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Elyse Brinkmann, Frank DiSilvio, Michael Tripp, Mitchell Bernstein, Hobie Summers, William D Lack
OBJECTIVES: To assess the relationship between the distal nail target and postoperative alignment for distal tibia fractures treated with intramedullary nailing. DESIGN: Retrospective cohort study. SETTING: A single level 1 trauma center. PATIENTS/PARTICIPANTS: One hundred thirty distal tibia fractures treated with intramedullary nailing over a 10-year period. MAIN OUTCOME MEASUREMENTS: Malalignment >5 degrees...
March 2019: Journal of Orthopaedic Trauma
Timothy Fowler, Michael Whitehouse, Andrew Riddick, Umraz Khan, Michael Kelly
OBJECTIVES: To compare the rates of deep infection, flap failure, and nonunion after temporary internal fixation (TIF) with temporary external fixation (ex-fix) in the management of Gustilo-Anderson type IIIB open tibia fractures. DESIGN: Retrospective comparative cohort study. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Sixty-four consecutive patients with a Gustilo-Anderson type IIIB open diaphyseal tibia fracture (OTA/AO 42) were treated between May 2014 and May 2016...
March 2019: Journal of Orthopaedic Trauma
Sharan Mallya, Surendra U Kamath, Arkesh Madegowda, Sunil Lakshmipura Krishnamurthy, Manesh Kumar Jain, Ramesh Holla
INTRODUCTION: Presently, unstable intertrochanteric femur fractures are treated commonly with intramedullary nailing devices. Various designs of intramedullary nail are introduced. The conventional Proximal Femoral Nail has given diverse outcome. Complications have also been noted with this implant. Newer designs like Proximal Femoral Nail Antirotation-2 have been introduced for Asian population. The aim of our study was to compare the radiological and functional outcome of unstable intertrochanteric femur fracture treated with conventional Proximal Femoral Nail and Proximal Femoral Nail Antirotation-2 in osteoporotic patients...
February 18, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Timothy Nacarelli, Lena Lau, Takeshi Fukumoto, Joseph Zundell, Nail Fatkhutdinov, Shuai Wu, Katherine M Aird, Osamu Iwasaki, Andrew V Kossenkov, David Schultz, Ken-Ichi Noma, Joseph A Baur, Zachary Schug, Hsin-Yao Tang, David W Speicher, Gregory David, Rugang Zhang
Cellular senescence is a stable growth arrest that is implicated in tissue ageing and cancer. Senescent cells are characterized by an upregulation of proinflammatory cytokines, which is termed the senescence-associated secretory phenotype (SASP). NAD+ metabolism influences both tissue ageing and cancer. However, the role of NAD+ metabolism in regulating the SASP is poorly understood. Here, we show that nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme of the NAD+ salvage pathway, governs the proinflammatory SASP independent of senescence-associated growth arrest...
February 18, 2019: Nature Cell Biology
Sarah Bond, Philippa Rust, Maria Boland
PURPOSE: Avulsion injury of the flexor digitorum profundus (FDP) tendon has been traditionally repaired with a pull-out suture over the nail plate. Complication rates with this method and improvements in anchor design have led to the increased use of bone anchors to give a rigid all-inside repair. However, the dimensions of the distal phalanx may limit their use. The primary hypothesis was that 2 micro bone anchors could fit in either perpendicular or 45° proximally angled positions within each distal phalanx...
February 15, 2019: Journal of Hand Surgery
A Memeo, E Panuccio, R D D'Amato, M Colombo, S Boero, A Andreacchio, C Origo, L Pedretti
INTRODUCTION: Femoral shaft fractures are the commonest major pediatric fractures. For generations, traction and casting were the standard method of treatment for children. However, over the past two decades there has been growing recognition of the advantages of fixation and rapid mobilization. METHODS: A prospective multicenter study was conducted at four Italian centers of reference for pediatric fractures (January 2005 to December 2014). The study involved 62 patients of both sexes, between 6 and 14 years of age, with closed femoral shaft fractures...
February 7, 2019: Injury
Pravin Mundada, Minerva Becker, Vincent Lenoir, Salvatore Stefanelli, Anne-Laure Rougemont, Jean Yves Beaulieu, Sana Boudabbous
Although the nail is a small anatomical structure, it can be affected by various tumors and tumor-like conditions. Because of the distinctive nail anatomy, the clinical presentation of tumors is modified, thus rendering the diagnosis challenging. As nail biopsy and surgery are painful procedures associated with an increased risk of permanent onychodystrophy, pre-operative diagnosis is desirable. Although conventional radiographs are still the first-line radiologic examination for the assessment of bony structures beneath the nail matrix, they do not allow detailed evaluation of the phalangeal soft tissues...
March 2019: European Journal of Radiology
Lara Yildirimer, Colin T Brewster, Hina Aziz, Zeynep Unluer, Barbara Jemec, Anna De Leo
The aim of this study was to analyse the management of nail bed injuries from a clinical and economic perspective. We carried out a retrospective analysis of nail bed injuries treated operatively at a tertiary Plastic Surgery Hand Trauma Unit during 2016. The National Schedule of Reference Costs (2015-2016) was used to estimate the costs of treating 630 patients. The most common mechanism was a crush injury in a door (33%). Fifty-five per cent of patients had an associated tuft fracture. The minimum cost per annum for patients treated for nail bed injuries in our unit was calculated to be £511,560 (€573,362; US$666,664)...
February 18, 2019: Journal of Hand Surgery, European Volume
Michela Starace, Aurora Alessandrini, Nicolò Brandi, Bianca Maria Piraccini
The term melanonychia describes a black-brown-gray pigmentation of the nail plate that, in most cases, appears as a longitudinal band. Melanonychia can be observed at any age, affecting one digit or several digits, in both fingernails and toenails. Its causes can be difficult to differentiate clinically and depend on the number of bands and on their color, edge, and width. For this reason, especially in adults and when the pigmentation is localized in one single digit, biopsy and histopathological examination still represent the gold standard for a definitive diagnosis...
January 2019: Dermatology Practical & Conceptual
Choonghee Park, Moonyoung Hwang, Yongwook Baek, Soonwon Jung, Youngmee Lee, Domyung Paek, Kyungho Choi
BACKDGROUND: Phthalates and bisphenol A (BPA) have been used in a variety of consumer products and are detected widely in both humans and the environment. Demographic and socio-economic characteristics that affect exposure to these chemicals have been investigated among several general populations; however, nationally-representative population-based studies are limited to Canada, Germany, and the USA. Moreover, relatively little is known about the socio-demographic characteristics that influence exposure to these chemicals among nationally representative populations of Asia...
February 14, 2019: International Journal of Hygiene and Environmental Health
Stephen J Wallace, Tomas E Liskutin, Adam P Schiff, Michael S Pinzur
BACKGROUND: Unstable ankle fractures in diabetics with peripheral neuropathy have an increased risk of postoperative complications, often leading to amputation. Primary ankle arthrodesis has been suggested as an alternative when acceptable reduction and mechanical stabilization cannot be obtained. METHODS: Over a fourteen year period, thirteen diabetic patients with peripheral neuropathy underwent an attempt at primary ankle arthrodesis following the early post-fracture development of acute neuropathic (Charcot) deformity of the ankle after sustaining a low energy unstable ankle fracture...
February 5, 2019: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
José Grau, Juan L Benedé, Javier Serrano, Andrea Segura, Alberto Chisvert
This work describes a new analytical method useful for monitoring the human exposure to the endocrine-disrupting plasticizer triphenyl phosphate (TPP) via nail polish use. The method allows trace determination of this parent compound and its main metabolite, namely diphenyl phosphate (DPP), in urine samples of nail polish users. The method is based on a novel microextraction technique termed stir bar sorptive-dispersive microextraction (SBSDME) using a magnetic composite made of CoFe2 O4 magnetic nanoparticles embedded into a mixed-mode weak anion exchange polymer (Strata™ -X-AW), followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS)...
February 7, 2019: Journal of Chromatography. A
Jun Wang, Yi Yang, Rongli Yang, Xiaodong Tang, Wei Guo
INTRODUCTION: This is a retrospective study that evaluate the outcome of patients with extremity sarcoma between extramedullary plate and intramedullary nailing for the biological reconstruction after tumor resection. METHODS: 58 patients (40 treated with plate fixation and 18 with intramedullary nailing, IM group) with sarcomas of the lower and upper extremity who received biological reconstruction at our bone tumor center from November 2003 to November 2015 were reviewed for the study...
February 6, 2019: Injury
Florian Laubé, Andy Poupon, Philippe Zinck, Christel Müller-Goymann, Stephan Reichl, Véronique Nardello-Rataj
The human nail, like any biological material, is not readily available in large amounts and shows some variability from one individual to another. Replacing it by synthetic models is of great interest to perform reproducible and reliable tests in order to assess drug diffusion or nail lacquer adhesion for example. Keratin films, produced at the lab scale from natural hair, and the commercially available Vitro-nail® sheets have been proposed as models of human nails. In this study, we have investigated in detail these two materials...
February 13, 2019: European Journal of Pharmaceutical Sciences
Won Chul Shin, Jae Hoon Jang, Jae Yoon Jeong, Kuen Tak Suh, Nam Hoon Moon
INTRODUCTION: Although various clinical applications of geneX® ds have been reported, no study has reported the clinical application of geneX® ds in osteoporotic hip fracture. The present study aimed to identify the clinical effect of the application of geneX® ds in elderly patients with intertrochanteric fracture treated using proximal femoral nail antirotation (PFNA). MATERIALS AND METHODS: From March 2014 to October 2017, 233 patients with intertrochanteric fracture (65 men and 168 women) were enrolled in this study...
February 12, 2019: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Razvan Nicolescu, Stephen M Quinnan, Charles M Lawrie, James J Hutson
Proximal tibia shaft fractures are often challenging to manage because of their intrinsic tendency toward valgus and apex anterior deformity. In recent years, intramedullary nailing (IMN) has become more frequently used to treat these injuries, allowing for biologic advantages such as load-sharing, immediate weight-bearing, and avoidance of disruption of periosteal blood supply. Several adjunctive techniques, such as semiextended positioning, blocking screws, and external fixation, have been developed to assist with fracture reduction during IMN...
March 2019: Journal of Orthopaedic Trauma
K Nilsson, M Friberg, O Rollman, E Tano
Dermatophytes are common pathogens in superficial mycoses that are routinely identified by culture or PCR analysis of freshly collected skin, nail or hair specimens. Although clinical samples are normally processed without delay, practical or research issues may necessitate sample storage until later analysis. However, the influence of extended sample storage on the ability to recover fungi by culture vs. PCR analysis has not been specifically studied. Here, a total of 172 dermatological samples collected from 2013-2015 were examined before and after refrigerated storage at 4°C for 10...
February 11, 2019: Journal de Mycologie Médicale
Dayoung Ko, Clara Oromendia, Richard Scher, Shari R Lipner
BACKGROUND: Longitudinal melanonychia (LM) is a common finding in clinical practice; however, it has a broad differential diagnosis, including subungual melanoma (SUM), which can be difficult to distinguish clinically from benign conditions. OBJECTIVE: To identify clinical and dermoscopic features that distinguish histopathologically diagnosed SUM from benign LM and to evaluate the validity of the ABCDEF criteria among patients on whom a biopsy was performed. METHODS: Retrospective cohort study of consecutive patients who underwent nail matrix biopsy for LM at a single center from January 2011 to November 2017...
February 11, 2019: Journal of the American Academy of Dermatology
Oliver W G Manley, Justin C R Wormald, Dominic Furniss
Hospital Episode Statistics (HES) include freely accessible records of all hospital episodes in England. We analysed HES from 1998-1999 to 2014-2015 for diagnoses of hand fractures, tendon injuries, nerve injuries, blood vessel injuries, traumatic amputations and nail bed injuries. Population data were used to calculate the incidence. The overall incidence of the injuries increased from 70 to 110 per 100,000. There were especially large increases in the incidence of fractures in the over 75 years age group and nail bed injuries in the 0-14 years age group...
February 14, 2019: Journal of Hand Surgery, European Volume
Caitlyn M Rerucha, John T Ewing, Kathryn E Oppenlander, Wesley Charles Cowan
Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep fascial planes, bursae, joint spaces, and bones. Superficial hand infections are more common than deep infections and are typically managed with elevation, warm soaks, splinting in the position of function, analgesics, and empiric antibiotics when indicated...
February 15, 2019: American Family Physician
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