We recently completed the Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT), a large, multicenter trial
of reamed and unreamed intramedullary nailing of tibial shaft fractures in 1226 patients. Using the SPRINT data, we conducted an investigation of baseline and surgical factors to determine any associations with an increased risk of adverse events within one year of intramedullary nailing.
Methods: Using multivariable logistic regression analysis, we investigated fifteen baseline and surgical factors for any associations with an increased risk of negative outcomes.
Results: There was an increased risk of negative events in patients with a high-energy mechanism of injury (odds ratio [OR] find more = 1.57; 95% confidence interval [CI], 1.05 to 2.35), a stainless steel compared with a titanium nail (OR = 1.52; 95% CI, 1.10 to 2.13), a fracture gap (OR = 2.40; 95% CI, 1.47 to 3.94), and full weight-bearing status after surgery (OR = 1.63; 95% CI, 1.00 to 2.64). There was no increased risk with the use of nonsteroidal anti-inflammatory agents, late or early time to surgery, or smoking status. Open fractures had a higher risk of events
among patients PD0332991 treated with reamed nailing (OR = 3.26; 95% CI, 2.01 to 5.28) but not in patients treated with unreamed nailing (OR = 1.50; 95% CI, 0.92 to 2.47). Patients with open fractures who had wound management either without any additional procedures or with delayed primary closure had a decreased AZD6244 mouse risk of events compared with patients who required subsequent, more complex reconstruction (OR = 0.18 [95% CI, 0.09 to 0.35] and 0.29 [95% CI, 0.14 to 0.62], respectively).
Conclusions: We identified several baseline fracture and surgical characteristics that may increase the risk of adverse events in patients with tibial shaft fractures. Surgeons should consider
the predictors identified in our analysis to inform patients treated for tibial shaft fractures.”
“Mastication of natural rubber (NR) is undertaken as a preliminary step towards the preparation of NR-based vulcanizates, a process during which the elastomer is broken down to a homogeneous matrix of lower viscosity. Several tests and indicators are in use for characterizing the behavior of elastomers but these have mostly been adopted for the nonmasticated product. This study uses coefficients generated from modeled Mooney relaxation data, as indicators of elasticity, to examine the effect of high-temperature mastication on the processability of the masticated rubber. Some derived coefficients such as the terminal relaxation time (T) from Maxwell’s triexponential model, the elastic component (a) from Wu-Abbott model [Y = 1 + a* ln(t) - bt/(c + t)], and the constant (b) from the Power law model (Y = at(-b)), adequately characterized the effect of mastication on NR.