Dexmedetomidine added to levobupivacaine for axillary brachial plexus block shortens the onset time and prolongs the duration of the block and the duration of postoperative analgesia. However, dexmedetomidine also may lead to bradycardia.
We believe that good results were obtained in patients with early, stable, and accurate reductions by either closed or open methods. Concentric reduction absolutely should be confirmed by radiographs of the pelvis and, if necessary, by computed tomographic scan. The routine use of seat belts could have prevented many of these injuries.
We investigated the effects of the antioxidant alphae-tocopherol on early- and late-phase fracture healing in a rat model. Sixty male Sprague-Dawley rats were randomized into two groups. The right tibia of each rat was fractured manually under anaesthesia, and fracture sites fixed with intramedullary Kirschner wires. The alpha-tocopherol group received 20 mg/kg alpha-tocopherol intraperitoneally; the control group received intraperitoneal saline injections. Ten rats from each group were sacrificed on day 15, day 45 and day 60. In the alpha-tocopherol group, malondialdehyde concentrations, a measure of lipid peroxidation associated with oxygen free radicals, were significantly decreased on day 15 and day 45 compared with the control group, but had regained the 15-day value on day 60. On histopathological and radiological assessment, fracture healing on day 60 was significantly more advanced in the alpha-tocopherol group. We conclude that alpha-tocopherol has a positive effect on both early and late-phase fracture healing, and may be beneficial in clinical fracture
The results following primary and delayed primary repair in zone 2 flexor tendon injuries were evaluated prospectively in 88 fingers of 71 patients using two different early postoperative mobilization programmes. In 33 patients, the Kleinert rubber band passive flexion method was used. In the remaining 38 patients, the early active mobilization programme was used. All patients were reviewed 1 year after operation and the results assessed by the Strickland criteria. During this evaluation maximum grip strength was also measured. The results were excellent or good in 78% of digits and mean grip strength was 84% of the uninjured hand in the Kleinert rubber band passive flexion group. In the early active mobilization group, excellent or good results were achieved in 85% of the digits and the mean grip strength was 90% of the uninjured hand. There were two early ruptures in each group.
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