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Li SC, Chiang CC, Tsai YS, Chen CJ, Lee TH. Fabrication of a Three-Dimensional Microfluidic System from Poly(methyl methacrylate) (PMMA) Using an Intermiscibility Vacuum Bonding Technique. Micromachines (Basel) 2024; 15:454. [PMID: 38675265 PMCID: PMC11052095 DOI: 10.3390/mi15040454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
In this study, the fabrication of microfluidic chips through the bonding of poly (methyl methacrylate) (PMMA) boards featuring designed patterns to create a three-dimensional sandwich structure with embedded microchannels was explored. A key focus was optimization of the interface quality of bonded PMMA pairs by adjusting the solvent, such as such as acetone, alcohol, and their mixture. Annealing was conducted below 50 °C to leverage the advantages of low-temperature bonding. Because of the differences in the chemical reactivity of PMMA toward acetone, alcohol, and their combinations, the resulting defect densities at the bonding interfaces differed significantly under low-temperature annealing conditions. To achieve the optimal sealing integrity, bonding pressures of 30 N, 40 N, and 50 N were evaluated. The interface was analyzed through microstructural examination via optical microscopy and stress measurements were determined using digital photoelasticity, while the bonding strength was assessed through tensile testing.
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Affiliation(s)
| | | | | | | | - Tien-Hsi Lee
- Department of Mechanical Engineering, National Central University, Taoyuan City 32001, Taiwan; (S.-C.L.); (C.-C.C.); (Y.-S.T.); (C.-J.C.)
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2
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Wan HH, Zhu H, Chiang CC, Li JS, Ren F, Tsai CT, Liao YT, Neal D, Esquivel-Upshaw JF, Pearton SJ. High sensitivity saliva-based biosensor in detection of breast cancer biomarkers: HER2 and CA15-3. J Vac Sci Technol B Nanotechnol Microelectron 2024; 42:023202. [PMID: 38362284 PMCID: PMC10866624 DOI: 10.1116/6.0003370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024]
Abstract
The prevalence of breast cancer in women underscores the urgent need for innovative and efficient detection methods. This study addresses this imperative by harnessing salivary biomarkers, offering a noninvasive and accessible means of identifying breast cancer. In this study, commercially available disposable based strips similar to the commonly used glucose detection strips were utilized and functionalized to detect breast cancer with biomarkers of HER2 and CA15-3. The results demonstrated limits of detection for these two biomarkers reached as low as 1 fg/ml much lower than those of conventional enzyme-linked immunosorbent assay in the range of 1∼4 ng/ml. By employing a synchronized double-pulse method to apply 10 of 1.2 ms voltage pulses to the electrode of sensing strip and drain electrode of the transistor for amplifying the detected signal, and the detected signal was the average of 10 digital output readings corresponding to those 10 voltage pulses. The sensor sensitivities were achieved approximately 70/dec and 30/dec for HER2 and CA15-3, respectively. Moreover, the efficiency of this novel technique is underscored by its swift testing time of less than 15 ms and its minimal sample requirement of only 3 μl of saliva. The simplicity of operation and the potential for widespread public use in the future position this approach as a transformative tool in the early detection of breast cancer. This research not only provides a crucial advancement in diagnostic methodologies but also holds the promise of revolutionizing public health practices.
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Affiliation(s)
- Hsiao-Hsuan Wan
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Haochen Zhu
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Chao-Ching Chiang
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Jian-Sian Li
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Fan Ren
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Cheng-Tse Tsai
- Department of Electronics and Electrical Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Hsinchu, Taiwan
| | - Yu-Te Liao
- Department of Electronics and Electrical Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Hsinchu, Taiwan
| | - Dan Neal
- Department of Surgery, University of Florida, Gainesville, Florida 32610
| | - Josephine F Esquivel-Upshaw
- Department of Restorative Dental Science, Division of Prosthodontics, University of Florida, Gainesville, Florida 32611
| | - Stephen J Pearton
- Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611
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Chiang CC, Huang SJ, Immanuel PN, Lan JH, Lo FY, Young KC. Using a 3D Silicon Micro-Channel Device and Raman Spectroscopy for the Analysis of Whole Blood and Abnormal Blood. Micromachines (Basel) 2023; 15:21. [PMID: 38258140 PMCID: PMC10819504 DOI: 10.3390/mi15010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/23/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
Blood testing is a crucial application in the field of clinical studies for disease diagnosis and screening, biomarker discovery, organ function assessment, and the personalization of medication. Therefore, it is of the utmost importance to collect precise data in a short time. In this study, we utilized Raman spectroscopy to analyze blood samples for the extraction of comprehensive biological information, including the primary components and compositions present in the blood. Short-wavelength (532 nm green light) Raman scattering spectroscopy was applied for the analysis of the blood samples, plasma, and serum for detection of the biological characteristics in each sample type. Our results indicated that the whole blood had a high hemoglobin content, which suggests that hemoglobin is a major component of blood. The characteristic Raman peaks of hemoglobin were observed at 690, 989, 1015, 1182, 1233, 1315, and 1562-1649 cm-1. Analysis of the plasma and serum samples indicated the presence of β-carotene, which exhibited characteristic peaks at 1013, 1172, and 1526 cm-1. This novel 3D silicon micro-channel device technology holds immense potential in the field of medical blood testing. It can serve as the basis for the detection of various diseases and biomarkers, providing real-time data to help medical professionals and patients better understand their health conditions. Changes in biological data collected in this manner could potentially be used for clinical diagnosis.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan; (C.-C.C.); (P.N.I.); (J.-H.L.)
| | - Song-Jeng Huang
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan; (C.-C.C.); (P.N.I.); (J.-H.L.)
| | - Philip Nathaniel Immanuel
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan; (C.-C.C.); (P.N.I.); (J.-H.L.)
| | - Jun-Han Lan
- Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taipei 10607, Taiwan; (C.-C.C.); (P.N.I.); (J.-H.L.)
| | - Fang-Yuh Lo
- Department of Physics, National Taiwan Normal University, Taipei 10611, Taiwan;
| | - Kung-Chia Young
- Department of Medical Laboratory Science and Biotechnology, National Cheng Kung University, Tainan 70101, Taiwan
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Chiang CC, Lee HC, Lin SC, Qu D, Chu MW, Chen CD, Chien CL, Huang SY. Unequivocal Identification of Spin-Triplet and Spin-Singlet Superconductors with Upper Critical Field and Flux Quantization. Phys Rev Lett 2023; 131:236003. [PMID: 38134800 DOI: 10.1103/physrevlett.131.236003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023]
Abstract
Spin-triplet superconductors play central roles in Majorana physics and quantum computing but are difficult to identify. We show the methods of kink-point upper critical field and flux quantization in superconducting rings can unequivocally identify spin-singlet, spin-triplet in centrosymmetric superconductors, and singlet-triplet admixture in noncentrosymmetric superconductors, as realized in γ-BiPd, β-Bi_{2}Pd, and α-BiPd, respectively. Our findings are essential for identifying triplet superconductors and exploring their quantum properties.
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Affiliation(s)
- C C Chiang
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
- Willian H. Miller III Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Maryland 21218, USA
| | - H C Lee
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | - S C Lin
- Center for Condensed Matter Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - D Qu
- Center for Condensed Matter Sciences, National Taiwan University, Taipei 10617, Taiwan
- Center of Atomic Initiatives for New Materials, National Taiwan University, Taipei 10617, Taiwan
| | - M W Chu
- Center for Condensed Matter Sciences, National Taiwan University, Taipei 10617, Taiwan
- Center of Atomic Initiatives for New Materials, National Taiwan University, Taipei 10617, Taiwan
| | - C D Chen
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - C L Chien
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
- Willian H. Miller III Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Maryland 21218, USA
| | - S Y Huang
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
- Center of Atomic Initiatives for New Materials, National Taiwan University, Taipei 10617, Taiwan
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Chen JJ, Cheng YC, Lin LH, Chiang CC, Lin KH, Liu TC, Chou YJ, Lee IH, Huang N. Perception of transitional care quality associated with functional outcomes among patients with fractures and stroke in Taiwan. Geriatr Nurs 2023; 53:247-254. [PMID: 37598428 DOI: 10.1016/j.gerinurse.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/22/2023]
Abstract
This study aimed to examine the relationship between self-perceived quality of transitional care and functional outcome among patients with stroke and fractures. The Care Transition Measure (CTM-15) was used to survey patient's self-perceived transitional care quality before discharge. General estimating equations were used to investigate the influences of transitional care quality on patient's functional outcomes at before, 1 week after, and 1 or 3 months after discharge. Among stroke patients, higher CTM-15 scores were positively associated with greater outcome in Instrumental Activities of Daily Living (IADL) following discharge. Higher scores for "reader-friendly written care plan," "consideration of patient's preferences," and "understanding of health management" had significantly positive effects on functional recovery in IADL among both patient groups following discharge. These findings suggest that heterogeneity in transitional care needs between medical and surgical patients shall not be overlooked. A one-size-fits-all strategy may be insufficient for ensuring patient care continuity following discharge.
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Affiliation(s)
- Jing-Jer Chen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Chun Cheng
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Hwa Lin
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kung-Hou Lin
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzu-Ching Liu
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yiing-Jenq Chou
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - I-Hui Lee
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Nicole Huang
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Chiang CC, Xia X, Craciun V, Rocha MG, Camargo SEA, Rocha FRG, Gopalakrishnan SK, Ziegler KJ, Ren F, Esquivel-Upshaw JF. Enhancing the Hydrophobicity and Antibacterial Properties of SiCN-Coated Surfaces with Quaternization to Address Peri-Implantitis. Materials (Basel) 2023; 16:5751. [PMID: 37687444 PMCID: PMC10488823 DOI: 10.3390/ma16175751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023]
Abstract
Peri-implantitis is a major cause of dental implant failure. This disease is an inflammation of the tissues surrounding the implant, and, while the cause is multi-factorial, bacteria is the main culprit in initiating an inflammatory reaction. Dental implants with silicon carbonitride (SiCN) coatings have several potential advantages over traditional titanium implants, but their antibacterial efficiency has not yet been evaluated. The purpose of this study was to determine the anti-bacterial potential of SiCN by modifying the surface of SiCN-coated implants to have a positive charge on the nitrogen atoms through the quaternization of the surface atoms. The changes in surface chemistry were confirmed using contact angle measurement and XPS analysis. The modified SiCN surfaces were inoculated with Streptococcus mutans (S. mutans) and compared with a silicon control. The cultured bacterial colonies for the experimental group were 80% less than the control silicon surface. Fluorescent microscopy with live bacteria staining demonstrated significantly reduced bacterial coverage after 3 and 7 days of incubation. Scanning electron microscopy (SEM) was used to visualize the coated surfaces after bacterial inoculation, and the mechanism for the antibacterial properties of the quaternized SiCN was confirmed by observing ruptured bacteria membrane along the surface.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (C.-C.C.)
| | - Xinyi Xia
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (C.-C.C.)
| | - Valentin Craciun
- National Institute for Lasers, Plasma and Radiation Physics, RO-077125 Magurele, Ilfov, Romania
| | - Mateus Garcia Rocha
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
| | - Samira Esteves Afonso Camargo
- Department of Comprehensive Oral Healthy, Adams Dental School, University of North Carolina, Chapel Hill, NC 27599, USA
| | | | - Sarathy K. Gopalakrishnan
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (C.-C.C.)
| | - Kirk J. Ziegler
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (C.-C.C.)
| | - Fan Ren
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (C.-C.C.)
| | - Josephine F. Esquivel-Upshaw
- Department of Restorative Dental Sciences, Division of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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Xia X, Chiang CC, Gopalakrishnan SK, Kulkarni AV, Ren F, Ziegler KJ, Esquivel-Upshaw JF. Properties of SiCN Films Relevant to Dental Implant Applications. Materials (Basel) 2023; 16:5318. [PMID: 37570022 PMCID: PMC10420248 DOI: 10.3390/ma16155318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/17/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023]
Abstract
The application of surface coatings is a popular technique to improve the performance of materials used for medical and dental implants. Ternary silicon carbon nitride (SiCN), obtained by introducing nitrogen into SiC, has attracted significant interest due to its potential advantages. This study investigated the properties of SiCN films deposited via PECVD for dental implant coatings. Chemical composition, optical, and tribological properties were analyzed by adjusting the gas flow rates of NH3, CH4, and SiH4. The results indicated that an increase in the NH3 flow rate led to higher deposition rates, scaling from 5.7 nm/min at an NH3 flow rate of 2 sccm to 7 nm/min at an NH3 flow rate of 8 sccm. Concurrently, the formation of N-Si bonds was observed. The films with a higher nitrogen content exhibited lower refractive indices, diminishing from 2.5 to 2.3 as the NH3 flow rate increased from 2 sccm to 8 sccm. The contact angle of SiCN films had minimal differences, while the corrosion rate was dependent on the pH of the environment. These findings contribute to a better understanding of the properties and potential applications of SiCN films for use in dental implants.
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Affiliation(s)
- Xinyi Xia
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Chao-Ching Chiang
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Sarathy K. Gopalakrishnan
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Aniruddha V. Kulkarni
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Fan Ren
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Kirk J. Ziegler
- Department of Chemical Engineering, College of Engineering, University of Florida, Gainesville, FL 32611, USA; (X.X.)
| | - Josephine F. Esquivel-Upshaw
- Department of Restorative Dental Sciences, Division of Prosthodontics, College of Dentistry, University of Florida, Gainesville, FL 32610, USA
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Chou TFA, Tzeng YH, Teng MH, Huang YC, Wang CS, Lin CC, Chiang CC. Trimalleolar Fractures Treated by Open Reduction Internal Fixation Compared With Arthroscopically Assisted Reduction and Minimally Invasive Surgery. Foot Ankle Int 2023; 44:431-442. [PMID: 36946569 DOI: 10.1177/10711007231157676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Currently, the standard of treatment for trimalleolar (TM) fracture is osteosynthesis through open reduction and internal fixation (ORIF). This study assessed whether arthroscopically assisted reduction and minimally invasive surgery (AARMIS) can be an alternative surgical method for TM fractures. METHODS This retrospective cohort study included 49 patients with TM that were surgically treated. 27 patients received ORIF and 22 patients underwent AARMIS . At baseline, we recorded the patient's demographic features, fracture pattern (AO-OTA and Haraguchi classification), and surgical method. For postoperative results, we examined the patient's radiographic outcome, including time to union, quality of fracture reduction, as well as functional outcomes (American Orthopaedic Foot & Ankle Society ankle hindfoot score, ankle range of motion, and visual analog scale of pain) and perioperative complications. RESULTS At mean follow-up of 46.6±24.6 (ORIF) and 36.4±18.5 months (AARMIS), both groups had comparable radiographic outcomes. No significant difference in rates of early ankle OA were detected. In terms of functional outcome, VAS pain and AOFAS score at postoperative day 3, postoperative month 3, and at final follow-up were not different. In terms of range of motion, we did not find a significant difference in mean range of motion. CONCLUSION Patients with TM fractures treated with AARMIS achieved satisfactory results and was not significantly different in radiographic and functional performance compared with ORIF. LEVEL OF EVIDENCE Level III, retrospective cohort study.
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Affiliation(s)
- Te-Feng Arthur Chou
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei
- Department of Radiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Ming-Hung Teng
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Yen-Chun Huang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Chien-Shun Wang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Chun-Cheng Lin
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei
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Xian M, Stephany JL, Chiu CW, Chiang CC, Ren F, Tsai CT, Shan SS, Liao YT, Esquivel-Upshaw JF, Pearton SJ. High sensitivity CIP2A detection for oral cancer using a rapid transistor-based biosensor module. J Vac Sci Technol B Nanotechnol Microelectron 2023; 41:013201. [PMID: 36531804 PMCID: PMC9750712 DOI: 10.1116/6.0002175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
Oral squamous cell carcinoma (OSCC) is one of the most common lip and oral cavity cancer types. It requires early detection via various medical technologies to improve the survival rate. While most detection techniques for OSCC require testing in a centralized lab to confirm cancer type, a point of care detection technique is preferred for on-site use and quick result readout. The modular biological sensor utilizing transistor-based technology has been leveraged for testing CIP2A, and optimal transistor gate voltage and load resistance for sensing setup was investigated. Sensitivities of 1 × 10-15 g/ml have been obtained for both detections of pure CIP2A protein and HeLa cell lysate using identical test conditions via serial dilution. The superior time-saving and high accuracy testing provides opportunities for rapid clinical diagnosis in the medical space.
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Affiliation(s)
- Minghan Xian
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Jenna L Stephany
- Department of Restorative Dental Sciences, University of Florida, Gainesville, Florida 32610
| | - Chan-Wen Chiu
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Chao-Ching Chiang
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Fan Ren
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Cheng-Tse Tsai
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Siang-Sin Shan
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Yu-Te Liao
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | | | - Stephen J Pearton
- Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611
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Yang TC, Chiang CC. Authors' reply to concerns regarding "Critical analysis of the ratio of fracture site diameter to the isthmus femoral canal diameter as a potential predictor of complications following antegrade intramedullary nailing for the distal femur shaft fractures". Injury 2022; 53:3561. [PMID: 35688706 DOI: 10.1016/j.injury.2022.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Tzu-Cheng Yang
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Ma HH, Chiang CC, Su YP, Chen KH. Is double-crossed retrograde elastic stable intramedullary nailing an alternative method for the treatment of diaphyseal fractures in the adult humerus? J Orthop Traumatol 2022; 23:40. [PMID: 35978204 PMCID: PMC9385937 DOI: 10.1186/s10195-022-00662-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to compare two techniques for the surgical treatment of diaphyseal fractures in the adult humerus: double-crossed retrograde elastic stable intramedullary nailing (DCR-ESIN) and limited-contact dynamic compression plate (LC-DCP). METHODS This was a retrospective study conducted at a single hospital. We included 122 patients with diaphyseal fractures of the humerus who had received DCR-ESIN or LC-DCP from January 2011 to January 2017. We compared union rates, union times, disabilities of the arm, shoulder, and hand (DASH) scores at the postoperative 1-year follow-up, and complications between the two groups. RESULTS Plating management was performed in 63 patients, while DCR-ESIN was performed in 59 patients. The union rate was higher in the DCR-ESIN group than in the LC-DCP group (100% vs. 90.5%; p = 0.052). The union time was shorter in the DCR-ESIN group than in the LC-DCP group (12.0 weeks vs. 14.8 weeks; p < 0.001). The intraoperative blood loss and operative time were less in the DCR-ESIN group than in the LC-DCP group (76.4 min vs. 129.5 min; p < 0.001; 60.9 ml vs. 244.8 ml; p < 0.001, respectively). The DCR-ESIN had superior results for the rate of overall complications (p = 0.006). At the 1-year follow-up, the DCR-ESIN group had better DASH scores than the LC-DCP group (p = 0.014). CONCLUSIONS The DCR-ESIN technique, used to treat diaphyseal fractures of the humerus, has shorter operative times, less intra-operative blood loss, shorter union times, and better functional outcomes at 1-year follow-up than the LC-DCP technique. DCR-ESIN may be an alternative method for the surgical treatment of diaphyseal humeral fractures in adults.
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Affiliation(s)
- Hsuan-Hsiao Ma
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road Taipei 112, Taipei, Taiwan.,Division of Orthopaedics, Department of Surgery, Taipei Veterans General Hospital Taitung Branch, Taitung, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Orthopaedics, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road Taipei 112, Taipei, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Ping Su
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road Taipei 112, Taipei, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kun-Hui Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road Taipei 112, Taipei, Taiwan. .,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. .,Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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12
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Chiu CW, Xian M, Stephany JL, Xia X, Chiang CC, Ren F, Tsai CT, Shan SS, Liao YT, Esquivel-Upshaw JF, Rananaware SR, Nguyen LT, Macaluso NC, Jain PK, Cash MN, Mavian CN, Salemi M, Leon ME, Chang CW, Lin J, Pearton SJ. Rapid SARS-CoV-2 diagnosis using disposable strips and a metal-oxide-semiconductor field-effect transistor platform. J Vac Sci Technol B Nanotechnol Microelectron 2022; 40:023204. [PMID: 36032199 PMCID: PMC8830941 DOI: 10.1116/6.0001615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/25/2022] [Indexed: 06/15/2023]
Abstract
The SARS-CoV-2 pandemic has had a significant impact worldwide. Currently, the most common detection methods for the virus are polymerase chain reaction (PCR) and lateral flow tests. PCR takes more than an hour to obtain the results and lateral flow tests have difficulty with detecting the virus at low concentrations. In this study, 60 clinical human saliva samples, which included 30 positive and 30 negative samples confirmed with RT-PCR, were screened for COVID-19 using disposable glucose biosensor strips and a reusable printed circuit board. The disposable strips were gold plated and functionalized to immobilize antibodies on the gold film. After functionalization, the strips were connected to the gate electrode of a metal-oxide-semiconductor field-effect transistor on the printed circuit board to amplify the test signals. A synchronous double-pulsed bias voltage was applied to the drain of the transistor and strips. The resulting change in drain waveforms was converted to digital readings. The RT-PCR-confirmed saliva samples were tested again using quantitative PCR (RT-qPCR) to determine cycling threshold (Ct) values. Ct values up to 45 refer to the number of amplification cycles needed to detect the presence of the virus. These PCR results were compared with digital readings from the sensor to better evaluate the sensor technology. The results indicate that the samples with a range of Ct values from 17.8 to 35 can be differentiated, which highlights the increased sensitivity of this sensor technology. This research exhibits the potential of this biosensor technology to be further developed into a cost-effective, point-of-care, and portable rapid detection method for SARS-CoV-2.
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Affiliation(s)
- Chan-Wen Chiu
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Minghan Xian
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Jenna L. Stephany
- Department of Restorative Dental Sciences, University of Florida, Gainesville, Florida 32610
| | - Xinyi Xia
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Chao-Ching Chiang
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Fan Ren
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Cheng-Tse Tsai
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Siang-Sin Shan
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Yu-Te Liao
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | | | - Santosh R. Rananaware
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Long T. Nguyen
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Nicolas C. Macaluso
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Piyush K. Jain
- Department of Chemical Engineering, University of Florida, Gainesville, Florida 32611
| | - Melanie N. Cash
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida 32611
| | - Carla N. Mavian
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida 32611
| | - Marco Salemi
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida 32611
| | - Marino E. Leon
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida 32611
| | - Chin-Wei Chang
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, Florida 32611
| | - Jenshan Lin
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, Florida 32611
| | - Stephen J. Pearton
- Department of Materials Science and Engineering, University of Florida, Gainesville, Florida 32611
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13
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Chiang CC, Lin CFJ, Tzeng YH, Teng MH, Yang TC. Arthroscopic Quantitative Measurement of Medial Clear Space for Deltoid Injury of the Ankle: A Cadaveric Comparative Study With Stress Radiography. Am J Sports Med 2022; 50:778-787. [PMID: 35289224 DOI: 10.1177/03635465211067806] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The deltoid ligament (DL) is an important stabilizer of the ankle. DL injury of varying severity can occur alone or with syndesmotic injury and fibular fracture. Limited diagnostic tools are available to assess DL injury quantitatively. PURPOSE To establish an arthroscopic quantitative assessment of DL injury and to compare its performance with that of external rotation stress (ERS) and gravity stress (GS) radiography. STUDY DESIGN Controlled laboratory study. METHODS In total, 24 cadaveric lower extremities were divided into 4 groups: group 1 consisted of intact DL, group 2 of superficial DL disruption, group 3 of deep DL disruption, and group 4 of complete DL (superficial and deep) disruption. All specimens underwent sequential sectioning of syndesmotic ligaments, and medial clear space (MCS) was measured with ankle arthroscopy, ERS radiography, and GS radiography at different stages of syndesmotic sectioning. RESULTS For noninjured deltoid (group 1) and injured deltoid (groups 2-4), area under the receiver operating characteristic curve (AUC) of measurement of MCS was 0.939 for arthroscopy, 0.932 for ERS radiography, and 0.874 for GS radiography, with a significant difference between arthroscopy and GS radiography (P = .014). For incomplete deltoid injury (groups 1-3) and complete deltoid injury (group 4), the AUC of MCS was 0.811 for arthroscopy, 0.656 for ERS radiography, and 0.721 for GS radiography, with a significant difference between arthroscopy and ERS radiography (P < .001) and between arthroscopy and GS radiography (P = .035). For all stages of syndesmotic sectioning, cutoff values of arthroscopic MCS with intact fibula were ≤2.5 mm for intact DL, between 2.5 and 3.5 mm for partial DL injury (superficial or deep), and ≥3.5 mm for complete DL injury. Arthroscopy was unable to detect a difference between superficial deltoid injury (group 2) and deep deltoid injury (group 3) in partial DL injury, with a measured MCS between 2.5 and 3.5 mm. The intraclass correlation coefficient of interrater reliability was 0.975 for arthroscopy, 0.917 for ERS radiography, and 0.811 for GS radiography. CONCLUSION Arthroscopic MCS measurement can differentiate intact DL, partial DL injury, and complete DL injury. Compared with ERS and GS radiography, arthroscopic MCS measurement has greater accuracy with excellent interrater reliability. CLINICAL RELEVANCE For patients with suspected DL injury, arthroscopic MCS is useful for determining deltoid lesion severity based on defined cutoff values for consideration in preoperative planning to improve surgical outcomes.
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Affiliation(s)
- Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Fu Jeff Lin
- Department of Statistics, National Taipei University, Taipei, Taiwan.,Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan.,Department of Radiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ming-Hung Teng
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Orthopedics, Taipei Veterans General Hospital, Yuli Branch, Hualien, Taiwan
| | - Tzu-Cheng Yang
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Orthopaedics, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
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14
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Wang CS, Chiang CC, Tzeng YH, Yang TC, Lin CC. Response to "Letter Regarding: First-Ray Radiographic Changes After Flexible Adult Acquired Flatfoot Deformity Correction". Foot Ankle Int 2022; 43:459-460. [PMID: 35139687 DOI: 10.1177/10711007221077050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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15
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Abstract
BACKGROUND Adult acquired flatfoot deformity (AAFD) and hallux valgus (HV) are common foot and ankle deformities. Few studies have reported the changes in radiographic parameters of HV after reconstructive surgery for AAFD. This study aimed to evaluate the changes in radiographic parameters of HV and analyze the risk factors for increased HV after correction of AAFD. METHODS Adult patients with flexible AAFD who underwent similar bony procedures including medializing calcaneal osteotomy and Cotton osteotomy were included. Radiographic parameters were measured on weightbearing radiographs preoperatively, postoperatively, and at the final follow-up. Patients were divided into hallux valgus angle (HVA) increased and HVA nonincreased groups; logistic regression analysis was performed to identify risk factors affecting increased HV. RESULTS Forty-six feet of 43 patients were included. After AAFD reconstructive surgery, the tibial sesamoid position improved by 1 grade, but the HVA increased 4 degrees in average. Further, 21 of 46 feet (46%) showed an HVA increase ≥5 degrees immediately after AAFD correction surgery. Preoperative talonavicular coverage angle <21.6 degrees was a risk factor associated with HV increase immediately after the surgery. CONCLUSION In this case series, using plain radiographs to measure standard parameters of foot alignment, we found the association between AAFD correction and HV deformity measures somewhat paradoxical. Correction of overpronation of the hindfoot and midfoot appears to improve the first metatarsal rotational deformity but may also increase HVA. A lower preoperative talonavicular coverage angle was associated with an increase of the HVA after surgery. LEVEL OF EVIDENCE Level IV, case series study.
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Affiliation(s)
- Chien-Shun Wang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics; School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei.,Department of Radiology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzu-Cheng Yang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics; School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Chun-Cheng Lin
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics; School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Ming-Chau Chang
- Department of Orthopaedics; School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Orthopaedics; School of Medicine, National Yang Ming Chiao Tung University, Taipei
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16
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Ma HH, Chiang CC, Lin CC, Wang CS. The influence of proximal femur canal size on reduction of intertrochanteric fracture with cephalomedullary nail. Orthop Traumatol Surg Res 2021; 107:103006. [PMID: 34217864 DOI: 10.1016/j.otsr.2021.103006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/22/2021] [Accepted: 04/07/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Malalignment is the most important risk factor for fixation failure after intertrochanteric fracture treated with a cephalomedullay nail (CMN). Malalignment continues to occur despite advances in surgical techniques. HYPOTHESIS We hypothesized that small femur canal size causes intra-operative reduction loss during cephalomedullary nail insertion. METHODS A retrospective study was performed from 2014 to 2017. Patients with acute intertrochanteric fracture implanted with the same sized CMN (Stryker, Mahwah, NJ, USA, diameter: 10mm, length: 170mm, degree 130) were included. Evaluated radiographic parameters included femoral canal size, corrected neck-shaft angle, and calcar reduction. RESULTS The study totally included and analyzed the data from 108 patients. Patients with smaller femoral canal size tended to have increased calcar distance according to Pearson's correlation coefficient analysis (r(106)=-0.805, p<0.001). Patients with calcar mal-reduction had higher corrected neck-shaft angle post-operatively. This observed correction tended to be lost during follow up. CONCLUSIONS Small femoral canal size resulted in poorer reduction quality. Reduction loss during nail insertion may be due to the whole proximal fragment instead of the superolateral femoral neck. Reaming the isthmus before nail insertion or choosing a smaller sized CMN is indicated in this patient population to prevent intra- or post-operative loss of reduction. LEVEL OF EVIDENCE III; retrospective study.
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Affiliation(s)
- Hsuan-Hsiao Ma
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Cheng Lin
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chien-Shun Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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17
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Cheng MF, Chiang CC, Lin CC, Chang MC, Wang CS. Loss of radial height in extra-articular distal radial fracture following volar locking plate fixation. Orthop Traumatol Surg Res 2021; 107:102842. [PMID: 33548565 DOI: 10.1016/j.otsr.2021.102842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/27/2020] [Accepted: 09/15/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Radial height is an important prognostic factor in treating distal radius fracture. However, does further collapse of radial height in distal radius fractures after with volar locking plate fixation have a great impact on the prognosis? The present study aimed to elucidate radial height loss and determine the associated risk factors after open reduction and internal fixation with volar locking plate in patients with extra-articular distal radius fractures. HYPOTHESIS Patients with radial height collapse after fracture reduction and internal fixation with a volar locking plate may have poor outcomes. METHODS Data of 87 patients (21 male) undergoing surgery for acute extra-articular distal radius fractures (AO: 23-A2 or 23-A3) between February 2014 and July 2016 were evaluated retrospectively. Patients were divided into two groups by radial height loss. Potential risk factors were tested by Pearson correlation coefficients. Stepwise multiple regression logistic analysis determined significant independent risk factors for extra-articular distal radius fractures. Clinical evaluation was performed by the same surgeon by determining wrist ROM. Grip strength was measured with a Jamar dynamometer and compared with non-affect wrist in percentage. In addition, all the patients were asked to grade modified Mayo wrist score and Visual Analogue Scale (VAS) score. These findings were recorded postoperative 1 year of follow-up. RESULTS Mean radial height loss was 1.3±0.9mm. Age (ß=0.002, p=0.003), postoperative ulnar-positive deformity (ß=0.107, p<0.001), DEXA (ß=-0.015, p=0.008), and shortest diameter of distal fracture fragment in AP and lateral views (ß=-0.050, p=0.037; ß=-0.080, p=0.043) were significantly associated with radial height loss. As for the outcome of clinical prognosis, though radial height collapse group had poorer wrist range of motion, there was no statistical difference. Besides, there were no significant differences in grips strength and VAS score between these two groups. However, in regards of modified Mayo wrist score, the percentage of patients with poor outcomes is significant higher in radial height collapse group (p=0.039). Moreover, all patients with poor outcomes in radial height collapse groups were older than 65-year-old. DISCUSSION Radial height loss is noted in patients undergoing open reduction and internal fixation with volar locking plate for extra-articular distal radius fractures. Risk factors for radial height collapse include advanced age, poor bone quality, shortest distance between fracture site and articular surface and postoperative ulnar-positive deformity. LEVEL OF EVIDENCE IV; non-comparative prospective study.
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Affiliation(s)
- Ming Fai Cheng
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and national Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and national Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Cheng Lin
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and national Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and national Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Shun Wang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and national Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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18
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Wang CS, Tzeng YH, Yang TC, Lin CC, Chang MC, Chiang CC. Radiographic and clinical results of modified 2-incision sinus tarsi approach for treatment of calcaneus fracture. Injury 2021; 52:1971-1977. [PMID: 34039469 DOI: 10.1016/j.injury.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sinus tarsi approach (STA) is the most commonly used minimally invasive surgery (MIS) in the treatment of displaced intra-articular calcaneal fracture (DIACF). However, there are some limitations related to its limited access. The goal of the present study is to describe a modified 2-incision STA and to evaluate the radiographic and clinical outcomes in the treatment of DIACF. MATERIALS AND METHODS Patients had a Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification 82-C, Sanders type II, III calcaneal fracture, and underwent modified 2-incision STA and internal fixation were included in this retrospective study. Serial radiographic measurements and clinical assessment were taken to evaluate the effectiveness of this technique. RESULTS Thirty-four feet of 33 patients treated between 2014 and 2019 were included with an average follow-up of 28.5 (range, 12-65) months. Mean preoperative Böhler's angle was 1.5 ± 10.0 (range, -26.0-16.9) degrees and mean final Böhler's angle was 29.8 ± 4.9 (range, 19.3-39.3) degrees with significant difference (P < .001). The average American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS) pain score at last follow-up were 86.2 ± 5.0 (range, 76-97) and 1.6 ± 1.1 (range, 0-4), respectively. Major complications included 2 (5.9%) wound infections and 1 (2.9%) incomplete separation of the lateral wall prior to plate insertion. DISCUSSION AND CONCLUSIONS This modified 2-incision STA is a safe and effective procedure. It allows access to the posterior facet and posterior calcaneal tuberosity, appropriate restoration of blowout lateral wall, and easy placement of a standard calcaneal plate.
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Affiliation(s)
- Chien-Shun Wang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics; School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management; Cheng-Hsin General Hospital, Taipei, Taiwan; Department of Radiology, School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Tzu-Cheng Yang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics; School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chun-Cheng Lin
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics; School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ming-Chau Chang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics; School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics; School of Medicine; National Yang Ming Chiao Tung University, Taipei, Taiwan.
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19
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Ma HH, Tsai SW, Chen CF, Wu PK, Chen CM, Chiang CC, Chen WM. Impact of screening COVID-19 on orthopedic trauma patients at the emergency department: A consecutive series from a level I trauma center. J Chin Med Assoc 2021; 84:423-427. [PMID: 33595990 DOI: 10.1097/jcma.0000000000000503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) posed a major threat to the clinical practice of orthopedic surgeons, especially in the emergency department. We aim to present: (1) the criteria established by the Surgery Management Committee of Taipei Veterans General Hospital in response to COVID-19 and (2) the impact of COVID-19 screening on orthopedic trauma patients in the emergency department. METHODS From April 1 to April 30, 2020, all orthopedic trauma patients in the emergency department were screened for COVID-19 if they fulfilled any of the following: (1) travel from abroad within 14 days, (2) high-risk occupation, (3) contact or cluster history with a COVID-19-positive patient, and (4) any associated symptom, including fever up to 38°C, cough, sore throat, rhinorrhea, loss of taste or smell, muscle soreness, malaise, or shortness of breath. We recorded details on the injury, fever, management, and associated outcomes. RESULTS Of the 163 orthopedic trauma patients presenting to the emergency department, 24 were screened for COVID-19; of these, 22 received surgery. Sixty-two patients received surgery without screening for COVID-19. Fever was the most common reason to screen for COVID-19 (N = 20; 83.3%). No patients were COVID-19 positive. Screened patients had a significantly longer mean interval from presentation to the emergency department to surgery (2.7 ± 2.5 vs. 1.5 ± 0.8 days, p = 0.037). Of the 20 patients screened because of fever, the focus was not identified in 12 (60.0%) patients. The other eight had urinary tract infection (N = 6; 27.2%), septic hip (N = 1; 4.6%), and concomitant pneumonia and urinary tract infection (N = 1; 4.6%). The mean duration of fever and hospital stay was 4.3 ± 4.6 and 8.7 ± 4.9 days, respectively. There were no thromboembolic events, surgical complications, or in-hospital mortality. CONCLUSION We developed safe and reliable screening criteria for this COVID-19 pandemic. The delay in surgery was reasonable and did not adversely affect in-patient outcomes.
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Affiliation(s)
- Hsuan-Hsiao Ma
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shang-Wen Tsai
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Cheng-Fong Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Po-Kuei Wu
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chao-Ming Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Wei-Ming Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan ROC
- Department of Orthopaedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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20
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Yang TC, Tzeng YH, Wang CS, Lin CC, Chang MC, Chiang CC. Untreated small posterior fragment of ankle fracture with early removal of syndesmotic screw is associated with recurrent syndesmotic instability. Injury 2021; 52:638-643. [PMID: 33051073 DOI: 10.1016/j.injury.2020.10.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 09/08/2020] [Accepted: 10/06/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION This retrospective study aimed to report outcomes of fixation of bi-malleolar or tri-malleolar fractures combined with syndesmotic injury with or without posterior malleolar fracture (PMF), and to ascertain whether syndesmotic screw removal at 6 to 8 weeks or 3 months postoperatively is more beneficial. METHODS We retrospectively reviewed patients who received open reduction and internal fixation for bi-malleolar (without PMF) or tri-malleolar ankle fracture (with PMF) with syndesmotic injury between January 2013 and December 2017 with at least 24 months of postoperative follow-up. All patients suffered syndesmotic instabilities and were treated using a syndesmotic screw without PMF fixation. Patients with bi-malleolar fracture with syndesmotic screw removal at 6 to 8 weeks postoperatively were included in Group I, tri-malleolar fracture with syndesmotic screw removal at 6 to 8 weeks in Group II, and tri-malleolar fracture with syndesmotic screw removal at 3 months in Group III. Demographic data, clinical and radiographic outcomes were analyzed. RESULTS A total of 113 patients were included (Group I, n=47; Group II, n=43; Group III, n=23). Average size of PMF was 14% in patients with tri-malleolar fractures (Groups II and III). No significant difference in ankle functional outcome among groups was observed. The recurrence rate of syndesmotic instability was 10.6% in Group I, 20.9% in Group II, and 8.7% in Group III. Although the difference in recurrence rates of syndesmotic instability among three groups was not statistically significant (P=0.264), Group II showed more interval change in tibiofibular clear space between initial postoperative radiographs and last follow-up radiographs (P=0.028) compared to the other two groups. Fracture union was achieved in all patients without screw breakage. CONCLUSION We suggest that the better timing for syndesmotic screw removal is 3 months, instead of 6 to 8 weeks postoperatively, to reduce the risk of recurrence of syndesmotic instability for tri-malleolar fracture without posterior fragment fixation. LEVEL OF EVIDENCE Level III- Case-control study.
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Affiliation(s)
- Tzu-Cheng Yang
- Division of Orthopaedic Trauma; Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec.2, Shih-Pai Rd. Taipei 112, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University.
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital; Department of Radiology, School of Medicine, National Yang-Ming University.
| | - Chien-Shun Wang
- Division of Orthopaedic Trauma; Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec.2, Shih-Pai Rd. Taipei 112, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University.
| | - Chun-Cheng Lin
- Division of Orthopaedic Trauma; Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec.2, Shih-Pai Rd. Taipei 112, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University.
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec.2, Shih-Pai Rd. Taipei 112, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University.
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma; Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, 201, Sec.2, Shih-Pai Rd. Taipei 112, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University.
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Yang TC, Tzeng YH, Wang CS, Chang MC, Chiang CC. Distal Metatarsal Segmental Shortening for the Treatment of Chronic Metatarsophalangeal Dislocation of Lesser Toes. Foot Ankle Int 2021; 42:183-191. [PMID: 33138646 DOI: 10.1177/1071100720961086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND This retrospective study aimed to describe the techniques and results of distal metatarsal segmental shortening (DMSS) for the treatment of chronic irreducible metatarsophalangeal (MTP) dislocation of lesser toes. METHODS We retrospectively reviewed patients who underwent DMSS for chronic dislocation of MTP joints of lesser toes between January 2010 and December 2017 with follow-up of at least 24 months. Demographic data, radiographic measurements, functional outcomes, and complications were analyzed. Furthermore, the results of patients with short segment of shortening (group I, <10 mm) were compared to those with long segment of shortening (group II, ≥10 mm). A total of 43 MTP joints of 30 patients with an average age of 70.4 years were included. RESULTS Union was observed in 42 metatarsals (97.7%). Mean American Orthopaedic Foot & Ankle Society scale scores improved significantly from 42.2 (range, 15-65) preoperatively to 79.1 (range, 52-90) (P < .001). Mean visual analog scale pain score improved significantly from 5.0 (range, 1-9) preoperatively to 1.8 (range, 0-6) (P < .001). Complications included 1 nonunion, 1 osteonecrosis, 3 metatarsal angulation, 4 recurrent instability, 4 symptomatic osteoarthritis, 3 transfer metatarsalgia, and 1 floating toe. Group I included 23 MTP joints and group II included 20 MTP joints. There was no significant difference in clinical outcomes and complications between the 2 groups. CONCLUSION DMSS was a reliable procedure for the treatment of chronic irreducible dislocated MTP joint of lesser toes. It provided satisfactory surgical outcomes and a low rate of postoperative complications, regardless of length of metatarsal shortening. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Tzu-Cheng Yang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei,Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei,Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei,Taiwan.,Department of Radiology, School of Medicine, National Yang-Ming University, Taipei,Taiwan
| | - Chien-Shun Wang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei,Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei,Taiwan
| | - Ming-Chau Chang
- Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei,Taiwan.,Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei,Taiwan
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei,Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei,Taiwan
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Tai HC, Chiang CC, Lee BTH. Forming a Photoluminescent Layer on Another Surface in the Dark through Lasering of N-Type Silicon in an Electrolyte. ACS Omega 2020; 5:26497-26503. [PMID: 33110977 PMCID: PMC7581246 DOI: 10.1021/acsomega.0c03165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
Photoetching of n-type silicon induces a photoluminescent (PL) layer containing nanocrystals on the irradiated surface, usually through band gap absorption (wavelength <1100 nm). Here, we demonstrate the formation of a PL layer restricted to the backside surface, not the irradiated surface, by using a 1064 nm Nd:YAG laser. A nanoscale structure of the PL layer is achieved by merely modifying the electrolyte concentration without adding oxidants. To illustrate the working principle, we submit the hypothesis of a quasi-pn structure based on the theory of a quasi-Fermi level. Because of the "injection current" effect due to the quasi-pn structure, the hole current promoted by free-carrier absorption flows toward the backside surface, leading to anodization. This result is remarkable because anodization of n-type silicon is very hard to achieve with just an etchant in the dark.
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Yang TC, Tzeng YH, Wang CS, Chang MC, Chiang CC. Arthroscopic Ankle Arthrodesis Provides Similarly Satisfactory Surgical Outcomes in Ankles With Severe Deformity Compared With Mild Deformity in Elderly Patients. Arthroscopy 2020; 36:2738-2747. [PMID: 32497657 DOI: 10.1016/j.arthro.2020.05.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 04/12/2020] [Accepted: 05/22/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the surgical outcome in terms of radiographic measurements, functional outcomes, and complications following arthroscopic ankle arthrodesis (AAA) in patients 60 years of age or older, and to compare the results of patients with mildly deformed ankle with those of patients with severely deformed ankle. METHODS We retrospectively reviewed patients who underwent AAA with 3 cannulated screws between January 2008 and December 2017 and followed postoperatively for at least 24 months. All included patients were 60 years of age or older. Demographic data and radiographic and functional outcomes were compared between patients with coronal deformity of less than 15° (group I) and those with a deformity equal to or greater than 15 degrees (group II). RESULTS A total of 41 patients with a mean age of 70.6 years were included (group I, n = 26; group II, n = 15) and mean follow-up was 51.4 months. Group II had significantly more severe preoperative coronal deformity of tibiotalar angle than group I (20.1 ± 2.9 vs 6.6 ± 4.1°, P < .01). Near-normal tibiotalar alignment was achieved postoperatively in both groups (group I, 3.4 ± 3.3 vs group II, 4.7 ± 3.1°, P = .227). Union was achieved in 39 (95.1%) patients with 2 cases in group I experiencing non-union. Union rate, mean American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, and visual analog scale pain scores were not significantly different between the 2 groups at final follow-up. CONCLUSIONS AAA is a reliable procedure for end-stage ankle arthritis in patients 60 years of age or older resulting in a high union rate, encouraging radiographic and functional outcomes, and a low complication rate, even in cases with severe preoperative deformity. In addition, arthroscopic intra-articular malleolar osteotomy was a useful technique for correcting severe coronal deformity in our series. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Tzu-Cheng Yang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan; Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Shun Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Chiang CC, Tzeng YH, Lin CFJ, Wang CS, Lin CC, Chang MC. Author Reply to "Regarding 'Arthroscopic Reduction and Minimally Invasive Surgery in Supination-External Rotation Ankle Fractures: A Comparative Study With Open Reduction'". Arthroscopy 2020; 36:1219-1220. [PMID: 32370884 DOI: 10.1016/j.arthro.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 03/10/2020] [Indexed: 02/02/2023]
Affiliation(s)
- Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan; Department of Radiology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Fu Jeff Lin
- Department of Statistics, National Taipei University, Taipei, Taiwan; Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Shun Wang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Cheng Lin
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Lin CC, Chen YP, Chiang CC, Chang MC, Lee OKS. Real-Time Streaming of Surgery Performance and Intraoperative Imaging Data in the Hybrid Operating Room: Development and Usability Study. JMIR Med Inform 2020; 8:e18094. [PMID: 32209528 PMCID: PMC7316181 DOI: 10.2196/18094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background The trend of quick evolution and increased digital data in today’s operating rooms (ORs) has led to the construction of hybrid ORs. There is often a main control room with monitors for integrating intraoperative data from multiple devices in the hybrid OR. However, there is no adequate solution for communicating the data with people outside the OR. Objective The objective of this study was to design an intelligent operating room (iOR) system, augmented onto the existing information technology (IT) infrastructure of hybrid ORs, to stream surgery performance and intraoperative imaging data. Methods In this study, an all-in-one device with synergetic encoder and decoder was used. The device was able to stream multiple sources to one display. The lossless video and images from specific surgical workflows were streamed outside the hybrid OR through network protocols and were further managed by a streaming server and wireless control system. The steps of this study included the following: (1) defining the requirements and feasibility of an iOR system in the hybrid OR, (2) connecting multiple sources, (3) setting up equipment across the hybrid OR and a conference room, (4) designing a video management system, and (5) real-time streaming under specific surgical workflows. Results The wired streamed video was shown simultaneously on the display in the hybrid OR and the display in the conference room with near-zero latency. Additionally, an interactive video between the hybrid OR and the conference room was achieved through the bidirectional wireless control system. The functions of recording, archiving, and playback were successfully provided by the streaming server. The readily available hardware components and open-access programming reduced the cost required to construct this streaming system. Conclusions This flexible and cost-effective iOR system not only provided educational benefits, but also contributed to surgical telementoring.
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Affiliation(s)
- Chun-Cheng Lin
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Surgery, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Surgery, National Yang-Ming University, Taipei, Taiwan.,Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Oscar Kuang-Sheng Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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26
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Wang CS, Tzeng YH, Lin CC, Chang MC, Chiang CC. Comparison of screw fixation versus non-fixation in dorsal opening wedge medial cuneiform osteotomy of adult acquired flatfoot. Foot Ankle Surg 2020; 26:193-197. [PMID: 30796000 DOI: 10.1016/j.fas.2019.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/31/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND The aim of this study was to compare the radiographic and functional results between fixation and non-fixation in the Cotton osteotomy for the treatment of adult acquired flatfoot. METHODS A retrospective, case-controlled study of consecutive stage IIB posterior tibial tendon dysfunction (PTTD) patients treated with the same bony reconstructive surgery including cotton osteotomy between 2013 and 2017. Meary's angle, the medial arch sag angle (MASA), and medial cuneiform cobb angle (MCCA) were evaluated pre-operation, at first weight bearing after surgery, and 12 months post operation. RESULTS Forty feet were included in the study. The cotton osteotomy utilized screw fixation (n = 20) or non-fixation technique (n = 20). No significant differences between groups were found in pre-operative and follow-up radiographic parameters, union rate, and functional results. CONCLUSION The non-fixation with press fit technique is a reliable procedure for Cotton osteotomy and as effective as screw fixation. LEVEL OF EVIDENCE Level III, case control study.
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Affiliation(s)
- Chien-Shun Wang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Devision of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Chun-Cheng Lin
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan; Department of Orthopedic Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Tsai SW, Ma HH, Hsu FW, Chou TFA, Chen KH, Chiang CC, Chen WM. Risk factors for refracture after plate removal for midshaft clavicle fracture after bone union. J Orthop Surg Res 2019; 14:457. [PMID: 31864405 PMCID: PMC6925412 DOI: 10.1186/s13018-019-1516-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/11/2019] [Indexed: 12/20/2022] Open
Abstract
Background Open reduction and internal fixation (ORIF) with plates and screws is one of the treatment options for clavicle fractures. However, an additional operation for implant removal after union of the fracture is commonly performed due to a high incidence of hardware irritation. Despite union of the fracture, a subsequent refracture might occur after removal of the implant which requires additional surgeries for fixation. This study aims to determine the risk factors associated with refracture of the clavicle after hardware removal. Methods We retrospectively reviewed the medical records of 278 patients that were diagnosed with a midshaft clavicle fracture (male 190; female 88) that had (1) undergone ORIF of the clavicle with plates and (2) received a second operation for removal of hardware after solid union of the fracture between 2010 and 2017. Their mean age was 40.1 ± 15.1 years, and mean interval from fixation to plate removal was 12.5 ± 7.5 months. The patients were then divided into two groups based on the presence of refracture (n = 20) or without refracture (n = 258). We analyzed patient demographics, interval between fixation and implant removal, fracture classification (AO/OTA, Robinson), fixation device, whether wires or interfragmentary screws were used, clavicular length, and bone diameter at the fracture site. Results The overall refracture rate was 7.2%, and the mean interval between plate removal and refracture was 23.9 days. A multivariate analysis showed that female (adjusted odds ratio [aOR] 4.74; 95% CI 1.6–14.1) and body mass index [BMI] (for every 1-unit decrease, aOR 1.25; 95% CI 1.06–1.48) were risk factors for refracture. In women, BMI was the only risk factor. The optimal BMI cutoff value was 22.73. In a female patient with a lower BMI, the refracture rate was 29.8%. Conclusions There are no significant radiographic parameters associated with refracture. Routine plate removal in a female patient with a low BMI after bony union of a midshaft clavicle fracture is not recommended because of a high refracture rate.
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Affiliation(s)
- Shang-Wen Tsai
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsuan-Hsiao Ma
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Fang-Wei Hsu
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Orthopaedics, Kuang-Tien General Hospital, Taichung, Taiwan
| | - Te-Feng Arthur Chou
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Hui Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan. .,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Ming Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.,Department of Orthopaedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Chiang CC, Huang SY, Qu D, Wu PH, Chien CL. Absence of Evidence of Electrical Switching of the Antiferromagnetic Néel Vector. Phys Rev Lett 2019; 123:227203. [PMID: 31868421 DOI: 10.1103/physrevlett.123.227203] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/16/2019] [Indexed: 06/10/2023]
Abstract
Much theoretical and experimental attention has been focused on the electrical switching of the antiferromagnetic (AFM) Néel vector via spin-orbit torque. Measurements employing multiterminal patterned structures of Pt/AFM show recurring signals of the supposedly planar Hall effect and magnetoresistance, implying AFM switching. We show in this Letter that similar signals have been observed in structures with and without the AFM layer, and of an even larger magnitude using different metals and substrates. These may not be the conclusive evidence of spin-orbit torque switching of AFM, but the thermal artifacts of patterned metal structure on substrate. Large current densities in the metallic devices, beyond the Ohmic regime, can generate unintended anisotropic thermal gradients and voltages. AFM switching requires unequivocal detection of the AFM Néel vector before and after SOT switching.
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Affiliation(s)
- C C Chiang
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | - S Y Huang
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | - D Qu
- Institute of Physics, Academia Sinica, Taipei, 11529, Taiwan
| | - P H Wu
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | - C L Chien
- Department of Physics, National Taiwan University, Taipei 10617, Taiwan
- Institute of Physics, Academia Sinica, Taipei, 11529, Taiwan
- Department of Physics and Astronomy, Johns Hopkins University, Baltimore, Maryland 21218, USA
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Yang TC, Tzeng YH, Wang CS, Lin CC, Chang MC, Chiang CC. Are proximal screws necessary for osteosynthesis of stable-stem periprosthetic femoral fractures fixed with non-locking plate and cable? Injury 2019; 50:1739-1744. [PMID: 31182231 DOI: 10.1016/j.injury.2019.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/25/2019] [Accepted: 06/03/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The purpose of this study was to assess the effectiveness of the cable-plate-cable technique which comprises fixation of the proximal fragment using cable loops without additional proximal screws on the plate for the treatment of stable-stem periprosthetic femoral fractures around hip prostheses. METHODS We retrospectively reviewed Vancouver types B1 and C periprosthetic femoral fractures treated with a dynamic compression plate combined with Dall-Miles cable between 2010 and 2016 at a single institution and followed for at least 12 months. Patients were treated with proximal fragment fixation using cable combined with screws (Group I) or with proximal fragment fixation using cable alone (Group II). Demographic data, fracture types, and clinical and radiological outcomes were analyzed. RESULTS A total of 50 patients were included (Group I, n = 23 patients; Group II, n = 27). Fracture union was achieved in 49 patients with one case of non-union in Group I and no cases of non-union in Group II. Mean time to union was 5.4 months in Group I and 5.1 months in Group II (P = 0.624). Mean Harris hip score at latest assessment was 69.5 in Group I and 69.4 in Group II (P = 0.919). Regarding complications, there was one deep wound infection, one stem subsidence, and one loss of reduction in Group I, and one stem subsidence in Group II. No significant difference in clinical and radiological outcomes between groups was observed. CONCLUSIONS The cable-plate-cable technique sufficiently treats Vancouver types B1 and C periprosthetic femoral fractures without use of additional screws in the proximal fragment.
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Affiliation(s)
- Tzu-Cheng Yang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital; Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan.
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, 45, Cheng-Hsin St., Peitou, Taipei 112, Taiwan.
| | - Chien-Shun Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital; Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan.
| | - Chun-Cheng Lin
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital; Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan.
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital; Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan.
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital; Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan.
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Abstract
BACKGROUND We elucidated the effect of open reduction and internal fixation with locking plate for acute isolated displaced greater tuberosity fractures of humerus in elder adults (aged >60 years). METHODS From 2009 to 2015, data from 32 patients, aged between 60 and 88 years, who had acute unilaterally displaced greater tuberosity fractures of humerus were collected and evaluated retrospectively. All the fractures were managed with open reduction and internal fixation with locking plate. The follow-up period was 50.8 months on an average (range 22-80 months). Finally, 25 patients were available for final evaluation of radiographic and functional results. RESULTS All the 32 fractures had union with the average union time of 14 weeks (range 10-18 weeks) and with no complications. The average of preoperative Visual Analogue Scale (VAS) was 6.2 (range 4-8), ASES was 30.4 (range 13-45), and Constant score was 30.4 (range 20-45). At the last follow-up, the mean VAS was 1.3 (range 0-2.5), the mean ASES score was 90.1 (range 72-100), and the mean Constant score was 90.3 (range 80-100). There were statistically significant differences between preoperative and final follow-up in VAS, ASES, and Constant score. Hundred percent of patients had good or excellent results by Constant score, with excellent results (86-100) in 17 (68%) patients and good result (71-85) in 8 (32%). CONCLUSION In conclusion, open reduction and internal fixation with locking plate is an effective treatment for acute displaced greater tuberosity fractures of humerus in elder adults.
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Affiliation(s)
- Ming Fai Cheng
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shih-Hsin Hung
- Department of Nursing, National Yang-Ming University and Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yu-Pin Su
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fang-Yao Chiu
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Yang JCS, Lin KP, Wei HW, Chen WC, Chiang CC, Chang MC, Tsai CL, Lin KJ. Importance of a moderate plate-to-bone distance for the functioning of the far cortical locking system. Med Eng Phys 2019; 56:48-53. [PMID: 29685856 DOI: 10.1016/j.medengphy.2018.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 03/21/2018] [Accepted: 04/10/2018] [Indexed: 11/17/2022]
Abstract
The far cortical locking (FCL) system, a novel bridge-plating technique, aims to deliver controlled and symmetric interfragmentary motion for a potential uniform callus distribution. However, clinical data for the practical use of this system are limited. The current study investigated the biomechanical effect of a locking plate/far cortical locking construct on a simulated comminuted diaphyseal fracture of the synthetic bones at different distance between the plate and the bone. Biomechanical in vitro experiments were performed using composite sawbones as bone models. A 10-mm osteotomy gap was created and bridged with FCL constructs to determine the construct stiffness, strength, and interfragmentary movement under axial compression, which comprised one of three methods: locking plates applied flush to bone, at 2 mm, or at 4 mm from the bone. The plate applied flush to the bone exhibited higher stiffness than those at 2 mm and 4 mm plate elevation. A homogeneous interfragmentary motion at the near and far cortices was observed for the plate at 2 mm, whereas a relatively large movement was observed at the far cortex for the plate applied at 4 mm. A plate-to-bone distance of 2 mm had the advantages of reducing axial stiffness and providing nearly parallel interfragmentary motion. The plate flush to the bone prohibits the dynamic function of the far cortical locking mechanism, and the 4-mm offset was too unstable for fracture healing.
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Affiliation(s)
- Jesse Chieh-Szu Yang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kang-Ping Lin
- Department of Electrical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan; Technology Translation Center for Medical Device, Chung Yuan Christian University, No. 200, Chung-Pei Rd., Chung Li District, Taoyuan 32023, Taiwan
| | - Hung-Wen Wei
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan; Technology Translation Center for Medical Device, Chung Yuan Christian University, No. 200, Chung-Pei Rd., Chung Li District, Taoyuan 32023, Taiwan
| | - Wen-Chuan Chen
- Technology Translation Center for Medical Device, Chung Yuan Christian University, No. 200, Chung-Pei Rd., Chung Li District, Taoyuan 32023, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Lun Tsai
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan ; Technology Translation Center for Medical Device, Chung Yuan Christian University, No. 200, Chung-Pei Rd., Chung Li District, Taoyuan 32023, Taiwan
| | - Kun-Jhih Lin
- Technology Translation Center for Medical Device, Chung Yuan Christian University, No. 200, Chung-Pei Rd., Chung Li District, Taoyuan 32023, Taiwan .
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Hsu KH, Tzeng YH, Chang MC, Chiang CC. Comparing the coracoclavicular loop technique with a hook plate for the treatment of distal clavicle fractures. J Shoulder Elbow Surg 2018; 27:224-230. [PMID: 29054381 DOI: 10.1016/j.jse.2017.08.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 08/21/2017] [Accepted: 08/28/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Treatment of displaced distal clavicular fractures is still controversial. This study reports the utility of a new coracoclavicular (CC) loop technique for acute displaced distal clavicular fractures and compared its surgical outcomes with those of the hook plate method. METHODS In this retrospective study, a total of 23 patients with acute displaced distal clavicular fractures were treated with a new CC loop technique at a single institution from 2010 to 2014. Another group comprising 49 patients treated with a hook plate was compared with the CC loop group regarding clinical and radiologic outcomes. RESULTS Seventy-two patients with at least 1 year of follow-up after both operations were included in this study. The Constant score was significantly greater in the CC loop group (95 vs 87, P = .009) at final follow-up. Moreover, the complication rate was significantly lower in the CC loop group (0% vs 24.5%, P = .007). The University of California, Los Angeles shoulder score and radiologic nonunion rate revealed no significant differences between the 2 groups. CONCLUSIONS The new CC loop technique had better clinical outcomes and lower complication rates compared with the hook plate technique.
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Affiliation(s)
- Kuei-Hsiang Hsu
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Tsai SW, Lin CFJ, Tzeng YH, Lin CC, Huang CK, Chang MC, Chiang CC. Risk factors for cut-out failure of Gamma3 nails in treating unstable intertrochanteric fractures: An analysis of 176 patients. J Chin Med Assoc 2017; 80:587-594. [PMID: 28601630 DOI: 10.1016/j.jcma.2017.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 02/12/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Cut-out failure is one of the most common complications in the Gamma3 nail fixation system. The purpose of this retrospective study was to determine pre-operative or intra-operative risk factors for cut-out failure of lag screws in unstable, intertrochanteric fractures fixed with short Gamma3 nails. METHODS One hundred and seventy-six patients over 60 years of age, with unstable intertrochanteric fractures (AO/OTA 31-A2, 31-A3) treated with short Gamma3 nails were included in this study. All patients completed a minimum of 1-year follow-up. Analysis of post-operative radiographs included assessment for cut-out failure of lag screw, appropriateness of the entry point, posterior lag screw axis, fracture gaps, posterior displacement of the proximal fragment, and tip-apex distance. RESULTS Of the 176 patients in this study, 22 patients were identified with cut-out failure. Multivariate logistic regression analysis revealed that improper entry point in an antero-posterior projection (odds ratio 10.39, 95% confidence interval 1.74-78.4), posterior displacement distance of the proximal fragment in a lateral projection (odds ratio 1.35, 95% confidence interval 1.17-1.59), and female sex (odds ratio 17.14, 95% confidence interval 1.88-876.11) were correlated with cut-out failure. CONCLUSION This study emphasizes the importance of an optimal position of reduction in the lateral projection in reducing the risk of cut-out failure. In addition, sex difference in bone mineral density, proximal femur geometry, and the bone strength in elderly females may explain why female sex is a risk factor.
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Affiliation(s)
- Shang-Wen Tsai
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chien-Fu Jeff Lin
- Department of Statistics, National Taipei University, Taipei, Taiwan, ROC; Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, ROC
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
| | - Chun-Cheng Lin
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ching-Kuei Huang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ming-Chau Chang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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Chou PH, Lin HH, Su YP, Chiang CC, Chang MC, Chen CM. Staged protocol for the treatment of chronic femoral shaft osteomyelitis with Ilizarov's technique followed by the use of intramedullary locked nail. J Chin Med Assoc 2017; 80:376-382. [PMID: 28242358 DOI: 10.1016/j.jcma.2017.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Accepted: 10/19/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Infected nonunion of the femoral shaft is uncommon, and usually presents with challenging therapeutic and reconstructive problems. There are still controversies over treating infected nonunion of the femoral shaft. The purposes of this retrospective study were to review the treatment outcomes and describe a staged protocol for spontaneous wound healing. METHODS Six patients with chronic femoral shaft infected-nonunion from October 2002 to September 2010 were included in this retrospective study. Serial plain films and triple films of lower legs were performed to evaluate the alignment of the treated femoral shaft and bony union following our staged protocol of Ilizarov distraction osteogenesis and intramedullary nailing. RESULTS An average bone defect of 7 cm was noted after staged osteotomy. Mean follow-up was 87.5 (range, 38-133) months. Union was achieved in all six patients, with an average external fixation time of 6.8 (range, 5-11) months. There was no reinfection. One complication of a 4-cm leg discrepancy was noted, with an initial shortening of 15 cm. The mean knee ranges of motion (ROM) before staged protocols and at final follow-up were 64.2±8.6 (range, 60-75)° and 53.3±9.3 (range, 40-65)°, respectively. The ROM at the knee joint statistically decreased following staged protocols. CONCLUSION In the treatment of chronic femur osteomyelitis, the staged protocol of Ilizarov distraction osteogenesis followed by intramedullary nailing was safe and successful, and allowed for union, realignment, reorientation, and leg-length restoration. With regard to the soft tissue, this technique provides a unique type of reconstructive closure for infected wounds. It is suggested that the staged protocol is reliable in providing successful simultaneous reconstruction for bone and soft tissue defects without flap coverage.
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Affiliation(s)
- Po-Hsin Chou
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Hsi-Hsien Lin
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yu-Pin Su
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chao-Ching Chiang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ming-Chau Chang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chuan-Mu Chen
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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Wang CS, Tzeng YH, Lin CC, Huang CK, Chang MC, Chiang CC. Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture. Foot Ankle Int 2016; 37:944-9. [PMID: 27188694 DOI: 10.1177/1071100716649928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. METHODS Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. RESULTS The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). CONCLUSION The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. LEVEL OF EVIDENCE Level II, comparative study.
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Affiliation(s)
- Chien-Shun Wang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Chun-Cheng Lin
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Kuei Huang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Ching Chiang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Chiang CC, Su CY, Yang AC, Wang TY, Lee WY, Hua CC, Kang DY. Relationships between the solution and solid-state properties of solution-cast low-k silica thin films. Phys Chem Chem Phys 2016; 18:20371-80. [PMID: 27401818 DOI: 10.1039/c6cp04166c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This paper reports on the fabrication of low-k (amorphous) silica thin films cast from solutions without and with two different types of surfactants (TWEEN® 80 and Triton™ X-100) to elucidate the relationships between the structural/morphological features of the casting solutions and the physical properties of the resulting thin films. Cryogenic transmission microscopy (cryo-TEM), static/dynamic light scattering (SLS/DLS), and small-angle X-ray scattering (SAXS) revealed contrasting colloidal dispersion states and phase behavior among the three casting solutions. Casting solution with the Triton™ X-100 surfactant produced stable (>90 days) nanoparticles with good dispersion in solution (mean particle size ∼10 nm) as well as good mesopore volume (characterized by nitrogen physisorption) in powder and thin films of high mechanical strength (characterized by the nanoindentation test). The longer main chain and bulkier side units of the TWEEN® 80 surfactant led to stable micelle-nanoparticle coexisting dispersion, which resulted in the highest mesopore volume in powder and thin films with the lowest dielectric constant (∼3) among the samples in this study. The casting solution without the surfactant failed to produce a stabilized solution or thin films of acceptable uniformity. These findings demonstrate the possibility of fine-tuning low-k silica film properties by controlling the colloidal state of casting solutions.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Chemical Engineering, National Taiwan University, Taipei 10617, Taiwan, Republic of China.
| | - Chien-You Su
- Department of Chemical Engineering, National Chung Cheng University, Chia-Yi 62102, Taiwan, Republic of China.
| | - An-Chih Yang
- Department of Chemical Engineering, National Taiwan University, Taipei 10617, Taiwan, Republic of China.
| | - Ting-Yu Wang
- Electron Microscope Unit of Instrument Center, National Taiwan University, Taipei 10617, Taiwan, Republic of China
| | - Wen-Ya Lee
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 10608, Taiwan, Republic of China
| | - Chi-Chung Hua
- Department of Chemical Engineering, National Chung Cheng University, Chia-Yi 62102, Taiwan, Republic of China.
| | - Dun-Yen Kang
- Department of Chemical Engineering, National Taiwan University, Taipei 10617, Taiwan, Republic of China.
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Abstract
BACKGROUND Open reduction and internal fixation (ORIF), the standard treatment for unstable ankle fractures, has well-known wound complications. Minimally invasive surgery (MIS) has been proposed to decrease these complications. The objectives of this study were to describe an algorithm of MIS for fibular plating and compare the radiographic restoration of fibular anatomy, functional outcomes, and complications between ORIF and MIS for ankle fractures. METHODS This retrospective study included 71 patients with AO/OTA 44-B ankle fractures treated by a single surgeon. ORIF group consisted of 34 patients (54.5-month follow-up) and MIS group was composed of 37 patients (55.9-month follow-up). Among 37 MIS patients, 13 patients were treated with minimally invasive percutaneous plate osteosynthesis and 24 patients with minimally invasive trans-fracture approach according to our MIS algorithm. Operative outcomes were evaluated and compared between the 2 groups by radiographic measurements, functional assessment, and complications. RESULTS The MIS group had less blood loss but longer operative time and greater exposure to fluoroscopy. Radiographic measurements revealed similar union time, fibular length, talocrural angle, medial clear space, and tibiofibular clear space in both groups. Lower visual analogue pain score was observed in the MIS group in the early postoperative period. At last follow-up, there were no significant differences regarding pain score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and range of motion between the 2 groups. Total complication rate was significantly higher in the ORIF group. CONCLUSION Patients with AO/OTA 44-B fractures treated with MIS fibular plating achieved similar radiographic and functional outcomes but had less pain in the early postoperative period and fewer wound complications compared with those treated with ORIF. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yun-Hsuan Tzeng
- Division of Medical Imaging for Health Management, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Chun-Cheng Lin
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Kuei Huang
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Chau Chang
- Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Orthopaedics and Traumatology; Taipei Veterans General Hospital, Taipei, Taiwan
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Affiliation(s)
- Chao-Ching Chiang
- Department of Chemical Engineering; National Taiwan University; No. 1, Sec. 4, Roosevelt Road Taipei 10617 Taiwan
| | - Dai-Yuan Wu
- Black Water Foundry, Inc.; Taichung City Taiwan
| | - Dun-Yen Kang
- Department of Chemical Engineering; National Taiwan University; No. 1, Sec. 4, Roosevelt Road Taipei 10617 Taiwan
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Tsai SW, Wu PK, Chen CF, Chiang CC, Huang CK, Chen TH, Liu CL, Chen WM. Etiologies and outcome of osteonecrosis of the femoral head: Etiology and outcome study in a Taiwan population. J Chin Med Assoc 2016; 79:39-45. [PMID: 26387635 DOI: 10.1016/j.jcma.2015.07.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 03/26/2015] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Osteonecrosis of the femoral head (ONFH) is an important indication for total hip arthroplasty in Taiwan. We demonstrated the etiologies of ONFH and outcomes based on stratification of patients according to different etiologies. METHODS We reviewed medical records and images from January 2000 to May 2010 in our database with the diagnosis of "osteonecrosis of the femoral head." We categorized all patients into different etiologies, including corticosteroid, alcohol, and idiopathic. All patients received subsequent follow up for ipsilateral precollapse ONFH and contralateral disease-free femoral head status after initial diagnosis. RESULTS Of the 1153 patients who had undergone 1674 hip surgeries including core decompression and total hip replacement, alcohol use was the most prevalent etiology in our population (45.2%). Patients with corticosteroid- and alcohol-associated ONFH were younger and more likely to have bilateral disease. Patients with alcohol- or steroid-associated ONFH were found to have a higher rate of contralateral disease and faster progression of precollapse ONFH than patients who had or had not undergone core decompression. CONCLUSION Alcohol use had the greatest impact on ONFH in our population. Nonidiopathic ONFH patients had the worst outcome. Understanding the nature of progression of ONFH and incidence of contralateral disease may provide great prognostic value to detect and perform early intervention.
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Affiliation(s)
- Shang-Wen Tsai
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Po-Kuei Wu
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Cheng-Fong Chen
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chao-Ching Chiang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ching-Kuei Huang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Tain-Hsiung Chen
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chien-Lin Liu
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Wei-Ming Chen
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Orthopedics, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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Chen YJ, Chiang CC, Huang PJ, Huang J, Karcher K, Li H. Tapentadol immediate-release for acute postbunionectomy pain: a phase 3, randomized, double-blind, placebo-controlled, parallel-group study in Taiwan. Curr Med Res Opin 2015; 31:2001-9. [PMID: 26293513 DOI: 10.1185/03007995.2015.1082992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of tapentadol immediate-release (IR) for treating acute pain following orthopedic bunionectomy surgery in a Taiwanese population. METHODS This was a phase 3, randomized, double-blind, placebo-controlled, parallel-group bridging study in which Taiwanese patients (N = 60) with moderate-to-severe pain following bunionectomy were randomized (1:1:1) to receive tapentadol IR 50 or 75 mg or placebo orally every 4-6 hours over a 72 hour period. The primary endpoint was the sum of pain intensity difference over 48 hours (SPID48), analyzed using analysis of variance. RESULTS Out of 60 patients randomized (mainly women [96.7%]; median age 44 years), 41 (68.3%) completed the treatment. Mean SPID48 values were significantly higher for tapentadol IR (p ≤ 0.006: 50 mg, p ≤ 0.004: 75 mg) compared with placebo. Between-group differences in LS means of SPID48 (vs. placebo) were tapentadol IR 50 mg: 105.6 (95% CI: 32.0; 179.2); tapentadol IR 75 mg: 126.6 (95% CI: 49.5; 203.7). Secondary endpoints including SPID at 12, 24, and 72 hours, time to first use of rescue medication, cumulative distribution of responder rates, total pain relief and sum of total pain relief and sum of pain intensity difference at 12, 24, 48, and 72 hours, and patient global impression of change showed numerically better results supporting that tapentadol IR (50 and 75 mg) was more efficacious than placebo in relieving acute pain. The most frequent treatment emergent adverse events reported in ≥ 10% patients in either group were dizziness, nausea, and vomiting. A limitation of this study may possibly include more controlled patient monitoring through 4-6 hour dosing intervals, which reflects optimal conditions and thus may not approximate real-world clinical practice. However, all treatment groups would be equally affected by such bias of frequent monitoring, if any, since it was a randomized and double-blind study. CONCLUSIONS Tapentadol IR treatment significantly relieved acute postoperative pain and was well tolerated in a Taiwanese population. ClinicalTrials.gov identifier: NCT01813890.
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Affiliation(s)
- Yeung-Jen Chen
- a a Chang Gung University, Chang Gung Memorial Hospital , Linkou Branch , New Taipei , Taiwan
| | - Chao-Ching Chiang
- b b Department of Orthopaedics & Traumatology , Taipei Veterans General Hospital , Taipei , Taiwan
- c c Department of Surgery, School of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - Peng-Ju Huang
- d d Department of Orthopaedic Surgery , Kaohsiung Medical University Hospital College of Medicine, Kaoshiung Medical University , Kaohsiung City , Taiwan
| | - Jason Huang
- e e Janssen Research & Development LLC , Taiwan
| | | | - Honglan Li
- f f Janssen Research & Development LLC , NJ , USA
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Liu DH, Tsai MW, Lin SH, Chou CL, Chiu JW, Chiang CC, Kao CL. Ultrasound-Guided Hyaluronic Acid Injections for Trigger Finger: A Double-Blinded, Randomized Controlled Trial. Arch Phys Med Rehabil 2015; 96:2120-7. [PMID: 26340807 DOI: 10.1016/j.apmr.2015.08.421] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/04/2015] [Accepted: 08/18/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the effects of ultrasound-guided injections of hyaluronic acid (HA) versus steroid for trigger fingers in adults. DESIGN Prospective, double-blinded, randomized controlled study. SETTING Tertiary care center. PARTICIPANTS Subjects with a diagnosis of trigger finger (N=36; 39 affected digits) received treatment and were evaluated. INTERVENTIONS Subjects were randomly assigned to HA and steroid injection groups. Both study medications were injected separately via ultrasound guidance with 1 injection. MAIN OUTCOME MEASURES The classification of trigger grading, pain, functional disability, and patient satisfaction were evaluated before the injection and 3 weeks and 3 months after the injection. RESULTS At 3 months, 12 patients (66.7%) in the HA group and 17 patients (89.5%) in the steroid group exhibited no triggering of the affected fingers (P=.124). The treatment results at 3 weeks and 3 months showed similar changes in the Quinnell scale (P=.057 and .931, respectively). A statistically significant interaction effect between group and time was found for visual analog scale (VAS) and Michigan Hand Outcome Questionnaire (MHQ) evaluation (P<.05). The steroid group had a lower VAS at 3 months after injection (steroid 0.5±1.1 vs HA 2.7±2.4; P<.001). The HA group demonstrated continuing significant improvement in MHQ at 3 months (change from 3wk: steroid -2.6±14.1 vs HA 19.1±37.0; P=.023; d=.78). CONCLUSIONS Ultrasound-guided injection of HA demonstrated promising results for the treatment of trigger fingers. The optimal frequency, dosage, and molecular weight of HA injections for trigger fingers deserve further investigation for future clinical applications.
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Affiliation(s)
- Ding-Hao Liu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mei-Wun Tsai
- Institute of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Shan-Hui Lin
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan
| | - Chen-Liang Chou
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Jan-Wei Chiu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan
| | - Chao-Ching Chiang
- Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Lan Kao
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan; Institute of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang-Ming University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Chiang CC, Tzeng YH, Lin CFJ, Huang CK, Chen WM, Liu CL, Chen TH. Subtalar distraction arthrodesis using fresh-frozen allogeneic femoral head augmented with local autograft. Foot Ankle Int 2013; 34:550-6. [PMID: 23463777 DOI: 10.1177/1071100713481432] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Tricortical autograft has been commonly used in subtalar distraction arthrodesis (SDA) for severe calcaneal malunion. Structural allograft enriched with orthobiological agents is an alternative. This study was performed to evaluate the results of SDA using fresh-frozen allogeneic femoral head without the addition of orthobiological agents. MATERIALS AND METHODS We retrospectively reviewed 15 consecutive SDA procedures (13 patients) with allogeneic femoral head augmented with local autograft for the treatment of severe calcaneal malunion. Clinical outcome was evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, visual analog scale (VAS) pain score, Short Form-12 (SF-12), range of motion (ROM) of the ankle joint, and patient satisfaction rate. Radiographic assessment included the talar declination angle (TDA), calcaneal inclination angle (CIA), lateral talocalcaneal angle (LTCA), heel height, calcaneal length, and union time. RESULTS At a median follow-up of 36.0 months (range, 24-47 months), all 15 feet (100%) achieved union, at a median of 13.0 weeks (range, 12-18 weeks). The AOFAS score and VAS pain score improved significantly, with a satisfaction rate of 93.3%. The TDA, CIA, LTCA, and heel height improved significantly. The median increase in heel height was 8.6 mm (range, 1.9-20.1 mm). There was a significant reduction in calcaneal length. Complications included 1 varus malalignment, 1 complex regional pain syndrome, 1 hardware irritation, and 1 sural neuralgia. CONCLUSION This study found that SDA using fresh-frozen femoral head allograft without an orthobiological agent was cost-effective and may have outcomes comparable to those using autograft or allograft enriched with orthobiological agents.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
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Abstract
The authors retrospectively evaluated the effects of a single cortical screw in the open reduction and internal fixation of displaced distal clavicle fractures. Fifteen patients without associated acromioclavicular joint dislocation were treated by open reduction and internal fixation with a single cortical screw (4.5-mm diameter, 60-mm length) between 2004 and 2011. Mean follow-up was 39.2 months (range, 13-84 months). Reduction with a fracture gap of less than 1 mm and solid union were achieved in all cases. Delayed superficial infection developed in 1 patient. All other patients had good to excellent final Constant-Murley functional results.
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Affiliation(s)
- Hsi-Hsien Lin
- Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei City, Taiwan 11217, Republic of China
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Wang TI, Chen CF, Chen WM, Chiang CC, Huang CK, Liu CL, Chen TH. Joint replacement in human immunodeficiency virus-infected patients. J Chin Med Assoc 2012; 75:595-9. [PMID: 23158038 DOI: 10.1016/j.jcma.2012.08.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 05/22/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-infected patients are at risk for bacterial and opportunistic infections with worsening immunosuppression. METHODS From June 2000 to January 2009, six patients who were diagnosed with HIV infection underwent 10 joint replacement procedures, including six total hip arthroplasties, two total knee arthroplasties, and one shoulder hemiarthroplasty. An ordinary dose of postsurgical-empirical antibiotics was prescribed, with an average follow-up period of 38.6 months. All prostheses of total knee arthroplasty and shoulder hemiarthroplasty were fixed with vancomycin-impregnated bone cement. RESULTS The rate of postoperative infection for HIV infected patients is supposed to be higher than for HIV negative patients. However, in our institution, there have been no HIV- positive patients who have suffered postoperative infection. CONCLUSION HIV-positive patients can have excellent outcomes after undergoing various arthroplastic surgeries. This revelation, coupled with the advances in antiviral therapy that have helped to lengthen HIV patient lifespans, strongly suggests that these patients should receive arthroplastic surgery.
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Affiliation(s)
- Ta-I Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Wang JY, Chang CC, Chiang CC, Chen WM, Hung SC. Silibinin suppresses the maintenance of colorectal cancer stem-like cells by inhibiting PP2A/AKT/mTOR pathways. J Cell Biochem 2012; 113:1733-43. [PMID: 22213051 DOI: 10.1002/jcb.24043] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Silibinin, an effective chemo-preventive agent in various cancer types, suppresses cancer cell growth, but its effects on cancer stem-like cells (CSLCs) remain unclear. This study aimed to examine whether silibinin inhibited the development of CSLCs and disclose the underlying signaling. The colorectal cancer spheroid culture system was used for enriching CSLCs. The effects of silibinin on CSLCs were evaluated by counting sphere numbers, and calculating the percentage of CD133+ cells by flow cytometry and immunofluorescence both in the absence and presence of different concentrations of silibinin. The results showed the sphere number of CCS was 36 ± 9.6 after 15 days of CSLC enrichment in spheroid culture, and the percentage of CD133+ cells increased to 18 ± 6.4% compared to 3 ± 0.8% before enrichment. Treatment with silibinin reduced the sphere formation to 5 ± 3.3 and decreased the CD133+ percentage to 8 ± 2.3%. Interestingly, treatment of silibinin suppressed the activation of the AKT Ser473/mTOR pathway in spheroid culture through suppressing the activity of protein phosphatase 2Ac subunit (PP2Ac). In a xenograft tumor model, treatment with silibinin also inhibited tumor formation rate and tumor growth. Silibinin, which inhibits colon CSLCs self-renewal and sphere formation by suppressing the PP2Ac/AKT Ser473/mTOR pathway, may be a compound for developing new strategies in modulating CSLCs in cancer therapy.
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Affiliation(s)
- Jir-You Wang
- Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Yew TL, Huang TF, Ma HL, Hsu YT, Tsai CC, Chiang CC, Chen WM, Hung SC. Scale-up of MSC under hypoxic conditions for allogeneic transplantation and enhancing bony regeneration in a rabbit calvarial defect model. J Orthop Res 2012; 30:1213-20. [PMID: 22278907 DOI: 10.1002/jor.22070] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 12/20/2011] [Indexed: 02/04/2023]
Abstract
To realize the therapeutic potential of mesenchymal stem cells (MSCs), we aimed to develop a method for isolating and expanding New Zealand rabbit MSCs in a great scale. Rabbit MSCs expanded under hypoxic and normoxic conditions were compared in terms of replication capacity, differentiation potential, and the capacity for allogeneic transplantation in a calvarial defect model. The cells from all tested rabbits were expanded more rapidly when plated at low-density under hypoxic conditions compared to under normoxic conditions. Moreover, cells expanded under hypoxic conditions increased in the potential of osteoblastic, adipocytic, and chondrocytic differentiation. More importantly, radiographic analysis and micro-CT measurement of bone volume revealed the hypoxic cells when transplanted in the calvarial defects of another rabbit increased in the ability to repair bone defect compared to the normoxic cells. Six weeks after allogeneic transplantation of hypoxic MSCs, histological analysis revealed a callus spanned the length of the defect, and several bone tissues spotted in the implant. At 12 weeks, new bone had formed throughout the implant. Using BrdU labeling to track the transplanted cells, the hypoxic cells were more detected in the newly formed bone compared to the normoxic cells. For defects treated with allogeneic MSCs, no adverse host response could be detected at any time-point. In conclusion, we have developed a robust method for isolation and expansion of rabbit MSCs by combining low-density with hypoxic culture, which can be applied for the design of clinical trials in allogeneic transplantation of MSCs for bone healing.
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Affiliation(s)
- Tu-Lai Yew
- Faculty of Dentistry, Institute of Oral Biology, National Yang-Ming University, Taipei 112, Taiwan
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Lin CJ, Chiang CC, Wu PK, Chen CF, Huang CK, Su AW, Chen WM, Liu CL, Chen TH. Effectiveness of plate augmentation for femoral shaft nonunion after nailing. J Chin Med Assoc 2012; 75:396-401. [PMID: 22901724 DOI: 10.1016/j.jcma.2012.06.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 03/16/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Treatment options for nonunion of the femoral shaft fracture after intramedullary nail fixation are controversial. The methods of exchanging an existing nail with a larger-sized nail, dynamization, removal of the nail followed by plating, and bone grafting have all been reported. From those options, exchange nailing seems to be the most popular choice. In our study, we used plate augmentation and bone grafting with retention of the nail. The purpose of our study was to evaluate the effectiveness of this method in treating femoral shaft nonunion after open reduction and internal fixation with intramedullary nail fixation. METHODS Between January 2003 and December 2009, 22 patients who had nonunion after open reduction and internal fixation with intramedullary nail for femoral shaft fracture were included in our study. There were 13 men and nine women participants, with a mean age of 34.3 years (range, 17-77 years). The mean period of nonunion after surgery was 20.0 months (range, 7-63 months). The patients were classified into three groups, atrophic, oligotrophic, and hypertrophic. We retained the nail and performed plate augmentation for all patients, with simultaneous autologous bone grafting as indicated. We followed up on all patients with plain film examination, and to assess functional recovery status to determine osseous union condition. RESULTS All 22 of the patients achieved postoperative bony union uneventfully at a mean time of 22.1 weeks (range, 12-40 weeks). The mean operative time was 105 minutes (range, 60-150 minutes), and the mean blood loss was 340 ml (range, 150-700 ml). All of the patients could walk bearing full weight without pain within 3 months. There were no significant complications such as broken hardware, implant back-out, axial or rotational malalignment, or deep infections. CONCLUSION Plate augmentation with retention of the nail with autologous bone grafting may be an effective and reliable alternative in treating nonunion of the femoral shaft fracture after open reduction and internal fixation with intramedullary nail.
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Affiliation(s)
- Chin-Jung Lin
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Chiang CC, Lin CFJ, Tzeng YH, Huang CK, Chen WM, Liu CL. Distal linear osteotomy compared to oblique diaphyseal osteotomy in moderate to severe hallux valgus. Foot Ankle Int 2012. [PMID: 22735320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There are no comparative studies of proximal and distal osteotomy for treatment of moderate to severe hallux valgus. Our purpose was to compare the surgical outcomes of modified proximal Ludloff (oblique diaphyseal) osteotomy with modified distal Bösch (distal linear) osteotomy by a single surgeon in moderate to severe hallux valgus. METHODS This retrospective study included feet with a hallux valgus angle greater than 30 degrees. A total of 30 feet (average age, 64.5 years) underwent Ludloff and 32 feet (average age, 61.1 years) underwent Bösch osteotomy. Both osteotomies were combined with distal soft tissue procedure. Clinical outcomes including AOFAS score and satisfaction rate were compared and radiographic parameters analyzed at 2~years of followup. RESULTS AOFAS scores were equivalent (p=0.483), with comparable satisfaction rates in both groups (p=0.418). The radiographic results including hallux valgus angle (p=0.026), intermetatarsal angle 1-2 (p<0.001), sesamoid position (p=0.008), correction of intermetatarsal angle 1-2 (p<0.001), and change of sesamoid position (p<0.001) were significantly better in the Bösch group. Correction of hallux valgus angle (p=0.308) and shortening of the first metatarsal (p=0.086) were insignificant with the numbers available. Recurrence developed in eight feet of the Ludloff group and two of the Bösch group (p=0.040). Dorsiflexion malunion occurred in four feet in the Bösch group, as compared with one in the Ludloff group. CONCLUSION Our study found that distal linear osteotomy was a more reliable reconstruction with equivalent function outcomes than an oblique diaphyseal osteotomy. Additional fixation may be necessary to decrease sagittal malunion in distal Bösch osteotomy.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, and Department of Surgery, School of Medicine, National Yang-Ming University, 201, Sec.2, Shih-Pai Rd., Taipei 112, Taiwan, Republic of China.
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Chiang CC, Lin CFJ, Tzeng YH, Huang CK, Chen WM, Liu CL. Distal linear osteotomy compared to oblique diaphyseal osteotomy in moderate to severe hallux valgus. Foot Ankle Int 2012; 33:479-86. [PMID: 22735320 DOI: 10.3113/fai.2012.0479] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND There are no comparative studies of proximal and distal osteotomy for treatment of moderate to severe hallux valgus. Our purpose was to compare the surgical outcomes of modified proximal Ludloff (oblique diaphyseal) osteotomy with modified distal Bösch (distal linear) osteotomy by a single surgeon in moderate to severe hallux valgus. METHODS This retrospective study included feet with a hallux valgus angle greater than 30 degrees. A total of 30 feet (average age, 64.5 years) underwent Ludloff and 32 feet (average age, 61.1 years) underwent Bösch osteotomy. Both osteotomies were combined with distal soft tissue procedure. Clinical outcomes including AOFAS score and satisfaction rate were compared and radiographic parameters analyzed at 2~years of followup. RESULTS AOFAS scores were equivalent (p=0.483), with comparable satisfaction rates in both groups (p=0.418). The radiographic results including hallux valgus angle (p=0.026), intermetatarsal angle 1-2 (p<0.001), sesamoid position (p=0.008), correction of intermetatarsal angle 1-2 (p<0.001), and change of sesamoid position (p<0.001) were significantly better in the Bösch group. Correction of hallux valgus angle (p=0.308) and shortening of the first metatarsal (p=0.086) were insignificant with the numbers available. Recurrence developed in eight feet of the Ludloff group and two of the Bösch group (p=0.040). Dorsiflexion malunion occurred in four feet in the Bösch group, as compared with one in the Ludloff group. CONCLUSION Our study found that distal linear osteotomy was a more reliable reconstruction with equivalent function outcomes than an oblique diaphyseal osteotomy. Additional fixation may be necessary to decrease sagittal malunion in distal Bösch osteotomy.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, and Department of Surgery, School of Medicine, National Yang-Ming University, 201, Sec.2, Shih-Pai Rd., Taipei 112, Taiwan, Republic of China.
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Chiang CC, Wu HT, Lin CFJ, Tzeng YH, Huang CK, Chen WM, Liu CL. Analysis of initial injury radiographs of occult femoral neck fractures in elderly patients: a pilot study. Orthopedics 2012; 35:e621-7. [PMID: 22588401 DOI: 10.3928/01477447-20120426-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Diagnosis of occult hip fractures by initial radiographs remains challenging in the emergency department. Previously, the gold standard for accurate diagnosis of occult hip fractures was magnetic resonance imaging. This study used initial radiographs obtained in the emergency department to evaluate specific signs and measurements as diagnostic references for occult femoral neck fractures in elderly patients.Initial negative radiographs were reviewed for 2 groups of patients: a group with occult femoral neck fractures (n=16) and a group without fractures (n=32). Reviews of initial radiographs and all imaging studies were performed by a senior orthopedist (C-C.C.) and a radiologist (H-T.W.). Diagnostic signs included lateral, medial, anterior, and posterior signs; measurements included elevation of the fat pad and external rotation of the femur. The prevalence of occult femoral neck fracture was 3.3%. Initial radiographs of occult femoral neck fractures were not routinely negative; 14 (87.5%) of 16 patients with fractures had at least 1 radiographic sign. Using the positive lateral or posterior sign as the diagnostic reference, the sensitivity was 0.875 and the specificity was 0.906. When elevation of the fat pad was ⩾1.5 mm, the sensitivity was 0.867 and the specificity was 0.857 for the diagnosis of occult femoral neck fracture.The lateral and posterior signs and elevation of the fat pad ⩾1.5 mm on initial radiographs are recommended as diagnostic references for occult femoral neck fracture. These references are clearly defined and may offer important information for all clinicians and radiologists in the emergency department.
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Affiliation(s)
- Chao-Ching Chiang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei 112, Taiwan, Republic of China.
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