ABSTRACT
OBJECTIVE: To compare the outcomes of dynamic hip screws (DHS) and intramedullary nailing (IMN) in the treatment of extra-capsular metastatic carcinoma of the proximal femur. METHODS: A retrospective case analysis method was used to examine data of patients with proximal metastatic cancer of the femur who were treated with internal fixation in Department of Orthopaedics, Beijing Friendship Hospital, from January 2007 to December 2018. Blood loss, postoperative pain, functional score, length of stay, and survival rates were compared, and postoperative complications were assessed. RESULTS: Complete follow-up data were available for 33 patients. The mean follow-up period was 12.2±3.6 (range: 9-32) months and the average age was 72.3±4.7 (range: 59-83) years old. There were 20 females and 13 males. Twenty-three patients had undergone IMN and 10 DHS, according to bone defects and the patient's overall condition. The median survival time was 10 months in the IMN group and 11 months in the DHS group. Duration of surgery (t=-7.366, P<0.001) and length of hospital stay (t=-3.509, P<0.001) differed significantly between the two groups. There was one case of breakage of internal fixation in the IMN group. CONCLUSIONS: There was no significant difference between DHS and IMN in terms of surgical efficacy. IMN and DHS were different in terms of surgical time and hospital stay. However, due to the limited number of cases in this study, multi-factor analysis has not been performed and needs to be further verified in future analysis. When developing a surgical plan, it is recommended to consider the patient's condition and the surgeon's experience.
ABSTRACT
We developed paper-based powder X-ray diffraction (PP-XRD) to implement phase identification and/or crystal structure determination on paper-based platforms. These aims are not possible with other paper-based detectors, such as Raman spectroscopy and mass spectrometry. PP-XRD overcomes these limitations. Here we reported the simple and low-cost in situ PP-XRD protocol for phase identifications of inorganic and organic materials. We demonstrated that sample amounts of lead nitrate on paper substrate can be reduced into 1/30 of conventional ones by using the standard glass substrate at the same signal-to-noise ratio (S/N) of the X-ray diffraction (XRD) pattern. The paper-based method was comparable in sample quantity and intensity with zero background holder method, even though single crystal Si(100) substrate as zero background holder was used for the specimen preparation of CTAB (C19H42BrN). More importantly, paper substrates helped reduce preferred orientation that was generally present in routine powder XRD. Also, combined with paper chromatography, overlap peaks were eliminated in the XRD detection patterns of lead nitrate and cobalt nitrate hexahydrate. This new PP-XRD protocol may accelerate the process to identify phase or determine the molecular structures of new materials using trace sample directly. It also includes a hyphenated technique of powder XRD with a simple paper-based microfluidic separation of chemical solutions.
ABSTRACT
OBJECTIVE: To analyze the result of the distal radial fractures with or without ulnar styloid fracture. METHODS: From January 2007 to October 2010, 62 cases with distal radial fractures were treated by ORIF, of which 52 were followed-up entirely with an average of 15 months (6-34 months), including 6 male cases and 46 female cases at an average age of (62.25±8.25) years. All ulnar styloid fractures were not fixed. According to ulnar styloid fractures, all cases were divided into two groups, group A (32 cases with ulnar styloid fractures) and group B (20 cases without). Group A was further divided into type I (tip fracture of ulnar styloid, 12 cases) and type II (base fracture of ulnar styloid, 20 cases). AO classification, volar tilt, radial inclination and radial height were recorded before and after operation. Complications and Garlant-Werley Scores were evaluated 3 months and 1 year after operation. RESULTS: All distal radial fractures were union in 8 weeks to 12 weeks. There were significant differences in radial inclination and radial process height, but not in volar tilt between groups A and B before operation. We found no significant differences in volar tilt, radial inclination, radial process height and Garlant-Werley scores between groups A and B 3 months and 1 year after operation. There were also no significant differences between type I and type II. Fineness was 81%. Complications were found in 6 cases (4 in group A and 2 in group B), in which there were 1 case with a screw cutting-off and traumatic arthritis, 2 cases with sup-nerve injury and 1 case with heterotopic ossification, 1 case of malunion , and 1 case with wrist stiffness and traumatic arthritis. CONCLUSION: ORIF with locking plate in distal radial fracture is safe and effective. There is no significant difference between the outcomes of patients with and without ulnar styloid fractures, also in patients with type I and type II fractures, union or nonunion of fractures, according to the X-ray measurement and Garlant-Werley wrist function scores. However, long-term following-up is still needed.
