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Temporal Changes in Reverse Torque of Locking-Head Screws Used in the Locking Plate in Segmental Tibial Defect in Goat Model.

Front Surg 2021 27;8:637268. Epub 2021 Apr 27.

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.

The objective of this study was to evaluate changes in peak reverse torque (PRT) of the locking head screws that occur over time. A locking plate construct, consisting of an 8-hole locking plate and 8 locking screws, was used to stabilize a tibia segmental bone defect in a goat model. PRT was measured after periods of 3, 6, 9, and 12 months of ambulation. Read More

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Stroke Prediction Based on the Spontaneous Nystagmus Suppression Test in Dizzy Patients: A Diagnostic Accuracy Study.

Neurology 2021 May 13. Epub 2021 May 13.

Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.

ObjectiveFailure of fixation suppression of spontaneous nystagmus is sometimes seen in patients with vestibular strokes involving the cerebellum or brainstem, however, the accuracy of this test for the discrimination between peripheral and central causes in patients with an acute vestibular syndrome (AVS) is unknown.MethodsPatients with AVS were screened and recruited (convenience sample) as part of a prospective cross-sectional study in the Emergency Department between 2015-2020. All patients received neuroimaging which served as a reference standard. Read More

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Anatomical Study of the Interosseous Ligament of the Tibiofibular Syndesmosis: An Analysis of Osseous Morphology and Attaching Interposing Structures.

J Bone Joint Surg Am 2021 May;103(10):905-912

Departments of Clinical Anatomy (A.T., M.T., R.Y., and K.A.), Orthopaedic and Spinal Surgery (A.T. and A.O.), and Functional Joint Anatomy (A.N.), Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Background: The morphological features of the interosseous tibiofibular area in relation to the tensile stress of the interosseous ligament (IOL) have rarely been discussed. The purpose of the present study was to investigate the IOL on the basis of osseous surface morphology and macroscopic and histological anatomy. We hypothesized that the osseous surface of the interosseous tibiofibular area has a specific feature corresponding to the fibrous structure in the IOL. Read More

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C1 and C2 Fractures Above a Previous Fusion Treated with Internal Fixation without Fusion: A Case Report.

JBJS Case Connect 2021 04 14;11(2). Epub 2021 Apr 14.

Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota.

Case: A 71-year-old woman sustained C1 lateral mass and type 2 odontoid fractures 3 years after C2-T2 anterior-posterior fusion. She was treated with C1-C4 instrumentation without fusion for 9 months followed by instrumentation removal to restore atlantoaxial motion. After instrumentation removal, she maintained clinically relevant cervical lateral bending, rotation, and flexion and extension. Read More

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Delayed Treatment of a Traumatic Lumbosacral Dislocation With Associated Injuries: A Case Report.

JBJS Case Connect 2021 04 19;11(2). Epub 2021 Apr 19.

Department of Surgery, Sir H.N. Reliance Foundation Hospital, Girgaon, Mumbai, India.

Case: A 41-year-old woman sustained a degloving injury over her lumbosacral and perineal region with fractures of her right tibia and fibula. After diversion colostomy and osteosynthesis for the fractures at a primary center, a missed grade 2 lumbosacral dislocation was diagnosed at a tertiary center and the degloving injury was treated with debridement and skin grafting. After 5 months, the dislocation had progressed to grade 4 and she underwent delayed posterior lumbosacral reduction, interbody fusion, and L4-S1 fixation, with superior gluteal artery perforator flap and subsequent colostomy closure, with good outcomes (Oswestry Disability Index 10%) at the 3-year follow-up. Read More

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Distal Biceps Reconstruction With an Alternative Technique for Tendon Tensioning and Fixation: A Case Report.

JBJS Case Connect 2021 05 11;11(2). Epub 2021 May 11.

São João University Hospital, Porto, Portugal.

Case: A 41-year-old right-handed male patient presented to our institution with a chronic distal biceps rupture after failed primary surgery 6 months previously. We performed a reconstruction with semitendinosus autograft fixed proximally with a Pulvertaft weave and distally with a cortical button plus interference screw. The patient showed complete pain resolution and excellent functional results. Read More

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The Value of Three-Dimensional Printing Spine Model in Severe Spine Deformity Correction Surgery.

Global Spine J 2021 May 11:21925682211008830. Epub 2021 May 11.

Department of Orthopedic Surgery, 74639Beijing Chao-Yang Hospital, Capital Medical University, Chaoyang District, Beijing, China.

Study Design: Retrospective case-control study.

Objective: We aimed to evaluate the value of 3-dimensional printing (3DP) spine model in the surgical treatment of severe spinal deformity since the prosperous development of 3DP technology.

Methods: Severe scoliosis or hyper-kyphosis patients underwent posterior fixation and fusion surgery using the 3DP spine models were reviewed (3DP group). Read More

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Comparison of three different screw trajectories in osteoporotic vertebrae: a biomechanical investigation.

BMC Musculoskelet Disord 2021 May 5;22(1):418. Epub 2021 May 5.

Department of Orthopedic Surgery, Traumatology and Plastic Surgery, Leipzig University, Liebigstraße 20, 04103, Leipzig, Germany.

Background: Pedicle screw insertion in osteoporotic patients is challenging. Achieving more screw-cortical bone purchase and invasiveness minimization, the cortical bone trajectory and the midline cortical techniques represent alternatives to traditional pedicle screws. This study compares the fatigue behavior and fixation strength of the cement-augmented traditional trajectory (TT), the cortical bone trajectory (CBT), and the midline cortical (MC). Read More

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Comparison of four posterior approaches of the ankle: A cadaveric study.

OTA Int 2020 Sep 12;3(3):e085. Epub 2020 Aug 12.

Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Objectives: The purpose of this study is to provide a detailed comparison of 4 posterior approaches of the ankle: the posteromedial, modified posteromedial (mPM), Achilles tendon-splitting (TS), and posterolateral approaches.

Methods: Cadaveric dissections were performed to assess the influence of the medial and lateral retraction forces on the neuro-vascular bundle with suspension scales and to measure the medial and lateral exposed areas of the posterior tibia and talus. Data was acquired with the ankle in neutral position and in plantar flexion. Read More

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September 2020

Does provisional mini-fragment fixation prevent compression with dynamic compression plating? A biomechanical analysis.

J Orthop Trauma 2021 Apr 8. Epub 2021 Apr 8.

Department of Orthopedic Surgery, Allegheny Health Network, Pittsburgh, PA Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA.

Methods: Fourth generation composite large humeral sawbones underwent transection and were divided into two groups. The first group underwent fixation with a 3.5mm compression plate; the second group underwent provisional fixation with a 2. Read More

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Adolescent mid-shaft clavicular fracture displacement does not predict nonunion or inferior functional outcome at long-term follow-up.

Bone Joint J 2021 May;103-B(5):951-957

Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.

Aims: The aim of this study was to define the complications and long-term outcome following adolescent mid-shaft clavicular fracture.

Methods: We retrospectively reviewed a consecutive series of 677 adolescent fractures in 671 patients presenting to our region (age 13 to 17 years) over a ten-year period (2009 to 2019). Long-term patient-reported outcomes (abbreviated version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and EuroQol five-dimension three-level (EQ-5D-3L) quality of life score) were undertaken at a mean of 6. Read More

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Biomechanical comparison of 3 types of transdiscal fixation implants for fixing high-grade L5/S1 spine spondylolisthesis.

Spine J 2021 Apr 29. Epub 2021 Apr 29.

London Health Science Centre, Victoria Hospital, London, N6A 5W9, Canada; Dept. of Surgery (Div. of Orthopaedic Surgery), Western University, London, N6A 3K7, Canada.

Background Context: There are several options for the stabilization of high-grade lumbosacral spondylolisthesis including transdiscal screws, the Bohlman technique (transdiscal fibular strut) and the modified Bohlman technique (transdiscal titanium mesh cage). The choice of an optimum construct remains controversial; therefore, we endeavoured to study and compare the biomechanical performance of these 3 techniques.

Purpose: The aim of this study was to compare 3 types of transdiscal fixation biomechanically in an in vitro porcine lumbar-sacral spine model. Read More

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Brain-Computer Interface Speller Based on Steady-State Visual Evoked Potential: A Review Focusing on the Stimulus Paradigm and Performance.

Brain Sci 2021 Apr 1;11(4). Epub 2021 Apr 1.

College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110169, China.

The steady-state visual evoked potential (SSVEP), measured by the electroencephalograph (EEG), has high rates of information transfer and signal-to-noise ratio, and has been used to construct brain-computer interface (BCI) spellers. In BCI spellers, the targets of alphanumeric characters are assigned different visual stimuli and the fixation of each target generates a unique SSVEP. Matching the SSVEP to the stimulus allows users to select target letters and numbers. Read More

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My Evolution with Endoscopic Brow-Lift Surgery.

Facial Plast Surg Clin North Am 2021 May 24;29(2):163-178. Epub 2021 Apr 24.

University of Utah School of Medicine, 5445 South Highland Drive, Salt Lake City, UT 84117, USA.

The endoscopic approach for forehead rejuvenation and brow lift has many advantages. It provided excellent exposure for release of periorbital soft tissues combined with endoscopic magnification, shorter scars, and reduced risk of alopecia and scalp sensory changes compared with the traditional open coronal brow lift. The technique has improved over the last 15 years with better fixation devices, a better understanding of the longevity, and decreased complications of the procedure. Read More

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Reoperative genioplasty: a 10-year retrospective study.

Oral Maxillofac Surg 2021 Apr 27. Epub 2021 Apr 27.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wang Mai, Patumwan, Bangkok, 10330, Thailand.

Purpose: The purpose of this retrospective cohort study was to identify the causes of requiring reoperative genioplasty and determine the factors associated with reoperation.

Methods: Medical records and radiographs of patients who underwent genioplasty were reviewed. The demographic data, characteristics of operation, and treatment outcomes were gathered to analyze the causes that required reoperation. Read More

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Chronic pain with neuropathic characteristics after surgery for major trauma to the lower limb: prevalence, predictors, and association with pain severity, disability, and quality of life in the UK WHiST trial.

Bone Joint J 2021 Apr 27:1-8. Epub 2021 Apr 27.

Kadoorie Research Centre, Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Aims: To identify the prevalence of neuropathic pain after lower limb fracture surgery, assess associations with pain severity, quality of life and disability, and determine baseline predictors of chronic neuropathic pain at three and at six months post-injury.

Methods: Secondary analysis of a UK multicentre randomized controlled trial (Wound Healing in Surgery for Trauma; WHiST) dataset including adults aged 16 years or over following surgery for lower limb major trauma. The trial recruited 1,547 participants from 24 trauma centres. Read More

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Lumbar Intervertebral Spacer With Cement Augmentation of Endplates and Integrated Screws as a Fixation Device in an Osteoporotic Model: An In Vitro Kinematic and Load-to-Failure Study.

Int J Spine Surg 2021 Apr 23;15(2):324-333. Epub 2021 Mar 23.

Musculoskeletal Education and Research Center (MERC), a Division of Globus Medical, Inc, Audubon, Pennsylvania.

Background: Integrated lateral lumbar interbody fusion (LLIF) devices have been shown to successfully stabilize the spine and avoid complications related to posterior fixation. However, LLIF has increased subsidence risk in osteoporotic patients. Cement augmentation through cannulated pedicle screws enhances pedicle fixation and cage-endplate interface yet involves a posterior approach. Read More

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Augmented Reality Navigated Sacral-Alar-Iliac Screw Insertion.

Int J Spine Surg 2021 Feb 18;15(1):161-168. Epub 2021 Feb 18.

Department of Orthopedics, University Hospital Balgrist, University of Zürich, Zürich, Switzerland.

Background: Sacral-alar-iliac (SAI) screws are increasingly used for lumbo-pelvic fixation procedures. Insertion of SAI screws is technically challenging, and surgeons often rely on costly and time-consuming navigation systems. We investigated the accuracy and precision of an augmented reality (AR)-based and commercially available head-mounted device requiring minimal infrastructure. Read More

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February 2021

Current Management of Post-radical Prostatectomy Urinary Incontinence.

Front Surg 2021 9;8:647656. Epub 2021 Apr 9.

Mainz University Hospital, Mainz, Germany.

Prostate cancer is the second most common cancer in men worldwide. Radical prostatectomy and radiation beam therapy are the most common treatment options for localized prostate cancer and have different associated complications. The etiology of post prostatectomy incontinence is multifactorial. Read More

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Vestibular Organ and Cochlear Implantation-A Synchrotron and Micro-CT Study.

Front Neurol 2021 7;12:663722. Epub 2021 Apr 7.

Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.

Reports vary on the incidence of vestibular dysfunction and dizziness in patients following cochlear implantation (CI). Disequilibrium may be caused by surgery at the cochlear base, leading to functional disturbances of the vestibular receptors and endolymphatic duct system (EDS) which are located nearby. Here, we analyzed the three-dimensional (3D) anatomy of this region, aiming to optimize surgical approaches to limit damage to the vestibular organ. Read More

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Heterojunction photocatalysts for artificial nitrogen fixation: fundamentals, latest advances and future perspectives.

Nanoscale 2021 Apr 9;13(15):7011-7033. Epub 2021 Apr 9.

Multidisciplinary Platform of Advanced Engineering, Chemical Engineering Discipline, School of Engineering, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Selangor, Malaysia.

As an indispensable energy source, ammonia plays an essential role in agriculture and various industries. Given that the current ammonia production is still dominated by the energy-intensive and high carbon footprint Haber-Bosch process, photocatalytic nitrogen fixation represents a low-energy consuming and sustainable approach to generate ammonia. Heterostructured photocatalysts are hybrid materials composed of semiconductor materials containing interfaces that make full use of the unique superiorities of the constituents and synergistic effects between them. Read More

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Spontaneous healing of a traumatic critical radius bone defect in adolescent: A rare case report.

Int J Surg Case Rep 2021 Apr 22;81:105806. Epub 2021 Mar 22.

Department of Orthopaedics and Traumatology, Cipto Mangunkusumo National Central Hospital and Faculty of Medicine, Universitas Indonesia, Jalan Diponegoro No. 71, Jakarta Pusat, Jakarta 10430, Indonesia.

Introduction And Importance: Fracture with a critical bone loss is associated with a profound burden of disease impact. Although there are several options exist for its treatment, but still those reconstructive procedures are technically demanding, relatively expensive and sometimes the result is less than what was expected. The objective of this study is to report a rare case of spontaneous healing of a critical radial bone defect in an adolescent. Read More

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Engineering One-Dimensional AuPd Nanospikes for Efficient Electrocatalytic Nitrogen Fixation.

ACS Appl Mater Interfaces 2021 May 22;13(17):20233-20239. Epub 2021 Apr 22.

State Key Laboratory Breeding Base of Green-Chemical Synthesis Technology, College of Chemical Engineering, Zhejiang University of Technology, Hangzhou 310014, P. R. China.

Designing one-dimensional (1D) bimetallic nanomaterials is of great significance for electrochemical nitrogen fixation. Inspired by this, 1D AuPd nanospikes (AuPd NSs) composed with internal Au nanowire and external Pd nanohumps were fabricated by a flexible low-temperature wet-chemical method. Benefiting from the excellent electron transport efficiency of the 1D material and the accessible surface area provided by the unique nanospike-like structure, AuPd NSs exhibit outstanding nitrogen reduction reaction performance with an NH yield rate of 16. Read More

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Difficult Management of a Femur Fracture in a Patient with Dyskeratosis Congenita: A Literature Review and Case Report.

JBJS Case Connect 2021 Apr 21;11(2):e20.00486. Epub 2021 Apr 21.

Rady Children's Hospital San Diego, Division of Orthopaedic Surgery, San Diego, California.

Case: A 14-year-old boy with dyskeratosis congenita (DKC), status-post unrelated bone marrow transplant (BMT), sustained a femoral shaft fracture. Despite immediate fixation with the widest possible titanium elastic nails, fixation construct rigidity was insufficient and malunion occurred with refracture 5 years later. Revision fixation with rigid intramedullary nailing has maintained position for 1 year, although callus formation remains meager. Read More

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Gerstmann-Sträussler-Scheinker syndrome misdiagnosed as cervical spondylotic myelopathy: A case report with 5-year follow-up.

Medicine (Baltimore) 2021 Apr;100(16):e25687

Department of Neurology, The First Affiliated Hospital of Shenzhen University.

Rationale: Gerstmann-Sträussler-Scheinker syndrome (GSS) is a rare autosomal dominant disease caused by a mutation in the prion protein gene (PRNP) that is not well known among neurologists and is therefore easily misdiagnosed.

Patient Concerns: : A 49-year-old man was admitted for the first time because of an unsteady walk with mogilalia for 1 year. He underwent a cervical discectomy and a plate-screw fixation 6 months prior, although postoperative gait instability did not improve. Read More

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Hip Dislocation After Correction for Scoliosis in an Adolescent with Angelman Syndrome: A Case Report.

JBJS Case Connect 2021 04 20;11(2). Epub 2021 Apr 20.

Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara City, Kanagawa, Japan.

Case: Although scoliosis is common in Angelman syndrome (AS), there are no reports of hip dislocation as a complication of scoliosis surgery. We experienced a case of hip dislocation after posterior spinal instrumentation and fusion from T4 to L5 because of scoliosis progression in an adolescent girl with AS. Postoperatively, posterior dislocation of the left hip occurred; after closed reduction, instability remained. Read More

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