ABSTRACT
PURPOSE: Plasminogen activator inhibitor 1 (PAI-1) is a critical enzyme that regulates coagulation and fibrinolytic systems. The aim of this study was to determine the role of PAI-1 4G/5G polymorphism in nontraumatic avascular necrosis of the lunate. METHODS: The study included 45 patients with Kienböck disease and 45 healthy individuals as a control group. In both groups, genomic DNA was extracted from peripheral blood samples to determine the distributions of PAI-1 4G/5G polymorphism using allele-specific polymerase chain reaction and sequencing. RESULTS: No statistically significant difference was determined in the distribution of the gene polymorphism between the patient and control groups. We found the 5G/5G genotype to be 1.7 times higher in the control group compared with the patient group. A 1.6-fold increase in the 4G homozygote genotype was identified in the patient group. The patient and control groups were also evaluated for 4G/4G plus 4G/5G and 5G/5G in terms of genotype distribution. No statistically significant difference was found. CONCLUSIONS: The findings suggest that the PAI-1 4G/4G polymorphism is not a genetic risk for Kienböck disease. CLINICAL RELEVANCE: This study aimed to reveal the genetic etiology of Kienböck disease.
Subject(s)
Osteonecrosis , Plasminogen Activator Inhibitor 1 , Genetic Predisposition to Disease , Genotype , Humans , Necrosis , Osteonecrosis/genetics , Plasminogen Activator Inhibitor 1/genetics , Polymorphism, GeneticABSTRACT
OBJECTIVES: This study aims to present the results of early nerve explorations in cases with radial nerve palsy associated with humeral shaft fracture and to investigate in which cases early nerve explorations may be beneficial. PATIENTS AND METHODS: Twenty-four patients (17 males, 7 females; mean age 36 years; range 18 to 72 years) with complete sensory and motor radial nerve damage associated with humeral shaft fracture were retrospectively analyzed. The patients with high-energy trauma and the ones who had spiral and segmental fractures with low energy traumas were included in the study. Early nerve exploration was performed in all patients within an average of 4.8 days (range 1 to 20 days) after fracture development. Electrophysiological assessments were performed in cases with no neurological recovery until 12th week. RESULTS: Spiral fractures of the humerus shaft observed in 14 (58.3%) of the 24 operated patients were the most common fracture type, followed by transverse fracture in four patients (16.6%) and comminuted fracture in two patients (8.3%). As a result of the exploration, we observed nerve compression between the fracture fragments in seven patients (29.1%); a majority of these patients (n=6) had spiral fractures of humerus and one patient had comminuted fracture. One patient with a spiral type fracture had nerve transection. Radial nerve function recovered in most of the patients (95.8%). Average duration for fracture union was 6.7±3.8 months (range 3 to 18 months). CONCLUSION: Spiral fractures of humerus, particularly with wedge fragment, may be a candidate for early surgical exploration. Early exploration may be beneficial in terms of early identification of neural injury in patients with radial nerve dysfunction associated with spiral and comminuted humerus fracture.
Subject(s)
Fracture Fixation, Internal/methods , Humeral Fractures , Humerus , Radial Nerve , Radial Neuropathy , Adult , Aged , Early Diagnosis , Electrodiagnosis/methods , Female , Humans , Humeral Fractures/classification , Humeral Fractures/complications , Humeral Fractures/surgery , Humerus/diagnostic imaging , Humerus/injuries , Humerus/surgery , Male , Middle Aged , Neurologic Examination/methods , Outcome Assessment, Health Care , Radial Nerve/injuries , Radial Nerve/physiopathology , Radial Neuropathy/diagnosis , Radial Neuropathy/etiology , Radiography , Recovery of Function , Retrospective Studies , Time-to-TreatmentABSTRACT
OBJECTIVES: This study aims to evaluate whether the collagen membrane (membrane) wrapping around the methotrexate (MTX)-containing calcium-phosphate cement (CPC) reduces the side effects on soft tissue healing. MATERIAL AND METHODS: In 36 rats, femoral bone defects were created and treated in six groups which were CPC only, CPC and membrane wrapping around, CPC containing 2% MTX, CPC containing 2% MTX and membrane wrapping around, CPC containing 5% MTX, CPC containing 5% MTX and membrane wrapping around. RESULTS: Histological examinations revealed a statistically significantly improved healing in the connective tissue samples of the CPC containing 5% MTX group wrapped around by membrane compared to those without membrane (p=0.04). However, this was not seen in other groups. CONCLUSION: Membrane wrapping around the CPC containing MTX reduces the side effect of MTX on cellular proliferation at its highest concentration, particularly. Membrane wrapping may allow administration of higher doses of an anti-neoplastic drug which can be more effective.
