ABSTRACT
Introduction Most surgeons prefer a single implant for segmental proximal and diaphyseal femur fractures, although results are controversial and still no consensus for proper management is present. This prospective study analyses the functional and radiological outcome of managing 17 patients with ipsilateral shaft and proximal femur fractures by dual implant osteosynthesis at our center. Methods Over a two-year period, we managed 17 patients with a mean age of 35 years, with cancellous cannulated screws or dynamic hip screws for intracapsular femur fractures and improvised proximal femoral nail for extracapsular proximal femur fractures. Distal femoral locking plates or distal femoral nails were used for shaft femur fractures depending upon fracture morphology. The patients had a maximum follow-up of 18 months. Results A total of 80% of patients had a good functional outcome (using the Friedman-Wyman scoring system) while 60% had an excellent Harris Hip Score. The mean time taken for the bone union for proximal femur fractures was 4.75 months and for shaft femur fractures, it was 6 months. Conclusion We had a satisfactory functional and clinical outcome of managing these fractures with two implants, one focusing biomechanically on each fracture. This principle of dual implant osteosynthesis can reliably be used in such difficult fracture patterns and it negates the use of the single cephalomedullary nail for fixating both fractures.
ABSTRACT
The total number of inhabitants on the Earth is estimated to cross a record number of 9 × 103 million by 2050 that present a unique challenge to provide energy and clean environment to every individual. The growth in population results in a change of land use, and greenhouse gas emission due to increased industrialization and transportation. Energy consumption affects the quality of the environment by adding carbon dioxide and other pollutants to the atmosphere. This leads to oceanic acidification and other environmental fluctuations due to global climate change. Concurrently, speedy utilization of known conventional fuel reservoirs causes a challenge to a sustainable supply of energy. Therefore, an alternate energy resource is required that can maintain the sustainability of energy and environment. Among different alternatives, energy production from high carbon dioxide capturing photosynthetic aquatic microbes is an emerging technology to clean environment and produce carbon-neutral energy from their hydrocarbon-rich biomass. However, economical challenges due to low biomass production still prevent the commercialization of bioenergy. In this work, we review the impact of fossil fuels burning, which is predominantly used to fulfill global energy demand, on the quality of the environment. We also assess the status of biofuel production and utilization and discuss its potential to clean the environment. The complications associated with biofuel manufacturing using photosynthetic microorganisms are discussed and directed evolution for targeted phenotypes and targeted delivery of nutrients are proposed as potential strategies to increase the biomass production.
