ABSTRACT
Fracture of the distal radius has a second peak of incidence in the second half of life. Because complex injuries are seen frequently, there is a need for differentiated treatment to achieve good results. The aim of our study was to evaluate the treatment of distal radius fractures with 2.4-mm locking compression (LC) plates in patients older than 65 years suffering from osteoporosis to determine the complications and compare costs of treatment with different interventions. Thirty-seven patients were included in this prospective study. The distribution of fractures according to AO classification was: nine type A, one type B, and 27 type C. The mean age was 76 years. Twenty-six volar plates, seven dorsal and four "sandwich" procedures were applied. The mean follow-up for 33 patients was 11.1 months. Using the functional Lidström score, we found 13 very good results, 15 good, four fair, and one poor, the radiologic Lidström scores were: 15 very good, 13 good, four fair, and one poor results. With the application of 2.4-mm LC plates, findings were good or very good in over 80%of osteoporotic distal radial fractures. Compared to other treatments, the real costs of intervention for LC plates is much higher.
Subject(s)
Bone Plates , Fracture Fixation, Internal/methods , Age Factors , Aged , Aged, 80 and over , Bone Plates/economics , Costs and Cost Analysis , Female , Follow-Up Studies , Fracture Fixation, Internal/economics , Fracture Fixation, Internal/instrumentation , Humans , Male , Osteoporosis/complications , Prospective Studies , Radiography , Radius Fractures/complications , Radius Fractures/diagnostic imaging , Time Factors , Treatment OutcomeABSTRACT
Isolated human bronchi and rat tracheae were incubated in organ baths to measure histamine release. The calcium ionophore A23187, 3 micromol/L in rat trachea and 10 micromol/L in human bronchi, stimulated histamine release by 145 +/- 50% (n = 6) and 270 +/- 48% (n = 7) above the prestimulation level, respectively. Acetylcholine (100 pmol/L; human bronchi) or oxotremorine (1, 100, 10,000 nmol/L; rat trachea) did not affect the spontaneous histamine release. In rat tracheae neither acetylcholine nor oxotremorine inhibited A23187-evoked histamine release, whereas 100 pmol/L acetylcholine significantly suppressed the evoked histamine release in human bronchi by 86%. For receptor characterization the following subtype-specific muscarinic receptor antagonists were applied: pirenzepine (M1 subtype), para-fluorohexahydrosiladifendiol (pFHHSiD; similar affinities at human cloned M1-, M3-, and M4-receptors), AF-DX 116 (M2 subtype), and clozapine (antagonist at cloned M1-, M2-, M3-receptors; agonist at cloned M4-receptors). Pirenzepine, pFHHSiD, AF-DX 116, and clozapine (100 nmol/L each) antagonized the inhibitory effect of 100 pmol/L acetylcholine by 83 +/- 20% (n = 6), 83 +/- 9% (n = 8), 50 +/- 14% (n = 6), and 35 +/- 7% (6). In conclusion, a species difference exists in the cholinergic control of histamine release between human and rat airways. In human airways muscarinic receptors most likely of the M1 subtype are involved in the inhibitory control of mast cell function, whereas such an inhibitory pathway does not exist in the rat trachea.
