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Introduction: As operative techniques and the quality of implants are improving, surgical management of diaphyseal fractures of forearm bones in elderly patients is gaining widespread acceptance. A combination of a better understanding of the fractures, preoperative antibiotics, properly designed newer implants, minimal soft tissue handling techniques, and C-Arm guidance have made surgical fixation practical and safe while treating these fractures. Titanium elastic nailing system (TENS) provides flexural, axial, translational, and adequate amounts of rotational stability. Aim and objectives: The treatment of diaphyseal forearm bone fracture with TENS nail aims to regain length, axial, and adequate rotational stability without extensive soft tissue injury, neurovascular compromise, and periosteal stripping. Objective of this study is to analyze the demographic distribution, union rates, functional outcomes, cosmetic outcomes, complications, and functional rehabilitation of the upper limb. Methods: Elderly patients admitted to the Department of Orthopedics at SRG Hospital and Medical College, Jhalawar with BBFA diaphyseal fractures during the period from JUNE 2019 TO MAY 2023 were selected and evaluated clinically and radiologically. We followed all those patients for an average of 6 months. The outcome was assessed using the Grace-Eversmann scoring system. We followed up with all 25 patients and evaluated them every 2 weeks until the fracture unites. Results: Our study consisted of 25 patients, 14 males, and 11 females. The mean age of distribution was 65 years. The average time to bone union was 12 (8–20) weeks, and the average surgery time was 35 (15–60) minutes. There was a superficial infection in 1 case. No one had a deep infection, mal-union, non-union, fracture, nail migration, compartment syndrome, nerve palsy, synostosis, or rupture of any tendon. Most patients had a full range of Elbow and Wrist Movements after the union. Conclusion: Based on our experience and results, we conclude that the titanium elastic nailing technique is a better method for the treatment of displaced BBFA diaphyseal fractures in elderly patients also. It is easy, cheap, convenient, and gives elastic mobility promoting a rapid union of fractures and stability which is ideal for early mobilization. It provides a lower complication rate, shorter surgery time, good cosmetic outcome, and easy implant removal when compared to other methods of treatment.

Background The 3-point shot plays a significant and pivotal role in the historical context of basketball competitions. Visual attention exerts a crucial influence on the shooting performance of basketball players. This study aims to investigate the eye movement characteristics exhibited by high-level basketball players while executing 3-point shot at varying exercise intensities, as well as explore the correlation between these eye movement characteristics and 3-point field goal percentage. Methods A total of twenty highly skilled female basketball players were recruited as participants for this study. During the experiment, the participants wore an eye tracker to record their eye movement data while executing 3-point shot at varying exercise intensities (low, moderate, and high). The collected eye movement data was analyzed using Tobii Pro Lab software. Additionally, the participants’ exercise intensity was monitored by wearing Polar Team Pro sensors. Results The average number of fixations during the execution of a 3-point shot at three exercise intensities exhibited statistically significant differences in the front, bottom, top left, and bottom right. Moreover, notable disparities were observed in the average fixation duration for the front, bottom, and bottom right. The average total number of fixations and fixation duration in the moderate intensity shot were comparatively lower than those observed in the low and high intensity shots, while the average number of fixations and percentage of fixation duration on the front were relatively higher compared to those in the low and high intensity shots. Under varying intensities, there were no significant differences observed in the average number of fixations and the 3-point field goal percentage each AOI; however, a significantly positive correlation was found between the front average fixation duration and the 3-point field goal percentage. Conclusion During the execution of a moderate intensity 3-point shot, the player’s fixation is focused and stable, their information search strategy is efficient, and their information processing is precise. Variations in exercise intensity result in changes to both the information search strategy and degree of processing. Fixating on the front has a positive impact on 3-point field goal percentage.

Background: Inguinal hernia is one of the most common surgical problems in the world, with a high risk in men. The treatment modalities have evolved from open to laparoscopic procedures. Laparoscopic procedures are getting attention and widespread utilization among surgeons. The choice between the two procedures is still a debate between the surgeons. This study aims to compare the transabdominal pre-peritoneal approach to the totally extraperitoneal approach in its perioperative outcomes. Materials and Methods: A prospective analytical study was conducted on 86 adult patients, who underwent laparoscopic inguinal hernia reduction between June 2022 to June 2023 at Nobel Medical College Teaching Hospital in Biratnagar, Nepal. The patients were randomized into two groups of 43 participants each and were analyzed on different variables. Results: All of the 86 patients included in the study were male. Among them, 30.23% of patients had direct inguinal hernia. There were 12.79% of patients with bilateral hernias. There was a statistically significant difference in the duration of operation among the patients undergoing totally extraperitoneal and transabdominal preperitoneal hernia repair. Total duration of hospital stay was shorter in totally extraperitonealand postoperative pain was slightly lesser in totally extraperitoneal procedure. The intraoperative and postoperative complications among totally extraperitoneal and transabdominal preperitoneal hernia repair were comparable. There was no conversion to open procedure or recurrence of hernia during the study period. The return to daily life took longer in the transabdominal preperitoneal procedure than in the totally extraperitoneal hernia repair. Conclusion: Totally extraperitoneal hernia repairhas an advantage over transabdominal preperitoneal hernia repairin terms of shorter operative time, postoperative pain, duration of hospital stays, and return to daily life.

Human eye fixation is steadily interrupted by small, physiological or abnormal, eye movements. Square-wave jerks (SWJ) are the most common saccadic intrusion which can be readily seen at the bedside and also quantified using oculographic techniques. Various neurological, neuropsychiatric and psychiatric disorders display abnormal fixational eye movement patterns characterized by frequent SWJ. For the clinician, SWJ are particularly important because they can be readily observed at the bedside. Here, we will discuss the pathological conditions that present with SWJ and explore the expanding body of literature suggesting that SWJ may serve as a potential indicator for various clinical conditions.

Introduction:To define the characteristics of infantile esotropia and evaluate the results of bilateral medial rectus recession in infantile esotropia.Methods:A retrospective review was performed on medical charts of patients diagnosed with infantile esotropia. All patients underwent an ophthalmological examination to detect the conditions that accompany infantile esotropia. Patients with two years of age or older and without fixation preference or amblyopia underwent bilateral medial rectus recession.Results:There were a total of 117 patients with infantile esotropia patients. Infantile esotropia was accompanied by inferior oblique hyperfunction, fixation preference, cross-fixation, pseudoabduction deficit, pattern deviations, nystagmus, dissociated vertical deviation, convergence insufficiency, and abnormal head position. Approximately forty percent of the patients compatible with visual acuity measurements had amblyopia. Bilateral medial rectus recession decreased the mean esotropia from 43.1±15.3 to 7.8±12.8 prism diopters (PD) in 65 patients. Postoperatively, 41 patients had an ocular alignment within 10 PD of orthotropia, 22 patients showed undercorrection and 2 overcorrection.Conclusion:The characteristics of infantile esotropia in our study are substantially consistent with those of early reports, except for convergence insufficiency. This study also showed that bilateral medial rectus recession appears to have a high percentage of undercorrection in short-term postoperative follow-up in infantile esotropia.

Background: In routine histopathology, 10% neutral buffered formalin (NBF) is the choice fixative. However, formalin is a human carcinogen, so there is a necessity for a safer alternative. To the best of our knowledge, neutral honey, not natural or artificial honey, has not been tested to fix histological samples. This study determined the effectiveness of neutral buffered honey and other types of fixatives to fix histological tissues. Methods: The study was conducted between July 2019 and August 2020 at Sultan Qaboos University, Oman. Sections from three rat livers, kidneys, and stomach tissues were fixed with 10% NBF, neutral buffered Sumer honey, neutral buffered date honey, formalin, Sumer honey, date honey, alcoholic formalin, alcoholic Sumer honey, and alcoholic date honey for 24 hours. Samples were stained with hematoxylin and eosin (H&E), special stains, and vimentin methods. Three expert biomedical scientists then evaluated the fixed and stained samples for the quality of all sections. The fixation ability of the different honey solutions was then compared to 10% NBF and the utility was determined using nuclear and cytoplasmic criteria, specificity, and intensity. Results: H&E showed adequate staining in all groups compared to 10% NBF. The specificity and intensity of all groups for the Periodic acid–Schiff method were identical to 10% NBF except for Sumer honey and alcoholic date honey. Vimentin showed comparable findings with 10% NBF as there were no significant differences. Conclusions: The findings of this study encourage the use of honey, including neutral, as a possible safe substitute fixative for formalin, however, further experiments on larger specimens should be conducted.

The aim of the present study was to compare the clinical outcomes of volar plate screw fixation with the K-wire fixation with external fixator applied with closed technique in instable distal radius fractures extending to the joint in elderly patients. The study included 60 patients who were treated for AO type C distal radius fracture in our clinic between January 2016 and January 2019. The patients were divided into two groups: Group External fixator (EF) with 30 patients who underwent multiple K-wires using closed technique and Group Volar Plate (VP) with 30 patients who underwent volar plate and screw fixation using open technique. Wrist range of motion (ROM), disabilities of the arm, shoulder and hand (DASH) score and grip strength values, radiologic parameters were compared between groups. After 12 months of follow-up, there was no significant difference in DASH score and grip strength values between the two groups (p = 0.263 and 0.085, respectively). The mean duration of surgery was found to be shorter in the EF group (p < 0.001). There was no significant difference between radiologic parameters. Significantly fewer fluoroscopy applications were needed in the VP group than in the EF group (p < 0.001). Both VP and EF treatments had similar functional outcomes in patients over 65 years of age. Considering its shorter duration of surgery and less invasive nature, EF treatment was concluded to be more applicable in patients over 65 years of age. [Med-Science 2022; 11(1.000): 81-4]

A chemical regularly used to image cells can dramatically alter the way cellular compartments called condensates look under the microscope.

Fixing cells with paraformaldehyde (PFA) is an essential step in numerous biological techniques as it is thought to preserve a snapshot of biomolecular transactions in living cells. Fixed-cell imaging techniques such as immunofluorescence have been widely used to detect liquid–liquid phase separation (LLPS) in vivo. Here, we compared images, before and after fixation, of cells expressing intrinsically disordered proteins that are able to undergo LLPS. Surprisingly, we found that PFA fixation can both enhance and diminish putative LLPS behaviors. For specific proteins, fixation can even cause their droplet-like puncta to artificially appear in cells that do not have any detectable puncta in the live condition. Fixing cells in the presence of glycine, a molecule that modulates fixation rates, can reverse the fixation effect from enhancing to diminishing LLPS appearance. We further established a kinetic model of fixation in the context of dynamic protein–protein interactions. Simulations based on the model suggest that protein localization in fixed cells depends on an intricate balance of protein–protein interaction dynamics, the overall rate of fixation, and notably, the difference between fixation rates of different proteins. Consistent with simulations, live-cell single-molecule imaging experiments showed that a fast overall rate of fixation relative to protein–protein interaction dynamics can minimize fixation artifacts. Our work reveals that PFA fixation changes the appearance of LLPS from living cells, presents a caveat in studying LLPS using fixation-based methods, and suggests a mechanism underlying the fixation artifact.

Introduction: Subarachnoid block remains the anaesthesia modality of choice for surgical fixation of femur. Extreme fracture pain makes ideal positioning for spinal anaesthesia difficult. Preoperative continuous femoral block can provide analgesia for such patients. Aim: To evaluate the effect of continuous femoral nerve block in ease of administration of spinal anaesthesia for fracture neck of femur stabilisation. Materials and Methods: This was a prospective case-control study conducted at the Government Medical College, Kozhikode, Kerala, India, from September 2020 to September 2021. Total of 86 adult patients posted for fracture femur neck stabilisation were selected and divided into two groups- group 1 and group 2. Patients in group 1, were administered ultrasound guided continuous femoral nerve block with 0.2% ropivacaine (15 mL) followed by subarachnoid block and group 2 patients were administered subarachnoid block without prior femoral nerve block. Parameters observed included were Visual Analogue Score (VAS) score while positioning for spinal anaesthesia, ease of palpating interspinous space, time required to perform spinal anaesthesia, number of attempts required to achieve dural puncture, patient satisfaction score as well as haemodynamic and respiratory changes while positioning for subarachnoid block. Statistical analysis was done using IBM SPSS (Statistical Package for the Social Sciences) Statistics for Windows, version 20.0. Results: Group 1 patients had significantly lower VAS scores while positioning for spinal anaesthesia (4.2±1.8 in group 1 as compared to 6.3±1.2 in group 2, p-value=0.001). There was a significant difference in the number of attempts required for dural puncture (1.3±0.4 in group 1 as compared to 1.8±0.6 in group 2, p-value=0.04) and total performance time for spinal anaesthesia (2.2±0.4 min in group 1 as compared to 3.3±0.9 minutes in group 2, p-value=0.02) between two groups. Patient satisfaction scores were significantly higher in group 1 compared to group 2 (9.3±0.6 in group 1 as compared to 6.5±0.5, p-value

Introduction: The most prominent transformation in the treatment of fractures has been modified from intensive open reduction and internal fixation with absolute stability to the biological fixation with relative stability and secondary healing with callus formation, with priority on preservation of the vascularity of bone and soft tissue to improve fracture healing. Aim: To evaluate the outcome of biological fixation of extra-articular proximal tibia fractures in adults using the locking compression plate. Materials and Methods: The present prospective longitudinal study was conducted at Government Medical College and Hospital, Nagpur, which included 30 patients who had extraarticular proximal tibia fractures belonging to AO type 41A2 and 41A3 treated by proximal tibia lateral locking plate 4.5/5.0 mm. The patients were followed-up at two weeks, six weeks, three months, six months and one year. The fracture union, coronal, sagittal alignment was assessed radiologically at the end of follow-up. Functionally the outcome was evaluated using lower extremity functional score. Descriptive statistics were used for statistical analysis. Results: Biological plating with locking compression plate has shown promising results both in terms of function and radiology. There was non-significant difference in lower extremity functional score between patients with malunion and normal alignment. Mean union time was 19.93 weeks with a standard deviation of 2.21 weeks. There was non-significant difference between the range of motion and fracture type (p-value 0.38) as well as that between Lower Extremity Functional Score (LEFS) and fracture type (p-value 0.0501). On functional evaluation of patients treated with biological plating, there was statistical significance in Knee Range of Motion (ROM) for the patients between malunion and normal alignment (p value 0.01). Conclusion: The biological fixation using minimally invasive techniques is an effective method of stabilisation for extra-articular proximal tibia fracture, yielding good mechanical alignment and protecting soft tissues and blood supply, leading to higher union rates with good functional outcome.

Objectives:Fixation preference testing is widely used to detect amblyopia, particularly in preverbal children. Pattern electroretinogram (pERG) is an electrophysiological test which is a sensitive indicator of macular function. The aim of this study was to investigate the relationship between fixation preference and macular function on pERG in children with strabismus.Materials and Methods:The study included 11 children with strabismus. All underwent ophthalmological examination including fixation preference by binocular fixation pattern test, best corrected visual acuity (BCVA) assessment, and pERG.Results:The mean age of the patients was 10.09±1.18 years. All patients had unilateral fixation. The mean BCVA was 0.85±0.17 in preferred and 0.48±0.19 in non-preferred eyes (p=0.003). The mean p50 amplitude was 6.07±2.06 μV in preferred and 5.29±2.20 μV in non-preferred eyes (p=0.203), and the mean N95 amplitude was 8.27±2.86 μV and 8.03±3.24 μV respectively (p=0.594). BCVA was correlated with p50 and N95 amplitudes in the non-preferred eyes (p=0.023 and p=0.014). Interocular BCVA difference was correlated with interocular P50 amplitude difference (r=0.688, p=0.019).Conclusion:Although amblyopia is typically considered a cortical phenomenon, future larger studies are needed to investigate the relationship between fixation preference and macular electrophysiological function.

The problem of fixing removable plate prostheses remains the most urgent in orthopedic dentistry. Polyamide prostheses (Vertex, Deflex) are widely used in practical dentistry. A significant disadvantage of polyamide dentures is the transfer of a chewing load to the gingival mucosa and the alveolar ridge, which provokes the development of atrophy of the alveolar process of the jaws after some time of their use. We have proposed a method for fixing removable polyamide plate prostheses, which eliminates the gap between the base of the orthopedic structure and the atrophied mucous membrane of the oral cavity. We introduced our proposed method of fixing removable plate prostheses based on the use of an elastic substrate made of A-silicone “Ufi Gel P”. Initially, it was proposed to improve the fixation of acrylic dentures, but when applied similarly to polyamide dentures, there is no strong connection. In order to use this elastic pad in polyamide prostheses, we conducted a laboratory and clinical test, which consisted in the use of an elastic substrate made of A-silicone «Ufi Gel P» applied to the base of the polyamide prosthesis pre-treated with liquid for repairing flexible prostheses Vertex Thermo Fusing Liquid. Vertex Thermo Fusing Liquid is a universal liquid and is suitable for polyamide (nylon) prostheses of any manufacturer. During the preparation of the prosthesis for relocation, the method of etching is used not by gluing, thanks to the fluid the surface layer of nylon softens and, as a result, microretention is formed. The results of the study of patients’ subjective assessment of the effectiveness of the treatment clearly demonstrate the advantages of partial removable prostheses made of thermoplastic materials and relocation by our improved method of fixing removable plate prostheses in comparison with partial removable prostheses made of acrylic plastics. The study took into account such subjective criteria as «habituation», «absence of food under the prosthesis», «stability of the prosthesis when chewing». Patients of the first clinical group noted that they quickly got used to the use of new types of prostheses, emphasizing the ease of removal and installation of prostheses.

Glaucoma represents a chronic eye disease that becomes increasingly prevalent worldwide. Therapies are commonly based on the reduction of intraocular pressure (IOP). Implant devices for micro-invasive glaucoma surgery (MIGS) represent a promising therapy option in refractory cases but suffer from limitations in long term efficacy or from dislocation associated complications. Our approach of an innovative drug-eluting glaucoma microstent for MIGS was presented previously. Within the current work we developed concepts and prototypes of a mechanism for the fixation of our glaucoma microstent in the region of the corneal limbus. A tripod and a haptics design of the fixation mechanism were developed and manufactured. Semifinished products were tested with regard to dimensional stability and mechanical properties according to the standard ANSI Z80.27-2014. Considering the mechanical properties of ocular target tissues, a gelatin based in vitro model for the measurement of microstent retention force was developed. Retention force testing of microstent prototypes in vitro resulted in a proof of concept for the fixation mechanism. Future studies will focus on the use of smaller fixation fibers, for example commercially available suture material, and on an overall miniaturization of the fixation mechanism enabling the use of our applicator device with a 22G x 1½” cannula.

Pediatric femoral neck fracture is rare and account for less than 1% of all fractures in childhood. The proximal femur in children is extremely strong, and high-energy forces in 80-90%, following the axial force associated with hip rotation or direct blow are necessary to cause fracture. In this report, the method of femoral neck fracture fixation in eight-year-old girl after car accident is reported. During the operation, we noted a severe femoral neck fracture that was irreparable with the available tools (pin, screw, plate and DHS), which inevitably had to be used by Transosseous method with fiber wire #2, used in proximal humeral fracture fixation. Then, we obtained a fairly satisfactory result with a distal femoral pin inserting it into two-sided spica cast. Although, this kind of fracture is rare, but with a qualified clinical examination, early diagnosis, proper treatment, familiarity with surgical techniques and fixation reduces the complications and this method can be effective in obtaining the desired result.

Preservation and restoration of dental health of patients is achieved by early detection and treatment of diseases, finding ways of individual prevention, detection and elimination of risk factors for their development. The amount of materials significantly increased used to restore the integrity of teeth and dentition. Among them are dental materials for permanent fixation of indirect non-removable restorations. The material is used to fill the space between the inner surface of the artificial structure and the support element. This helps to mechanically fix the restoration in place to prevent its displacement during chewing. The correct choice of dental material for permanent fixation is an important decision and will determine the long-term success of permanent restorations. The aim of the study is to analyze the durability using non-removable structures of dentures mounted on different glass ionomer cements.

Introduction. Flail chest can become life-threatening when accompanied by other complications of thoracic trauma. Current hospital flail chest management includes mechanical ventilation and pain control. Although mechanical ventilation management is constantly improving, prolonged intubation and intensive care lead to increased morbidity. Surgical fixation is gaining more ground against non-operative care and authors have reported better outcome and fewer complications in restricted retrospective studies, but a consensus still has to be reached regarding the guidelines for surgical fixation. In this article, we wish to present our perspective on the surgical fixation of flail chest. Materials and Method. A 39-year-old patient, known with chest trauma after a car accident for which he had undergone surgical treatment at another department, was admitted to our unit for chest instability and chronic pain. During the clinical examination of the left hemithorax, we noticed chest wall instability at the posterior arches of the 8th, 9th and 10th left ribs. CT scans of the thorax showed approximation of the ribs on the anterior fracture line and multiple displaced rib fractures, without callus formation, on the posterior fracture line. Results. The 5th to 10th left ribs were cleared of fibrotic tissue, re-approximated and repositioned using matrix RIB titanium plates and screws. After surgery, the patient was kept in the intensive care unit for two days and was discharged after another seven days. Postoperative pain was managed with opioid therapy. Conclusions. The debate regarding the operative management vs. the non-operative management of flail chest is ongoing given the relatively small number of patients included in the existing randomizedcontrolled trials. Osteosynthesis with plates and screws is easy to manage and we recommend the use of operative treatment of flail chest in patients who can withstand thoracic procedures.

Study Design This was a prospective study of 50 patients of thoracolumbar fracture dislocation treated at a single institution with short-segment fixation with the inclusion of fracture level. Purpose To assess the outcomes of including the fracture level in short-segment fixation for thoracolumbar fracture dislocation. Overview of Literature Traditionally, thoracolumbar fracture dislocation is treated with long-segment posterior fixation. However, to save motion segments, short-segment fixation has been used instead in many cases of thoracolumbar trauma. Methods In this study, 50 patients with thoracolumbar fracture dislocation were treated with short-segment fixation with inclusion of the fracture level; patients with pathological fractures or with a McCormack load-sharing score >6 were excluded. The 50 patients were prospectively followed for at least 1 year. The duration of surgery, blood loss, and complications were noted. The Visual Analog Scale (VAS) score was used to measure pain, and the American Spinal Injury Association (ASIA) scale was used to determine the neurological status at follow-up. Preoperative, immediate postoperative, and final follow-up X-rays were used to measure the kyphotic angle using Cobb’s method. Results The mean age of our patients was 33.4 years, and the male:female ratio was 1.9:1. The mean follow-up period was 18.4 months (range, 12–23 months). Injuries were mainly at the thoracolumbar junction area (T11–L2, 41 cases, 82%). The average duration of surgery was 94.6 minutes, and the average blood loss was 394.8 mL. Postoperative infection occurred in two cases and implant failure in one case. The kyphosis angle values were as follows: average preoperative, 26.80°±14.50°; immediate postoperative, 4.30°±8.70°; and final follow-up, 5.50°±110°. The ASIA scale and VAS score at final follow-up showed improvement. Conclusions Inclusion of the fracture level in short-segment fixation for thoracolumbar fracture dislocation (McCormack load-sharing score ≤6) gives good kyphosis correction and correction maintenance. It can also obviate the need for traditional long-segment fixation.

Background Microplates have thin diameter making them less palpable, more malleable, easily applied, and adaptable to fracture site. In the past, microplates were used in midface fractures only, but we can obtain their benefits in mandibular fractures as well. Objective The aim of this systematic review was to verify the efficiency of microplates either alone or in combination with miniplates for fixation of mandibular fractures in comparison with miniplates. Materials and methods A systematic review was conducted using electronic databases for collecting articles that met the inclusion and exclusion criteria. Data were extracted from each article, and the quality of studies was assessed by Jadad scale. Four articles were selected that met the inclusion and exclusion criteria. Conclusion Microplates have high holding power and were efficacious for internal fixation of simple, minimally displaced, isolated mandibular fractures, but to support this information safely, numerous future studies with sound method and larger sample size are needed to evaluate their use in the other forms of mandibular fractures.

Objective: We systematically reviewed the literature and pooled data for a meta-analysis to compare the efficacy and safety of mesh fixation and nonfixation in laparoscopic total extraperitoneal (TEP) hernia repair. Materials and Methods: We performed a systematic search of PubMed® and a Cochrane review for all randomized controlled trials that compared the efficacy and complications of mesh fixation versus nonfixation in TEP hernia repair. The evaluated outcomes included perioperative (operative time and conversion rate) and postoperative parameters (pain scores, duration of hospital stay, surgical complications including seroma, delayed return of bladder function, chronic pain, and recurrence). Cochrane Collaboration Review Manager Software (RevMan®, version 5.2.6) was used for statistical analysis. Results: Ten trials met the inclusion criteria and were included in a pooled analysis. In total, 1099 patients (1467 hernias) had received TEP hernia repair (748 and 719 hernia defects in the nonfixation and fixation groups, respectively). The nonfixation group required shorter operative time (weighted mean difference [WMD] = −2.36 min, P= 0.0006) and had less pain on postoperative day 1 (WMD = −0.44, P= 0.04) than the fixation group. No significant differences were observed between groups with regard to conversion rate, hospital stay, recurrence rate, or complication rate. However, the incidence of postoperative urine retention was higher in the fixation group (odds ratio = 0.26, P= 0.03). Conclusion: For patients with a nonrecurrent uncomplicated hernia defect with the size

INTRODUCTION[|]In this study, it was compared the clinical results of the Bosworth technique and hook plating in acromioclavicular (AC) dislocations.[¤]METHODS[|]44 patients are retrospectively evaluated in this study whom diagnosed as type III AC dislocations and treated by two different surgical methods in two different clinics. The patients were 30 males and 14 females with a mean age of 44 years (range, 18–80 years). The patients were divided into 2 groups according to the applied surgical technique. Group I comprised 25 patients to whom coracoclavicular fixation was applied by using the Bosworth technique. Group II comprised 19 patients to whom acromioclavicular fixation was applied by using hook plate. All patients are evaulated by The University of California at Los Angeles Shoulder Score (UCLA) and The disabilities of the arm, shoulder and hand (DASH) scoring system.[¤]RESULTS[|]The mean follow-up period was 23 months (range, 12–42 months). A statistically significant diffference was determined between the surgical groups in respect of the modified UCLA scale (p=0.012) and Quick DASH score (p=0.008). Hook plating group had better clinical results according to Bosworth group in terms of both UCLA and DASH score. A statistically highly significant negative correlation was determined between the UCLA and DASH scores (r=0.677, p=0.000).[¤]DISCUSSION AND CONCLUSION[|]Although hook plating had better clinic outcomes compared to Bosworth technique, there is not seen difference between two groups in terms of the time of return to work. Treatment of the AC dislocation should perform early reconstruction for better reduction, fewer complications and higher levels of patient satisfaction.[¤]

The method and results of cement samples evaluation under the cyclic compression are presented in the paper. The study included 6 cements for permanent fixation of non-removable dentures, namely, 2 zinc phosphate cements Viscine and Adhessor, 2 polycarboxylate cements Belokor and Durelon and 2 glass ionomer cements Stion-F and Restocem-PL. The sample corresponded to a tooth with the crown which was fixed with cement. For testing, 6 batches of samples were manufactured (3 samples per batch). The special test bench was used in the process of investigation which made it possible to test the samples applying the cyclic compression with the load frequency of 5.4 Hz or 324 cycles per minute and the increase in the cyclic compression from 10 to 100 kgf. Three levels of maximum compression efforts were chosen: 25 +1,40 +1.60 +1 kgf at which the cyclic endurance of the samples was determined. Endurance was evaluated by the number of cycles which the sample withstood before destruction at chosen load levels. The loss of cement retaining property was accepted as sample destruction which was distinguished in the insignificant crown displacement in relation to tooth with the application of weak static force (~ 23 kg) for crown separation from tooth. The comparative analysis of the mechanical compressive properties of dental cements for permanent fixation has determined that the resulting deformation curves were significantly different for various cements used in the experiment. All studied cements have fairly significant strength parameters, but the presence of plastic deformation in individual materials suggests that polycarboxylate cements should have higher functional properties. Considering the fact that the load on dental bridges is greater than on individual crowns, the zinc phosphate and glass ionomer cements are advisable to use while fixing them. The research results of the physical and mechanical properties of cements have determined that zinc phosphate cement Viscine and glass ionomer cements Stion-F and Restocem-PL have the most advisable complex of properties. This fact is the most clearly confirmed while studying the cement samples endurance under the cyclic compression which simulates the real conditions.

The aim of this study to analyze results of a new method which eliminates complications associated with the classic mesh fixation areas and does not increase recurrence rates. This prospective study included a total of 70 patients applied with inguinal or femoral hernia repair with the laparoscopic TEP method. The patients were randomly separated into two groups as Group 1 applied with tack fixation and Group 2 applied with plug mesh and subcutaneous vicryl fixation. The groups were followed up and compared. The group applied with the newly-developed repair technique of plug mesh and vicryl fixation were observed to have a shorter length of stay in hospital, a lower requirement for postoperative analgesia, and reduced urinary retention and seroma rates. No difference was determined between the two groups in respect of operating time and return to normal activities. In the 24-month follow-up period, there was no significant difference in respect of hernia recurrence. The results of the study showed that the use of the newly-developed repair technique of plug mesh and vicryl fixation in laparoscopic TEP inguinal hernia repair increased the life quality after surgery. There are also cost advantages. This is a technique that can be selected for suitable patients. [Med-Science 2018; 7(4.000): 878-81]

Another technique for the fixation of an arch bar which is needed to maintain proper occlusion is described. It gives secure fixation for the treatment of maxillo-mandibular fracture with shorter fixation and removal time from about thirty minutes to fifteen minutes. This technique can also be used in orthognathic surgery.

The choice of the type of stabilization device in the osteosynthesis of dorso-lumbar spine fractures remains a subject of controversy. The present study aims to evaluate the efficiency of short segment in patients suffering post-traumatic thoracolumbar fractures. This study was conducted in the Department of Orthopedic Surgery and Traumatology of the Habib Bourguiba University Hospital, Sfax, Tunisia. All our patients had a spinal osteosynthesis via the posterior approach with a short segment pedicle screw fixation. We established a record of the pre and post-operative data, the functional results in the post-operative stage during the follow-up period and in retrospect according to the Denis Pain Scale, as well as the Oswestry score. The the correction was evaluated by determining the relative gain and loss at the last period of retrospect: Vertebral kyphosis, Regional kyphosis, Gardner Segment Kyphotic Deformity, and CT scan in retrospect to check the quality of the arthrodesis. The average Oswestry score was 14%. Twenty-nine patients had an Oswestry score ≤40%. The relative gain obtained postoperatively was 57.3% for vertebral kyphosis, 67.2% for regional kyphosis and 71.3% for Gardner kyphosis deformity; while the loss of correction at the last follow-up was 0.6° for vertebral kyphosis, 1.5° for regional kyphosis and 0.9° for GSKD. No cases of non-union were reported. The short segment fixation makes it possible to limit operating time, the abundance of bleeding and the aggression of the soft tissues.

Background: The present study evaluated the effect of internal mesh fixation and external fixation (inguinal hernia truss) on postoperative complications in patients with inguinal hernia. Materials and Methods: This randomized clinical trial was performed on 64 patients that were candidates for inguinal hernia repair by laparoscopic method following the totally extraperitoneal procedure. These patients were randomly divided into two groups. In the first group, the mesh was fixed with a maximum of three absorbable tacks. In the second group, the inguinal hernia truss was used as the external fixation for 6 weeks immediately after the surgery. Results: The results revealed that seroma, neuralgia, and recurrence were observed with the values of 6.4%, 19.4%, and 3.2% in Group A and 3.3%, 13.3%, and 3.3% in Group B (P > 0.05). Moreover, patients' pain scores 1 week and 1 month after the surgery in Group B were significantly lower than those of Group A (P < 0.05). However, the mean pain score of patients was not different between the two groups 3 and 6 months after the surgery (P > 0.05). Furthermore, the duration of return to work in Group B with an average of 8.07 ± 3.09 days was less than that of Group A with the average of 9.65 ± 5.34 days (P > 0.05). Conclusion: The mentioned findings can trigger the use of external fixation and an inguinal hernia truss as a support for the abdominal wall to make the dream of not using a foreign body in the human body come true.

Abstract Background Interest in single-cell transcriptomic analysis is growing rapidly, especially for profiling rare or heterogeneous populations of cells. In almost all reported works investigators have used live cells, which introduces cell stress during preparation and hinders complex study designs. Recent studies have indicated that cells fixed by denaturing fixative can be used in single-cell sequencing, however they did not usually work with most types of primary cells including immune cells. Methods The methanol-fixation and new processing method was introduced to preserve human peripheral blood mononuclear cells (PBMCs) for single-cell RNA sequencing (scRNA-Seq) analysis on 10× Chromium platform. Results When methanol fixation protocol was broken up into three steps: fixation, storage and rehydration, we found that PBMC RNA was degraded during rehydration with PBS, not at cell fixation and up to 3-month storage steps. Resuspension but not rehydration in 3× saline sodium citrate (SSC) buffer instead of PBS preserved PBMC RNA integrity and prevented RNA leakage. Diluted SSC buffer did not interfere with full-length cDNA synthesis. The methanol-fixed PBMCs resuspended in 3× SSC were successfully implemented into 10× Chromium standard scRNA-seq workflows with no elevated low quality cells and cell doublets. The fixation process did not alter the single-cell transcriptional profiles and gene expression levels. Major subpopulations classified by marker genes could be identified in fixed PBMCs at a similar proportion as in live PBMCs. This new fixation processing protocol also worked in several other fixed primary cell types and cell lines as in live ones. Conclusions We expect that the methanol-based cell fixation procedure presented here will allow better and more effective batching schemes for a complex single cell experimental design with primary cells or tissues.

Aim. In the laparoscopic inguinal hernia repair, the current trend is to limit the aggressiveness of the fixation means. The use of n -butyl-cyanoacrylate (NBCA) is such an option and the aim of our work is to present the results obtained by this technique. Material and methods. Patients who were surgically resolved through the TAPP approach with the fixation of the mesh exclusively by NBCA were prospectively analyzed. Follow-up was done by clinical checks at approximately 2 weeks (control 1) and 5 months (control 2) postoperatively, as well as annual phone checks. The quality of life has been assessed by using a specific numeric scale (from 0 to 10). Results. We analyzed 209 patients with primary inguinal hernia for an average follow-up of 19 months and 31 patients (14.8%) were lost to follow-up. Demographic data were recorded and compared (89% men and 11% women), together with the main morbidity, hernia characteristics according to the European Hernia Society (EHS) classification, average operative time (50 minutes for unilateral hernia and 65 minutes for bilateral hernia), intraoperative complications (0%), postoperative complications (between 1% and 8.6%), postoperative hospital stay (mean 24 h, SD ± 4.4 h). Quality of Life Analysis (QoL) showed a significant improvement (p = 0.001) throughout the evaluation, with significant differences between preoperative and control 1 (p = 0.004) as well as control 2 (p = 0.005). There was only one case with chronic pain and no recurrence during the follow-up period. Conclusions. Laparoscopic treatment of inguinal hernia by TAPP approach and using NBCA to secure the mesh is safe and effective.

Background Most humerus shaft fractures can be treated successfully using the conservative methods. When choosing surgical fixation, there is a debate between the use of plate and screws and intramedullary nails. Aims The aim of this study was to compare the results of the dynamic compression plate and the antegrade interlocked humeral nail in the fixation of humerus shaft fractures. Patients and methods A total of 40 patients were selected by a randomized method to be treated by either method; there were 20 patients in each group and patients were followed up for at least 6 months until union. Result The results showed superiority of the plate in terms of the union rate and shoulder function and the use of the nail was better in terms of the infection rate and radial nerve palsy. Conclusion The plate is still the standard of treatment of the humerus shaft fracture and the nails better be used for more comminuted or open fractures. More future studies with large numbers required to overcome our relatively small number.

Posterior pedicle screw fixation has become a popular method for treating thoracolumbar burst fractures. However, it remains unclear whether additional fixation of more segments could improve clinical and radiological outcomes. This meta-analysis was performed to evaluate the effectiveness of fixation levels with pedicle screw fixation for thoracolumbar burst fractures. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, and Google Scholar were searched for relevant randomized and quasirandomized controlled trials that compared the clinical and radiological efficacy of short versus long segment for thoracolumbar burst fractures managed by posterior pedicle screw fixation. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. Based on predefined inclusion criteria, Nine eligible trials with a total of 365 patients were included in this meta-analysis. Results were expressed as risk difference for dichotomous outcomes and standard mean difference for continuous outcomes with 95% confidence interval. Baseline characteristics were similar between the short and long segment fixation groups. No significant difference was identified between the two groups regarding radiological outcome, functional outcome, neurologic improvement, and implant failure rate. The results of this meta-analysis suggested that extension of fixation was not necessary when thoracolumbar burst fracture was treated by posterior pedicle screw fixation. More randomized controlled trials with high quality are still needed in the future.

The investigation of matching of endoprosthesis tibial components to the bone cross section is of interest for the manufacturer as well as for the surgeon. On the one hand, a systemic design of the prosthesis and the assortment is possible, on the other hand, a better matching implantation is enabled on the basis of experience of this study. CT sections were segmented manually using a CAD system and fitted by spline functions, then superseded with cross sections of the tibial component of a modified Hintermann H3 prosthesis. The principal moments of inertia, the direction of the principal axes and the area of the section were evaluated. Based on the relative differences of the principal moments of inertia, recommendations for application of the different prosthesis size and its selection with the surgery can be made.

The comparison of memory performance during free and fixed viewing conditions has been used to demonstrate the involvement of eye movements in memory encoding and retrieval, with stronger effects at encoding than retrieval. Relative to conditions of free viewing, participants generally show reduced memory performance following sustained fixation, suggesting that unrestricted eye movements benefit memory. However, the cognitive basis of the memory reduction during fixed viewing is uncertain, with possible mechanisms including disruption of visual-mnemonic and/or imagery processes with sustained fixation, or greater working memory demands required for fixed relative to free viewing. To investigate one possible mechanism for this reduction, we had participants perform a working memory task—an auditory n-back task—during free and fixed viewing, as well as a repetitive finger tapping condition, included to isolate the effects of motor interference independent of the oculomotor system. As expected, finger tapping significantly interfered with n-back performance relative to free viewing, as indexed by a decrease in accuracy and increase in response times. By contrast, there was no evidence that fixed viewing interfered with n-back performance relative to free viewing. Our findings failed to support a hypothesis of increased working memory load during fixation. They are consistent with the notion that fixation disrupts long-term memory performance through interference with visual processes.

Introduction Oligochaetes are recognized as valuable bioindicators of sediment quality in streams and lakes. The development of an oligochaete index based on the identification of specimens using DNA barcodes requires a method for simultaneously preserving the DNA quality and information on the specimen density and oligochaete community composition. Absolute ethanol optimally preserves DNA but fixation of freshwater oligochaetes with this medium can cause disintegration and fragmentation of specimens. Here, we investigated the possibility to preserve oligochaete specimens in low-pH formalin and in neutral buffered formalin for up to four weeks before genetic analyses and tested if the addition of absolute ethanol to formalin-fixed oligochaetes resulted in a loss of specimens and/or species. Methods We performed guanidine extraction and polymerase chain reaction (PCR) amplification/sequencing of a fragment of the cytochrome c oxidase I (COI) gene on tissue fragments preserved in low-pH formalin for up to 3 weeks and in neutral buffered formalin for up to 4 weeks. In addition, we compared the density and taxonomic composition of formalin-fixed oligochaetes of several sieved sediment samples before and after the addition of absolute ethanol. Results The COI fragment of all oligochaete specimens preserved in neutral buffered formalin for up to 28 days was successfully amplified by PCR and obtained sequences were complete and of high quality. The amplification success rate for low-pH formalin fixed specimens declined after 7 days of storage. The addition of absolute ethanol to formalin-fixed oligochaete communities did not alter density or diversity estimates. Discussion Our results indicate that sediment samples can be stored in neutral buffered formalin for up to 4 weeks and the sieved material can then be transferred to absolute ethanol, without affecting DNA quality, density and community composition of oligochaetes. Based on these results, a protocol for preserving freshwater oligochaetes, describing all the steps from collection of sediments to preservation of the biological material in absolute ethanol, is proposed. This method of fixation/preservation is of relevance for establishing DNA barcode reference databases, inventories of genetic diversity and developing genetically based biological indices.

Bone specimens obtained for biomechanical experiments are fresh-frozen for storage to slow down tissue degradation and autolysis in long-term storage. Alternatively, due to infectious risks related to the fresh tissues, fixative agents are commonly used. However, fixatives will likely change the mechanical properties of bone. Existing studies on this issue gave controversial results that are hardly comparable due to a variety of measurement approaches. For this reason, the influence of ethanol and a formalin-based fixative agent was evaluated on the mechanical properties of human cortical bone specimens by means of four-point-bending tests. 127 prismatic specimens with rectangular cross sections (2.5 x 2.5 x 20 mm3) were obtained from different regions of two fresh human femora (medial, lateral, dorsal, ventral). Specimens were either fixed in ethanol or in a mixed formalin solution or frozen following a given scheme. After two weeks of storage the samples were re-hydrated in isotonic saline and subsequently tested mechanically. The elastic bending modulus and ultimate bending strength were computed considering the actual dimensions of each specific specimen. For statistical analysis a one-way-ANOVA and an LSD post-hoc-test were performed. For ultimate bending strength no significant differences due to formalin or ethanol fixation, as compared to unfixed-fresh bone specimens could be found. And only for few cases significant differences in elastic bending modulus were observed when the two bones were evaluated separately. Since more differences of significant level due to the anatomical region of the samples were determined, the original location seems to have more influence on the evaluated mechanical properties than the method of (chemical) fixation. Consequently, ethanol and the mixed formalin solution can be recommended as a fixation agent for samples in biomechanical testing, if these samples are rinsed in isotonic saline prior to static mechanical testing.