Comparative analysis of external locking plate and combined frame external fixator for open distal tibial fractures: a comprehensive assessment of clinical outcomes and financial implications.

BACKGROUND: Open distal tibial fractures pose significant challenges regarding treatment options and patient outcomes. This retrospective single-centre study aimed to compare the stability, clinical outcomes, complications, and financial implications of two surgical interventions, namely the external locking plate and the combined frame external fixator, to manage open distal tibial fractures. METHODS: Forty-four patients with distal open tibial (metaphyseal extraarticular) fractures treated between 2020 and 2022 were selected and formed into two main groups, Group A and Group B. Group A (19 patients) are patients that underwent treatment using the external locking plate technique, while Group B (25 patients) received the combined frame external fixator approach. Age, gender, inpatient stay, re-operation rates, complications, functional recovery (measured by the Johner-Wrush score), pain ratings (measured by the Visual Analogue Scale [VAS]), and cost analyses were evaluated for each group. Statistical analyses using SPSS were conducted to compare the outcomes between the two groups. RESULTS: The research found significant variations in clinical outcomes, complications, and cost consequences between Group A and Group B. Group A had fewer hospitalisation periods (23.687.74) than Group B (33.5619.47). Re-operation rates were also considerably lower in Group A (26.3%) than in Group B (48%), owing to a greater prevalence of pin-tract infections and subsequent pin loosening in the combination frame external fixator group. The estimated cost of both techniques was recorded and analysed with the locking average of 26,619.69 ± 9,602.352 and the combined frame average of 39,095.64 ± 20,070.077. CONCLUSION: This study suggests that although the two approaches effectively manage open distal tibia fractures, the locking compression plate approach (Group A) has an advantage in treating open distal tibia fractures. Shorter hospitalisation times, reduced re-operation rates, and fewer complications will benefit patients, healthcare systems, and budget allocation. Group A's functional recovery results demonstrate the locking plate technique's ability to improve recovery and patient quality of life. According to the cost analysis, the locking plate technique's economic viability and cost-effectiveness may optimise healthcare resources for open distal tibia fractures. These findings might improve patient outcomes and inform evidence-based orthopaedic surgery.

Effects of chrysophanol on NO of brain tissue and anti-anoxia in mice with cerebral ischemia-reperfusion injury / 天津医药

Objective To study the effects of chrysophanol(Chry)on NO of brain tissue and anti-anoxia in mice with cerebral ischemia-reperfusion injury. Methods A total of 75 SPF Kunming mice were randomly allocated into five groups:sham operation group, ischemia-reperfusion group, high-dose group (Chry 10.0 mg ·kg-1), medium-dose group (Chry 1.0 mg ·kg-1) and low-dose group (Chry 0.1 mg ·kg-1). Using improved Himori method, cerebral ischemia reperfusion-injury model was produced in conscious mice by temporarily obstructing bilateral common carotid arteries. The neurological function was measured according to the Bederson scoring standard. The mice were subjected to decapitation for hypoxia tolerance test. The gasping time was measured by anoxia tolerance test in beheaded mice. The level of NO in cerebrum was detected. Results Chrysophanol can decrease the level of NO in cerebrum of mice with cerebral ischemia-reperfusion injury and prolong the gasping time in beheaded mice with cerebral ischemia-reperfusion injury [low-dose group, (14.6±1.2) s; medium-dose group, (16.4 ± 1.2)s; high-dose group, (17.4 ± 1.1)s; ischemia-reperfusion group, (13.2 ± 1.0)s, P<0.05]. Conclusion The protective effects of chrysophanol on cerebral ischemia-reperfusion injury are involved in decreasing the content of NO in brain tissue and anti-anoxia in mice.

Diagnosis and management of non-palpable breast cancer / 中华内分泌外科杂志

ObjectiveTo evaluate the diagnosis and surgical management of non-palpable breast cancer (NPBC). MethodsDiagnosis, preoperative localization and surgical management of 26 cases of NPBC were analyzed retrospectively.ResultsAll the 26 lesions were found by ultrasound or mammography.Local-extensive excision was performed under preoperative ultrasound-guided or radio-guided wire localization.Of the 26 lesions, 14 were ductal carcinoma in situ (DCIS), 9 were DCIS with micro-invasion and 3 were invasive ductal carcinoma.ConclusionsCombination of ultrasound and mammography improves the discovery rate of NPBC.Local-extensive excision under preoperative ultrasound-guided or radio-guided wire localization of NPBC shortens the duration of surgical procedure, avoids excessive resection of breast tissues and maintains the apperance of the breast.