Background: In children supracondylar fracture of the humorous is one of the most common fractures in the first decade of life. This study was conducted to establish the efficacy and the accuracy of a new own method for measuring the Trochleocapitellar index (TCI) in the management of supracondylar humeral fracture in children versus Baumann’s angle. Methods: This study made on base AP elbow radiograms and clinical charts of 54 children that were treated due to supracondylar fracture of the elbow. Cases included were of either gender with age range from four to 13 years with a supracondylar fracture presenting within 72 hours of the reduction. Outcome measures: Two measure roentgen logic modalities studied for comparison: Baumann’s angle and TCI were taken into consideration when examining the AP roentgenograms (immediately after the reduction and during 1-3 months thereafter). Results: During 1-3 months after the reduction Baumann’s angle modality gave normal results in 51 (94.4%), valgus result in one (1.9%) and varus result in two (3.7%) patients. While TCI showed normal results in 31 (57.4%), valgus result in one (1.9%) and varus results in 22 (40.7%) patients. Correlation was found between the measurements of the normal Baumann’s angle and normal TCI immediately after fracture reduction (r=0.75, p<0.001) and on the period between one to three months follow-up (r=0.54, p<0.001). TCI was found as more accurate for detection of cubitus varus. Conclusions: Authors recommends post reduction measurement of the TCI in supracondylar fractures to determine the adequacy of reduction.

Background: Cell-based therapy for soft tissue injuries remains controversial. Adult mesenchymal stem cells (MSCs) are therapeutic candidates given their capacity for self-renewal, immunoprivilege, and differentiation capacity for chondrocyte and tenocyte lineages. Platelet rich plasma (PRP) has been reported to promote collagen synthesis and cell proliferation, influencing the healing of ligaments and cartilage. We hypothesize that allogeneic MSCs and PRP have additive effects on promoting ligament healing in an in-vivo rat medial collateral ligament (MCL) injury model. Methods: MCLs of 20 females Sprague rats were bilaterally transected and treated with either saline (controls) or 1 of 3 treatment groups; (1) allogeneic MSCs (105 cells), (2) PRP and (3) allogeneic MSCs & PRP. In addition, five rats were used for the Sham group (surgery + no ligament injury). Rats were sacrificed two weeks post-surgery and the MCLs harvested for histological analysis by hematoxylin and eosin and alcian blue staining. Statistical analysis was performed using Fischer’s exact test with pair-wise comparisons and Bonferroni multiple comparison correction. Results: Histologically, differences across all injured groups (treatment groups and controls) were observed in cellularity (p < 0.0185), regeneration of collagen fibers (p < 0.0084), vascularity (p = 0.0129), inflammation (p = 0.0121) and glycosaminoglycan content (p = 0.0085). From pair-wise comparisons, only the combination allogeneic MSCs & PRP group differed significantly from controls in increased cellularity (p = 9.04 x 10-4) and regeneration of collagen fibers (p = 6.58x10-4). In addition, the PRP group showed significant increase in glycosaminoglycan (p = 0.006) content when compared to the allogeneic MSCs group. Conclusion: The addition of allogeneic MSCs and PRP to an injured MCL show a significant histological increase in degree of cellularity, vascularity and the regeneration of collagen fibers when compared to controls. These data support a possible additive effect of combining allogeneic MSCs and PRP therapy to increase important repair factors during the proliferation/repair phase of post ligament injury. This preliminary study demonstrates that additional functional and biomechanical studies are warranted to determine the role that inflammatory responses versus tissue regeneration are contributing to this mechanism.

Studies have been investigating whether the symptoms of polycystic ovary syndrome (PCOS) could be improved by using resistance training. The authors searched various databases to identify such studies. The majority of the studies considered resistance training without considering specific calorific and macronutrient intake, even though these have been proven to be an important factor to be considered along with resistance training.

The recognition of the pattern and severity of deformity in knee osteoarthritis has important implications in its management and prognosis. A number of methods can be used to assess and measure the coronal and sagittal knee alignment: clinical deformity measuring device like a goniometer, standard knee radiographs, hip-knee-ankle (HKA) radiographs, computer navigation systems, magnetic resonance scan, computerized tomographic scan or simply a surgeon’s subjective measurement. Each of these methods has advantages and disadvantages. The aim of this study was to compare three methods of measurement: clinical measurement with a goniometer; HKA radiographs and computer navigation. This study included 54 patients with arthritic knees, who underwent total knee replacement with computer navigation. The deformity in both coronal and sagittal planes was measured using the three methods and the results compared using Bland Altman limits of agreement. The clinical measurement differed greatly from radiographic and computer navigation measurements. According to Bland Altman limits of agreement clinical measurements could be up to 10° away from the radiographic or computer navigated measurements in coronal plane. In the sagittal plane the clinical measurements could be up to 12° away compared to computer navigation measurements. A combination of these measurements methods should be taken into account when assessing the deformity of a knee especially in relation to posture and weight bearing status. The methodical clinical measurement of knee deformity as described in this paper gives too wide a margin of error and should not be relied upon in isolation.