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Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The aim of this study was to evaluate the reliability of assessing preoperative conventional X-ray diagnostics in determining whether a comminuted clavicle fracture is present. Methods: A total of 326 patients with complete clinical and radiological documentation treated for a central clavicle fracture at the author's department between January 1, 2012, and June 30, 2023, were included. Among these, 73 were female, and 253 were male in a mean age of 37.5 ± 17 years. Results: On preoperative X-ray images or operation reports, 109 (33%) or 78 (24%) simple and 217 (67%) or 248 (76%) comminuted fractures were identified. Thity-one out of 248 comminuted fractures were only discovered intraoperatively, accounting for 13%. According to the AO classification on preoperative X-ray or operation reports, 109 or 78 fractures were classified as type A (33% or 24%), 51 or 45 as type B (16% or 14%), and 166 or 203 as type C (51% or 62%). For 40 patients, the discrepancy between the preoperative X-ray and the intraoperative fracture type led to a change in the surgical procedure. This represents 12% of the total cohort or 91% of the fractures that were classified differently preoperatively compared to intraoperatively. In these cases, fractures were treated with open reduction and angular stable plate osteosynthesis instead of the preoperatively planned elastic stable intramedullary nailing (ESIN). Conclusion: The results of this study suggest that conventional X-ray diagnostics may not always detect comminuted clavicle shaft fractures. The treating physician should be aware of this issue. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 5-month-old infant who developed new-onset Type 1 diabetes mellitus (T1DM) following a COVID-19 infection. Topics discussed include the relationship between viral infections and autoimmune diabetes, the challenges in diagnosing T1DM in very young patients, and the increased incidence of diabetic ketoacidosis (DKA) during the COVID-19 pandemic.

Multiple neurological disorders are associated with gastrointestinal (GI) symptoms, including autism spectrum disorder (ASD). However, it is unclear whether GI distress itself can modify aspects of behavior. Here, we show that mice that experience repeated colitis have impaired active social engagement, as measured by interactions with a foreign mouse, even though signs of colitis were no longer present. We then tested the hypothesis that individuals with ASD harbor a microbiota that might differentially influence GI health by performing microbiota transplantation studies into male germfree animals, followed by induction of colitis. Animals that harbor a microbiota from ASD individuals have worsened gut phenotypes when compared to animals colonized with microbiotas from familial neurotypical (NT) controls. We identify the enrichment of Blautia species in all familial NT controls and observe an association between elevated abundance of Bacteroides uniformis and reductions in intestinal injury. Oral treatment with either of these microbes reduces colon injury in mice. Finally, provision of a Blautia isolate from a NT control ameliorates gut injury-associated active social engagement in mice. Collectively, our data demonstrate that past intestinal distress is associated with changes in active social behavior in mice that can be ameliorated by supplementation of members of the human microbiota. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition commonly studied in the context of early childhood. As ASD is a life-long condition, understanding the characteristics of brain microstructure from adolescence into adulthood and associations to clinical features is critical for improving outcomes across the lifespan. In the current work, we utilized Tract Based Spatial Statistics (TBSS) and Gray Matter Based Spatial Statistics (GBSS) to examine the white matter (WM) and gray matter (GM) microstructure in neurotypical (NT) and autistic males. Methods: Multi-shell diffusion MRI was acquired from 78 autistic and 81 NT males (12-to-46-years) and fit to the DTI and NODDI diffusion models. TBSS and GBSS were performed to analyze WM and GM microstructure, respectively. General linear models were used to investigate group and age-related group differences. Within the ASD group, relationships between WM and GM microstructure and measures of autistic symptoms were investigated. Results: All dMRI measures were significantly associated with age across WM and GM. Significant group differences were observed across WM and GM. No significant age-by-group interactions were detected. Within the ASD group, positive relationships with WM microstructure were observed with ADOS-2 Calibrated Severity Scores. Conclusion: Using TBSS and GBSS our findings provide new insights into group differences of WM and GM microstructure in autistic males from adolescence into adulthood. Detection of microstructural differences across the lifespan as well as their relationship to the level of autistic symptoms will deepen to our understanding of brain-behavior relationships of ASD and may aid in the improvement of intervention options for autistic adults. [ABSTRACT FROM AUTHOR]

In this retrospective cohort study of 276 patients with metastatic renal cell carcinoma (mRCC), we demonstrate that higher hemoglobin (Hb) levels prior to, and increases in Hb during systemic therapy predict better outcomes across three established frontline treatments. This study identifies Hb as a promising clinical marker of treatment outcomes in mRCC, of which there have been few to date. Introduction: Clinical markers of response in metastatic renal cell carcinoma (mRCC) are lacking. Low hemoglobin (Hb) is associated with poor outcomes in the IMDC risk score. This study evaluates the role of Hb as a marker of treatment outcomes in mRCC. Patients and Methods: This multicenter retrospective study evaluated 276 patients with mRCC treated with frontline immune checkpoint inhibitor (ICI) therapy, ICI and vascular endothelial growth factor (VEGF) inhibitor (VEGFI) combinations (ICI/VEGFI), or VEGFI monotherapy between 2014 and 2021. Hb levels at baseline, week 6 and 12 and at disease progression or death were recorded. Patients were categorized as responders (CR + PR) or 0.19-0.83, P = .009). Conclusion: Baseline and dynamic changes in Hb are associated with first-line treatment outcomes in patients with mRCC and represent a pragmatic early serological marker. nonresponders (SD + PD) using cross-sectional imaging at week 12. The association between baseline and dynamic changes in Hb and oncological outcomes was assessed. Results: Thirty-seven percent, 40% and 22% of patients received ICIs, ICI/VEGFI and VEGFI respectively. In patients receiving ICIs, there was a significant increase in Hb amongst responders from baseline to week 12 (P = .02). Amongst patients receiving ICI/VEGFI, there was an increase in Hb from baseline to week 12 which was greater in responders (P < .001). In patients receiving VEGFI monotherapy, responders had a higher Hb at baseline (P = .01), week 6 (P = .04), and week 12 (P = .003). An increase in Hb was a significant independent predictor of progression-free survival amongst patients receiving ICIs (HR 0.40, 95%CI. 0.19-0.83, P = .009). Conclusion: Baseline and dynamic changes in Hb are associated with first-line treatment outcomes in patients with mRCC and represent a pragmatic early serological marker. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has necessitated adaptation of cancer patient care. Oncology patients who contract COVID-19 have poor outcomes. Telemedicine clinics (teleclinics) have been introduced for cancer patients to reduce the risk of horizontal transmission at St. Bartholomew's Hospital and The Royal Free Hospital in London. Teleclinics have become routine in many specialities; however, inclusion in oncology care was not standard prior to the pandemic. A mixed-methods survey was designed and delivered to cancer patients (n = 106) at St. Bartholomew's Hospital and The Royal Free Hospital who had transitioned to teleclinics in March 2020. The survey explored patients' perceptions of this format. In total, 96 (90.5%) patients consented to take part, across a range of tumour types. Overall, respondents reacted favourably to the format of the teleclinics, with 90.6% of respondents (87/96) stating they would utilise teleclinics beyond the pandemic. Additionally, a survey was distributed to clinicians delivering these teleclinics (n = 16) to explore previous training in, perceptions of, and lessons learned from the introduction of telemedicine. Results suggest patients are accepting of teleclinic use for most clinical purposes. Teleclinic implementation affords benefits to cancer patient care both during and after COVID-19, but there is an urgent need for telemedicine education in oncology specialty training. [ABSTRACT FROM AUTHOR]

Intelligence (IQ) scores are used in educational and vocational planning for individuals with autism spectrum disorder (ASD) yet little is known about the stability of IQ throughout development. We examined longitudinal age-related IQ stability in 119 individuals with ASD (3–36 years of age at first visit) and 128 typically developing controls. Intelligence measures were collected over a 20-year period. In ASD, Full Scale (FSIQ) and Verbal (VIQ) Intelligence started lower in childhood and increased at a greater rate with age relative to the control group. By early adulthood, VIQ and working memory stabilized, whereas nonverbal and perceptual scores continued to change. Our results suggest that in individuals with ASD, IQ estimates may be dynamic in childhood and young adulthood. [ABSTRACT FROM AUTHOR]

Aseptic prosthetic loosening and periprosthetic joint infections (PJI) are among the most frequent complications after total knee/hip joint arthroplasty (TJA). Current research efforts focus on understanding the involvement of the immune system in these frequent complications. Different immune cell types have already been implicated in aseptic prosthetic loosening and PJI. The aim of this study was to systematically analyze aspirates from knee and hip joints, evaluating the qualitative and quantitative composition of soluble immunoregulatory markers, with a focus on co-inhibitory and co-stimulatory markers. It has been shown that these molecules play important roles in immune regulation in cancer and chronic infectious diseases, but they have not been investigated in the context of joint replacement. For this purpose, aspirates from control joints (i.e., native joints without implanted prostheses), joints with TJA (no signs of infection or aseptic loosening), joints with aseptic implant failure (AIF; i.e., aseptic loosening), and joints with PJI were collected. Fourteen soluble immunoregulatory markers were assessed using bead-based multiplex assays. In this study, it could be shown that the concentrations of the analyzed immunoregulatory molecules vary between control, TJA, AIF, and PJI joints. Comparing TJA patients to CO patients, sCD80 was significantly elevated. The marker sBTLA was significantly elevated in AIF joints compared to TJA joints. In addition, a significant difference for eight markers could be shown when comparing the AIF and CO groups (sCD27, sCTLA-4, sCD137, sCD80, sCD28, sTIM-3, sPD-1, sBTLA). A significant difference was also reached for nine soluble markers when the PJI and CO groups were compared (sLAG-3, sCTLA-4, sCD27, sCD80, sCD28, sTIM-3, sPD-1, IDO, sBTLA). In summary, the analyzed immunoregulatory markers could be useful for diagnostic purposes as well as to develop new therapeutic approaches for AIF and PJI. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Depression among methamphetamine users is more prevalent in females than males, but gender-specific treatment options for this comorbidity have not been described. Reduced brain phosphocreatine levels have been shown to be lower in female methamphetamine users compared to males, and, of relevance, studies have demonstrated an association between treatment-resistant depression and reduced brain phosphocreatine concentrations. The nutritional supplement creatine monohydrate has been reported to reduce symptoms of depression in female adolescents and adults taking antidepressants, as well as to increase brain phosphocreatine in healthy volunteers. Therefore, the purpose of this pilot study was to investigate creatine monohydrate as a treatment for depression in female methamphetamine users. Methods: Fourteen females with depression and comorbid methamphetamine dependence were enrolled in an 8-week open label trial of 5 g of daily creatine monohydrate and of these 14, 11 females completed the study. Depression was measured using the Hamilton Depression Rating Scale (HAMD) and brain phosphocreatine levels were measured using phosphorus magnetic resonance spectroscopy pre– and post–creatine treatment. Secondary outcome measures included anxiety symptoms, measured with the Beck Anxiety Inventory (BAI), as well as methamphetamine use, monitored by twice weekly urine drug screens and self-reported use. Results: The results of a linear mixed effects repeated measures model showed significantly reduced HAMD and BAI scores as early as week 2 when compared to baseline scores. This improvement was maintained through study completion. Brain phosphocreatine concentrations were higher at the second phosphorus magnetic resonance spectroscopy scan compared to the baseline scan; Mbaseline = 0.223 (SD = 0.013) vs. Mpost-treatment = 0.233 (SD = 0.009), t (9) = 2.905, p <.01, suggesting that creatine increased phosphocreatine levels. Also, a reduction in methamphetamine positive urine drug screens of greater than 50% was observed by week 6. Finally, creatine was well tolerated and adverse events that were related to gastrointestinal symptoms and muscle cramping were determined as possibly related to creatine. Conclusions: The current study suggests that creatine treatment may be a promising therapeutic approach for females with depression and comorbid methamphetamine dependence. This study is registered on clinicaltrials.gov (NCT01514630). [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate comorbid psychiatric disorders and psychotropic medication use among adults with autism spectrum disorder (ASD) ascertained as children during a 1980's statewide Utah autism prevalence study ( n = 129). Seventy-three individuals (56.6 %) met criteria for a current psychiatric disorder; 89 participants (69.0 %) met lifetime criteria for a psychiatric disorder. Caregivers reported a psychiatric diagnosis in 44 participants (34.1 %). Anxiety disorder had the highest current and lifetime prevalence (39.5 and 52.7 %, respectively). Participants with intellectual disability ( n = 94, 72.8 %) were significantly less likely to have community-based diagnoses of anxiety (χ = 5.37, p = 0.02) or depression (χ = 13.18, p < 0.001) reported by caregivers. Seventy-six participants (58.9 %) were taking ≥1 psychotropic medication. Comorbid psychiatric disorders occur frequently in adults with ASD, though identifying these disorders poses a challenge in community settings. A greater understanding of the presentation of these conditions within this population will increase assessment validity and the potential for efficacious intervention. [ABSTRACT FROM AUTHOR]

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a study on the repair of articular cartilage. Transplantation of chondrocyte experiments on sheep reveals a qualitatively better regenerative tissue compared to periosteal flap and no treatment. Some sheeps were treated with periosteal while other were treated with periosteal and filled with autologous de novo cartilage graft. The result shows that the implanted group has a remarkable improvement in grade of defect filling, cartilage stability and cell distribution. It further shows that de novo cartilage transplantation for chondral defects has a better qualitative microscopic and macroscopic regeneration compared to other treatment.

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Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The presented study reveals the single centre experiences with the minimally invasive endovascular repair for acute traumatic thoracic aortic lesions in the care of multitrauma patients. Methods: We reviewed ten patients with acute traumatic thoracic aortic lesions treated with a thoracic aortic stent graft between April 2001 and December 2006. The prospective collected data included age, sex, injury severity score, type of endovascular graft, endovascular operation time, length of stay, length of stay in the intensive care unit, and mortality. Followup data consisted of contrast-enhanced spiral computed tomography at regular intervals. Results: All patients (m:f 5:5; median age, 46 years; interquartile range [IQR], 29–68.5 years) suffered severe traumatic injury, the median Injury Severity Score was 39.5 (IQR 37.3–43). All endovascular procedures were technically successful, and the median operating time for the endovascular procedure was 90 min (IQR, 65–120 min). The overall hospital mortality was 20% (n = 2), and all deaths were unrelated to the aortic rupture or stent placement. No incidence of paraplegia was present. No intervention-related mortality occurred during a median follow-up of 14.7 months (IQR, 9.7–55.8 months). Conclusions: The endovascular approach to acute traumatic thoracic aortic lesions is feasible, safe, and effective in multitrauma patients. The low endovascular therapy-related morbidity and mortality in the postoperative period is encouraging. The results seem to be favorable to those published of open emergency repair. [ABSTRACT FROM AUTHOR]

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Kiddie Schedule for Affective Disorders and Schizophrenia was modified for use in children and adolescents with autism by developing additional screening questions and coding options that reflect the presentation of psychiatric disorders in autism spectrum disorders. The modified instrument, the Autism Comorbidity Interview-Present and Lifetime Version (ACI-PL), was piloted and frequently diagnosed disorders, depression, ADHD, and OCD, were tested for reliability and validity. The ACI-PL provides reliable DSM diagnoses that are valid based on clinical psychiatric diagnosis and treatment history. The sample demonstrated a high prevalence of specific phobia, obsessive compulsive disorder, and ADHD. The rates of psychiatric disorder in autism are high and are associated with functional impairment. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Reduction and intramedullary fixation of midclavicular fractures with an elastic titanium nail with the goal to reduce pain and to quickly resume activities of daily living postoperatively. Indications: Midclavicular fractures types A and B according to the OTA (Orthopaedic Trauma Association) classification of fractures. Contraindications: Surgery > 3 weeks after trauma. Fractures type C according to the OTA classification. Osteoporosis. Surgical Technique: Skin incision just above the sternal end of the clavicle. Approximately 1 cm lateral to the sternoclavicular joint, a hole is drilled into the anterior cortex. A titanium nail varying in diameter between 2.5 to 3.5 mm is mounted on a universal chuck with a T- handle. With oscillating movements the titanium nail is advanced until it reaches the fracture site. If closed reduction maneuvers are unsuccessful, an additional skin incision has to be made at the level of the fracture site enabling direct manipulation of the fragments. Postoperative Management: Postoperatively, no immobilization is performed. Patients are encouraged to move the arm as much as tolerated and to use it in daily activities. Results: Intramedullary fixation was applied to 136 clavicle fractures in 132 patients (89 men, 43 women, mean age 32.9 years). In 78 fractures closed reduction was successful. Average subjective pain assessment using a visual analog scale decreased from 72.4 points preoperatively to 18.9 points 3 days postoperatively. Average shoulder abduction increased significantly. The average Constant-Murley clinical outcomes score 1 year after implant removal was 97.1 points. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The objective of this retrospective study was to compare the results of two operative techniques used for the treatment of distal radius fractures classified as AO type A3. Patients and Methods: Patients were treated with either fixed-angle volar plates or intrafocal Kirschner wires (K-wires) using a Kapandji-like technique. The functional results were determined with the Gartland & Werley Score as well as the DASH Score after an average follow-up of 28 months. Results: 55 patients were included in the study. Of these, 33 were female and 22 male, with an average age of 59 years. In patients < 60 years, the Gartland Score was 1.4 points in the fixed-angle volar plate group, and 4.6 points in the Kapandji group. In patients ≥ 60 years, no significant difference between the therapy groups could be ascertained. The DASH Score measured 17 points in each group. In all cases, a satisfactory reduction was obtained. The Kapandji group experienced significantly more loss of reduction position at follow-up in terms of volar tilt and radioulnar inclination than the fixed-angle volar plate group. Conclusion: These results show that intrafocal K-wire fixation in older patients is a suitable method to attain and hold sufficient bony reduction. However, younger patients achieve better radiologic and functional results when treated with open reduction using the 3.5-mm LCP fixed-angle volar plate. [ABSTRACT FROM AUTHOR]

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To investigate the role of linezolid in the treatment of skeletal methicillin-resistant Staphylococcus aureus (MRSA) infections in a university clinic for trauma surgery with regard to treatment results, side effects, practicability, and costs. Patients and Methods: Data were recorded retrospectively in a single center over a 1-year period. Four patients with MRSA osteitis/infected pseudarthrosis of the upper extremity following prolonged fracture treatment were administered linezolid, after therapy with established antibiotics such as vancomycin had failed. In two patients with vertebral osteitis due to progressive spondylodiscitis, linezolid was used as the only effective antibiotic with oral availability, when intravenous application was technically impossible (central venous line complications/vena cava thrombosis). Adequate surgical treatment (debridement, stabilization, osteosynthesis) was performed in all patients. Results: Linezolid was administered for a mean of 2.2 months (1.5-3 months). Side effects of intravenous or oral linezolid treatment were not seen. One patient died after 6 weeks (heart failure). Mean follow-up time was 17.4 months (13-24 months). MRSA arthritis after 12 months was observed in one patient. A second critically ill patient was diagnosed with MRSA infection of a prosthetic hip 15 months later. Reinfection was excluded in four patients. High daily costs also of oral linezolid application compete with advantages of an early ambulatory treatment. Conclusion: Linezolid is a potent antibiotic that should be left to skeletal MRSA infection after stabilization and debridement if (1) vancomycin treatment has failed and (2) intravenous application of vancomycin is not possible. [ABSTRACT FROM AUTHOR]

Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Can distal radius fractures be held in place with palmar locking compression plates (LCPs) and heal completely without an additional bone transplant? From 1 March 2001 to 1 September 2002, 40 patients with distal radius fractures (CCF: 2× A2, 13× A3, 2× C1, 22× C2 and 1× C3 fractures) were treated with locking compression small fragment titanium plates. In 37 cases, the plates were inserted in a palmar direction without an additional corticocancellous bone graft. All patients received a follow-up check-up after an average of 12.1 months. On this occasion, the range of motion, grip strength and radiological result were measured and rated according to the Gartland and DASH score. All fractures healed completely. In one case, a re-osteosynthesis was carried out after the plate had bent because full load was placed on it prematurely. An average of 5.1 points was achieved in the Gartland and 12.6 points in the DASH score. An extremely good result was achieved in 19 cases, a good result in 15 and a satisfactory result in 6. At the follow-up examination, the average range of motion was 52°-0°-50° for stretching and bending in the wrist, 20°-0°-27° for radial and ulnar deviation and 82°-0°-78° for pronation and supination. On the radiographs, the average radiocarpal angle in the anteroposterior projection was 22° with a palmar tilt of an average of 5°. Radius fractures with metaphyseal, one-sided comminuted zones can be treated with locking compression plates with good results using a palmar approach without a cancellous bone graft. [ABSTRACT FROM AUTHOR]

Background: Intramedullary fixation of middavicular fractures may be a better option than non-operative treatment for high performance/professional athletes because of the potential reduction in recovery time. Objectives: To evaluate the effectiveness of intramedullary fixation in high performance athletes and the time required to return to sporting activity. Methods: Data were taken from a prospective study on intramedullary fixation techniques using the elastic stable Ti nail (TEN, Synthes) for the treatment of displaced midclavicular fractures, initiated in 1996. The patients in 12 cases were classified as high performance/professional athletes. These cases were used to evaluate the technique specifically in this population. Fractures were classified according to the Orthopaedic Trauma Association (OTA) system. Patients were evaluated before and after surgery for shoulder function and subjective pain. After the operation, radiological assessments documented fracture healing, and clinical outcomes scores were obtained. Time required to return to training and competition was documented. Results: All fractures were transverse or oblique. Mean (SD) shoulder abduction increased from 36.3 (8) before surgery to 154.2 (17) °afterwards (p<0.001). Mean subjective pain score using a visual analogue scale (0-100) decreased from 71.7 (18) points before surgery to 19.2 (6) points (p<0.001) three days after. There were no complications. Hospital stay averaged 2.9 (1) days. Mean delay to resumption of training was 5.9 (1) days, and to resumption of competition it was 16.8 (5) days. The mean Constant clinical outcomes score one year after hardware removal was 98.3 (2) points. Conclusions: Intramedullary fixation of displaced midclavicular fracture was successful in terms of clinical outcome and rapid resumption of sporting activities. This treatment should be offered to athletes as an alternative to non-operative treatment. [ABSTRACT FROM AUTHOR]

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Autism is hypothesized to represent a disorder of brain connectivity, yet patterns of atypical functional connectivity show marked heterogeneity across individuals. Methods: We used a large multi-site dataset comprised of a heterogeneous population of individuals with autism and typically developing individuals to compare a number of resting-state functional connectivity features of autism. These features were also tested in a single site sample that utilized a high-temporal resolution, long-duration resting-state acquisition technique. Results: No one method of analysis provided reproducible results across research sites, combined samples, and the high-resolution dataset. Distinct categories of functional connectivity features that differed in autism such as homotopic, default network, salience network, long-range connections, and corticostriatal connectivity, did not align with differences in clinical and behavioral traits in individuals with autism. One method, lag-based functional connectivity, was not correlated to other methods in describing patterns of resting-state functional connectivity and their relationship to autism traits. Conclusion: Overall, functional connectivity features predictive of autism demonstrated limited generalizability across sites, with consistent results only for large samples. Different types of functional connectivity features do not consistently predict different symptoms of autism. Rather, specific features that predict autism symptoms are distributed across feature types. [ABSTRACT FROM AUTHOR]