Comparison of Clinical and Radiological Results of Two Fixation Materials after Distal Chevron Osteotomy for Hallux Valgus? - Two Kirschner Wires versus Single Screw Fixation.

PURPOSE OF THE STUDY Although distal chevron osteotomy (DCO) is considered as an intrinsically stable osteotomy, various fixation methods have been used to date. The purpose of this study was comparison of two commonly used methods in DCO, Kirschner (K)-wire and titanium fully threaded headless cannulated screw fixation, based on the clinical and radiological results, and their complications. MATERIAL AND METHODS Thirty patients were included in K-wire group and 36 patients were included in screw group. Mean age was 43.4 11.1 (rage; 19-65) years, and mean follow-up was 21.2 5.5 (range; 12-35) months. American Orthopaedic Foot Ankle Society (AOFAS) metatarsophalengeal-interphalangeal score was used for clinical evaluation. For radiological evaluation, hallux valgus angle (HVA), first-second intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), medial sesamoid grade (MSG), and lateral sesamoid distance (LSD) to mid-axis of the second metatarsal were measured for all patients on both preoperative and postoperative final follow-up radiographs. RESULTS Mean AOFAS scores were significantly improved and radiographic measurements were significantly reduced at postoperatively in both groups (p< 0.01 for AOFAS, HVA, IMA, DMAA and MSG; p = 0.01 for LSD). Mean preoperative and mean postoperative, as well as the mean difference (difference between postoperative and preoperative) of the radiographic measurements, and AOFAS scores were not significantly different between two groups (p > 0.05). A total of 5 complications were observed (four in K-wire group, one in screw group). Complication rates between two groups was not statistically significant (p = 0.12). DISCUSSION Initial description of DCO did not include any fixation material. Afterwards, the procedure was modified by using single K wire in order to enhance the stability of the osteotomy. Previous studies were unable to demonstrate significant differences between K-wire fixation and cortical or Herbert type screw fixation based on clinical and radiological outcomes. Differently, in this study we compared two K-wire fixation with 3.5-mm titanium fully threaded headless cannulated screw fixation. Our results demonstrated that function and radiological measurements significantly improved after both fixation methods. Despite the increased complication rate in K-wire group, it was not statistically significant. Moreover, none of the complications was associated with unstable osteotomy, and required re-operation. CONCLUSIONS Both fixation methods provided comparable radiological and clinical outcomes with favourable results after DCO. Key words: hallux valgus, distal chevron osteotomy, Kirschner wire, headless cannulated screw, fixation method.

Effects of dietary boron supplementation on some biochemical parameters, peripheral blood lymphocytes, splenic plasma cells and bone characteristics of broiler chicks given diets with adequate or inadequate cholecalciferol (vitamin D3) content.

(1) The effects of 5 and 25 mg/kg boron supplementation of diets with inadequate (6.25 microg/kg) or adequate (50 microg/kg) cholecalciferol (vitamin D3) content on some biochemical parameters, tibia characteristics, peripheral blood lymphocyte and splenic plasma cell counts of broilers were investigated. (2) Supplementation of the diet with boron affected plasma concentrations of boron, iron, copper and zinc and also tibia boron, zinc and calcium concentrations but did not have any effect on tibia iron or copper concentrations or tibia ash and tibia weight values. (3) Boron supplementation caused significant increases in splenic plasma cell count but decreased the proximal and distal tibia growth plate widths. There was no effect of boron supplementation on peripheral blood alpha-naphthyl acetate esterase (ANAE) content. Whole blood haematocrit and haemoglobin counts were significantly increased by boron supplementation but there were no effects on leucocyte ratios such as eosinophil, basophil, monocyte, lymphocyte and thrombocyte. (4) In general, the findings of the present study support the hypothesis that boron has an important biological role that affects the mineral metabolism of animals by influencing both biochemical and haematological mechanisms.

Zinc supplementation decreases total thyroid hormone concentration in small ruminants.

The effect of dietary zinc (Zn) supplementation on plasma Zn and serum thyroid hormones was evaluated in healthy male Merino lambs and Angora goats. A total of 12 lambs and 12 goats were divided into two equal groups as control and Zn groups in separate experiments. The lambs and goats of the control groups were fed basal rations alone. The Zn contents of these rations prepared for lambs and goats were 40 mg/kg and 35 mg/kg in dry matter (DM), respectively. Both species of animals in the Zn groups were fed a basal ration supplemented with zinc sulphate adjusted to 250 mg Zn/kg diet in DM. The feeding trial lasted for 12 weeks in lambs and 8 weeks in goats. Blood samples were taken from the jugular vein at 4-week intervals. Both animal species in the Zn groups had higher plasma Zn values than the controls throughout the experimental period, except in the 4th week in goats. However, the levels of serum total thyroxine (T4) and triiodothyronine (T3) were lower in the lambs and goats of the Zn groups, except in the 4th week, as compared to those in the controls. Moreover, serum total thyroid hormone levels of the goats were higher at the 4th week than at the 8th week. Although there was a decrease in the levels of free thyroxine and triiodothyronine of both small ruminant species in the Zn groups when compared to the controls, these alterations were not statistically significant. These results may show that zinc supplementation to the diet at this dose reduces total thyroid hormone levels in small ruminants but does not yet impair the euthyroid status of the organism.

Effects of zinc and vitamin A supplements on plasma levels of thyroid hormones, cholesterol, glucose and egg yolk cholesterol of laying hens.

The effects of zinc and vitamin A supplementation to the diet on some blood metabolites were evaluated in Hisex brown laying hens from 56 weeks to 68 weeks of age. A total of 130 birds were divided into two main groups according to vitamin A treatment (0 and 3.44 mg retinyl acetate kg(-1) feed, respectively), each consisting of 65 hens. Hens in both of the main groups were then divided into five zinc treatment groups (0, 25, 50, 100 and 200 mg zinc kg diet(-1) respectively) of 13 hens each. It was observed that plasma T4, T3 and total cholesterol levels were affected by only zinc supplementation. While 100 and 200 mg Zn kg(-1) decreased plasma T4 level compared to control value, plasma T3 level was reduced by 100 mg Zn kg(-1) compared to groups fed less Zn. Adding 50 and 200 mg Zn kg(-1) to the diet increased plasma total cholesterol level in the birds compared to other groups. Vitamin A, zinc, and their interaction did not influence the concentration of plasma high-density lipoprotein (HDL)-cholesterol, glucose and egg yolk cholesterol in laying hens.

Effect of clinoptilolite on serum biochemical and haematological characters of broiler chickens during aflatoxicosis.

Clinoptilolite (CLI, a natural zeolite) incorporated into the diet at 1.5 and 2.5 per cent were evaluated for their ability to reduce the deleterious effects of 2.5 mg total aflatoxin (AF) kg(-1)diet on broiler chickens from 1 to 21 days of age. In total 360 broiler chicks were divided into six equal treatment groups (control, AF, CLI (1.5 per cent), AF plus CLI (1.5 per cent), CLI (2.5 per cent) and AF plus CLI (2.5 per cent)). When compared with the controls, AF treatment significantly decreased serum total protein, albumin, inorganic phosphorus, uric acid, total cholesterol and the values of haematocrit, red blood cell counts, mean corpuscular volume, haemoglobin, thrombocyte counts, percentage of monocyte counts; increased values of white blood cell and heterophil counts. The addition of CLI (1.5 per cent) and CLI (2.5 per cent) to the AF -containing diet reduced the adverse effects of AF and should be helpful in a solution to the aflatoxicosis problem in poultry.

Effects of polyvinylpolypyrrolidone, synthetic zeolite and bentonite on serum biochemical and haematological characters of broiler chickens during aflatoxicosis.

1. Polyvinylpolypyrrolidone (PVPP), synthetic zeolite (SZ) and bentonite (BNT), when incorporated into the diets at 3, 5 and 5 g/kg respectively, were evaluated for their ability to reduce the deleterious effects of 2.5 mg aflatoxin (AF; 83.06% AFB1, 12.98% AFB2, 2.84% AFG1, and 1.12% AFG2,)/kg diet on growing broiler chickens from 1 day to 3 weeks of age. A total of 210 chicks were divided into 10 treatment groups (control, AF, PVPP, AF plus PVPP, PVPP plus SZ, AF plus PVPP plus SZ, PVPP plus BNT, AF plus PVPP plus BNT, AF plus SZ and AF plus BNT) each consisting of 21 chicks. 2. When compared to control, the AF treatment significantly decreased serum total protein, albumin, inorganic phosphorus, uric acid and total cholesterol, and the values of haematocrit, haemoglobin, mean corpuscular haemoglobin, thrombocyte counts, percentage of lymphocyte and monocyte counts; increased values of white blood cell and heterophil counts. 3. Decreased serum albumin caused by AF was significantly ameliorated by PVPP plus BNT. A similar increase was obtained in serum total cholesterol by adding BNT to the AF-containing diet. 4. The serum uric acid, white blood cell counts and percentage of lymphocyte and monocyte counts were numerically intermediate between control and AF values in all of the adsorbent treatments containing AF. The change in thrombocyte counts was alleviated by all of the adsorbent treatments containing AF, except AF plus SZ. The addition of the adsorbents in the AF-free diets did not significantly alter the serum biochemical and haematological parameters compared to controls.