Short Plate Research Articles

Long Low-profile Proximal Tibial Locking Plate for the Fixation of Periprosthetic Femoral Fractures Above the Prosthesis: A Pilot Study

Background: Anatomic distal femoral plates locking compression plate (LCP) are generally used for the fixation of distal femoral fractures. However, they are not suitable for periprosthetic femoral fracture after total knee arthroplasty (TKA), mainly owing to the impingement with prosthesis. Objectives: In this case series, we report the outcome of proximal tibial LCP fixation in the treatment of periprosthetic femoral fracture after TKA. Patients and Methods: Twelve patients with a periprosthetic femoral fracture who underwent surgical treatment were included. According to Su et al. classification, all fractures were type II, originating from the femoral component with proximal extending. Fractures were managed with open reduction and plate fixation. The plate choice was either a long low-profile proximal tibial LCP (n=9) or a short anatomic distal femoral LCP (n=3). Results: The study population included one male and 11 females with a mean age of 74.5±9.3 years and a mean follow-up of 2.8±1.3 years. Union of fracture was observed in all fractures that were fixed with a long locking plate during a mean period of 3.1±2.1 months. Fixation failed in all three patients who were managed with a short plate. These patients underwent revision surgery with a long low-profile proximal tibial LCP. In one of them, the fixation failed again and finally fixed with tumor prosthesis. The other two fractures were united with no complications. Conclusion: Long low-profile proximal tibial LCP omits the problem of impingement by prosthesis, which is caused by short anatomic distal femoral LCP in the treatment of periprosthetic femoral fractures above the prosthesis. However, future large-scale comparative studies are required before we can recommend it for routine implications in these fractures.

The effect of surgeon-controlled variables on construct stiffness in lateral locked plating of distal femoral fractures

BackgroundNonunion following treatment of supracondylar femur fractures with lateral locked plates (LLP) has been reported to be as high as 21 %. Implant related and surgeon-controlled variables have been postulated to contribute to nonunion by modulating fracture-fixation construct stiffness. The purpose of this study is to evaluate the effect of surgeon-controlled factors on stiffness when treating supracondylar femur fractures with LLPs:Does plate length affect construct stiffness given the same plate material, fracture working length and type of screws?Does screw type (bicortical locking versus bicortical nonlocking or unicortical locking) and number of screws affect construct stiffness given the same material, fracture working length, and plate length?Does fracture working length affect construct stiffness given the same plate material, length and type of screws?Does plate material (titanium versus stainless steel) affect construct stiffness given the same fracture working length, plate length, type and number of screws?MethodsMechanical study of simulated supracondylar femur fractures treated with LLPs of varying lengths, screw types, fractureworking lenghts, and plate/screw material. Overall construct stiffness was evaluated using an Instron hydraulic testing apparatus.ResultsStiffness was 15 % higher comparing 13-hole to the 5-hole plates (995 N/mm849N vs. /mm, p = 0.003). The use of bicortical nonlocking screws decreased overall construct stiffness by 18 % compared to bicortical locking screws (808 N/mm vs. 995 N/mm, p = 0.0001). The type of screw (unicortical locking vs. bicortical locking) and the number of screws in the diaphysis (3 vs. 10) did not appear to significantly influence construct stiffness (p = 0.76, p = 0.24). Similarly, fracture working length (5.4 cm vs. 9.4 cm, p = 0.24), and implant type (titanium vs. stainless steel, p = 0.12) did also not appear to effect stiffness.DiscussionUsing shorter plates and using bicortical nonlocking screws (vs. bicortical locking screws) reduced overall construct stiffness. Using more screws, using unicortical locking screws, increasing fracture working length and varying plate material (titanium vs. stainless steel) does not appear to significantly alter construct stiffness. Surgeons can adjust plate length and screw types to affect overall fracture-fixation construct stiffness; however, the optimal stiffness to promote healing remains unknown.

Complications of open wedge high tibial osteotomy. Analysis of the causes of complications and ways to eliminate them

Objective – to study the complications of open wedge high tibial osteotomy (OWHTO) in patients who underwent this surgery in the V.A. Nasonova Research Institute of Rheumatology.Materials and methods. The study included 43 patients (46 knee joints) with primary and secondary OA of the knee of I–III stages, who underwent OWHTO in the period from 2005 to 2019. The operation was performed according to the standard technique using short spacer plates (Puddu I (5 times) and II generation (24 times), Osteomed (17 times)) and bone grafting. The identified OWHTO specific complications were divided into those related to the osteotomy, fixation, and bone grafting. To assess the result, we studied the change in pain according to the Visual Analog Scale (VAS), as well as the functional and objective state of the knee according to the Knee Society Score (KSS) before surgery, after 3 months and 1 year after surgery.Results. In 15 (32.7%) cases have been diagnosed 26 complications. Of these, 21 (81.0%) were associated with fixation, 2 (7.7%) with the osteotomy 2 (7.7%) with bone grafting of the osteotomy gap, and 1 (3.6%) a local complication. Patients without complications had a statistically significantly better decrease in pain intensity according to VAS (p=0.0005), and an improvement in the total score of KSS (p=0.0023) one year after surgery. Outcomes were also better in patients without complications: 96.7% excellent and good results versus 60.0% in patients with complications one year after OWHTO. In total, we had 43.5% excellent, 41.3% good and 15.2% satisfactory results one year after surgery.Conclusions. OWHTO is a highly effective method of surgical treatment of the osteoarthritis of the knee, which allows to obtain an excellent and good treatment result in 84.8% of cases one year after surgery. Performing OWHTO with fixing the height of the osteotomy gap using short spacer plates and bone grafting in 32.7% of cases is associated with the development of complications. To improve the results of OWHTO, it is necessary to improve the surgical technique and fixator.

Short Plate with Screw Angle over 20 Degrees Improves the Radiologic Outcome in ACDF: Clinical Study

Background: Anterior cervical discectomy and fusion surgery is a common procedure for degenerative cervical spine. This describes allospacer and implant-related outcomes, comparing medium plate–low screw angle and short plate–high screw angle techniques. Methods: From January 2016 to June 2019, 79 patients who underwent ACDF were prospectively enrolled. Patients were divided, depending on the plate–screw system used: medium plate–low screw angle (12.3 ± 2.5 to 13.2 ± 3.2 degrees), and short plate–high screw angle (22.8 ± 5.3 to 23.3 ± 4.7 degrees). Subsidence, ALOD, and sagittal cervical balance were analyzed using lateral cervical X-rays. NDI and VAS scores were also evaluated. Results: Age for medium plate–low-angled screw group is 58.0 ± 11.3 years, and 55.3 ± 12.0 in the short plate–high-angled screw group (p-value = 0.313). Groups were comparable in mean NDI (p-value = 0.347), VAS (p-value = 0.156), C2–C7 SVA, (p-value = 0.981), and lordosis angle (p-value = 0.836) at 1-year post-surgery. Subsidence was higher in the medium plate–low-angled screw than in the short plate–high-angled screw (25% and 8.5%, respectively, p-value = 0.045). ALOD is also more common in the medium plate group (p-value = 0.045). Conclusion: Use of a short plate and insertion of high-angled screws (more than 20 degrees) has less chance of subsidence and occurrence of ALOD than the traditional technique of using medium plate and low angle.

Composition of the genus emConnexochiton/em Kaas, 1979 (Mollusca: Polyplacophora: Ischnochitonidae).

The species composition of the genus Connexochiton is revised. So far, six Recent species of the genus Connexochiton have been known: C. platynomenus, C. kaasi, C. crassus, C. bromleyi, C. moreirai and C. discernibilis After the present revision, the genus consists of Connexochiton platynomenus, C. kaasi, C. crassus, as well as three new species, C. costatus n. sp. from the Philippines, C. kermadeci n. sp. from New Zealand and C. solomonicus n. sp. from the Solomon Islands. Connexochiton discernibilis was assigned to the ischnochitonid genus Stenosemus (now Stenosemus discernibilis). Connexochiton bromleyi and C. moreirai are transferred back to the genus Ischnochiton. Principle features of the genus Connexochiton include: a distinctive shape of the valves with the hind edge of the intermediate valves noticeably turned down, which makes the lateral areas narrow and appearing strongly raised; tegmentum delicately sculptured by quincuncially arranged triangular granules that form an alveolate pattern; each granule has 9 to 11 aesthete pores; apophyses are connected medially by a short jugal plate, dorsal scales of the girdle are strongly bent, with short longitudinal ribs or spherules or both; head of the major lateral teeth of radula is unicuspid and sickle-shaped. An identification key for the species of the genus Connexochiton is provided.

전방향성 방사 패턴을 갖는 차량용 HF 대역 저자세 안테나

This paper proposes a high-frequency (HF) band on an extremely low-profile antenna that can be mounted on the roof of a car. This antenna generates a monopole-like omnidirectional radiation pattern despite the low height of the patch shape (5 cm, 0.0034λ @ 20 MHz). A coil was installed at the edge of the antenna feeding part and the patch to increase the quality factor (Q-factor) and a shorting pin was connected next to the coil to ensure that in-phase current flows through the feeding part and shorting pin. The coil is designed such that the quality coefficient reaches 1,000 considering the mutual inductance and internal resistance. The Q-factor of the antenna is increased by changing the shorting pin to a shorting plate. A quarter-wavelength monopole antenna with a target frequency of 20 MHz is 6 m in length, whereas the proposed antenna height is only 5 cm (0.0034λ @ 20 MHz) and the patch size is 70 cm × 70 cm (0.047 λ×0.047 λ @ 20 MHz), making it easy to install the antenna on the vehicle roof. The gain in the Q-factor of the antenna, calculated using a 3D radio wave simulation software, was −9 dBi, and the gain when it was mounted on the vehicle roof was −2.7 dBi. The power value measured by introducing the antenna showed a star similar to the gain value calculated via simulations.

Effects of basal drag on subduction dynamics from 2D numerical models

Abstract. Subducting slabs are an important driver of plate motions, yet the relative importance of different forces in governing subduction motions and styles remains incompletely understood. Basal drag has been proposed to be a minor contributor to subduction forcing because of the lack of correlation between plate size and velocity in observed and reconstructed plate motions. Furthermore, in single subduction system models, low basal drag leads to subduction behaviour most consistent with the observation that trench migration velocities are generally low compared to convergence velocities. By contrast, analytical calculations and global mantle flow models indicate basal drag can be substantial. In this study, we revisit this problem by examining the drag at the base of the lithosphere, for a single subduction system, in 2D models with a free trench and composite non-linear rheology. We compare the behaviour of short and long plates for a range of asthenospheric and lithospheric rheologies. We reproduce results from previous modelling studies, including low ratios of trench over plate motions. However, we also find that any combination of asthenosphere and lithosphere viscosity that produces Earth-like subduction behaviour leads to a correlation of velocities with plate size, due to the role of basal drag. By examining Cenozoic plate motion reconstructions, we find that slab age and plate size are positively correlated: higher slab pull for older plates tends to be offset by higher basal drag below these larger plates. This, in part, explains the lack of plate velocity–size correlation in observations, despite the important role of basal drag in the subduction force balance.

Seasonal variations of carcass characteristics, meat quality and nutrition value in Iberian wild red deer

Aim of study: The effects of hunting season (autumn vs. winter) on carcass characteristics and meat quality of Iberian wild red deer were assessed.Area of study: A total of 100 males of wild red deer of Iberian genetic line (Cervus elaphus) were hunted on Ciudad Real (south central Spain).Material and methods: Yields for shoulder (with bone), neck, backbone, loin, tenderloin, leg (with bone), short plate and flank were determined. In addition, samples of Longissimus thoracis et lumborum and Rectus abdominis muscles were collected. Then, pH48, colour measurements, chemical composition, cooking loss, Warner Bratzler shear blade, fatty acid and amino acid profiles and mineral content were analyzed.Main results: Deer hunted in autumn (n=50) had higher (p<0.01) yields of shoulder, backbone and short plate and higher contents of intramuscular fat (IMF), cholesterol and K, Fe and Mn but lower (p<0.001) pH48 and Na, Mg, Zn and Cu contents than deer hunted in winter (n=50). Shear force tended (p=0.05) to be lower for meat collected in autumn than for meat collected in winter. However, loin yield was 59.2% higher (p<0.001) for winter than for autumn carcasses. Deer hunted in winter had higher α-linoleic acid (p<0.05) and long chain n-3 polyunsaturated (p<0.001) percentages than deer hunted in autumn.Research highlights: Autumn hunting is recommended to obtain carcasses with higher yields of shoulder, backbone and short plate and meat with higher IMF. Conversely, winter hunting is advisable for higher loin yield and for a profile richer in polyunsaturated fatty acids.

Effect of Plate Length on Subduction Kinematics and Slab Geometry: Insights From Buoyancy‐Driven Analog Subduction Models

AbstractSubduction style is controlled by a variety of physical parameters. Here we investigate the effect of subducting plate length on subduction style using laboratory experiments of time‐evolving buoyancy‐driven subduction in 3‐D space. The investigation includes two experimental sets, one with a lower (~740) and one with a higher (~1,680) subducting plate‐to‐mantle viscosity ratio (ηSP/ηM). Each set involves five models with a free‐trailing‐edge subducting plate and variable plate length (20–60 cm, scaling to 1,600–4,800 km), and one model with a fixed‐trailing‐edge subducting plate representing an infinitely long plate. Through determining the contact area between subducting plate and underlying mantle, plate length affects the resistance to trenchward motion of the subducting plate and thus controls the partitioning of the subduction velocity (vS) into the subducting plate velocity (vSP) and trench velocity (vT). This subduction partitioning thereby determines the subduction style by controlling the dip angle of the slab tip once it first touches the 660 km discontinuity. The low ηSP/ηM models display two subduction styles. Short plates (≤40 cm) induce a higher subduction partitioning ratio (vSP/vS), promoting trench advance and slab rollover geometries, whereas longer plates (≥50 cm) lead to a lower vSP/vS, producing continuous trench retreat and backward slab draping geometries. In contrast, the high ηSP/ηM models exclusively show trench retreat with draping geometries, as the high ηSP/ηM enables less slab bending before its tip touches the 660 km discontinuity. Our study indicates that future modeling work should consider the effects of plate length on the style and evolution of subduction.

Characteristics of a Cutoff Cavity Probe Applicable to Crack Detection Using the Forced Resonance Microwave Method

This paper presents the current characteristics inside a cutoff cavity slot probe applied to crack detection using the forced resonance microwave method (FRMM). Crack detection using FRMM has two stages: preparation and detection. In the preparation stage, the current characteristics inside the probe with a shorting plate are important for determining the crack signal and detection sensitivity. The cutoff cavity probe produces a forced resonance by adjusting a control element. There are two kinds of forced resonance: series resonance (SR) and parallel resonance (PR). Four types of current characteristics are applied to crack detection using FRMM: SR, the region around SR, the region around PR, and non-resonance. These current characteristics are discussed from the point of view of current change for crack detection. The experimental results are compared with the theoretical results to check the current state inside the cutoff cavity probe.

The feasibility of urethral plate preservation in proximal and mid-penile hypospadias: sequential and anatomical approach to the repair

BackgroundThe assessment of a child having hypospadias with chordee/ventral curvature (VC) and meatal position that appears to be proximal/mid-penile can be challenging with regard to the choice of chordee correction and type of urethroplasty. The feasibility of preservation of native urethral plate is dependent on these choices. Classically, urethral plate resection of the corpora is performed to correct severe VC, whenever VC is presumed to be due to short urethral plate. But VC is seen to persist in many such cases, in spite of this maneuver that commits the patient to a more complex reconstruction. The aim of the study was to analyze the variation in preoperative and intraoperative assessment of proximal and mid-penile hypospadias, with respect to severity and possible surgical options, in patients treated by a standard protocol of sequential and anatomical approach to repair. The other objective was to ascertain if “extensive ventral urethral detethering” (in all cases) and “urethral plate augmentation” (in select cases) could facilitate more anatomical repair in these cases, with urethral plate preservation and utilization for repair wherever feasible.ResultsFifty-two children who underwent the specific protocol of repair during the 5-year period from January 2014 to December 2018 at a tertiary teaching institution were included in the study. The essential principles adopted for the surgery were as follows: (i) urethral plate preservation in all possible situations; (ii) “extensive ventral urethral detethering” up to the bulb, as a preliminary step, (iii) sequential correction of VC with urethral plate augmentation (in select cases); and (iv) selecting the optimal repair based on the following principles: (a) urethral plate tubularization, (b) urethral plate augmentation, and (c) urethral plate substitution. There was considerable difference in the preoperative and intraoperative assessment of meatal position, with 12 of the apparently mid-penile hypospadias being reclassified as distal penile after preliminary dissection. Three of the penoscrotal variants were regrouped as proximal penile and 6 of the proximal penile were regrouped as mid-penile type. Majority of cases which were deemed to require complex reconstruction on preoperative assessment could be treated by a single-stage procedure.ConclusionThe meatal position is seen to shift distally in select cases of proximal or mid-penile hypospadias after thorough degloving, dartos release, and detethering of Buck’s fascia over ventral urethra. Urethral plate can be preserved for utilization in repair in many of these cases by augmenting the urethral plate, enabling a more anatomical neourethral reconstruction. Resection of urethral plate can be thus restricted to the most severe cases of VC.

Processing Characteristics, Composition, Shelf-life, and Sensory Attributes of Beef Bacon Manufactured From Seven Value-Added Cuts of Beef

The purpose of this study was to evaluate the influence of different beef cuts on their potential for adding value by assessing processing characteristics, composition, shelf-life, and sensory attributes of these cuts as beef bacon. Six briskets (Institutional Meat Purchase Specification [IMPS]#120), 6 clod hearts (IMPS#114E; divided horizontally into 2 halves: silver-skin side and non–silver-skin side), 6 flanks (IMPS#193), 6 outside flats (IMPS#171B), and 7 short plates (IMPS#121A; cut into a deboned short-rib half and navel half) were sourced commercially from separate Canadian quality grade AA beef carcasses. Data for processing yields, composition, and image analysis were analyzed as a generalized linear mixed model with fixed effect of cut and random effect of replication nested within block (processing group). Sensory data collected using a trained sensory panel were analyzed in the same manner, with an additional fixed effect of storage day and additional random effects of session and panelist. Rested pump uptake, which was targeted at 20%, was not different (P = 0.21) among cuts; however, smokehouse cook yield differed (P < 0.01) among cuts, with heavier cuts (brisket, plate cuts, and outside flat) generally having greater yields compared with lighter cuts (clod cuts and flank). As expected, composition of bacon slices was affected (P < 0.01) by cut, with leaner cuts (clod cuts, flank, and outside flat) having greater moisture, lower lipid levels, and greater protein compared with fatter cuts (brisket and plate cuts). Sensory analysis revealed significant differences in muscle fiber toughness and connective tissue among cuts. The differences that were quantified in this study should allow manufacturers to tailor their cut selection to the processing specifications that may be most profitable and well-suited for the meat industry and its customer base. Overall, this research should help define beef bacon and further indicate that a variety of beef cuts can be used to manufacture beef bacon.

Study on the effect of simple incision of ventral tunica albuginea on the correction of penile curvature in hypospadias

Objective: To investigate the therapeutic effect of simple tunica albugineaincision and ventral penile lengthening surgery on the correction of penile curvature due to asymmetry of the cavernous bodies in hypospadias. Methods: A retrospective analysis was performed in 39 children with hypospadias who underwent simple tunica albuginea incision and ventral penile lengthening surgery for correcting asymmetry of the cavernous bodies from January 2016 to December 2018(36 of them were from Department of Pediatric Urology surgery, The Children's Hospital, Zhejiang University School of Medicine, and 3 from Department of Urology surgery, Affiliated Hospital ofJiaxing University), all of whom aged from 0.5 to 5, with a median age of 1.1 years. During the first stage of the operation, firstly penile skin and sarcoma was released by completely degloving the skin and fascia of penis, secondly the factor of short urethral plate was solved by transection of urethral plate, and then the dorsal length of penis (A), the ventral length of the penis before and after straightening by incision of tunica albuginea (B and C) were measured and recorded; onto the second stage of the operation, an artificial erection test was performed to observe the curvature of the penis, the dorsal and ventral length of the penis (D and E) were measured. The dorsal and ventral length of the penis before and after straightening were compared. Results: The dorsal length of penis (A) was 33-39(35.6±3.2) mm, the length of ventral length of penis before straightening (B) was 28-35 (29.8±2.8) mm and the length of ventral length of penis after straightening (C) was 32-38 (34.3±2.1) mm, which were measured during the first stage of operation, and the difference between B and C was statistically significant (P<0.05), while the difference between A and C was not statistically significant (P>0.05). The dorsal length of penis (D) was34-41 (36.4±2.5) mm and the ventral length of penis (E) was 33-40 (35.7±3.6) mm, which were measured during the second stage of operation, and there was no significant difference between D and E (P>0.05). The degree of penile curvature at the time of erection was less than 15° by measuring with the side photos in all patients during 0.5 to 2.5 years of follow-ups with an average of 1.7 years. Conclusions: Penile curvature due to the asymmetry of the cavernous bodies could be effectively corrected by simple incision of ventral tunica albuginea, which showed a good result of early follow-up. The effect of this surgery on ventral penile straightening could be verified by measuring and comparing the ventral and dorsal length of penis during surgery.

The Effect of Stiff Foot Plate Length on Walking Gait Mechanics.

Exoskeletons are increasingly being used to treat gait pathologies. Many of these exoskeletons use a foot plate to actuate the foot, altering the effective stiffness of the foot. Stiffness of the biological foot and ankle plays an important role in the energy modulating function of the leg, so it is important to examine how a foot plate in and of itself impacts gait. Therefore, this study quantified how foot plates themselves alter the walking gait of 16 healthy young adults. The effect of the foot plate length was also examined through the use of two foot plates, one that ended at the metatarsals and one that extended past the toes, about 20% longer. Gait parameters examined included walking speed, step frequency, joint angles for the hip, knee, ankle, forefoot, and toe, ground reaction forces (GRF), and foot-ankle power. The most significant changes were caused by the full plate, which caused an average 13% decrease in the ankle range of motion (ROM) and a 23% decrease in forward GRF at push off. The shorter plate also decreased ankle ROM to a lesser degree. This indicates that the presence of a foot plate impacted foot and ankle kinematics. However, the presence of the tested foot plate had no effect on walking speed or hip or knee kinematics. This indicates that subjects were mostly able to compensate both kinematically and energetically via their foot and ankle for the increased foot stiffness due to the tested foot plate.

Biomechanical comparison of the angle of inserted screws and the length of anterior cervical plate systems with allograft spacers

BackgroundComparative studies of the biomechanical effects of plates of varying lengths and different screw insertion angles on allograft spacers are lacking. MethodsFinite element model analysis of a previously validated, three-dimensional, intact cervical spinal segment model of C3–6 was conducted in the present study. On the C5–6 segment, anterior discectomy and fusion were performed using allograft spacers and different combinations of anterior plates and screws. The biomechanical characteristics of combinations of short, medium, and maximal length plates with screw insertion angles of 0°, 8°, 16°, and 32° were analyzed. FindingsIn flexion and extension, the risk of allograft spacer subsidence decreased as screw angles increased. Short plates with a screw insertion angle of 32° posed the lowest subsidence risk, similar to medium length plates with a screw insertion angle of 16°, in all motion conditions. The risk of bone yielding increased as plate length increased, but decreased as the screw insertion angle increased. InterpretationShort plates with a large screw insertion angle (32°) showed the highest mechanical stability and load sharing of allograft spacers and the lowest risk of screw loosening. Accordingly, we recommend the use of a short plate and large screw insertion angle for anterior cervical discectomy and fusion.

Flow characteristics of a fixed circular cylinder with an upstream splitter plate: On the plate-length sensitivity

In the present study, we place a short splitter plate onto the upstream side of a circular cylinder to modify its incoming flow conditions and the wake-vortex patterns and to attenuate the aerodynamic forces. Wind-tunnel investigations are performed at a Reynolds number of Re = 2.66×104. Special interests are paid to the length sensitivity of the rigid splitter plate. The 2D particle image velocimetry (PIV) technique is employed to measure the flow patterns around the natural and controlled cylinders to reveal the great modifications of the upstream plate to the cylinder flow. Except for PIV tests, sectional pressure measurements are also conducted to obtain the pressure distribution around the cylinder surface so as to estimate the aerodynamic forces, i.e. drag and lift forces of the natural and controlled cylinders. Results of the surface-pressure measurement demonstrate clearly the control effectiveness and the surrounding flow topologies obtained by PIV system help to uncover the mechanism of the passive upstream-plate control.

V09-11 WATCH SHAPED BUCCAL MUCOSA GRAFT FOR SIMULTANEOUS CORRECTION OF SEVERE CHORDEE AND URETHROPLASTY AS A ONE STAGE REPAIR OF SCROTAL HYPOSPADIAS

You have accessJournal of UrologyPediatrics (V09)1 Apr 2020V09-11 WATCH SHAPED BUCCAL MUCOSA GRAFT FOR SIMULTANEOUS CORRECTION OF SEVERE CHORDEE AND URETHROPLASTY AS A ONE STAGE REPAIR OF SCROTAL HYPOSPADIAS Miroslav Djordjevic*, Abdulmuttalip Simsek, Marta Bizic, Borko Stojanovic, Joshua Roth, and Rajveer Purohit Miroslav Djordjevic*Miroslav Djordjevic* More articles by this author , Abdulmuttalip SimsekAbdulmuttalip Simsek More articles by this author , Marta BizicMarta Bizic More articles by this author , Borko StojanovicBorko Stojanovic More articles by this author , Joshua RothJoshua Roth More articles by this author , and Rajveer PurohitRajveer Purohit More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000923.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Severe hypospadias repair still presents a great challenge. We evaluated a novel approach of using a specially shaped buccal mucosa graft for simultaneous ventral tunica grafting and new urethral plate creation in combination with a longitudinal dorsal island skin flap for a one-stage repair of severe hypospadias. METHODS: A 14-month-old boy underwent scrotal hypospadias repair. The short and non-elastic urethral plate is divided. Buccal mucosa graft is harvested from the inner cheek, and designed in a special “watch” shape, with the spherical part in the middle and two rectangular parts on both sides. The tunica albuginea is opened ventrally for penile straightening and grafted to the spherical part of the "watch-shaped" buccal mucosa with 6-8 “U-shape” stitches. The rectangular parts are fixed to the tip of the glans distally and native urethral meatus proximally. A longitudinal dorsal skin flap is harvested, button-holed ventrally and joined with the buccal graft. Penile skin reconstruction is performed using available penile skin. RESULTS: Good appearance of the penis is achieved without residual chordee, urethral fistula or stricture. CONCLUSIONS: A watch shaped buccal mucosa graft for simultaneous curvature correction and urethroplasty could be a good choice for single stage repair of scrotal hypospadias with severe chordee. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e836-e836 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Miroslav Djordjevic* More articles by this author Abdulmuttalip Simsek More articles by this author Marta Bizic More articles by this author Borko Stojanovic More articles by this author Joshua Roth More articles by this author Rajveer Purohit More articles by this author Expand All Advertisement PDF downloadLoading ...

An effective microscale approach for determining the anisotropy of polymer composites reinforced with randomly distributed short fibers

In this paper, an effective microscopic modeling scheme is presented to analyze mechanical properties of composites with random short fibers. To this end, the displacement-load tests of the standard samples, which are acquired by cutting a short fiber-reinforced composite plate of 650 mm × 650 mm × 2.5 mm, are firstly executed under the quasi-static tensile loads. To identify the geometric sizes of the short fibers and their distributions at microscopic scale, the advanced micro-computed tomography (micro-CT) is employed by testing a small sample of 1 cm × 2.5 mm × 2.5 mm. On this basis, a simplified microscopic model is reconstructed by the 3D parametric finite-volume direct averaging micromechanics (FVDAM) theory according to the statistic results of the micro-CT images. The proposed method is further validated by comparing the effective modulus obtained from tensile tests. The scanning electron microscopy (SEM) is also used to visualize the fracture morphology of the fibers. It is found that brittle fracture occurs in the short-fibers paralleled to the external loading.

Open Reduction and Internal Fixation for Dorsal Fracture-dislocation of the Proximal Interphalangeal Joint.

The purpose of this study was to investigate and compare the clinical and radiological results of ORIF with inter-fragment screw or buttress plate fixation of acute PIP joint fracture dorsal dislocation. Between January 2007 to December 2016, nineteen patients-14 men and 5 women with an average age of 40.9 (19 to 64) years-were included in this study; 9 patients underwent small sized interfragmentary screw fixation and 10 patients underwent small buttress plating. The average follow-up period was 45.1 (13 to 78) months. Clinical assessment included measurement of range of motion (ROM) of the proximal and distal interphalangeal joint (PIP, DIP), grip and pinch strength, and pain with use of the Visual Analog Scale (VAS). At the postoperative X-ray, articular step off, gap, and degree of dorsal subluxation was measured, and maintenance of the reduction, fracture union, and the presence of degenerative changes were assessed. All patients achieved solid unions without instability. The overall average range of motion of PIP joint were from 9° to 85° (10-83° in the screw group, 8-87° in the plate group without significant difference). However, the screw group (average: 53°) presented more flexion in the distal interphalangeal joint than the plate group (average: 34°). Plate fixation can cause limited DIP flexion. Six of the ten patients from the plate group, underwent implant removal and two of these patients required PIP joint arthrolysis due to the PIP flexion contracture of more than 30°. Three of the nine patients in screw group underwent implant removal and two of the three patients required PIP joint arthrolysis. Mini plate and screw fixation of acute PIP joint fracture dorsal dislocation can achieve comparable favorable clinical and radiographic outcomes through stable fixation and early range of motion exercise. Screw fixation, if possible, is probably preferable to plate fixation because of better DIP joint ROM and lower incidence of hardware removal. If there is a need for plate fixation the use of a short plate is recommended to avoid joint stiffness.

2008-2016 Water security status and short plate element screening in Shandong province

In order to explore the applicability of the methods for protecting regional water resources, the water resources safety evaluation index system of Shandong Province was constructed, and the water resources safety relative closeness degree was used to characterize the water resources security situation of Shandong Province from 2008 to 2016; the matrix of water resources safety impact factors of Shandong Province was constructed. The factor analysis method is used to calculate three principal component factors, and the short board elements are identified. The paper concluded by comparing the development trend of water resources security in Shandong from the aspects of vertical (interannual) and horizontal (indicator). The results show that: (1) The water security system of Shandong Province was mildly unsafe in 2009. It was barely safe in 2015 and 2016, and the rest of the year was in an unsafe state. In 2008-2016, the state of water resources security in Shandong Province showed that the situation in the previous period was relatively tight and the later contradictions eased, but the overall security situation was still severe. (2) Factor analysis shows that the lack of water resources and high-intensity development and utilization are the main short-term factors affecting water resources security in Shandong Province.