Search

Elastic stable intramedullary nailing (ESIN) is used routinely world-wide for treating femoral and tibial shaft fractures in children before skeletal maturity. Overall, ESIN allows rapid limb mobilisation with few complications. However, many centres have experienced some complications resulting from secondary fracture displacement, especially in heavy adolescents and in spiroid or complex fractures due to changes in the nail’s position, leading to limb shortening, malrotation and malalignment. End caps were designed by the AO expert group to address these complications. The purpose of this study is to evaluate the efficiency, safety and tolerance of this new device in our first series of ten patients and 11 fractures. Prospective follow-up of our first ten patients operated on with end caps. Our results show that there were no serious complications at a mean follow-up of 13.1 months. There was only one 10-mm leg shortening in a patient in whom the end caps could not be properly inserted. There were no infections, no additional pain and no skin irritation. The use of end caps eased the removal of the nails after bone healing, thereby preventing the formation of ossification over the tips of the nails and appeared to protect the skin next to the nail tip. These results seem to prove the advantage of using end caps when performing ESIN in lower limb shaft fractures in children. A longer follow-up that includes more patients and a randomised prospective study should be carried out in the future to determine more precisely the indications of this new device. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to investigate late effects following stereotactic single fraction and small volume irradiation on cerebral blood flow and histologic alterations in the rat brain parenchyma.Material and Methods: 66 Copenhagen rats, separated into eleven groups of six animals each received single doses of 20, 30, 40, 50 and 100 Gy using a 15 MV linear accelerator. Six rats served as controls. Two cylindrical collimators of 2 mm and 3 mm aperture were used. The diameters of the spherical 80% isodose were 3.7 and 4.7 mm, respectively (Table 1). Irradiation was applied to a predefined area in the right frontal lobe. 19 months after irradiation local cerebral blood flow (LCBF) was measured by the autoradiographic method in one animal of each dose group between 20 and 50 Gy. 9 and 19 months after irradiation, half of the animals of each group were sacrificed for brain histology. All animals irradiated with 100 Gy were sacrificed 7 months after irradiation.Results: An increase of local cerebral blood flow was measured in brain structures within the 80% isodose in animals irradiated with 50 Gy (Figure 3) compared to the contralateral hemisphere. Measurements close to necrotic areas showed a strong decrease of local cerebral blood flow (Figure 1). A volume increase of the irradiated hemisphere was seen after 19 months (Figure 2). The histologic examination after 19 months showed necrotic areas in the 30-50 Gy groups (Figure 4b) but not in the 20 Gy groups (Figure 4c). The animals who received 100 Gy demonstrated brain necrosis within 9 months after irradiation (Figure 4a). At both points in time the groups irradiated with the 3-mm collimator showed more pronounced histomorphologic and functional changes compared to the groups irradiated with the 2-mm collimator.Conclusion: Alterations of the local cerebral blood flow were measured as a late effect after single dose irradiation. The alterations of the local cerebral blood flow could be explained by the histomorphologic changes of the blood vessels. Using a semi-quantitative classification a dose, time and volume dependence for the endpoint radionecrosis was seen. [ABSTRACT FROM AUTHOR]

Copyright of Strahlentherapie und Onkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Strasbourg Fractomed brace is a TLSO used since 1980 for the treatment of flexible scoliosis of the adolescent. This brace is made with an original material: Polyvinyl alcohol. This porous foam, rigid at room temperature, is moldable with steam, a property which allows one to mold the brace directly on the patient, without a plaster mold. Making a Strasbourg brace is rapid, and no specific equipment is required, so that this brace can be realized in a hospital cast room. Reduction of the scoliosis is adapted from the EDF technique, achieved supine on a traction table. After initial hardening of the brace, modifications or additional corrections can be made, since the properties of the material persist, whatever the number of moldings. The Strasbourg brace is efficient for the treatment of 15° to 35° curves, with a residual flexibility of more than 50%, and an apex not located above T7. Le corset Fractomed de Strasbourg est une orthèse thoracolombo-sacrée courte utilisée depuis 1980 pour le traitement des scolioses souples de l'adolescent. Son originalité réside dans le matériau utilisé pour sa fabrication, le Polyvinyle alcool. Ce matériau est une mousse poreuse rigide à température ambiante et modelable à la vapeur d'eau, ce qui permet de réaliser le corset directement sur le patient, sans passer par l'intermédiaire d'un positif plâtré. La confection du corset est très rapide et ne nécessite aucun équipement particulier, ce qui rend sa fabrication possible en service hospitalier, sans intervenant extérieur. La réduction de la scoliose est effectuée selon les principes de la technique EDF, en décubitus sur table d'élongation. Après durcissement initial, des retouches ou compléments de correction peuvent être effectués si nécessaire, les propriétés du matériau persistant quelque soit le nombre de ramollissements effectués. Ce corset est efficace pour le traitement des scolioses de 15° à 35°, gardant une réductibilité de plus de 50% aux bendings, et dont le sommet n'est pas situé au-dessus de T7. [ABSTRACT FROM AUTHOR]

A new treatment planning program was developed for the heavy-ion therapy facility at GSI. In addition, a concise quality standard for treatment planning has been set up. It covers acceptance and constancy checks of all critical aspects in treatment planning. Dose verification measurements done during the commissioning phase show an overall good agreement with the treatment planning calculations. [ABSTRACT FROM AUTHOR]

In the present stage between the technological realization and the clinical phase, quality management gains a predominant role at the heavy ion therapy facility at GSI. Specific quality inspection procedures had to be developed for the subsequent parts of the beam delivery system, the treatment planning, the raster scanning device, the patient positioning, the dose verification and the safety interlock system. In the meantime the acceptance test of the whole facility has been carried out and an overview about our first experience with quality assurance procedures at the heavy ion irradiation facility is given, with a special emphasis on the medical physics part. [ABSTRACT FROM AUTHOR]