Lateral View Research Articles

Femoral Head Fractures: Conservative or Surgical Treatment? About 2 Cases

Femoral head fractures are uncommon and invariably occur alongside hip dislocation. High-energy trauma is the sole cause, and diagnosis can be missed using only standard pelvic radiographs (anterior-posterior, lateral, ¾ alar and obturator views), a CT scan is often recommended for a precise diagnosis. Treating dislocated hips with femoral head parcelar fractures is challenging. This difficulty arises from selecting both the surgical approach and the management of the fracture fragments. Additionally, the risk of osteonecrosis and osteoarthritis compromises the long-term function of the hip. We report two cases of femoral head fracture associated with hip dislocation. The first was received surgical treatment, while the second was managed conservatively.

Machine learning regression algorithms for predicting muscle, bone, carcass fat and commercial cuts in hairless lambs

The growth in demand and demand for quality in the sheep chain has generated the need for automation techniques in the meat industry and the need to obtain responses with greater speed and standardization. The research aimed to predict tissue characteristics of the carcass and commercial cuts based on measurements obtained by VIA – see oimage analysis, carried out on cold carcasses of hairless lambs, using machine learning employing regressive techniques for variable selection. Information from 72 carcasses of castrated male lambs, aged between 8 and 11 months, with an average cold carcass weight of 16.13 ± 3.98 kg, was used. Images of the right side of the carcasses were captured from the dorsal and lateral views using a digital camera. From the ImageJ2 software, VIA data, measurements and shape descriptors (areas, perimeters, widths, lengths, convexities, solidities) were obtained, combined with cold carcass weight and used to generate four sets of data, called descriptor sets (DSs). Obtaining DS1, DS1’, DS2, DS2’, DS3, DS3’, DS4 AND DS4’. To generate these sets, a database was formed and divided into a training bank (with 70% of the observations) and a test bank (30% of the observations). Multiple linear regression models were developed using Stepwise, LASSO, and Elastic Net regression methods, combined with k-fold cross-validation, to evaluate the performance of the models. The accuracy of the estimates was based on RMSE, R2, Pearson correlation and bias metrics. For the variables tested in this study, the proposed shape descriptors were mostly efficient in predicting tissue and weight variables. DS1' with the LASSO technique presented the best adjustments for variables total muscle and fat followed by shoulder, loin and rib cuts. The descriptors tested by this study were able to predict with quality the vast majority of the characteristics tested, the variable cold carcass weight (CCW), introduced as additional predictor, promoted a consistent improvement in the fits of all models. DS1 presented greater constancy for the twenty-three predicted characteristics and Stepwise presented the worst predictive performance, in relation to LASSO and Elastic Net. Despite close adjustments between the generated models, in general, Elastic Net presented lower performance than LASSO.

How to see stress in chickens: On the way to a Stressed Chicken Scale

For many species, scales are used to classify discomfort and stress (e.g., facial expression/pain scales). Although a significant number of vertebrates used for scientific purposes are chickens, a corresponding scale for birds has not yet been established. We developed a Stressed Chicken Scale (SCS) to investigate whether it is possible to assess discomfort in a chicken by its body posture. A selective review with additional handsearch was conducted to find suitable parameters for visual stress assessment. Seven potential body signals were identified: Tail and head position, eye closure, beak opening, leg and wing position, and plumage fullness (ruffled or fluffed up feathers). The SCS was evaluated for interobserver reliability with veterinary students (n = 20), using randomized pictures of stressed and unstressed chickens in lateral view (n = 80). Observers were able to identify the body signals on the pictures after a brief training session. Agreement scores for interobserver agreement ranged from κ = 0.31 (fair agreement) for eye closure to κ = 0.78 (substantial agreement) for beak opening. We found that the number of body signals displayed in a stressed expression had an impact on observers' overall assessment of the chickens, for example, chickens were more likely to be rated as stressed if more than 4 signals indicative of stress were present. We conclude that the 7 individual body signals can be used to identify discomfort in chickens.

Clinical analysis of surgical outcome of 89 patients having large cerebral arteriovenous malformations.

The article analyzes the clinical features, morphological characteristics, surgical subtleties and long-term outcome of surgery in 89 cases of 'large' sized AVMs. During the period 2004 to 2022, 89 cases of 'large' arteriovenous malformations were operated in the neurosurgery departments of the authors. Large AVMs were defined as those that were more than 4cm on either lateral or antero-posterior view of digital subtraction angiogram. The factors that determined the extent of surgical difficulties included site and eloquence of the area, number of feeding vascular territories and draining veins, degree and rate of flow, presence of flow-related aneurysms, and the physical nature of the arteriovenous malformation. There were 59 males and 30 females and the average age was 32 years. Headache, giddiness and convulsions were the common presenting complaints. Six patients were unconscious after surgery. Of these, five patients died in the immediate post-operative period and one patient gradually recovered. Additionally, seven patients developed unilateral limb weakness that included hemiplegia (4 patients) and hemiparesis (3 patients) following surgery. Clinical follow-up ranged from 6 months to 18 years (average 43 months). All surviving patients are leading normal and essentially symptom free life and have recovered from their symptoms of headache, convulsions and giddiness. Large AVMs are amenable to 'curative' surgery with 'acceptable' results. The surgery can be challenging and appropriate case selection that is based on the surgeons experience is vital and decisive.

Occurrence of the large aquatic snake Palaeophis cf. africanus (Serpentes, Palaeophiidae) in the middle Eocene of the Sabkha El Breij, southwestern Morocco

ABSTRACT We here report an anterior trunk vertebra of a large snake that we tentatively refer to Palaeophis africanus. The vertebra comes from lower middle Eocene deposits of the El Breij Depression, in the Sahara Desert of southern Morocco. It is principally characterised by weak lateral compression; horizontality of the cotyle-condyle axis; dorsoventrally thick zygosphene; lower pterapophyses with an upper edge that remains lower than that of the zygosphene in lateral view; a rather reduced neural canal; very distinct and prominent interzygapophyseal crests; low position of the diapophyses; and the presence of two hypapophyses. This occurrence adds to the geographic distribution of Palaeophis africanus, which has been formerly identified from Nigeria, Togo, Angola, and South America, and represents an additional Palaeophis species for the Moroccan fossil record.

Lateral Posterior Method for Depth Correction while Using the Gates Protocol for GFR Estimation: Is it Comparable to the Gold Standard GFR Estimation by Plasma Sampling?

Background Glomerular filtration rate (GFR) estimation by Gates protocol using the gamma camera for diethylenetriaminepentaacetic acid (DTPA) dynamic renography has not compared well with the gold standard GFR by plasma sampling method. This is because depth of the kidneys is generally not considered. Our aim was to study whether manual depth correction using the skin to middle of kidney distance in lateral view and posterior aspect-lateral posterior method would reduce the bias in the Gates GFR as compared with the gold standard. Materials and Methods Retrospective study of 27 adult prospective renal donors who underwent GFR by plasma sampling and DTPA dynamic renography at Inlaks and Budhrani Hospital, Pune, Maharashtra, India between January 2022 and April 2023. The entire data was statistically analyzed using Statistical Package for Social Sciences (SPSS ver 21.0, IBM Corporation, United States) for MS Windows. Results There is no significant agreement between plasma sampling versus gamma camera method and plasma sampling versus lateral posterior method for depth correction for GFR measurements; however, the evidence of systemic bias is lower for the gamma camera method compared with the lateral posterior method for depth correction as against the plasma sampling method. Conclusion The lateral posterior method for depth correction while using the gamma camera-based Gates protocol is not a reliable method for depth correction in the western Indian adult population with preserved renal function.

Radiological study of carrying angle among male and female and its clinical importance

: The long axes of the ulna and humerus form an acute angle when the upper limb is in its anatomical position and the elbow is fully extended is known as the carrying angle. It is typically larger in females than in males Anthropologists use the carrying angle to predict a person's sex; orthopaedic surgeons use it to surgically treat a variety of elbow disorders; and total elbow prosthetics. The study aimed to assess the carrying angle in an attempt to determine its value in both sexes, proposing a simple and reliable method for measuring it.The elbow radiographs taken in the normal anteroposterior and lateral views were assessed independently and uniformly by anatomists. A total of 70 adult radiographs between the ages of 18 to 76 years, 35 males and 35 females were gathered. To measure the angle, two lines were drawn: one along the mid-axis of the upper limb of the forearm, passing between the radius and ulna through the superior radioulnar joint, and the other along the mid-axis of the lower third of the humerus, where the angle is measured.The carrying angle is statistically more significant in females than in males among 70 radiographs. The p-value was 0.000 and the mean and SD for males were 14.3±2.740, while the mean and SD for females were 21.92±3.170.The current study concludes that there is a significant gender difference between females and males; carrying angle influences secondary sexual characteristics.

THE TEN-YEAR RADIOLOGICAL RESULTS OF THE UNCEMENTED OXFORD MEDIAL COMPARTMENT KNEE ARTHROPLASTY

IntroductionThe Oxford Unicompartmental Knee Replacement (OUKA) is the most popular unicompartmental knee replacement (UKR) in the New Zealand Joint Registry with the majority utilising cementless fixation. We report the 10-year radiological outcomes.MethodsThis is a prospective observational study. All patients undergoing a cementless OUKA between May 2005 and April 2011 were enrolled. There were no exclusions due to age, gender, body mass index or reduced bone density.All knees underwent fluoroscopic screening achieving true anteroposterior (AP) and lateral images for radiographic assessment. AP assessment for the presence of radiolucent lines and coronal alignment of the tibial and femoral components used Inteliviewer radiographic software. The lateral view was assessed for lucencies as well as sagittal alignment.Results687 OUKAs were performed in 641 patients. Mean age at surgery was 66 years (39–90yrs), 382 in males and 194 right sided. 413 radiographs were available for analysis; 92 patients had died, 30 UKRs had been revised and 19 radiographs were too rotated to be analysed the remainder were lost to follow-up. Mean radiograph to surgery interval was 10.2 years (7.1–16.2yrs).RLLs were identified in zone 1 (3 knees), zone 2 (2 knees), zone 3 (3 knees), zone 5 (3 knees), zone 6 (2 knees) and zone 7 (42 knees). No RLL had progressed, and no case had any osteolysis or prosthesis subsidence.Alignment in the coronal plane: mean 2.90° varus (9.30° varus - 4.49° valgus) of the tibial component to the tibial anatomic axis and the femoral component in mean 4.57° varus (17.02° varus - 9.3° valgus). Sagittal plane posterior tibial slope was a mean 6.30° (0.44° -13.60° degrees) and mean femoral component flexion of 8.11° (23.70° flexion – 16.43° extension).ConclusionThe cementless OUKA demonstrates stable fixation with low revision rates at our centre supporting results earlier published by the design centre.

Insertional Achilles tendinopathy: A radiographic cross-sectional comparison between symptomatic and asymptomatic heel of 71 patients

PurposeThis retrospective study aimed to investigate whether the standard radiographic indicators for Haglund's syndrome are applicable to insertional Achilles tendinopathy. MethodsPatients who underwent surgery for insertional Achilles tendinopathy in one heel and experienced no pain in the other heel were enrolled in this study. Preoperative calibrated radiographs of the lateral view of the calcaneus were assessed using (1) calcaneal pitch angle, (2) Fowler-Phillip angle, (3) posterior calcaneal angle, (4) Chauveau-Liet angle, (5) X/Y ratio, (6) Haglund’s deformity height, (7) Haglund’s deformity peak angle, (8) calcification length, (9) calcification width, (10) parallel pitch test, and (11) presence of free body. The Wilcoxon signed rank test and McNemar’s test were used for statistical analyses. ResultsSeventy-one patients (52 males; mean age, 57.2; mean body mass index, 27.1) were included. Mean values for each index in the symptomatic and asymptomatic heels were as follows, respectively: (1) 23.5, 23.0 (p = 0.30); (2) 58.9, 57.8 (p < 0.05); (3) 7.6, 9.2 (p < 0.05); (4) 15.8, 13.9 (p < 0.05); (5) 2.8, 2.8 (p = 0.87); (6) 5.4, 5.0 (p < 0.05); (7) 99.6, 99.0 (p = 0.44); (8) 10.5, 7.6 (p < 0.001); and (9) 5.1, 4.4 (p < 0.05). The sensitivity, specificity, and area under curve of significant indicators were as follows, respectively: (2) 0.78, 0.37, 0.55; (3) 0.45, 0.72, 0.58; (4) 0.63, 0.54, 0.57; (6) 0.45, 0.69, 0.59; (8) 0.48, 0.80, 0.66; and (9) 0.63, 0.54, 0.59. The presence of free body also showed a significant difference between both heels (p < 0.05). ConclusionSome radiographic indicators for Haglund's syndrome are applicable to the diagnosis of insertional Achilles tendinopathy. A comparison of the parameters of Haglund’s syndrome with those of insertional Achilles tendinopathy may illuminate the etiology and pathology of insertional Achilles tendinopathy and lead to novel treatments.

A new remarkable big-eyed minute litter bug in Cenomanian Kachin amber from Myanmar (Hemiptera, Dipsocoromorpha)

The Dipsocoromorpha is a small modern heteropteran infraorder, with some fossils documented in Mesozoic amber in recent years. We herein report a new remarkable specimen trapped in mid-Cretaceous Kachin amber, which can be attributed to Dipsocoromorpha: Schizopteridae. Kuanzuia cavanii gen. et sp. nov. is erected for the new specimen on the basis of the following unique autapomorphic characteristics amongst known dipsocoromorphans: pronotal second and third lobes completely fused together and embowed, metafemora nearly triangular in lateral view and with one row of c. 20 strong ventral spines, and metatibiae greatly curved at about its 2/3 length. Mesozoic dipsocoromorphan fossils reported in America, Lebanon, France and Myanmar provide paleontological evidences that this ancient heteropteran insect lineage had probably been distributed worldwide at latest in the Early to mid-Cretaceous. Our new finding further indicates that compared to their modern descendants, early dipsocoromorphans in the late Mesozoic were flourishing and also likely with high morphological disparity.

TREATMENT OF PAEDIATRIC ARTHROGRYPOTIC CLUBFOOT: 20 YEARS OF CLINICAL EXPERIENCE

BackgroundTreatment of arthrogrypotic clubfoot (AC) presents a challenging problem. Over time many different methods have been proposed, with variable rates of success, recurrence and other complications. In this study we describe our 20-year experience in treatment of AC.Materials and methodsBetween 1996 and 2016, 165 AC in 90 children (51 males and 39 females) were treated in our department. Their mean age was 7.6 years (3 months-16 years). Ponseti casting and Achilles tendon release (PCATR) was performed on 38 children (68 feet) and soft tissue release and casting (STRC) on 35 children (67 feet). The remaining 17 children (30 feet) underwent wide soft tissue release and correction using the Ilizarov method (STRIL). The results of each subgroup were graded according to clinical (pain, foot appearance, residual deformities, walking and standing status and shoe modifications) and radiological (anteroposterior and lateral talocalcanear angles, the angle between longitudinal axes of talus and the first metatarsal and the position of talus in the lateral view) criteria.ResultsThe average follow up was 6.4 (2–10) years. Results were excellent (plantigrade, painless, properly loaded feet, without deformities, adapted to common shoes) in 56 PCATR group feet, 59 STRC group feet and 23 STRIL group feet. Good results (required orthopaedic shoes) were obtained in 10 PCATR group feet, 6 STRC group feet and 7 STRIL group feet. Fair results (residual temporary pain and/or mild deformity) presented 2 PCATR group feet and 1 STRC group foot, while bad results (reoccurrence of clubfoot) were found in 1 STRC group foot.ConclusionsOn the basis of our 20-year clinical experience we believe that pediatric AC can be successfully treated with PCATR in the age of less than 1 year old (y.o), with STRC between 1–5 y.o. and with STRIL in children over the age of 5 y.o.

Biomechanical Posture Analysis in Healthy Adults with Machine Learning: Applicability and Reliability.

Posture analysis is important in musculoskeletal disorder prevention but relies on subjective assessment. This study investigates the applicability and reliability of a machine learning (ML) pose estimation model for the human posture assessment, while also exploring the underlying structure of the data through principal component and cluster analyses. A cohort of 200 healthy individuals with a mean age of 24.4 ± 4.2 years was photographed from the frontal, dorsal, and lateral views. We used Student's t-test and Cohen's effect size (d) to identify gender-specific postural differences and used the Intraclass Correlation Coefficient (ICC) to assess the reliability of this method. Our findings demonstrate distinct sex differences in shoulder adduction angle (men: 16.1° ± 1.9°, women: 14.1° ± 1.5°, d = 1.14) and hip adduction angle (men: 9.9° ± 2.2°, women: 6.7° ± 1.5°, d = 1.67), with no significant differences in horizontal inclinations. ICC analysis, with the highest value of 0.95, confirms the reliability of the approach. Principal component and clustering analyses revealed potential new patterns in postural analysis such as significant differences in shoulder-hip distance, highlighting the potential of unsupervised ML for objective posture analysis, offering a promising non-invasive method for rapid, reliable screening in physical therapy, ergonomics, and sports.

PROPOSAL OF A MODIFIED TIP APEX DISTANCE FOR PREDICTION OF LAG SCREW CUT-OUT IN TROCHANTERIC HIP FRACTURES

Lag screw cut-out is a serious complication of dynamic hip screw fixation in trochanteric hip fractures. Lag screw position is recognised as a crucial factor influencing the occurrence of lag screw cut-out. We propose a modification of the Tip Apex Distance (TAD) and hypothesize that it could enhance the reliability of predicting lag screw cut-out in these injuries.A retrospective study of hip fracture cases was conducted from January 2018 to July 2022. A total of 109 patients were eligible for the final analysis. The modified TAD was measured in millimetres, based on the sum of the traditional TAD in the lateral view and the net value of two distances in the anteroposterior (AP) view. The first distance is from the lag screw tip to the opposite point on the femoral head along the lag screw axis, while the second distance is from that point to the femoral head apex. The first distance is a positive value, whereas the second distance is positive if the lag screw is superior and negative if it is inferior. Receiver operating characteristic (ROC) curve analysis was used to assess the reliability of various parameters for evaluating the lag screw position within the femoral head.Factors such as reduction quality, fracture pattern according to the AO/OTA classification, TAD, Calcar-Referenced TAD, Axis Blade Angle, Parker’s ratio in the AP view, Cleveland Zone 1, and modified TAD were statistically associated with lag screw cut-out. Among the tested parameters, the novel parameter exhibited 90.1% sensitivity and 90.9% specificity for predicting lag screw cut-out at a cut-off value of 25 mm, with a p-value &lt; 0.001.The modified TAD demonstrated the highest reliability in predicting lag screw cut-out. A value of 25 mm may potentially reduce the risk of lag screw cut-out in trochanteric hip fractures.

Multiple fluoroscopic views, including an external rotation-adduction view, are required to detect uncontained screws in the femoral neck

Introduction: Peripheral screws in the femoral neck are often used for fixation of femoral neck fractures. The posterior-cranial screw can violate the femoral head blood supply if it is extra-osseous, and can be difficult to image intraoperatively. The purpose of this study was to identify whether any specific radiographic views were superior at detecting an uncontained screw in the femoral neck. Additionally, the external rotation-adduction view was defined and its efficacy at detecting an unsafe posterior cranial screw assessed. Methods: A radiographic study using three-dimensional (3D) computed tomography scanswas performed at a single institution academic hospital. Forty-six patients with normal CT scans of the pelvis were included. Cannulated screws were digitally templated on 3D renderings of the femoral neck in an inverted triangle configuration. Each screw was systematically moved to a position where it was uncontained. Ghost images were created, and the pelvis rotated to simulate obtaining various iterations of a lateral view of the proximal femur. The ability of a given radiographic view to detect an uncontained screw was determined. Results: A flat-lateral view detected 72% of unsafe anterior screw, while a neck-shaft colinear view detected 98%. The flat lateral view detected 61% of unsafe posterior cranial screws, while a new external rotation-adduction view identified 100% of unsafe posterior cranial screws. Conclusions: Multiple radiographic views should be obtained to assess screw safety when treating femoral neck fractures with peripherally placed screws. The external rotation-adduction view may be useful for detection of uncontained posterior cranial screws. Level of evidence: III

New Anatomic Anterolateral Ligament Reconstruction Used in a Complex Revision ACL Reconstruction

Background: Anterior cruciate ligament reconstructions (ACLRs) are performed to restore knee biomechanics, increase knee stability, and slow the progression of osteoarthritis. After ACLRs, many patients still have residual anterolateral instability which is a risk factor for ACL graft failure. An anterolateral ligament reconstruction (ALLR) attempts to restore the native function of the anterolateral complex to augment the ACL. Performing an ALLR with an ACLR has been reported to reduce symptoms of instability and improve clinical outcomes. Indications: While no definitive indication for an ALLR has been set, current considerations include high posterior tibial slope &gt;12°, revision ACLR, high-grade pivot shift, skeletally immature patients, hyperlaxity, and patients in high-level sports. Technique Description: The preoperative assessment includes a thorough physical examination with special attention paid to rotational laxity assessed via the pivot-shift examination. Imaging should include standard radiographic series (anteroposterior, posteroanterior flexion, lateral, and sunrise views), long-leg mechanical axis views to assess coronal plane alignment and standing lateral ACL stress radiographs to assess sagittal alignment and objective instability. The iliotibial band ALLR graft is harvested first. An 8-cm long by 1-cm wide strip of the inferior iliotibial band is harvested in a standard fashion, leaving the distal aspect attached to Gerdy’s tubercle. An anchor is placed centered upon the native ALL distal tibial insertion. The native ALL femoral origin is identified at 4.7 mm posterior and proximal to the fibular collateral ligament, and a second suture anchor is placed at this point. Final fixation is performed after the final fixation of the ACLR graft. Results: A study by Pioger et al reported that patients with ACLR and ALLR had significantly less reoperation rate than patients with isolated ACLR, 8.9% versus 20.5% respectively. Lee et al found that a revision ACLR in combination with an ALLR was effective in reducing rotational laxity, which was assessed by the pivot-shift test. Discussion: We describe a technique for a new anatomic ALLR using the iliotibial band that attempts to restore the native ALL anatomy. This surgical technique effectively restores rotational laxity and improves knee stability. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Bilateral renal dysplasia in a ferret (Mustela putorius furo)

AbstractRenal dysplasia is a histological diagnosis characterised by disorganised architecture of the renal cortex and medulla with disrupted nephron differentiation and primitive ducts surrounded by collarettes of the mesenchymal tissue. This condition has been reported once previously in ferrets as a component of multiple congenital abnormalities of the urogenital tract. A 1.5‐year‐old, male, neutered ferret was presented after being found minimally responsive under a fallen shelf in its enclosure. The ferret was obtunded, with mild intermittent muscle tremors and severe dehydration. Survey radiographs, including thoracic and abdominal ventrodorsal and right and left lateral views, were performed to assess for general trauma. The right renal silhouette was normal in size, and the left was moderately reduced. The capsular margins of both renal silhouettes were moderately undulating and mildly indistinct with perirenal retroperitoneal striations. No signs of trauma or other abnormalities were identified. Whole blood biochemical analysis demonstrated elevated creatinine, elevated blood urea nitrogen, hypernatraemia, hypercalcaemia, hyperphosphataemia and hyperproteinemia characterised by hyperalbuminemia and haemoconcentration. The hypernatraemia and mentation failed to improve with intravenous fluid therapy, and the ferret was euthanased. Bilateral renal dysplasia was confirmed via gross postmortem examination and histopathology.

A STUDY OF FUNCTIONAL OUTCOME IN THREE COLUMN FIXATION OF COMPLEX TIBIAL PLATEAU FRACTURES

Introduction: The treatment of complex tibial plateau fractures (TPF), especially those caused by high-energy trauma, remains a challenge in many respects. Tibial plateau fractures are one of the commonest periarticular fractures. These fractures include 1% of all fractures and 8% of fractures in elderly. Motor vehicle accidents account for the majority of these fractures in younger individuals with good bone stock, but in elderly individuals these fractures may result from simple fall due to osteopenic bone. Conservative methods may result in malunion and articular congruity cannot be restored. Surgical treatment can regain articular congruity and restore mechanical alignment, and can allow early range of motion. Open reduction and internal fixation techniques had been associated with wound complications. Aim Of The Study: To evaluate functional outcome in patients of complex tibial plateau fractures treated by three column fixation. Materials and Methods: In our institution 20 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. This is a prospective study done from AUGUST 2023 to APRIL 2024(9 months).Patients were evaluated with X rays (AP and lateral views) and Computed Tomography (axial, coronal, sagittal with 3D reconstruction views). Fractures classified based on 3 column concept classification. Mean follow up period was 6 months .Functional and radiological outcome was assessed using functional knee score , modified rasmussen score and WOMAC score. Inclusion Criteria: 1. Patients admitted with complex tibial plateau fractures involving medial, lateral and posterior column of tibia. 2. Both sexes 3. Age 20-60 yrs. Exclusion Criteria: 1) Bad skin status of the fractured site. 2) Patients with co morbidities not fit for surgery. 3) Patients with neurovascular deficit. 4) Patients not willing for surgery. Results:In our study, 70% of the patients were in active productive age group (30-50 years). 85% of the patients were male. The fractures were left sided in 75% patients. 85% patients in study sustained injury due to road traffic accident. 80% cases in the study were type 5 schatzker type 5 fractures and all the cases included in the study were 3 column fractures. 8 cases out of 20 cases in the study required epidural analgesia instead of a repeat spinal as the duration of the surgery was longer. Conclusion: To conclude,3 column fixation in high energy displaced tibial plateau fractures with three column fractures resulted in Good clinical and radiological outcomes.

Morphological and Position Factors of Vertical Surface Light Source Affecting Discomfort Glare Perception

Distinguished from conventional lighting, the LED vertical surface light source (VSLS) is directly exposed to human view, and the effects of which form it takes on visual perception are non-negligible. In the current discomfort glare evaluation system, the solid angle and the position index, which represent the relative relation between the glaring light source and human visual field, are not completely applicable for large-area VSLS, and hence are awaiting supplementation and modification. In this study, a physical experimental setup was established to conduct an evaluation experiment on discomfort glare, employing an LED display and white translucent frosted film to simulate vertical surface light sources (VSLS). The experiments were arranged with 21 VSLS shapes (comprising 3 areas and 7 length-to-width ratios) and 11 mounting positions. Subjective ratings and four eye-movement data parameters—namely, the change rate of pupil diameter (CRPD), mean saccadic amplitude (SA), blinking frequency (BF), and saccadic speed (SS)—were collected from 24 participants under each working condition using the Boyce Evaluation Scale and eye tracking techniques. The main results of this study are the following: (a) CRPD is the most appropriate eye-movement index for characterizing VSLS glare perception; (b) The area of the VSLS is the primary shape element influencing discomfort glare. Furthermore, with the same surface area, the lateral view angle (LaVA) and the longitudinal view angle (LoVA) perceived by the human eye also impact glare perception; (c) A functional equation between the VSLS area, LaVA, and LoVA to the borderline luminance between comfort and discomfort (BCD luminance) is fitted; (d) Based on the eccentric angle and the azimuthal angle, a modified position index P’ is proposed to represent the relative position of the VSLS in the visual field, and the ratio function of BCD luminance of the VSLS at non-central positions and the central position is fitted.

Sagittal Full-Spine vs. Sectional Cervical Lateral Radiographs: Are the Measurements of Cervical Alignment Interchangeable?

(1) Background: This study assessed the relationship between cervical spine parameters taken on standing full-spine lateral radiographic images compared to sectional lateral cervical radiographs. (2) Methods: Full-spine (FS) and sectional lateral cervical (LC) radiographs from four spine treatment facilities across the USA retrospectively provided data collected on 220 persons to assess the comparison of three sagittal cervical radiographic measurements between the two views. The measures included cervical lordosis using the absolute rotation angle from C2-C7, sagittal cervical translation of C2-C7, and atlas plane angle to horizontal. Linear correlation and R2 models were used for statistical comparison of the measures for the two views. (3) Results: The mean values of the three measurements were statistically different from each other: C2-C7 translation (FS = 19.84 ± 11.98 vs. LC = 21.18 ± 11.8), C2-C7 lordosis (FS = -15.3 ± 14.63 vs. LC = -18.32 ± 13.16), and atlas plane (FS = -19.99 ± 8.88 vs. LC = -22.56 ± 8.93), where all values were p < 0.001. Weak-to-moderate-to-strong correlations existed between the full-spine and sectional lateral cervical radiographic variables. The R2 values varied based on the measurement were R2 = 0.768 (p < 0.001) for sagittal cervical translation of C2-C7 (strong), R2 = 0.613 (p < 0.001) for the absolute rotation angle C2-C7 (moderate), and R2 = 0.406 (p < 0.001) for the atlas plane line (weak). Though a linear correlation was identified, there were consistent intra-person differences between the measurements on the full spine versus sectional lateral cervical radiographic views, where the full-spine view consistently underestimated the magnitude of the variables. (4) Conclusion: Key sagittal cervical radiographic measurements on the full spine versus sectional lateral cervical radiographic views show striking intra-person differences. The findings of this study confirm that full spine versus sectional lateral cervical radiographic views provide different biomechanical magnitudes of cervical sagittal alignment, and caution should be exercised by health care providers as these are not interchangeable. We recommend the LC view for measurement of cervical sagittal alignment variables.

Shell shape polymorphism analysis of the Manila clam Ruditapes philippinarum across different geographical populations in China

Morphology of bivalves, a kind of quantitative character, is closely connected with the ecological and physiological behaviors of bivalves, including growth, survival, metabolism and reproduction. In this study, a multivariate statistical method was used to analyze seven indices for shell shape evaluation of Ruditaps philippinarum (R. philippinarum). Polymorphism of R. philippinarum shell shape across seven geographical populations from the southern and northern regions of China was revealed, and decisive effect of shell shape in determining the trait of weight was discussed. In total, three types of R. philippinarum shell shape were observed: globular, flat, and lateral-view round. The Laizhou (LZ) population from the north of China displayed an approximately globular shell shape, with a shell-width-to-shell-length ratio of 0.5496 and an ellipse index ventral view (EIV) value of 0.9543. The Lianjiang (LJ) population from the south of China displayed a flat shell shape, with a shell-width-to-shell-length ratio of 0.4044, an ellipse index lateral view (EIL) value of 1.2518, and an EIV value of 0.7063. The Zhangzidao (ZZD) population from the north of China displayed a lateral view round shell shape, with a shell-width-to-shell-length ratio of 0.7476 and a circle index lateral view (CIL) value of 0.7195. According to the results of principal component analysis (PCA), discriminant analysis and cluster analysis on shell shape parameters, LJ population and LZ population could be grouped separately. However, despite the long geographical distance, Rongcheng (RC) population was highly similar with ZZD population in terms of shell shape traits, implying that these two populations might be more closely related. Lowest degree of divergence in shell shape was observed in Beihai (BH) population and Yingkou (YK) population, both of which belonged to Zuidong (ZD) population. Weight of globular Manila clams was significantly higher than that of flat clams (P &amp;lt; 0.05). This study not only lays a foundation for conservation of R. philippinarum germplasm resources, but also highlights the importance of considering shell morphology in the breeding and culture of R. philippinarum.