Evaluation of the results of open reduction and internal fixation of intra-articular calcaneal fractures by one third tubular plate

Treatment of intra-articular calcaneal fracture is still controversial. The aim is to evaluate the results of open reduction and fixation of calcaneal fracture using one third tubular plate and small set screws. Twenty patients with intra-articular calcaneal fractures were treated by open reduction and fixation using one third tubular plates. The average age was 32.5 +/- 4.5 years. The majority were manual workers. Falling from height was the causative trauma in all patients. Eleven patients [55%] had associated fractures. Fractures were classified according to Sanders classification into: six type II, twelve type III and two type IV fractures. Our results showed three excellent, eleven good, three fair and three poor outcomes. The results were affected by the height of falling, type of fracture, time elapsed before surgery, presence of infection and the degree of Gissane angle restoration. We concluded that reduction is the main factor to have satisfactory results and that one third tubular plates is an acceptable method of fixation of type II and III intra-articular calcaneal fractures but should not be used in type IV

prognostic value of congestion index in patients with portal hypertension due to schistosomal hepatic fibrosis with and without chronic hepatitis C: a clinico-pathological and hemodynamic study

We intended to assess the value of congestion index of portal vein [Cl PV] [derived from the ratio between the cross-sectional area of the portal vein and the mean velocity of portal flow] in assessing the severity of portal hypertension and its correlation with North Italian Endoscopic Club [NIEC] index and risk of bleeding in patients with schistosomal hepatic fibrosis with and without chronic hepatitis C. We studied 64 patients with portal hypertension who were categorized into three groups based on histological diagnosis: group I [19 with pure schistosomal hepatic fibrosis], group II [22 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C] and group III [23 patients with combined schistosomal hepatic fibrosis and chronic hepatitis C with cirrhosis]. All patients were of the Child class A.They were subjected to; clinical examination, stool and serological examinations for schistosoma infection, serum transaminases and alkaline phosphatase, serum albumin, prothrombin activity and virological markers. Upper endoscopy, abdominal Ultrasonography with duplex as well as liver biopsies were performed to all patients. The results showed that the mean value of Cl PV was found to be higher in groups II [0.155 +/- 0.05] and III [0.179 +/- 0.04] than in group I [0.134 +/- 0.04], which reached a significant level only between groups III and I [P<0.05]. The mean values of NIEC index and NIEC risk of bleeding were found to be significantly higher in group III [28.5 +/- 4, 18.3 +/- 6.3] respectively than in groups I [23.6 +/- 5, 10.6 +/- 7.8] and II [23.5+4, 11+6.5] [P<0.05] with no significant difference between groups I and II. The Cl PV was found to have a significant positive correlation with the degree of fibrosis as assessed by both the sonographic and the histopathologic examinations. It was also significantly correlated with NIEC risk of bleeding. We concluded that the congestion index of portal vein is a valuable non invasive parameter in assessing the severity of portal hypertension and in predicting bleeding in schistosomal patients with and without chronic hepatitis C