Independent volumetric internal fixation reduces posterior column acetabular fracture site motion as compared to plate/screw construct: A biomechanical analysis.

Aims & objectives: To establish whether a suprapectineal pelvic reconstruction plate and posterior column screw (P&S) construct or a single 6.5-mm cannulated posterior column screw (PCS) construct demonstrates greater mechanical stability for fixation of acetabulum fractures involving the posterior column (PC). We hypothesized that the PCS construct would result in less fracture site motion. Materials & methods: Twelve fourth-generation composite hemipelvi were utilized, 6 for each construct. The P&S construct consisted of a suprapectineal pelvic reconstruction plate with two 3.5-mm posterior column screws crossing the fracture site in lag-by-technique fashion and two screws anchoring the plate to the sciatic buttress. The PCS construct consisted of a single 6.5-mm partially threaded cannulated screw placed in an antegrade fashion. Both fixation models were cyclically loaded at 0.5 cycles/second at 400N and 800N, first in a sit-to-stand position that is expected during recovery, and subsequently in a squat-to-stand position to test overload conditions. Results: Under sit-to-stand loading, the PCS construct resulted in less motion at the fracture site than the P&S construct (0.06 ± 0.02 mm vs 0.1 ± 0.02 mm at 400N, p = 0.02; 0.13 ± 0.03 mm vs 0.19 ± 0.04 mm at 800N, p = 0.03). The PCS construct also demonstrated less fracture site motion under squat-to-stand loading (0.22 ± 0.13 mm vs 1.9 ± 0.5 mm at 400N, p = < 0.001; 1.48 ± 0.44 mm vs 4.77 ± 0.3 mm at 800N, p = < 0.001). At 800 N, half of the repairs failed during squat-to-stand loading (2 PCS, 4 P&S). Conclusion: Fixation of the posterior column of the acetabulum with a 6.5-mm cannulated screw demonstrated comparable fracture motion upon loading compared to the plate and screw construct.

Surface Enhancement of Additively Manufactured Bone Plate Through Hybrid-Electrochemical Magnetorheological Finishing Process.

Additive manufacturing or 3D printing provides the benefits of individualizing the implant per patient requirements. However, the poor surface quality of additively manufactured biomaterial is a major limitation. Hence, hybrid-electrochemical magnetorheological (H-ECMR) polishing is developed to improve the surface quality of fabricated parts. H-ECMR finishing is an advanced surface polishing operation that avails the synergic action of mechanical abrasion and the electrochemical reaction to enhance the surface quality of the workpiece without hampering its surface topography. Furthermore, the developed H-ECMR finishing process reduces the finishing time and produces a uniform surface quality compared with the conventional magnetorheological (MR) finishing process. However, the surface finishing of the parts having a hole-of-pocket feature through the H-ECMR finishing process is a major challenge as MR fluid gets trapped inside those holes or pockets. A feature-based hybrid H-ECMR finishing process is developed to resolve the issue. In this case, paraffin wax is applied to the holes and pockets before the H-ECMR process occurs. In the present work, bone plates are fabricated through selective laser melting, and their surface quality is further enhanced through the H-ECMR finishing process. Bone plates are necessary to provide mechanical stability during bone fracture healing by adapting to the chemical environment. The final Ra value of 21.37 nm is attained from 9.36 µm through H-ECMR finishing. Pin-on-disk study is carried out on the biomaterial to analyze its wear resistance. The surface topography of the workpiece is analyzed through scanning electron microscopy before and after finishing, and it was observed that a uniform surface is achieved after polishing. Apart from the average surface roughness (Ra ), other roughness parameters such as skewness (R sk) and kurtosis (R ku) are analyzed to study the attribute of the surface irregularities.

Acoustic radiation characteristics of shark skin inspired surface modified plates.

This paper aims to evaluate the acoustic radiation characteristics of thin plates featuring a layer of small-scale biomimetic shark skin type additive surface treatment. The shark skin dermal denticles are modelled as point masses arranged in a bi-directional pattern on both the upper and lower surfaces of the plate. The governing equations are obtained through a variational approach, incorporating the Dirac Delta function in the derivation of the proposed semi-analytical model for the shark skin layer. A semi-analytical method based on the Rayleigh-Ritz formulation is utilized to analyze the vibrations of these plates with surface modification. The sound radiation characteristics are then derived from the solution of the Rayleigh integral. A comprehensive investigation is performed on the influence of surface modification on different vibro-acoustic characteristics, using a continuous structural mode and power transfer matrix-based approach. Notable observations include a reduction in peak vibro-acoustic responses with dense denticle arrangements, especially at resonance, demonstrating a direct relationship with mass ratios, i.e., the ratio of denticle mass to plate mass. The study further reveals a shift of vibro-acoustic responses towards low frequencies with an increase in mass ratios. A thorough comparative study indicates that while additive surface modifications inspired by shark skin may weaken sound radiation characteristics at resonance frequencies, a reverse effect can be observed at intermittent operational frequencies.

The Effectiveness of Temporary Hemiepiphysiodesis for Non-idiopathic Coronal Angular Deformity of the Knee in Children: A Comparison of Hinge Eight-Plate and Traditional Eight-Plate.

OBJECTIVE: Temporary hemiepiphysiodesis (TH) is a very common technique for coronal angular deformity of the knee in children, especially non-idiopathic. However, there is currently a dearth of comparative research on the hinge eight-plate (HEP) and traditional eight-plate (TEP). This study aimed to assess the clinical effectiveness and implant-related complication rates of TH using TEP and HEP for non-idiopathic coronal angular deformity, as well as to identify clinical factors affecting correction velocity. METHODS: We retrospectively observed a consecutive series of patients with non-idiopathic coronal angular deformity of the knee who underwent TH using HEP or TEP and completed the deformity correction process from July 2016 to July 2022. According to the kind of eight plates, we divided those patients into the HEP group and the TEP treatment group. Relevant clinical factors, including the mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), screw divergence angle (SDA), angle of plate and screw (APS), hinge angle of HEP (HA), and the knee zone location of the lower extremity mechanical axis, were documented. Additionally, deformity correction velocity, complications, and clinical efficacy were assessed. Categorical variables were analyzed using the chi-squared test, Fisher exact test, or Wilcoxon test, while continuous variables were evaluated using the t-test or analysis of variance (ANOVA). RESULTS: There were 29 patients in the HEP treatment group (seven girls and 22 boys) and 33 patients (12 girls and 21 boys) in the TEP treatment group. In all, 91.86% (79/86 knees) of the genu angular deformities were completely corrected, 6.98% (6/86 knees) had the overcorrection condition, and 10.47% (9/86 knees) had screw loosening. The swayback HEP rate was 11.29% (7/62 HEPs), which was related to the screw loosening in the HEP group (p < 0.001). The overall correction velocities and screw divergence angle change speeds in the HEP group were all significantly faster than those in the TEP group (p < 0.05). The initial APS of the HEP implanted was higher than that of TEP (p < 0.01), and multisite changes of APS during deformity correction of the HEP group were smaller than that of the TEP group. CONCLUSION: HEP proved to be an appropriate device for TH for non-idiopathic coronal angular deformities of the knee with high correction velocity in children. Avoiding the occurrence of the swayback phenomenon may reduce the complications of HEP.

Outcome Analysis of Fixed angle Locking Plate in Comminuted Patella Fractures : A Single Centre Prospective study from South India with Early Results.

Introduction: Comminuted patella fractures pose a challenge to orthopaedic surgeons , since tension band wiring and cerclage is not effective and often lead to loosening of wires, hardware problem, dislocation of fracture and failure of osteosynthesis resulting in post-traumatic osteoarthritis and knee stiffness. The aim of this study is to evaluate the clinical outcome in patients with AO 34C2 and 34C3 highly comminuted patella fractures treated with unidirectional fixed angle titanium patella locking plate. Materials and Methods: Twelve patients who presented with AO 34C2 and 34C3 comminuted patella fractures, aged between 18-79 years were included in the study. All fractures were reduced and fixed with unidirectional angle fixed stable titanium patella locking plate. Knee range of motion and knee outcome survey activities of daily living scale (KOS-ADL) was used to evaluate the outcome. Results: Union of fracture was achieved in all twelve patients. Mean flexion at final follow-up was 123° (110°-130°). None of the patients had extensor lag. One patient had hardware irritation which resolved at final followup. Conclusion: This technique serves as an effective option in highly comminuted patella fractures by providing excellent mechanical stability resulting in anatomical reduction , excellent functional outcome , lower incidence of hardware irritation or failure of osteosynthesis.

Bridge Versus Volar Plating Distal Radius Fractures in Patients With Concomitant Lower-Extremity Fractures.

Purpose: Our objective was to determine if patients with a distal radius fracture and concomitant lower-extremity fracture benefit from bridge plating when compared with volar plating. Methods: We conducted a retrospective cohort study evaluating distal radius fractures fixated by bridge or volar plating in orthopedic trauma patients with a concomitant lower-extremity fracture. Patients were prescribed a platform walker and followed for gait aid use and both upper and lower-extremity fracture-related outcomes. Results: Differences in platform walker use, radiographic findings, and rates of complications for both distal radius and lower-extremity fractures were comparable between groups. Conclusions: Although more studies are needed, it appears that this cohort of patient's ability to mobilize using a gait aid is similar, regardless of the distal radius fracture fixation method. A concomitant lower-extremity fracture should not necessarily indicate bridge plating over volar plate fixation. Type of study/level of Evidence: Therapeutic Study IV.

Novel surgical method for the exposure and plating of dorsally displaced unstable distal radius fractures.

The dorsal approach to the wrist is challenging because of the high number of extensor tendons crossing the wrist joint and extensor retinaculum (ER) enveloping the distal dorsal end of the radius. Dorsal plating of the radius has gained popularity owing to the concept of fragment-specific fixation of the distal radius. Here, we describe a novel method of selectively sectioning the extensor retinaculum that ensures adequate soft tissue care and good fixation with low-profile implants with good clinico- radiological outcome.

Countermovement Jump and Isometric Strength Test-Retest Reliability in English Premier League Academy Football Players.

PURPOSE: To examine the test-retest reliability of countermovement jump (CMJ) and isometric strength testing measures in elite-level under-18 and under-23 academy football players. METHODS: A total of 36 players performed 3 maximal CMJs and isometric abductor (IABS), adductor (IADS), and posterior chain (IPCS) strength tests on 2 separate test days using dual force plates (CMJ and IPCS) and a portable strength testing device (IABS and IADS). Relative (intraclass correlation coefficient) and absolute (coefficient of variation, standard error of the measurement, and minimal detectable change [MDC%]) reliabilities for 34 CMJ, 10 IABS, 10 IADS, and 11 IPCS measures were analyzed using between-sessions best, mean, and within-session methods. RESULTS: For all methods, relative reliability was good to excellent for all CMJ and all IADS measures and poor to good for all IABS and IPCS measures. Absolute reliability was good (ie, coefficient of variation < 10%) for 27 (best) and 28 (mean) CMJ variables and for 6 (IABS and IADS) and 2 (IPCS) isometric measures. Commonly used CMJ measures (jump height, eccentric duration, and flight-time:contraction-time ratio) had good to excellent relative reliability and an MDC% range of 14.6% to 23.7%. Likewise, commonly used isometric peak force measures for IABS, IADS, and IPCS had good to excellent relative reliability and an MDC% range of 22.2% to 26.4%. CONCLUSIONS: Commonly used CMJ and isometric strength measures had good test-retest reliability but might be limited by their MDC%. Rate-of-force-development measures (for all isometric tests) and impulse measures (IPCS) are limited by poor relative and absolute reliability and high MDC%. MDC% statistics should be considered in the context of typical responsiveness.

Innovative hierarchical porous hydrophilic molecularly imprinted resin for high-throughput detection of perfluorocarboxylic acids in milk using 96-well plate SPE-LC-MS/MS.

The accumulation of perfluorocarboxylic acids (PFCAs) in environment and foods represents a significant threat to public health due to the long-term ingestion of contaminated food. This study introduces a novel adsorbent, the hierarchical porous hydrophilic molecularly imprinted resin (HPHMIR), which was synthesized by integrating molecular imprinting techniques with hydrophilic resins. The HPHMIR, characterized by its extensive mesoporous structure (average pore width ∼9.71 nm) and favorable imprinting factors (2.6-5.0), facilitates the effective adsorption of PFCAs from complex matrices through multiple interaction mechanisms, including hydrogen bonding and electrostatic interactions. This innovative material was employed in a 96-well plate format for solid-phase extraction (SPE), and combined with LC-MS/MS, a high-throughput method for the determination of PFCAs in milk was developed. The proposed method demonstrated exceptional performance, including excellent linearity (0.48-240 ng mL-1; r ≥ 0.9986), low detection limits (0.04-0.11 ng mL-1), high precision (relative standard deviation ≤ 9.9 %), and satisfactory recovery (75.7-118.1 %). These results highlight the efficacy of the method in extracting trace levels of PFCAs from complicated sample matrices, presenting a promising alternative for monitoring PFCA contamination and advancing public health standards.

A clinical investigation of force plate drift error on predicted joint kinetics during gait.

Inverse dynamic analysis is a technique used during gait analysis to estimate intersegmental forces and net joint moments. Inverse dynamic calculations are susceptible to various forms of error. One such error is force plate drift, often produced by humidity condensing within the input connectors and electronics, causing an undesired change in output over time. This can be particularly concerning for movement laboratories where inverse dynamics are considered in clinical decision-making processes. Manufacturers will provide tolerance levels for drift. However, levels of acceptable drift are rarely considered from a clinical perspective. Therefore, this study aims to establish clinically acceptable limits of force plate drift error, induced by applying systematic errors to force plate channels, on predicted lower limb joint moments during gait. Gait data of 10 children with typical development were analysed and induced errors of 0.5 N, 1 N, 1.5 N, 3 N, 6 N and 12 N were incrementally applied to the horizontal and vertical force channels. Data were recalculated for each increment and mean profiles compared to an error free mean (±1SD) band. Error was deemed clinically significant when moments fell outside the mean (±1SD) band. Induced error at 6 N and above was sufficient to cause a clinically significant change. Sagittal and coronal plane moments at the hip were most affected, followed by the knee and then the ankle. While manufacturer guidelines for acceptable drift are usually well below 6 N, care is needed when using force plates over several minutes or more as drift may eventually exceed clinically acceptable limits.

Objective assessment of shared plate eating using a wearable camera in urban and rural households in Ghana.

Background: Shared plate eating (SPE), defined as two or more individuals eating directly from the same plate or bowl, is a common household food consumption practice in many Low- and Middle-Income Countries (LMICs). Examination of household engagement in SPE remains largely unexplored, highlighting a gap in research when interpreting dietary information obtained from these settings. The dearth of research into SPE can be attributed to the inherent limitations of traditional dietary assessment methods which constrain their usability in settings where SPE is common. Objective: In this expository narrative, we describe what SPE is when it is practiced in an LMIC such as Ghana; and also compare the frequency of SPE versus individual plate eating (IPE) by different household members in rural and urban households using a wearable camera (Automatic Ingestion Monitor version 2: AIM-2). Methods: Purposive convenience sampling was employed to recruit and enroll 30 households each from an urban and a rural community (n = 60 households) in Ghana. The AIM-2 was worn on eyeglass frames for 3 days by selected household members. The AIM-2, when worn, automatically collects images to capture food consumption in participants' environments, thus enabling passive capture of household SPE dynamics. Results: A higher percentage of SPE occasions was observed for rural (96.7%) compared to urban (36.7%) households (p < 0.001). Common SPE dynamics included only adults sharing, adults and children sharing, only children sharing, and non-household member participation in SPE. Conclusion: The wearable camera captured eating dynamics within households that would have likely been missed or altered by traditional dietary assessment methods. Obtaining reliable and accurate data is crucial for assessing dietary intake in settings where SPE is a norm.

Biofilm Producing Organisms and Their Antibiotic Sensitivity in Chronic Suppurative Otitis Media: A Cross-Sectional Study.

Chronic Suppurative Otitis Media (CSOM) is an inflammation of the mucoperiosteal lining of the middle ear cleft. Recently, biofilms have been discovered to play a pivotal role in the pathogenesis of CSOM. A biofilm is a bacterial aggregation that adheres to the mucosal surfaces and is connected with an extracellular matrix. Biofilms enhance antibiotic resistance, facilitate genetic alterations and amplify competence to combat host immunity. This study aims to identify the spectrum of biofilm-producers in CSOM and investigate their antibiotic sensitivity. Samples (648) were obtained from the deeper part of external auditory meatus of patients with CSOM. Pus samples were collected and processed for culture sensitivity. Biofilms detected. The findings were compiled and statistically analyzed. Out of 500 culture-positive samples, most commonly isolated bacteria was Pseudomonas (62.6%), followed by MRSA (13.8%). Biofilm-producers were 350, with 119 being strong, 167 moderate, and 64 weak. Biofilms were produced by 70% of the isolates, with Pseudomonas producing the most (74.6%), followed by MRSA. Gentamicin was the most effective antibiotic against biofilm-producers. Amoxicillin-Clavulanic Acid, Ceftriaxone, Cefuroxime, and Minocyclin were resistant. Pseudomonas had the highest sensitivity to Levofloxacin (96.6%), followed by Ceftazidime and Ciprofloxacin. Pseudomonas was resistant to Cefuroxime, Amoxicillin-Clavulanic acid and Linezolid. Multi-drug resistance has been widespread among CSOM causal species, particularly in biofilm producers. Thus, screening for biofilm formation, in addition to the standard antibiogram, must be undertaken as part of CSOM protocol. This will address the multi-drug resistance and select an appropriate treatment modality.

Management of Rarest Type of Talus Fracture: A Case Report.

This is a case of the rarest type of talus fracture in a 28-year-old male who presented with pain in his right ankle and foot following a road traffic accident. He was unable to bear weight or walk after the injury. Imaging studies indicated fractures in the head and neck of the talus, as well as the talar dome, with a fracture line extending into the subtalar joint. The patient underwent open reduction and internal fixation using mini fragment plating and Herbert screw fixation for the osteochondral fragment. Both the intraoperative and postoperative periods were without complications. The patient was placed in plaster of Paris (POP) slab immobilization for four weeks and was advised to avoid weight-bearing while using a walker for eight weeks, after which physiotherapy commenced. Follow-up assessments showed satisfactory fracture union, good range of motion in the ankle, an excellent American Orthopedic Foot and Ankle Society (AOFAS) score, an excellent 17-Italian Foot Function Index (FFI) score, and a good Hawkins score.

Constitutive relationship of soil in contact with mortar under continuous loading.

Mortars will remain critical in future land wars due to their flexibility and versatility. When mortars are fired continuously, the contact soil is gradually compacted by the mortar base plate, and dynamic research into this process is the basis for innovative mortar design. However, the discontinuity and nonlinearity of soil contact absolutely necessitate the constitutive relationship of soil contact, which is difficult to study. Therefore, this study conducted experimental research and theoretical derivation to establish an accurate dynamic model of the mortar system. First, based on the nonlinear elastic-plastic theory and the stress-strain relationship of soil under cyclic loading, a theoretical analysis method for the constitutive relationship of contact soil under continuous loading was proposed. Second, an experimental and testing system was designed to simulate launch loads, and the stress-strain response of soil under continuous impact loads was obtained experimentally. Subsequently, based on theoretical analysis and experimental data, the stress-strain relationship during the gradual compaction of soil was established using the least squares method. Finally, a constitutive relationship model of the contact soil in the mortar system was established in ABAQUS using the VUMAT subroutine interface, and the calculated results were compared and analyzed with traditional calculation results. The results indicated that studying the constitutive relationship of mortar in contact with soil during continuous firing using this method can improve the accuracy of dynamically modeling mortar systems. Moreover, this study has practical value in the engineering design of mortar systems.

Fixing Cho Type IIC Distal Clavicle Fractures with Hook Plates Leads to a High Incidence of Subacromial Osteolysis: A Retrospective Study and Literature Review.

Background: This retrospective study investigates the complications, particularly subacromial osteolysis (SAO), associated with hook plate (HP) fixation, in the treatment of unstable distal clavicle fractures characterized by complete coracoclavicular (CC) ligament rupture. The decision-making process for employing HP in fractures of this nature, such as Neer types IIB and V and Cho classification IIC, involves considerations of distal fragment size and displacement. While HP offers advantages in clinical practice, it is not without complications, with SAO being a notable concern. Factors such as non-anatomic hook tip placement and fracture classification may influence the risk of SAO. Methods: The study comprises a retrospective analysis of unstable distal clavicle fractures treated with HP at our institution from 2019 to 2022. Exclusions include non-displaced fractures, those treated with other locking plates, and pathologic fractures. A total of 91 patients with displaced distal clavicle fractures underwent open reduction and internal fixation with HP. Cho classification was employed to differentiate cases with CC ligament rupture. Patient demographics, classifications, postoperative radiographs, distal fragment size, plate position, timing of implant removal, and complications, including SAO, were recorded. Results: Among the 91 patients, 32 were classified as Cho IIB, 43 as Cho IIC, and 16 as Cho IID. Ninety-one percent exhibited solid union before implant removal. The prevalence of SAO was 43.8%, 76.7%, and 62.5% in Cho IIB, IIC, and IID, respectively. Univariate analysis revealed a significant difference only in Cho classification (p = 0.014). Binary logistic regression identified Cho classification type IIC as the sole risk factor for SAO (p = 0.021; odds ratio, 4.48; 95% confidence interval, 1.56-12.87). Conclusions: Cho type IIC fractures, characterized by CC ligament deficiency causing horizontal instability, demonstrated the highest SAO rate. In contrast, Neer type IIB fractures retained the trapezoid ligament, and Neer type V fractures had intact CC ligaments, resulting in lower SAO rates. Biomechanically, combining HPs with CC ligament reconstruction provided better structural stability than using HPs alone in treating Cho type IIC fractures.

Corrigendum: Outcomes of olecranon fractures in adolescents: comparison of tension band wiring and Herbert screw fixations.

[This corrects the article DOI: 10.3389/fped.2023.1269628.].

Manganese-arginine nanozymes as oxidase mimics for smartphone-based intelligent detection of 4'-O-methylpyridoxine.

By self-assembly of MnCl2 and arginine under alkaline conditions, ultra-small MnArg nanoparticles were successfully constructed as oxidase (OXD) mimics for intelligent detection of the Ginkgo toxin 4'-O-methylpyridoxal (MPN). The obtained MnArg nanozymes possessed excellent OXD-like activity and thermal stability. Based on the inhibitory effect of MPN for the catalytic activity of MnArg, this system was utilized for the colorimetric sensing of MPN with a low limit of detection (LOD) of 2.16 µg mL-1. The detection  system exhibited good selectivity against other potential interferents. FTIR data showed that the presence of MPN binds with MnArg and shields the active sites, thereby interfering with the oxidase-like activity. Combined with a smartphone and the ColorMax software, this nanozyme-based intelligent detection platform could effectively detect MPN with a LOD of 2.1 µg mL-1. Our MnArg nanozyme-based system was applied to detect real ginkgo nut samples with recoveries of 92.4-108.7%, and the relative standard deviations were less than 0.7%. This work may promote the development of novel nanozymes and expand their applications in the field of food safety detection.

Plate centrifugation enhances the efficiency of polyethylenimine-based transfection and lentiviral infection.

PURPOSE: To propose an efficient, reproducible, and consistent transgenic technology based on plate centrifugation, which is particularly useful for polyethylenimine (PEI) transfection and lentiviral infection. METHODS: We optimized multiple factors that could contribute to transfection efficiency, such as the dosage of the PEI or DNA, the working solution buffer used for diluting the PEI or DNA, the incubation time for the PEI/DNA complexes, and the transfection time. RESULTS: Plate centrifugation led to a 5.46-fold increase in the transfection efficiency of PEI-based transfection while maintaining the cell survival rate. Moreover, the average copy number of viral genes in each genome increased 4.96-fold with plate centrifugation. Plate centrifugation alters the spatial arrangement of the PEI/DNA complexes or lentiviruses, increasing the chances of these complexes or viruses coming into contact with target cells, ultimately resulting in improved transfection or infection efficiency. CONCLUSIONS: We present a protocol based on plate centrifugation for transfection or lentiviral infection that is suitable for genetic modification of primary cells or stem cells.

Application of a customized 3D-printed osteotomy guide plate for tibial transverse transport.

Enhance the efficiency of tibial transverse transport by employing customized 3D-printed osteotomy guide plates and striving to improve precision through CT evaluation for enhanced guide design. 17 diabetic foot patients were treated with the plate for tibial transverse transport. Preoperatively, we collected DICOM data from the affected tibia's CT and designed the geometric parameters of the tibial cortical bone window. A customized 3D-printed osteotomy guide plate was then fabricated using 3D printing technology. Postoperative X-ray and CT evaluations, conducted at two and five weeks post-surgery, assessed five crucial geometric parameters of the bone window. Measurements included the distance from the upper edge of the tibial cortical bone window to the tibial plateau, the distance from the anterior edge of the tibial cortical bone window to the bone ridge, the height of the tibial cortical bone window, the center-to-center distance between the 4.0 mm diameter Schanz pin and the osteotomy Kirschner pin, and the center-to-center distance of the 4.0 mm diameter Schanz pin. These measured parameters were subsequently compared to the preoperative design parameters. The Clinical trial registration number is ChiCTR2400087174. CT measurements showed no significant differences (P > 0.05) from preoperative design parameters across the five evaluated aspects. The average osteotomy duration was 35 ± 15 min with no bone window fractures. The bone window aligned effectively with the tibial shaft, achieving complete incorporation after distraction. A 4 to 8-month postoperative follow-up confirmed full healing of the tibial surgical wound and diabetic foot wounds. Utilizing customized 3D-printed osteotomy guide plates in tibial transverse bone transport surgery enables accurate translation of preoperative virtual designs into real-time procedures, enhancing surgical efficiency and quality.

Comparison of surgical and conservative therapy in older patients with distal radius fracture: a prospective randomized clinic al trial.

INTRODUCTION: The distal radius fracture is considered the most common fracture in humans. For fractures classified as Arbeitsgemeinschaft für Osteosynthese (AO) 23-C1 + C2, there is no consensus on treatment in older patients due to inconsistent study results. The aim of this study was to compare conservative and surgical treatment in relation to wrist function and satisfaction in patients older than 65 years. METHODS: In this prospective randomized clinical trial, patients aged older than 65 years who suffered an isolated AO-classified C1 or C2 distal radius fracture were randomized to surgical treatment using palmar plate osteosynthesis or conservative treatment. Patient-rated wrist evaluation (PRWE) score and disabilities of arm, shoulder, and hand (DASH) was assessed 3, 6 and 12 months post-interventionally. Satisfaction, range of motion (ROM) and pain scores were evaluated at 6 weeks and 3, 6 and 12 months post-interventionally. RESULTS: A total of 80 patients with a mean age of 77.3 years (± 6.1 years) in the conservative group and 72.5 years (± 5.3 years) in the surgery group were included. Both the PRWE score, and the DASH score showed a statistically significant difference between the two groups after 3 months, 6 months and 12 months (p < 0.001). Patients in the surgical cohort showed a statistically significant higher satisfaction at the 6-week, 6-month and 12-month follow-up (p < 0.001 6 weeks + 12 months; p = 0.004 6 months). CONCLUSION: In this prospective randomized study, surgical treatment proved to be superior to conservative treatment in terms of the primary outcome variable PRWE score. Satisfaction was significantly better in the surgical group.