![]() ![]() And in five years, he steered the company onto the path of profitability-a rarity among local wind energy firms. With a corpus of Rs 40 crore borrowed from Gujarat Fluorochemicals Limited, he started Inox Wind in 2009, at a time when major players like Suzlon and Bharat Forge were stumbling. But the Inox Group was looking to diversify, and given India’s energy deficit and the global thrust towards cleaner forms of energy, Devansh convinced his family of the power of wind. Neither his father nor his uncle Pavan (chairman and managing director of Inox Air Products) had prior experience in this sector. ![]() When he returned to India from the US in 2007, he shadowed his father Vivek (managing director, Gujarat Fluorochemicals Limited) for two years before deciding to enter the renewable energy sector. ![]() “We have a market cap of almost a billion-and-a-half dollars,” says Devansh, who, as director of his company, is the youngest family member to hold a position in the chemicals-to-multiplexes Inox Group. His company, Inox Wind, the renewable wind energy solutions provider, raised Rs 1,000 crore and was oversubscribed 18 times. In March 2015, the 28-year-old third-generation scion of Inox Group led one of the biggest initial public offerings (IPOs) that India has seen in the last two years. No one can accuse Devansh Jain of false pride. The Inox Group had no expertise in renewable energy, but backed by a successful IPO, third-generation scion Devansh Jain proved that there is profit in the sector 3 Small-Cap Stocks to Buy - Daily Stocks News on Inox Wind.Land Rover Media Hub – Nur ein weiteres Auto Bildideen on Manufacturing Facilities. ![]() Inox Login - Login Individual on Sitemap.INOX Wind: When promoters put in money in troubled business, it calls for deeper look.Inox Wind Board approves merger of Inox Wind Energy Limited into the Company.Inox Wind’s 3 MW Wind Turbine receives certification.Inox Wind’s 3MW Turbine gets Type Certification from Germany, paves way for commercial launch.Inox Wind receives Type Certification from TUV SUD for its 3 MW wind turbine.Thanks for your help and advice in advance. I like both, but I think I'm leaning more towards the Manfrotto 055XPROB or the 190XPROB. So I was thinking that either of those two tripods could handle that but wondering which would be better. I was thinking about getting a 50mm, some sort of wide angle, and a 300mm sometime down the road. I have a Nikon D5100 with the 18-55mm and 55-200mm lenses. I think the 055XPROB seems tall enough, (maybe too tall?) but I might also go with the 190XPROB because it is a little shorter. I'm 5'4", so I was looking for a tripod that words at eye level. But other than that, they look to be the same and both seem good quality. Also, I'll be spending a bit more on the Manfrotto because I have to buy the head for it. I think the SLIK is a bit heavier? 7kg compared to the Manfrotto's 5kg if I remember correctly. For the Manfrotto I was thinking the 496RC2 Ball Head with Quick Release.įrom all the reviews I've read, they seem to be very similar. I want to start taking landscapes and nighttime/time lapse, which is really hard without a tripod. I was wondering which one would be better. ![]()
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![]() The VS Code extension for Arduino in action. browsing code samples or monitor your serial port). The VS Code extension for Arduino is built on top of the official Arduino IDE-which you need to install once but will probably never open ever again-and provides you with all the features you’d expect to find in the classic IDE (e.g. And now that more and more platforms are compatible with Arduino, from RISC-V developer kits such as HiFive1, to ESP32 or STM32 Nucleo family, there are even more reasons for looking for a better IDE for Arduino development. It is a great tool, especially for helping newcomers get started with the Arduino ecosystem, but it is lacking some key features for anyone interested in doing more than just blinking an LED or running basic programs. It’s been a very long time since I last opened the Arduino IDE on my computer. In this article, we look at some essential VS Code extensions that will help you become a more productive IoT developer. Rather than having to switch from one development environment or command line terminal to the other, I wouldn’t be surprised if, just like me, you’d be interested in doing most of your work without ever leaving your IDE. ![]() Still, once in a while, you may want to tune some Python scripts used for you build system, or use a command-line tool to check that your IoT backend services are up and running. You may very well be spending most of your days working on developing and testing the firmware of your connected embedded device in C. Whether you’re just getting into IoT or whether you’ve been working on IoT solutions for some time already, you’ve probably realized that “full-stack developer” is a term that also often applies to IoT. ![]() In fact, in Stack Overflow’s most recent developer survey, VS Code is ranked at over 50% market share among the 90,000+ developers who responded. It took off very quickly in the web development communities, but it has now also become the IDE of choice for Java, Python, or C/C++ developers as well, whether they run Linux, MacOS, or Windows. ![]() In just a few years, Visual Studio Code has conquered the hearts of a wide variety of developers. ![]() ![]() ![]() The Indiana American Water company has more than eight million gallons per day of excess capacity in its system, making Delaware County a prime location of water intensive companies. ![]() Indiana Michigan Power is the electrical provider for the county and will be adding a new 20-megawatt substation in the Industria Centre Industrial Park, with the capability to service up to 40 megawatts. ![]() Start receiving free quotes from reputable installers in your area by creating an account on the EnergySage Marketplace today.Muncie-Delaware County is serviced by state-of-the-art, affordable utility providers. Delaware Electric Cooperative Delaware Municipal Electric Corporation Chesapeake Utilities Corporation. Lower Rates Local publicly owned utility rates are traditionally lower than the rates of private power companies. How this works is Conectiv matches donations from businesses, customer contributions as well as donations from individuals and other agencies with a donation from shareholders. The organization was formed in 1948 and continues to help cooperatives provide efficient and low-cost energy to their. The contribution of natural gas-fired power plants to Delawares electricity net generation. ODEC is owned by Delaware Electric Cooperative and the other 10 electric cooperatives it serves. Natural gas fuels most of Delawares in-state power generation. Delmarva Power (Conectiv) This energy provider runs the Good Neighbor Fuel Fund for its low income customers. ODEC has full or partial ownership of several power plants in Virginia and Maryland and provides electric to 1.2 million people. Public power leads the way in providing efficient, low-cost electric service. Utility assistance from utility companies. We’ve already vetted all of our installer partners, and keep a close watch over their performance to ensure their installations and customer satisfaction are up to the levels that you–and we–expect. Newark Electric offers reliable service at non-profit rates. Your supplier may also bill you directly. You can find the name of the natural gas provider for your address there. Make sure your solar installer provides a consultative, professional solar experience, and if you’re also purchasing a solar battery system, they have proven experience with those products too.īy doing the legwork for you, EnergySage makes it easy to find reputable solar installation companies in Delaware County, NY. If your utility bills you, look for a line item or section that says, natural gas supply, gas supply charges or something similar. When you’re comparing your options, the best installers will work with you to understand your needs, as well as how solar fits your overall energy plans. Contact the Utility Billing Office at 74 x 4 at least 24 hours prior to the date you request. Electric Company in Delaware - Choose a Plan Direct Energy Choose a Delaware Power Company with Options Make Direct Energy your electric company and trusted home protection provider. How does each installer tailor their system to your needs?īeyond ensuring that your solar installer has all of the appropriate licenses and industry-specific certifications, it’s important to work with a solar installer who has experience custom designing systems to fit their customers’ needs. ![]() ![]() ![]() I hope that the powerful affirmations by Louise Hay in this blog post will help you through your journey of self-love, healing, and personal growth. Related: 50 Positive Affirmations for Anxiety Final thoughtsĪffirmations are one way to keep a positive attitude and make your dreams come true. I return to the basics of life: forgiveness, courage, gratitude, love, and humor.I flow easily with new experiences, new challenges, and new people who enter my life.I choose now to release all hurt and resentment.I am willing to forgive myself and move on.It is now safe for me to release all of my childhood traumas and move into love.I choose to develop the positive habit of knowing that life is here for me.I forgive myself, and I set myself free.Related: Positive Sleep Affirmations For A Peaceful Night More Affirmations by Louise Hay I lovingly release the day and slip into a peaceful sleep, knowing tomorrow will take care of itself.I sleep deeply and soundly and awaken bright and refreshed. I rest well, I sleep peacefully, and awaken with joy.I am pain-free and totally in sync with life.Love flows through my body, healing all dis-ease.I send love to each organ, bone, muscle, and part of my body.I am open and receptive to all the healing energies in the universe.I accept healing and good health here and now.I now release any and all impediments to my perfect healing.I am grateful to my body for all the good health I have had in the past.Related: 75 Powerful Self-Love Affirmations Louise Hay Affirmations for Healing Today, I listen to my feelings, and I am gentle with myself.I practice loving-kindness toward everyone, including myself.The more I love myself, the more it is easier for others to love me.I am free to move forward with love in my heart. I now live in limitless love, light, and joy.Loving others is easy when I love and accept myself.I forgive myself for not being perfect.I am beautiful, and everybody loves me.I am comfortable looking in the mirror, saying, “I love you, I really love you.”.Related: 15 Important Health Tips For Women Louise Hay Affirmations for Self-Love I watch my thinking and think only healthy thoughts.With every breath I take, I am getting healthier and healthier.Perfect health is my Divine right, and I claim it now.I balance my life between work, rest, and play.I lovingly take care of my body, my mind, and my emotions.I drink lots of water to cleanse my body and mind.Wellness is the natural state of my body.I devote a portion of my time to helping others.My happy thoughts help create a healthy body.I listen with love to my body’s messages.My body appreciates how I take care of it.I enjoy the foods that are best for my body.I am constantly discovering new ways to improve my health.Related: 40 Daily Affirmations To Build A Positive Mindset Louise Hay affirmations for Health My life is joyously balanced with work and play.I am now free to allow the good to manifest in my life.I now release all negative patterns that have contributed to fear of loss, fear of the dark, fear of being harmed, or fear of poverty.I now choose to move away from the limiting beliefs that have been denying me the benefits I so desire.I am in the process of positive change.Life supports me in every possible way.This is the moment I take my power back.I claim my power and move beyond all limitations.Read on for 60 Powerful affirmations by Louise Hay.Īffirmations by Louise Hay to unlock your full potential These short statements aim to help you focus on your goals instead of dwelling on your fears or limiting beliefs. Louise Hay has created affirmations for every situation you might find yourself in – from feeling unloved and unworthy to being happy with yourself. One way to do this is by using affirmations. She believed that we all have the ability to take responsibility for our own mental health it’s not something that only happens when we’re sick or unhappy but rather a continual process of self-love and care. Her work has been translated into over 30 languages, and she’s sold more than 80 million books worldwide, which are available in 46 countries around the globe. She has devoted her life to helping people heal themselves through the power of positive thinking. Louise Hay is an author and the founder of The Hay Foundation. The affirmations I am about to share with you today are from an exceptional woman, Louise Hay. They can be a great way of taking control of your thoughts, feelings, and emotions when things get tough in life. Affirmations are positive statements that we repeat to ourselves over and over again. I know how much they can help us during tough times. I am so excited to share this post with you! It’s about affirmations. ![]() ![]() Cleanse the non-believers, spread enlightenment, and perform mystical rituals on the journey to become the mighty lamb god. We've launched a new Cult of the Lamb update that adds a few highly requested quality of life and accessibility features. Cult of the Lamb finds itself in good company in this regard, as it is a cute game with solid gameplay mechanics in what is. ![]() Train your flock and embark on a quest to explore and discover the secrets of four mysterious regions. The animals are the hook, but the gameplay makes them excellent games. Cult of the Lamb was released on Augand is available on PC, PS4, PS5. Start your own cult in a land of false prophets, venturing out into diverse and mysterious regions to build a loyal community of woodland worshippers and spread your Word to become the one true cult.Ĭollect and use resources to build new structures, perform dark rituals to appease the gods, and give sermons to reinforce the faith of your flock.Įxplore a sprawling, randomly generated world, fight off hordes of enemies and defeat rival cult leaders in order to absorb their power and assert your cult's dominance. The good thing is that several of these issues could theoretically be addressed in a future patch or update. Summary: Start your own cult in a land of false prophets, venturing out into diverse and mysterious regions to build a loyal community of woodland worshippers and spread your Word to become the one true cult. Fixed issue that limited 6 Followers entering the Temple at once. Start your own cult in a land of false prophets, venturing out into diverse and mysterious regions to build a loyal community of woodland worshippers and spread your Word to become the one true cult. Generally favorable reviews based on 178 Ratings. Read on for what’s new in the Cult of the Lamb October 11 patch notes. This is a small download and looks to solve a few nagging issues the game still has. ![]() Implemented minor optimisations to dungeon performance. The list from PlayStation (in alphabetical order) includes: Astros Playroom Bugsnax Call of Duty: Modern Warfare II Cult of the Lamb Dead Space. Massive Monster has released Cult of the Lamb update 1.07 (PS5 version 1.000.007) that’s out on last-gen and current-gen platforms. You'll be the envy of every cult.Ĭult of the Lamb casts players in the role of a possessed lamb saved from annihilation by an ominous stranger and must repay their debt by building a loyal following in his name. Fixed issue that occurred when the Lamb collected a certain amount of Tarot cards during a single dungeon run. We’ll keep an eye out for more news on the game’s second major update.Cult of the Lamb: Cultist Edition bundles the base game with the Cultist Pack which includes a seven-piece decoration pack for your charming commune, as well as five exclusive Follower forms. In Cult of the Lamb, you play as a possessed. Janu4:12 pm in News Massive Monster has rolled out Cult of the Lamb update 1.11 (PS5 version 1.011), which is an unannounced title update for the action-RPG. Unfortunately, a release date remains elusive, but Cult of the Lamb is still targeting 2022. ![]() That would be PlayStation 5, Xbox Series X/S, and Switch, to be specific. Cleanse the non-believers, spread enlightenment and perform mystical. ![]() Train your flock and embark on a quest to explore and discover the secrets of five mysterious regions. The full patch notes follow below, courtesy of Massive Monster. PC had been the only confirmed platform, but a new update has announced that Cult of the Lamb will spread its influence to consoles. Explore a sprawling, randomly generated world, fight off hordes of enemies and defeat rival cult leaders in order to absorb their power and assert your cults dominance. The upcoming v1.1.0 patch otherwise adds minor, albeit much-requested features, such as the ability to rename your cult at any time, controller remapping, detailed playthrough statistics, the ability to bless a group of followers rather than just individually, and automatic cooking and fishing settings. ![]() ![]() ![]() Keep It 100 Trop Blue in an all-day vape juice that comes flavor-packed from beginning to end. The deliciously made trifecta soaks into the taste buds and you notice a slightly sour taste of blue raspberry, immediately following are sweet strawberries, and to finish it all is a mouthwatering tropical explosion of fruits that linger from the back of your throat throughout your tongue, leaving you puzzled by the experience but totally satisfied.Īvailable in a 100mL Chubby Gorilla bottle, refills are made to be easy, and the large bottle results in more time with this precious flavor. Trop Blue is made with a 70/30 ratio, creating a balancing act between flavor and vapor production. Immediately upon taking your first puff, your tastes are bombarded by an overwhelming splash of flavors. Just before the device touches your lips, a wisp of tropical notes hit your airway. The puzzling list of flavors all seems to come together to create an all-day-vape that you have to taste to believe. ![]() It utilizes Keep It 100’s original Slushie flavor, Blue Slushie Ejuice, and infuses it with a set of tropical fruits. Trop Blue Vape Juice presents extraordinary first impressions. Within its arsenal of brilliant tastes, Trop Blue by Keep It 100 seems to offer the most. Each unique flavor provides a sense of quality due to the use of fine ingredients and complex flavors. Satisfied to no end, the expert culinary craftsmen have been hard at work, creating what we know today as some of the best vaping products on the market. It consists of a giant collection of flavors that were all designed to generate a fun, exciting, and adventurous experience. Towering others in the market, Keep It 100 Ejuice has become the go-to brand for discovering premium vape juice flavors. This is why vapers know that one of their vapes will check every box.įor exquisite vapes guaranteed to dazzle your sweet tooth and palate with authentic, satisfying vaping goodness, grab a freebase or Keep It 100 Salts nic salt from the Keep It 100 collection today! And if you’re a huge fan of this brand, and simply cannot get enough, grab a bundle and experience 100% awesomeness.Trop Blue by Keep it 100 - 100ml Keep it 100 Trop Blue Vape Juice Review ![]() Despite their ever-growing popularity, they’ve never abandoned their extremely high standards that are reminiscent of a small-batch, artisanal mentality. Keep It 100 is considered a veteran in the vaping industry, which speaks to their commitment to quality, and their ability to deliver in a consistent manner. One thing that we can say for certain is that as you explore their magnificent collection, you’ll be blown away by the tempting choices, and you’ll undoubtedly struggle to choose just one. They offer some pretty spectacularly refreshing options for those who crave smooth, thirst-quenching nectars, and their tobacco flavor is one of the finest that the vaping market has to offer. They’re renowned throughout the vaping industry for offering unique spins on our favorite cakes and cookies, but that’s not all that they have up their sleeve. Whether you desire gloriously fresh fruit blends, rich, decadent desserts, menthol, delightful candy sensations or yummy cookie and donut flavors, Keep It 100 Ejuice has something for you. No matter what it is that you crave, Keep It 100 has a special juice just for you. They have mastered the art of blending yummy tastes in order to create intensely flavorful E-Liquids. How? Simply put, each juice is made with only the finest of high-quality ingredients. Keep It 100 Ejuice has blessed us with vape flavors that can easily satisfy our cravings. ![]() ![]() ![]() Simple math game, originally used as a debug game for LövePotion.Ī port of Legend of Zelda: Return of the Hylian, a Zelda fangame, to 3DS.įive-lane underwater whale swimming/pearl pickup adventure game in Python.Īn open source 1:1 reimplementation of Supaplex for the 3DS. No longer under development.Ī tiny adaptation of the popular Cookie Clicker game for the 3DS.Ī simple Cookie Clicker type of game inspired by Kaisogen's Cookie CollectorĪn unofficial port of EDuke32 for the 3DS. 3D can also be enabled."Ī checkers game in glorious ASCII. Go between screens through the holes in the sides of the floor. "Move your player to bounce around and collect coins. No longer under (active) development?Ī port of Nyan Cat for the 3DS, using LIBSF2D. Identify whether New 3DS LCD panels are TN or IPS.Ī Lua interpreter for 3DS, brought to life by the remnants of the µLua community.įirst Lua interpreter 3DS homebrew, under Lua 5.3.1Ī port of the popular game 2048 for the 3DS.Ī Minecraft port for the 3DS. Tool to get past the 10 coin per day limit on earning Play Coins by walking.Īllows you to use your 3DS as a NFC/RFID UID Scanner. Appears to be non-active and out-of-date. No longer under (active) development?Ī WIP repo-based online marketplace for homebrew applications & games. The included parse_hidstream tool can be used to parse that HID data to simulate keyboard/mouse input events, via Linux uinput. It can also send HID state to the client (see the README) when enabled. No longer under (active) development?Ī 3DS homebrew audio/video playback server. Allows you to quickly poke service-commands and syscalls over Wi-Fi from a Python shell on your PC. Generate patches that edit LED notificationsĪ small and easily extensible RPC server/client written in C/Python. Reset 8-hour per-console StreetPass rate limiting Identity tool for the Nintendo 3DS heavily inspired by PSPident. Simple program that creates folders with TitleID and copy plugins on themĪ simple program for detecting touch screen input. Small 3DS version of a popular Linux ricing script called screenfetch. Homebrew Launcher with grid and folder support. The old version of the 3DS Homebrew Launcher, originally created for ninjhax 1.x (Discontinued) Run homebrew on your 3DS! Compatible with Rosalina and all prior 3dsx loading solutions Recent enough versions can freely navigate the filesystem to select an application. 3dsx files, but will only display an icon for those who have one according to the format described above. The Homebrew Launcher will scan the SD card for all. 3dsx, launching it with potentially different arguments so that a single application can run in different modes. ![]() xml file can point to a differently-named. installed titles which the app supports replacing in memory at runtime, thus inheriting its permissions), and of any arguments to be passed to the. (Not required in any case, and may be integrated into the. Sometimes crashes.Applications are installed by copying the necessary files directly to the 3ds/ folder in the root of the SD card (preferred for new designs), or in a subdirectory of 3ds/, in which case said subfolder must be named identically to its executable. Close the game: SELECT from the title screen Open lists screen (fishes, monsters, barter items): L and B Open the map: START (outside of dungeons) Teleport ONI at the temple entrance: L + R Pause game and activate item selection: L + START Spin attack: hold B then release it when fully charged (after the tone) The game creates a Zelda3T subfolder inside the 3ds folder if doesn't exist. below there is a QR code to download the cia from FBI.Īll the resources are included in the executable using romfs. The CIA file is to be installed with FBI. All the resources are included in the executable using romfs. In the zip there is a folder with the 3dsx and the smdh files inside, to be used with a homebrew launcher. The game is complete, but sometimes crashes for some memory leaks to be fixed. Added possibility to change item with touchscreen This game uses the SDL 1.2 library for 3ds The original game is made by Vincent Jouillat ( ) While the other two games where using a fake SDL layer, this one uses the SDL lib for 3ds. More info about this game are in the official site of the game: Until the day when, after months spent watching out for an attack, an event came up and put an end to this endless waiting. Story : After the events that occured in Termina and the victory of the hero on his evil alter-ego, Zelda and Link knew that, from the bottom of hell, Ganon the immortal drawed his power from his wish to the Triforce, and rounded up his army with a view to invade Hyrule. Today I'm releasing the port for the 3ds of the long awaited third chapter of this Zelda fan game saga: Zelda Time to Triumph. ![]() ![]() ![]() Pin's pinning effect on a Lead or Ceramic), are also affected by MIB. Counter-Espionage shurikens removing camo from Camo Leads), rather than the effect of the status effect on a bloon (e.g. Most attacks with status effects exclusively dependent on the condition of the attack damaging a bloon (e.g. Note that the Monkey Intelligence Bureau buff does not necessarily grant towers the ability to target or affect any bloon type including MOAB-class bloons, but it allows them to damage any bloon type. This includes bloons that contain any mix of these aforementioned bloon attributes. All towers within its radius can pop Lead Bloons, Thermal Bloons, Frozen Bloons, and Purple Bloons, but not Dreadbloon class immunities, on top of camo detection via its previous Radar Scanner upgrade. It essentially grants all the towers in its radius the Normal damage type. Monkey Intelligence Bureau (sometimes abbreviated as MIB for short) is the third upgrade of Path 2 for the Monkey Village in Bloons TD 6. The Bureau grants special Bloon popping knowledge, allowing nearby Monkeys to pop all Bloon types.
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![]() ![]() ![]() We measured the maximum ulnar bow (MUB) and location of the bow on true lateral forearm radiographs, because humeral tilting on forearm radiography affected the assessment of ulnar bowing ( Fig. Deformity of the radial head, osteoarthritic changes, and congruency of the radiocapitellar joint were evaluated with routine preoperative and postoperative serial radiographs. 29Īll radiologic measurements were performed by two orthopedic clinical fellows who were blinded to the study. These four parameters are weighted equally, giving 25 points to each parameter, for a total score of 100 points. 29 The Kim's index is based on four parameters: deformity, pain, range of motion, and function. 28 We also compared the preoperative and postoperative Kim's elbow functional scores. Preoperative and postoperative Mayo Elbow Performance Index (MEPI) scores were ascertained for all patients. The mean period of follow-up was 3.8 years (range, 1–14 years).Īll patients were checked for elbow pain, range of elbow movement, carrying angle, and any disabilities in daily life by two independent orthopedic residents who were blinded to the study. The mean interval from injury to surgery was 16.1 months (range, 1 month–7 years). They complained of limited elbow and forearm motion, and none of patients had signs of neuropathy or a history of previous elbow surgery. All patients had a history of trauma involving the ipsilateral elbow or forearm and were referred from other hospitals. All cases were classified as Bado 27 type I. The right elbow was injured in 13 patients, and the left was injured in 9. The mean age of the patients at operation was 7.6 years (range, 3.5–14.3 years), and there were 11 boys and 11 girls. Patients with congenital dislocation or neuromuscular diseases were excluded. Patients who presented at least 1 month after injury were included in the study. We identified 22 patients who were treated with open reduction of the radial head with or without combined ulnar osteotomy between July 2003 and November 2015 for missed Monteggia fracture. This retrospective study was approved by the Institutional Review Board at our institution. This study was perfomed at Severance Children's Hospital. Therefore, the purposes of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indication for open reduction alone in surgical treatment of missed Monteggia fracture. On the basis of our clinical observations, we hypothesized that open reduction could be performed as a solitary procedure without ulnar osteotomy or ALR in some cases of missed Monteggia fracture. 1, 4, 6, 25, 26 Although these reports could not suggest the indications for open reduction alone for missed Monteggia fracture, open reduction alone might be the ideal procedure in select patients.Īt our institution, surgical reconstruction has always begun with open reduction of the radial head. 17, 18, 19, 20, 21, 22 Moreover, several papers have reported satisfactory results with open reduction alone in some patients with missed Monteggia fracture. Some surgeons have performed open reduction of the radial head as a first procedure before ulnar osteotomy or ALR to remove posttraumatic fibrosis and annular ligament remnants, 7, 8, 10, 15, 23, 24 while others insist that indirect reduction of the radial head by ulnar osteotomy could achieve good results without open reduction. 20, 21, 22 Although many studies have reported various techniques, there is no established standard treatment protocol for missed Monteggia fracture.Īlthough many surgeons agree that ulnar length and alignment must be restored to reduce the radial head congruently, opinions differ regarding the need for open reduction of the radial head. 5 For this, there are various surgical treatment options, including open reduction of the radial head and ulnar osteotomy with or without annular ligament reconstruction (ALR), 2, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 closed reduction by ulnar correction using single-stage osteotomy, 16, 17, 18, 19 or gradual distraction lengthening using an external fixator. 1, 2, 3, 4 Surgical treatment is usually recommended for patients with pain or limited functionality with loss of elbow motion, in whom the concave morphology of the radial head is preserved. A missed Monteggia fracture refers to an unreduced dislocation of the radial head that is still present 4 weeks after injury, which may lead to elbow pain, decreased elbow motion, increasing valgus deformity, and neurologic problems. ![]() |
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