ABSTRACT
Proximal humeral fractures in the pediatric population are commonly treated conservatively. When there is an indication for surgery, percutaneous pinning is considered to be the elective choice. We report our experience with a new external fixator that reduces the risk of pin migration and permits an early rehabilitation. The range of motion was completely restored in all patients and no pain or discomfort was detected at follow-up. According to the literature, a small varus malunion at the first x-ray control can be tolerated in the pediatric population because of the remodeling ability of the bone. We conclude that this system provides a good stability and healing of Salter-Harris type II proximal humerus injuries.
Subject(s)
External Fixators , Fracture Fixation/instrumentation , Shoulder Fractures/surgery , Accidental Falls , Adolescent , Fracture Fixation/methods , Fracture Healing/physiology , Humans , Injury Severity Score , Male , Postoperative Care/methods , Radiography , Range of Motion, Articular/physiology , Recovery of Function , Shoulder Fractures/diagnostic imaging , Shoulder Fractures/rehabilitation , Treatment OutcomeABSTRACT
BACKGROUND: Nocturnal home pulse oximetry (NHPO) provides information by measuring a series of variables: time spent with SaO(2) <90% expressed as percentage (T90) or in minutes (Tm90), mean SaO(2) (MnS), and lowest SaO(2) (LwS.) The presence of significant nocturnal desaturation has been proposed as a parameter in decision making with regard to initiating home mechanical ventilation (HMV) or monitoring HMV effectiveness. However, there is limited information on the possible variability of the test, and this could influence the interpretation of results. OBJECTIVES: To explore the variability between 2 consecutive measurements of NHPO and to determine clinical applications in HMV. METHODS: The patients presented diseases susceptible to HMV treatment and were enrolled in stable condition without respiratory failure. NHPO was conducted on 2 consecutive nights. The variables analyzed were: T90, Tm90, Mns, and LwS. The coefficient of variation (CV), a concordance coefficient (CC), and the Bland-Altman method were used in order to explore the variability. RESULTS: We studied 40 cases. Two were excluded, and the remaining 38 were aged 58 ± 16 years (19 males). Eighteen were receiving HMV. CV values exceeded 100% for T90 and Tm90 and were below 5% for MnS and LwS. The CC for T90, Tm90, and LwS showed confidence intervals with lower limits below 0.5, while for MnS the value was 0.88 (0.79-0.93). CONCLUSIONS: There is a wide variability in NHPO recordings for T90, Tm90, and LwS, so a single determination to detect nocturnal desaturation may not be valid for decision making; the parameter with the least interindividual variability and intraindividual variability was MnS.
Subject(s)
Oximetry/methods , Respiration, Artificial/methods , Respiratory Tract Diseases/physiopathology , Respiratory Tract Diseases/therapy , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Cytogenetic analysis of a case of dedifferentiated chondrosarcoma with a malignant fibrous histiocytoma (MFH) component revealed a near-triploid karyotype with multiple copies of chromosome 7, deletion of chromosome arm 9p, and a derivative chromosome 19 [add(19p)] in each metaphase. Whereas numerical anomalies of chromosome 7 have been frequently reported in chondrosarcoma, deletion 9p and add (19p) have been observed in MFH. A putative MFH tumor suppressor gene could be present in a critical region on chromosome bands 9p21~p22.
