RESUMO
LEVEL OF EVIDENCE: Level III-case-control study.
RESUMO
Background: The pins and rubber traction system (PRTS) has proven effective in managing intra-articular fractures of the proximal interphalangeal joint. However, there is scant evidence in the literature regarding its efficacy in treating distal interphalangeal joint (DIPJ). This study aims to investigate the outcomes of PRTS in the treatment of comminuted intra-articular fractures of the DIPJ. Methods: We conducted a retrospective review of patients with comminuted intra-articular fractures of the DIPJ treated with PRTS between 2017 and 2021. At the final follow-up, we measured and compared the active range of motion (ROM) in both affected and non-injured contralateral fingers. The subjective evaluation utilised the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) questionnaire and the Visual Analogue Scale (VAS). Results: Ten patients with a mean follow-up of 13.2 months (range: 12-17) were included in the study. Fracture locations included the base of the distal phalanx in two patients, the condyle of the middle phalanx in seven and both in one patient. At the final follow-up, the average VAS score was 0.5 (range: 0-2). The average active motion of the DIPJ was 61° (range: 50°-70°) for the injured side and 76° (range: 75°-80°) for the opposite side. The mean range of DIPJ movement was 80% (range: 68%-87%) of the non-injured side. Extension deficits were observed in five patients, with a median deficit value of 10° (range: 5°-10°). The average Quick-DASH score was 2.9 (range: 0-11.3). Conclusions: The PRTS can be considered as an effective surgical technique in managing comminuted intra-articular fractures of the DIPJ. Level of Evidence: Level IV (Therapeutic).
Assuntos
Articulações dos Dedos , Fraturas Cominutivas , Fraturas Intra-Articulares , Amplitude de Movimento Articular , Tração , Humanos , Masculino , Feminino , Estudos Retrospectivos , Fraturas Intra-Articulares/cirurgia , Fraturas Intra-Articulares/terapia , Adulto , Articulações dos Dedos/fisiopatologia , Tração/métodos , Fraturas Cominutivas/cirurgia , Fraturas Cominutivas/terapia , Pessoa de Meia-Idade , Pinos Ortopédicos , Adulto Jovem , Traumatismos dos Dedos/terapia , Avaliação da DeficiênciaRESUMO
In an attempt to produce the polyunsaturated fatty acid (PUFA)-enriched glycerides, commercially available Turkish anchovy oil (PUFA content of 27%), was hydrolyzed with 1,3-specific Rhizomucor miehei lipase. After the hydrolysis, the triglyceride (TG), diglyceride (DG), monoglyceride (MG), and free fatty acid (FFA) composition of the reaction mixture was determined, and fatty acid components of these fractions were analyzed. R. miehei lipase released PUFA extremely slowly, resulting in their accumulation in the TG and DG fractions, especially in TG. The PUFA content in the glyceride mixture (including TG, DG, and MG) increased as hydrolysis progressed. The effects of operational parameters (pH, temperature, time, and enzyme concentration) on the extent of hydrolysis were investigated. Based on these results, optimal reaction conditions were established. At optimal conditions (pH 4.0, 35 degrees C, 3 h, and enzyme concentration of 500 U/g oil), the level of PUFA in the glyceride mixture was raised to 40%. The individual TG and DG fractions contained 45 and 30% PUFA, respectively. Less than 2% of the total PUFA was lost in the FFA fraction.