Risk Of Shortening Research Articles

Results of quadruple elastic nailing for length unstable fracture femur in pediatrics

Background Length-unstable shaft femur fractures including spiral, long oblique, and comminuted fractures are mechanically unstable under axial, bending, and rotational forces. The risk of shortening, rotation, and malalignment increases substantially with the standard technique using only two nails. Our study was the first to report the results of quadruple elastic nailing for length-unstable femoral fractures on a prospective basis. Moreover, our study was the first to correlate this technique to the operative time and to the radiation exposure time. Patients and methods In all, 26 patients with simple length-unstable pediatric shaft fracture femur were included from October 2020 to October 2022. We used four elastic stable intramedullary nails (ESINs) for fracture fixation. Operative time and radiation exposure time were calculated for each patient. Follow-up of union was judged by radiograph at 1, 2, 3, and 6 months postoperatively. The Flynn score was used for evaluation at the 6th month postoperatively. Results Most of the studied cases were associated with excellent outcomes (84.6%) with four cases being associated with satisfactory outcomes (15.4%). Entire cases were associated with full ROM with no recorded angular deformity or rotational deformity. The mean operative time, radiation exposure time, and full union duration were 1.23 ± 0.31 h, 1.26 ± 0.27 min, and 9.08 ± 2.78 weeks, respectively. Conclusion Our case series supports the use of ESIN in length-unstable diaphyseal femur fractures with 26 patients treated with a quartet of ESINs.

HERG agonists pose challenges to web-based machine learning methods for prediction of drug-hERG channel interaction

Pharmacological blockade of the IKr channel (hERG) by diverse drugs in clinical use is associated with the Long QT Syndrome that can lead to life threatening arrhythmia. Various computational tools including machine learning models (MLM) for the prediction of hERG inhibition have been developed to facilitate the throughput screening of drugs in development and optimise thus the prediction of hERG liabilities. The use of MLM relies on large libraries of training compounds for the quantitative structure-activity relationship (QSAR) modelling of hERG inhibition. The focus on inhibition omits potential effects of hERG channel agonist molecules and their associated QT shortening risk. It is instructive, therefore, to consider how known hERG agonists are handled by MLM. Here, two highly developed online computational tools for the prediction of hERG liability, Pred-hERG and HergSPred were probed for their ability to detect hERG activator drug molecules as hERG interactors. In total, 73 hERG blockers were tested with both computational tools giving overall good predictions for hERG blockers with reported IC50s below Pred-hERG and HergSPred cut-off threshold for hERG inhibition. However, for compounds with reported IC50s above this threshold such as disopyramide or sotalol discrepancies were observed. HergSPred identified all 20 hERG agonists selected as interacting with the hERG channel. Further studies are warranted to improve online MLM prediction of hERG related cardiotoxicity, by explicitly taking into account channel agonism as well as inhibition.

Risk of shortening in operatively treated proximal femur fractures with cephalomedullary nails with dynamically versus statically locked helical blades

IntroductionCephalomedullary nails (CMN) have proven to be effective for the fixation of unstable pertrochanteric hip fractures, but limited data exists regarding the degree of shortening that occurs with nailing systems that offer “dynamically” versus “statically” locked helical blades. This study aimed to determine the incidence, timing, and amount of postoperative fracture shortening in patients with pertrochanteric hip fractures treated with “dynamically” versus “statically” locked helical blades. MethodsA retrospective review was performed on patients requiring operative fixation of pertrochanteric fractures. Inclusion criteria were patients aged 55 or older, low energy mechanism of injury, primary surgical open reduction and internal fixation of the injury, surgery performed by a fellowship-trained orthopaedic traumatologist, and radiographic follow up until healing or failure (minimum of 3 months). Quantification of fracture shortening was determined using the lateral screw protuberance method. Fracture shortening measurements were calculated from immediate post-operative films and subsequent radiographs at each follow-up visit. Results222 patients met inclusion criteria (123 using Depuy Synthes Trochanteric Fixation Nail proximal femoral nailing system (TFN) with static locking; 65 TFN with dynamic locking; 23 using Depuy Synthes Trochanteric Fixation Nail-Advanced proximal nailing system (TFNA) with static locking; and 11 TFNA with dynamic locking). When comparing the final screw protuberance, the TFN dynamic (10.31 mm), TFNA static (9.52 mm), and TFNA dynamic (7.02 mm) groups were found to be significantly less compared to the TFN static cohort (11.67 mm; p < 0.001). The distribution of fracture shortening was found to be significant (p < 0.01). Interval measurements of fracture shortening by repeated measures of ANOVA within groups showed statistically significant increases in screw protuberance for the TFN static (p < 0.001), TFN dynamic (p < 0.001), and TFNA static (p < 0.01) cohorts within the first 60 days postoperatively. The TFNA with dynamic locking group was found to have statistically significant increases until the first 100 days post-operatively (p < 0.02). DiscussionThe incidence of fracture shortening remains high even with the use of cephalomedullary nails, regardless of dynamization status. Current pertrochanteric fixation constructs continue to favor fracture healing at the direct expense of fracture shortening.

Physical meat quality characteristics of hot-deboned ostrich ( Struthio camelus var. domesticus) Muscularis gastrocnemius, pars interna during post-mortem aging

There is a risk of shortening and toughening with hot-deboning of muscles. However, with refrigerated aging this phenomenon may be negated. Vacuum-packed hot and cold-deboned ostrich Muscularis gastrocnemius, pars interna were stored for 21 d at 4 °C to investigate the effects of hot-deboning on quality characteristics of ostrich meat during refrigerated storage. Muscle pH did not differ ( P > 0.05) between hot and cold-deboned muscles during storage. Hot-deboning caused ( P < 0.0001) more purge in the vacuum packages of the hot-deboned muscles (1.83 ± 1.31%) than in the cold-deboned muscles (0.67 ± 075%) during the 21-d aging period. Hot-deboned muscles were tougher ( P < 0.05) than cold-deboned muscles from 24 h up to 5 d. Although hot-deboning caused muscles to be tougher than cold-deboned muscles, with aging at 4 °C beyond 5 d this toughness was found to be insignificant.

Use of Soda Produced by the Hydrochemical Method from Nepheline Material in Glass Melting

The corrosive effect of nepheline-based soda on the refractory lining of glass-melting furnaces is tested. The main principle of the process of melting industrial glass from batches containing such soda are discussed. It is established that the use of soda does not provoke complications in glass melting and does not entail the risk of shortening the furnace campaign.