Is fixation of the medial malleolus necessary in unstable ankle fractures?

Introduction: It is unclear whether the medial malleolus in unstable bi- and tri- malleolar ankle fractures without medial talar displacement should be addressed surgically. This study reviews a fixation protocol for the medial malleolar component of unstable bi- or tri- malleolar ankle fractures.

Materials And Methods: Two hundred fifty-seven patients who sustained bi- (AO/OTA 44-B2) or tri- (AO/OTA 44-B3) malleolar ankle fractures between January 2005 and August 2019 at two Level 1 trauma centers were retrospectively identified.

Phrenic nerve palsy after cervical laminectomy and fusion.

Background: Phrenic nerve palsy is a rare complication of cervical spine surgery. There are no previously reported cases of unilateral diaphragmatic paralysis following posterior cervical spine surgery. Here, we present a case of a 69 year-old Caucasian male with severe cervical stenosis with myelopathy who underwent posterior spinal instrumentation and fusion (PSIF) from C2 to T2, with laminectomies at C3-C7.

Calcium pyrophosphate deposition disease of the cervical and thoracolumbar spine: A report of two cases.

Background: Spinal calcium pyrophosphate deposition disease (CPPD) is uncommon, and often resembles more common spine pathologies causing pain and neural compression. Here, we present two unusual cases of CPPD of the cervical and thoracolumbar spines.

Case Description: Case 1: A 71-year old female smoker presented with a large epidural mass causing rapidly progressive cervical myelopathy with weakness in the upper and lower extremities.

Current Strategies in Prevention of Postoperative Infections in Spine Surgery.

Study Design: Narrative review.

Objectives: Postoperative surgical site infections (SSIs) are among the most common acute complications in spine surgery and have a devastating impact on outcomes. They can lead to increased morbidity and mortality as well as greater economic burden.

The Effect of Level I Evidence on Surgical Decision Making in the United States Versus Canada.

Background: In this study, we examined the difference that randomized trials favoring either surgery or nonsurgical treatment had on the surgical indications of American versus Canadian surgeons.

Methods: One randomized trial favoring surgical management of clavicle fractures and another one favoring nonsurgical management of Achilles tendon ruptures were used. American and Canadian orthopaedic surgeons were surveyed regarding their surgical indications for these injuries.

Traumatic Lumbosacral Dislocation: Current Concepts in Diagnosis and Management.

Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis.

The Significance of Upper Extremity Neuromonitoring Changes During Thoracolumbar Spine Surgery.

Study Design: This is a retrospective matched-pair cohort study.

Objective: To investigate the significance of upper extremity (UE) neuromonitoring changes in patients undergoing thoracolumbar surgery in prone position.

Summary Of Background Data: Peripheral nerve injuries in the UEs due to the prone positioning during prolonged thoracolumbar spinal procedures can cause diminished postsurgical outcomes.

Posttraumatic Spinal Cord Injury without Radiographic Abnormality.

"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too.

BMPR1A antagonist differentially affects cartilage and bone formation during fracture healing.

A soluble form of BMP receptor type 1A (mBMPR1A-mFC) acts as an antagonist to endogenous BMPR1A and has been shown to increase bone mass in mice. The goal of this study was to examine the effects of mBMPR1A-mFC on secondary fracture healing. Treatment consisted of 10 mg/kg intraperitoneal injections of mBMPR1A-mFC twice weekly in male C57BL/6 mice.

Biological rationale for the intramedullary canal as a source of autograft material.

Bone harvested by intramedullary reaming offers a minimally invasive alternative to harvesting bone from the iliac crest, which has long been considered the gold standard for autogenous bone grafting. The biologic potential of intramedullary reaming material has been studied both in vitro and in vivo. The material provides osteogenic, osteoinductive, and osteoconductive properties that are comparable to the material harvested from the iliac crest.

Long-lived electron capture dissociation product ions experience radical migration via hydrogen abstraction.

To explore the mechanism of electron capture dissociation (ECD) of linear peptides, a set of 16-mer peptides were synthesized with deuterium labeled on the alpha-carbon position of four glycines. The ECD spectra of these peptides showed that such peptides exhibit a preference for the radical to migrate to the alpha-carbon position on glycine via hydrogen (or deuterium) abstraction before the final cleavage and generation of the detected product ions. The data show c-type fragment ions, ions corresponding to the radical cation of the c-type fragments, c*, and they also show c*-1 peaks in the deuterated peptides only.

A new hybrid electrospray Fourier transform mass spectrometer: design and performance characteristics.

A new hybrid electrospray quadrupole Fourier transform mass spectrometry (FTMS) instrument design is shown and characterized. This instrument involves coupling an electrospray source and mass-resolving quadrupole, ion accumulation, and collision cell linear ion trap system developed by MDS Sciex with a home-built ion guide and ion cyclotron resonance (ICR) cell. The iterative progression of this design is shown.

Characterization of a new qQq-FTICR mass spectrometer for post-translational modification analysis and top-down tandem mass spectrometry of whole proteins.

The use of a new electrospray qQq Fourier transform ion cyclotron mass spectrometer (qQq-FTICR MS) instrument for biologic applications is described. This qQq-FTICR mass spectrometer was designed for the study of post-translationally modified proteins and for top-down analysis of biologically relevant protein samples. The utility of the instrument for the analysis of phosphorylation, a common and important post-translational modification, was investigated.

A minimum thickness gate valve with integrated ion optics for mass spectrometry.

A minimum thickness gate valve design for mass spectrometry is described in detail. The ion optics required to transmit ions from the source to the ICR cell are integrated into the design to minimize fringe field effects on the ions as they travel through the gate valve. The total thickness of the complete gate valve assembly is 1.

Deamidation: Differentiation of aspartyl from isoaspartyl products in peptides by electron capture dissociation.

Deamidation of asparaginyl and isomerization of aspartyl residues in proteins proceed through a succinimide intermediate producing a mixture of aspartyl and isoaspartyl residues. Isoaspartic acid is an isomer of aspartic acid with the C(beta) incorporated into the backbone, thus increasing the length of the protein backbone by one methylene unit. This post-translation modification is suspected to contribute to the aging of proteins and to protein folding disorders such as Alzheimer's disease, so that differentiating the two isomers becomes important.

A high pressure matrix-assisted laser desorption ion source for Fourier transform mass spectrometry designed to accommodate large targets with diverse surfaces.

A new design for a high pressure MALDI-FTMS instrument is described and initial data are shown. The instrument incorporates a large, 10 cm x 10 cm, sample translation stage to accommodate and position the MALDI target. The new instrument allows coupling to a wide variety of surface techniques such as gel electrophoresis or surface plasmon resonance.

Attomole peptide analysis by high-pressure matrix-assisted laser desorption/ionization Fourier transform mass spectrometry.

A new high-pressure matrix-assisted laser desorption/ionization (HP-MALDI) source for FTMS has recently been described (O'Connor et al. J. Am.

Experimental studies of electroosmotic flow dynamics during sample stacking for capillary electrophoresis.

Electroosmotic flow dynamics during a field-amplified sample stacking experiment have been studied experimentally using the periodic photobleaching of a dilute, neutral fluorophore added to the separation buffer. The effects of hydrodynamically injecting different sample plug lengths containing a mixture of arsenic compounds dissolved in 0.125 mM (120, 240, and 600 s) and 41.

Experimental studies of electroosmotic flow dynamics in microfabricated devices during current monitoring experiments.

Electroosmotic flow (EOF) was monitored in glass microfluidic devices at rates up to 2 Hz with a precision of 0.2-1.0% using a technique based on the periodic photobleaching of a dilute, neutral fluorophore added to the running buffer.

Laser ablation construction of on-column reagent addition devices for capillary electrophoresis.

A simple and reproducible technique for constructing perfectly aligned gaps in fused-silica capillaries has been developed for postcolumn reagent addition with capillary electrophoresis. This technique uses laser ablation with the second harmonic of a Nd:YAG laser (532 nm) at 13.5 mJ/pulse and a repetition rate of 15 Hz to create these gaps.