysis, as a first step in addressing the problem. Six generations i.e.., P1, P2, F1, F2, BC1P1 and BC1P2 of a cross between a sclerotinia stem rot resistant genotype viz., RH 1222-28 and two susceptible genotypes viz., EC 766300 and EC 766123 were evaluated for sclerotinia stem rot resistance, yield and its component traits at timely sown conditions. For resistance assessment, plants were artificially inoculated with 5 days-old pure culture of S. Sclerotiorum at the post-flowering stage and stem lesion length was measured (cm) from each inoculated stem at 20 days after inoculation. Sclerotinia stem rot resistance, seed yield, and their component traits were adequately explained by the epistatic interaction model. Furthermore, additive, dominance, and epistatic gene effects were implicated in the expression of resistance, yield, and traits associated with it. In order to generate Indian mustard cultivars with high yielding potential and resistant to sclerotinia stem rot, reciprocal recurrent selection would be the most successful method

Comparison of different routes of administration of clonidine for analgesia following anterior cruciate ligament repair

Background and Aims: A high percentage of patients undergoing arthroscopic repairs on day care basis complain of inadequate postoperative pain relief. Clonidine was evaluated for the best route as an adjuvant in regional anesthesia in anterior cruciate ligament (ACL) repair to prolong analgesia. Material and Methods: A prospective randomized double-blinded study was planned in a tertiary care hospital in North India in which 85 American Society of Anesthesiologists I and II patients undergoing ACL repair were enrolled. All groups received 0.5% hyperbaric bupivacaine intrathecally as in control group C. Group IT received intrathecal 1 μg/kg of clonidine along with hyperbaric bupivacaine, group IA received 0.25% bupivacaine and 1 μg/kg clonidine intra-articularly, and group NB received 0.25% bupivacaine and 1 μg/kg clonidine in femoro-sciatic nerve block (FSNB). Postoperative pain free interval and block characteristics were the primary outcomes studied. Results: Pain-free duration was 546.90 (±93.66) min in group NB (P 0.001) in comparison to other groups. The mean rescue analgesic requirement and cumulative frequency of rescue analgesia were least in group NB, followed by groups IT, IA and C. Conclusion: Clonidine is safe and effective adjuvant with bupivacaine in prolonging analgesia through various routes employed for post knee surgery pain. The maximum prolongation of analgesia is achieved through FSNB with a risk of prolonging postanesthesia care unit stay