Decreasing Complications of Quadricepsplasty for Knee Contracture after Femoral Fracture Treatment with an External Fixator: Report of Four Cases

Introduction: In performing quadricepsplasty for contracture that develops after application of an external fixator for femoral fractures, surgeons must be aware of the potential risk for re-fracture and pin-related problems. The purpose of this report is to highlight these not well-detailed complications and to discuss specific findings and treatment suggestions.Case Report: 4 men (mean age, 40 years) presenting with secondary to contracture that developed after application of an external fixator for femoral fractures were included in this study. The radiographs showed union across the fracture site however two of these patients couldn't stand on one leg raising suspicion about the union status. A computed tomographic image indeed demonstrated limited continuity of the cortex. Bone grafting was performed prior to quadricepsplasty. The mean extension and flexion before the quadricepsplasty were 0o and 570 , respectively. At the final follow-up examination, the mean active flexion of the knee had increased to 98o.Results: The incidence of re-fracture during and after quadricepsplasty has been reported to be between 10 and 25%. There are 2 preoperative features that may mislead surgeons into believing that complete union of the fractures has been attained: one is the patient's ability to stand on a single leg, and the other is the fact that plain radiographs may lend themselves to different interpretations. In such cases, computed tomography will provide evidence of the continuity of the cortical bone. Bone grafting in 2 of our patients is thought to have prevented the postoperative complications of re-fracture. Complications at pin sites induce contracture at surrounding structures. When extreme tightness of the skin is noted, a tension-releasing procedure such as a skin graft should be performed.Conclusion: In conclusion, re-fracture or pin-site contracture should be carefully managed before quadricepsplasty, because the patients who need a lengthy application of an external fixator experience greater difficulty in bone healing and have more soft tissue damag

Immunostaining of the rat jejunal (A–E) and ileal (F–J) mucosae with anti-mucin monoclonal antibody PGM34

Small-bowel tissues were obtained from control rats (A, F), rats treated with 5-fluorouracil (5-FU) alone (B, G), rats treated with omeprazole (Ome)+5-FU (C, H), rats treated with lansoprazole (Lan)+5-FU (D, I), and rats treated with lafutidine (Laf)+5-FU (E, J). Notice that goblet cells in the jejunum and ileum show positive staining with PGM34. Original magnification ×25.<p><b>Copyright information:</b></p><p>Taken from "Effects of acid antisecretory drugs on mucus barrier of the rat against 5-fluorouracil-induced gastrointestinal mucositis"</p><p></p><p>Scandinavian Journal of Gastroenterology 2008;43(5):531-537.</p><p>Published online Jan 2008</p><p>PMCID:PMC2430178.</p><p></p

Immunostaining of the gastric corpus (A–E) and antral (F–J) mucosae with anti-mucin monoclonal antibodies

Gastric tissues were obtained from control rats (A, F), rats treated with 5-fluorouracil (5-FU) alone (B, G), rats treated with omeprazole (Ome+ 5-FU (C, H), rats treated with lansoprazole (Lan)+5-FU (D, I), and rats treated with lafutidine (Laf)+5-FU (E, J). Notice that surface epithelial mucus cells in the corpus show positive staining with RGM21, and those in the antrum show positive staining with RGM26. Original magnification ×25.<p><b>Copyright information:</b></p><p>Taken from "Effects of acid antisecretory drugs on mucus barrier of the rat against 5-fluorouracil-induced gastrointestinal mucositis"</p><p></p><p>Scandinavian Journal of Gastroenterology 2008;43(5):531-537.</p><p>Published online Jan 2008</p><p>PMCID:PMC2430178.</p><p></p

Influence of acid antisecretory agents on the gastric corpus mucin accumulation in the 5-FU-induced gastric mucosal damage

Fr-1 hexose values corresponding to mucin content are expressed as micrograms of hexose per rat and represent means ± SD. Abbreviations: 5-FU = 5-fluorouracil; Ome = omeprazole; Lan = lansoprazole; Laf = lafutidine. = 6–9 (each group); * < 0.05.<p><b>Copyright information:</b></p><p>Taken from "Effects of acid antisecretory drugs on mucus barrier of the rat against 5-fluorouracil-induced gastrointestinal mucositis"</p><p></p><p>Scandinavian Journal of Gastroenterology 2008;43(5):531-537.</p><p>Published online Jan 2008</p><p>PMCID:PMC2430178.</p><p></p

Influence of acid antisecretory agents on the jejunal (A) and ileal (B) mucin accumulation in the 5-FU-induced small-bowel mucosal damage

Fr-1 hexose values corresponding to mucin content are expressed as micrograms of hexose per rat and represent means±SD. Abbreviations: 5-FU = 5-fluorouracil; Ome = omeprazole; Lan = lansoprazole; Laf = lafutidine. = 6–9 (each group); *<p><b>Copyright information:</b></p><p>Taken from "Effects of acid antisecretory drugs on mucus barrier of the rat against 5-fluorouracil-induced gastrointestinal mucositis"</p><p></p><p>Scandinavian Journal of Gastroenterology 2008;43(5):531-537.</p><p>Published online Jan 2008</p><p>PMCID:PMC2430178.</p><p></p