An analysis of functional outcome following conservative versus surgical management in fractures of the distal radius

Background: Distal radial fractures are one of the most common injuries seen in the orthopaedic department, which can be managed both conservatively and surgically. There are advantages and disadvantages in each method of management. The aim of this study was to compare the functional and radiological outcomes of intra-articular fractures of the distal end of the radius with conservative and surgical management.Methods: 80 cases of intra articular fractures of the distal radius managed by both conservative and surgical means were studied between January 2011 to January 2013 and were followed up for a minimum period of two years.Results: In our series of 80 patients, there 53 males and 27 females. Most of the patients were between 20-30 years of age with the mean age being 40.35 years. RTA was the most common mode of injury (45%). Frykman’s type 3 (41.7%) was the most common fracture type seen followed by type 8. All fractures united by the end of 6 months. Excellent results were seen in 47.5% of cases in the surgical group and 30% of cases in the conservative group. Conclusions: From this study, we conclude that surgical management is better than conservative in the treatment of intra articular fractures of the distal end of radius. Therefore, one treatment method of treatment cannot be generalized for all types of fractures and treatment should be individualized to a particular fracture in terms of age, fracture pattern, degree of displacement and amount of communition present.

Flow-acoustic Characterisation of a Cavity-based Combustor Configuration

This study concerns the flow-acoustic characterisation of a cavity-based combustor configuration. A well-validated numerical tool has been used to simulate the unsteady, two-dimensional reacting flow. Initially, a conventional flow over a cavity with dimensions and conditions corresponding to a compact cavity combustor was studied. Cavity mass injections in the form of fuel and air injections required for trapped vortex formation were then employed and the resonance features of this configuration were studied. The results indicate that the cavity depth mode resonance mechanism is dominant at the conditions studied in this work and that the oscillation frequencies do not change with cavity air injection. This observation is important since it implies that the only important variable which can alter resonant frequencies is the cavity depth. With combustion, the pressure oscillation amplitude was observed to increases significantly due to periodic entrainment of the cavity air jet and fluctuation of fuel-air mixture composition to produce highly fluctuating heat-release rates. The underlying mechanisms of the unsteady flow in the cavity combustor identified in this study indicate the strong dependence of the acoustics on the cavity injection strategies.Defence Science Journal, 2011, 61(6), pp.523-528, DOI:http://dx.doi.org/10.14429/dsj.61.87

The role of primary cemented total hip arthroplasty in the management of fractures of the neck of femur in the elderly population

Background: Femoral neck fractures are common injuries in the elderly population and are associated with high rates of morbidity and mortality. The aim of surgical intervention in these elderly patients is to restore them to the pre-fracture status as rapidly as possible. The aim of this study was to evaluate the role of total hip arthroplasty as a primary option in the management of these fractures and to compare the results with studies of other authors as available in literature.Methods: 45 patients with femoral neck fractures treated with cemented total hip arthroplasty were studied from January 2011 to January 2013 and were followed up for a minimum period of two years.Results: There were 18 males and 27 females ranging from 60 to 75 years of age. Mean age was 64.6 years. Majority (80%) of the fractures were completely displaced, Garden type 4 fractures followed by type 3 in 20% of cases. The most common mode of injury was a simple slip and fall. Excellent results were seen in 17 patients, good results in 24 patients and fair results in 4 patients. No poor results were seen. Conclusions: Cemented total hip arthroplasty is a very useful procedure for the primary treatment of femoral neck fractures in elderly patients. This procedure markedly improves the functional status of the patients and gives good functional results

An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

Background: Management of fractures of the distal tibia remains a challenging proposition due to the fact that the major part of the bone is in a subcutaneous location and the blood supply is quite precarious. Conventional forms of osteosynthesis are associated with high rates of infection and nonunion. Due to extensive soft tissue stripping, the vascularity is compromised and often results in poor wound healing and tends to compromise fracture healing as well. Closed reduction with minimally invasive plate osteosynthesis (MIPO) addresses these issues and has emerged as a viable treatment option with minimal complications. The aim of this study was to assess the functional outcome MIPO using locking compression plates (LCP).Methods: 32 patients with distal tibial fractures treated by MIPO technique with LCP fixation were studied from January 2012 to January 2014 and were followed up for a period of 2 years.Results: All the fractures in our series united well at the end of 6 months with mean time to radiological evidence of callus formation at 10 weeks and the mean time to fracture union was 20 weeks. There were 2 cases with varus angulation in our series and no cases with implant failure. There were 3 patients with superficial skin infections and no cases of deep infection.Conclusions: We conclude that MIPO with LCP is an effective treatment option for distal tibial fractures avoiding all the complications associated with other forms of internal fixation. We strongly recommend its usage in these types of complex injuries

Face selectivity in electrophilic additions to methylenenorsnoutanes: relative importance of through-space, through-bond and electrostatic interactions

4-Substituted 9-methylenenorsnoutanes undergo a variety of electrophilic additions with a small but consistent syn preference; ab initio MESP maps indicate that electrostatic factors and through-space interaction between the double bond and cyclopropane Walsh orbitals are unimportant in determining the face selectivity, while AM1 transition state energetics suggest that the observed preferences are determined primarily by through-bond interactions

Rapid growth and high cloud-forming potential of anthropogenic sulfate aerosol in a thermal power plant plume during COVID lockdown in India

The COVID lockdown presented an interesting opportunity to study the anthropogenic emissions from different sectors under relatively cleaner conditions in India. The complex interplays of power production, industry, and transport could be dissected due to the significantly reduced influence of the latter two emission sources. Here, based on measurements of cloud condensation nuclei (CCN) activity and chemical composition of atmospheric aerosols during the lockdown, we report an episodic event resulting from distinct meteorological conditions. This event was marked by rapid growth and high hygroscopicity of new aerosol particles formed in the SO2 plume from a large coal-fired power plant in Southern India. These sulfate-rich particles had high CCN activity and number concentration, indicating high cloud-forming potential. Examining the sensitivity of CCN properties under relatively clean conditions provides important new clues to delineate the contributions of different anthropogenic emission sectors and further to understand their perturbations of past and future climate forcing

Enhanced aerosol particle growth sustained by high continental chlorine emission in India

Many cities in India experience severe deterioration of air quality in winter. Particulate matter is a key atmospheric pollutant that impacts millions of people. In particular, the high mass concentration of particulate matter reduces visibility, which has severely damaged the economy and endangered human lives. But the underlying chemical mechanisms and physical processes responsible for initiating haze and fog formation remain poorly understood. Here we present the measurement results of chemical composition of particulate matter in Delhi and Chennai. We find persistently high chloride in Delhi and episodically high chloride in Chennai. These measurements, combined with thermodynamic modelling, suggest that in the presence of excess ammonia in Delhi, high local emission of hydrochloric acid partitions into aerosol water. The highly water-absorbing and soluble chloride in the aqueous phase substantially enhances aerosol water uptake through co-condensation, which sustains particle growth, leading to haze and fog formation. We therefore suggest that the high local concentration of gas-phase hydrochloric acid, possibly emitted from plastic-contained waste burning and industry, causes some 50% of the reduced visibility. Our work implies that identifying and regulating gaseous hydrochloric acid emissions could be critical to improve visibility and human health in India