Search Results (5)

The Holy Cross Mountains represent an isolated outcrop of Palaeozoic rocks located in the Trans-European Suture Zone, which is the boundary between the Precambrian East European Craton and Phanerozoic mobile belts of South-Western Europe. Despite extensive structural history studies, high-resolution seismic profiling has not been applied to this region until now. This research introduces near-surface seismic imaging of the Holy Cross Fault, separating two tectonic units of different stratigraphic and deformation history. In our study, we utilize a carefully designed weight drop source survey with 5 m shot and receiver spacing and 4.5 Hz geophones. The imaging technique, combining seismic reflection profiling and travel time tomography, reveals detailed fault geometries down to 400 m. Precise data processing, including static corrections and noise attenuation, significantly enhanced signal-to-noise ratio and seismic resolution. Furthermore, the paper discusses various fault imaging techniques with their shortcomings. The data reveal a complex network of intersecting fault strands, confirming general thrust fault geometry of the fault system, that align with the region’s tectonic evolution. These findings enhance understanding of the Holy Cross Mountains’ structural framework and provide valuable reference data for future studies of similar tectonic environments. Full article

Objective: Managing flexor tendon injuries surgically remains challenging due to the ongoing debate over the most effective suture technique and materials. An optimal repair must be technically feasible while providing enough strength to allow for early active mobilization during the post-operative phase. This study aimed to assess the biomechanical properties of three modified Kessler repair techniques using two different suture materials: a conventional two-strand and a modified four-strand Kirchmayr–Kessler repair using 3-0 Prolene^® (2s-KK-P and 4s-KK-P respectively), and a four-strand Kessler–Tsuge repair using 4-0 FiberLoop^® (4s-KT-FL). Methods: Human flexor digitorum profundus (FDP) tendons were retrieved from Thiel-embalmed prosections. For each tendon, a full-thickness cross-sectional incision was created, and the ends were reattached using either a 2s-KK-P (n = 30), a 4s-KK-P (n = 30), or a 4s-KT-FL repair (n = 30). The repaired tendons were tested using either a quasi-static (n = 45) or cyclic testing protocol (n = 45). Maximum force (F_max), 2 mm gap force (F_2mm), and primary failure modes were recorded. Results: In both quasi-static and cyclic testing groups, tendons repaired using the 4s-KT-FL approach exhibited higher F_max and F_2mm values compared to the 2s-KK-P or 4s-KK-P repairs. F_max was significantly higher with a 4s-KK-P versus 2s-KK-P repair, but there was no significant difference in F_2mm. Suture pull-out was the main failure mode for the 4s-KT-FL repair, while suture breakage was the primary failure mode in 2s- and 4s-KK-P repairs. Conclusions: FDP tendons repaired using the 4s-KT-FL approach demonstrated superior biomechanical performance compared to 2s- and 4s-KK-P repairs, suggesting that the 4s-KT-FL tendon repair could potentially reduce the risk of gapping or re-rupture during early active mobilization. Full article

Anterior dislocation of the coccyx is rare, but it can occur due to trauma. Conservative treatment is usually performed. However, dislocation reduction may be required to control severe pain in the acute phase or to prevent chronic complications. If manual reduction fails, open reduction is required. The extent of the incision and the method used to maintain the reduction should be considered during open reduction. A 56-year-old male patient experienced a dislocation of the sacrococcygeal joint after falling backwards. Despite conservative treatment, the patient complained of persistent pain during sitting and when using the bathroom. A manual reduction was attempted but failed. We performed joystick reduction via minimal incision and maintained the reduction using a one-strand trans-osseous suture passing through the skin. The patient was advised to use a soft cushion when sitting or lying down for four weeks after surgery. The supine position was not restricted. The patient’s symptoms significantly improved after surgery. At the 6-month follow-up, the sacrococcygeal joint showed good alignment and no surgical complications occurred. During the treatment of sacrococcygeal dislocation, the rapid alleviation of acute pain and minimizing potential complications are key points. If open reduction is needed, the minimally invasive reduction technique with a one-strand trans-osseous suture may offer patient satisfaction and a good surgical outcome. Full article

Wound closure is a key element of any procedure, especially aesthetic and reconstructive plastic surgery. Therefore, over the last decades, several devices have been developed in order to assist surgeons in achieving better results while saving valuable time. In this work, we give a concise review of the literature and present a biomechanical study of different suturing materials under mechanical load mimicking handling in the operating theatre. Nine different suture products, all of the same USP size (4-0), were subjected to a standardized crushing load by means of a needle holder. All materials were subjected to 0, 1, 3 and 5 crushing load cycles, respectively. The linear tensile strength was measured by means of a universal testing device. Attenuation of tensile strength was evaluated between materials and between crush cycles. In the pooled analysis, the linear tensile strength of the suture materials deteriorated significantly with every cycle (p < 0.0001). The suture materials displayed different initial tensile strengths (in descending order: polyglecaprone, polyglactin, polydioxanone, polyamid, polypropylene). In comparison, materials performed variably in terms of resistance to crush loading. The findings were statistically significant. The reconstructive surgeon has to be flexible and tailor wound closure techniques and materials to the individual patient, procedure and tissue demands; therefore, profound knowledge of the physical properties of the suture strands used is of paramount importance. The crushing load on suture materials during surgery can be detrimental for initial and long-term wound repair strength. As well as the standard wound closure methods (sutures, staples and adhesive strips), there are promising novel devices. Full article

Purpose:Our hypothesis was that the rupture rate after primary flexor tendon repair in the modified 4-strand core suture technique using the FiberLoop^® (Arthrex, Munich, Germany) is lower than in other suture materials and functional outcome and patient satisfaction are superior compared to the current literature. Patients and methods: A 2-stage retrospective, randomized follow-up study of 143 patients treated with the Arthrex FiberLoop^® after flexor tendon injury in zones 2 or 3 from May 2013 to May 2017 was performed. In the 1^st stage, the rupture rate of all patients was assessed after a follow-up of at least one year by interview to exclude revision surgery. In the 2nd stage, 20% of the patients could be randomly clinically examined. Functional parameters, such as finger and wrist range of motion measured by goniometer, grip strength measured by Jamar dynamometer (Saehan, South Korea), patient satisfaction measured by school grades (1–6), pain levels measured by visual rating scales (0–10) and functional outcome according to the DASH-score were assessed. The Buck-Gramcko and Strickland scores were calculated. The length of sick leave was recorded. Results: A rupture rate of 2.1% was recorded. 29 patients (20%) were followed up at a mean of 34 ± 7.5 months postoperatively. 10.3% of these patients had an incomplete fingertip palm distance. The mean postoperative grip strength was 24 ± 3.1 kg. 93% of the patients were very satisfied with the treatment. No patient complained of pain postoperatively. The mean postoperative DASH score was 6.7 ± 2.8 points. The mean Buck-Gramcko score was 14 ± 0.2 points. 93% of the patients had excellent and 7% good results according to the Strickland score. 67% of patients had a work accident and returned to work at a mean of 4 ± 0.2 months postoperatively. 31% of patients suffered a non-occupational injury and returned to work at a mean of 3 ± 0.4 months postoperatively. Conclusions: Primary flexor tendon repair in the modified 4-strand core suture technique using the Arthrex FiberLoop^® has proven to be a viable treatment option in our series. The rupture rate was lower than in other suture materials. It leads to acceptable pain relief, grip strength and functional outcome. Level of Evidence: IV; therapeutic. Full article