RESUMEN
Neer type II (Edinburgh type 3B) fractures of the lateral clavicle are unstable fractures. The optimal management of these fractures remains controversial with many surgical techniques described in the literature. Our study reports the long-term results of a modified suture (1.5-mm polydioxanone cord) and sling technique for these fractures to avoid complications associated with current techniques in the literature. Over a 5-year period, 23 patients who were (12 males, 11 females; 14 left, 9 right) with a mean age of 42 years were treated with this technique. At last follow-up, the mean Oxford score was 45.1 (range 36-48); the mean SPADI score was 7.4 (range 0-32.3); and the mean Constant score was 91.5 (range 71-100). There were one non-union and no malunion. All patients in our series, except one, returned to their pre-injury activity level. This modified suture fixation technique is safe, technically simple to perform and cheap. It achieves excellent rates of fracture union without the complications associated with other fixation methods in the literature.
Asunto(s)
Clavícula/lesiones , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Adolescente , Adulto , Hilos Ortopédicos , Clavícula/cirugía , Femenino , Fijación Interna de Fracturas/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
Subacromial corticosteroid injections are frequently used for both diagnostic and therapeutic purposes in shoulder pain. Subacromial septic bursitis is a recognized but rare complication. There have been no reports of methicillin-resistant Staphylococcus aureus infections of the subacromial bursa after subacromial injections in the literature. We describe case reports of two patients who presented with subacromial methicillin-resistant Staphylococcus aureus septic bursitis following subacromial corticosteroid injections in the community and highlight the diagnostic and management challenges of this condition.
RESUMEN
We study foam flow in an elementary model porous medium consisting of a convergent and a divergent channel positioned side by side and possessing a fixed joint porosity. Configurations of converging or diverging channels are ubiquitous at the pore scale in porous media, as all channels linking pores possess a converging and diverging part. The resulting flow kinematics imposes asymmetric bubble deformations in the two channels, which modulate foam-wall friction and strongly impact the flux distribution. We measure, as well as quantitatively predict, the ratio of the fluxes in the two channels as a function of the channel widths by modeling pressure drops of both viscous and capillary origins. This study reveals the crucial importance of boundary-induced bubble deformation on the mobility of a flowing foam, resulting in particular in flow irreversibility.