RESUMO
PURPOSE: The present study was designed to evaluate the effect of intermittent electrical stimulation (ES) of the sciatic nerve on the expression of neuronal nitric oxide synthase (nNOS) protein in the soleus and in the medial gastrocnemius muscles 2 weeks following hindlimb suspension (HS). MATERIALS AND METHODS: In the HS+ES group, a pair of stainless steel electrodes were placed at the midportion of the unilateral sciatic nerve during hindlimb unloading. Square wave pluses with a 5 seconds ON-OFF pattern were applied to the sciatic nerve 4 hours a day for 14 days. The electrical stimulation parameters were 20 Hz, 0.3 ms, 1-5 voltage. 14 days later the sciatic nerve stimulation maximal twitch response was measured in the soleus and medial gastrocnemius muscles using an isometric tension transducer and polygraph. Western blot was used to analyze the expression of nitric oxide synthase (nNOS) protein in hindlimb muscles. RESULTS: The soleus muscle consisted of slow-twitch muscle fiber and showed a prominent decrease in maximum twitch tension and muscle weight than the medial gastrocnemius muscle 2 weeks after hindlimbs suspension. Hindlimbs suspension caused a reduction in the relative quantity of nNOS protein by 89% and 55% in the soleus and the medial gastrocnemius muscles, respectively, after 2 weeks of unloading compared with the ambulatory controls. However, intermittent electrical stimulation of the sciatic nerve delayed reduction significantly with respect to the expression of nNOS protein and twitch tension during hindlimb unloading. CONCLUSION: The results suggest that application of electrical stimulation to the sciatic nerve has a significant effect on NO signal transduction by regulating nNOS expression in atrophied hindlimb extensor muscles.
Assuntos
Animais , Ratos , Western Blotting , Estimulação Elétrica , Eletrodos , Elevação dos Membros Posteriores , Membro Posterior , Fibras Musculares de Contração Lenta , Músculo Esquelético , Músculos , Atrofia Muscular , Neurônios , Óxido Nítrico Sintase , Óxido Nítrico Sintase Tipo I , Nervo Isquiático , Transdução de Sinais , Aço Inoxidável , TransdutoresRESUMO
PURPOSE: We reviewed the functional and radiological results of unstable intraarticular fractures of the distal radius treated by percutaneous pinning with an external fixator. MATERIALS AND METHODS: Twenty-seven cases of unstable intraarticular fractures of the distal radius were treated by percutaneous pinning and external fixation between October 1996 and September 1999, and followed up for more than 1 year. We classified them using the Frykman classification and evaluated functional and radiological results according to the subjective point system of Cole & Obletz and the objective evaluation by Scheck. RESULTS: Subjectively, we obtained the following results: excellent in 7 cases, good in 13 cases, fair in 6 cases and poor in 1 case, and objectively, 8 cases were excellent, 14 cases were good, 4 cases were fair and 1 case was poor. Radiographically, mean volar tilt, radial inclination and radial length were 9.5degrees, 22.1degrees and 10.3 mm respectively on the last follow-up. Two cases of reflex sympathetic dystrophy and one of each of skin necrosis, pin tract infection, joint stiffness and metacarpal bone fracture occurred during the follow-up period. CONCLUSION: Percutaneous pinning and external fixation is a useful method for reducing mal-alignment and radial length maintenance, preventing reduction loss and restoring the articular surface and function of the distal radius in cases of intraarticular comminution, open fracture with soft tissue injury and multiple injury.
Assuntos
Classificação , Fixadores Externos , Seguimentos , Fraturas Ósseas , Fraturas Expostas , Fraturas Intra-Articulares , Articulações , Traumatismo Múltiplo , Necrose , Rádio (Anatomia) , Distrofia Simpática Reflexa , Pele , Lesões dos Tecidos MolesRESUMO
Osteoid Osteoma occurs anywhere in skeleton. They are most common in lower extremity, particularly femur about 40%. Two-thirds of femoral lesions is in the intertrochanter or intracapsular regions of the hip. The lesion is usually cortical and may extend into the periosteal or endosteal surface of the bone. It is rare in the cancellous bone. We experienced a case of osteoid osteoma in intertrochanteric cancellous portion of the femur in 50 year old man. Many complained right hip pain worsend three weeks before his visit. Radiograph shows sclerosis around a lucent nidus in cancellous portion. The lesion did not extend to the endosteal surface. We have removed nidus and surrounding reactive portion completely with curettage. Follow up radiographic results after 20 weeks, showed no evidence of recurrence.
Assuntos
Adulto , Humanos , Pessoa de Meia-Idade , Curetagem , Fêmur , Seguimentos , Quadril , Extremidade Inferior , Osteoma Osteoide , Recidiva , Esclerose , EsqueletoRESUMO
Fractures significantly involving the weight-bearing articular surface and the overlying metaphysis of the distal tibia have deserved notoriety as a severe and challenging subject of ankle injuries. It was not until 1963 that the AO group developed principles for open reduction and internal fixation of pilon fracture. But recently, limited internal fixation of the joint surface combined with external fixation may avoid the soft tissue complications associated with formal open reduction and internal fixation. We have treated 22 cases of tibial pilon fracture with biologic principle. The mean follow-up period was two years ranging from one to three years. According to the Riiedi and Allgower classification, three cases were type I, five cases were type II, and fourteen cases were type III Biologic treatment includes combination of internal and external fixation, external fixation alone, or plating was done with careful soft tissue dissection, limited stripping of fracture fragments, and indirect reduction technique. Radiographic results were assessed by Burwell and Charnley criteria. Three cases of type I, three cases of type II and seven cases of type III pilon fractures obtained good anatomic radiographic results. We also assessed the functional results by Mast and Teipner criteria. Three cases of type I, three cases of type II, six cases of type III pilon fractures obtained good functional outcome. We believed that combination of internal and external fixation provides the patient who has a markedly displaced pilon fracture and diaphyseal comminution with the best chance of good clinical result and minimal risks. As such, we believe biologic treatment is excellent for these injuries.
Assuntos
Humanos , Traumatismos do Tornozelo , Classificação , Seguimentos , Articulações , Tíbia , Suporte de CargaRESUMO
No abstract available.
RESUMO
Fractures in the subtrochanteric region of the femur present more formidable problems in treatment than do other trochanteric fractures, because such severe stresses exit at the fracture site. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recommanded for use in subtrochanteric fractures and each of these devices have advantages in certain types of subtrochanteric fractures, and their selection should be based on the individual fracture anatomy. A total of 20 patients with fracture of the subtrochanteric region of the femur, who were treated by internal fixation with Judet plate between January 1982 and December 1988 have been reviewed. Our conclusions were as follows; 1. Average age was 38 years old and most common cause of injury was traffic accident. 2. Cast immobilization was done after Judet plate fixation. Partial weight bearing ambulation was enabled from POD 10 weeks and full weight bearing ambulation was enabled from POD 16 weeks. 3. 18 in 20 cases, primary bony union was happened and the mean duration of radiological bony union was 24 weeks. 4. 3 cases of complications, metal failure with refracture (2 cases) and screw loosening (1 case), were occured due to early weight bearing in the post operative course. 5. Judet plate fixation was gave satisfactory result in uncomminuted subtrochanteric fracture, especially Seinsheimer's type I, II-A,B,C or Fieldings type I, II. 6. From a consideration of these series, Judet plate showed easy to use, perfect adaptation and rigid fixation. We thought Judet plate is one of a good implants for rigid fixation of subtrochanteric fracture without severe medial cortical disruption.
Assuntos
Humanos , Acidentes de Trânsito , Estudo Clínico , Fêmur , Fraturas do Quadril , Imobilização , Fixadores Internos , Caminhada , Suporte de CargaRESUMO
Significant traumatic disruption of the ligaments about the knee can occur in a child. Recently several reports have described knee ligament, injuries with open growth plates. And these reports contradict the notion that complete tears of knee ligaments occur only after growth plates have closed. The youngest patient with medial collateral ligament injury reported before was a 4-year-old boy by Joseph and Pogrund in 1978. But authors experienced a case of ruptured medial collateral ligament of the knee in a 2-year and 1-month old boy, who seemed to be youngest with the ligament injury.