Does fluoroscopy improve outcomes in paediatric forearm fracture reduction?

AIM: To compare the radiographic results of paediatric forearm fracture reduced with and without fluoroscopic enhancement to investigate whether fractures reduced under fluoroscopic guidance would have smaller residual deformities and lower rates of re-reduction and surgery. MATERIALS AND METHODS: A retrospective cohort analysis was conducted comparing paediatric patients with acute forearm fracture in two trauma centres. Demographics and radiographic data from paediatric forearm fractures treated in Trauma Centre A with the aid of a C-arm fluoroscopy were compared to those treated without fluoroscopy in Trauma Centre B. Re-reduction, late displacement, post-reduction deformity, and need for surgical intervention were compared between the two groups. RESULTS: The cohort included 229 children (175 boys and 54 girls, mean age 9.41±3.2 years, range 1-16 years) with unilateral forearm fractures (83 manipulated with fluoroscopy and 146 without). Thirty-four (15%) children underwent re-reduction procedures in the emergency department. Fifty-three (23%) children had secondary displacement in the cast, of which 18 were operated on, 20 were re-manipulated, and the remaining 15 were kept in the cast with an acceptable deformity. Twenty-nine additional children underwent operation for reasons other than secondary displacement. There were no significant differences in re-reduction and surgery rates or in post-reduction deformities between the two groups. CONCLUSION: The use of fluoroscopy during reduction of forearm fractures in the paediatric population apparently does not have a significant effect on patient outcomes. Reductions performed without fluoroscopy were comparably accurate in correcting deformities in both coronal and sagittal planes.

[The immediate results of treating patients with acute early postoperative intestinal obstruction]. / Blizhaishie rezul'taty lecheniia bol'nykh s ostroi rannei posleoperatsionnoi neprokhodimost'iu kishechnika.

We performed 58,938 operations on the abdominal organs. Three hundred and six (37.8%) patients developed early postoperative acute ileus. After its operative elimination, 22 (7.2%) patients required performance of a reoperation. Ninety (29.4%) patients died. Of them in 72, death was caused by peritonitis, in 18--pneumonia, acute cardiovascular failure, impairement in cerebral circulation and pulmonary thromboembolism.

[A new method of cholecystectomy]. / Novyi sposob kholetsistéktomii.

On the basis of the results of specially performed investigations on 47 complexes of the liver with extrahepatic bile ducts and gallbladder, a new method of cholecystectomy has been developed. In the clinic, 132 patients were operated on for cholelithiasis, acute and chronic cholecystitis. In performance of subserous cholecystectomy, a danger of injuring the vessels of the hepatoduodenal ligament is excluded, its adequate blood supply and that of hepatic parenchyma adjacent to the gallbladder is preserved.

[Photometric and chromatographic methods of measuring the concentration of acelysin in the air of a work area]. / Fotometricheskii i khromatograficheskii sposoby izmereniia kontsentratsii atselizina v vozdukhe rabochei zony.

Two methods were applied to evaluation of acelysine level. Spectrophotometric one was based on reaction with p-nitrophenyldiasonium and evaluation of the product optic density at 510 nm. The second was chromatography in thin layer, where a mixture of n-butanol, formic acid and water was used as an eluent and 0.2% ninhydrin solution in butanol and 3 ml of ice acetic acid (60-70 degrees C) served as a developer. Both methods are supposed to evaluate acelysine level in the air of working area, when a half of MAC and admixtures are present.