Early Treatment Outcome of Humeral Shaft Fracture Non-Union in Adults: Comparative Study of Plating versus Interlocking Nailing

Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3rd of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.

Comparison of Clinical Effect of PFNA and Internal Fixation with Anatomical Locking Plate of Proximal Femur in Treatment of Intertrochanteric Fracture of Femur

Purpose:To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods:The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results:The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion:The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.

Common-mode noise rejection using fringe-locking method in WEP test by simultaneous dual-species atom interferometers

We theoretically investigate the application of the fringe-locking method（FLM） in the dual-species quantum test of the weak equivalence principle（WEP）.With the FLM,the measurement is performed invariably at the midfringe,and the extraction of the phase shift for atom interferometers is linearized.For the simultaneous interferometers,this linearization enables a good common-mode rejection of vibration noise,which is usually the main limit for high precision WEP tests of the dual-species kind.We note that this method also allows for an unbiased determination of the gravity accelerations difference,which meanwhile is ready to be implemented.

The Effects of Bone Screw Configurations on the Interfragmentary Movement in a Long Bone Fixed by a Limited Contact Locking Compression Plate

The locking compression plates (LCP) are efficient tools in open reduction and internal fixation (ORIF), especially in osteoporotic bones. Two important factors of screw density and screw position can affect the functionality of the bone plate. Several studies have assessed the influence of the screw configurations on the bone-plate stiffness, but the effects of screw positions on the interfragmentary strain, εIF of LCP construct have not been investigated yet. In this study, finite element method was used to investigate the influence of screws number and position on the interfragmentary strain of LCP-femur system for a mid-shaft fracture. Results of this study showed that by insertion of screws closer to the fracture site, εIF decreases by 2nd degree polynomial function versus screw position, but by adding the screws from the ends of the plate, or by moving and placing the screws towards the fracture site, the reduction of εIF will be linear. Results of this study were compared and are in agreement with some studies in the literature, even though their scope was mostly stability of the bone-implant system, whereas our scope was focused on the interfragmentary strain.

Application of proximal femur locking compression plate for unstable four part intertrochanteric fractures

Objective To evaluate the clinical results of proximal femur locking compression plate (LCP) for unstable four-part intertrochanteric femoral fractures.Methods Clinical data of53patients wiith unstable four-part intertrochanteric

Comparison of effect of locking compression plate internal fixation and reconstruction plate fixation for treatment of mid-shaft clavicular fracture

Objective:To compare the effect of locking compression plate internal fixation and reconstruction plate fixation for the treatment of mid-shaft clavicular fracture.Methods: In this study, the medical records of 68 patients with mid-shaft clavicular fractures treated in our department from May 2014 to May 2017 were retrospectively analyzed. 32 patients in the control group received the reconstruction plate fixation, while 36 patients in the observation group received the locking compression plate internal fixation. Patients were followed up for 12 months, thereafter, various indicators including operative indexes, Constant-Murley (CM) score, disability of arm shoulder and hand (DASH) score, activities of daily living (ADL), and complications were compared between groups.Results: The incision length, intraoperative blood loss, operation time, and fracture healing time of the observation group were significantly lower than the control group (P<0.05). The postoperative CM scores of the two groups were significantly increased, moreover, the scores of muscle strength, daily life and activity were significantly in the observation group were higher than those of the control group (P<0.05), and no difference was found in the pain degree (P>0.05). There was a decrease trend in the DASH score and an increase trend in the ADL score in both groups, while both indexes were better in the observation group than in the control group (P<0.05). The total incidence of complications in the observation group was significantly lower than that in the control group (8.33% vs 18.75%,P<0.05).Conclusion: Compared with the reconstruction plate fixation, locking compression plate internal fixation has the advantages of more mini invasive, better amelioration of shoulder joint function and less complication for patients with mid-shaft clavicular fractures.

Effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures

Objective:To investigate the effect of locking compression plate internal fixation on the injury extent and bone metabolism of Robinson 2A and 2B middle clavicular fractures.Methods:Totally 80 cases of patients with Robinson 2A and 2B middle clavicular fractures admitted to our hospital between March 2017 and January 2019 were divided into the control group(n=41)receiving conventional kirschner wire internal fixation and the observation group(n=39)receiving locking compression plate internal fixation according to the operation plans.The differences in serum contents of inflammatory factors,oxidative stress indexes and bone metabolism indexes were compared between the two groups of patients before patients entered operating room,24 h after surgery and 48 h after surgery.Results:Before patients entered operating room,there were no statistically significant differences in the serum contents of inflammatory factors,oxidative stress indexes or bone metabolism indexes between the two groups(P>0.05).At 24 h and 48 h after surgery,serum inflammatory factors interleukin-1(IL-1),interleukin-17(IL-17),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factorα(TNF-α)contents in the observation group were lower than those in the control group;serum reactive oxygen species(ROS)and lipid hydroperoxide(LHP)contents were lower than those in the control group,while catalase(CAT)and glutathione peroxidase(GSH-Px)contents were higher than those in the control group;serum N-terminal propeptide of procollagen type I(PINP),bone gla protein(BGP)and alkaline phosphatase(ALP)contents were higher than those in the control group,while N-telopeptide of typeⅠcollagen(NTX),C-telopeptide of typeⅠcollagen(CTX)and tartrate-resistant acid phosphatase 5b(TRACP5b)contents were lower than those in the control group(P<0.05).Conclusion:Locking compression plate internal fixation can reduce the postoperative trauma extent and help promote the fracture healing in patients with Robinson 2A and 2B middle clavicular fracture.

Relationship between Inter Canine Width and Inter Alar Width, Inter Commissural Width, and Inter Canthal Distance: A Pilot Study

The aim of this study was to determine the relationship between inter canine width (ICW) and inter alar width (IAW), inter commissural width (ICoW), and inter canthal distance (ICaD) in Bantu population. Materials and Methods: It was a pilot study included all participants who were aged at least 18 years, without a history of orthodontics treatment from Prosthodontics Department, Faculty of Dental Medicine, University of Kinshasa. The Ethics committee of the National Center of Research for Dental Sciences in DR Congo approved the study protocol (CNRSB 1504.218). The participants medical records were obtained from the interview and dental examination. Nature of the study was explained with participant information sheet, and an informed consent of all participants was obtained. The inclusion criteria were no missing maxillary and mandibular teeth, no diastema, and no anterior restorations, 18 years old before enrollment in the study. The exclusion criteria were inability to meet the above requirements, pregnancy, and refusal to participate in the study. The inter-canine width (ICW), inter alar width (IAW), inter canthal distance (ICaD) and inter-commissural width (ICoW) of each participant were measured with a digital Vernier caliper (Mitutoyo, UK Ltd.,) (0.01 mm) three times and the average value was recorded. The inter canthal distance (ICaD) was measured without applying pressure by bringing the recording parts of the caliper just in contact with the medial angle. The inter alar width (IAW) was marked with a fine marked pencil on the widest outer surface of the alae of the nose on either side or width. Those two points were measured without applying pressure by bringing the recording parts of the caliper just in contact with the outer surface. The participant was told to stop breathing shortly to avoid any change in shape of the nose. The inter-commissural width (ICoW) was determined by measuring the maxillary lip vermilion from commissure to commissure without the application of pressure on the tissue in the relaxed state. The inter-canine width (ICW) was measured indirectly using a dental floss. A dental floss was marked on one end prior to placement in the mouth. Using that point as reference, the dental floss was circumference along the curvature of the anterior dentition such that it passed along the contact point of all the teeth. The distal end of the canine teeth on both sides was then marked on the floss while it was stretched in the patients mouth. Floss was marked on both sides with the marker pencil. The distance between the two proximal contact points was measured and recorded. Data, analysis and validation were performed by the SPSS software (version 22.0, IBM SPSS Statistics, Chicago, IL, USA). Unpaired t-test was used, of Kolmogorov-Smirnov test. Analysis of variance (ANOVA) test was used to test for comparability between socio-demographic characteristics dental measurements. Pearsons correlation coefficients test was calculated to determine the relationship between facial and dental parameters. Significance was set at P 0.01. Results: Of 314 participants enrolled, 202 were included. The age ranged from 18 to 68 years, with a mean age of 40.62 12.99 years. Although the Pearsons correlation coefficients were negative. Ninety-three participants (46%) were men and one hundred and nine (54%) were women. The overall mean age was 40.62 12.99 years. Facial and dental measurements were greater in women than men with significant differences for ICW (p = 0.04). However, no significant difference was seen between men and women for IAW, ICaD and ICoW (p = 0.44, p = 0.23, p = 0.31 respectively). The correlation including Pearsons correlation coefficient and P-values for all participants is not demonstrated. Conclusion: Within the limitations of this study, the results suggest that IAW, ICaD and ICoW cannot be used as a preliminary method for determining the width of the maxillary for anterior teeth for edentulous patients.

Comparison of Clinical Effect of PFNA and Internal Fixation with Anatomical Locking Plate of Proximal Femur in Treatment of Intertrochanteric Fracture of Femur

Purpose To investigate the clinical value of proximal femoral nail antirotation and anatomical locking plate of proximal femur in the treatment of intertrochanteric fracture of femur.Methods The study group is treated with PFNA internal fixation.The control group is treated by internal fixation with anatomical locking plate of proximal femur.Results The time of operation,the amount of intraoperative bleeding and the time of fracture healing in the study group are significantly less than those in the control group.The incidence rate of complication in the study group(3.23%)is significantly lower than that in the control group(17.2%).Data comparison shows P<0.05.Conclusion The curative effect and prognosis for patients with intertrochanteric fracture of femur treated by PFNA internal fixation are more ideal.

A novel dual-channel thermo-optic locking method for the whispering gallery mode microresonator

Mode locking can be effectively achieved by using the thermo-optic effects in the whispering gallery mode(WGM)optical microcavity,without the help of external equipment.Therefore,it has the advantages of small size,low integration costs,and self-locking,which shows great potential for application.However,the conventional single-channel microcavity thermal-locking method that relies solely on internal thermal balance will inevitably be disturbed by the external environment.This limitation affects the locking time and stability.Therefore,in this paper,we propose a new method for closed-loop thermal locking of a dual-channel microcavity.The thermal locking of the signal laser and the thermal regulation of the control laser are carried out respectively by synchronously drawing a dual-path tapered fiber.The theoretical model of the thermal dynamics of the dual-channel microcavity system is established,and the influence of the control-laser power on the thermal locking of the signal laser is confirmed.The deviation between the locking voltage of the signal laser and the set point value is used as a closed-loop feedback parameter to achieve long-term and highly stable mode locking of the signal laser.The results show that in the 2.63 h thermal-locking test,the locking stability is an order of magnitude higher than that of the single tapered fiber.This solution addresses the issue of thermal locking being disrupted by the external environment,and offers new possibilities for important applications such as spectroscopy and micro-optical sensor devices.

Inter-Row Spacing of PV Power Plant

When designing a solar power plant, it is much more important to avoid the shadow on the PV Panels. As the shadow falls on the PV Panels;it significantly reduces the generation of required power as planned and designed. This research paper and case study will help a lot to avoid shadow, especially when selecting inter-row spacing between the strings of solar power plants.

Treatment of a femoral neck fracture combined with ipsilateral femoral head and intertrochanteric fractures: A case report

BACKGROUND This article presents a rare case of a complex hip fracture involving the ipsilateral femoral neck,trochanter,and femoral head,that was accompanied by hip dislocation.Currently,there is no established standard treatment method for this specific type of fracture.Therefore,it is crucial to comprehensively consider factors such as patient age,fracture type,and degree of displacement to achieve a successful outcome.CASE SUMMARY A 38-year-old man sustained a comminuted fracture of his right hip as a result of a car accident.The injuries included a fracture of the femoral head,a fracture of the femoral neck,an intertrochanteric fracture of the femur,and a posterior dislocation of the hip on the same side.We opted for a treatment approach combining the use of a proximal femoral locking plate,cannulated screws,and Kirschner wires.Following the surgery,we developed an individualized rehabil-itation program to restore patient limb function.CONCLUSION For this complex fracture,we selected appropriate internal fixation and for-mulated individualized rehabilitation,which ultimately achieved good results.

Unlocking Cellular Mysteries:Advancements in Single-Cell Omics Analysis with Genome-Scale Metabolic Modeling

The widespread applications of single-cell technologies have generated a large amount of single-cell data,resulting in a growing need for single-cell data analysis and interpretation methods.While methods such as machine learning allow for single-cell data analysis,they cannot interpret the data very well.

Inter-Fraction Analysis of One Week Hypo-Fractionation of Deep Inspiration Breath Hold (DIBH) Technique for Left Sided Breast Cancer Radiation Treatment

The aim of this study was to investigate the inter-fraction variations, patient comfort and knowledge at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). The differences in set-up that occurred between treatment sessions for the left sided breast patients were observed and recorded. Measurements of routine set-up variation for 24 patients were performed by matching the cone beam computed tomography (CBCT) and the planning computed tomography (CT). Scans of all five fractions per patient were used to quantify the setup variations with standard deviation (SD) in all the three directions (anterior posterior, left right, and superior inferior). The patients DIBH comfort and knowledge was also evaluated. The average translational errors for the anterior posterior (AP, z), left-right (LR, x), and Superior-inferior (SI, y) directions were 0.40 cm, 0.40 cm, and 0.40 cm, respectively. The translation variation of the three directions showed statistical significance (P < 0.05). On comfort and knowledge investigation, among all participants, 80% moderately agreed that the therapist’s instructions for operating the deep inspiration breath hold (DIBH) technique were easy to understand, and 63.33% indicated that their comfort with the DIBH technique was neutral or average. The inter-fraction variations in patients with left-sided breast cancer were qualitatively analyzed. Significant shifts between CBCT and planning CT images were observed. The daily treatment verification could assist accurate dose delivery.

颈椎前路减压Inter Fix椎体间融合

目的 观察颈椎前路减压InterFix椎体间融合的稳定性及融合效果。方法 采用前路减压InterFix椎体间融合术治疗颈椎病及颈椎间盘突出症 2 7例 ,术后定期摄颈椎X线片检查 ,观察手术椎节的稳定性和融合情况。结果 随访 7～ 19个月 ,术后次日即下床活动 ,手术节段稳定 ,术后 3～ 4个月融合。结论 InterFix颈椎椎体间固定融合技术使施术椎节立即稳定 ,避免了自体植骨引起的并发症 ,可作为颈椎前路减压后椎体间融合的一种方法。

InterTAN治疗老年股骨转子间骨折疗效的影响因素分析

目的：探讨多因素对于Inter TAN治疗老年股骨转子间骨折疗效的影响,为其合理治疗提供临床依据。方法：回顾分析2010年4月至2012年10月期间收治的老年股骨转子间骨折115例。回顾期间的5个相关影响因素：致病原因、年龄、骨折类型、手术时机、术后康复。采用Harris评分及患者满意度评价术后疗效。首先进行单因素分析。计数资料、等级分组资料采用χ2检验,将单因素分析后P〈0.05的因素进行Logistic回归分析。结果：随访6~36个月[平均（12.2±4.6）个月]。末次Harris功能评分：52~98分,平均（73.6±10.4）分,依据评判标准结果：优72例,良28例,一般15例,差0例,优良率86.95%。单因素分析,术后疗效不受年龄、致病原因影响。Logistic回归分析：骨折类型系数值=-1.508,P=0.003;手术时机系数值=-1.419,P=0.009;术后康复系数值1.351,P=0.000。结论：股骨转子间骨折使用Inter TAN治疗,临床疗效满意。建议尽早行手术治疗,并进行术后康复锻炼。

Inter Tan、PFNA在治疗老年股骨粗隆间骨折加压作用的对比研究

目的比较Inter Tan和PFNA两种方法治疗老年股骨粗隆间骨折加压固定后的加压效果。方法 59例老年股骨粗隆间骨折患者随机分为2组,分别给予Inter Tan(n=39例)和PFNA(n=20例)治疗,X线随访2组患者术前、术后即时、术后4周和术后24周时骨折分离距离。结果 Inter Tan和PFNA两种方法治疗患者术前、术后即时和术后24周时骨折分离距离差异均无统计学意义(P>0.05),但是在术后4周时发现PFNA组有20.0%患者有骨折线增宽表现,而Inter Tan组仅为5.1%,组间比较差异有统计学意义(P<0.05)。结论 Inter Tan固定系统由于具有双螺钉交锁加压作用,在粗隆间骨折患者骨折复位后二次加压及持续维持加压作用方面,优于PFNA固定系统。

防旋髓内钉和InterTan固定A3型股骨转子间骨折：生物力学变化的有限元分析

背景:股骨转子间骨折是髋部常见骨折之一,伴随着老年骨质疏松以及高能量伤,骨折线常常下移导致A3型股骨转子间骨折,治疗困难。常见的髓内固定包括股骨近端防旋髓内钉和Inter Tan等,由于其具有较高的稳定性和微创性,得到了广泛的应用。目的:通过有限元分析的方法比较股骨近端防旋髓内钉和InterT an修复股骨转子间A3型骨折的生物力学稳定性。方法:分别建立AO3.1,3.2,3.3型股骨转子间骨折及股骨近端防旋髓内钉和InterT an两种内固定的三维有限元模型,按骨科要求予以固定,观察不同模型股骨、内固定的应力分布,比较股骨及内固定模型不同区域的应力峰值,分析其生物力学稳定性。结果与结论:AO3.1型骨折股骨近端防旋髓内钉组股骨侧应力集中在股骨近端外侧,InterT an组股骨侧应力集中在股骨近端内侧;AO3.2型骨折两种内固定系统股骨侧各个区域均无明显应力集中;AO3.3型骨折股骨近端防旋髓内钉组股骨侧应力集中在股骨近端内侧及内固定远端内侧,InterT an组股骨侧无明显应力集中。6种模型内固定远端应力均集中在内侧,其中股骨近端防旋髓内钉组应力大于InterT an组;内固定远端内外侧应力差值股骨近端防旋髓内钉组大于InterT an组;除股骨近端防旋髓内钉固定AO3.3型骨折外,其余5种模型应力峰值均位于头钉与主钉交叉处内侧。提示AO3.1和AO3.3型骨折中,InterT an比股骨近端防旋髓内钉具有更好的稳定性,AO3.2型骨折中,二者稳定性无明显差异;采用InterT an修复股骨转子间骨折时股骨端应力分布更加合理。

Inter Tan系统治疗老年股骨转子间骨折19例

据统计,1990年全球与骨质疏松有关的股骨近端骨折患者约166万,预计2050年可能达到626万,69岁以上老年患者髋部骨折病死率高,其中股骨转子间骨折死亡率约15%～20%〔1〕。为了尽量减少老年患者保守治疗并发症的发生,老年转子间骨折临床上首选内固定治疗,可供选择的内固定方法很多〔2,3〕,但由于老年人骨质的特殊性,现有的内固定器材都很难满足老年患者股骨转子间骨折的治疗需求。新一代股骨近端顺行联合拉力交锁髓内（Inter Tan）系统的问世,给老年股骨转子间骨折的治疗提供了新的途径。本文就应用Inter Tan系统治疗老年股骨转子间骨折进行临床分析。

Genetic relationship of interspecies for eight birch species

Genetic relationships of eight species of genus Betula were evaluated using ISSR marks. A total of 236 loci were generated from 17 ISSR primers. Percentage of polymorphic bands (PPB) varied from 5.93 to 19.92. The highest and the lowest level of genetic differentiation were detected in B. ovalifolia and B. maximowicziana Regel respectively. In these eight species, genetic diversity of birch (HT) was 24.38 %, and the genetic variation (GST ) interspecies was accounting for 79.36% of total genetic variation. According to the cluster results of genetic distance, the eight species were classified into three groups as B. davurica, B. ovalifolia, B. platyphylla and B. pendula for one group; B. schmidtii, B. costata and B. ermanii Cham. var. communis for one group, and B. maximowicziana Regel for another group. The result of cluster is consistent with traditional morphological classification.