Late Recognized Vascular Injury after High-energy Fracture of the Proximal Tibia: a Pitfall to Know in Current Practice

Failure to recognize associated soft-tissue injuries after high-energy proximal tibia fractures is not uncommon. Despite the progress in managing these complex injuries, a prompt diagnosis of associated arterial injuries still remains difficult. A high index of suspicion for arterial damages is nevertheless mandatory in these severe fractures. Treatment protocols have been developed to reduce the previously reported high rates of amputation and permit an optimal management of soft-tissue and an acceptable functional outcome. We report here a well-documented case of a severely displaced proximal tibia fracture that illustrates the problem of diagnosing and managing the associated vascular injurie

Operative Treatment of an Atypical Segmental Bipolar Fracture of the Clavicle

Introduction: Clavicle fractures are very common, accounting for approximately 4% of all adult fractures. Segmental bipolar fractures involving the lateral and the medial ends of the clavicle are extremely rare, with only isolated cases reported in the literature. The injury mechanism is often unclear and the management of these fractures remains controversial. Case presentation: Here is to report a case of a segmental bipolar fracture of the clavicle with a lateral fracture and a displaced medial fracture without dislocation of the sternoclavicular joint following a low energy fall to the outstretched hand, and discuss its management. Conclusions: Stability of the clavicle is crucial for shoulder function and care should be taken not to miss or underestimate segmental bipolar fractures even with a low energy mechanism. Authors believe that operative treatment should be taken into consideration for displaced fractures

The role of legislation and management practices in the coal mining industry on the Olifants River catchment, South Africa

The economic development of South Africa has relied heavily on coal mining and water quality is adversely affected by mining - thus coal mining poses a significant risk to South Africa’s water resources. Ensuring judicious use and management of natural capital is always a complex undertaking but the benefits to the mining industry and society as a whole, derived from thoroughly laid-out plans, a supportive but strict regulatory environment and decision-making processes based on sound, scientific information are immense. Value addition to mining products is important to promote conservation of assets and resources. Using the Olifants Water Management Area as a case study, the chemistry of groundwater associated with coal mining was characterised. General concepts regarding the relationship of geology to water chemistry are surmised. CopyrightDissertation (MSc)--University of Pretoria, 2012.Geologyunrestricte

Les formes de communication des chartreuses de Franconie avec leur ordre et leur environnement 1328-1525

Nova Cella de Grünau, Cella Salutis de Tückelhausen, Hortus Angelorum de Wurtzbourg, Cella Beatae Mariae de Nuremberg, Pontis Mariae d'Astheim et enfin Hortus Mariae d'Ilmbach sont les six chartreuses fondées en Franconie, région morcelée en multiples seigneuries et centres urbains. La Franconie est-elle une réalité pour l’ordre des Chartreux des XIVe et XVe siècles ? Ce sont d’abord l’historiographie de l’ordre des chartreux ainsi que celle de la Franconie qui doivent être confrontées dans le but d’identifier cet objet de recherche finalement assez peu évident. Plusieurs mécanismes institutionnels cartusiens sont ensuite décortiqués afin de mettre en perspective le fonctionnement de l’ordre sur un territoire clairement défini. Enfin l’étude de l’appropriation de l’observance par les Franconiens expose les modalités de l’insertion des chartreuses dans leur environnement immédiat.The purpose of this work is to analyse in which way the six charterhouses of Franconia could be regarded as a coherent ensemble, and if it is possible to recognize a franconian identity of the Carthusian monks. The territory of the Land zu Franken is contested since the contemporaries tend to define the territory according to their private interests. The order of the Carthusian monks settles tardily in Franconia. They propose a renewal of the contemplative orders which were so far incarnated by the Benedictines and Cistercians whose expansion finishes at the end of 13th century. A study of the institutional mechanisms of the order, accompanied by a prosopography of the officers of the area shows that the monks of Franconia fit within the border framework of the province of lower Germany. The officers, by their displacements limited within the area of the province, build the network between the communities and thereby provide a structure of lower Germany. The process of foundation shows that the order of the Carthusians is used by the founders with an aim of representation of their might which explains why the houses are joined together in the valley of the Main, where the lordships stand in a fierce competition. The funerary liturgy of the Carthusians also explains the choices of the founders for this observance, since some monasteries become places of burials. Finally, the relations of the franconian Carthusians with the world are considered by their literary activities, as well as by their engagement in the beginning of the Reformation.Unter der Bezeichnung fränkische Kartausen versteht man eine Gruppe von sechs Klöstern, die zwischen 1328 und 1453 gestiftet wurden: Nova Cella in Grünau (1328), Cella Salutis in Tückelhausen (1348), Hortus Angelorum in Würzburg (1350), Cella Beatae Mariae in Nürnberg (1380), Pontis Mariae in Astheim (1409) und Hortus Mariae in Ilmbach (1453). Diese Bezeichnung wird vor allem durch die heutige Vorstellung des fränkischen Raumes geprägt: Bilden die Kartäuser von Franken im Mittelalter tatsächlich eine einheitliche zu untersuchende Gruppe? Lässt sich von einem Gruppenbewusstsein der fränkischen Kartäuser sprechen, wenngleich die Verwendung des Begriffs Identität im Mittelalter Schwierigkeiten mit sich bringt? Ist es möglich, dass die fränkischen Kartausen vom Orden selbst als solche verstanden wurden oder handelt es sich um eine, dem kartäusischen System fremde Konstruktion

Radial nerve palsy after the use of an adjuvant hinged external fixator in a complex fracture-dislocation of the elbow: a case report and review of the literature.

The combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture is known as "terrible triad" injury of the elbow. This injury is one of the most challenging injuries of the musculoskeletal system and almost always causes instability of the elbow. The use of an adjuvant hinged external fixator in such injuries is still debated. In this case report we present a case of radial nerve palsy after setting up an adjuvant hinged external fixator in a complex fracture-dislocation of the elbow. The patient was a 39-year-old white man. A revision of his radial nerve was undertaken at 7 weeks. A radial nerve injury at two levels facing the humeral apex pins was found intraoperatively; the pins were carefully removed and partial nerve grafts done. The functional outcome at 18 months was excellent. This case report highlights that the use of an adjuvant hinged external fixator in complex fracture -dislocation of the elbow is technically demanding and not without risk

Les formes de communication des chartreuses de Franconie avec leur ordre et leur environnement 1328-1525

Nova Cella de Grünau, Cella Salutis de Tückelhausen, Hortus Angelorum de Wurtzbourg, Cella Beatae Mariae de Nuremberg, Pontis Mariae d'Astheim et enfin Hortus Mariae d'Ilmbach sont les six chartreuses fondées en Franconie, région morcelée en multiples seigneuries et centres urbains. La Franconie est-elle une réalité pour l’ordre des Chartreux des XIVe et XVe siècles ? Ce sont d’abord l’historiographie de l’ordre des chartreux ainsi que celle de la Franconie qui doivent être confrontées dans le but d’identifier cet objet de recherche finalement assez peu évident. Plusieurs mécanismes institutionnels cartusiens sont ensuite décortiqués afin de mettre en perspective le fonctionnement de l’ordre sur un territoire clairement défini. Enfin l’étude de l’appropriation de l’observance par les Franconiens expose les modalités de l’insertion des chartreuses dans leur environnement immédiat.The purpose of this work is to analyse in which way the six charterhouses of Franconia could be regarded as a coherent ensemble, and if it is possible to recognize a franconian identity of the Carthusian monks. The territory of the Land zu Franken is contested since the contemporaries tend to define the territory according to their private interests. The order of the Carthusian monks settles tardily in Franconia. They propose a renewal of the contemplative orders which were so far incarnated by the Benedictines and Cistercians whose expansion finishes at the end of 13th century. A study of the institutional mechanisms of the order, accompanied by a prosopography of the officers of the area shows that the monks of Franconia fit within the border framework of the province of lower Germany. The officers, by their displacements limited within the area of the province, build the network between the communities and thereby provide a structure of lower Germany. The process of foundation shows that the order of the Carthusians is used by the founders with an aim of representation of their might which explains why the houses are joined together in the valley of the Main, where the lordships stand in a fierce competition. The funerary liturgy of the Carthusians also explains the choices of the founders for this observance, since some monasteries become places of burials. Finally, the relations of the franconian Carthusians with the world are considered by their literary activities, as well as by their engagement in the beginning of the Reformation.Unter der Bezeichnung fränkische Kartausen versteht man eine Gruppe von sechs Klöstern, die zwischen 1328 und 1453 gestiftet wurden: Nova Cella in Grünau (1328), Cella Salutis in Tückelhausen (1348), Hortus Angelorum in Würzburg (1350), Cella Beatae Mariae in Nürnberg (1380), Pontis Mariae in Astheim (1409) und Hortus Mariae in Ilmbach (1453). Diese Bezeichnung wird vor allem durch die heutige Vorstellung des fränkischen Raumes geprägt: Bilden die Kartäuser von Franken im Mittelalter tatsächlich eine einheitliche zu untersuchende Gruppe? Lässt sich von einem Gruppenbewusstsein der fränkischen Kartäuser sprechen, wenngleich die Verwendung des Begriffs Identität im Mittelalter Schwierigkeiten mit sich bringt? Ist es möglich, dass die fränkischen Kartausen vom Orden selbst als solche verstanden wurden oder handelt es sich um eine, dem kartäusischen System fremde Konstruktion