Elastic stable intramedullary nailing versus Kirschner wire in the treatment of pediatric metaphyseal-diaphyseal junction fractures of the distal radius: a case-control study.

BACKGROUND: Several methods have been used for the treatment of pediatric distal radius fractures, such as the elastic stable intramedullary nail (ESIN), Kirschner wire (K-wire), and plate, but there has been no consensus about the optimum method. The purpose of this study was to compare ESIN and K-wire techniques used in metaphyseal-diaphyseal junction (MDJ) fractures of the pediatric distal radius. METHODS: The data of patients who were treated at a children's hospital affiliated with Shandong University between August 2018 and January 2022 were analyzed retrospectively. The children were divided into the ESIN and K-wire groups. Clinical outcomes were measured by the Gartland and Werley scoring system. Variables were analyzed using a statistical approach between the two groups. RESULTS: The study included 26 patients, of whom 11 were treated with K-wire and 15 with ESIN. At the final follow-up, all of the fractures were healed. There were no differences in terms of age, sex, fracture location, or wrist function score. However, the ESIN was superior to K-wire in operative time, fluoroscopic exposure, and estimated blood loss (EBL). CONCLUSIONS: K-wire and ESIN are both effective methods in the treatment of MDJ fractures of the pediatric distal radius. The use of the ESIN technique represents less EBL, fluoroscopy exposure, and operation time compared with K-wire. We recommend osteosynthesis by ESIN rather than K-wires in patients with MDJ fractures of the distal radius. LEVEL OF EVIDENCE: III, a case-control study.

The Liexi fauna: a new Lagerstätte from the Lower Ordovician of South China.

The Ordovician Lagerstätten record substantial amounts of excellent preservation and soft-bodied fossils during the Great Ordovician Biodiversification Event (GOBE). However, few Lagerstätten are known from the Lower Ordovician, most of which are preserved in restricted environments and high-latitude regions. Here, we report on a new tropical Lagerstätte, Liexi fauna, which has been recently discovered from a carbonate succession within the Lower Ordovician Madaoyu Formation in western Hunan, South China. It contains a variety of soft tissues, as well as rich shelly fossils, including palaeoscolecidan worms, possible Ottoia, trilobites, echinoderms, sponges, graptolites, polychaetes, bryozoans, conodonts and other fossils. The fauna includes taxa that are not only Cambrian relics, but also taxa originated during the Ordovician, constituting a complex and complete marine ecosystem. The coexistence of the Cambrian relics and Ordovician taxa reveals the critical transition between the Cambrian and Palaeozoic Evolutionary faunas. The unusual Liexi fauna provides new evidence for understanding Ordovician macroevolution and the onset of the GOBE.

Barium enema findings in total colonic aganglionosis: a single-center, retrospective study.

BACKGROUND: Preoperative diagnosis of total colonic aganglionosis is important for the rational choice of treatment. The present study aimed to evaluate the diagnostic performance of radiographic signs on preoperative barium enema in patients with total colonic aganglionosis. METHODS: Forty-four patients [41 (3-659) days] with total colonic aganglionosis, including 17 neonatal patients, who received preoperative barium enema at Beijing Children's Hospital, from January 2007 to December 2019 were included. All radiographs were retrospectively restudied by 2 pediatric radiologists to ascertain radiographic signs including rectosigmoid index, transition zone, irregular contraction, gas-filled small bowel, microcolon, question-mark-shaped colon and ileocecal valve reflux. Kappa test was performed to assess the accuracy and consistency of the radiographic signs. RESULTS: The 2 radiologists showed slight agreement for gas-filled small bowel, microcolon and rectosigmoid index, fair agreement for transition zone and irregular contraction, and moderate agreement for question-mark-shaped colon and ileocecal valve reflux (Kappa values, 0.043, 0.075, 0.103, 0.244, 0.397, 0.458 and 0.545, respectively). In neonatal patients, the 2 radiologists showed moderate agreement for ileocecal valve reflux and substantial agreement for question-mark-shaped colon (Kappa values, 0.469 and 0.667, respectively). In non-neonatal patients, the 2 radiologists showed substantial agreement for ileocecal valve reflux (Kappa value, 0.628). In 36 patients with total colonic aganglionosis extending to the ileum, the accuracies of question-mark-shaped colon, ileocecal valve reflux and the combination of both were 47%, 53%, and 75%, respectively, in one radiologist and 53%, 50% and 72%, respectively, in the other radiologist. CONCLUSIONS: Ileocecal valve reflux is a relatively reliable radiographic sign for diagnosing total colonic aganglionosis and could improve the diagnostic accuracy upon combination with question-mark-shaped colon.

CT and MRI Features of Hairy Polyps in Neonates and Infants: A Retrospective Study of 14 Patients.

BACKGROUND: The typical imaging findings of hairy polyps have been described mostly in case reports. This study was conducted to describe the CT and MRI features of hairy polyps and their common associated abnormalities. METHODS: Medical records of 14 patients with pathological diagnosis of hairy polyps were collected for this study. For each patient, the medical records, including demographics, clinical manifestations, and imaging findings were reviewed. RESULTS: The female-to-male ratio was 3.7:1. The age at first episode varied from birth to 2.7 years. The masses were derived from the back side of the soft palate in seven (50.0%) cases, from the lateral pharyngeal wall in four (28.6%) cases, from the soft palate in one (7.1%) case, from the nasal vestibule in one (7.1%) case, and from the parapharyngeal space in one (7.1%) case. A total of 11 (78.6%) cases presented with pedicled masses containing fat and a central core of soft tissue, there were 3 (21.4%) cases whose imaging findings were atypical, and there were 6 (42.9%) patients who had other pathologies. CONCLUSIONS: Hairy polyps typically presented as pedicled masses containing fat and a central core of soft tissue, but sometimes their imaging findings can be atypical and they can be associated with other congenital abnormalities. CT and MRI are reliable methods for the diagnosis of hairy polyps and their associated abnormalities.

Stable ocean redox during the main phase of the Great Ordovician Biodiversification Event.

The Great Ordovician Biodiversification Event (GOBE) represents the greatest increase in marine animal biodiversity ever recorded. What caused this transformation is heavily debated. One hypothesis states that rising atmospheric oxygen levels drove the biodiversification based on the premise that animals require oxygen for their metabolism. Here, we present uranium isotope data from a Middle Ordovician marine carbonate succession that shows the steepest rise in generic richness occurred with global marine redox stability. Ocean oxygenation ensued later and could not have driven the biodiversification. Stable marine anoxic zones prevailed during the maximum increase in biodiversity (Dapingian-early Darriwilian) when the life expectancy of evolving genera greatly increased. Subsequently, unstable ocean redox conditions occurred together with a marine carbon cycle disturbance and a decrease in relative diversification rates. Therefore, we propose that oceanic redox stability was a factor in facilitating the establishment of more resilient ecosystems allowing marine animal life to radiate.