Use of Kirschner wires with eyelets for tension band wiring of olecranon fractures.

PURPOSE: To evaluate the clinical and radiographic outcomes of tension band wiring of displaced olecranon fractures treated using Kirschner wires with eyelets to assess their clinical performance with respect to complications such as backing out of the K-wires, restriction of forearm rotation, and neurovascular injury. METHODS: The authors retrospectively reviewed 44 patients treated for an isolated, displaced olecranon fracture and checked range of motion, postoperative pain, complications, and incidence of hardware removal. The mean follow-up period was 41 months (range, 26-73 mo). RESULTS: All fractures united, and anatomical reduction was achieved in all cases at final follow-up. Mean elbow flexion was 135° (range, 115° to 140°), and mean elbow extension was 4° (range, 0° to 15°). No pin migration, restriction of forearm rotation, or neurovascular injury occurred. Hardware removal was performed in 8 cases (18%). Compared to previous results with conventional Kirschner wires, no meaningful improvement in postoperative pain level or in the rate of hardware removal was observed. CONCLUSIONS: Tension band wiring using the pin studied produced excellent clinical and radiologic outcomes for the treatment of isolated, displaced Mayo type IIA and some type IIB olecranon fractures. The pin was effective in preventing the backing out of Kirschner wires and avoiding the complications associated with anterior cortical engagement of Kirschner wires, such as neurovascular injury or restriction of forearm rotation.

Short-term effects of systematized behavioral modification program for nocturia: a prospective study.

AIMS: This study is to investigate whether a repetitive education program for behavioral modification is necessary for the patients with nocturnal polyuria (NPU). MATERIALS AND METHODS: A prospective single-arm study was carried out and 82 patients with NPU were analyzed. We developed a 30-min systematized behavioral modification program (SBMP), which consisted of (1) watching videos about normal physiology of storing and emptying function of urine, (2) regulation of fluid intake, (3) explanation by giving specific examples, and (4) discussion with a specialized nurse practitioner. Patients received reinforcement SBMP if they still had NPU after the first SBMP. RESULTS: Mean age was 66 ± 8.3 years. Sixty-three males (77%) and 19 females (23%) were included. The results of all questionnaires showed significant improvement of nocturia after the first SBMP. Nocturnal voids, quality of life scores, nocturia index, and nocturnal bladder capacity index were significantly improved and the decrease of nocturnal urine volume was borderline significant. No additional significant improvement was demonstrated after the second SBMP. Overall, 62 patients (78.5%) were satisfied with the first SBMP and 6 patients (7.6%) became satisfied after reinforcement SBMP. Eleven patients (13.9%) were eventually dissatisfied with SBMP. CONCLUSIONS: A single SBMP was sufficient for treating most of the patients with NPU and reinforcement SBMP was effective in some patients. Moving from two to one rises at night may significantly reduce bother and this may explain quality of life improvements rather than any decrease in amount voided.

Marriage Intention among Korean Young Adults: Trends and Influencing Factors.

The recent increase in the tendency of people to marry late or to opt out of marriage entirely is among the key contributors to Korea's low fertility rate. One possible cause of this tendency may be a change in how marriage is valued among Korea's youth. The marriage intentions of young adults can be classified into "positive", "negative", and "neutral". Over time, positive marriage intentions have declined across all age groups (2010: 61% → 2020: 39%; ages 25-29), with no significant change in negative marriage intentions. In contrast, neutral marriage intentions have increased significantly (2010: 36% → 2020: 53%; ages 25-29). This phenomenon may be attributable to the increase in the number of young adults who prioritize survival over thinking about the future. However, neutral marriage values can be changed into positive values at any time. A holistic overview of Korean society is necessary to determine how the values of young adults might be influenced to align with a traditional life process.

A Comparison of Non-vascularized Bone Grafting and Internal Fixation in the Treatment of Unstable Scaphoid Waist Nonunion.

Background: When nonunion of scaphoid waist is treated with non-vascularized bone grafting with internal fixation, bony union would be affected not only type of bone graft but also fixation method. Thus, we attempted to investigate whether the bony union depends on how surgeons combine bone grafting and internal fixation. Methods: We treated 38 consecutive patients with unstable nonunion of scaphoid waist. The patients were treated with one of three types of non-vascularized bone grafting and internal fixation by random sampling, regardless of the configuration of the nonunion; cortico-cancellous bone grafting with Kirschner wire (K-wire) fixation group (12 cases), cortico-cancellous bone grafting with headless compression screw fixation group (13 cases) and cancellous bone grafting with K-wire fixation group (13 cases). We compared "union rate" and "time to union" between groups with statistical analysis. We described clinical features of "failure to union" cases. Results: The mean time to union of cancellous bone grafting with K-wire fixation group was significantly shorter than those of other groups. There was also significant difference in mean time to union between cortico-cancellous bone grafting with K-wire fixation group and cancellous bone grafting with K-wire fixation group (when the type of bone grafting was different). All the "failure to union" cases were sclerotic (Herbert type D2) nonunion treated by cortico-cancellous bone grafting. Conclusions: When treating unstable nonunion of scaphoid waist with non-vascularized bone grafting with internal fixation, cancellous bone grafting with K-wire fixation seems to be advantageous in terms of mean time to union. It seems that both bone grafting and fixation method affected "mean time to union" but the type of bone grafting was more influential in achieving union. The failure to union might be frequent in case of Herbert type D2 nonunion combined with cortico-cancellous bone grafting.

Racial and ethnic disparities in AIDS incidence: an examination of Milwaukee, Wisconsin, 1990-2000.

CONTEXT: Public health agencies have identified the elimination of health disparities as a major policy objective. OBJECTIVES: The main goals of this study were to assess the magnitude of racial/ethnic disparities in rates of Acquired Immune Deficiency Syndrome (AIDS) incidence in the metropolitan statistical area of Milwaukee, Wis, and determine how those disparities have changed over the period 1990-2000. METHODS: Incidence rates were calculated using data from the AIDS Public Information Data Set (numerators) and US Census Bureau (denominators). Rates of AIDS incidence were produced for broad demographic groups (eg, Hispanics) in Milwaukee. In addition, age-standardized incidence rates were produced for groups defined by age, sex, and race/ethnicity, permitting careful examination of trends in racial/ethnic disparities. RESULTS: In Milwaukee's general population, AIDS incidence dropped from 7.6 per 100,000 in 1990 to 6.4 per 100,000 in 2000--a decline of over 15%. AIDS incidence rates also dropped for Hispanics (-41.0%) and non-Hispanic whites (-52.1%), but climbed among non-Hispanic blacks (51.1%). Disparities in AIDS incidence between non-Hispanic blacks and non-Hispanic whites increased between 136% (young adult males) and 428% (young adult females) over the period. CONCLUSION: Despite progress in reducing rates of AIDS incidence in Milwaukee's general population, racial/ethnic disparities widened substantially between 1990 and 2000.

Prospective multicenter trial of modified retrograde percutaneous intramedullary Kirschner wire fixation for displaced metacarpal neck and shaft fractures.

BACKGROUND: The purpose of this prospective multicenter study was to assess the clinical and radiographic outcome of a newly devised technique of retrograde intramedullary fixation with multiple Kirschner wires in metacarpal neck and shaft fractures. METHODS: Between May of 2002 and June of 2007, a total of 121 metacarpal fractures in 105 patients that were treated with the authors' modified intramedullary Kirschner wire fixation technique were included in this study. The average follow-up period was 10 months. The surgical outcome was assessed by clinical and radiographic data. RESULTS: The average range of motion in the metacarpophalangeal joint of the injured side was not significantly different from that of the uninjured side. There was no case of residual rotational deformity postoperatively, and the average Disabilities of the Arm, Shoulder and Hand questionnaire score was 8.5 (range, 0 to 41). Average dorsal apex angulation and average shortening were reduced significantly from 39.0 degrees and 3.1 mm, to 9.7 degrees and 0.0 mm, respectively, in neck fractures; and from 29.5 degrees and 3.0 mm, to 7.0 degrees and -0.1 mm in shaft fractures, respectively. Average time to union was 5.6 weeks, and there were no cases of nonunion. CONCLUSION: Modified retrograde intramedullary fixation with multiple Kirschner wires is a straightforward and reliable technique that successfully resulted in good functional and cosmetic results in addition to excellent bone healing. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.