Comparison of curative effect of elastic locking intramedullary nail and anatomic locking plate in the treatment of mid-shaft clavicular fracture / 中华骨科杂志

Objective@#To compare the curative effect between Elastic Locking Intramedullary Nail (ELIN) and Anatomic Locking Plate (ALP) for the treatment of fracture in the mid-shaft of clavicle (Classification AO/OTA:2A/2B).@*Methods@#Data of 47 cases of 2A/2B clavicular fractures who were treated with operation from January 2014 to December 2016 were retrospectively analyzed. The patients were divided into ELIN group and ALP group according to different fixation methods. There were 23 cases in ELIN group, 14 male and 9 female, aged from 19 to 85 years (average, 55.26 years). 14 cases on the left side and 9 cases on the right side. There were 6 cases of type 2A and 17 cases of type 2B. There were 24 cases in the ALP group, 18 male and 6 female, aged from 15 to 71 years (average, 51.25 years). 16 cases on the left side and 8 cases on the right side. There were 9 cases of type 2A and 15 cases of type 2B. The operation time, intraoperative blood loss, length of skin incision, fracture healing time, extraction time of internal fixation, Constant-Murley score of shoulder joint, disabilities of the arm, shoulder, and hand (DASH) score, and complication incidence were compared between the two groups.@*Results@#All the operations were successfully performed. The mean follow-up for the patients in the ELIN group was 19.35 weeks (range, 14-23 weeks). The mean follow-up for the patients in the ALP group was 53.13 weeks (range, 28-76 weeks). In the ELIN group, the operative time was 20.78 ± 7.71 min, the intraoperative blood loss was 13.26±9.72 ml, the length of incision was 1.57±1.24 cm, the fracture healing time was 10.39±2.39 weeks, the extraction time of internal fixation was 13.17±2.37 weeks, the Constant-Murley score of shoulder joint was 99.09±1.86, and the DASH score was 1.20±2.47. In the ALP group, the operative time was 57.79±11.56 min, the intraoperative blood loss was 69.17±46.24 ml, the length of incision was 9.67±2.90 cm, the fracture healing time was 14.21±4.05 weeks, the extraction time of internal fixation was 47.38±10.46 weeks, the Constant-Murley score of shoulder joint was 98.00±2.17, and the DASH score was 0.89±1.65. The operation time (t=12.856, P=0.000), intraoperative blood loss (t=5.791, P=0.000) in the ELIN group were less than that of ALP group. The length of incision was significantly smaller in ELIN group than that of ALP group (t=12.549, P=0.000). The fracture healing time was earlier in ELIN group than that of ALP group (t=3.566, P=0.002). The extraction time of internal fixation was obviously earlier in ELIN group than that of ALP group (t=15.603, P=0.000). Constant-Murley score of shoulder joint and DASH score showed no significant difference. No delayed healing, no infection was found in the ELIN group, however skin irritation and tail bursitis were found in 6 cases, 3-6 weeks after the operation. The dressing was changed, kept clean. Skin irritation and tail bursitis disappeared, after the extraction of the internal fixation. There were 2 cases of delayed healing in the ALP group. After prolonged observation, the 2 cases healed. The healing time was extended to 24 and 27 weeks, respectively. There was 1 case of infection, 1 case of poor skin healing in the ALP group. The infected patient was treated with debridement and sensitive antibiotics, and the patient with poor skin healing was treated with dressing change. All the patients had wound healing about 4 weeks after surgery. 2 cases of skin irritation in the ALP group disappeared, after the extraction of the internal fixation.@*Conclusion@#Both ALP and ELIN are effective methods for the treatment of mid-shaft clavicular fracture. ELIN group has the advantages of more minimally invasive, faster union, shorter internal fixation time, better appearance, and lower medical cost. However, the ELIN group also had skin irritation and temporary bursitis.

Development of novel diclofenac potassium controlled release tablets by wet granulation technique and the effect of co-excipients on in vitro drug release rates

The aim of the present study was the formulation and evaluation of controlled release polymeric tablets of Diclofenac Potassium by wet granulation method for the release rate, release pattern and the mechanism involved in drug release. Formulations having three grades of polymer Ethocel [7P; 7FP, 10P, 10FP, 100P, 100FP] in several drugs to polymer ratios [10:3 and 10:1] were compressed into tablets using wet granulation method. Co-excipients were added to some selected formulations to investigate their enhancement effect on in vitro drug release patterns. In vitro drug release studies were performed using USP Method-1 [Rotating Basket method] and Phosphate buffer [pH 7.4] was used as a dissolution medium. The similarities and dissimilarities of release profiles of test formulations with reference standard were checked using f2 similarity factor and f1 dissimilarity factor. Mathematical/Kinetic models were employed to determine the release mechanism and drug release kinetics

Development of a novel ketoprofen transdermal patch: effect of almond oil as penetration enhancers on in-vitro and ex-vivo penetration of ketoprofen through rabbit skin

The aim of the study was to formulate and evaluate topically applied ketoprofen gels and patches and to see the effect of naturally occurring almond oil as penetration enhancer on the penetration of ketoprofen through artificial membrane/rabbit skin. Prior to ketoprofen gel and patch formulation, the particle size and particle size determination of ketoprofen was analyzed by Particle size analyzer [Horiba LA300]. Ketoprofen gels and patches were formulated and almond oil was added in several concentrations i.e. 0.5%, 1%, 1.5%, 2%, 2.5% and 3%. The formulated gels were evaluated by several parameters like pH, spreadibility, consistency, homogeneity, skin irritation and drug content determination. In vitro drug permeation studies from transdermal gels and patches were carried out across artificial membrane and rabbit skin by using Franz Cell Apparatus [PermeGear, USA]. Kinetics model was employed to the release patterns of ketoprofen from gel and patches in order to investigate the drug transport mechanism. The cumulative amount of drug penetrated from different formulations was statistically evaluated by using One-way analysis of variance [ANOVA]. Stability study was performed for various batches of ketoprofen transdermal gel. Almond oil as penetration enhancer in various concentrations significantly enhances the penetration of drug from transdermal gels and patch across synthetic membrane/rabbit skin but was most significant when used in 3% concentration

Outcome of supracondylar fractures of humerus in children treated with open reduction and internal stabilization with cross kirschner wires

To determine the surgical outcome of the open reduction and internal stabilization of supracondylar fracture [SC] of humerus in children. Descriptive case-series. District Headquarter Hospital Hangu, from May 2007 to May 2008. Thirty supracondylar fractures of the humerus [Gartland type III] were treated through Campbell posterior approach. Eighteen patients were males and twelve were females. Mean age of the patients was 6.5 year, ranging from 2-13 year. Patients having vascular compromises were excluded. All the fractures were reduced through open approach and stabilized with two cross Kirschner wires. All patients were assessed post-operatively for deformity, range of motion and pain through Flynn's criteria. Sixteen [53.4%] cases yielded excellent results, 6 [20%] had good results, 5 [16.6%] fair results, while 3 patients [10%] had poor results. Open reduction and internal stabilization of supracondylar fractures give better functional results

Formulation and in vitro evaluation of ofloxacin-ethocel controlled release matrix tablets prepared by wet granulation method: influence of co-excipients on drug release rates

Being controlled release dosage forms, tablets allow an improved absorption and release profiles of Ofloxacin. The fact that drugs with fine particles size can be compressed well after wetting, so in our research studies Ofloxacin controlled release matrix tablets were prepared by wet granulation technique. In order to investigate the potential of Ethyl cellulose ether derivatives as a matrix material, Ofloxacin formulations with different types and grades of Ethocel were prepared at several drug-to-polymer ratios. The method adopted for in vitro drug release studies was USP Method-1 [rotating Basket Method] by Pharma test dissolution apparatus using phosphate buffer 7.4 pH as a dissolution medium. Various Kinetic models were employed to the formulations for the purpose of determination of release mechanism. A comparative study was performed between the tested Ofloxacin-Ethocel formulations and a standard reference obtained from the local market. FI dissimilarity factor and f2 similarity factor were applied to the formulations for the checking of dissimilarities and similarities between the tested formulations and reference standard