Maisonneuve Fracture: A Rare But Significant Injury

Introduction: Maisonneuve fracture (MF) is a generally known entity in ankle trauma. However, details about this type of injury can be found only rarely in the literature. For these reasons we have decided to perform a study on MF epidemiology and pathoanatomy. Methods: The group comprised 70 patients (47 men, 23 women), with the mean age of 48 years, who sustained an ankle fracture-dislocation involving the proximal quarter of the fibula. Ankle radiographs in three views and lower leg radiographs in two views were performed in all patients. A total of 59 patients underwent CT examination in three views, including 3D CT reconstruction in 49 of these patients. MRI was performed in 4 patients. Operative treatment was used in 67 patients; open reduction of the distal fibula into the fibular notch was opted for in 54 of them. Results: The highest MF incidence rate was recorded in the 5th decade in the whole group and in men, while in women the peak incidence was in the 6th decade. After the age of 50, the share of women significantly increased. In 64 cases, the fibular fracture was subcapital, and in 6 cases it involved the fibular head. In 24% of the patients, the fibular fracture was seen only in the lateral radiograph of the lower leg. Widening of the tibiofibular clear space was shown by radiographs in 40 cases. Posterior dislocation of the fibula (Bosworth fracture) and tibiofibular diastasis were recorded in 2 cases each. An injury to the anterior and posterior tibiofibular ligaments was found in all 54 patients with open reduction of the distal fibula. A fracture of the medial malleolus was identified in 27 cases (39%) and a complete lesion of the deltoid ligament in 36 cases (51%); in 7 cases (10%) the medial structures were intact. A fracture of the posterior malleolus occurred in 54 (77%) patients. Osteochondral fracture of the talar dome was diagnosed in 2 patients and compression of the articular surface of the distal tibia in the region of the fibular notch in 1 patient. Conclusion: Maisonneuve fracture includes a wide range of injuries both to bone and ligamentous structures of the ankle. Therefore, CT examination is an indispensable part of assessment of this type of fracture.

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Herbicide Tolerance Of Transgenic `Stevens' Cranberry Plants Depends on the Test Environment

HortScience ◽

10.21273/hortsci.33.3.517a ◽

1998 ◽

Vol 33 (3) ◽

pp. 517a-517

Author(s):

Eric L. Zeldin ◽

Rodney A. Serres ◽

Brent H. McCown

Keyword(s):

Growth Form ◽

Herbicide Tolerance ◽

Genetically Engineered ◽

Shoot Tip ◽

Test Environment ◽

Growth Environment ◽

Commercial Formulation ◽

Tolerance Level ◽

Delayed Growth ◽

Significant Injury

`Stevens' cranberry was genetically engineered to confer tolerance to the broad spectrum herbicide glufosinate. Initially, herbicide tolerance was verified by spraying greenhouse plants with the commercial formulation Liberty. Although one transformant showed significant tolerance, the tolerance level was below that required to kill goldenrod, a common weed of cranberry beds. This transformant was propagated and the plants established outdoors in a coldframe, yielding a growth form more typical of field-grown plants than that of greenhouse-grown plants. These plants, as well as untransformed cranberry and goldenrod plants, were sprayed with various levels of the herbicide. The transformed plants were not killed at glufosinate concentrations up to 1000 ppm, although delayed growth did occur. Some runner tip injury was observed at 500 ppm as well as widespread shoot tip death at higher levels. The above-ground parts of goldenrod plants were killed at 400 ppm with significant injury at 200 ppm. Untransformed cranberry plants were killed at 300 ppm and had extensive tip death even at 100 ppm. Transformed cranberry plants with confirmed “field” tolerance were re-established in the greenhouse and new vegetative growth was forced. When these plants were sprayed with glufosinate, significant shoot tip injury was observed at levels as low as 100 ppm. The degree of herbicide tolerance of transformed cranberry appears to be modulated by the growth environment, which may affect the expression of the inserted genes or the physiological sensitivity of the impacted tissues.

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Prehospital shock index outperforms hypotension alone in predicting significant injury in trauma patients

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2021-000712 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000712

Author(s):

Tareq Kheirbek ◽

Thomas J Martin ◽

Jessica Cao ◽

Benjamin M Hall ◽

Stephanie Lueckel ◽

...

Keyword(s):

Blood Pressure ◽

Missing Values ◽

Injured Patient ◽

Injury Pattern ◽

Long Bone ◽

Shock Index ◽

Level Of Evidence ◽

Emergent Operation ◽

Serious Injury ◽

Significant Injury

BackgroundThe American College of Surgeons Resources for Optimal Care of the Injured Patient recommends using hypotension, defined as systolic blood pressure ≤90 mm Hg, as an indicator of a full team trauma activation. We hypothesized that an elevated shock index (SI) predicts significant traumatic injuries better than hypotension alone.MethodsThis is a retrospective cohort study analyzing full team trauma activations between February 2018 and January 2020, excluding transfers and those who had missing values for prehospital blood pressure or heart rate. We reviewed patients’ demographics, prehospital and emergency department vitals, injury pattern, need for operation, and clinical outcomes. The primary outcome was rate of significant injury defined as identified injured liver, spleen, or kidney, pelvis fracture, long bone fracture, significant extremity soft tissue damage, hemothorax, or pneumothorax.ResultsAmong 544 patients, 82 (15.1%) had prehospital hypotension and 492 had normal blood pressure. Of the patients with prehospital hypotension, 34 (41.5%) had a significant injury. There was no difference in age, gender, medical history, or injury pattern between the two groups. There was no difference between the two groups in rate of serious injury (41.5% vs. 46.1%, NS), need for emergent operation (31.7% vs. 28.1%, NS) or death (20.7% vs. 18.8%, NS). On the other hand, SI ≥1 was associated with increased rate of serious injury (54.6% vs. 43.4%, p=0.04). On a logistic regression analysis, prehospital hypotension was not associated with significant injury or need for emergent operation (OR 0.83, 95% CI 0.51 to 1.33 and OR 1.32, 95% CI 0.79 to 2.25, respectively). SI ≥1 was associated with both increased odds of significant injury and need for emergent operation (OR 1.57, 95% CI 1.01 to 2.44 and OR 1.64, 95% CI 1.01 to 2.66).DiscussionSI was a better indicator and could replace hypotension to better categorize and triage patients in need of higher level of care.Level of evidencePrognostic and epidemiologic, level III.

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Peanut Response to Naturally-Derived Herbicides Used in Organic Crop Production

Peanut Science ◽

10.3146/ps07-106.1 ◽

2008 ◽

Vol 35 (1) ◽

pp. 73-75 ◽

Cited By ~ 5

Author(s):

W. Carroll Johnson ◽

Benjamin G. Mullinix ◽

Mark A. Boudreau

Keyword(s):

Acetic Acid ◽

Crop Production ◽

Clove Oil ◽

Phytotoxic Effects ◽

Peanut Production ◽

Organic Crop Production ◽

Significant Injury

Abstract Weed-free irrigated trials were conducted in 2004 and 2005 to quantify phytotoxic effects of herbicides with the potential to be used in organic peanut production. Clove oil and citric plus acetic acid were each applied at vegetative emergence of peanut (VE), two weeks after VE (2 wk), four weeks after VE (4 wk), sequentially VE/2 wk, sequentially VE/4 wk, sequentially VE/2 wk/4 wk, and a nontreated control. Clove oil was more injurious (maximum of 28% visual injury) than citric plus acetic acid (maximum of 4% visual injury), with significant injury occurring with clove oil applied at 4-wk or sequentially. Citric plus acetic acid caused minimal peanut injury. There were no consistent effects of clove oil on peanut yield, although sequential applications of clove oil tended to reduce peanut yield. Peanut yield was not affected by citric plus acetic acid.

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Asymptomatic fatal post-lobectomy hemopericardium

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2008.391 ◽

2016 ◽

Vol 70 (3) ◽

Author(s):

C. Kotoulas ◽

S. Meraj ◽

N.J. Odom

Keyword(s):

Epicardial Fat ◽

Circumflex Artery ◽

Post Surgery ◽

Pathologic Findings ◽

Significant Injury

We report a case of an asymptomatic post-lobectomy hemopericardium in a female who died suddenly at day two post surgery. Autopsy revealed no pathologic findings, but 250 ml of blood and clots in the pericardium and a non-significant injury to the epicardial fat overlying the circumflex artery territory.

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Can Elbow Extension be Used as a Test of Clinically Significant Injury?

Southern Medical Journal ◽

10.1097/00007611-200205000-00015 ◽

2002 ◽

Vol 95 (5) ◽

pp. 539-541 ◽

Cited By ~ 1

Author(s):

MARTIN A. DOCHERTY ◽

ROBERT A. SCHWAB ◽

O JOHN MA

Keyword(s):

Elbow Extension ◽

Clinically Significant ◽

Significant Injury

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The Maisonneuve Fracture of the Fibula

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199302000-00034 ◽

1993 ◽

Vol &NA; (287) ◽

pp. 218???223 ◽

Cited By ~ 3

Author(s):

KEITH DOUGLAS MERRILL

Keyword(s):

Maisonneuve Fracture

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Histopathological changes in the liver and kidney tissues of Wistar albino rat exposed to fenitrothion

Toxicology and Industrial Health ◽

10.1177/0748233708100090 ◽

2008 ◽

Vol 24 (9) ◽

pp. 581-586 ◽

Cited By ~ 24

Author(s):

S Afshar ◽

AA Farshid ◽

R Heidari ◽

M Ilkhanipour

Keyword(s):

Control Group ◽

Histopathological Changes ◽

Albino Rat ◽

Hydropic Degeneration ◽

Leukocytic Infiltration ◽

Male Wistar Rats ◽

Liver And Kidney ◽

Dose Dependent ◽

Significant Injury ◽

Different Doses

The aim of this study was to investigate the dose-related effects of fenitrothion (FNT) on the liver and kidney. The study was conducted on 8-week-old male Wistar rats that were divided into four groups (three experimental groups and one control group) and were treated orally with different doses (25, 50, 100 mg/kg) of FNT for 28 consecutive days. After treatment, the rats were anesthetized with ether and liver and kidney samples were taken for histological studies. The results showed that the histopathological changes in the liver were mainly represented by parenchymatous degeneration of hepatocytes with mild necrosis, leukocytic infiltration in the portal area, severe congestion, and hemorrhage. These changes were dose dependent. Marked tubular dilation, hydropic degeneration in tubular epithelium, moderate congestion, and hemorrhage in the cortical and medulla part of the kidney were recorded. Histopathologic examination of the liver and kidney indicated a significant injury only in rats receiving 100 mg/kg FNT.

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