All patients had radiographic and clinical follow-up at a minimum of twenty-four months and an average of thirty-six months. Reduction and implant placement were evaluated radiographically. Clinical outcomes were measured with use of the Constant-Murley system.
Results: The mean Constant score (and standard deviation) at the time of
final follow-up was significantly better in the locked-plate group (68.6 +/- 9.5 points) than in the hemiarthroplasty group (60.6 +/- 5.9 points) (p < 0.001). The Constant scores for the three-part fractures in the locked-plate and hemiarthroplasty groups were 71.6 and 60.4 points (p < 0.001), respectively, and the scores for the four-part fractures in those groups selleckchem were 64.7 and 60.1 points (p = 0.19), respectively. Patients with an initial varus extension deformity in the locked-plate group had significantly worse outcomes than those with a valgus impacted pattern (Constant score, 63.8 compared with 74.6 points, respectively; p < 0.001). Complications in the group treated with locked-plate fixation included osteonecrosis in six patients, screw perforation of the humeral
head in six patients, loss of fixation in four patients, and wound infection in three patients. Loss of fixation was seen only in patients with >20 degrees of initial varus angulation of the humeral head. Complications in the hemiarthroplasty group included nonunion of the tuberosity in seven patients and wound infection in three patients.
Conclusions: In this series, open repair with use Selleck LDC000067 of a locked plate resulted in better outcome scores than did hemiarthroplasty in similar patients, especially in those with a three-part fracture, despite a higher overall complication rate. Open reduction and internal fixation of fractures with an initial varus extension pattern should be approached with caution.”
“Phytochemical studies of the wood and the stem bark of Tridesmostemon omphalocarpoides Engl. (Sapotaceae) led to the isolation of omphalocarpoidone (1), a new lanostane-type furano-spiro-gamma-lactone
together with beta-amyrin acetate (2), taraxerol (3), spinasterol (4), lichexanthone (5), epi-catechin (6), spinasterol 3-O-beta-D-glucopyranoside selleck kinase inhibitor (7), tormentic acid (8), and 1,2,3,4-tetrahydronorharman-1-one (9). Their structures were established on the basis of extensive NMR studies, mass spectrometry, and by comparison of the data with those previously reported in the literature. The structure of the new secondary metabolite was later confirmed by X-ray crystallography. Except for spinasterol, the antimicrobial activities of these secondary metabolites were investigated on ten bacterial strains and the alkaloid 9 showed a significant activity against Escherichia coli with a MIC at 16 mu g/mL. (C) 2013 Phytochemical Society of Europe. Published by Elsevier B.V. All rights reserved.