PURPOSE OF THE STUDY Radial head fractures in paediatric patients account for 5-19% of all elbow injuries and approximately 1% of all fractures in children. Non-displaced fractures are treated with plaster cast fixation. If the fracture is displaced, we proceed to closed reduction, or to osteosynthesis in case of unstable fragments. If closed reduction fails, we opt for open reduction and osteosynthesis. The prospective randomised clinical study aims to compare the two methods of minimally invasive osteosynthesis using the pre-bent Kirschner wire or Prévot nail and to identify differences between them. MATERIAL AND METHODS The prospective randomised clinical study was conducted in 2015-2019. The final cohort included 32 patients who met the inclusion criteria. The patients in whom other osteosynthesis implants had been used or in whom open reduction had to be performed were excluded from the study. Also excluded were the patients with serious concomitant injuries of elbow. For patients included in the cohort, demographic data, precise evaluation of the displacement and location of the fracture as well as the duration of plaster cast fixation and osteosynthesis implants used were recorded. In the clinical part, the methods were compared based on the achievement of full range of motion in dependence on the degree of original displacement, use of osteosynthesis implant, and occurrence of early and delayed complications. Clinical and radiological outcomes were compared. In both types of minimally invasive osteosynthesis, Métaizeau surgical technique was used. RESULTS Based on the clinical trial criteria, 26 (81%) excellent, 4 (13%) good and 2 (6%) acceptable outcomes were achieved. In 3 cases the loss of rotation was up to 20°, in 1 case the loss of flexion was up to 10°. In one patient the loss of flexion was 15° and rotation up to 30°. In another patient the loss of rotation was up to 40°. The radiological assessment showed 14 (44%) excellent outcomes, 15 good (47%) and 3 (9%) acceptable outcomes. The statistical analysis of both the groups of the cohort using non-parametric tests revealed no statistically significant differences in individual demographic parameters. The comparisons of both types of osteosynthesis in dependence on the degree of displacement by non-parametric Fisher's exact test showed no statistically significant difference in the radiologic or clinical results. The only statistically significant difference was observed in the duration of metal implant placement. DISCUSSION Comparable studies report excellent or good clinical outcomes in 80-95% of cases (1,13,16). In our cohort, excellent or good clinical outcomes were achieved in 30 patients (94%). In two patients, in whom Prévot nail was used, the outcomes were acceptable. Nonetheless, this fact did not result in any statistical significance when comparing the two methods separately or in comparisons based on the degree of displacement. CONCLUSIONS The comparison of the two methods of minimally invasive osteosynthesis revealed no statistically significant difference, namely not even when both the methods were compared based on the degree of displacement. When Kirschner wire is used, the possibility to remove the metal implant in the outpatient setting is considered to be an advantage. The drawback consists in potential penetration of the sharp Kirschner wire in the radiocapitellar joint, which we did not encounter when the second technique of osteosynthesis was used. The advantage of Prévot nail includes a lower risk of pin-tract infection. Key words: minimally invasive osteosynthesis, radial head, fracture, child.

• MeSH
• Child MeSH
• Radius Fractures * diagnostic imaging   etiology   surgery   MeSH
• Bone Wires MeSH
• Humans MeSH
• Prospective Studies MeSH
• Radius injuries   MeSH
• Fracture Fixation, Internal * methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

• MeSH
• Internal Medicine MeSH
• Publication type
• Handbook MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• vnitřní lékařství
• NML Publication type
• učebnice vysokých škol
• kolektivní monografie

The applications of gas plasma and plasma modified materials in the emerging fields of medicine such as dentistry, drug delivery, and tissue engineering. Plasma sterilization of both living and non-living objects is safe, fast and efficient; for example plasma sterilization of medical equipment quickly removes microorganisms with no damage to the tiny delicate parts of the equipment and in dentistry it offers a non-toxic, painless bacterial inactivation of tissues from a dental cavity. Devices that generate plasma inside the root canal of a tooth give better killing efficiency against bacteria without causing any harm to the surrounding tissues. Plasma modified materials fulfill the requirements for bioactivity in medicine; for example, the inclusion of antimicrobial agents (metal nano particles, antimicrobial peptides, enzymes, etc.) in plasma modified materials (polymeric, metallic, etc) alters them to produce superior antibacterial biomedical devices with a longer active life. Thin polymer films or coating on surfaces with different plasma processes improves the adherence, controlled loading and release of drug molecules. Surface functionalization by plasma treatment stimulates cell adhesion, cell growth and the spread of tissue development. Plasma applications are already contributing significantly to the changing face of medicine and future trends are discussed in this paper.

• Keywords
• plasma, sterilization, dentistry, surface functionalization, drug delivery, tissue engineering,
• MeSH
• Biocompatible Materials MeSH
• Biomedical Engineering methods   instrumentation   trends   MeSH
• Chemical Phenomena MeSH
• Financing, Organized MeSH
• Metals therapeutic use   MeSH
• Humans MeSH
• Drug Carriers MeSH
• Gases MeSH
• Polymers therapeutic use   MeSH
• Prostheses and Implants utilization   MeSH
• Alloys therapeutic use   MeSH
• Sterilization MeSH
• Investigative Techniques MeSH
• Catheters, Indwelling utilization   MeSH
• Dental Materials therapeutic use   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Drug-eluting stents (DES) reduce the need for repeat revascularization, but their long-term safety relative to that of bare-metal stents (BMS) in general use remains uncertain. We sought to compare the clinical outcome of patients treated with DES with that of BMS. METHODS AND RESULTS: All adults undergoing percutaneous coronary intervention with stenting between April 1, 2003, and September 30, 2004, at non-US government hospitals in Massachusetts were identified from a mandatory state database. Patients were classified from the index admission according to stent types used. Clinical and procedural risk factors were collected prospectively. Risk-adjusted mortality, myocardial infarction, and revascularization rate differences (DES-BMS) were estimated through propensity score matching without replacement. A total of 11 556 patients were treated with DES, and 6237 were treated with BMS, with unadjusted 2-year mortality rates of 7.0% and 12.6%, respectively (P<0.0001). In 5549 DES patients matched to 5549 BMS patients, 2-year risk-adjusted mortality rates were 9.8% and 12.0%, respectively (P=0.0002), whereas the respective rates for myocardial infarction and target-vessel revascularization were 8.3% versus 10.3% (P=0.0005) and 11.0% versus 16.8% (P<0.0001). CONCLUSIONS: DES treatment was associated with lower rates of mortality, myocardial infarction, and target-vessel revascularization than BMS treatment in similar patients in a matched population-based study. Comprehensive follow-up in this inclusive population is warranted to identify whether similar safety and efficacy remain beyond 2 years.

• MeSH
• Angioplasty, Balloon, Coronary mortality   MeSH
• Databases, Factual statistics & numerical data   MeSH
• Incidence MeSH
• Myocardial Infarction mortality   therapy   MeSH
• Comorbidity MeSH
• Coronary Restenosis mortality   MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Coronary Artery Disease mortality   therapy   MeSH
• Mandatory Reporting MeSH
• Risk Factors MeSH
• Aged MeSH
• Drug-Eluting Stents statistics & numerical data   MeSH
• Stents statistics & numerical data   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Geographicals
• Massachusetts MeSH

• MeSH
• Reference Books, Medical MeSH
• Internal Medicine * MeSH

• Conspectus
• Lékařské vědy. Lékařství
• NML Fields
• vnitřní lékařství
• NML Publication type
• kolektivní monografie

• MeSH
• Pathology MeSH

• Conspectus
• Patologie. Klinická medicína
• Učební osnovy. Vyučovací předměty. Učebnice
• NML Fields
• patologie
• NML Publication type
• učebnice vysokých škol

• MeSH
• Clinical Medicine MeSH
• Oral Hygiene MeSH
• Health Promotion MeSH
• Preventive Dentistry MeSH
• Dental Care MeSH
• Dental Hygienists MeSH
• Dental Prophylaxis MeSH

• Conspectus
• Stomatologie
• NML Fields
• zubní lékařství
• hygiena
• NML Publication type
• kolektivní monografie