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1.
Appl Opt ; 63(13): 3570-3575, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38856542

RESUMEN

Inspired by the demodulation algorithm of Fabry-Perot composite sensors in the field of fiber-optic sensing, this paper proposes a method based on a widely tunable modulated grating Y-branch (MG-Y) laser combined with the cross-correlation algorithm to achieve a highly precise measurement of the optical thickness of each layer of a multilayer optical sample. A sample consisting of a double glass stack was selected, and the interference spectrum of the stacked sample was acquired using a widely tunable MG-Y laser. A fast Fourier transform (FFT) algorithm combined with a finite impulse response (FIR) bandpass filter was utilized to separate the different frequency components of the multilayer optical sample. The normalized spectra of each layer were reconstructed using the Hilbert transform. Subsequently, a cross-correlation algorithm was employed to process the normalized spectrum and determine the optical thickness of each layer with high precision. The samples were measured at predetermined locations, with 150 consecutive measurements performed to assess the repetition of the thickness. The standard deviation of these measurements was found to be lower than 1.5 nm. The results show that the cross-correlation algorithm is advantageous in the optical thickness measurement of multilayer films.

2.
Artículo en Inglés | MEDLINE | ID: mdl-38521483

RESUMEN

BACKGROUND: Locking plates are widely used in open reduction internal fixation (ORIF) for proximal humeral fracture (PHF). However, the optimal surgical treatment of unstable, displaced PHF in elderly patients remains controversial. This study aimed to compare the radiological and clinical outcomes of surgical treatment of PHF in the elderly with locking plate (LP) alone and locking plate combined with 3D printed polymethylmethacrylate (PMMA) prosthesis augmentation (LP-PA). METHODS: From May 2015 to April 2021, a total of 97 patients aged ≥ 60 years with acute unstable PHF who underwent osteosynthesis with either LP (46 patients) or LP-PA (51 patients) were retrospectively analyzed. For the LP-PA group, a customized proximal humeral prosthesis made of PMMA cement was intra-operatively fabricated by a three-dimensional (3D) printed prototype mold for the humeral medial support. Radiological outcomes were analyzed by measuring the value of neck-shaft angle (NSA) and humeral head height (HHH). The clinical outcomes were evaluated using Constant-Murley Score (CMS), Disabilities of the Arm Shoulder and Hand (DASH) score, American Shoulder and Elbow Surgeons (ASES) score, and the shoulder range of motion (ROM). Pain was measured using a visual analogue scale (VAS). RESULTS: At the one-year follow-up, all fractures healed radiologically and clinically. The mean changes of NSA and HHH over the follow-up period were markedly smaller in the LP-PA group (3.8 ± 0.9° and 1.7 ± 0.3 mm) than those in the LP group (9.7 ± 2.1° and 3.2 ± 0.6 mm, both P < 0.0001). The LP-PA group also presented lower DASH score (17.1 ± 3.6), higher ASES score (89.5 ± 11.2) and better ROM in forward elevation (142 ± 26°) and external rotation (59 ± 11°) compared to the LP group (28.9 ± 4.8 for DASH score, P < 0.0001; 82.3 ± 9.0 for ASES score, P < 0.001; 129 ± 21° for forward elevation, P = 0.008; and 52 ± 9° for external rotation, P = 0.001). There was no significant difference in overall complication rate between the two groups, although the complication rate of screw perforation was higher in the LP-PA group (P = 0.172). CONCLUSIONS: For PHF in elderly patients, the combination of LP fixation and PMMA prosthesis augmentation effectively improved humeral head support and reduction maintenance, providing satisfactory outcomes both radiologically and clinically. This technique also reduced the incidence of screw perforation associated with plate fixation alone, making it a reasonable option to ensure satisfactory clinical outcomes.

3.
Appl Opt ; 61(10): 2552-2557, 2022 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-35471322

RESUMEN

Experiment observations show that the spectra of Brillouin dynamic gratings in polarization-maintaining fibers based on a polarization decoupled scheme are quite broad and usually have multiple peaks. In this paper, we measure the birefringence distribution along polarization-maintaining fibers with high spatial resolution using optical frequency-domain reflectometry. Based on birefringence measurements, both the simulation and experiment are carried out to determine the spectra of Brillouin dynamic gratings generated within the same polarization-maintaining fibers, indicating quantitatively that spectral broadening and irregularity are mainly due to phase mismatch caused by the non-uniformity of birefringence along polarization-maintaining fibers.

4.
J Hand Surg Am ; 47(6): 583.e1-583.e9, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34563414

RESUMEN

PURPOSE: Infected forearm nonunion remains a challenge for the hand surgeon. Autologous bone grafting within an induced membrane following implantation of a cement spacer, also known as the Masquelet technique, is a procedure used for addressing segmental bone defects. This report summarized our experience using this technique to treat the infected forearm nonunion. METHODS: We retrospectively reviewed a series of 32 patients treated for infected forearm nonunion by the 2-stage Masquelet technique between 2009 and 2018. There was an infected nonunion of the ulna in 28 patients and an infected nonunion of the radius in 4 patients. All patients had undergone an average of 2.7 procedures before presenting at our institution. Treatment involved a staged procedure in which an antibiotic-impregnated cement spacer was implanted into the bone defect following debridement without internal fixation. It was left in place for 4-6 weeks, during which time a membrane formed around the cement spacer. In the second stage, the induced membrane was incised, and the cement spacer was removed. The defect was then filled with cancellous autograft with the addition of internal fixation. Postoperative radiographs were taken for the evaluation of bone healing. The functional results of the affected forearm were evaluated for motion loss of elbow or wrist and rotation loss of forearm. RESULTS: All nonunions healed without recurrent infection or loosening of internal fixation at the time of final follow-up. All the patients showed substantial functional improvement, with excellent results in 14 patients, satisfactory results in 13, and unsatisfactory results in 5. CONCLUSIONS: The induced membrane technique is an effective solution for infected forearm nonunion. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.


Asunto(s)
Fracturas no Consolidadas , Fracturas del Cúbito , Trasplante Óseo/métodos , Antebrazo , Curación de Fractura , Fracturas no Consolidadas/cirugía , Humanos , Estudios Retrospectivos , Resultado del Tratamiento , Fracturas del Cúbito/cirugía
5.
Opt Lett ; 46(19): 4944-4947, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-34598239

RESUMEN

In this Letter, we propose a dynamic fiber-optic white light interferometry (WLI) based on the compressed-sensing (CS) principle. The time-varying interference spectra of a Fabry-Perot cavity under vibration are considered as a two-dimensional (2D) signal with respect to both laser wavelength and time, which can be compressively sampled using a programmable semiconductor laser source during the measurement process. After CS reconstruction, the spectrum acquisition rate is equal to the random wavelength modulation rate, up to 10 MHz in this Letter, providing an attractive alternative to laser-based dynamic interferometry. Numerical simulations and nanometer-scale vibration experiments verify the effectiveness of the scheme.

6.
Opt Lett ; 46(7): 1502-1505, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33793475

RESUMEN

We present a novel, to the best of our knowledge, white light interferometric fiber-optic gyroscope (IFOG) scheme using a fiber-optic rhombic optical path difference (OPD) bias structure to interrogate with a sensing coil to realize rotation rate measurement without a phase modulator. The OPD bias structure composed of four (2×1) 3 dB single-mode fiber couplers was constructed to implement non-reciprocal OPD bias. White light interferometric demodulation was utilized to acquire the change in OPD due to the Sagnac-phase shift. Absolute linear output can be obtained. We produced the principle prototype of rhombic OPD bias white light IFOG without utilizing a phase modulator. An experimental demonstration of the IFOG prototype system achieves linear output with respect to the OPD difference in detecting rotation rate.

7.
Opt Express ; 28(7): 9563-9571, 2020 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-32225562

RESUMEN

In this work, we analyze the signal-to-noise ratio of the computational distributed fiber-optic sensing technique via differential ghost imaging in the time domain using the illumination pattern of Walsh-Hadamard sequences instead of random sequences. When only the white Gaussian noise is considered in the detection, both the theoretical and experimental results show that the computational method requires twice more number of averages compared to the conventional time-domain method in order to achieve the same level of signal-to-noise ratio. Since the computational approach is focusing on stationary measurement, doubling the measurement time can normally be acceptable in practice, but it can reduce the sampling rate requirement significantly compared to the conventional method, offering great advantage to simplify the data acquisition design in the distributed fiber-optic sensing system.

8.
Opt Express ; 27(12): 17069-17079, 2019 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-31252924

RESUMEN

Ghost imaging allows image reconstruction by correlation measurements between a light beam that interacts with the object without spatially resolved detection and a spatially resolved light beam that never interacts with the object. The two light beams are copies of each other. Its computational version removes the requirement of a spatially resolved detector when the light intensity pattern is pre-known. Here, we exploit the temporal analogue of computational ghost imaging, and demonstrate a computational distributed fiber-optic sensing technique. Temporal images containing spatially distributed scattering information used for sensing purposes are retrieved through correlating the "integrated" backscattered light and the pre-known binary patterns. The sampling rate required for our technique is inversely proportional to the total time duration of a binary sequence, so that it can be significantly reduced compared to that of the traditional methods. Our experiments demonstrate a 3 orders of magnitude reduction in the sampling rate, offering great simplification and cost reduction in the distributed fiber-optic sensors.

9.
Opt Lett ; 43(22): 5496-5499, 2018 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-30439879

RESUMEN

A compressed-sensing-technique-based Brillouin optical time-domain analysis is proposed. The Brillouin spectrum has a sparse representation in its discrete cosine transform domain, which can be successfully recovered from far fewer measurements with high probability through an orthogonal matching-pursuit algorithm. This work shows both empirically and experimentally that the amount of frequency acquisitions needed is only 30% of those required by a conventional distributed Brillouin fiber-optic sensing system with 1 MHz frequency increment in the acquisition process to obtain Brillouin spectra along an optical fiber; therefore, the number of acquisitions and the amount of data storage/transfer are greatly reduced. Moreover, the proposed method does not need any hardware modification in an existing sensing system and can also be adopted by Brillouin optical time-domain reflectometry.

10.
Opt Express ; 24(12): 13325-33, 2016 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-27410349

RESUMEN

The leakage light of optical pulses due to finite extinction ratio (ER) of an electro-optic modulator (EOM) leads to Rayleigh backscattered noises over the entire fiber length, and limits spatial resolution and sensing range in phase-sensitive optical time-domain reflectometry (Φ-OTDR). Two configurations are proposed to improve the ER of optical pulses for better spatial resolution over long sensing length. With ER of 55 dB using a nonlinear optical loop mirror, we achieved 2 m spatial resolution over 8.4 km sensing length; while with ER of 60 dB obtained by two cascaded EOMs, we can achieve a 1 m spatial resolution over the same range. Experimental results and analysis show that leakage of the optical pulses acts as a noise floor, which limits the highest spatial resolution over the same sensing range.

11.
Appl Opt ; 55(24): 6735-9, 2016 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-27556996

RESUMEN

Distributed dynamic strain measurement based on optical frequency-domain reflectometry is proposed. The technique makes use of the wide scanning range of a tunable laser source in a short sweeping time, and subdivides the overall spectrum into narrower frequency windows. The advantage of subdividing the laser spectral range is to improve the measurement uncertainty induced by the laser wavelength difference between repeated scans. The noise-limited dynamic strain resolution is investigated experimentally, indicating that a minimum detectable strain is less than 200 nε for a spatial resolution of 20 cm. By measuring the subdivided spectral shifts in the time sequence along the sensing fiber, the dynamic strain can be properly quantified over a 30 m measurement range for a highest sampling rate of up to 50 Hz.

12.
Cell Tissue Bank ; 16(3): 335-42, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25330756

RESUMEN

Mesenchymal stem cells derived from adipose tissue have the capacity to differentiate into endodermal, mesoderm and ectodermal cell lineages in vitro, which are an ideal engraft in tissue-engineered repair. In this study, mouse adipose-derived stem cells (ADSCs) were isolated from subcutaneous fat. The markers of ADSCs, CD13, CD29, CD44, CD71, CD73, CD90, CD105, CD166, Nestin, GFAP and MAP-2 were detected by immunofluorescence assays. The ADSCs were cultured in cocktail factors (including ATRA, GGF-2, bFGF, PDGF and forskolin) for neurogenic differentiation. The neurogenic cells markers, Nestin, GFAP and MAP-2 were analyzed using immunofluorescence and real-time PCR after dramatic changes in morphology. Neurogenic cells from ADSCs were autologous transplanted into the mouse of spinal cord injury for observation neurogenic cells colonization in spinal cord. The result demonstrated that the mouse ADSCs were positive for the CD13, CD29, CD44, CD71, CD73, CD90, CD105 and CD166 but negative for neurogenic cell markers, MAP-2, GFAP and Nestin. After neurogenic differentiation, the neurogenic cells were positive for neurogenic cell special markers, gene expression level showed a time-lapse increase, and the cells were successful colonized into spinal cord. In conclusion, our research shows that a population of neuronal cells can be specifically generated from ADSCs and that induced cells may allow for participation in tissue-repair.


Asunto(s)
Adipocitos/citología , Células-Madre Neurales/citología , Células-Madre Neurales/trasplante , Neurogénesis , Traumatismos de la Médula Espinal/patología , Traumatismos de la Médula Espinal/terapia , Adipocitos/metabolismo , Animales , Diferenciación Celular , Supervivencia Celular , Células Cultivadas , Ratones , Regeneración Nerviosa , Células-Madre Neurales/metabolismo , Traumatismos de la Médula Espinal/metabolismo , Trasplante Autólogo , Resultado del Tratamiento
13.
J Foot Ankle Surg ; 54(6): 1106-10, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26310621

RESUMEN

The present randomized controlled trial was undertaken to evaluate the effect of tranexamic acid (TXA) on reducing postoperative blood loss in calcaneal fractures. A total of 90 patients with a unilateral closed calcaneal fracture were randomized to the TXA (n = 45) and control (n = 45) groups. The corresponding groups received 15 mg/kg body weight of TXA or placebo (0.9% sodium chloride solution) intravenously before the skin incision was made. Open reduction and internal fixation was performed for all patients and selective bone grafting was performed. The patients were examined 3 months after surgery. The intraoperative and postoperative blood loss, blood test results, and wound complications were compared between the 2 groups. The complications of TXA were also investigated. No statistically significant differences were found in the baseline characteristics between the TXA and control groups. Also, no significant difference was noted in the intraoperative blood loss between the 2 groups. However, in the TXA group, the postoperative blood loss during the first 24 hours was significantly lower than that in the control group (110.0 ± 160.0 mL versus 320.0 ± 360.0 mL; p < .001). The incidence of wound complications was also reduced compared with that in the control group (7.3% versus 23.8%; p = .036). No significant difference was found in the incidence of thromboembolic events or adverse drug reactions between the 2 groups. We concluded that preoperative single-dose TXA can effectively reduce postoperative blood loss and wound complications in patients with calcaneal fractures and that no significant side effects developed compared with the control group.


Asunto(s)
Antifibrinolíticos/administración & dosificación , Calcáneo/lesiones , Fijación Interna de Fracturas/efectos adversos , Fracturas Óseas/cirugía , Hemorragia Posoperatoria/prevención & control , Ácido Tranexámico/administración & dosificación , Adulto , Trasplante Óseo , Femenino , Fracturas Óseas/complicaciones , Hematoma/etiología , Humanos , Masculino , Persona de Mediana Edad , Necrosis/etiología , Dehiscencia de la Herida Operatoria/etiología , Infección de la Herida Quirúrgica/etiología
14.
J Foot Ankle Surg ; 53(6): 813-6, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25027623

RESUMEN

Distal tibiofibular syndesmosis injury accounts for 1% to 11% of soft tissue injuries of the ankle. Some acute syndesmotic injuries will fail to heal effectively owing to inadequate treatment or misdiagnosis, eventually resulting in chronic instability, which can destroy the stability of the ankle joint. Various surgical techniques have been described for fixation of the syndesmosis. Among the existing methods, the suture button has the advantage of allowing for physiologic micromotion at the syndesmosis by maintaining the reduction and preventing the risk of screw breakage. However, the "relatively" long suture between buttons can gradually relax under continuous loading, resulting in fixation failure, which we have termed electric wire phenomenon. In the present report, we have described a modified technique for flexible fixation using the Endobutton CL ULTRA fixation device by tricortical fixation, instead of quadricortical fixation, to allow for robust and reliable fixation of the distal tibiofibular syndesmosis. The modified technique is devoid of the concern regarding the use of screw fixation and can reduce the risk of displacement or elongation and skin irritation associated with the suture button.


Asunto(s)
Traumatismos del Tobillo/cirugía , Articulación del Tobillo/cirugía , Inestabilidad de la Articulación/cirugía , Hilos Ortopédicos , Enfermedad Crónica , Fijación Interna de Fracturas/instrumentación , Humanos , Anclas para Sutura
15.
Zhongguo Gu Shang ; 37(4): 406-10, 2024 Apr 25.
Artículo en Zh | MEDLINE | ID: mdl-38664213

RESUMEN

OBJECTIVE: To investigate the efficacy of antibiotic cement column combined with iliac bone graft in the treatment of open fracture with bone defect of distal femur. METHODS: From October 2014 to March 2021, 16 patients of open fracture bone defect of distal femur were treated with antibiotic bone cement column and iliac bone graft, including 12 males and 4 females. The age ranged from 28 to 68 years old. There were 11 cases of traffic accident injury, 5 cases of falling injury, 3 cases as Gustilo type Ⅰ, 5 cases as type Ⅱ and 8 cases as type ⅢA. AO classification was used:9 cases of C2 type and 7 cases of C3 type. The time from injury to final bone grafting ranged from 4 to 119 days. The length of bone defect ranged from 2 to10 cm. Fractures healing time, complications and knee function Merchan score were recorded. RESULTS: All the 16 patients were followed up from 9 to 29 months. The incisions of 16 patients healed in one stage without postoperative infection, plate fracture, limb shortening and valgus and varus deformity. The healing time randed from 4 to 10 months . Knee joint function according to the Merchant scoring standard, showed that 8 cases were excellent, 4 cases were good, 3 cases were fair, and 1 case was poor. CONCLUSION: The use of antibiotic bone cement column combined with iliac bone graft in the treatment of open and complex bone defects of distal femur is an effective surgical method to prevent infection, assist fracture reduction, increase fixation strength and significantly reduce the amount of bone grafting.


Asunto(s)
Antibacterianos , Cementos para Huesos , Trasplante Óseo , Fracturas Abiertas , Humanos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Trasplante Óseo/métodos , Anciano , Fracturas Abiertas/cirugía , Antibacterianos/administración & dosificación , Fémur/cirugía , Fracturas del Fémur/cirugía
16.
Environ Sci Ecotechnol ; 20: 100412, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38560759

RESUMEN

Effective management of large basins necessitates pinpointing the spatial and temporal drivers of primary index exceedances and urban risk factors, offering crucial insights for basin administrators. Yet, comprehensive examinations of multiple pollutants within the Yangtze River Basin remain scarce. Here we introduce a pollution inventory for urban clusters surrounding the Yangtze River Basin, analyzing water quality data from 102 cities during 2018-2019. We assessed the exceedance rates for six pivotal indicators: dissolved oxygen (DO), ammonia nitrogen (NH3-N), chemical oxygen demand (COD), biochemical oxygen demand (BOD), total phosphorus (TP), and the permanganate index (CODMn) for each city. Employing random forest regression and SHapley Additive exPlanations (SHAP) analyses, we identified the spatiotemporal factors influencing these key indicators. Our results highlight agricultural activities as the primary contributors to the exceedance of all six indicators, thus pinpointing them as the leading pollution source in the basin. Additionally, forest coverage, livestock farming, chemical and pharmaceutical sectors, along with meteorological elements like precipitation and temperature, significantly impacted various indicators' exceedances. Furthermore, we delineate five core urban risk components through principal component analysis, which are (1) anthropogenic and industrial activities, (2) agricultural practices and forest extent, (3) climatic variables, (4) livestock rearing, and (5) principal polluting sectors. The cities were subsequently evaluated and categorized based on these risk components, incorporating policy interventions and administrative performance within each region. The comprehensive analysis advocates for a customized strategy in addressing the discerned risk factors, especially for cities presenting elevated risk levels.

17.
Sensors (Basel) ; 13(2): 1836-45, 2013 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-23385406

RESUMEN

A distributed optical fiber sensor with the capability of simultaneously measuring temperature and strain is proposed using a large effective area non-zero dispersion shifted fiber (LEAF) with sub-meter spatial resolution. The Brillouin frequency shift is measured using Brillouin optical time-domain analysis (BOTDA) with differential pulse-width pair technique, while the spectrum shift of the Rayleigh backscatter is measured using optical frequency-domain reflectometry (OFDR). These shifts are the functions of both temperature and strain, and can be used as two independent parameters for the discrimination of temperature and strain. A 92 m measurable range with the spatial resolution of 50 cm is demonstrated experimentally, and accuracies of ±1.2 °C in temperature and ±15 µÎµ in strain could be achieved.

18.
Zhongguo Gu Shang ; 36(6): 574-8, 2023 Jun 25.
Artículo en Zh | MEDLINE | ID: mdl-37366102

RESUMEN

OBJECTIVE: To analyze the clinical outcomes of mini-plate combined with wireforms in the treatment of Type C distal radial fractures with marginal articular fragments. METHODS: This retrospective study included a total of 10 cases, including 5 males and 5 females, with 6 cases involving the left side and 4 cases involving the right side, of Type C distal radial fractures with marginal articular fragments. The age of the patients ranged from 35 to 67 years old. All patients underwent surgical treatment utilizing mini-plate combined with wireforms for internal fixation. RESULTS: The follow-up period ranged from 6 to 18 months. Complete fracture healing was observed in all cases, with healing times ranging from 10 to 16 weeks. During the entire follow-up period, patients reported high levels of satisfaction with the treatment outcomes, and there were no incidences of incision infection, chronic wrist pain, or wrist traumatic arthritis. At the final follow-up assessment, the Mayo score for the wrist joint ranged from 85 to 95, with 7 cases rated as excellent and 3 cases as good. CONCLUSION: Mini-plate combined with wireforms proves to be an effective fixation method for Type C distal radial fractures with marginal articular fragments. The early initiation of wrist joint exercises, strong fixation, maintenance of proper reduction, minimal complications, and high rates of excellent and good outcomes demonstrate the reliability and efficacy of this treatment approach.


Asunto(s)
Fracturas del Radio , Fracturas de la Muñeca , Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Reproducibilidad de los Resultados , Fracturas del Radio/cirugía , Fijación Interna de Fracturas/métodos , Resultado del Tratamiento , Articulación de la Muñeca , Placas Óseas , Rango del Movimiento Articular
19.
Orthop Surg ; 15(1): 266-275, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36331126

RESUMEN

OBJECTIVE: Inferior pole fractures of patella are notorious fractures where it is difficult to obtain rigid internal fixation by conventional methods. The objective of the study was to introduce the Hand Plating System (HPS), which was a novel surgical technique for inferior pole fractures of patella, and to report the radiological and clinical outcomes following the application of the surgical technique. METHODS: The study was designed as a retrospective cohort study. Between July 2017 and December 2018, 30 patients who were diagnosed with inferior pole fracture of the patella without additional orthopaedic injuries were enrolled in this case series. After X-ray and 3D-CT examinations, all patients underwent open reduction and internal fixation by HPS with or without supplementary cannulated screw and lag screw stabilization. The bony union time, final range of motion (ROM), Bostman score, visual analog scale (VAS), and complications were measured as the clinical outcomes under a minimum of 12 months of follow-up. RESULTS: All of the operations went well with the mean operative time of 76.2 ± 15.3 min. Bony union achieved in all the cases at an average of 9.5 ± 1.4 weeks after surgery. There was no loss of reduction, fixative failure, or surgical implant removal during follow-up. The average range of motion 1 year postoperatively was 0°-123.3°. The mean Bostman Score at the last follow-up was 26.8 ± 2.1 with the satisfactory rate of 100%. The pain feeling during walking as measured by VAS averaged at 0.9 ± 1.3. No complications developed except for one case of poor incision healing, which healed eventually after surgical debridement. CONCLUSIONS: HPS was demonstrated as a secure fixation and as a kind of tension band for inferior pole fractures of the patella. Satisfactory recovery of knee function and low complication rate, including no need for hardware removal, could be expected.


Asunto(s)
Fracturas Óseas , Rótula , Humanos , Rótula/cirugía , Rótula/lesiones , Hilos Ortopédicos , Estudios Retrospectivos , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fijación Interna de Fracturas/métodos , Resultado del Tratamiento
20.
Injury ; 54(12): 111130, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37890289

RESUMEN

INTRODUCTION: The segmental bone defects post open distal femur fracture presents a reconstructive challenge, which often requires extreme solutions. The present study reviewed a new treatment strategy which used a cylindrical titanium mesh cage as an adjunct to the Masquelet technique. METHODS: We retrospectively reviewed a consecutive series of 23 patients treated for segmental bone defects post open distal femur fracture using a titanium mesh cage combined with the Masquelet technique under a 2-staged protocol in our institution from 2017 to 2021. The study group consisted of 13 men and 10 women with an average age of 44.1 years. The surgical debridement was performed with antibiotic polymethylmethacrylate (PMMA) cement spacer implanted into the bone defect combined with cement-wrapped plate stabilization, or antibiotic beads with vacuum sealing drainage (VSD) to cover the wound. The second stage of the Masquelet technique for bone defect repair began at least 4-6 weeks after the first stage, once all signs of possible infection were eliminated. After the cement spacer was removed, the definitive reconstruction was completed with exchange to a cylindrical titanium mesh cage filled with cancellous autograft within the induced membrane. The bone defect with cage was stabilized with a distal femoral Less Invasive Stabilization System (LISS). The radiological and clinical records of the enrolled patients were retrospectively analyzed. RESULTS: The mean follow-up was 38.6 months. The average number of operations before the second stage was 1.3. The mean interval between the two stages was 12.7 weeks. The average length of the defect measured 8.3 cm (ranging from 6.1 to 12.4 cm). All the defects filled with autograft within the cage achieved bony union, with a mean healing time of 8.4 months. At the latest follow-up, the mean knee extension measured 6.2° (ranging from 0° to 20°), and the mean flexion measured 101.8° (ranging from 60° to 120°). Complications included two instances of superficial stitch abscess, which eventually healed. CONCLUSIONS: The use of a titanium cage implanted into an induced membrane in a 2-staged Masquelet protocol could achieve satisfactory clinical outcomes in cases of segmental defects following open distal femur fractures.


Asunto(s)
Fracturas Femorales Distales , Fracturas del Fémur , Masculino , Humanos , Femenino , Adulto , Titanio , Estudios Retrospectivos , Fracturas del Fémur/diagnóstico por imagen , Fracturas del Fémur/cirugía , Antibacterianos/uso terapéutico , Trasplante Óseo/métodos , Resultado del Tratamiento
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