The aim of this work is to shed light on the role of porosity and pore architecture in the in vivo bone regeneration capacity of biodegradable glass scaffolds. A calcium phosphate glass in the system P2O5-CaO-Na2O-TiO2 was foamed using two different porogens, namely albumen and hydrogen peroxide (H2O2); the resulting three-dimensional porous structures were characterized and implanted in New Zealand rabbits to study their in vivo behavior. Scaffolds foamed with albumen displayed a monomodal pore size distribution centered around 150 μm and a porosity of 82%, whereas scaffolds foamed with H2O2 showed lower porosity (37%), with larger elongated pores, and multimodal size distribution. After 12 weeks of implantation, histology results revealed a good osteointegration for both types of scaffolds. The quantitative morphometric analysis showed the substitution of the biomaterial by new bone in the case of glasses foamed with albumen. In contrast, bone neoformation and material resorption were significantly lower in the defects filled with the scaffolds foamed with H2O2. The results obtained in this study showed that both calcium phosphate glass scaffolds were osteoconductive, biocompatible, and biodegradable materials. However, differences in porosity, pore architecture, and microstructure led to substantially different in vivo response.
We report on a patient with an unusual anatomic variation along the course of ulnar nerve above the elbow who had cubital tunnel syndrome. The variation consisted of a cutaneous neural branch that was originating at a distance of approximately 40 mm proximal to the medial epicondyle, and from the radial aspect of the main trunk of ulnar nerve. The branch had a superficial course and it was passing distally, anterior to the medial epicondyle without penetrating the fascia of the flexor muscles origin. Anterior intramuscular transposition of the ulnar nerve was performed leaving the newly found branch over the fascia between the muscles and the adipose subcutaneous tissue.
Objetivo: Evaluar los resultados de la retinaculotomía endoscópica para tratar el síndrome del túnel carpiano mediante la técnica de doble portal de Chow, entre enero de 2006 y diciembre de 2015. Materiales y Métodos: Estudio de 179 pacientes (edad promedio 48.2 años [rango 32-68]), con 217 casos de síndrome del túnel carpiano idiopático y un seguimiento promedio de 97.9 meses. Los pacientes eran 145 mujeres (81%) (31 bilaterales) y 34 hombres (19%) (7 bilaterales) y fueron evaluados con la Symptom Severity Scale (SSS) y la Functional Status Scale (FSS) del Boston Carpal Tunnel Questionnaire (BCTQ). Resultados: El puntaje medio de la SSS-BCTQ fue de 3,20 + 0,26 antes de la cirugía, mejoró a 1,30 + 0,12 a los 6 meses y se mantuvo en 1,25+ 0,11 a largo plazo. El puntaje medio de la FSS-BCTQ fue de 2,57 + 0,29 antes de la cirugía, mejoró a 1,28 + 0,18 a los 6 meses y se mantuvo en 1,20 + 0,09 a largo plazo. Hubo 7 casos (3,2%) de neuropraxia posquirúrgica transitoria. No hubo conversiones a técnica abierta. Conclusión: La liberación endoscópica del túnel carpiano con la técnica de Chow es un método quirúrgico eficaz y seguro para tratar el síndrome del túnel carpiano idiopático.
Palabras clave: Síndrome del túnel carpiano; técnica de doble portal de Chow; liberación endoscópica; compresión neural; nervio mediano.
Nivel de Evidencia: III
Background. To evaluate the outcomes of transiliac cerclage with Dall-Miles cable in the internal fixation of the posterior complex in unstable pelvic ring fractures between January 1995 and December 2014.
Material and methods. A study of 42 men injured at work with an average age of 35.2 years (range, 23 to 61) was conducted. The mechanisms of injury were traffic accidents in 25 cases (59.5%), crushing accidents in 12 cases (28.6%), and fall from height in 5 cases (11.9%). Thirty-six cases were polytraumatized patients (85.7%). The patients were evaluated using Majeed’s functional score and Matta’s radiological criteria.
Results. The average follow-up time was 135.8 ± 45.6 months. The clinical outcomes were excellent in 17 cases (40.5%), good in 19 cases (45.2%), fair in 5 cases (11.9%), and poor in 1 case (2.4%). The radiological outcomes were satisfactory in 32 cases (76.2%) and unsatisfactory in 10 cases (23.8%). All fractures were healed. The sequelae were 3 cases (7.2%) of lower limb dysmetria and 3 cases (7.2%) of chronic neuropathic pain.
Conclusion. The internal fixation of the sacroiliac complex by Dall-Miles cable cerclage reinforced with small fragment plates should be considered as an alternative method for minimally invasive osteosynthesis in selected cases of unstable pelvic ring fractures.
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