5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?

PURPOSE OF THE STUDY Fifth metatarsal fractures, in particular so-called Jones fractures, are relatively common injuries both in the general population and athletes. Although discussions about whether the surgical or conservative solution should be preferred are ongoing for decades, there is no clear consensus. Here, we aimed to prospectively compare the results of osteosynthesis using the Herbert screw with the conservative solution in patients from our department. MATERIAL AND METHODS Patients 18-50 years presenting to our department with Jones fracture and meeting further inclusion/exclusion criteria were offered participation in the study. Those willing to participate signed informed consent and were randomized by flipping the coin into surgically and conservatively treated groups. After six and twelve weeks, X-ray was performed in each patient and AOFAS score was determined. Conservatively treated patients who showed no signs of healing and whose AOFAS was below 80 after six weeks were offered surgery again. RESULTS Of 24 patients in total, 15 were assigned to the surgically treated group and nine were treated conservatively. After six weeks, AOFAS score of all but two patients (86%) in the surgically treated group ranged between 97 and 100, while this score exceeded 90 points only in three patients (33%) from the conservatively treated group. On X-ray, successful healing after six weeks was observed in seven patients (47%) from the surgically treated group but in none of the patients from the conservatively treated group. Three out of five patients in the conservative group whose AOFAS was below 80 after six weeks opted for surgery at that time and all improved significantly by the twelfth week. DISCUSSION Although studies on surgical treatment of Jones fracture using various screws or plates are not rare, we present an uncommon method of surgical treatment of this injury - the use of the Herbert screw. The results of this method are excellent and even on a relatively small sample yielded statistically significantly better results than conservative treatment. Moreover, the surgical treatment facilitated early loading of the injured limb, which allows an earlier return of the patients to normal life. CONCLUSIONS Osteosynthesis using Herbert screw in Jones fracture yielded significantly better results than conservative treatment. Key words: Jones fracture, AOFAS, Herbert screw, 5th metatarsal fracture, surgical treatment.

Postsynthetic modification of a zirconium metal-organic framework at the inorganic secondary building unit with diphenylphosphinic acid for increased photosensitizing properties and stability.

A zirconium metal-organic framework (MOF) PCN-222 was postsynthetically modified with diphenylphosphinic acid, resulting in an increased stability when activated from water and 4 times higher photosensitizing properties for singlet oxygen production. The phosphinic acid did not compromise the crystallinity of the MOF but made strong bonds with the zirconia secondary building units.

Combined bone lesion analysis in 3D CT data of vertebrae.

Two novel statistically based methods for bone lesion detection and classification are presented. Together with the previously published MRF method [15], they form a triad of mutually complementary methods that promise, when fused, to enable higher reliability of bone lesion assessment.

Electrochemical performance of cobalt hydroxide nanosheets formed by the delamination of layered cobalt hydroxide in water.

We report the preparation of monometallic Co(2+)/Co(3+) layered double hydroxide, intercalated with lactate anions (LCoH-Lactate), and its spontaneous delamination in water to form cobalt hydroxide nanosheets. These hydroxide nanosheets formed stable aqueous dispersions. The thickness of a nanosheet was estimated to be approximately 1 nm by atomic force microscopy and small angle X-ray scattering experiments, and corresponds to a single hydroxide layer. Some of the Co(2+) cations were oxidised by oxygen, resulting in a mixed Co(2+)(0.76)Co(3+)(0.24) layer composition. Upon water evaporation, the nanosheets restacked to form transparent self-standing films with a layered structure like that of the original material. The coverage of the surface with side-by-side stacks of nanosheets indicated two-dimensional agglomeration and suggested that these dispersions could be applied to prepare large monolayers of nanosheets. The layers prepared by spin-coating were stable and featured reversible and reproducible redox properties in an alkaline electrolyte. In an evaluation of their electrochemical performance, the cobalt hydroxide nanosheets exhibited durability and fast charge transfer kinetics during repetitive potential cycling up to 200 mV s(-1). The nanosheets prepared by the present method show promise for use in nanocomposite materials for energy storage applications.

Multiclass/multiresidue method for monitoring widely applied plant protecting agents in air during field dispersion work.

A multiclass/multiresidue method for surveying the uptake of plant protecting chemicals by inhalation during field spraying work is described. Eleven nowadays mainly dispersed compounds, which cover a wide range of chemical properties, are analysed in air with personal active sampling and in one single analytical run. This has the advantage, that one basic method only needs to be implemented, calibrated and validated in a laboratory to perform varying monitoring tasks without changing the method itself. Samples were taken with Tenax sorbent tubes operated to collect the active compounds simultaneously in the vapour state, in aerosol state or bound to particles. The procedure consists of four unit operations only: sampling, elution, dilution and HPLC measurement, and is described in SOP-format. The limits of quantification, calculated as method detection limits, were between 1 and 9 microg m(-3) based on 1 m3 air volume sampled (8 h). Method performance was characterised by way of generated test atmospheres and field spraying trials.

Information system for the registration of pollution sources associated with construction activities.

A prospective builder in Czech Republic has to apply for approval by local (regional, state) authorities and is liable, in the Environmental Impact Assessment (EIA) process to make an accurate statement of stress factor values produced during the life cycle of the construction work.These data should be kept in the information system, as only a substantial amount of relevant high quality data can be used in the decision-making process.Identifying and quantifying stress factors produced by a given construction activity can present a problem due to inadequate knowledge and opinion in this field. For large construction works, a knowledge-based system proposed in the second part of this paper may be useful; small structures can be covered by the information given as to local factors, which form part of the information system proposed by Vlcek and Moos (1991).