Plating Procedure Research Articles

Median Nerve Displacement during Hardware Removal after Distal Radius Fractures

Abstract Background This retrospective study aimed to evaluate median nerve displacement observed during hardware removal procedures following volar plating for distal radius fractures. Methods We reviewed all cases involving removal of distal radial volar locking plates at our institution by two surgeons from 2016 to 2021. Plating procedures and hardware removals were performed using the flexor carpi radialis (FCR) approach. We examined the position of the median nerve at the time of hardware removal. Results Median nerve displacement to the radial side of the FCR occurred in 17 out of 67 cases (25%). There were no significant differences in the degree of fracture severity or involved surgeons between the normal position and displaced groups. Conclusions The median nerve may be displaced radially from the FCR during hardware removal, and care should be taken to avoid causing iatrogenic nerve injury. Level of Evidence Level II.

Intramedullary Nailing Versus Plating Techniques in Femoral Fractures in Children: A Systematic Review and Meta-analysis

Abstract Background: The goal of the current study was to compare the usage of plating methods and intramedullary nailing (IMN) in children with femur fractures by doing a meta-analysis of the literature and conducting a systematic review of the literature. Methods: By adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted our systematic review and meta-analysis. Our search strategy was established based on the following primary keywords: ‘Intramedullary,’ ‘Nailing,’ ‘Plate,’ ‘Femur’ and ‘Fracture.’ We searched the PubMed, Web of Science, Cochrane Library and Scopus databases for relevant publications. Results: Regarding blood loss, IMN was associated with a lower amount of blood loss compared to plating techniques with the mean difference (MD) of − 57.27 (95% confidence interval [CI]: −68.09, −46.45, P < 0.00001). IMN was also associated with shorter operation time compared to plating techniques with an overall MD of − 25.16 (95% CI: −4.27, −6.04, P = 0.01). Moreover, IMN was statistically significant associated with lower hospitalisation with MD of − 0.82 (95% CI: −1.49, −0.15, P = 0.02). However, no significant difference was observed between both techniques regarding healing time with an MD of 0.04 (−0.38, 0.47, P = 0.84). IMN was associated with a higher incidence of complications compared to plating techniques with an odds ratio (OR) of 3.88 (95% CI: 1.75, 8.58, P = 0.0008). No significant difference was observed between both groups regarding the functional outcomes of the two surgeries with an OR of 1.04 (95% CI: 0.47, 2.3, P = 0.91). Conclusion: According to the current study, IMN is linked to less blood loss, a quicker recovery period following surgery and less hospitalisation than plating procedures in children with femur fractures. In contrast to IMN, plating procedures were statistically significantly linked to a decreased incidence of problems. Furthermore, they were similar in terms of the surgical results.

Recurrence and Pain Analysis in the Treatment Outcomes of Acromioclavicular Joint Dislocation Following Hook Plate Removal

Background: The treatment of acute dislocation of the acromioclavicular joint, specifically types III to V, involves various methods, each with its own advantages and disadvantages. Objectives: This study aims to investigate the treatment outcomes of acromioclavicular joint dislocation after hook plate removal, focusing on the recurrence of dislocation and pain in the affected area. Methods: A retrospective statistical study was conducted on 40 patients (18 - 40 years old) who presented with acromioclavicular joint dislocation and received treatment at Golestan and Imam Khomeini (RA) hospitals in Ahvaz between 2013 and 2021. Among the patients, 28 were male and 12 were female, and all were treated using the hook plate method. A follow-up was conducted on all patients after an average duration of one year. Patient data were collected through radiographic analysis and completion of relevant questionnaires to assess the specific objectives of this research. Results: None of the patients treated with the hook plate method required additional surgery due to reduction loss. All patients who underwent re-surgery had their hook plates removed after an average of six months. There were no cases of plate breakage or recurrence after the operation. However, four cases (10% of all patients) reported partial dislocation. The average duration of the hook plate procedure was estimated to be 45 minutes, with an estimated blood loss of 100 cc. Furthermore, complete immobilization after the hook plate procedure lasted between three days and one week. Conclusions: The hook plate method exhibits favorable outcomes, including lower complication rates, reduced postoperative pain, minimal blood loss, shorter treatment duration, and lower surgical costs. Therefore, it is considered a preferred and economically viable treatment option.

Microstructure and mechanical behavior of selective laser melted cast carbide reinforced 316 L stainless steel matrix composites

Limited research has been conducted on the selective laser melting (SLM) process for metal matrix composites characterized by high ceramic reinforcement ratios. This investigation explores the viability of the SLM process, particularly the laser powder bed fusion (LPBF) process, for cast tungsten carbide (CC) particle-reinforced 316 L stainless steel composites with CC content ranging from 30 to 40 vol%. A specialized Ni plating procedure was implemented to modify the surface of the original CC particles (Ni/CC) prior to SLM processing. The study revealed that Ni plating plays a pivotal role in enhancing the relative density of the SLMed 316 L-40 vol% Ni/CC composite, while concurrently safeguarding the CC particles from thermal damage during the SLM process. Through a comprehensive design of experiments, the optimal SLM processing parameters were ascertained to maximize the relative density of both 316 L-30 vol% and 40 vol% Ni/CC composites. Moreover, compared to pure 316 L stainless steel, higher CC proportions significantly improved the hardness, compression strength, and wear resistance of the SLMed 316 L-CC composites.

GC-MS analysis of hospital waste soil and isolation of antimicrobial agent producing bacteria

The current study, deals with the GC-Mass analysis of soil and antibiosis activity of soil bacteria, isolated from district hospital at Kabir Chaura, Varanasi, India. Standard serial dilution plate procedures were used to isolate the bacteria. Gram staining was used to identify the isolates morphologically. Strain KC14 was Gram-negative and all other isolates were Gram-positive. Isolated bacteria were tested against six human pathogens viz., Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Staphylococcus aureus, Shigella flexneri and Bacillus subtilis. Primary and secondary screening were done by perpendicular streaking and seed overlay techniques. Based on the results most potential isolates were selected for tertiary screening. The GC-MS of soil samples revealed some major medical pollutants such as para-hydroxy acetanilide, 2-methyl-5-nitro-imidazole and 2-acetoxybenzoic acid. The KC14 isolate was chosen for further studies after demonstrating positive results against S. aureus with a maximum antagonistic activity of 17.3 ± 0.5 zone of inhibition. The molecular identification of KC14 isolate was determined by using 16S rRNA sequencing. The obtained nucleotide sequences were subjected to BLASTN in NCBI, and found similar to the available sequence of Acinetobacter junii. The nucleotide sequences have been deposited in GenBank with accession no. OP265396. The active compound was partially purified by ethyl acetate and tested its activity against S. aureus. This study defines the composition of hospital waste soil and identified a Gram-negative bacterium producing antibacterial activity against important human pathogens.

Identification of Salmonella sp Bacteria in Processed Balado Shrimp Sold in Food Stalls Around Mulyosari Area

Background & Objective: Food quality is an issue of great concern in developing countries. Because many nutrients are obtained through food. Balado shrimp is a typical Padang dish with a spicy, sweet and savoury taste that is widely admired by all ages from children to adults. The presence of pathogenic bacteria, one of which is Salmonella sp, which contaminates balado shrimp food can cause health problems in the human body until death. The purpose of this study was to determine the presence or absence of Salmonella sp bacteria in processed shrimp balado sold in food stalls in the Mulyosari area. Method: In this study use as many as 30 samples of shrimp balado sold in food stalls Mulyosari area. This sample examination uses a streaking plate procedure and IMViC test. Data analysis using descriptive qualitative. Result: The results of this study showed that there were 3 samples identified Salmonella sp. Of the 30 samples, there was a range of 10% contaminated with Salmonella sp bacteria and 90% were not contaminated with Salmonella sp bacteria. Conclusion: This indicates that positive samples of balado shrimp must be further examined to determine the feasibility of consumption.

Knee Arthrodesis for Periprosthetic Knee Infection: Fusion Rate, Complications, and Limb Salvage-A Systematic Review.

The aim of this systematic review was to investigate the outcomes of knee arthrodesis (KA) after periprosthetic joint infection (PJI) of the knee. Differences in clinical outcomes and complication rates among the intramedullary nailing (IMN), external fixation (EF), and compression plating (CP) procedures were compared. A total of 23 studies were included. Demographics, microbiological data, types of implants, surgical techniques with complications, reoperations, fusion, and amputation rates were reported. A total of 787 patients were evaluated, of whom 601 (76.4%), 166 (21%), and 19 (2.4%) underwent IMN, EF, and CP, respectively. The most common causative pathogen was coagulase-negative Staphylococcus (CNS). Fusion occurred in 71.9%, 78.8%, and 92.3% of the patients after IMN, EF, and CP, respectively, and no statistically significant difference was found. Reinfection rates were 14.6%, 15.1%, and 10.5% after IMN, EF, and CP, respectively, and no statistically significant difference was found. Conversion to amputation occurred in 4.3%, 5%, and 15.8% of patients after IMN, EF, and CP, respectively; there was a higher rate after CP than after EF. The IMN technique is the most common option used for managing PJI with KA. No differences in terms of fusion, reinfection, or conversion-to-amputation rates were reported between IMN and EF. CP is rarely used, and the high amputation rate represents an important limitation of this technique.

Comparison of functional outcome of locking plate technique versus hybrid Ilizarov technique for complicated tibial plateau fractures

<p>This study compares the functional outcomes of two approaches, the locking plate technique and the hybrid Ilizarov technique, in managing complicated tibial plateau fractures. Enrolling 78 patients at Jinnah Hospital, the research explores a nuanced difference in results. In Group A (Hybrid Ilizarov Technique), 84.6% males and 15.4% females participated, while Group B (Locking Plate Technique) had 82.1% males and 17.9% females. The locking plate approach demonstrated superior outcomes, suggesting its efficacy in treating tibial plateau fractures. </p>
 <p>Study design: Cross sectional study.</p>
 <p>Study setting was department of Orthopedic Surgery, Jinnah Hospital Lahore</p>
 <p>Objective/purpose of the study was to evaluate the functional results of locking plate and hybrid Ilizarov procedure for tibial plateau fractures using Rasmussen's knee functional score.</p>

Melissopalynological analysis and microbiological safety of fresh and market honey (Apis mellifera L. and Meliponulabeccarii L.) from Western Oromia, Ethiopia

Honey is a natural product that is made by bees from the nectar of flowering plants. There is a flora preference by bees. Like other foods ready to eat,honey can be prone to microbial contamination. Honey plant sources can be analyzed from the composition of pollen grains in honey samples. The objective of this study was to assess microbial safety and floral origin of the honey samples. For this study, honey samples were purchased from local market, and collected from hives (fresh honey) in Western Oromia. Floral analysis was determined using harmonized method of melissopalynology. Microbiological safety was assessed through the pour plate procedures from the first serial dilution on a total of 45 honey sample sizes.The melissopalynological analysis demonstrated that A. melliferahoney purchased from the market(AMMH) was considered a multi-floral type while A. mellifera fresh honey (AMFH) cropped directly from the hive and M.beccarii honey purchased from the market (MBMH) was dominated pollen from Coffee arabica (68 % of its pollen grain counted) and Guizotiascabra (50.53 % of its pollen grain counted) plant, respectively. The Aerobic mesophilic bacteria, Staphylococci, Yeast, Mould, and Aerobic spore-forming bacteria were found below the standard countable level (<30 cfu/plate) from A. mellifera and M.beccarii honey bought from the market, while A. mellifera honey collected directly from the hive became free of any microbial contamination. C.arabica and G.scabra are major honey plants and their honey can be harvested in February and October, respectively. Furthermore, Vernoniaamygdalina, Eucalyptus spp, Combretummolle, Trifoliumruppelianum, and Syzgiumguineense were honey plants analyzed from multifloral market honey even though, their pollen dominance varies. M. beccarii visits herbaceous flora whilst A. mellifera visits all floral types. The level of contamination of the honey samples from the study area was very low showing its safety.

Optimized intermediate layer formation and electroless plating methods to obtain supported dense Pd surfaces.

Dense metallic membranes, especially Pd and Pd alloys, have been intensely investigated to provide an alternative and economical way to obtain H2 with ultrahigh purity. To overcome the high cost of Pd, composite membrane structures that comprise a thin layer of Pd are utilized. However, it is a challenge to obtain a thin, dense, and uniform Pd layer on the support materials. This study investigates the parametric analysis of γ-Al2O3 interlayer formation and the electroless Pd plating (Pd ELP) procedures on α-Al2O3 supports with the aim to achieve a thin, uniform Pd surface without annealing. Adjustments in PEG/PVA concentration, dipping time, and heat treatment enabled creating a thin γ-Al2O3 interlayer on α-Al2O3, minimizing pore size and density. Hydrazine concentration, heat treatment, and bath temperature were adjusted to optimize Pd ELP to achieve maximum yield from the plating bath and a dense, uniform surface without annealing. Pd/γ-Al2O3/α-Al2O3 structures were analyzed using scanning electron microscopy, X-ray diffraction, and thermogravimetric analysis to observe the impact of varied parameters on surface structures. Optimized sample was compared to an annealed Pd/α-Al2O3 prepared in accordance with literature methods and a Pd/graphite/α-Al2O3 sample to validate the use of optimized ELP procedure and the γ-Al2O3 interlayer. Results show that a dense and uniform 13 μm Pd coating was achieved on a γ-Al2O3-coated α-Al2O3 support without annealing, using three fresh ELP baths. This was done using sequential hydrazine addition with a decreased concentration (1 M) into the ELP baths at 30 °C, and applying heat treatment at 120 °C between each fresh ELP bath.

Dynamic Compression Plating Versus Antegrade Intramedullary Nailing for the Treatment of OTA/AO 12-A Fractures: A Retrospective Cohort Study.

Fractures of the humerus diaphysis are common and often result from motor vehicle accidents (MVAs). Treatment methods range from nonoperative approaches to various operative techniques, including antegrade intramedullary nailing (AIMN) and dynamic compression plate (DCP) fixation. This study aimed to compare the cost effectiveness and outcomes of plating and nailing for humerus diaphyseal fractures. A retrospective cohort study involving 59 cases of humerus diaphyseal OTA/AO 12-A fractures was conducted at King Saud Medical City (KSMC), a level I trauma center located in the center region in Riyadh, Saudi Arabia. Patients treated with AIMN, anterolateral plating, or posterior plating were included. Data on demographics, clinical parameters, radiographic healing, and costs were collected and analyzed. The average surgical duration was shorter in the AIMN group compared to the anterolateral and posterior plating groups but with no statistical significance (P > 0.05). The average length of stay (LOS) was shorter, and the change in hemoglobin levels was lower in the AIMN group when compared to other groups but without a statistically significant difference (P > 0.05). The average cost of AIMN was significantly higher than that of anterolateral and posterior plating groups (P < 0.0001). While both nailing and plating procedures are options for treating OTA/AO 12-A fractures, AIMN carries a higher overall procedural cost. The practice of drain placement in our study population is likely the cause of the increased LOS in the plating groups. Relative additional analgesic requirements were associated with AIMN. Surgeons should consider meticulous hemostasis to avoid drain placement, which can decrease LOS, thus possibly decreasing unnecessary treatment costs of humerus shaft fractures.

DNases improve effectiveness of antibiotic treatment in murine polymicrobial sepsis.

Neutrophil extracellular traps (NETs) have various beneficial and detrimental effects in the body. It has been reported that some bacteria may evade the immune system when entangled in NETs. Thus, the aim of the current study was to evaluate the effects of a combined DNase and antibiotic therapy in a murine model of abdominal sepsis. C57BL/6 mice underwent a cecum-ligation-and-puncture procedure. We used wild-type and knockout mice with the same genetic background (PAD4-KO and DNase1-KO). Mice were treated with (I) antibiotics (Metronidazol/Cefuroxime), (II) DNAse1, or (III) with the combination of both; mock-treated mice served as controls. We employed a streak plate procedure and 16s-RNA analysis to evaluate bacterial translocation and quantified NETs formation by ELISA and immune fluorescence. Western blot and proteomics analysis were used to determine inflammation. A total of n=73 mice were used. Mice that were genetically unable to produce extended NETs or were treated with DNases displayed superior survival and bacterial clearance and reduced inflammation. DNase1 treatment significantly improved clearance of Gram-negative bacteria and survival rates. Importantly, the combination of DNase1 and antibiotics reduced tissue damage, neutrophil activation, and NETs formation in the affected intestinal tissue. The combination of antibiotics with DNase1 ameliorates abdominal sepsis. Gram-negative bacteria are cleared better when NETs are cleaved by DNase1. Future studies on antibiotic therapy should be combined with anti-NETs therapies.

Isolation, Identification and Screening of Humic Acid Producing Fungi from Soil Environment of Oil palm (Elaeisguineensis) Associated with Empty Fruit Bunches

The demand for sustainable and sustainable biotechnological processes has developed as a result of a growing interest in converting agricultural waste into valuable products. In this study, fungal strainswere isolated from soil environment ofoil palm empty fruit bunchesandscreened for humic acid production. In Osun state, Nigeria, soil sample was taken from a local palm oil mill. Different colonies of fungi were obtained for further research using the serial dilution plating procedure. Plate screening was used to evaluate the fungal biomass as well as colony diameter of the fungal isolates, and a submerged fermentation test was used to measure the amount of humic acid concentration the isolates produced. Fungal isolates were identified by using molecular methods and morphological analysis. The fungi species Aspergillusniger, Rhizopusstolonifer, and Penicilliumchrysogenum were isolated from the soil environment. When compared to Rhizopusstolonifer, Aspergillusniger grew more superiorly in terms of zone diameter (26.5 1.50 mm) and biomass (2.23 0.16 g), while Penicilliumchrysogenum showed no growth. Throughout the fermentation process, Aspergillusnigeralso produced a greater quantity of humic acid, with concentrations varying from 0.70 mg/l to 2.20 mg/l. Aspergillusniger strain HR18's existence was confirmed by molecular analysis. This experiment proved that Aspergillusniger can efficiently produce humic acid from OPEFB, providing a useful method for waste utilization and sustainable practices.

Development and implementation of holmium sources produced by molecular plating for the HOLMES experiment

This manuscript reports on the optimization of a molecular plating procedure for the production of uniform and homogeneous films of holmium deposited onto gold-plated copper substrate. In particular, the effects caused by molecular plating solvents with different vapour pressure on the morphology and stability of the resulting films were investigated, allowing the selection of the optimum solvent. The developed procedure will allow allow the production of sources of holmium ions for the envisaged HOLMES experiment aiming at the direct measurement of the neutrino mass.

Unraveling the surface activity and micellization characteristics of linear alkyl benzene sulfonate in aqueous solution

Abstract The aggregation behavior of various neutralizing agents (monovalent and diamine bases) has been investigated for linear alkylbenzene sulfonate. Measurements employing conductivity at temperature (298.15 K, 303.15 K, 308.15 K, and 313.15 K) and surface tension at 298.15 K have been determined to study micellization and surface active properties. The conductivity versus concentration plot elucidated CMC and dissociation of counterion (α). Additionally, surface active parameters ϒCMC, A min, π CMC, and τ max were investigated via tensiometry using the Wilhelmy plate procedure. The wettability characteristic of the surfactant solution was determined using contact angle analysis. Furthermore, the particle size parameters were determined using DLS measurements. The Gemini salts of LABS portrayed improved efficiency and demonstrated economical in domestic and industrial applications.

Gold-coated porous silicon as a SERS substrate for near-infrared excitation: Off- and on-resonant conditions

Porous silicon, being one of the most popular SERS-active substrates, was in this work utilized for near-infrared 1064 nm excitation which minimizes the radiation-induced degradation of molecules. The production of porous silicon photonic crystals and deposition of gold nanoparticles, as the two possible methods for quenching the crystal silicon band-gap photoluminescence, were thoroughly discussed. For the off-resonant laser excitation conditions, gold nanoparticles were grown on porous silicon by the immersion plating procedure. For the on-resonant conditions, gold nanorods with the appropriate aspect ratio were synthesized by a seed-mediated protocol and deposited on the porous silicon surface. The capability of these metal-dielectric substrates toward SERS enhancement was evaluated using crystal violet dye and the advantages and drawbacks of both methods were addressed in detail. The obtained detection limits for the crystal violet dye were in the range between 10−7 and 10−8 M. So far, gold-coated porous silicon SERS-active substrates for near-infrared 1064 nm excitation have not been reported, both for the off- and on-resonant regimes.

Challenge tests reveal limited outgrowth of proteolytic Clostridium botulinum during the production of nitrate- and nitrite-free fermented sausages

Nitrate and nitrite salts perform a versatile role in fermented meats, including the inhibition of food pathogens (in particular proteolytic group I Clostridium botulinum). Despite the increasing interest in clean-label products, little is known about the behaviour of this pathogen in response to the removal of chemical preservatives from fermented meat formulations. Therefore, challenge tests with a cocktail of nontoxigenic group I C. botulinum strains were performed to produce nitrate/nitrite-free fermented sausages under different acidification conditions and starter culture formulations, including the use of an anticlostridial Mammaliicoccus sciuri strain. Results showed limited outgrowth of C. botulinum, even in the absence of acidification. The anticlostridial starter culture did not lead to an additional inhibitory effect. The selective plating procedure adopted within this study proofed robust to follow germination and growth of C. botulinum, inhibiting common fermentative meat microbiota. The challenge tests constitute a suitable tool to assess the behaviour of this food pathogen within fermented meats upon nitrate- and nitrite omission.

A novel procedure for CFU plating and counting

We present a novel method to automate plating for the Colony Forming Unit (CFU) counting procedure. The apparatus we developed for the application of this method is based on motorized stages and a syringe in order to spread fine drops of a liquid containing a solution of interest on a plate without direct contact with the surface. The apparatus can be used in two different modes. In the the first method which follows the same principle as the classical CFU count, fine drops of liquid are deposited homogeneously on an agar plate and microorganisms are allowed to form colonies. In the second, novel method that we call P0, isolated drops of the order of 10 μL containing both the microbes and the nutrient medium are deposited directly on a regular grid on a hard surface (plastic or glass); after incubation, drops that show no sign of growth inside are used to determine the microbes concentration. This new method removes the need for preparing agar surfaces and allows for easy disposal of waste and reuse of consumables. The apparatus is simple to build and use, the plating is fast and the CFU count in both type of plating is extremely reproducible and robust.

Evaluation of antinociceptive activity of minocycline in Swiss albino mice

Background: In an array of clinical diseases, pain management becomes increasingly complicated. The stimulation of glial cells and associations between neuroglial cells are emerging as being part of the primary mechanisms of pain. It has been observed that the tetracycline antibiotic minocycline inhibits microglial activation and thereby decreases nociception. Aims and Objectives: The primary purpose of this study is to assess and compare the antinociceptive activity of minocycline with that of the conventional analgesic tramadol in Swiss albino mice. Materials and Methods: Twenty-four Swiss albino mice in total were allocated into four groups, each including six mice. Using Eddy’s hot plate plus tail-flick procedure, the analgesic effects of tablet minocycline 5 mg/kg and tablet minocycline dose 10 mg/kg were assessed and compared to those of tramadol. Recordings of reaction time observations are made both before and after the administration of drugs. Results of a statistical analysis were obtained. Results: Results of our study showed that in the tail-flick plus hot plate procedures, minocycline in doses of 5 mg/kg and 10 mg/kg had a significant (P &lt; 0.05) antinociceptive effect in Swiss albino mice. However, the antinociceptive effect of minocycline is more when compared to distilled water, and is less when compared to standard analgesic tramadol. Conclusion: Minocycline showed significant antinociceptive activity in both doses in Swiss albino mice.

Glans augmentation by pedicled inner preputial flap in distal penile hypospadias: A prospective interventional study

Abstract Aims and Objective: The aim of the study was to describe a modification in the tubularized incised plate (TIP) procedure that incorporates glans augmentation with the inner preputial flap in cases of distal penile hypospadias with small glans and shallow groove. Materials and Methods: This was a prospective interventional study conducted over a period of 1 year from July 1, 2021, to June 31, 2022, at the Department of Pediatric Surgery, SMS Medical College and attached SPINCH, Jaipur. All distal penile hypospadias patients with small glans and shallow groove were included in the study. Patients with failed repairs and having associated congenital conditions were excluded. All the included patients underwent hypospadias repair by the standard TIP technique, and a modification was added to augment the glans by inner preputial flap. The incidence of glans dehiscence and fistula formation along with cosmetic appearance was recorded. Results: A total of 25 patients were included, which comprised subcoronal (n = 14; 56%), distal penile (n = 7; 28%), and coronal (n = 4; 16%) hypospadias. There were no immediate or late postoperative complications. Follow-up periods were ranging from 4 months to 12 months. There was no meatal stenosis or urethra cutaneous fistula formation after 6 months of follow-up period. The cosmetic appearance and color of the glans were satisfactory after 6–12 months of follow-up. Conclusions: With this modification of the TIP procedure in patients with distal penile hypospadias having small glans and shallow groove, a good glans width with normally placed meatus without stenosis and fistula can be achieved.