Notes

Review in the phytochemical report and also anti-oxidant activities associated with eight kiwi fruit (Actinidia arguta (Siebold & Zuccarini) Miquel) types within Cina.
To determine the incidence of iatrogenic peroneal nerve palsy after application of an intraoperative lateral distractor during open reduction and internal fixation of tibial plateau fractures.

Retrospective review.

Single academic Level I trauma center.

One hundred forty-seven patients met criteria and were included in the study.

Patients with unicondylar and bicondylar tibial plateau fractures underwent open reduction and internal fixation and received application of an intraoperative lateral distractor to aid in visualization and reduction of the impacted lateral plateau.

Incidence of iatrogenic peroneal nerve palsy.

There was a 2.0% incidence of iatrogenic peroneal nerve symptoms (3 of 147 patients), most of which were incomplete sensory deficits. There was no association with staged external fixation, regional anesthesia, or tourniquet use.

Use of G418 is safe and has a low incidence of iatrogenic peroneal nerve palsy if applied carefully.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
To compare the complication profile of femoral neck (FN) and intertrochanteric (IT) femur fractures in young patients.

Retrospective Database Review SETTING Large, national private insurer claims database with longitudinal follow-up PATIENTS Individuals undergoing surgical fixation of IT or FN fractures from 2010-2017 were identified. Patients were included if they were 18-50 years of age and had 1-year postoperative follow-up. Those with comorbid conditions of chronic kidney disease (CKD), congestive heart failure (CHF), diabetes, or coronary artery disease (CAD) were excluded from the primary analysis.

Complication data, including a diagnosis of nonunion, malunion, avascular necrosis (AVN) or need for revision surgery at 1-year follow-up were compared. Additionally, medical complication data at 90-days post-operatively was evaluated.

In total, 808 patients were identified 392 (48.5%) patients with IT femur fractures and 416 (51.5%) patients with FN fractures. On multivariate analysis, FN fractures hof evidence.
Intra-articular screw cut-out is a common complication after proximal humerus fracture (PHF) fixation using a locking plate. This study investigates novel technical factors associated with mechanical failures and complications in PHF fixation.

A retrospective radiological study.

Level 1 trauma center.

Clinical and radiological data from consecutive PHF patients treated between January 2007 and December 2013 were reviewed.

Open reduction and internal fixation with the Synthes Philos locking plate.

Postoperative radiographs were assessed for quality of initial reduction, humeral head offset, screw length, number and position, restoration of medial calcar support or the presence of calcar screws, and intra-articular screw perforations. Using SliceOMatic software, we validated a method to accurately identify screws of 45 mm or longer on AP radiographs. Follow-up radiographs were reviewed for complications.

Among 110 patients included [mean age 60 years, 78 women (71%), follow-up 2.5 years] and the following factors were associated with a worse outcome. (1) Screws >45 mm in proximal rows [Odds Ratio (OR) = 5.3 for screw cut-out); (2) lateral translation of the humeral diaphysis over 6 mm (OR = 2.7 for loss of reduction); (3) lack in medial support by bone contact (OR = 4.9 for screw cut-out); (4) varus reduction increased the risk of complications (OR = 4.3).

The importance of reduction and calcar support in PHF fixation is critical. This study highlights some technical factors to which the surgeon must pay attention avoid varus reduction, maximize medial support, avoid screws longer than 45 mm in the proximal rows, and restore the humeral offset within 6 mm or less.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
To compare the deep infection rates following immediate versus staged open reduction internal fixation (ORIF) for pilon fractures.

Retrospective cohort study.

Three Academic Level One Trauma Centers.

401 patients with closed OTA/AO type 43C distal tibia fractures treated with ORIF. 66% were male, mean age was 45.6. Median (Interquartile Range) follow-up was 1.7 (1.0-3.7) years.

Acute, primary (<24 hours) versus delayed, staged ORIF (>24 hours).

Deep infection or wound complication as defined by return to OR for surgical irrigation and debridement.

Patients were grouped by time from presentation to surgery acute ORIF (n=99) and delayed ORIF (n=302). Acute ORIF was more frequent in patients with OTA/AO type 43C1 fractures, low-energy mechanisms (i.e. fall from standing), younger and female patients. Patients who demonstrated severe swelling (242, 80%), swelling and fracture blisters (26, 9%), swelling and ecchymosis precluding planned surgical approach (4, 1%), polytrauma requiring resuscitaplafond fractures. If early definitive fixation is considered, extreme care should be taken to carefully evaluate the soft tissue envelope and assess for other risk factors (such as age, male gender, smokers, diabetics, and those with higher energy fracture patterns) that may predispose the patient to a post-operative soft tissue infection. #link# Our study has shown that the judicious use of early definitive fixation in closed pilon fractures, in the appropriate patient, and with careful evaluation of the soft tissue envelope, is likely safe and does not appear to increase the risk of wound complications and deep infection in the hands of experienced fracture surgeons.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Website: https://www.selleckchem.com/products/geneticin-g418-sulfate.html