ABSTRACT
CASE: A 32-year-old patient was diagnosed with a vertical patella fracture nonunion after a bone-patellar tendon-bone (BTB) anterior cruciate ligament reconstruction. In addition, a 1 × 2 × 1 cm patellar bone defect was noticed at the graft harvesting site. The patient was treated surgically with open reduction and internal fixation and iliac crest bone autograft which resulted in fracture union. CONCLUSION: Many intraoperative and postoperative risk factors for iatrogenic patella fracture when harvesting BTB autograft were identified. Surgeons should be aware of technical skills needed to prevent this complication and should treat the fracture appropriately to avoid nonunion and optimize the outcome.
Subject(s)
Fractures, Bone , Fractures, Ununited , Knee Injuries , Patellar Ligament , Adult , Anterior Cruciate Ligament/surgery , Autografts , Fractures, Bone/etiology , Fractures, Bone/surgery , Fractures, Ununited/complications , Fractures, Ununited/surgery , Humans , Knee Injuries/surgery , Patella/surgery , Patellar Ligament/transplantationABSTRACT
Pediatric patients with Osteogenesis Imperfecta (OI), a heritable connective tissue disorder, frequently suffer from long bone deformations. Surgical correction often results in bone non-unions, necessitating revision surgery with autogenous bone grafting using bone-marrow-derived stem cells (BM-SC) to regenerate bone. BM-SC harvest is generally invasive and limited in supply; thus, adipose tissue's stromal vascular fraction (SVF) has been introduced as an alternative stem cell reservoir. To elucidate if OI patients' surgical site dissected adipose tissue could be used as autologous bone graft in future, we investigated whether the underlying genetic condition alters SVF's cell populations and in vitro differentiation capacity. After optimizing SVF isolation, we demonstrate successful isolation of SVF of pediatric OI patients and non-OI controls. The number of viable cells was comparable between OI and controls, with about 450,000 per gram tissue. Age, sex, type of OI, disease-causing collagen mutation, or anatomical site of harvest did not affect cell outcome. Further, SVF-containing cell populations were similar between OI and controls, and all isolated SVF's demonstrated chondrogenic, adipogenic, and osteogenic differentiation capacity in vitro. These results indicate that SVF from pediatric OI patients could be used as a source of stem cells for autologous stem cell therapy in OI.
Subject(s)
Adipose Tissue/cytology , Osteogenesis Imperfecta/physiopathology , Stromal Cells/cytology , Adipogenesis , Adipose Tissue/metabolism , Adolescent , Child , Child, Preschool , Chondrogenesis , Collagen/genetics , Collagen/metabolism , Female , Humans , Male , Mutation , Osteogenesis Imperfecta/genetics , Osteogenesis Imperfecta/metabolism , Stromal Cells/metabolism , Stromal Vascular Fraction/metabolism , Young AdultABSTRACT
STUDY OBJECTIVES: This study attempted to assess sleep quality among medical students and examine the relationship between social network use and sleep quality. METHODS: Descriptive cross-sectional study, enrolling medical students of King Abdulaziz University and Batterjee Medical College. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. RESULTS: Of the 702 medical students who responded to our survey (410 females and 292 males), more than 66% suffered from poor sleep quality. Approximately 92.3% of the surveyed students used electronic devices before they fell asleep, and 88.4% used these devices for social networking purposes. Female students were found to suffer more than male students, and they also reported spending more time on social networking sites before sleeping (p = .006). CONCLUSION: This study suggests that students who reported poor sleep spent an average of 64.38 min on social networking sites before sleeping; this duration was negatively associated with medical students' sleep quality.
