ABSTRACT
BACKGROUND: The treatment of pediatric femoral shaft fractures has undergone an increasing change in recent years. The previously predominant treatment procedures were extensively replaced by minimally invasive techniques (e.g. elastic stable intramedullary nailing, ESIN). The aim of this study was the comparison of complication rates depending on patient factors as well as various treatment procedures. MATERIAL AND METHODS: This study involved a retrospective Xray morphometric evaluation of data. The patient files and Xrays of 101 children who were treated at 2 level I trauma centers were analyzed. RESULTS: Conservative treatment was carried out in 19% of the cases. Among the surgical procedures the ESIN technique was predominant (nâ¯= 60). Complications that needed revision occurred in 10% of the children after conservative treatment. Revision surgery had to be carried out in more than 6% of the cases in children who were surgically treated. Among the surgical procedures ESIN stabilization demonstrated the lowest revision rate with only 3%. Children under three years and adolescents had a higher risk for developing complications. If the ESIN wires used were too thin in relation to the diameter of the medullary cavity there was an increased probability of complications of around 30%. CONCLUSION: This study revealed a moderate risk of complications in the treatment of femoral shaft fractures in children. The risk of complications after external fixation and conservative treatment was the highest in this study. Overall, the ESIN technique showed the lowest risk of complications. The results of this study could confirm the known limitations of the ESIN technique depending on age and body weight.
Subject(s)
Femoral Fractures , Fracture Fixation, Intramedullary , Adolescent , Bone Nails , Child , Child, Preschool , Femoral Fractures/surgery , Fracture Fixation, Intramedullary/adverse effects , Fracture Healing , Humans , Postoperative Complications/etiology , Reoperation , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVES: Ongoing debates about benefits and risks of barefoot- and minimally-shod running have, to date, revealed no conclusive findings for long-term effects on physical performance. The purpose of this study was to examine the effects of an 8-week transition to minimalist footwear (MFW) on running economy (RE). DESIGN: Randomised controlled trial. METHODS: Thirty-two male, habitually-shod runners were assigned randomly to an 8-week training intervention either in minimalist (=intervention group) or conventional running shoes (=control group). The intervention consisted of a gradual increase in use of the new footwear by 5% of the individual weekly distance. Before and after the intervention, a VO2max test was followed by a submaximal RE test at 70% and 80% of vVO2max in both shoe conditions 7days later. RE was measured at the submaximal tests and expressed as caloric unit cost (kcalkg-1km-1) and oxygen consumption (mlkg-1km-1). RESULTS: RE improved in the intervention group over time compared to the control group with small to moderate effect sizes (ES) in both shoe conditions: Effects on RE (kcalkg-1km-1) in conventional running shoes: ES vVO270%: 0.68 (95% CI: -0.14 to 1.51), ES vVO280%: 0.78 (95% CI: 0-1.56). In minimalist footwear: ES vVO270%: 0.3 (95% CI: -0.54 to 1.14), ES vVO280%: 0.42 (95% CI: -0.41 to 1.25). These effects were not statistically significant (p>0.05). The repeated-measures ANOVA also showed no group by time interactions for all submaximal RE testing conditions (p>0.05). CONCLUSIONS: Although not reaching statistical significance, training in MFW compared to CRS resulted in small to moderate improvements in RE.
Subject(s)
Running/physiology , Shoes , Adult , Energy Metabolism , Humans , Male , Oxygen ConsumptionABSTRACT
A 14-year-old girl is reported in whom carcinoma of the parenchyma of the right kidney and horseshoe kidney were diagnosed. The right kidney with the neoplasm was removed (carcinoma was in stage I of development), Histological examination demonstrated clear cell carcinoma. The patient remains under follow-up observation and two years after the operation she is well and no signs of disease have been observed.
