Acetabular fractures are amongst the most complex fractures. It has been suggested that pre-contouring the fixation plates may save intra-operative time, blood loss, reduce intra-operative fluoroscopy and improve the reduction. The purpose of this study was to assess if the contouring could be done reliably using the mirror image of the uninjured hemipelvis. Using the CT data of 12 specimens with no bony abnormality 3D models were reconstructed. Using computer software (AMIRA, Visage Imaging) the mirror image of the left hemipelvis and the right hemipelvis were superimposed based on landmarks. The distances between the surfaces were then calculated and displayed in the form of colour maps. The colour maps demonstrated that for the areas around were acetabular fixation plates would be placed the differences were small. For the anterior column plate 50% of the specimens had differences of less than 1mm, which based on the work of Letournel and Judet would represent an anatomical reduction. For the posterior column plate 58% had differences of less than 1mm. This study demonstrates that there is considerable symmetry between both hemipelvises and that precontouring on the mirror image of the uninjured side is an accurate, quick and reliable method for precontouring.
The ability of activated platelets to induce cellular proliferation is well recognised. In a previous diffusion model, platelets combined with Tri-calcium phosphate (TCP) led to an osteoprogenitor mitogenic response followed by cellular differentiation. This study was designed to look at osteoprogenitor responses when cultured directly onto TCP granules combined with activated platelets. Human osteoprogenitors were loaded onto TCP with activated platelets at a low seeding density and high seeding densities. Cellular proliferation was assessed using the pico-green DNA content analysis. Differentiation towards osteoblastic phenotype was assessed using an alkaline phosphatase assay. RNA extraction, reverse transcription and quantitative real-time polymerase chain reaction was used to assess gene expression for type 1 collagen and osteocalcin. Histological assessment for live/dead staining and alkaline phosphatase was used on cultured granule samples.Introduction
Method
Acetabular fractures are amongst the most complex fractures to treat. It has been suggested that pre-contouring the fixation plates may save intra-operative time, blood loss, reduce intra-operative fluoroscopy and improve the reduction. The purpose of this study was to assess if the contouring could be done reliably using the mirror image of the uninjured hemipelvis. Using the CT data of 12 specimens with no bony abnormality 3D models were reconstructed. Using computer software (AMIRA, Visage Imaging) the mirror image of the left hemipelvis and the right hemipelvis were superimposed based on landmarks. The distances between the surfaces were then calculated. The results were collected in the form of mean distance and colour maps. The mean difference between surfaces ranged from 1.76mm and 8.47mm. The colour maps demonstrated that for the areas around were acetabular fixation plated would be placed the differences were small. For the anterior column plate 6 (50%) of the specimens had differences of less than 1mm, which based on the work of Letournel and Judet would represent an anatomical reduction. (None had a difference of more than 6mm.) For the posterior column plate 7 (58%) had differences of less than 1mm. (None had a difference of more than 3mm. This study demonstrates that there is considerable symmetry between both hemipelvises and that precontouring on the mirror image of the uninjured side is an accurate, quick and reliable method for precontouring. However the symmetry is not exact and the operating surgeon needs to be aware that fine-contouring may be required intra-operatively.
To investigate the effects of trauma and fracture surgery on leukocyte maturation and function. Unbalanced inflammation triggered by trauma has been linked to multiorgan dysfunction (MOD) and death. In animal and cellular models, changes in neutrophil function and failure of monocyte infiltration and resolution have been implicated as possible causes. The investigators combine assays on neutrophil function with surface antigen expression on circulating neutrophils and monocytes. These are correlated with severity of traumatic injury, type of surgery and clinical outcome to help explain the aetiology of distant organ injury, and pose a case for damage control surgery.Objective
Background
