Correlation of Incisura Anatomy With Syndesmotic Malreduction

Background: The anatomy of the syndesmosis is variable, yet little is known on the correlation between differences in anatomy and syndesmosis reduction results. The aim of this study was to analyze the correlation between syndesmotic anatomy and the modes of syndesmotic malreduction. Methods: Bilateral postreduction ankle computed tomography (CT) scans of 72 patients treated for fractures with syndesmotic disruption were analyzed. Incisura depth, fibular engagement into the incisura, and incisura rotation were correlated with degree of syndesmotic malreduction in coronal and sagittal planes as well as rotational malreduction. Results: Clinically relevant malreduction in the coronal plane, sagittal plane, and rotation affected 8.3%, 27.8%, and 19.4% of syndesmoses, respectively. The syndesmoses with a deep incisura and the fibula not engaged into the tibial incisura were at risk of overcompression, anteverted incisuras at risk of anterior fibular translation, and retroverted incisuras at risk of posterior fibular translation. Conclusions: Certain morphologic configurations of the tibial incisura increased the risk of specific syndesmotic malreduction patterns. Level of Evidence: Level III, comparative study

A study on relations between soil and plant species in alpine zone at Kazdaği National Park, Turkey

This study examines the plant species distribution and cover abundance scales relations with soil and other environmental factors such as elevation, exposure, slope in the alpine region. 10 sample areas were determined for experimental field study in the alpine region. Plant species and their cover abundance scales and 0-5 and 5-15cm soil depth analysis were conducted in the field study. C, N, pH, soil salinity, soil texture, C/N and CaCO3 (%) were determined in soil laboratory analysis. To examine the effect of land use by the local people; sample areas were determined both on used area and non-used area in the alpine region.publisher versio

Osteogenic capacity of nanocrystalline bone cement in a weight-bearing defect at the ovine tibial metaphysis

The synthetic material Nanobone® (hydroxyapatite nanocrystallines embedded in a porous silica gel matrix) was examined in vivo using a standardized bone defect model in the ovine tibial metaphysis. A standardized 6 × 12 × 24-mm bone defect was created below the articular surface of the medial tibia condyles on both hind legs of 18 adult sheep. The defect on the right side was filled with Nanobone®, while the defect on the contralateral side was left empty. The tibial heads of six sheep were analyzed after 6, 12, and 26 weeks each. The histological and radiological analysis of the defect on the control side did not reveal any bone formation after the total of 26 weeks. In contrast, the microcomputed tomography analysis of the defect filled with Nanobone® showed a 55%, 72%, and 74% volume fraction of structures with bone density after 6, 12, and 26 weeks, respectively. Quantitative histomorphological analysis after 6, and 12 weeks revealed an osteoneogenesis of 22%, and 36%, respectively. Hematoxylin and eosin sections demonstrated multinucleated giant cells on the surface of the biomaterial and resorption lacunae, indicating osteoclastic resorptive activity. Nanobone® appears to be a highly potent bone substitute material with osteoconductive properties in a loaded large animal defect model, supporting the potential use of Nanobone® also in humans

Artificial Extracellular Matrices Containing Bioactive Glass Nanoparticles Promote Osteogenic Differentiation in Human Mesenchymal Stem Cells

The present study analyzes the capacity of collagen (coll)/sulfated glycosaminoglycan (sGAG)-based surface coatings containing bioactive glass nanoparticles (BGN) in promoting the osteogenic differentiation of human mesenchymal stroma cells (hMSC). Physicochemical characteristics of these coatings and their effects on proliferation and osteogenic differentiation of hMSC were investigated. BGN were stably incorporated into the artificial extracellular matrices (aECM). Oscillatory rheology showed predominantly elastic, gel-like properties of the coatings. The complex viscosity increased depending on the GAG component and was further elevated by adding BGN. BGN-containing aECM showed a release of silicon ions as well as an uptake of calcium ions. hMSC were able to proliferate on coll and coll/sGAG coatings, while cellular growth was delayed on aECM containing BGN. However, a stimulating effect of BGN on ALP activity and calcium deposition was shown. Furthermore, a synergistic effect of sGAG and BGN was found for some donors. Our findings demonstrated the promising potential of aECM and BGN combinations in promoting bone regeneration. Still, future work is required to further optimize the BGN/aECM combination for increasing its combined osteogenic effect

Artificial Extracellular Matrices Containing Bioactive Glass Nanoparticles Promote Osteogenic Differentiation in Human Mesenchymal Stem Cells

The present study analyzes the capacity of collagen (coll)/sulfated glycosaminoglycan (sGAG)-based surface coatings containing bioactive glass nanoparticles (BGN) in promoting the osteogenic differentiation of human mesenchymal stroma cells (hMSC). Physicochemical charac teristics of these coatings and their effects on proliferation and osteogenic differentiation of hMSC were investigated. BGN were stably incorporated into the artificial extracellular matrices (aECM). Oscillatory rheology showed predominantly elastic, gel-like properties of the coatings. The complex viscosity increased depending on the GAG component and was further elevated by adding BGN. BGN-containing aECM showed a release of silicon ions as well as an uptake of calcium ions. hMSC were able to proliferate on coll and coll/sGAG coatings, while cellular growth was delayed on aECM containing BGN. However, a stimulating effect of BGN on ALP activity and calcium deposition was shown. Furthermore, a synergistic effect of sGAG and BGN was found for some donors. Our findings demonstrated the promising potential of aECM and BGN combinations in promoting bone regeneration. Still, future work is required to further optimize the BGN/aECM combination for increasing its combined osteogenic effect

Safe and just Earth system boundaries

The stability and resilience of the Earth system and human well-being are inseparably linked 1-3, yet their interdependencies are generally under-recognized; consequently, they are often treated independently 4,5. Here, we use modelling and literature assessment to quantify safe and just Earth system boundaries (ESBs) for climate, the biosphere, water and nutrient cycles, and aerosols at global and subglobal scales. We propose ESBs for maintaining the resilience and stability of the Earth system (safe ESBs) and minimizing exposure to significant harm to humans from Earth system change (a necessary but not sufficient condition for justice) 4. The stricter of the safe or just boundaries sets the integrated safe and just ESB. Our findings show that justice considerations constrain the integrated ESBs more than safety considerations for climate and atmospheric aerosol loading. Seven of eight globally quantified safe and just ESBs and at least two regional safe and just ESBs in over half of global land area are already exceeded. We propose that our assessment provides a quantitative foundation for safeguarding the global commons for all people now and into the future

Safe and just Earth system boundaries

The stability and resilience of the Earth system and human well-being are inseparably linked1-3, yet their interdependencies are generally under-recognized; consequently, they are often treated independently4,5. Here, we use modelling and literature assessment to quantify safe and just Earth system boundaries (ESBs) for climate, the biosphere, water and nutrient cycles, and aerosols at global and subglobal scales. We propose ESBs for maintaining the resilience and stability of the Earth system (safe ESBs) and minimizing exposure to significant harm to humans from Earth system change (a necessary but not sufficient condition for justice)4. The stricter of the safe or just boundaries sets the integrated safe and just ESB. Our findings show that justice considerations constrain the integrated ESBs more than safety considerations for climate and atmospheric aerosol loading. Seven of eight globally quantified safe and just ESBs and at least two regional safe and just ESBs in over half of global land area are already exceeded. We propose that our assessment provides a quantitative foundation for safeguarding the global commons for all people now and into the future

Chopart Joint Injuries – 10-Year Results in 75 Cases

Category: Hindfoot, Midfoot/Forefoot, Trauma Introduction/Purpose: Fractures and dislocations at the mid-tarsal (Chopart) joints have a relatively low incidence but a highly variable clinical presentation. They are among the most commonly overlooked or misinterpreted injuries to the human body with potentially deleterious consequences for global foot function. There are only few reports available on the long-term outcome of operative treatment following a standardized protocol in these injuries. Methods: From 1994 to 2009 a total of 122 patients with mid-tarsal fractures and fracture-dislocations were entered into a pospective database. Injury patterns, comorbidities, treatment, and complications were documented. Seventy-three patients with 75 Chopart fracture-dislocations were available for follow-up treatment at an average of 10 years (range, 4-18 years). Mean patient age was 37.6 years, 68.5% were male. Foot function was assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score, the Foot-Function-Index (FFI-D) and the SF-36 physical and mental component summary scores. Weight-bearing radiographs were obtained to assess alignment and posttraumatic arthritis. Results: Motor-vehicle-accidents accounted for 53.4% of injuries, The navicular and cuboid bones were fractured more than twice as often as the talar head and anterior process of the calcaneus. In 54.7% of cases more than one of these bones was fractured. 29.3% of the patients were polytraumatized, another 26.7% had accopmanying injuries to the same foot. At latest followup the AOFAS score averaged 71.5, the FFI averaged 26.9, and the mean SF-36 physical and mental summary scores were 43.5 and 51.2, respectively. Negative prognostic factors were a high ISS, work-related accidents, open injuries, multiple fractures and purely ligamentous dislocations (4%) at the Chopart joint, two-step operations, delay of treatment for more than 4 weeks, postoperative infection, closed reduction and the use of primary or secondary arthrodeses. Conclusion: Fractures and fracture-dislocations at the Chopart joint are rare but severe injuries to the foot that lead to lasting functional restrictions in most cases in the long term. Purely ligamentous dislocations have the worst prognosis while injuries with fractures of a single bone have a better prognosis with open reduction and anatomical internal fixation. Fusions should be restricted to cases with completely destroyed joint surfaces

The burden of predatory journal and congress requests in foot and ankle surgery

IntroductionIn recent years the proportion of predatory invitations by email of the total number of emails received has grown dramatically. The aim of the current study was to objectify the increase in predatory journal and congress requests per email over a 5.5-year period and their relatedness to the receivers’ speciality in Foot and Ankle surgery.Material and methodA comprehensive Microsoft Outlook® analysis of 5.5 years’ worth of junk email from one surgical Foot & Ankle specialist working at a Level-1 trauma centre was evaluated. The topic of each email from the last year was scored according to the ‘degree-of-relatedness’.ResultsBetween July 1st 2013 and December 31th 2018 a total of 41,687 emails were collected in the junk email folder of Microsoft Outlook®. A total of 17.0 percent was attributed to emails from predatory journals and congresses. Over the 5.5-year period the percentage of total emails that consisted of invitations from predatory journals and congresses rose from 4.5% to 40.8%. Only an insignificant amount (2.3%) was directly related to the authors medical sub-speciality of Foot and Ankle surgery.ConclusionThis is the first study showing the individual burden of unsolicited emails from predatory publishers and journals. The authors acknowledge the risk that this publication, like all others, will likely result in yet even more invitations from predatory journals and congress invitations. All should be warned of a huge increase in emails from predatory journals and congresses, which has likely not peaked yet. Appropriate action is needed, as we urge foot–ankle interested scientists to publish in indexed journals with proper peer review