Fractional Lengthening of Forearm Flexor Tendons: A Cadaveric Biomechanical Analysis.

Purpose: Multiple procedures have been described for wrist and finger flexion contractures and spasticity. Fractional lengthening of forearm flexor tendons involves making parallel transverse tenotomies at the musculotendinous junction to elongate the muscle. Currently, there is limited literature to define the biomechanical consequences of this lengthening technique.

Biomechanical Analysis of Headless Compression Screw Versus Tension Band Wiring for Proximal Interphalangeal Joint Arthrodesis.

Purpose: Proximal interphalangeal (PIP) joint arthrodesis is a procedure employed to address arthritis, instability, and deformity. Multiple fixation methods are available to maintain stability across the arthrodesis interval, including headless compression screws (HCSs), tension band wiring (TBW), plating, and Kirschner wire constructs. The purpose of this study was to compare the biomechanical properties of the HCS and TBW techniques.

30-Day Postoperative Complications After Surgical Treatment of Proximal Humerus Fractures: Reverse Total Shoulder Arthroplasty Versus Hemiarthroplasty.

Introduction: The purpose of this study was to evaluate risk factors associated with complications after reverse total shoulder arthroplasty (TSA) and hemiarthroplasty for the treatment of proximal humerus fractures.

Methods: A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program database was conducted. Current Procedural Terminology codes were used to identify patients treated for proximal humerus fracture with reverse TSA or hemiarthroplasty between 2005 and 2018.

Amputation and infection are the greatest fears in patients with diabetes foot complications.

Aims: To determine the degree patients with diabetic foot ulcers, Charcot neuroarthropathy and neuropathic fractures and dislocations fear complications (death, dialysis, heart attack, stroke, blindness, diabetic foot infection, minor and major lower extremity amputation [LEA]) that can occur and to assess if there is a difference between fears of patients with diabetic foot ulcers, Charcot neuroarthropathy and neuropathic fractures and dislocations and diabetic patients without these complications.

Methods: 478 patients completed an eight question Likert scale survey. The study group was defined as non-infected foot ulcers, neuropathic fractures and Charcot neuroarthropathy.

Biomechanical Comparison of 4 Transsacral Fixation Constructs in a Type 61C, Zone II Pelvic Fracture Model.

Objectives: OTA/AO 61C pelvic ring injuries are vertically unstable because of complete sacral fractures combined with anterior ring injury. The objective of this study was to compare the biomechanical characteristics of 4 transsacral screw constructs for posterior pelvic ring fixation, including one that uses a novel fixation method with a pair of locked washers with interdigitating cams.

Methods: Type C pelvic ring disruptions were created on 16 synthetic pelvis models.

Evaluation of Radiographic Parameters Following Dorsal Wrist-Spanning Plate Fixation of Distal Radius Fractures to the Second Versus Third Metacarpal.

Purpose: Dorsal wrist-spanning plate fixation for comminuted, intra-articular distal radius fractures involves the indirect reduction of intra-articular fractures via ligamentotaxis. The reduction is maintained by application of a bridge plate from the radial diaphysis to either the second or third metacarpal. The objective of this study was to retrospectively compare radiographic outcomes between distal radius fractures managed with bridge plate fixation to the second versus third metacarpal.

Review of patient-reported outcomes in periprosthetic distal femur fractures after total knee arthroplasty: a plate or intramedullary nail?

Purpose: This study reviewed the literature regarding the patient-reported treatment outcomes of using either open reduction and internal fixation (ORIF) with a plate and screw system or intramedullary nail (IMN) fixation for periprosthetic distal femur fractures around a total knee arthroplasty.

Methods: A total of 13 studies published in the last 20 years met the inclusion criteria. The studies included 347 patients who were allocated to ORIF (n = 249) and IMN (n = 98) groups according to the implants used.

Risk Factors and Reasons for Emergency Department Visits Within 30 Days of Elective Hand Surgery: An Analysis of 3,261 Patients.

The frequency of hand and elbow surgeries occurring in outpatient and elective settings is on the rise. Emergency department (ED) visits in the postoperative period are increasingly used as quality measures for surgical care. The aim of this study is to determine the number of postoperative ED visits, the primary reason for these visits, and to identify risk factors associated with these visits.

Effect of Diabetes and Hemoglobin A1c on Complications Following Elective Hand Surgery.

: Limited research exists investigating the association between diabetes and glycemic control on complications following elective hand surgery. The goal of this research was to assess the incidence of complications within 30 days of elective hand surgery in a large population of diabetic patients compared to a population of non-diabetics. Furthermore, we sought to examine the relationship of glycemic control, as measured by HbA1c, and postoperative complications.

The Impact of Hospitalization for Diabetic Foot Infection on Health-Related Quality of Life: Utilizing PROMIS.

Diabetic foot infections (DFI) are an increasingly common cause of hospitalizations. Once hospitalized with DFI, many patients require some level of amputation, often undergoing multiple operations. With increasing importance on patient-centered metrics, self-reported health-related quality of life (HRQOL) tools have been developed.

Are Readmission and Reoperation Rates for Lower Extremity Necrotizing Fasciitis Different Between Patients With and Without Diabetes Mellitus?

Necrotizing fasciitis is a condition associated with high morbidity and mortality unless emergent surgery is performed. This study aims to understand the hospital course of diabetic and nondiabetic patients managed for lower-extremity necrotizing fasciitis by identifying factors contributing to readmissions and reoperations. About 562 patients treated for lower-extremity necrotizing fasciitis were selected from the American College of Surgeons-National Surgical Quality Improvement Program database between 2012 and 2017.

Development of a quantitative prediction algorithm for target organ-specific similarity of human pluripotent stem cell-derived organoids and cells.

Human pluripotent stem cell (hPSC)-derived organoids and cells have similar characteristics to human organs and tissues. Thus, in vitro human organoids and cells serve as a superior alternative to conventional cell lines and animal models in drug development and regenerative medicine. For a simple and reproducible analysis of the quality of organoids and cells to compensate for the shortcomings of existing experimental validation studies, a quantitative evaluation method should be developed.

Effects of pH and NaCl on hydrolysis and transpeptidation activities of a salt-tolerant γ-glutamyltranspeptidase from S0904.

Unlabelled: S0904 was selected as a hyperproducer of a glutamine-hydrolyzing enzyme which was identified as a γ-glutamyltranspeptidase catalyzing both hydrolysis and transpeptidation of glutamyl substrates. The signal peptide-truncated recombinant enzyme (rBAGGT) showed two-fold enhanced specific activity for hydrolysis and optimum pH shift to pH 7 from pH 6 compared with the wild type. The hydrolysis activity of rBAGGT was tolerant against NaCl up to 2.

Postoperative Outcomes in Diabetic Pediatric Orthopaedic Surgery Patients: A National Database Study.

Background: Although the negative effects of diabetes mellitus (DM) on operative outcomes in orthopaedic surgery is a well-studied topic in adults, little is known about the impact of this disease in children undergoing orthopaedic procedures. This study aims to describe the postoperative complications in pediatric orthopaedic surgery patients with DM.

Methods: Pediatric patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) were retrospectively identified while selecting for elective orthopaedic surgery cases from the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACS-NSQIP-Pediatric) database from 2012 to 2015.

Impedance Measurement System for Assessing the Barrier Integrity of Three-Dimensional Human Intestinal Organoids.

Human pluripotent stem cell (hPSC)-derived intestinal organoids (HIOs) hold unprecedented promise for basic biology and translational applications. However, developing a quantitative method to evaluate the epithelial cell membrane integrity of HIOs as an intestinal barrier model is a major challenge because of their complex three-dimensional (3D) structure. In this study, we developed an impedance system to measure the change in electrical resistance of 3D HIOs depending on the integrity of the intestinal epithelial cell membrane, which can reflect functionality and maturity.

Insulin Dependence Increases the Risk of 30-Day Postoperative Complications Following Ankle Fracture Surgery in Patients With Diabetes Mellitus.

Patients with diabetes mellitus that undergo ankle fracture surgery have higher rates of postoperative complications compared to patients without diabetes mellitus. We evaluated the rate of complications in insulin-dependent diabetes mellitus patients, non-insulin-dependent diabetes mellitus patients, and patients without diabetes in the 30-day postoperative period following ankle fracture surgery. We also analyzed hospital length of stay, unplanned readmission, unplanned reoperation, and death.

Multifunctional Additives for High-Energy-Density Lithium-Ion Batteries: Improved Conductive Additive/Binder Networks and Enhanced Electrochemical Properties.

Cylindrical-type cells have been widely adopted by major battery and electric vehicle manufacturers owing to their price competitiveness, safety, and easy expandability. However, placement of electrodes at the core of cylindrical cells is currently restricted because of high electrode curvature and the lack of specialized electrodes and electrode materials. Here, we report the realization of highly flexible high-energy-density electrodes (active material loading of >98.

TNFα enhances trovafloxacin-induced in vitro hepatotoxicity by inhibiting protective autophagy.

Trovafloxacin (TVX) is associated with idiosyncratic drug-induced liver injury (iDILI) and inflammation-mediated hepatotoxicity. However, the inflammatory stress-regulated mechanisms in iDILI remain unclear. Herein, we elucidated the novel role of tumor-necrosis factor alpha (TNFα), an inflammatory stress factor, in TVX-induced in vitro hepatotoxicity and synergistic toxicity.

Short Term Radiographic and Patient Outcomes of a Biplanar Plating System for Triplanar Hallux Valgus Correction.

Hallux valgus is a complex deformity with a variety of techniques described for correction. A biplanar plating system for triplanar correction system has been developed to address both the translation and rotational component of the hallux valgus deformity and allow an accelerated weightbearing protocol. The purpose of this study was to determine the correction and complications using radiographic parameters and patient reported outcomes.

Early Outcomes After Surgical Management of Geriatric Patella Fractures.

Objectives: To report the incidence and risk factors for prolonged hospitalization, discharge to a facility, and postoperative complications in geriatric patients who underwent surgery for patella fracture.

Design: Retrospective database review.

Setting: The American College of Surgeons-National Surgical Quality Improvement Program (NSQIP) collects data from 600 hospitals across the United States.

Quantification of non-alcoholic fatty liver disease progression in 3D liver microtissues using impedance spectroscopy.

Non-alcoholic fatty liver disease (NAFLD) has become a global pandemic. However, a pharmacological cure has not been approved for NAFLD treatment. The greatest barriers to the development of new treatments are the ambiguous criteria among the NAFLD stages and the lack of quantitative methodologies for its disease assessment in a translatable preclinical model.

Thirty-day Outcomes After Surgery for Metastatic Bone Disease of the Extremities: An Analysis of the NSQIP Database.

Introduction: Metastatic bone disease of the extremities is a notable cause of morbidity and mortality. Surgical management is not curative; therefore, risks and benefits of surgery must be carefully considered. Previous studies of surgical outcomes are limited by small sample sizes because of the rare incidence of these procedures.

Effect of Sensory Neuropathy on the Predictive Value of Inflammatory Biomarkers for Osteomyelitis in Diabetic and Nondiabetic Patients with Foot Infections.

Objective: To investigate the predictive value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in persons with and without diabetes with osteomyelitis (OM).

Methods: We evaluated 455 patients in a retrospective cohort study of patients admitted to the hospital with diabetic foot OM (n = 177), diabetic foot soft-tissue infections (STIs) (n = 176), nondiabetic OM (n = 51), and nondiabetic STIs (n = 51). Infection diagnosis was determined through bone culture, histopathologic examination for OM, and/or imaging (magnetic resonance imaging/single-photon emission computed tomography) for STI.

Systematic review and network meta-analysis of subscapularis management techniques in anatomic total shoulder arthroplasty.

Background: Controversy exists regarding the optimal subscapularis management technique in patients undergoing anatomic total shoulder arthroplasty. The purpose of this study was to compare clinical, radiographic, and functional outcomes between subscapularis tenotomy (ST), lesser tuberosity osteotomy (LTO), and subscapularis peel (SP) techniques.

Methods: We performed a level III systematic review and network meta-analysis comparing ST, LTO, and SP in patients undergoing anatomic total shoulder arthroplasty.

Charcot Midfoot Reconstruction: Does Subtalar Arthrodesis or Medial Column Fixation Improve Outcomes?

Charcot neuroarthropathy is a complication of neuropathy often secondary to diabetes mellitus and most commonly affects the midfoot. In these patients, reconstruction of the foot may be required for limb salvage. A superconstruct technique has previously been described using intramedullary beaming fixation of the midfoot and hindfoot to span the zone of injury.