Coracoid morphology and humeral version as risk factors for subscapularis tears.

BACKGROUND: The pathophysiology of subscapularis (SS) lesions is still relatively unknown despite recent interest in predictive factors for SS tears. Our goal was to determine the influence of the coracoid morphology and humeral version on SS tears. METHODS: This was a retrospective, controlled, single-blinded study. We analyzed 232 shoulders with SS lesions confirmed by magnetic resonance imaging. The coracoid proximal length, coracoid distal length (CLD), and coracoid total length were measured. The coracoid length ratio, coracoid angle (CA), and humeral version were also evaluated. RESULTS: We found that greater humeral retroversion was progressively related to more serious SS injuries, with values of -28.6° ± 19.5° and -51.0° ± 11.1° in the normal SS group and tear group, respectively (P < .001). The same tendency was shown for the CA, with values of 123.8° ± 11.1° in the control group vs. 97.4° ± 10.1° in the tear group (P < .001). Greater CLD, coracoid total length, and coracoid length ratio were also associated with an increased risk of SS tears (P < .001). The CA and CLD represented the best predictors of SS tears, presenting areas under the receiver operating characteristic curve of 90.0% and 89.0%, respectively. CONCLUSIONS: This article is the first to study the influence of different parameters of the coracoid process morphology and humeral version on SS tears. We proved that humeral version and coracoid morphology were important risk factors for SS pathology and could accurately predict these lesions. Finally, our study was the first to create a classification system to divide coracoids according to their morphology and relative risk of associated SS tears.

Coracohumeral distance and coracoid overlap as predictors of subscapularis and long head of the biceps injuries.

BACKGROUND: Subscapularis (SS) lesions are often underdiagnosed because of an incomplete understanding of contributing factors but also because of a greater difficulty in SS tear diagnosis with magnetic resonance imaging or physical examination. In this setting, predicting factors can be useful tools in these injuries' management. The goal of this study was to determine the influence of the coracohumeral distance (CHD) and coracoid overlap (CO) in anterior rotator cuff lesions, as well as to determine the CHD and CO values that can accurately predict SS and long head of the biceps (LHB) injuries. METHODS: We performed a retrospective, controlled, single-blinded study. We analyzed 301 patients with rotator cuff pathology and magnetic resonance imaging studies; patients with SS lesions represented the study group. The CHD and CO were measured. RESULTS: We found that lower CHD and higher CO values were progressively related to more serious injuries of the SS and LHB. The CHD was a very strong predictor of SS injury and tear and a good predictor of LHB injuries. A CHD of 7.6 mm had a sensitivity of 84.4% and specificity of 88.6% for SS tears. The CO was also a very strong predictor of SS tears and a good predictor of LHB injury, with a CO of 16.6 mm reaching a sensitivity of 77.8% and specificity of 68.3% for SS tears. CONCLUSIONS: The CHD is an excellent predictor of SS tears and a good predictor of LHB lesions, with the CO also being a very strong predictor of SS tears and a good model for LHB injuries.

Proximal femur geometry: a major predictor of proximal femur fracture subtypes.

INTRODUCTION: Proximal femur geometry (PFG) represents an important risk factor for the occurrence of hip fractures. There are currently few studies regarding the correlation between PFG and the occurrence of a specific fracture subtype, and those that exist have small cohorts and present with different methodologies and contradictory results. Therefore, there is no consensus in the literature regarding this topic. The present study aimed to establish the contribution of the PFG in the occurrence of different subtypes of proximal femur fractures (PFF): intertrochanteric, neck and subtrochanteric. METHODS: Analysis of 1022 plain anteroposterior pelvic radiographs of patients consecutively admitted to the emergency room of a Level 1 Trauma Centre between 2013 and 2019 after low energy trauma who presented with PFF and underwent surgical treatment. Patients were analysed considering age, gender and subtype of PFF (intertrochanteric, neck or subtrochanteric). Radiological parameters including cervicodiaphyseal angle (CDA), horizontal offset (HO), femoral neck width (FNW), femoral neck length (FNL), great trochanter-pubic symphysis distance (GTPSD), acetabular teardrop distance (ATD) and width of the intertrochanteric region (WIR) were measured and compared between the different subtypes of fractures (7154 measurements). Statistical analysis was conducted recurring to absolute measurements and measurements ratios. The correlation was assessed using t-test. RESULTS: There were statistically significant differences in proximal femur geometry between the different subtypes of fractures. Patients presenting with femoral neck fractures had greater CDA (132.5 ± 6.9 vs. 130.0 ± 7.3; p < 0.001) and lower HO (45.8 ± 7.4 vs. 49.0 ± 8.0; p < 0.001), HO/ATD (0.34 ± 0.068 vs. 0.37 ± 0.072; p < 0.001) and HO/GTPSD (0.26 ± 0.049 vs. 0.28 ± 0.039; p < 0.001) than patients with intertrochanteric/subtrochanteric fractures. CONCLUSIONS: PFG represents an important contributor to the occurrence of different fracture subtypes. Femoral neck fractures are associated with greater CDA and lower HO, HO/ATD and HO/GTPSD when compared to intertrochanteric or subtrochanteric fractures.

Thioglycolic acid grafted onto silica gel and its properties in relation to extracting cations from ethanolic solution determined by calorimetric technique.

Thioglycolic acid was immobilized onto silica gel surface using 3-aminopropyltrimethoxysilane as precursor silylating agent to yield silica. The amount of thioglycolic acid immobilized was 1.03 mmol per gram of silica. This new surface displayed a chelating moiety containing nitrogen, sulfur, and oxygen basic centers which are potentially capable of extracting cations from ethanolic solution, such as MCl3 ( M=Fe, Cr, and Mo). This process of extraction was carried out by the batch method when similar chemisorption isotherms were observed for all cations. The data were adjusted to a modified Langmuir equation. The sequence of the maximum retention capacity was Cr(III) > Mo(III) > Fe(III). The same adsorption was determined by calorimetric titration and the enthalpic values of -35.75 +/- 0.02, 32.90 +/- 0.15, and -84.08 +/- 0.12 kJmol(-1) for chromium, molybdenum, and iron, respectively, were obtained. From the calculated Gibbs free energy -23.4 +/- 0.2, -27.2 +/- 0.2, and -32.7 +/- 0.3 kJmol(-1), the variations in entropy obtained were 42 +/- 1, 201 +/- 1, 172 +/- 1 JK(-1)mol(-1) for the same sequence. All thermodynamic values are in agreement with the spontaneity of the proposed cation-basic center interactions for these chelating processes.

Chemisorption and thermodynamic data of the interaction between a chelate free acidic center with basic groups attached to grafted silicas.

The molecule 2-aminoethanethiol was added to the grafted silylant agent [(3-chlorosilylpropyl)trimethoxysilane] (cpts) onto silica gel(triple bond SilCl), obtaining a surface (triple bond SilSNH(2)) and giving 0.70 mmol g(-1) of nitrogen; the surface of silica was modified with [(3-mercaptosilylpropyl)trimethoxysilane] (mpts) with surface (triple bond SilSH), giving 0.78 mmol g(-1) of sulphur. Both matrices, (triple bond SilSNH(2)) and (triple bond SilSH), adsorb copper and cobalt acetylacetonates from ethanolic solution. Adsorption, using a batchwise process, showed that copper chelate was the most adsorbed. The interactions between the basic centers attached to organic chains of these modified silicas with the cations in the chelates Me(acac)(2) [M=Cu and Co] were followed through calorimetric titrations. Exothermic enthalpic results were obtained for the triple bond SilSNH(2) matrix. The spontaneity of these systems was reflected in negative free Gibbs energy and positive from entropic values.