Management of Open Tibial Diaphyseal Fractures by Limb Reconstruction System As Primary and Definitive Treatment: A Prospective Cohort Study.

Background One of the most frequent long bone fractures that most orthopaedic surgeons see is a tibial diaphyseal fracture. The tibia has more open fractures than any other major long bone because it is covered by skin for the majority of its length. The best course of therapy is still up for debate due to the high occurrence of comorbidities linked to these fractures. Materials and methods In this prospective study, 30 patients who met the inclusion criteria were admitted to the Department of Orthopaedics of Shri B. M. Patil Medical College Hospital and Research Centre, Vijayapura, Karnataka, India. The period of study was from January 2021 to May 2022. The patients were followed up for a period of six months. Longer follow-up was required for some patients. Results In our study, there were 26 (86.7%) male and four (13.3%) female patients. The mode of injury was road traffic accidents in all cases. The functional outcomes obtained using the modified Anderson and Hutchinson's criteria were good results in 22 (73.3%), moderate results in five (16.7%), and poor results in three (10%) of the study population. Pin tract infections (six cases; 20%) and shortening (eight cases; 26.7%) were the most frequent complications Conclusion Because of the ease of use, good fracture stability, adjustable geometry, light weight, reasonable price, and patient friendliness, the limb reconstruction system (LRS) provides an excellent alternative treatment option for treating compound fractures of the tibia.

Functional Outcomes of Tibia Fractures Treated With Intramedullary Interlocking Nails by Suprapatellar Approach: A Prospective Study.

Background Tibia fractures are the most common lower extremity fractures. The subcutaneous anatomy of this long bone predisposes it to high fracture frequency in a high-energy trauma. The tibia is a major weight-bearing, long tubular bone that is axially and rotationally unstable when fractured, which ideally necessitates its surgical fixation in adults. Tibia fractures can be treated with a variety of choice of implants and surgical approaches. This study aims to assess the clinical and functional outcomes of a tibia fracture treated with intramedullary interlocking nails by a suprapatellar approach. Methodology A total of 32 patients were selected from patients admitted at Shri B. M. Patil Medical College and Research Centre with tibia fractures between January 2021 and May 2022. All the patients were treated with closed reduction and internal fixation with intramedullary interlocking nails by suprapatellar approach with a semi-extended knee position. All patients were followed up clinically and radiologically at regular intervals of six weeks, three months, six months, and one year. All functional outcomes were assessed based on modified Lysholm knee scores. Results A total of 31 patients showed union at the fracture site. One patient had nonunion and implant failure at the distal locking site, and two patients had persistent anterior knee pain at the end of one year. Functional outcome assessment based on modified Lysholm scores had excellent results, with a mean score of 95. Patients were followed up for a mean of 11.5 months. The mean time of union was observed as 12.5 months. Conclusions Suprapatellar tibia nailing is an effective alternative approach with ease of reduction and decreased intraoperative fluoroscopy time. The entry is in line with the medullary cavity preventing malreduction of proximal and distal tibia fractures. The additional proximal locking option also increases the stability of implant fixation.

Optical, Structural and Photoluminescence Properties of Gd x SrO: CdO Nanostructures Synthesized by Co Precipitation Method.

To investigate the effect of Gd x SrO: CdO (x = 0.1, 0.3, 0.4) nanostructures (NS), in the present work an attempt has been made to synthesize Gdx SrO:CdO NS by co precipitation method. Structural properties were investigated by XRD (X-ray diffraction), FTIR (Fourier transform infrared spectroscopy), SEM (scanning electron microscopy), UV-Visible, XPS (X-ray photoelectron spectroscopy). XRD indicates having mixed phase of tetragonal crystal structure and SEM images indicate spherical shaped nanoparticles (NPs) of Gd x SrO:CdO with average size laying in between ~100 nm to ~130 nm. FTIR spectra of Gd x SrO: CdO NS show stretching and bending peaks of Gd-O-Gd, Cd-O-Cd and Sr-OH at ~1311 cm -1, ~1486 cm -1, ~ 3300 cm -1 and UV-visible optical absorptivity of Gd x SrO:CdO show absorption maxima shift from 330 nm to 324 nm (blue shift) and edges at 352.4 nm, 348 nm and 346.3 nm respectively for Gd concentration varying between 0.1, 0.3 and 0.4. binding energies of the Gd 3d 3/2, Sr 3d 3/2 and Cd 3d 3/2, O1s and C1s observed at 150.8 eV, 141.6 eV, 410.1 eV, 529.6 eV and 282.4 eV respectively which confirms the chemical composition of NS. Photoluminescence (PL) spectrum of Gd 0.4 Sr 0.5 O Cd 0.1O NS exhibit broad peaks from 338 nm to 397 nm centred around 369 nm with various Gd, O, Sr and Cd related native defects. Emission band observed at UV- Visible region for Gd 0.3 Sr 0.5 O Cd 0.2 O NS PL emission spectra has two emission peaks at 369 nm (UV region) and 550 nm (Visible region). The transitions can be ascertained with shielding of 4f shells of Gd+3 ions by 6 s, 5d shells by the interaction of the other Gd+3 ions.

Redesigning Supply Chains using Blockchain-Enabled Circular Economy and COVID-19 Experiences.

The COVID-19 pandemic has exposed businesses and societies to the shortfalls of normal patterns of production, consumption, and their long-lasting impact on supply chains. In this opinion paper, we provide insights from the COVID-19 pandemic for making supply chains more resilient, transparent, and sustainable. These insights include supply chains needing to develop localization, agility, and digitization (LAD) characteristics. We link LAD to a potential solution using blockchain technology and circular economy principle capabilities. Use cases are used to show how blockchain-enabled circular economy practices can support supply chain LAD efforts. Supply chain tracking, tracing, and responsiveness can be supported through blockchain-enabled circular economy practices. One result of identifying these relationships include solutions and insights at multiple levels and stakeholders - individual, organizational, supply chain, governmental, and community. These crisis-related observations and findings set a future research foundation for sustainable production and consumption.