Plate fixation of extra-articular fractures of the proximal phalanx: do new implants cause less problems?

BACKGROUND Limited range of finger motion is a frequent complication after plate fixation of phalangeal fractures. The purpose of this study was to evaluate the results of plate fixation of extra-articular fractures of the proximal phalanx using current low-profile mini-fragment-systems. METHODS From 2006 to 2012, 32 patients with 36 extra-articular fractures of the proximal phalanx of the triphalangeal fingers were treated with open reduction and plate fixation (ORPF) using 1.2 and 1.5 mm mini-fragment systems. Patients presenting with open fractures grade 2 and 3 or relevant laceration of adjacent structures were excluded from the study. We retrospectively evaluated the rate of mal-union or non-union after ORPF, the need for revision surgery, for plate removal, and for tenolysis. Data were analyzed for further complications with regard to infections or complex regional pain syndrome (CRPS). RESULTS No infections were noted. Five patients developed transient symptoms of CRPS. Six weeks postoperatively, total active finger motion (TAM) averaged 183°, and all 32 patients underwent formal hand therapy. At the latest follow-up or at the time of plate removal, respectively, the mean TAM improved to 213°. Extension lag of proximal interphalangeal joints was found in 67 % of all fractured fingers. Secondary surgery was necessary in 14 of 32 patients (2 corrective osteotomies, 12 plate removals including 7 procedures explicitly because of reduced mobility). CONCLUSIONS Despite of new implant designs significant problems persist. Adhesions of extensor tendons leading to limited range of finger motion are still the most frequent complications after ORPF of proximal phalangeal fractures, even in absence of significant soft-tissue damage. LEVEL OF EVIDENCE Therapeutic, Retrospective, Level IV.

Hydrogen atom in space with a compactified extra dimension and potential defined by Gauss' law

We investigate the consequences of one extra spatial dimension for the stability and energy spectrum of the non-relativistic hydrogen atom with a potential defined by Gauss' law, i.e. proportional to 1 /| x | 2 . The additional spatial dimension is considered to be either infinite or curled-up in a circle of radius R. In both cases, the energy spectrum is bounded from below for charges smaller than the same critical value and unbounded from below otherwise. As a consequence of compactification, negative energy eigenstates appear: if R is smaller than a quarter of the Bohr radius, the corresponding Hamiltonian possesses an infinite number of bound states with minimal energy extending at least to the ground state of the hydrogen atom.

Extra-Blatt: Aufruhr in Sachsen für die Anerkennung der Reichs-Verfassung: Ganz Sachsen ist in furchtbarer Gährung ...

Welsch (Projektbearbeiter): Reichsverfassungskampagne in Sachsen

Extra-Blatt: Neueste Nachricht aus Dresden: Der gestern Abend um 10 1/4 Uhr angekommene Zug ...

Welsch (Projektbearbeiter): Reichsverfassungskampagne in Sachsen

Extra-Beilage zur 'Constitution' am 22. Juli 1848: Die Thronrede, womit Erzherzog Johann den constituirenden Reichstag eröfnet hat, und die Antwortsrede des Präsidenten: Der Erzherzog erschien um 12 Uhr begleitet vom Generalstabe und dem Ministerium ...

Welsch (Projektbearbeiter): Rede Erzherzog Johanns anläßlich der Eröffnung des österreichischen Reichstages: Bestätigung der erworbenen Freiheiten, Gleichberechtigung aller Nationalitäten, Rechtfertigung des Krieges in Italien. Samt Antwort des Reichstagspräsidenten

Use of minimal invasive extracorporeal circulation in cardiac surgery: principles, definitions and potential benefits. A position paper from the Minimal invasive Extra-Corporeal Technologies international Society (MiECTiS).

Minimal invasive extracorporeal circulation (MiECC) systems have initiated important efforts within science and technology to further improve the biocompatibility of cardiopulmonary bypass components to minimize the adverse effects and improve end-organ protection. The Minimal invasive Extra-Corporeal Technologies international Society was founded to create an international forum for the exchange of ideas on clinical application and research of minimal invasive extracorporeal circulation technology. The present work is a consensus document developed to standardize the terminology and the definition of minimal invasive extracorporeal circulation technology as well as to provide recommendations for the clinical practice. The goal of this manuscript is to promote the use of MiECC systems into clinical practice as a multidisciplinary strategy involving cardiac surgeons, anaesthesiologists and perfusionists.

Extra-Blatt: Der Kaiser von Rußland abgesetzt! Contre-Revolution in Paris! Der Papst heirathet! Auf unbekannten Wegen treffen fortwährend wichtige Nachrichten ein, welche - in Extra-Blättern verbreitet - einen unverkennbaren Einfluß auf die Börsen ausüben ...

Welsch (Projektbearbeiter): Satire auf reißerische Sensationsmeldungen, die sich in der Folge als unwahr herausstellen

Extra-articular step osteotomy of the olecranon: A biomechanical assessment

BACKGROUND Trans-olecranon chevron osteotomies (COs) remain the gold standard surgical approach to type C fractures of the distal humerus. This technique is associated with a high complication rate and development of an extra-articular olecranon osteotomy may be advantageous. The aim of this study was to compare the load to failure of COs with extra-articular oblique osteotomies (OOs) as well as modified, extra-articular step osteotomies (SOs). METHODS These three osteotomies and their subsequent fixation utilizing a standardized tension band wiring technique were tested in 42 composite analog ulnae models at 20° and 70° of flexion. Triceps loading was simulated with a servo hydraulic testing machine. All specimens were isometrically loaded until failure. Kinematic and force data, as well as interfragmentary motion were recorded. RESULTS At 70°, CO failed at a mean load of 963N (SD 104N), the OO at 1512N (SD 208N) and the SO at 1484N (SD 153N), (P<0.001). At 20°, CO failed at a mean load of 707N (SD 104N) and OO at 1009N (SD 85N) (P=0.006). The highest load to failure was observed for the SO, which was 1277N (SD 172N). The load to failure of the SO was significantly higher than the CO as well as the OO. CONCLUSION Extra-articular osteotomies showed a significantly higher load to failure in comparison to traditional CO. At near full extension (20° of flexion), this biomechanical advantage was further enhanced by a step-cut modification of the extra-articular oblique osteotomy.

Extra-Blatt: Publicirung des Standrechts: Ehre unseren Bürgern, die gestern Abend auf dem Platze waren, und Ehre unserem braven, gesitteten Militair: Eine Horde Vandalen und Raubgesindel hat es am Montage Abend gewagt ...

Welsch (Projektbearbeiter): Forderung nach Einführung des Standrechts in Breslau nach dem dortigen Ausbruch blutiger Unruhen seitens "200 Personen des niedrigsten Gesindels" (17. April 1848). Bis auf den Erscheinungsvermerk mit Sf 16/35 identisch

Laparoscopic Ultrasound-Guided Repair of Uterine Scar Isthmocele Connected With the Extra-Amniotic Space in Early Pregnancy.

We present a video of an ultrasound-guided laparoscopic surgical management of a large uterine scar isthmocele connected with the extra-amniotic space in early pregnancy. A case of a pregnant patient who was diagnosed with a large isthmocele connected with the extra-amniotic space on routine ultrasound at 8 weeks of gestational age is presented. The uterine defect was successfully sutured laparoscopically under ultrasound guidance. The pregnancy continued uneventfully, and a healthy baby was delivered via cesarean section at 38 weeks gestational age.

The HARPS search for southern extra-solar planets XXXVII. Five new long-period giant planets and a system update

We describe radial-velocity time series obtained by HARPS on the 3.60 m telescope in La Silla (ESO, Chile) over ten years and report the discovery of five new giant exoplanets in distant orbits; these new planets orbit the stars HD 564, HD 30669, HD 108341, and BD -114672. Their periods range from 492 to 1684 days, semi-major axes range from 1.2 to 2.69 AU, and eccentricities range from 0 to 0.85. Their minimum mass ranges from 0.33 to 3.5 MJup. We also refine the parameters of two planets announced previously around HD 113538, based on a longer series of measurements. The planets have a period of 663 ± 8 and 1818 ± 25 days, orbital eccentricities of 0.14 ± 0.08 and 0.20 ± 0.04, and minimum masses of 0.36 ± 0.04 and 0.93 ± 0.06 MJup. Finally, we report the discovery of a new hot-Jupiter planet around an active star, HD 103720; the planet has a period of 4.5557 ± 0.0001 days and a minimum mass of 0.62 ± 0.025 MJup. We discuss the fundamental parameters of these systems and limitations due to stellar activity in quiet stars with typical 2 m s-1 radial velocity precision.

Ausst. 248 - Ḥuqat hap-pesaḥ. Ritus et celebratio phase iudeo[rum], cum orationibus eor[um], [et] benedictionibus mense ad littera[m] interp[re]tatis, cum omni obseruatione vti soliti su[n]t suu[m] pasca extra terra[m] p[ro]missionis sine esu agni pascalis celebrare

Per egrediu[m] doctorem. Thoma[m] murner ex hebreo in latinu[m] traducta eloquium