Hoffa fracture: analysis of factors affecting the final outcome after treatment with partially threaded screws

Background: Coronal fractures of the femoral condyles are rare injuries.Methods: This retrospective case series included patients with coronal fractures of the femoral condyles managed operatively. The surgeries were performed by authors NJ, RL and VB. A total of 11 patients with Hoffa fracture were operated between May 2011 and July 2012.Results: We report the outcome of open reduction and internal fixation using partially threaded screws in 11 patients with Hoffa fracture. There were 10 male and 1 female patient operated at a mean age of 37 years. The average duration of follow up was 15.6 months. Fractures in all the patients united with a mean 115.450 range of flexion at knee at final review. The final outcome had a poor correlation with the shear angle of the fracture but fracture comminution and open nature of injury had a negative effect on the final outcome achieved. The number of screws used and the type of rehabilitation followed post operatively also had no bearing on the final range of motion achieved.Conclusions: Partially threaded screws offer consistently good results in coronal fractures of the femoral condyles and the outcome is dictated only by perioperative factors like comminution and open nature of injury

Antifibrinolytic in reducing postoperative blood loss in total hip replacement and its effect on coagulation profile: A prospective randomized study

BACKGROUND: Studies have shown that tranexamic acid reduces blood loss and transfusion need in patients undergoing total hip arthroplasty. However, till date, no study has been large enough to determine definitively whether the drug is safe and effective in total hip arthroplasty. We examined whether intravenous tranexamic acid, when compared with placebo, is safe and effective in total hip arthroplasty. MATERIALS AND METHODS: A prospective, randomized, double blinded study was conducted in a group of 142 patients undergoing total hip arthroplasty divided equally into tranexamic acid group and control group. Our protocol included administration of one dose of 15 mg/kg of TXA (given as infusion over 15 min ) in 100 ml NS just 15 min before incision and the subsequent 8 hourly in TXA group. In control group we have given 100 ml normal saline infusion just before operation and 100 ml NS infusion 8 hourly for 2 days postoperatively. Postoperative blood parameters were recorded. RESULTS: The total postoperative drain output and transfusion requirement was found to be lower in patients who received TXA (352-412 ml) as compared to control group (804-878 ml). We have observed 3 and 4 cases of DVT in TXA and control group respectively. Coagulation profile is least affected in both the groups. CONCLUSION: We conclude that tranexamic acid significantly reduces postoperative blood loss and transfusion requirements during total hip arthroplasty

Small molecule induced poly(A) single strand to self-structure conformational switching: evidence for the prominent role of H-bonding interactions

All messenger RNAs (mRNAs) have a polyadenylic acid tail that is added during post transcriptional RNA processing. Investigation of the structure–function and interactions of polyadenylic acid is an important area to target for cancer and related diseases. Jatrorrhizine and coptisine are two important isoquinoline alkaloids that are structurally very similar, differing only in the substituents on the isoquinoline chromophore. Here we demonstrate that these alkaloids differentially induce a self-structure in single stranded poly(A) using absorbance, thermal melting and differential scanning calorimetry experiments. Jatrorrhizine was found to be more effective than coptisine in binding to poly(A) from spectroscopy and calorimetry data. Molecular modeling results suggested the involvement of more H-bonds in the complexation of the former with poly(A). It appears that the presence of substituents on the alkaloid that can form H-bonding interactions with the adenine nucleotides may play a critical role in the binding and structural rearrangement of poly(A) into the self-structure. The atomic force microscopy data directly visualized the poly(A) self-structured network. We propose a plausible mechanism of the small molecule induced self-structure formation in poly(A). The results presented here may help in the design of effective poly(A) targeted molecules for therapeutic use