Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 566
Filtrar
1.
Cureus ; 16(9): e70553, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39355463

RESUMEN

Supracondylar humerus fractures (SCH) are the most prevalent elbow fractures in the pediatric age group. Delay in treatment poses challenges and an elevated risk of complications. We describe a case of revision for postoperative malalignment with closed reduction percutaneous pinning with good clinical outcomes. Malunion complications in SCH can be minimized with early intervention in cases of postoperative displacement. Careful use of technical skills can help with closed reduction in cases with delayed presentation.

2.
J Orthop Sci ; 2024 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-39370315

RESUMEN

BACKGROUND: Retrograde intramedullary multiple pinning using a modified palm tree technique for proximal humeral fractures has attracted interest from surgeons because of its minimal invasiveness into the soft tissue around the shoulder joints. We aimed to evaluate the clinical and radiological outcomes of this procedure. METHODS: This retrospective study included 21 patients who underwent surgery using a modified palm tree technique for proximal humeral fractures between March 2010 and March 2022. Patients with two- and three-part proximal humeral fractures that could be reduced by closed manipulation under general anesthesia were included in this study. All patients were clinically evaluated using the Japanese Orthopaedic Association (JOA) and University of California at Los Angeles (UCLA) shoulder scores. Postoperative radiographic findings, including fracture healing and signs of pinning-related complications, were evaluated. RESULTS: Twenty-one shoulders in 21 patients (9 men and 12 women) with mean age at surgery of 66.3 ± 19.3 years were evaluated. The mean period until bone union was 2.6 ± 0.7 months. The mean JOA and UCLA shoulder scores at the final follow-up were 84.8 ± 12.1 and 27.5 ± 5.4, respectively. Perforation of the humeral head by Kirschner (K) wires was observed in 9 of the 21 (42.9 %) shoulders. The JOA and UCLA shoulder scores at the final follow-up were not significantly different between the groups with and without perforations (p = 0.41 and 0.27, respectively). The oblique or Y-view detected significantly more wires with perforation of the humeral head than did the anteroposterior view (6 vs. 15 wires, p < 0.01). CONCLUSIONS: The modified palm tree technique for proximal humeral fractures demonstrated good postoperative clinical outcomes and early fracture healing. However, modifications in postoperative management and surgical techniques should be considered to reduce the high rate of perforation of the humeral head by K-wires.

3.
Int J Surg Case Rep ; 123: 110264, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39303483

RESUMEN

INTRODUCTION AND IMPORTANCE: Slipped capital femoral epiphysis (SCFE) is one of the most common hip pathology in adolescents. Outcome of SCFE management largely depends on the grading of the pathology. Severe, unstable SCFE poses high risk for avascular necrosis (AVN). The objective of this study is to report a good outcome without AVN in an acute, unstable, high grade SCFE managed by closed reduction and percutaneous pinning along with factors that need to be given consideration. CASE PRESENTATION: A 13 years old boy was unable to bear weight due to severe pain on right hip after trauma since 2 weeks. Patient was diagnosed with acute, unstable high grade SCFE, patient underwent closed reduction and percutaneous pinning (CRPP) using cannulated screw and K wire augmented with spica cast. At 12 weeks patient was already fully active. At 18 month follow up there was no sign of AVN with full hip range of movement. CLINICAL DISCUSSION: Treatment for unstable, severe SCFE is still challenging. Unreduced severe slippage will deliver serious impingement and end up with early degenerative arthritis. The magnitude of reduction in a severe, unstable SCFE poses high risk for AVN. While some studies claimed reduction is justified only when it is serendipitous, we successfully and purposely performed CRPP. CONCLUSION: Even after 2 weeks from onset, an acute and severe slippage can still be reduced closely and fixed percutaneously. The hip regain full range of motion with no sign of AVN on x ray at 18 months follow up.

4.
J Hand Surg Eur Vol ; : 17531934241275448, 2024 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-39275975

RESUMEN

The combination of double antegrade intramedullary pinning with proximal interphalangeal joint transfixation offers an effective and minimally invasive approach to reduce the complications of joint stiffness and functional disability.Level of evidence: V.

5.
J Phys Condens Matter ; 36(50)2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39241805

RESUMEN

Monolayer Ge2Sb2Te5exhibits great potential in non-volatile memory technology due to its excellent electronic properties and phase-change characteristics, while the fundamental nature of Ge2Sb2Te5-metal contacts has not been well understood yet. Here, we provide a comprehensiveab initiostudy of the electronic properties between monolayer Ge2Sb2Te5and Pt, Pd, Au, Cu, Cr, Ag, and W contacts based on first-principles calculations. We find that the strong interaction interfaces formed between monolayer Ge2Sb2Te5and Pt, Pd, Cr, and W contacts show chemical bonding and strong charge transfer. In contrast, no apparent chemical bonding and weak charge transfer are observed in the weak interaction interfaces formed with Au, Cu, and Ag. Additionally, our study reveals the presence of a pronounced Fermi level pinning effect between monolayer Ge2Sb2Te5and metals, with pinning factors ofSn=0.325andSp=0.350. By increasing the interlayer distance, an effective transition fromn-type Ohmic contact ton-type Schottky contact is facilitated because the band edge of Ge2Sb2Te5is shifted upwards. Our study not only provides a theoretical basis for selecting suitable metal electrodes in Ge2Sb2Te5-based devices but also holds significant implications for understanding Schottky barrier height modulation between semiconductors and metals.

6.
ACS Appl Mater Interfaces ; 16(37): 49496-49507, 2024 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-39231283

RESUMEN

The latest synthesized monolayer (ML) MoSi2N4 material exhibits stability in ambient conditions, suitable bandgap, and high mobilities. Its potential as a next-generation transistor channel material has been demonstrated through quantum transport simulations. However, in practical two-dimensional (2D) material transistors, the electrical contacts formed by the channel and the electrode must be optimized, as they are crucial for determining the efficiency of carrier injection. We employed the density functional theory (DFT) combined with the nonequilibrium Green's function (NEGF) method to systematically explore the vertical and horizontal interfaces between the typical metal electrodes and the ML MoSi2N4. The DFT+NEGF method incorporates the coupling between the electrode and the channel, which is crucial for quantum transport. Among these metals, Sc and Ti form n-type Ohmic contacts with zero tunneling barriers at both vertical and horizontal interfaces with ML MoSi2N4, making them optimal for contact metals. In-ML MoSi2N4 contacts display zero Schottky barriers but a 3.11 eV tunneling barrier. Cu and Au establish n-type Schottky contacts, while Pt forms a p-type contact. The Fermi pinning factors of the metal-ML MoSi2N4 contacts for both electrons and holes are above 0.51, much higher than the typical 2D semiconductors. Moreover, there is a strong positive correlation between the Fermi pinning factor and the band gap, with a Spearman rank correlation coefficient of 0.897 and a p-value below 0.001. Our work provides insight into the contact optimization for the ML MoSi2N4 transistors and highlights the promising potential of ML MoSi2N4 as the channel material for the next-generation FETs.

7.
Artículo en Inglés | MEDLINE | ID: mdl-39316133

RESUMEN

PURPOSE: This multicenter, retrospective cohort study aimed to compare the risk of ulnar nerve injury in pediatric supracondylar humeral fractures treated with percutaneous lateral-pins, blinded-crossed-pins, and crossed-pins with a mini-incision. METHODS: Data were collected from 1705 children treated between January 2010 and December 2023 at four orthopedic centers in Colombia. The incidence of postoperative ulnar nerve injury was compared among three fixation techniques: lateral-pin, blinded-crossed-pin, and crossed-pin with a mini-incision. RESULTS: A statistically significant difference in nerve injury rates was observed between the lateral-pin and both blinded-crossed-pin and mini-incision crossed-pin techniques (p < 0.001), with the lateral-pin technique demonstrating a significantly lower risk of injury. No significant difference was found between the blinded-crossed-pin and mini-incision crossed-pin techniques (p = 0.67). CONCLUSION: Crossed-pin fixation was associated with a higher incidence of ulnar nerve injury, regardless of the use of a mini-incision. The lateral-pin technique remains the safest option for minimizing iatrogenic nerve injury. There is insufficient evidence to support the mini-incision as a safer alternative to traditional crossed-pin fixation.

8.
J Colloid Interface Sci ; 678(Pt C): 1230-1238, 2024 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-39342868

RESUMEN

HYPOTHESIS: Despite its importance in colloid and interface science, contact line pinning remains poorly understood, especially in the presence of a precursor film. We hypothesized that this is due to a lack of an experimental method capable of directly observing their physics at the nanoscale. METHODS: Using coherence scanning interferometry, we visualized the three-dimensional behavior of contact lines with a precursor film near a nanogroove structure composed of flat terrace surfaces and steps with an inclination angle of 30° while achieving nanoscale vertical resolution. FINDINGS: We found that even when the contact line is pinned at the edge of the step, the precursor film is not and advances beyond the edge. Furthermore, we discovered that the precursor film has two distinct effects on contact line motion. Specifically, the precursor film facilitates depinning when the contact line descends the step - a contact angle change was 0.9°, only 3.0% of the value predicted by a classical theory of contact angle at a solid edge. This ultra-early depinning is attributed to the formation of a new liquid film past the edge, driven by the progression of the precursor film that overcomes the pinning effect. In contrast, when the contact line ascends the step, the precursor film acts as a resistance to movement due to steric interaction.

9.
Nano Lett ; 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39348164

RESUMEN

The magnetic heating effect under alternating magnetic fields (AMFs) has recently gained attention in catalysis due to its potential to greatly boost catalytic activities by providing localized heating around magnetic nanoparticles. However, nanoparticles still suffer from low magnetic heating efficiency due to their low magnetic anisotropy and thermal fluctuation, which is a key barrier in the wide application of AMF-assisted catalysis. Herein, by introducing the pinning effect of ferromagnetic/antiferromagnetic (FM/AFM) coupling, NiO/NiOOH (AFM/FM) core-shell nanoparticles exhibit significantly enhanced oxygen evolution reaction activity and resistance to thermal fluctuations under AMF, compared to NiOOH nanoparticles. Notably, magnetized NiO/NiOOH nanoparticles provide an overpotential of 186 mV at 10 mA cm-2, outperforming unmagnetized ones (218 mV) under the same conditions, further emphasizing the prominent role of the pinning effect in enhanced magnetic heating efficiency. This work provides valuable inspiration to design advanced magnetic catalysts and meet the challenge of the development of AMF-assisted catalysis.

10.
Zhongguo Gu Shang ; 37(8): 801-7, 2024 Aug 25.
Artículo en Chino | MEDLINE | ID: mdl-39183005

RESUMEN

OBJECTIVE: To investigate global optimisation of anterior acetabular column pinning channels can be achieved based on large density point cloud data. METHODS: Data were collected on the CT scans of the normal pelvis in 40 adults from January 2022 to January 2023, including 22 males and 18 females, aged 20 to 54 years old. Medical imaging data from three of the samples were selected for experimental study. In planning access for anterior acetabular column pinning, to address the issue of whether the current CAD planning methods were advanced or not, four combinations of the same point cloud acquisition channels, different directional line creation software, and the same 3D design and virtual experiment software were proposed: Mimics+Imageware+UG, Mimics+3DReshaper+UG, Mimics+ZEISS Quality Suite+UG and Mimics+Design X+UG, and directional lines created based on the centroid point set and solid point cloud of the secondary pruning model, respectively, and it applied to the planning of the left anterior column pinning channel of the three acetabular samples. The maximum internally connected cylinder without acetabular socket and pubic bone penetration was used as a safe passage for nailing of the anterior acetabular column to evaluate the advancement of each method. RESULTS: The fitting effect of the directional line was better than that of the unnoised solid point cloud when the central point set with obvious relevant features was selected as the sample points;and the combination of Mimics+Imageware+UG and Mimics+3DReshaper+UG could efficiently and stably obtain the desirable planning results when planning with the central point set, respectively, in the three acetabular samples 1, 2, 3. The maximum internal joint circle diameters obtained in samples 1, 2, and 3 were 10.35 mm, 9.62 mm, and 9.24 mm;and when the directional lines were based on the solid point cloud the combined methods of Mimics+ZEISS Quality Suite+UG and Mimics+Design X+UG were not applicable;whereas the Mimics+3DReshaper+UG the solid point cloud denoising planning method could stably obtain the maximum value of the safe channel for nail placement, and the maximum internal joint circle diameters obtained in acetabular samples 1, 2, and 3 are 10.66 mm, 10.96 mm, and 9.48 mm, respectively. CONCLUSION: It is recommended that the nail placement channel planners use robust Mimics+Imageware+UG or Mimics+3DReshaper+UG centre point set planning method, and if there is enough time, it is recommended to use the solid point cloud denoising planning method of Mimics+3DReshaper+UG in order to obtain the maximum value of safe channels for nail placement.


Asunto(s)
Acetábulo , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Acetábulo/cirugía , Acetábulo/diagnóstico por imagen , Clavos Ortopédicos , Tomografía Computarizada por Rayos X , Adulto Joven
11.
Curr Med Imaging ; 20: e15734056279954, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39087571

RESUMEN

BACKGROUND: Imaging techniques such as X-rays and 3D Computed Tomography (CT) are used to diagnose and evaluate a patient's shoulder before and after surgery. Identifying the kind, location, and severity of a shoulder fracture helps surgeons choose the right treatment and surgery. OBJECTIVES: The study examines the effectiveness of small incision reduction and superior closure pinning in treating Ideberg type III glenoid fractures identified by X-ray and CT scans. MATERIALS AND METHODS: From October 2017 to June 2022, 40 patients with Ideberg type III glenoid fractures underwent mini-incision reduction and superior closed pinning fixation using the Anterior (AA) and Posterior (PA) approaches. Pre- and post-surgery shoulder scores and imaging data were analyzed. Outpatient review and shoulder anteroposterior radiographs were collected at 1, 3, 6, and 12 months after surgery. We assessed shoulder joint function using the American Shoulder and Elbow Society (ASES) shoulder score, VAS score, Constant-Murley Shoulder Outcome (Constant) score, and DASH score. RESULTS: A total of 40 patients were monitored for 14-16 months, averaging 15.2 ± 0.3 months. All fractures were healed between 14-25 weeks from X-rays, averaging 17.6 ± 5.4 weeks. Both the AA and PA groups had similar shoulder score changes. However, the AA group did better. In all cases, ASES shoulder scores were outstanding at 80%. Radiographs demonstratedno traumatic arthritis or internal fixation failure consequences like screw loosening or breakage. CONCLUSION: It was concluded that Ideberg type III glenoid fracture reduction with an anterior small incision and superior closed pinning hollow lag screw internal fixation could be successful.


Asunto(s)
Tomografía Computarizada por Rayos X , Humanos , Masculino , Femenino , Tomografía Computarizada por Rayos X/métodos , Persona de Mediana Edad , Adulto , Clavos Ortopédicos , Fracturas del Hombro/cirugía , Fracturas del Hombro/diagnóstico por imagen , Fijación Interna de Fracturas/métodos , Resultado del Tratamiento , Anciano , Fracturas Óseas/cirugía , Fracturas Óseas/diagnóstico por imagen , Escápula/diagnóstico por imagen , Escápula/cirugía , Escápula/lesiones , Estudios Retrospectivos
12.
J Colloid Interface Sci ; 678(Pt A): 322-333, 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39208760

RESUMEN

Surface nanobubbles have revealed a new mechanism of gas-liquid-solid interaction at the nanoscale; however, the nanobubble evolution on real substrates is still veiled, because the experimental observation of contact line motions at the nanoscale is too difficult. HYPOTHESIS: This study proposes a theoretical model to describe the dynamics and stability of nanobubbles on heterogeneous substrates. It simultaneously considers the diffusive equilibrium of the liquid-gas interface and the mechanical equilibrium at the contact line, and introduces a surface energy function to express the substrate's heterogeneity. VALIDATION: The present model unifies the nanoscale stability and the microscale instability of surface bubbles. The theoretical predictions are highly consistent to the nanobubble morphology on heterogeneous surfaces observed in experiments. As the nanobubbles grow, a lower Laplace pressure leads to weaker gas adsorption, and the mechanical equilibrium can eventually revert to the classical Young-Laplace equation above microscale. FINDINGS: The analysis results indicate that both the decrease in substrate surface energy and the increase in gas oversaturation are more conducive to the nucleation and growth of surface nanobubbles, leading to larger stable sizes. The larger surface energy barriers result in the stronger pinning, which is beneficial for achieving stability of the pinned bubbles. The present model is able to reproduce the continual behaviors of the three-phase contact line during the nanobubble evolution, e.g., "pinning, depinning, slipping and jumping" induced by the nanoscale defects.

13.
BMC Musculoskelet Disord ; 25(1): 683, 2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39210474

RESUMEN

PURPOSE: This study investigated the clinical and functional outcomes of children with distal both-bone forearm fractures treated by fixation of the radius only compared to fixation of both the radius and ulna. METHODS: A total of 71 patients from two centres with distal both-bone forearm fractures (30 in the ulna-yes group, 41 in the ulna-no group) who underwent closed reduction and percutaneous pinning treatment were retrospectively analysed. Operation duration, number of fluoroscopic exposures, loss of reduction rate and angulation based on radiographic assessment were compared between the two groups. Evaluation of wrist function including Gartland-Werley Score and Mayo Wrist Score were compared at the last follow-up. RESULTS: Ulna angulation upon bone healing on the posteroanterior and the lateral plane of ulna-no group (6.11 ± 1.56°; 6.51 ± 1.69°) was significantly greater than that of ulna-yes group (4.49 ± 1.30°; 5.05 ± 2.18°) (p < 0.05). No significant difference was found in the loss of reduction rate between ulna-yes group (6.67%, 2/30) and the ulna-no group (4.88%, 2/41) (p > 0.05). At last follow-up, no significant difference was found between the Gartland-Werley Scores of the ulna-yes group (1.83 ± 3.25, range: 0-16) and ulna-no group (1.85 ± 2.72, range: 0-11.5) (p > 0.05). No significant difference was found between the Mayo Wrist Scores of the ulna-yes group (92.60 ± 6.20) and ulna-no group (92.15 ± 7.58) (p > 0.05). CONCLUSIONS: For distal both-bone forearm fractures in children, fixation of only the radius appears to be a viable method with equivalent clinical outcomes compared to fixation of both the radius and ulna.


Asunto(s)
Clavos Ortopédicos , Fracturas del Radio , Fracturas del Cúbito , Humanos , Estudios Retrospectivos , Femenino , Masculino , Niño , Fracturas del Cúbito/cirugía , Fracturas del Cúbito/diagnóstico por imagen , Fracturas del Radio/cirugía , Fracturas del Radio/diagnóstico por imagen , Resultado del Tratamiento , Preescolar , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas/instrumentación , Adolescente , Cúbito/cirugía , Cúbito/diagnóstico por imagen , Cúbito/lesiones , Estudios de Seguimiento
14.
ACS Nano ; 18(36): 25009-25017, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39172704

RESUMEN

The persistent challenges encountered in metal-transition-metal dichalcogenide (TMD) junctions, including tunneling barriers and Fermi-level pinning, pose significant impediments to achieving optimal charge transport and reducing contact resistance. To address these challenges, a pioneering self-aligned edge contact (SAEC) process tailored for TMD-based field-effect transistors (FETs) is developed by integrating a WS2 semiconductor with a hexagonal boron nitride dielectric via reactive ion etching. This approach streamlines semiconductor fabrication by enabling edge contact formation without the need for additional lithography steps. Notably, SAEC TMD-based FETs exhibit exceptional device performance, featuring a high on/off current ratio of ∼108, field-effect mobility of up to 120 cm2/V·s, and controllable polarity─essential attributes for advanced TMD-based logic circuits. Furthermore, the SAEC process enables precise electrode positioning and effective minimization of parasitic capacitance, which are pivotal for attaining high-speed characteristics in TMD-based electronics. The compatibility of the SAEC technique with existing Si self-aligned processes underscores its feasibility for integration into post-CMOS applications, heralding an upcoming era of integration of TMDs into Si semiconductor electronics. The introduction of the SAEC process represents a significant advancement in TMD-based microelectronics and is poised to unlock the full potential of TMDs for future electronic technologies.

15.
Cureus ; 16(7): e64888, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39156472

RESUMEN

A 12-year-old male came to our Emergency Department with chief complaints of pain and inability to move the right shoulder for one day following a fall while playing. The range of motion of the right shoulder was restricted and painful in all directions. Initial radiographs revealed a transverse, displaced proximal humerus fracture at the head-shaft junction. The patient was managed by closed reduction internal fixation with percutaneous K-wiring (Kirschner wires). The K-wires were removed after four weeks, and the shoulder was mobilized. The patient had a near-normal and pain-free range of motion at three months of follow-up. Percutaneous K-wiring remains a viable option for the treatment of paediatric proximal humerus fractures, and good post-operative rehabilitation can help restore near-normal function, as demonstrated in this report.

16.
Front Pediatr ; 12: 1394853, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39161637

RESUMEN

Background: The treatment of severely displaced Rockwood and Wilkins' type C (RWC) thumb metacarpal basal fractures remains controversial in children. This retrospective study aimed to compare the efficacy of two treatment methods, open vs. closed reduction with pinning of such injuries. Methods: This study included 30 patients with open physes, 14 boys and 16 girls, who all received either closed or open reduction treatment. The primary outcomes of interest included healing time, complications, and functional results, which were evaluated using the improved Mayo score standard. The minimum follow-up period was 24 months, with a mean of 30.3 months (range 24.0-45.0 months). Statistical significant was defined as P < 0.05. Results: All fractures were healed within 7 weeks after surgery, regardless of which surgical approach was used. However, the recovery time was markedly faster in the closed group, with a mean of 4.2 weeks, than in the open group, with a mean of 4.7 weeks (P < 0.05). The operation time for closed group, taking 20 min in average, was also shorter than that for open group (P < 0.05). The total incidence of mild complications was lower for patients in the closed group than for patients in the open group (6.3% vs. 21.4%, P < 0.05). No major complications were observed in either group. In the closed group, a total of 15 patients exhibited excellent outcomes, while only one patient demonstrated good outcomes. On the other hand, in the open group, 12 patients experienced excellent outcomes, whereas two patients had good outcomes. There were no instances of osteomyelitis, refractures or nonunion, avascular necrosis (AVN), or premature physeal closure in either group. Conclusion: The data from the open group and closed group procedures for severely shifted RWC fractures in children indicate comparable prognoses and complication rates between the two groups. Obviously closed reduction, in particular, offers several advantages over open procedure, including shorter surgical duration, fewer K-wires required, and no need for open incisions. Consequently, closed reduction is the preferred method for treating such RWC fractures.

17.
J Child Orthop ; 18(4): 421-431, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39100985

RESUMEN

Purpose: Fractures occurring at the metaphyseal-diaphyseal junction of the distal humerus in children are not commonly documented in the literature. Until this moment, there is no gold standard technique regarding its management and most surgeons treat it as a regular supracondylar humerus fracture by conventional pinning. This systematic review explores the relevant literature to assess the efficacy of different techniques. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Our literature search encompassed several online databases, including PUBMED/MEDLINE, Scopus, Web of Science Core Collection, and Google Scholar. Data from articles that met our general inclusion criteria were extracted and categorized into treatment method groupings. Functional and cosmetic outcomes, demographic characteristics, and complications were the main parameters used to analyze the data. Results: Ten retrospective studies met our inclusion criteria with a total of 178 participants of unilateral pediatric distal humerus metaphyseal-diaphyseal junction fractures. Most literature chose closed reduction and percutaneous pinning in seven articles, followed by elastic stable intramedullary nail technique used in three articles, then conservative treatment was chosen in two articles, while only one article used lateral miniplate and assisted K-wire and another article used combined closed reduction and percutaneous pinning and intramedullary K-wire. As regards the operation time; elastic stable intramedullary nails had the shortest time with a mean of 39.7 min (range: 37.5-41.9 min), while closed reduction and percutaneous pinning had the longest time with a mean of 75.47 min (range: 55.9-92.1 min). The shortest healing time was observed in miniplate with a mean of 7.2 weeks, while the most prolonged was in conservative management with a mean of 12 weeks and closed reduction and percutaneous pinning was a mean of 10 weeks. Regarding Flynn's criteria, all participants received excellent and good except in closed reduction and percutaneous pinning; 13 cases were fair and 2 cases were poor. Regarding complications, the most commonly observed complication after metaphyseal-diaphyseal junction fracture was cubitus varus, the highest incidence was in conservative management (33% of cases), followed by closed reduction and percutaneous pinning (10.9% of cases), the least incidence was observed in elastic stable intramedullary nails (3.77% of cases), and none of the cases treated with mini plate developed this complication. Other complications were observed only with closed reduction and percutaneous pinning; 8.5% of cases developed fixation loss, 6.2% of cases had a significantly reduced range of motion, and one case refractured. Conclusion: Pediatric distal humerus metaphyseal-diaphyseal junction fractures should be distinguished from the more prevalent supracondylar humerus fractures, as conventional pinning techniques are associated with a higher incidence of complications and increased both operative and healing times.Level of evidence: III.

18.
Heliyon ; 10(14): e34065, 2024 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-39108911

RESUMEN

Synchronization in complex networks is a ubiquitous and important phenomenon with implications in various fields. Excessive synchronization may lead to undesired consequences, making desynchronization techniques essential. Exploiting the Proximal Policy Optimization algorithm, this work studies reinforcement learning-based pinning control strategies for synchronization suppression in global coupling networks and two types of irregular coupling networks: the Watts-Strogatz small-world networks and the Barabási-Albert scale-free networks. We investigate the impact of the ratio of controlled nodes and the role of key nodes selected by the LeaderRank algorithm on the performance of synchronization suppression. Numerical results demonstrate the effectiveness of the reinforcement learning-based pinning control strategy in different coupling schemes of the complex networks, revealing a critical ratio of the pinned nodes and the superior performance of a newly proposed hybrid pinning strategy. The results provide valuable insights for suppressing and optimizing network synchronization behavior efficiently.

19.
Cureus ; 16(7): e63975, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39109094

RESUMEN

Lateral condyle fractures of the humerus are a common elbow injury sustained by pediatric patients. Complications from surgical intervention can include malunion, fishtail deformity, osteonecrosis, and avascular necrosis (AVN). AVN of the capitellum is a rare complication of lateral condyle fractures with very few cases reported in the current literature. Here we report the rare case of dissolution of the capitellum following closed reduction and percutaneous pinning for a lateral condylar fracture of the humerus of a six-year-old child performed at an outside hospital that was subsequently managed at our academic pediatric level 1 trauma center. Other than a long-arm cast, no specific intervention was provided as the patient remained neurovascularly intact and improved clinically. Through careful follow-up and conservative management, the patient regained the full range of motion of the elbow and clinical resolution of the fracture. The single posterior blood supply of the capitellum likely contributes to the pathophysiology of this condition and further supports the methodology of avoiding posterior soft tissue stripping during surgical correction of distal humerus fractures. We conclude that the prognosis of this condition is favorable and can be managed by conservative treatment.

20.
Materials (Basel) ; 17(14)2024 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-39063686

RESUMEN

Ultra-high temperature ceramics (UHTCs) have been widely applied in many fields. In order to enhance the comprehensive properties of TaB2-based UHTCs, the first collaborative use of fine TaC particles and dispersed multi-walled carbon nanotubes (MWCNTs) was employed via spark plasma sintering (SPS) at 1700 °C. The derived UHTCs exhibited an average grain size of 1.3 µm, a relative density of 98.6%, an elastic modulus of 386.3 GPa, and a nano hardness of 21.7 GPa, leading to a greatly improved oxidation resistance with a lower linear ablation rate at -3.3 × 10-2 µm/s, and a markedly reinforced ablation resistance with mass ablation rate of -1.3 × 10-3 mg/(s·cm2). The enhanced ablation resistance was attributable to the physical pinning effect, sealing effect and self-healing effect. Thus, this study provides a potential strategy for preparation of UHTCs with bettered ablation resistance and physical properties.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA