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Management of osteoporotic acetabular fractures
Published in Peter V. Giannoudis, Thomas A. Einhorn, Surgical and Medical Treatment of Osteoporosis, 2020
Peter V. Giannoudis, Panagiotis Douras
Indications for acute THR are preexisting osteoarthritis in the affected hip joint, fracture of the femoral head, severe comminution of the acetabulum, severe impaction, wide abrasion of the femoral head, multipartite acetabular fracture, and bone with a great degree of osteoporosis (Figures 21.5 and 21.6). Relative indications include delayed presentation and no medical comorbidities. Two strategic pathways can be selected. First, to perform THR after an ORIF of the acetabular fracture, and second to perform THR without attempting to reduce the fracture.
Antiviral Activity of Seaweeds and their Extracts
Published in Leonel Pereira, Therapeutic and Nutritional Uses of Algae, 2018
The genome of a virus may consist of DNA or RNA, which may be single stranded (SS) or double stranded (DS), linear or circular. The entire genome may occupy either one nucleic acid molecule (monopartite genome) or several nucleic acid segments (multipartite genome). The different types of genome necessitate different replication strategies (Gelderblom 1991).
The ankle and foot
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Sesamoid chondromalacia is a term coined by Apley to explain changes such as fragmentation and cartilage fibrillation of the medial sesamoid. X-rays in these cases may show a bipartite or multipartite medial sesamoid, which is often mistaken for a fracture.
Lateral ankle anatomical variants predisposing to peroneal tendon impingement
Published in Alexandria Journal of Medicine, 2018
Mahmoud Agha, Mohamed Saied Abdelgawad, Nasser Gamal Aldeen
Os peroneum and os vesalianum are two sesamoid bones which infrequently may be seen in PL and PB tendons; respectively. They are considered to be another impinging elements as described in the literatures. Both are fibrocartilaginous type of sesamoids which may be missed in X ray, if still not ossified. MR imaging can confidently demonstrate them, as intra-tendinous oval well-corticated ossicle or cartilaginous structures if still not ossified. These two sesamoids should not be confused with other tendon pathologies such as avulsion fracture or apophysis of the 5th metatarsal bone.21,22 Although theses sesamoid bones are usually discovered incidentally; it may be complicated causing acute or chronic considerable regional lateral plantar foot pain, which is known as painful os peroneum syndrome (POPS). The POPS could be a result of acute trauma, or more frequently has chronic presentation secondary to repetitive injuries of the foot. OP was seen in 9.3% of our candidates; 47% of them had POPS. The POPS spectrum includes: an acute fracture or diastasis of a multipartite os peroneum, old fracture with callus formation. These all will end in stenosing PL tenosynovitis; partial or complete tear of the peroneus longus tendon21,23 (Fig. 7). In Group B patients who had no anatomical variants; only 18% had PTT. Fisher exact test revealed significant difference between the two groups; denoting the higher susceptibility of patients of group A (Fig. 8).
A new multipartite plate system for anterior cervical spine surgery; finite element analysis
Published in British Journal of Neurosurgery, 2018
Hakan Şimşek, Emre Zorlu, Serdar Kaya, Murat Baydoğan, Cem Atabey, Ahmet Çolak
We assume that segmental and terminal plates of articulated system are assembled during surgery through a limited surgical area in a stepwise fashion. The surgical exposure does need to be as long as the plate as it is true for conventional plates. When a suitable plate is chosen for each vertebral body, both the dimensions of system and the screw hole locations are going to be optimally provided. The spontaneous slight angulations at articulations will provide perfect adaptation of the plate system to the lordosis of individual spine, providing optimum plate-bone interface. Owing to this feature, the pull-out forces applied on screws will be minimized and equally distributed. The articulation points however seem to introduce potential of failure that might be mentioned for any multipartite construct. Another important point to emphasize is that the articulation area maintains a good vision of grafts through the midline. Since this was a pure finite element study, aforementioned features need confirmation with further application in clinical settings and biomechanical studies on cadavers. Whether the articulated plate system contributes to prevention of pseudoarthrosis needs to be clinically tested.