ABSTRACT
In this study, we aimed to show the results of exchange nail and decortication in patients whose subtrochanteric femur fractures were treated with intramedullary nails and subsequently developed fracture nonunion and nail breakage com- plications. This study consisted of patients presenting with subtrochanteric femur fractures between January 2013 and April 2019 who underwent surgery and later experienced nail breakage due to hypertrophic nonunion. There were a total of 10 patients aged 26-62 years (Avg 40,30, SD: 9,989). Nine patients were smokers, and 1 patient had diabetes and hypertension. Three patients were admitted to the trauma center due to a car accident and 7 patients were admitted because of a fall. The infection parameters of all patients were normal. All patients had pathological movement complications and pain at the fracture site. Preoperatively, medulla diameter was measured with standard radiography in all patients. The diameters of the old nails applied to the patients ranged from 10 to 12 mm, and the diameters of the newly applied nails ranged from 14 to 16 mm. The fracture lines of all patients were opened to remove the broken nails, and decortication was performed. No additional autograft or allograft was applied to any patient. Union was achieved in all patients. We conclude that the use of larger diameter nails in conjunction with decortication will prevent nail breakage, improve healing and provide early union in patients with subtrochanteric femur fractures with hypertrophic pseudoarthrosis.
Subject(s)
Femoral Fractures , Fracture Fixation, Intramedullary , Hip Fractures , Pseudarthrosis , Humans , Pseudarthrosis/etiology , Bone Nails , Hip Fractures/surgery , Femur/surgery , Fracture Fixation, Intramedullary/adverse effects , Fracture Fixation, Intramedullary/methods , Treatment Outcome , Femoral Fractures/surgery , Femoral Fractures/etiologyABSTRACT
PURPOSE: To evaluate a simpler approach of the medial transposition of split lateral rectus technique in patients with complete third nerve palsy. METHODS: All eyes with complet third nerve palsy were followed in our Strabismus Department between 2014 and 2016. All patients had complete oculamotor nerve palsy. All patients assed routine ophthalmologic examination. Also the ocular deviation, horizontal and vertical ocular alignments were measured at 6 m and at 1/3 m using the Krimsky corneal reflection test and alternate prism cover test with best optical correction. Same surgeon (BG) performed all procedures in general anesthesia. In this procedure, same Gokyigit's technique except upper and lower part of lateral rectus muscle was passed under the superior oblique tendon and inferior oblique tendon. Final deviation from 0 to 14 PD was considered a successful result. RESULTS: Eight patients were included in the study. The average ages were 39.4 years and male to female ratio 5:3. Patients had a preoperative horizontal deviation - 42.5 ± 2.7 PD and postoperative horizontal deviation - 1.7 ± 2.6 PD. All patients follow-up time were at least 6 months. CONCLUSIONS: Achieved to acceptable alignment in primary position, manage to diplopia and cosmetical appearance are the main aims of patients with third nerve palsy.
Subject(s)
Eye Movements/physiology , Oculomotor Muscles/surgery , Oculomotor Nerve Diseases/surgery , Ophthalmologic Surgical Procedures/methods , Strabismus/surgery , Vision, Binocular/physiology , Adolescent , Adult , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Oculomotor Muscles/physiopathology , Oculomotor Nerve Diseases/complications , Oculomotor Nerve Diseases/physiopathology , Postoperative Period , Retrospective Studies , Strabismus/etiology , Strabismus/physiopathology , Treatment Outcome , Young AdultABSTRACT
The release rate of nicardipine HCl from various alginate gel bead formulations was investigated. The formulations were prepared by utilizing 23 factorial design. The effect of drug:polymer weight ratio, CaCl2 and sodium-alginate concentration on the time for 50% of the drug to be released (t50%) and the drug entrapment efficiency were evaluated with analysis of variance. The mean particle size and the swelling ratio of the beads were determined. The in vitro release studies were carried out by flow-through cell apparatus in different media (pH 1.2, 2.5, 4.5, 7 and 7.5 buffer solutions). Drug:polymer weight ratio and the interaction of drug:polymer weight ratio and CaCl2 concentration had a significant effect on the drug entrapment efficiency. The release of nicardipine was extended with the alginate gel beads, which were prepared in a ratio of 1:1 (drug:polymer). The release of drug from alginate gel beads took place both by diffusion through the swollen matrix and relaxation of the polymer at pH 1.2-4.5. However, the release was due to the diffusion and erosion mechanism at pH 7-7.5.
