The optimal management of posterior malleolar ankle fractures, a prevalent type of ankle trauma, is essential for improved prognosis. However, there remains a debate over the most effective surgical approach, particularly between screw and plate fixation methods. This study aims to investigate the differences in outcomes associated with these fixation techniques. We conducted a comprehensive review of clinical trials comparing anteroposterior (A-P) screws, posteroanterior (P-A) screws, and plate fixation. Two investigators validated the data sourced from multiple databases (MEDLINE, EMBASE, and Web of Science). Following PRISMA guidelines, we carried out a network meta-analysis (NMA) using visual analogue scale and American Orthopaedic Foot and Ankle Score (AOFAS) as primary outcomes. Secondary outcomes included range of motion limitations, radiological outcomes, and complication rates.Aims
Methods
Interleukin (IL)-1β is one of the major pathogenic regulators during the pathological development of intervertebral disc degeneration (IDD). However, effective treatment options for IDD are limited. Suramin is used to treat African sleeping sickness. This study aimed to investigate the pharmacological effects of suramin on mitigating IDD and to characterize the underlying mechanism. Porcine nucleus pulposus (NP) cells were treated with vehicle, 10 ng/ml IL-1β, 10 μM suramin, or 10 μM suramin plus IL-1β. The expression levels of catabolic and anabolic proteins, proinflammatory cytokines, mitogen-activated protein kinase (MAPK), and nuclear factor (NF)-κB-related signalling molecules were assessed by Western blotting, quantitative real-time polymerase chain reaction (qRT-PCR), and immunofluorescence analysis. Flow cytometry was applied to detect apoptotic cells. The ex vivo effects of suramin were examined using IDD organ culture and differentiation was analyzed by Safranin O-Fast green and Alcian blue staining.Aims
Methods
Two-stage reconstructive technique has been proved to be a safe and effective method in the treatment of deep infection of hip joint implants. Between stages, however, the patients may be uncomfortable with limited mobility and activity because the joint function is severely restricted by the removal of the infected prosthesis and a thorough debridement. Furthermore, the delayed reimplantation procedure after a Girdlestone-like surgery is often complicated by shortening, bone loss, and dislocation due to scar formation, disuse osteoporosis, and distorted tissue planes. We reported the technical details of a new method to make a cement-on-cement prosthesis as a temporary spacer for the period between resection and reimplantion. The doughy cement, mixed with antibiotics, was introduced into a metal mold made with the shape of a unipolar prosthesis to form the femoral component. Several large K-wires were placed in the mold in advance to act as strut support in order to prevent late fracture of the cement prosthesis. The remained cement was put into the acetabular cavity and molded into a hemispherical shape with a retrieved unipolar prosthesis of identical femoral head size. After consolidation of the cement, the femoral component was taken out from the metal mold and implanted into the femoral canal with fixation by antibiotic-loaded cement on the proximal portion. Between the year 1999 and 2000, we have treated 42 infected hip implants by this technique with few complications. This new molding method has been a routine procedure in our practice. We believe it to be a simple, safe, and inexpensive way to eradicate local infection and provide comfort and mobility for the patient and an easier reimplantation procedure for the surgeon.
The periacetabular osteotomies are effective but technically demanding surgical procedures in the treatment of adult dysplastic hips. We developed a modified technique which combines the two most popular surgeries: the rotational acetabular osteotomy (RAO), and the Bernese osteotomy. Transtrochanteric approach was used in our new spherical osteotomy and provided a good surgical exposure for redirecting the acetabulum with minimal complications. This article describes the surgical procedures in detail and reports the preliminary results in the first 32 hips. As the experiences are encouraging in terms of technical ease and reproducibility, the authors feel that this new osteotomy with transtrochanteric exposure is an ideal choice of surgery in treating residual hip dysplasia in the adult. Key words: osteotomy, periacetabular, hip dysplasia, adult.
