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Background Plate osteosynthesis is the gold standard treatment for the management of humeral shaft fractures. In the present study, we performed plate osteosynthesis on the anteromedial and anterolateral surfaces using the anterolateral approach to compare the functional outcomes. Aims and objectives To study and compare the functional outcome, time to achieve union and associated complications of anteromedial and anterolateral plating in humerus shaft fracture by anterolateral approach. Methods This prospective, randomised control study was performed at Dr Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India. This study had 46 patients in total, who were divided into two equal groups at random. All of the fractures in group A were treated using a limited contact dynamic compression plate (LCDCP) on the anterolateral surface using an anterolateral approach, while all of the fractures in group B were corrected using an anteromedial surface using an anterolateral approach using LCDCP. All the patients were followed for six months at regular intervals. At each follow-up, patients were assessed radiologically with X-rays and clinically by Rodriguez-Merchan criteria (RM criteria). Results and conclusions The union was achieved in the majority of the cases of the anteromedial plating group within 12 weeks (78.3%) with a mean union time of 11.7±1.5 weeks than the anterolateral group (56.5%) with a mean union time of 12.3±1.8 weeks. Based on functional assessment according to RM criteria, the excellent outcome was achieved in 69.6% and 65.2% of the anterolateral and anteromedial plating groups, respectively. There was no case of non-union and radial nerve palsy in anteromedial plating cases whereas in anterolateral cases one patient did not achieve union and two (8.7%) had radial nerve injury, which recovered completely by the end of the study. An anterolateral approach with anteromedial surface plating on the flat medial aspect of the humerus is a good technique for fixing humeral fractures.
RESUMO
Background: Cubitus varus, a common post-traumatic deformity of the elbow in children, poses challenges for both patients and surgeons. Step cut osteotomy has emerged as a reasonable surgical technique to address this condition, offering multiple approaches and modifications. Methods: We present a comprehensive systematic review of techniques for step cut osteotomy in cubitus varus, analyzing 13 studies that meet our inclusion criteria. These studies encompass diverse patient populations, including pediatric and adult cases, and span different geographical regions. Results: Our systematic review explores three primary osteotomy techniques-Classic Step-Cut Osteotomy, Reverse V Osteotomy, and Modified Step Cut Osteotomy-along with their modifications, providing surgeons with valuable options for individualized correction. Functional outcomes showcase improvements in range of motion, functional scores, and carrying angle, highlighting the technique's efficacy in restoring elbow function and enhancing quality of life. Radiological evaluations demonstrate successful corrections of various angles and achievement of bony union, reinforcing the stability and anatomical improvements achieved through step cut osteotomy. Conclusions: Complication rates are notably low, with transient nerve palsies being the most commonly encountered, often resolving within months. Implant failure and other complications are infrequent, underlining the safety and reliability of step cut osteotomy as a surgical intervention for cubitus varus.While the predominance of retrospective studies and heterogeneity across included studies warrant caution, our systematic review provides a robust and diverse synthesis of evidence. It underscores the significance of step cut osteotomy in managing cubitus varus deformity, emphasizing its versatility, favourable outcomes, and safety profile. Further research with rigorous designs and longer follow-up periods will enhance our understanding of step cut osteotomy's role in cubitus varus correction.
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The purpose of this paper is twofold: (i) to investigate the emotion representation models and find out the possibility of a model with minimum number of continuous dimensions and (ii) to recognize and predict emotion from the measured physiological signals using multiresolution approach. The multimodal physiological signals are: Electroencephalogram (EEG) (32 channels) and peripheral (8 channels: Galvanic skin response (GSR), blood volume pressure, respiration pattern, skin temperature, electromyogram (EMG) and electrooculogram (EOG)) as given in the DEAP database. We have discussed the theories of emotion modeling based on i) basic emotions, ii) cognitive appraisal and physiological response approach and iii) the dimensional approach and proposed a three continuous dimensional representation model for emotions. The clustering experiment on the given valence, arousal and dominance values of various emotions has been done to validate the proposed model. A novel approach for multimodal fusion of information from a large number of channels to classify and predict emotions has also been proposed. Discrete Wavelet Transform, a classical transform for multiresolution analysis of signal has been used in this study. The experiments are performed to classify different emotions from four classifiers. The average accuracies are 81.45%, 74.37%, 57.74% and 75.94% for SVM, MLP, KNN and MMC classifiers respectively. The best accuracy is for 'Depressing' with 85.46% using SVM. The 32 EEG channels are considered as independent modes and features from each channel are considered with equal importance. May be some of the channel data are correlated but they may contain supplementary information. In comparison with the results given by others, the high accuracy of 85% with 13 emotions and 32 subjects from our proposed method clearly proves the potential of our multimodal fusion approach.
