External fixation as a primary and definitive treatment for tibial diaphyseal fractures

The aim of this study was to evaluate the effectiveness of unilateral external fixator as primary and definitive treatment for open tibial fractures, fractures with severe soft tissues injuries, threatened compartment syndrome, and in multiply injured patients. Two hundred and twenty-three tibial shaft fractures (212 patients) were treated. In open fractures, union was achieved in 25 weeks, while in closed in 21. There were 18 nonunions, 21 delayed unions, 4 malunions, 58 pin infections and 3 osteomyelitis. A reoperation was performed in 42 patients. Fat embolism was diagnosed in three patients, pulmonary embolism in five and deep venous thrombosis in 14. The external fixator was definitive treatment in 87.27%. Unilateral external fixators can be used as primary and definitive treatment for complicated tibia shaft fractures. Re-operation or change of the method must be performed only when there is a delay in callus formation

Symptomatic intracranial abscess after treating lower cervical spine fracture with halo vest: a case report and review of literature

We present the case of a nineteen year old male, who sustained a fracture of anterior-superior surface of C7, combined with anterior subluxation at the level of C6–C7 vertebrae. After x-ray and CT examination, he was treated conservatively by a Halo-vest. After mobilization, the patient was discharged from the hospital with instructions to visit the outpatient's clinic at regular bases

Obesity and physical fitness indices of children aged 5-12 years living on remote and isolated islands

Introduction: Obesity has become one of the major health risks in childhood, significantly affecting children’s health and physical fitness. Although the marked increase of obesity in urban areas is well established, evidence is limited in remote and isolated areas with adverse socioeconomic features. The aim of this study was to examine the prevalence of obesity and its association with physical performance indices in young school-aged children living in 18 remote and isolated Greek islands. Methods: Four hundred and sixty-three children (244 boys, 219 girls), aged 5-12 years underwent a series of physical fitness tests including 20 m sprint, standing long jump, 1 kg medicine ball throw, agility T-test and sit-and-reach test. Age and gender BMI cut-off points were determined according to World Health Organisation (WHO) norms. Results: The prevalence of obesity was 23.8% and 13.2% for boys and girls, respectively. A negative body mass index (BMI) main effect was observed for weight-bearing activities, such as 20 m sprint (F=6.21, p=0.000, eta(2)=0.041) and standing long jump (F=11.369, p=0.000, eta(2)=0.074), while medicine ball throw was positively correlated with BMI in children aged 9-12 years. Conclusion: The results of this study confirmed previous findings on obesity prevalence in Greece. A negative association was also found between BMI and physical fitness indices and, in particular, in weight -bearing activities. It is critical to establish physical education interventions and physical fitness programs at schools, aiming to increase motivation for physical activity participation

The Staircase (geological formation), Undoolya, near Alice Springs, Central Australia, Northern Territory, 1911 [picture].

Title devised by cataloguer from accompanying information.; Part of the: Barclay-Macpherson expedition to the McArthur River and Gulf of Carpentaria regions, Northern Territory, 1911-12.; Condition: Good.; Also available online at: http://nla.gov.au/nla.pic-vn6157026

Truncal Changes in Patients After Total Hip or Knee Arthroplasty: A Surface Topography Study

Introduction Total hip and knee arthroplasty (THA/TKA) are among the most successful orthopedic operations performed, aiming at the alleviation of osteoarthritic pain. This report is a surface topography study that assesses the mechanism by which THA or TKA influences truncal parameters. This study represents the first time that surface topography has been used for the assessment of truncal parameters. Methods In total, 15 patients with THA, including nine women and six men, with a mean age of 65.07 +/- 9.73 years (range: 47-80 years), and 23 patients with TKA were assessed preoperatively and four and 12 months postoperatively. These patients were also compared with a control group (CG) that included 25 individuals, including 12 women and 13 men, with a mean age of 69.28 +/- 10.11 years (range: 55-86 years). The Diers Formetric four-D analysis system was used to calculate several truncal parameters in all planes. Results Data analysis revealed statistically significant differences in the kyphotic angle (degrees; 56.50 -> 63.57, p < 0.05) and the pelvic obliquity (degrees; 3.40 -> 1.93, p < 0.05) between measurements at baseline and 12 months after THA. Statistically significant differences were noted for the pelvic obliquity (degrees; 2.74 -> 1.43, p < 0.05) between measurements at baseline and 12 months after TKA. Conclusions THA and TKA are causes of truncal morphological alterations. THA and TKA improved pelvic obliquity, contributing to correct the posture in the patients

Percutaneous Vertebroplasty in Adult Degenerative Scoliosis for Spine Support: Study for Pain Evaluation and Mobility Improvement

We evaluate the efficacy-safety of percutaneous vertebroplasty (PV) as primary treatment in adult degenerative scoliosis. During the last 4 years, PV was performed in 18 adult patients (68 vertebral bodies) with back pain due to degenerative scoliotic spine. Under anaesthesia and fluoroscopy, direct access to most deformed vertebral bodies was obtained by 13G needles, and PMMA for vertebroplasty was injected. Scoliosis’ inner arch was supported. Clinical evaluation included immediate and delayed studies of patient’s general condition and neurological status. An NVS scale helped assessing pain relief, life quality, and mobility improvement. Comparing patients’ scores prior to (mean value 8.06±1.3 NVS units), the morning after (mean value 3.11±1.2 NVS units), at 12 (mean value 1.67±1.5 NVS units), and 24 months after vertebroplasty (mean value 1.67±1.5 NVS units) treatment, patients presented a mean decrease of 6.39±1.6 NVS units on terms of life quality improvement and pain relief (P=0.000). Overall mobility improved in 18/18 (100%) patients. No complications were observed. During follow-up period (mean value 17.66 months), all patients underwent a mean of 1.3 sessions for facet joint and nerve root infiltrations. Percutaneous vertebroplasty in the inner arch seems to be an effective technique for supporting adult degenerative scoliotic spine

Clinical Outcome after Surgical Treatment of Sacral Chordomas: A Single-Center Retrospective Cohort of 27 Patients

Introduction: The aims of our study were (1) to determine disease-specific and disease-free survival after the en-bloc resection of sacral chordomas and (2) to investigate potential risk factors for tumor recurrence and major postoperative wound-related complications. Methods: We retrospectively analyzed 27 consecutive patients with sacral chordomas who were surgically treated in our institution between 2004 and 2022. Three patients (11.1%) had a recurrent tumor and four patients (14.8%) had history of a second primary solid tumor prior to or after their sacral chordoma. A combined anterior and posterior approach, colostomy, plastic reconstruction, and spinopelvic instrumentation were necessitated in 51.9%, 29.6%, 37%, and 7.4% of cases, respectively. The mean duration of follow-up was 58 ± 41 months (range= 12–170). Death-related-to-disease, disease recurrence, and major surgical site complications were analyzed using Kaplan–Meier survival analysis, and investigation of the respective risk factors was performed with Cox hazard regression. Results: The estimated 5-year and 10-year disease-specific survival was 75.3% (95% CI = 49.1–87.5%) and 52.7% (95% CI = 31–73.8%), respectively. The estimated 1-year, 5-year, and 10-year disease-free survival regarding local and distant disease recurrence was 80.4% (95% CI = 60.9–91.1%), 53.9% (95% CI = 24.6–66.3%), and 38.5% (95% CI = 16.3–56.2%), respectively. The mean survival of the recurred patients was 61.7 ± 33.4 months after their tumor resection surgery. Conclusions: Despite the high relapse rates and perioperative morbidity, long-term patient survival is not severely impaired. Positive or less than 2 mm negative resection margins have a significant association with disease progression