The traditional experience strategy (TES) and combined ultrasonography examination (CUE) for the treatment of lateral compression type 1 pelvic fractures: a historical control study.

BACKGROUND: It is difficult to judge the stability of lateral compression type-1 (LC-1) pelvic fracture, as it is often based on static images of the pelvis. Compared with the traditional experience strategy, ultrasonography examination may be able to distinguish operative and conservative patients before definitive treatment. However, in previous studies, we have not compared the outcomes between traditional experience strategy (TES group) and combined ultrasonography examination (CUE group). Thus, the aim of the study is comparing the differences between TES and CUE strategy, to identify the value of ultrasonography examination. METHODS: Medical records system for patients with LC-1 pelvic fractures who were treated with TES and CUE strategy were included. Patients' baseline characteristics, treatment strategy, and function were recorded at follow-up. Functional outcomes were evaluated using the Majeed grading system. RESULTS: In total, 77 patients with LC-1 pelvic fractures were included in the study. There were 42 and 35 patients in TES and CUE group, respectively. Compared to TES group (69 %), there were less proportion patients chosen the operative treatment in CUE group (43 %, P = 0.021). The volume of intraoperative blood loss in CUE operative group was more than TES operative group (P = 0.037). There were more patients with complete sacral fracture in CUE operative group than TES operative group (P = 0.002). The Majeed scores in CUE conservative group was higher than TES conservative group (P = 0.008). The overall Majeed scores in CUE group was higher than that in TES group (P = 0.039). CONCLUSIONS: The ultrasonography examination could relatively accurately identify the unstable LC-1 pelvis than the traditional experience strategy, the operative rate could be reduced and the overall function of LC-1 patients could be improved under the ultrasonography examination. LEVEL OF EVIDENCE: Level III.

Clinical Analysis of Single and Double Sacroiliac Screws in the Treatment of Tile C1 Pelvic Fracture.

We investigated the difference between fixation of single and double sacroiliac screws in the treatment of Tile C1 pelvic fractures. The data of 54 patients with Tile C1 pelvic fractures who were admitted to the trauma center of the Red Society Hospital Affiliated to Xi'an Jiaotong University between August 2016 and August 2020 were retrospectively analyzed. All patients with posterior pelvic ring injuries underwent fixation with sacroiliac screws assisted by a percutaneous robotic navigation system. The operative time, amount of intraoperative blood loss, and postoperative follow-up time between the two groups (single sacroiliac and double sacroiliac screw groups) were compared. The Matta and Majeed scores at the last follow-up were compared between the groups to evaluate fracture reduction and functional recovery. Forty-nine patients were followed up for 17.2 (±4.5) months and 16.2 (±3.4) months in the single and double sacroiliac screw groups, respectively. All patients had excellent fracture reduction immediately after surgery, according to the Matta score. All fractures healed without complications. There was no statistically significant difference in preoperative general information, amount intraoperative blood loss, intraoperative anterior ring fixation method, and postoperative follow-up time between the two groups (P > 0.05). The operative time of the single sacroiliac screw group was shorter than that of the double sacroiliac screw group (P < 0.05). At the last follow-up, the Matta score of the double sacroiliac screw group was significantly better than that of the single sacroiliac screw group (P < 0.05), and there was no statistically significant difference in the Majeed functional scores (P > 0.05). For Tile C1 pelvic fractures, double sacroiliac screw fixation of posterior ring injuries can provide a more stable treatment with no statistically significant difference in functional recovery.

Fast-Charging Nonaqueous Potassium-Ion Batteries Enabled by Rational Construction of Oxygen-Rich Porous Nanofiber Anodes.

Practical applications of carbon anodes in high-power potassium-ion batteries (PIBs) were hampered by their limited rate properties, due to the sluggish K+ transport kinetics in the bulk. Constructing convenient ion/electron transfer channels in the electrode is of great importance to realize fast charge/discharge rates. Here, cross-linked porous carbon nanofibers (inner porous carbon nanotubes and outer soft carbon layer) modified with oxygen-containing functional groups were well designed as anodes to realize robust de-/potassiation kinetics. The novel anode delivered excellent rate capabilities (107 mAh g-1 at 20 A g-1 and 78 mAh g-1 at 40 A g-1) and superior cycling stability (76% capacity retention after 14,000 cycles at 2 A g-1). In situ XRD measurement, in situ Raman spectra, and galvanostatic intermittent titration verified its surface-dominated potassium storage behavior with fast de-/potassiation kinetics, excellent reversibility, and rapid ion/electron transport. Moreover, theoretical investigation revealed that the carboxyl groups in the carbon offered additional capacitive adsorption sites for K+, thus significantly enhancing the reversible capacity. Surprisingly, a full cell using the anode and perylene-3,4,9,10-tetracarboxylic dianhydride cathode achieved an outstanding power density of 23,750 W kg-1 and superior fast charge/slow discharge performance.

The Effect of Integrity of Lateral Wall on the Quality of Reduction and Outcomes in Elderly Patients with Intertrochanteric Fracture: A Controlled Study.

OBJECTIVE: The study is aimed at evaluating the effect of the integrity of lateral wall on the quality of reduction and outcome in intertrochanteric fracture treated with proximal femoral nail antirotation (PFNA). METHODS: Medical record systems for elderly patients with intertrochanteric fracture treated with PFNA were included. The patients were divided into incompetent and intact lateral wall groups. Patients' baseline characteristics, quality of reduction, and Harris Hip scores (HHS) were collected. RESULTS: The study included 115 patients with intertrochanteric fractures, with 59 in the incompetent lateral wall group and 56 in the intact group. Lateral wall thickness was 16.47 ± 2.46 mm and 23.68 ± 1.59 mm in the incompetent group and intact group (t = -18.766, P < 0.001), respectively. There was no significant difference in the quality of reduction (P = 0.646) between intact and incompetent groups. Mean HHS at final follow-up were 83.02 ± 13.89 in the incompetent group and 86.04 ± 3.39 in the intact group, with no significant difference (P = 0.123). In addition, there was no significant difference in weight-bearing or clinical healing between intact and incompetent groups. The partial weight-bearing with crutches was allowed at 2.71 ± 0.93 and 2.66 ± 1.01 weeks after the operation in the incompetent and intact groups. Time to clinical healing was 5.83 ± 0.99 and 6.00 ± 0.92 months in the incompetent and intact groups, respectively. However, the operative time in the incompetent group (58.54 ± 18.14 mins) were longer than that in the intact group (51.79 ± 17.77 mins). CONCLUSIONS: In conclusion, it seems that lateral wall thickness does not affect the quality of reduction and outcome in patients with intertrochanteric fracture receiving PFNA.

[Percutaneous transforaminal endoscopic TESSYS technique for the treatment of bilateral lumbar disc herniation in single segment].

OBJECTIVE: To investigate the early clinical effects of transforaminal endoscopic spine system (TESSYS) for the treatment of bilateral lumbar disc herniation in single segment. METHODS: The clinical data of 38 patients with single-segment bilateral lumbar disc herniation treated by TESSYS technique from February 2016 to February 2018 were retrospectively analyzed. There were 26 males and 12 females, aged from 30 to 55 years old with an average of(35.2±6.4) years, 6 cases of L3,4, 22 cases of L4,5, and 10 cases of L5S11. Using the intervertebral foramen endoscope produced by Joimax GmbH, Germany, under local anesthesia, bilateral puncture to the outside of the intervertebral foramen of the diseased segment, four-stage dilatation catheter to complete the progressive enlargement of the intervertebral foramen, and the ring saw progressively enlarge the intervertebral foramen. The bilateral foramen was placed and the herniated nucleus was removed until the nerve root was completely released. Postoperatively, the patients were reviewed on regular outpatient visits and telephone follow-ups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were compared before operation and after operation at 1, 3, 6, 12 months respectively. At the final follow-up, according to modified MacNab criteria to evaluate the clinical effect. RESULTS: Thirty-six patients underwent successful surgery and were followed up for more than 12 months. The ODI score and VAS score of the lower extremities pain at 1, 3, 6, 12 months after operation were obviously improved (P<0.05), there was significant difference between 1, 3 months and 6, 12 months after operation(P<0.05), there was no significant difference between 1 and 3 months, between 6 and 12 months after operation (P>0.05). At the final follow-up, according to MacNab criteria, 14 cases got excellent results, 16 good, 4 fair, 2 poor. CONCLUSIONS: Using TESSYS technique to remove the bilateral herniated nucleus from single segment can fully decompress for the nerve root, and can be effectively applied to patients with single-segment bilateral lumbar disc herniation.