Comparative Analysis of Clavicular Hook Plate Versus Distal Radius Volar Plate With Coracoclavicular Augmentation for Neer's Type 2b Lateral Clavicle Fractures: A Prospective Study.

Background Clavicle fractures are common injuries in the adult population. The commonest site of fracture in the clavicle is the mid-shaft followed by the lateral end fracture. The anatomy and biomechanics of the lateral end clavicle make it prone to be unstable. Conservative management usually fails due to the deforming forces. Aim Our study evaluates pain relief, functional outcome, and the union rate in unstable lateral end clavicle fracture fixed by two different modalities of operative management, namely clavicular hook plate fixation and distal radius volar plate fixation. Materials and method A total of 60 patients with the unstable lateral end of clavicle fracture were evaluated in this study at a single tertiary care center between August 2015 and September 2021. Half of the patients (30 patients) were managed by open reduction and internal fixation with clavicular hook plate. The remaining half (30 patients) underwent open reduction and internal fixation by distal radius volar plate supplemented with coracoclavicular fixation. All patients were followed up for a mean duration of 20 months. The functional outcome was assessed at regular intervals by Constant score and Disability of the Arm, Shoulder and the Hand (DASH) score for a period of one year. Result There was significant pain relief and improvement in the functional status of patients. The pain relief was significant in the group managed by distal radius volar plate. The decrease in DASH score and increase in Constant score suggests better functional outcomes in these patients. Conclusion Our study highlights the fact that the distal radius volar plate is an excellent alternative to the hook plate in the treatment of unstable lateral third clavicle fractures. The decrease in pain and improved functional outcome stresses the fact that the volar locking plate is the recent most advancement in the fracture fixation of Neer's type ll fractures. The distal radius volar plate is the recent internal fixation technique to manage unstable lateral end clavicle fractures.

Chronic Unreduced Anterior Shoulder Dislocation Managed by Latarjet Procedure: A Prospective Study.

The shoulder joint is the most common joint to undergo dislocation, with the anterior subtype being the most common. The most accepted definition of chronic dislocation is a shoulder joint that has remained dislocated for a minimum of three weeks. Due to rare presentation, there is a lack of consensus among surgeons regarding the optimal management option of chronic shoulder dislocation. The goal of this prospective study was to assess the efficacy of open reduction with Latarjet procedure in the management of chronic unreduced shoulder dislocation. A total of seven patients were included in this study. Five patients were males and two were females. The study was conducted in a single tertiary care centre between July 2015 and May 2018. All patients were managed by open reduction with the Latarjet procedure. The capsulolabral structures were repaired in all the cases. The post-operative functional outcome was assessed by shoulder range, Rowe score, and the University of California, Los Angeles (UCLA) score at regular intervals for a period of one year. There was a significant improvement in terms of pain relief and functional status of the patients. The patients were satisfied as they could do their daily routine activities without pain at a one-year follow-up. Early post-operative rehabilitation and physiotherapy are key to improving the functional range.

Design, synthesis and bioevaluation of novel 6-(4-Hydroxypiperidino)naphthalen-2-ol-based potential Selective Estrogen Receptor Modulators for breast cancer.

In a study directed towards development of novel Selective Estrogen Receptor Modulators (SERMs), 1-(4-(2-(dialkylamino)ethoxy)benzyl)-6-(4-hydroxypiperidin-1-yl)-2-naphthol and corresponding aryl methyl ethers were synthesized and bioevaluated against the estrogen-responsive human MCF-7 breast cancer cell line. The phenolic analogs displayed little or no activity, but aryl methyl ether analogs showed significant cytotoxic potency. Also, representative compounds from the aryl methyl ether series showed significant binding and antagonistic activity against ERα. Two representative compounds were also evaluated for in vitro membrane permeability, plasma stability as well as in-vivo toxicity in mice. The compounds displayed well-acceptable drug-like in vitro membrane permeability as well as plasma stability and were well-tolerated in experimental mice at 300 mg/kg dose.

Converting oxazoles into imidazoles: new opportunities for diversity-oriented synthesis.

We report the optimization of a neglected reaction for the rapid and direct conversion of oxazoles into N-substituted imidazoles. The utility of this microwave-promoted reaction for diversity-oriented synthesis is demonstrated in the preparation of >40 N-substituted imidazoles, including α-imidazolyl esters.

Highly efficient copper-catalyzed domino ring opening and Goldberg coupling cyclization for the synthesis of 3,4-dihydro-2H-1,4-benzoxazines.

trans-3,4-Dihydro-2H-1,4-benzoxazine moieties can be synthesized by domino aziridine ring opening with o-iodophenols followed by the copper-catalyzed Goldberg coupling cyclization (intramolecular C(aryl)-N(amide) bond formation) with good to excellent yields.

General, mild, and intermolecular Ullmann-type synthesis of diaryl and alkyl aryl ethers catalyzed by diol-copper(I) complex.

A wide range of diaryl ethers and alkyl aryl ethers are synthesized through intermolecular C(aryl)-O bond formation from the corresponding aryl iodides/aryl bromides and phenols/alcohols through Ullmann-type coupling reaction in the presence of a catalytic amount of easily available (+/-)-diol L3-CuI complex under very mild reaction conditions. Less reactive aryl bromides can also be used for O-arylation of phenols under the same reaction conditions without increasing the reaction temperature, catalyst loading, and time. The catalytic system not only is capable of coupling hindered substrate but also tolerates a broad range of a series of functional groups.

Highly stereoselective chlorination of beta-substituted cyclic alcohols using PPh3-NCS: factors that control the stereoselectivity.

A variety of trans-beta-substituted cyclic alcohols were stereoselectively chlorinated to either the corresponding cis-chloride or trans-chloride (inversion or retention of configuration) with good to excellent yields; the stereochemical outcome is determined by the size of the ring and the nature of the beta-substituents, especially the electronegativity of the substituted atom.