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Open reduction and internal fixation (ORIF) for unstable ankle fractures (AF) are relatively predictable with excellent outcomes. Rehabilitation strategies are still being debated after surgical intervention for AF: non-weight bearing and cast immobilization for six weeks after the surgical repair of unstable AF or early functional treatment with partial weight bearing. This study aimed to compare early weight bearing and functional outcomes and complications.Between April 2014 and March 2019, 1421 patients with AF underwent ORIF at 11 institutions (TRON group). The patients were divided into two groups: Group E started weight bearing within six weeks after surgery, and group L started weightbearing for more than six weeks after. To adjust for baseline difference between groups, a propensity score-matched algorithm was used to match Group E with Group L in a 1:1 ratio of 294 cases each. We compared the American Orthopedic Foot and Ankle Society (AOFAS) score as the functional outcome, the rate of wound dehiscence, superficial and deep infections, blistering, nonunion, neurapraxia, and reoperation at 3, 6, and 12 months after surgery.The mean period of non-weight bearing was significantly shorter in group E (3.68 ± 1.02 vs. 6.67 ± 1.43; P 0.001). The mean period of cast immobilization term were shorter in group E (1.84 ± 1.35 vs. 2.65 ± 1.51; P 0.001). There were no differences in the AOFAS score at any period. The rates of deep infection and reoperation in Group E were significantly lower than those in Group L (1.7% vs. 6.1%; P = 0.009, 2.0% vs. 7.8%; P = 0.002, respectively). There were no significant differences in superficial infection (9 vs. 15; P = 0.297), nonunion (9 vs. 15 P = 0.30), blistering (4 vs. 3; P = 1.00), neurapraxia (2 vs. 1; P = 1.00), and wound dehiscence (15 vs. 18; P = 0.72).Although functional outcome was similar depending on whether early weight bearing was allowed, the rates of deep infection and reoperation decreased in patients with early weight bearing. We recommend early postoperative weight bearing in patients with a surgically treated AF.

Introduction One of the complications of the surgical therapy for ankle fractures includes wound infection. This study aimed to evaluate postoperative function and clarify the risk factors associated with postoperative wound infection in patients receiving the open reduction and internal fixation for ankle fracture through a multicenter study. Subjects and method Among 1421 patients diagnosed as having closed ankle fracture and who were treated by surgical therapy in 11 institutions from 2014 through 2019, 1201 patients (men, n = 512, women, n = 689; the mean (SD) age, 50.9 (15.6) years; the mean body mass index [BMI] (SD), 24.3 (4.2) kg/m2) were included as subjects. Excluded were 220 patients due to self-termination of treatment, inability to follow up after discharge, open fracture, distal tibia shaft fracture, and pilon fracture. We extracted the following as risk factors of wound infection: age, sex, BMI, fracture type, injury energy and histories of smoking, diabetes, arteriosclerosis, heart failure and myocardial infarction. We conducted logistic regression analysis to investigate the risk factors of wound infection using these extracted items as explanatory variables and the presence or absence of wound infection as the response variable. Results Wound infection occurred after surgery for closed ankle fracture in 69 the 1201 patients (5.7%). The causative organism was methicillin-susceptible Staphylococcus aureus (MSSA) in 15 patients, methicillin-resistant S. aureus (MRSA) in 4 patients, Finegoldia magna in one patient, and S. haemolyticus in one patient. In the other patients, causative organisms were not detected, culture of the causative organisms was not conducted, or they were unknown. The univariate analysis showed significant differences in sex (p = 0.01) and for smoking (p = 0.002), fracture type (p = 0.02) and heart failure (p = 0.042). Logistic regression analysis showed that smoking and type of fracture (trimalleolar fracture) were significant explanatory factors for infection (odds ratio 1.83 and 1.98, p = 0 .040 and 0.042, respectively). Conclusions At 5.7%, the rate of postoperative wound infection in closed ankle fracture was not low. Staphylococcus was the most frequent causative organism. The surgeon should pay attention infection after surgery in the patients who had a trimalleolar fracture or smoking habits.

金沢大学理工研究域自然システム学系, We examined formation of solvated electrons in several ionic liquids composed of ammonium, pyrrolidinium and piperidinium cations by observing absorption spectra in the visible and near-infrared regions using pulse radiolysi. We also examined reactions of the solvated electrons with imidazolium cations in the ionic liquids. The reaction rate constants were an order of magnitude faster than the diffusion-limited rate calculated from the viscosity. The electrons before full solvation (dry electrons) reacted efficiently with the imidazolium cations. These observations suggest that the electrons in the ionic liquids can move easily before solvation. The scavenging of the dry electron by the imidazolium cation was also examined using C2-alkylated-imidazolium cations. It is found that the alkylation of imidazolium suppresses the reactivity with the dry electron. © 2008 Elsevier Ltd. All rights reserved.

Isolated ultrathin films of YBa 2 Cu 3 O 7−x (YBCO) on PrBa 2 Cu 3 O 7−x (PrBCO) and YBCO/PrBCO superlattices were epitaxially grown on SrTiO 3 by reactive coevaporation with measurement of reflection high energy electron diffraction (RHEED) specular intensity. X-ray diffraction profiles and cross sectional electron microscopic (TEM) observation reveal that the heterostructures are excellent crystallinity with no interface disorder and fit for the ptudy of superconductivity of the 1 unit-cell layer of YBCO. The 1 unit-cell layer of YBCO sandwiched between PrBCO layers exhibits a superconducting transition with the onset temperature at 70K and the zero resistance at 30K. A reduction of the onset temperature is found to be mainly due to a decrease of the hole carriers but not due to the absence of interlayer coupling. It was demonstrated that the 1 unit-cell layer of YBCO needed the overlayer of PrBCO to give rise to superconductivity. The overlayer of PrBCO may have the role of supply of carriers for the underlying YBCO layer. The resistive transition for the ultrathin YBCO layer below 4 unit-cells thick was independent of the magnetic field up to 10T applied parallel to the CuO 2 layer.