Reattachment of the tuberosities with cable wires and bone graft in hemiarthroplasties done for proximal humeral fractures with cable wire and bone graft: 58 patients with a 22-month minimum follow-up

OBJECTIVE: The stability of 2 fixation techniques for the tuberosities in patients with 3- or 4-part proximal humerus fractures treated with hemiarthroplasties was compared. DESIGN: Retrospective review of a nonrandomized sequential series of patients. SETTING: Level I university orthopaedic surgery department. PATIENTS: A consecutive series of 58 patients (average age, 64 years) from 1990 to 1999 with 3- and 4-part fractures of the proximal humerus. INTERVENTION: In group 1, 31 patients were treated with either a Neer or Aequalis shoulder prosthesis using nonabsorbable sutures and no bone graft for the reattachment of the tuberosities. In group 2, 27 patients were treated with either an Aequalis or Epoca shoulder prosthesis and a combination of cable fixation and bone grafting. MAIN OUTCOME MEASUREMENTS: At follow-up (average, 32 months), radiographs were taken to confirm tuberosity fixation or degree of displacement or resorption. Functional outcome was assessed by the Constant-Murley Score. RESULTS: Significantly more dislocated tuberosities were found radiographically in group 1 (10 of 13 in total, P = 0.011), and significantly more tuberosities were resorbed in group 1 (9 of 12 in total, P = 0.012). Significant differences in functional results among healed versus failed tuberosity fixation were observed for activity of daily living (P = 0.05), range of motion (P = 0.002), strength (P = 0.01), the total score (P = 0.008), and the passive rotation amplitude (P = 0.04). CONCLUSION: In hemiarthroplasties for proximal humeral fractures, the reattachment of the tuberosities with cable wire and bone grafting gives consistently better radiographic and functional results than with suture fixation alone.

The use of intramedullary helix wire for the treatment of proximal humerus fractures

OBJECTIVE: To present the functional and radiographic outcome 1 and 6 years after application of a new intramedullary fixation device for proximal humerus fractures. DESIGN: Retrospective case series. SETTING: Level II orthopaedic surgery hospital. PATIENTS: Twenty-six consecutive patients (average age 68.9 years) with 2-, 3- and 4-part fractures of the proximal humerus were operated at a single institution. Follow-up was performed after 1 year (26 patients) and 6 years (16 patients). INTERVENTION: All patients were treated with closed reduction and intramedullary helix wires. MAIN OUTCOME MEASUREMENTS: The Constant-Murley score and the University of California Los Angeles (UCLA) score. Clinical complications and radiological posttraumatic arthritis were recorded. RESULTS: The average Constant-Murley score was 70.3 (points) and 70.7 after 1 and 6 years, respectively; the average UCLA score was 27.2 and 31.5 after 1 and 6 years, respectively. Major complications were 4 revisions for 3 secondary fragment displacements and 1 nonunion with partial avascular osteonecrosis in the first postoperative year. Complications were found predominantly in 4-part fractures (3/5, 60%). There were no further complications or progressive posttraumatic arthritis up to 6 years following surgery. CONCLUSION: The helix wire is well suited for displaced or unstable 2- and 3-part proximal humerus fractures. Adequate functional outcome, a low number of implant displacements, a low number of application morbidity, and infrequent implant removals were recorded. The use of this device is not recommended for 4-part fractures.

Microscopic wire guide-based orotracheal mouse intubation: description, evaluation and comparison with transillumination

Airway access is needed for a number of experimental animal models, and the majority of animal research is based on mouse models. Anatomical conditions in mice are small, and the narrow glottic opening allows intubation only with a subtle technique. We therefore developed a microscopic endotracheal intubation method with a wire guide technique in mice anaesthetized with halothane in oxygen. The mouse is hung perpendicularly with its incisors on a thread fixed on a vertical plate. The tongue is placed with a pair of forceps between the left hand's thumb and forefinger and slightly pulled, while the neck and thorax are positioned using the third and fourth fingers. By doing so, the neck can be slightly stretched, which allows optimal visualization of the larynx and the vocal cords. To ensure a safe intubation, a fine wire guide is placed under vision between the vocal cords and advanced about 5 mm into the trachea. An intravenous 22G x 1 in. plastic or Teflon catheter is guided over this wire. In a series of 41 mice, between 21 and 38 g, the success rate for the first intubation attempt was >95%. Certainty of the judgement procedure was 100% and success rate was higher using the described method when compared with a transillumination method in a further series. The technique is safe, less invasive than tracheostomy and suitable for controlled ventilation and pulmonary substance application.

Two-dimensional Lattice Gauge Theories with Superconducting Quantum Circuits

A quantum simulator of U(1) lattice gauge theories can be implemented with superconducting circuits. This allows the investigation of confined and deconfined phases in quantum link models, and of valence bond solid and spin liquid phases in quantum dimer models. Fractionalized confining strings and the real-time dynamics of quantum phase transitions are accessible as well. Here we show how state-of-the-art superconducting technology allows us to simulate these phenomena in relatively small circuit lattices. By exploiting the strong non-linear couplings between quantized excitations emerging when superconducting qubits are coupled, we show how to engineer gauge invariant Hamiltonians, including ring-exchange and four-body Ising interactions. We demonstrate that, despite decoherence and disorder effects, minimal circuit instances allow us to investigate properties such as the dynamics of electric flux strings, signaling confinement in gauge invariant field theories. The experimental realization of these models in larger superconducting circuits could address open questions beyond current computational capability.

Endovascular stent reconstruction of a chronic total occlusion of the inferior vena cava using bidirectional wire access and a balloon puncture by a re-entry device.

Venous angioplasty with stenting of iliac veins is an important treatment option for patients suffering from post-thrombotic syndrome due to chronic venous obstruction. Interventional treatment of a chronically occluded vena cava, however, is challenging and often associated with failure. We describe a case of a chronic total occlusion of the entire inferior vena cava that was successfully recanalized using bidirectional wire access and a balloon puncture by a re-entry catheter to establish patency of the inferior vena cava.

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea