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Shoulder damage linked to Sinovac COVID-19 vaccine: In a situation record.
The aim of this study was to evaluate volumetric changes of the posterior airway space (PAS) following bimaxillary surgery using a high oblique sagittal split osteotomy (HSSO) of the mandibular ramus. The cone beam CTs of Class II and Class III patients taken before (T0) and 6-12 months after surgery (T1) were analyzed using 3D software (Mimics® Innovation Suite 18.0). The PAS was divided into three segments (superior, middle, inferior) by three planes parallel to the Frankfurt horizontal plane intersecting at the posterior nasal spine, the velum palatinum and the epiglottis. Total (TPAS) and partial volumes (SPAS = superior, MPAS = middle, IPAS = inferior) were calculated. For the 25 Class II patients, a highly significant increase (p less then 0.001) of the total, middle and inferior airway space (TPAS +33.6%, MPAS +43.1%, IPAS +55.9%) was found, while the increase of the upper airway space was statistically not significant (+5.4%, p = 0.074). For the 28 Class III patients, the total, middle and inferior airway space increased statistically insignificantly (TPAS +4.6%, p = 0.265, MPAS +2.7%, p = 0.387, IPAS +2.8%, p = 0.495), while the increase of the upper airway space was statistically significant (+9.7%, p = 0.010). Bimaxillary orthognathic surgery using the HSSO technique led to a significant increase of PAS for Class II patients and could conserve the PAS for Class III patients.
Open surgical tracheotomy performed beside (STB) is a standardized procedure in critical ill patients. The aim of the study was to evaluate perioperative complications and the safety of STB in a tertiary care university hospital setting.

Intra- and postoperative complications were retrospectively recorded and associations based on the evaluation of clinical and laboratory parameters were studied using regression analyses.

A total of 562 patients were included. Early tracheotomy shortened ventilation time after tracheotomy (ventilation before STB≤5 days mean 9.2±9.1 days; ventilation before STB≥6 days mean 11.5±10.5 days, p=0.0001). Overall complications were found in 30/562 cases (5.3%), major complications in 12/562 cases (2.1%). Significant risk factors for overall tracheotomy related complications were higher body mass index (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01-1.07, p=0.02), lower CRP (OR 0.99, CI 0.99-1.00, p=0.03), higher INR (OR 5.67, CI 1.27-25.34, p=0.02), longer duration of operation (OR 1.03, CI 1.00-1.06, p=0.04) and tracheotomy during extracorporeal membrane oxygenation (ECMO) support (OR 6.26, CI 1.21-32.44, p=0.03).

STB represents a safe surgical procedure, also suitable for patients with an increased risk profile. Careful evaluation of individual risk factors should be favored to reduce procedure related complications.
STB represents a safe surgical procedure, also suitable for patients with an increased risk profile. Careful evaluation of individual risk factors should be favored to reduce procedure related complications.The purpose of this study was to explore the rotational effect of scarf osteotomy with transarticular lateral release (TALR) on hallux valgus correction. From January 2016 to January 2018, 28 consecutive patients (30 feet) were included in this study. The first intermetatarsal angle (IMA), hallux valgus angle (HVA), and round-shaped lateral edge of the first metatarsal head (R sign), and sesamoid rotation angle (SRA) were recorded prior to and 3 months after the surgery. The rotation of the capital fragment of the first metatarsal was termed the capital rotation angle (CRA) and was measured intraoperatively after the completion of scarf osteotomy. The IMA, HVA, and SRA were significantly reduced from 13.9 ± 4.9°, 34.6 ± 7.4°, and 28.7 ± 9.8° to 2.4 ± 2.3°, 7.3 ± 4.7°, and 13.4 ± 8.8°, respectively (p .05). The R sign was positive in 40% (12/30) of the feet preoperatively compared to 13.3% (4/30) postoperatively (p less then .001). Scarf osteotomy produced a supination effect on the capital fragment of the first metatarsal and supinated the sesamoids via lateral translation of the first metatarsal head. These changes may contribute to the correction of the pronation component of hallux valgus deformity.Pilon fractures with intact fibula have been associated with low-energy trauma. However, the compression force onto the ankle joint can damage the tibiofibular linkage as in a Maisonneuve fracture. Herein, we describe a case of a patient who had a pilon fracture (AO type 43 C3.2) without a fibular fracture. Three-dimensional preoperative simulation by reduction with the surface registration technique was performed as the fibular length was intact and there was no reference for the tibial length. The preoperative simulation revealed superior fibular head dislocation and shortening of the distal tibia. After emergency external fixation on the day of arrival, a 2-staged surgery was performed. During the first operation, the fibular head was reduced and the tibial posterolateral fragment was fixed to restore the tibia length. During the second operation, medial and anterolateral fragments were fixed in order to reduce joint surface of the distal tibia. In general, proximal fibular head fractures are easily overlooked. In the case of pilon fractures with severe length shortening of the tibia without a fibular fracture, a proximal tibiofibular injury should be suspected.Hallux rigidus can be treated with a proximal hemiarthroplasty (HemiCAP®) to preserve the motion in the first metatarsophalangeal joint and reduce pain. This study examines the functionality, and survival rates of HemiCAP® implants, with or without a dorsal flange. One hundred and five patients were treated with a HemiCAP® (N = 116 HemiCAPs®) between 2006 and 2014. Revision rates, arthrosis score, hallux valgus (HV), intermetatarsal (IM), distal metaphyseal articular angle (DMAA), visual analog scale (VAS) (1-10 points), American Orthopaedic Foot and Ankle Score (AOFAS) MTP-IP (AOFAS 0-100 points), SF-12, range of motion (ROM), and radiographs were analyzed pre- and postoperatively. Statistics Kaplan-Meier survival analysis, Cox-regression, and paired t tests. At 2, 4, and 6 years, the implant survival was 87%, 83%, and 81%, respectively. All revised due to pain. Dorsal flange, gender, arthrosis, HV, IM, and DMAA did not influence the results. selleck kinase inhibitor At the mean 5-year follow-up (n = 47) median (range) dorsal ROM was 45° (10°-75°), AOFAS was mean 87.
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