1,721,127 research outputs found

    Fifth metatarsal tuberosity avulsion fractures: A new surgical technique without metal implant

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    Background: Lawrence and Botte classified in the 1993 the fractures of 5MTB in a Zone 1 (tuberosity avulsion fracture), Zone 2 (Jones fracture), and Zone 3 (stress diaphyseal fractures). Despite good outcomes with non-operative treatment, displacement, intra-articular involvement, comminution or painful non-union of Zone 1 fracture have been reported to benefit with early open reduction and fixation. We considered a Zone 1 fracture (tuberosity avulsion) with displacement of the segment from the metatarsal metaphysis > 2 mm. Surgical technique: We describe a surgical procedure for the tuberosity avulsion fractures (Zone 1 of Lawrence and Botte classification or type I-B of Mehlhorn classification) using FiberWire or Vycril sutures. Conclusions: This technique, without using metal implant, provides a theoretically lower rate of infections, could be useful in patients referring metal allergy or hypersensitivity to metal implants and it is not necessary the fluoroscopic guidance

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Uterine myomectomy: Role of gasless laparoscopy in comparison with other minimally invasive approaches

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    Abstract Introduction: The aim of this review was to assess the role of gasless laparoscopy (GLM) in comparison with two other minimally invasive approaches to myomectomy, CO(2) laparoscopy (LM) and minilaparotomy (MM), focusing on the most recent randomized or prospective controlled studies. Material and methods: A computerized search was made of the Medline, Science Citation Index, Current Contents, Embase, and PubMed databases for English language publications from the first reports of GLM, LM, and MM in 1995 to 2010. The fifteen most recent randomized or prospective controlled studies were selected and analyzed considering the operative and postoperative parameters. Results: One randomized controlled, one multicenter controlled, three prospective studies about GLM, four randomized controlled studies and one prospective study about LM, four randomized controlled trials and one prospective study about MM were reviewed and analyzed. Discussion: GLM offers some advantages eliminating the adverse effects and potential risks of CO(2) insufflation, particularly when large myomas have to be removed. The advantages of LM are the tamponade effect generated by the gas on the small vessels and the more precise myoma enucleation by using the endoscopic instruments, thus reducing intraoperative bleeding. MM can be a suitable option being associated with a lower overall level of surgical skill, even if it is desirable to have a standard universally accepted definition of "minilaparotomy" in order to correctly compare the results of the different studies. Lastly, the surgical outcomes of the three minimally invasive approaches to myomectomy are influenced by size, site, and number of the myomas, as well as by the skill and preference of the surgeon.All these criteria should be considered in the choice of the best minimally invasive approach to myomectomy
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