Impaired Continuity Research Articles

OCCS Classification and Treatment Algorithm for Comminuted Mandibular Fractures Based on 109 Patients and 11 Years Experiences: A Retrospective Study.

Comminuted mandibular fractures (CMFs) pose significant challenges to surgeons for their serious complications and poor outcomes. We aimed at proposing a classification with treatment algorithm of each category for CMFs. Patients with CMFs were retrospectively reviewed and classified into five categories: Type I: relatively good occlusion, no or slightly displaced fragments, no continuity destruction or bone defect; Type II: relatively good occlusion, damaged morphology, low comminution degree but intact continuity without bone defect; Type III: damaged morphology and higher comminution degree with intact continuity and relatively good occlusion; Type IV: high comminution, impaired continuity and poor occlusion without segmental bone defect; Type V: segmental bone defect. Conservative treatment, open reduction and internal fixation or microvascular osteocutaneous free flap transplantation was performed, accordingly. Demographics, perioperative data, complications and reasons for reoperations were recorded. The chi-square test was used for statistical analysis. In total, 109 patients were included in the study. After surgery, in the following group, 5 manifested infections, 1 manifested bone non-union, and 2 experienced reoperations, while in the unfollowing group, 10 manifested infections, 5 manifested bone non-union and 8 experienced reoperations. The OCCS classification and algorithm for CMFs achieve better outcomes and with lower complication rate.

Impaired continuity of flow in congenital heart disease with single ventricle physiology☆

We report the comprehensive evaluation of cardiac morphology, valve function, and three-dimensional (3D) blood flow in a pediatric patient with congenital heart disease. 3D visualization of cardiovascular flow paths and quantitative flow analysis based on flow-sensitive 4D magnetic resonance imaging (MRI) provided detailed insight into hemodynamic changes associated with valve insufficiency and the complex single ventricle physiology. Despite only moderate atrio-ventricular regurgitation (fraction=28%) a marked redirection of atrial flow and pronounced vortex flow in the entire atrium was observed. Disturbed retrograde flow was even found upstream within the left pulmonary veins (regurgitant fraction=27%) indicating interrupted continuity of flow directed through the single atrium and ventricle. Such findings indicate the potential of flow-sensitive 4D MRI to detect and quantify complex 3D flow alterations.

Reflections from the GP surgery at the turn of the year

Reflections from the GP surgery at the turn of the year