Surgical exposures and options for instrumentation in acetabular fracture fixation: Pararectus approach versus the modified Stoppa.

BACKGROUND As an alternative to the modified Stoppa approach, the Pararectus approach is used clinically for treatment of acetabular fractures involving the anterior column. The current study assessed the surgical exposure and the options for instrumentation using both of these approaches. METHODS Surgical dissections were conducted on five human cadavers (all male, mean age 88 years (82-97)) using the modified Stoppa and the Pararectus approach, with the same skin incision length (10cm). Distal boundaries of the exposed bony surfaces were marked using a chisel. After removal of all soft-tissues, distances from the boundaries in the false and true pelvis were measured with reference to the pelvic brim. The exposed bone was coloured and calibrated digital images of each inner hemipelvis were taken. The amount of exposed surface using both approaches was assessed and represented as a percentage of the total bony surface of each hemipelvis. For instrumentation, a suprapectineal quadrilateral buttress plate was used. Screw lengths were documented, and three-dimensional CT reconstructions were performed to assess screw trajectories qualitatively. Wilcoxon's signed rank test for paired groups was used (level of significance: p<0.05). RESULTS After utilization of the Pararectus approach, the distances from the farthest boundaries of exposed bone towards the pelvic brim were significantly higher in the false but not the true pelvis, compared to the modified Stoppa approach. The percentage (mean±SD) of exposed bone accessible after utilizing the Pararectus approach was 42±8%, compared to 29±6% using the modified Stoppa (p=0.011). In cadavers exposed by the Pararectus approach, screws placed for posterior fixation and as a posterior column screw were longer by factor 1.8 and 2.1, respectively (p<0.05), and screws could be placed more posteromedial towards the posterior inferior iliac spine or in line with the posterior column directed towards the ischial tuberosity. CONCLUSION Compared to the modified Stoppa, the Pararectus approach facilitates a greater surgical access in the false pelvis, provides versatility for fracture fixation in the posterior pelvic ring and allows for the option to extend the approach without a new incision.

Progress report on plant studies: the fixation and absorption of fission products by plants /

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Mode of access: Internet.

A comparison of the results obtained by the complement fixation test for the diagnosis of syphilis performed according to the new technique of Kolmer and the technique of the California state hygienic laboratory,

Thesis (M.A.)--Univ. of California. Dec. 1922.

Examen des conciles qui ont été célebrés depuis la primitive église : conséquences naturelles qui en dérivent, et fixation des points de morale évangélique que découlent de ces conséquences /

Mode of access: Internet.

Titles of literature concerning the fixation of free nitrogen by plants /

In v. 37 of a series of botanical tracts collected and bound together by Rev. Julius A. Nieuwland, University of Notre Dame.

A Guide to the performance of the standardized diagnostic complement fixation method and adaptation to micro test /

"Based on Public Health Monograph No. 74, Standardized Diagnostic Complement Fixation Method and Adaptation to Micro Test."

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Mode of access: Internet.

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Mode of access: Internet.

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Effect of salinity on growth, pigmentation, N2 fixation and alkaline phosphatase activity of cultured Trichodesmium sp

Trichodesmium sp. isolated from the Great Barrier Reef lagoon was cultured in artificial seawater media containing a range of salinities. Trichodesmium sp. actively grew over a wide range of salinities (22 to 43 psu) and hence can be classed as euryhaline. Maximum growth occurred with salinities in the range 33 to 37 psu. Chl a content and alkaline phosphatase activity were found to increase with salinity over the range 22 to 43 psu, but the N-2 fixation rate was reduced at salinities below and above the range for maximum growth. Growth in media exhibiting maximum growth was characterised by well-dispersed cultures of filaments, while significant aggregations of filaments formed in other media. It is proposed that the tendency for Trichodesmium filaments to aggregate in media with salinities outside the range for maximum growth is an opportunistic response to a deficiency of cellular nitrogen, which results from the reduced N-2 fixation rates, and the aggregation occurs in order to enhance the uptake of combined N released within the aggregates and/or the N-2 fixation within the aggregates.

Factors affecting N2 fixation by the cyanobacterium Trichodesmium sp. GBRTRLI101

Various factors affecting N-2 fixation of a cultured strain of Trichodesmium sp. (GBRTRLI101) from the Great Barrier Reef Lagoon were investigated. The diurnal pattern of N2 fixation demonstrated that it was primarily light-induced although fixation continued to occur for at least 1 h in the dark in samples that had been actively fixing N-2. N-2 fixation was dependent on the light intensity and stimulated more by white light when compared with blue, green, yellow and red light whereas rates of N-2 fixation decreased most under red light. Inorganic phosphorous concentrations in the lower range of treatments up to 1.2 muM significantly stimulated N-2 fixation and further additions promoted little or no increase in N-2 fixation. Organic phosphorous (Na-glycerophosphate) also stimulated N-2 fixation rates. Added combined nitrogen (NH4+, NO3-, urea) of 10 muM did not inhibit N-2 fixation in short-term studies (first generation), however it was depressed in the long-term studies (fifth generation). (C) 2003 Federation of European Microbiological Societies. Published by Elsevier Science B.V. All rights reserved.