INTRODUCTIONWe conducted a biomechanical study comparing cerclage wiring using a power tool with the traditional manual method.

MATERIALS AND METHODSOur study consisted of 4 experimental arms based on the method of fixation and diameter of wires. The 4 arms were: 1) power tool method using 0.8 mm cerclage wires, 2) power tool method using 1.0 mm cerclage wires, 3) conventional manual method using 0.8 mm cerclage wires, and 4) conventional manual method using 1.0 mm cerclage wires. Synthetic femur bones were employed in our study. Six specimens were prepared for each arm. Each specimen was cut lengthwise and pressure sensors were placed in between. For the power tool method, while maintaining tension, wires were coiled using the Colibri power tool until just before secondary coiling occurred. For the conventional manual method, each specimen was compressed by plier twisting for 10 rounds, while maintaining tension. Cerclaging and data recording was done thrice for each specimen, giving a total of 18 readings per arm. Peak and steady-state forces were recorded.

RESULTSThere was no significant difference between the peak forces recorded between the power drill and manual methods. The steady-state forces achieved using the power tool method were significantly higher than that achieved in the manual fixation method (0.8 mm wires: 54.89N vs 27.26N, P = 0.037; 1.0 mm wires: 71.59N vs 39.66N, P = 0.025).

CONCLUSIONThe power tool method achieved a superior steady-state force of compression across the fracture site for both 0.8 mm and 1 mm wires.

Biomechanical Phenomena ; Bone Wires ; Femur ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Models, Anatomic

OBJECTIVE: The contents of microbial information are complicated because of being hierarchical, duplicated as well as their changes are continuous and various. Much of time and cost are required for maintaining, expanding the information after representing them into a relational database. The relational database is not adequate to make the information sharable via Internet. In addition, user's meta-knowledge is insufficient to use the information via Internet and users may not be able to cope with the continuous changes of microbial information through the static web interface. Therefor, this study is conducted to develop an active microbial web database for resolving those problems. METHODS: To solve these problems, object-oriented database, which was able to represent the complicated contents and knowledge, was used, and intelligent agents were implemented to cope with the continuous evolution of microbial information. Also, they were incorporated into user interface to assist users in an interactive environment, who want to use information via Internet. RESULTS: The implemented system have shown advantages of solving difficulties arising from hierarchical and duplicated microbial data. It showed the possibility to share and manage the complex microbial data via Internet. It helped the system to be implemented as the active database, information stored in the object-oriented database. CONCLUSION: This study indicates that a similar approach may lead to develop an expert system based on the web and active database, which is able to be evolved, and to develop intelligent interface, using the agent.
Expert Systems ; Internet

BACKGROUND: To date, there is no study comparing outcomes between post-total knee replacement genu recurvatum and fixed flexion. This study aims to provide data that will help in deciding which side to err on when neutral extension is not achieved. METHODS: A prospective cohort study of primary total knee arthroplasties was performed, which compared the 6-month and 2-year clinical outcomes between fixed flexion and genu recurvatum deformities at 6 months. RESULTS: At 6 months, knees in genu recurvatum did better than knees in fixed flexion deformity in terms of knee flexion. However, at 2 years, knees in fixed flexion deformity did better in terms of knee scores and showed better improvement in the degree of deformity. CONCLUSIONS: We conclude that it is better to err on the side of fixed flexion deformity if neutral alignment cannot be achieved.
Aged ; Arthroplasty, Replacement, Knee/*adverse effects/*statistics & numerical data ; Female ; Humans ; Knee Joint/*physiopathology/*surgery ; Male ; Middle Aged ; Prospective Studies ; Range of Motion, Articular ; Treatment Outcome