Science.gov

Sample records for external compression-induced fracture

  1. External compression-induced fracture patterning on the surface of poly(dimethylsiloxane) cubes and microspheres

    PubMed Central

    Uchida, Tomoyuki; Mills, K.L.; Kuo, Chuan-Hsien; Roh, Whijae; Tung, Yi-Chung; Garner, Amanda L.; Koide, Kazunori; Thouless, M.D.; Takayama, Shuichi

    2009-01-01

    This paper describes a method for creating sub-micron surface patterns on cubes and microspheres. In this method, PDMS cubes and microspheres are exposed to oxygen plasma, which creates a very thin, hard, surface-modified layer on a compliant substrate. These are then compressed, causing the layer to crack in patterns dictated by the distribution of tensile stresses in the surface layer. Cracks with sub-micron widths were generated on 1 cm3 cubes and 800 µm-diameter microspheres, and the resulting crack patterns were observed. Finite-element simulations of the tensile stress distributions reveal that the fracture patterns arise from different mechanisms in the cubes and spheres. In particular, pattern formation is associated with frictional contact in the cubes; but not in the microspheres where geometrical effects associated with changes in the cross-sectional area along the axis lead to generation of tensile stress. These observations and analyses provide a foundation on which to predict and guide crack pattern formation on a wide variety of small 3D objects. In anticipation of future applications in materials science and biology, we demonstrate selective deposition of compounds into the cracks to make them functionally differentiable from the rest of the surface. PMID:19437776

  2. Nonbridging external fixation of distal radius fractures.

    PubMed

    Eichenbaum, Matthew D; Shin, Eon K

    2010-08-01

    Surgical management of distal radius fractures continues to evolve because of their high incidence in an increasingly active elderly population. Traditional radiocarpal external fixation relies on ligamentotaxis for fracture reduction but has several drawbacks. Nonbridging external fixation has evolved to provide early wrist mobility in the setting of anatomic fracture reduction. Several studies of the nonbridging technique have demonstrated satisfactory results in isolated nonbridging external fixation series and in comparison with traditional spanning external fixation. Nonbridging external fixation for surgical treatment of distal radius fractures can be technically demanding and requires at least 1 cm of intact volar cortex in the distal fracture fragment for successful implementation.

  3. Bicondylar tibial fractures: Internal or external fixation?

    PubMed

    Kumar, Gunasekaran; Peterson, Nicholas; Narayan, Badri

    2011-03-01

    Bicondylar fractures of the tibia, representing the Schatzker V and VI fractures represent a challenging problem. Any treatment protocol should aim at restoring articular congruity and the metaphyseo-diaphsyeal dissociation (MDD)-both of these are equally important to long-term outcome. Both internal and external fixations have their proponents, and each method of treatment is associated with its unique features and complications. We review the initial and definitive management of these injuries, and the advantages and disadvantages of each method of definitive fixation. We suggest the use of a protocol for definitive management, using either internal or external fixation as deemed appropriate. This protocol is based on the fracture configuration, local soft tissue status and patient condition. In a nutshell, if the fracture pattern and soft tissue status are amenable plate fixation (single or double) is performed, otherwise limited open reduction and articular surface reconstruction with screws and circular frame is performed. PMID:21430865

  4. Description of Fracture Systems for External Criticality Reports

    SciTech Connect

    Jean-Philippe Nicot

    2001-09-21

    The purpose of this Analysis/Model Report (AMR) is to describe probabilistically the main features of the geometry of the fracture system in the vicinity of the repository. They will be used to determine the quantity of fissile material that could accumulate in the fractured rock underneath a waste package as it degrades. This AMR is to feed the geochemical calculations for external criticality reports. This AMR is done in accordance with the technical work plan (BSC (Bechtel SAIC Company) 2001 b). The scope of this AMR is restricted to the relevant parameters of the fracture system. The main parameters of interest are fracture aperture and fracture spacing distribution parameters. The relative orientation of the different fracture sets is also important because of its impact on criticality, but they will be set deterministically. The maximum accumulation of material depends primarily on the fracture porosity, combination of the fracture aperture, and fracture intensity. However, the fracture porosity itself is not sufficient to characterize the potential for accumulation of a fracture system. The fracture aperture is also important because it controls both the flow through the fracture and the potential plugging of the system. Other features contributing to the void space such as lithophysae are also investigated. On the other hand, no analysis of the matrix porosity is done. The parameters will be used in sensitivity analyses of geochemical calculations providing actinide accumulations and in the subsequent Monte Carlo criticality analyses.

  5. External Fixation of Unstable, “Flail” Nasal Fractures

    PubMed Central

    Anastassov, George E.; Payami, Ali; Manji, Zain

    2012-01-01

    Nasal bone fractures are the most common among facial fractures. Usually these are adequately treated with closed reduction and internal and/or external stabilization with splints. However, there are clinical situations where the nasal bones are severely displaced, the nasal septum fractured and displaced, or there are external drape lacerations which preclude the use of nasal splints. If the nasal bones are reducible but unstable we consider them “flail” and in this case transmucosal, endonasal Kirschner wires are used for dorsal support until sufficient healing occurs. The technique is simple, quick, and predictable and causes minimal discomfort to the patients. PMID:23730426

  6. Temporary bridging external fixation in distal tibial fracture.

    PubMed

    Lavini, F; Dall'Oca, C; Mezzari, S; Maluta, T; Luminari, E; Perusi, F; Vecchini, E; Magnan, B

    2014-12-01

    Fractures that involve the distal area of the tibia are associated with a high percentage of complications. Soft tissue oedema, swelling, blisters, skin abrasions and open wounds could compromise the outcome of these lesions. The waiting time before surgery with ORIF is mostly due to soft tissue conditions. Early application of a simple joint-spanning external fixator would achieve the initial goal of stability and the respect of soft tissue, thereby decreasing the time necessary for definitive treatment. A total of 40 consecutive patients (22 male and 18 female) with a mean age of 52 years (range 17-82 years) with distal tibial fracture treated between January 2010 and January 2013 were evaluated. Early temporary external fixation was the first treatment step. Twenty patients had pilon fractures, characterised by the intra-articular involvement of the distal tibia with metaphyseal extension, and 20 patients had malleolar fracture-dislocation. Patients were divided into two groups, A and B. Group A comprised 10 patients with ankle fracture-dislocation and bone fragmentation, who were treated with a temporary bridging external fixation that was maintained after ORIF to exploit ligamentotaxis during the first phases of bone healing. In Group B (30 patients), the external fixation was removed after ORIF. The results of the study are in line with the recent literature: temporary external fixation in high-energy trauma and fracture-dislocation of the ankle enables soft tissue to be restored, which facilitates postoperative assessment of bone fragments by CT scan. The complication rate in this study was 5% in patients with malleolar fractures and 20% in patients with pilon fractures. The maintenance of temporary external fixation after ORIF synthesis during the entire first stage of bone healing seems to be a good method of treatment that has a low rate of soft tissue complications.

  7. Far-forward fracture stabilization: external fixation versus splinting.

    PubMed

    Camuso, Matthew R

    2006-01-01

    With improvements in body armor, soldiers often survive previously fatal injuries but incur devastating extremity trauma. Orthopaedic and general surgeons in forward-deployed areas must be well-versed in the selection and application of both external fixation and splinting devices in order to best preserve life and limb of the wounded. The surgeon must consider tactical environment, injury severity, injury location, available resources, and his or her own level of experience. Advantages to using external fixation in the field include preventing future injury to the traumatized soft-tissue envelope, reducing the risk of infection, minimizing fracture hemorrhage, providing pain control, and facilitating medical evacuation. Splinting is reserved for closed, low-energy, stable fractures of either the upper or lower extremity and for unstable fractures that are not amenable to battlefield external fixation; because of the risks of compartment syndrome, casts are avoided. PMID:17003182

  8. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices §...

  9. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices §...

  10. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices §...

  11. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices §...

  12. 21 CFR 878.3250 - External facial fracture fixation appliance.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false External facial fracture fixation appliance. 878.3250 Section 878.3250 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices §...

  13. Segmental fractures of the tibia treated by circular external fixation.

    PubMed

    Giotakis, N; Panchani, S K; Narayan, B; Larkin, J J; Al Maskari, S; Nayagam, S

    2010-05-01

    We have carried out a retrospective review of 20 patients with segmental fractures of the tibia who had been treated by circular external fixation. We describe the heterogeneity of these fractures, their association with multiple injuries and the need for multilevel stability with the least compromise of the biology of the fracture segments. The assessment of outcome included union, complications, the measurement of the functional IOWA knee and ankle scores and the general health status (Short-form 36). The mean time to union was 21.7 weeks (12.8 to 31), with no difference being observed between proximal and distal levels of fracture. Complications were encountered in four patients. Two had nonunion at the distal level, one a wire-related infection which required further surgery and another shortening of 15 mm with 8 degrees of valgus which was clinically insignificant. The functional scores for the knee and ankle were good to excellent, but the physical component score of the short-form 36 was lower than the population norm. This may be explained by the presence of multiple injuries affecting the overall score. PMID:20436007

  14. Treatment of Palatal Fractures by Osteosynthesis with 2.0-mm Locking Plates as External Fixator

    PubMed Central

    Cienfuegos, Ricardo; Sierra, Eduardo; Ortiz, Benjamin; Fernández, Gerardo

    2010-01-01

    Treatment options for palatal fractures range from orthodontic braces, acrylic bars, and arch bars for maxillomandibular fixation to internal fixation, with plates and screws placed under the palate mucosa and periosteum, together with pyriform aperture or alveolar plating plus buttress reconstruction. Forty-five patients, ages 4 to 56, were treated using medium- or high-profile locking plates placed over the palatal mucosa as an external fixator for palatal fractures, together with treatment for other associated facial fractures. In open fractures, plates were placed after approximating the edges of the mucosal wounds. Plates and screws for palate fixation were removed at 12 weeks, when computed tomography scans provided evidence of fracture healing. All palatal fractures healed by 12 weeks, with no cases of mucosal necrosis, bone exposure, fistulae, or infections. This approach achieves adequate stability, reduces the risk of bone and mucosal necrosis, and promotes healing of mucosal wounds in case of open fractures. PMID:22132261

  15. External rotation views in the diagnosis of posterior colliculus fracture of the medial malleolus.

    PubMed

    Ebraheim, N A; Wong, F Y

    1996-05-01

    A 25-year-old white man sustained a fracture dislocation of the right ankle with a displaced fracture of the lateral malleolus while playing basketball. He also sustained a fracture of the medial aspect of the distal tibia, in addition to an apparent deltoid ligament injury. The patient underwent open reduction and internal fixation of the lateral malleolus and insertion of a syndesmotic screw. Intraoperatively, external rotation radiographs of the ankle were obtained to determine the origin of the fracture of the medial side of the ankle joint. The radiographs clearly showed a minimally displaced fracture of the posterior colliculus. Posterior colliculus fracture can be occult. This fracture may not be clearly visible on plain antero-posterior or mortise-view radiographs and external rotation is necessary for its diagnosis. This fracture is usually minimally displaced and can be satisfactorily treated conservatively. The patient's leg was placed in a short-leg cast for 6 weeks. Follow-up radiographs revealed healing of the fracture.

  16. Hybrid External Fixation for Arbeitsgemeinschaft für Osteosynthesefragen (AO) 43-C Tibial Plafond Fractures.

    PubMed

    Abd-Almageed, Emad; Marwan, Yousef; Esmaeel, Ali; Mallur, Amarnath; El-Alfy, Barakat

    2015-01-01

    Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 43-C tibial plafond/pilon fractures represent a challenge for the treating orthopedic surgeon. We assessed the outcomes of using hybrid external fixation for this fracture type. The present prospective cohort study was started in August 2009 and ended by July 2012. Thirty consecutive patients (mean age 37.4 ± 10.7 years) with a type C tibial plafond fracture who had presented to our tertiary care orthopedic hospital were included. Motor vehicle accidents and fall from height were the cause of the fracture in 14 (46.7%) and 13 (43.3%) patients, respectively. A type C3 fracture was present in 25 patients (83.3%), and type C1 and C2 fractures were present in 2 (6.7%) and 3 (10.0%) patients, respectively. Nine fractures (30.0%) were open. Hybrid external fixation was used for all fractures. All fractures were united; clinical healing was achieved by a mean of 18.1 ± 2.2 weeks postoperatively and radiologic healing at a mean of 18.9 ± 1.9 weeks. The fixator was removed at a mean of 20.4 ± 2.0 weeks postoperatively. At a mean follow-up point of 13.4 ± 2.6 months, the mean modified Mazur ankle score was 84.6 ± 10.4. It was not associated with wound classification (p = .256). The most commonly seen complication was ankle osteoarthritis (17 patients; 56.7%); however, it was mild in >50.0% of the affected patients. In conclusion, using hybrid external fixation for type C tibial plafond fractures resulted in good outcomes. However, this should be investigated further in studies with a higher level of evidence.

  17. Nail hooks and elastic bands external dynamic traction for fractures of the proximal interphalangeal joint.

    PubMed

    Siddiqui, Farhaj; Hossain, Shahan; Huq, Nasimul

    2012-09-01

    Intra-articular fractures of the proximal interphalangeal joint remain a treatment challenge for hand specialists. The purpose of this investigation was to review the results of 12 patients, 6 men and 6 women (average age, 21 y), who were treated using the nail hooks and elastic bands external dynamic traction technique for their intra-articular proximal interphalangeal joint fractures. Of the total 12 fractures, 6 involved the proximal phalanx and 6 involved the middle phalanx. The final arc of motion at the proximal interphalangeal joint averaged 89 degrees (range, 25 to 111 degrees). At the conclusion of treatment: 1 patient developed a radial deviation and 1 developed a slight ulnar deviation. All patients were able to return to their preinjury level of functioning. Nail hooks and elastic bands external dynamic traction provides an effective treatment for intra-articular proximal interphalangeal joint fractures. It is an inexpensive, easily applied, nonoperative method of treatment. PMID:22913996

  18. Management of Femoral Shaft Fracture in Klippel-Trenaunay Syndrome with External Fixator

    PubMed Central

    Gupta, Yogendra; Jha, Ranjib Kumar; Karn, Navin Kumar; Sah, Sanjaya Kumar; Mishra, Bibhuti Nath; Bhattarai, Manoj Kumar

    2016-01-01

    Klippel-Trenaunay syndrome (KTS) is a rare complex malformation characterized by the clinical triad of capillary malformations, soft tissue and bone hypertrophy, and venous/lymphatic malformation. Fractures of long bones in such cases are challenging to treat. A 12-year-old female with this syndrome presented with femoral shaft fracture of right thigh. She was initially kept on skeletal traction for two weeks and then she underwent closed reduction and immobilization with external fixator with uneventful intraoperative and postoperative period. Fracture united at four and half months. PMID:26885423

  19. Finite element analysis of three commonly used external fixation devices for treating Type III pilon fractures.

    PubMed

    Ramlee, Muhammad Hanif; Kadir, Mohammed Rafiq Abdul; Murali, Malliga Raman; Kamarul, Tunku

    2014-10-01

    Pilon fractures are commonly caused by high energy trauma and can result in long-term immobilization of patients. The use of an external fixator i.e. the (1) Delta, (2) Mitkovic or (3) Unilateral frame for treating type III pilon fractures is generally recommended by many experts owing to the stability provided by these constructs. This allows this type of fracture to heal quickly whilst permitting early mobilization. However, the stability of one fixator over the other has not been previously demonstrated. This study was conducted to determine the biomechanical stability of these external fixators in type III pilon fractures using finite element modelling. Three-dimensional models of the tibia, fibula, talus, calcaneus, navicular, cuboid, three cuneiforms and five metatarsal bones were reconstructed from previously obtained CT datasets. Bones were assigned with isotropic material properties, while the cartilage was assigned as hyperelastic springs with Mooney-Rivlin properties. Axial loads of 350 N and 70 N were applied at the tibia to simulate the stance and the swing phase of a gait cycle. To prevent rigid body motion, the calcaneus and metatarsals were fixed distally in all degrees of freedom. The results indicate that the model with the Delta frame produced the lowest relative micromovement (0.03 mm) compared to the Mitkovic (0.05 mm) and Unilateral (0.42 mm) fixators during the stance phase. The highest stress concentrations were found at the pin of the Unilateral external fixator (509.2 MPa) compared to the Mitkovic (286.0 MPa) and the Delta (266.7 MPa) frames. In conclusion, the Delta external fixator was found to be the most stable external fixator for treating type III pilon fractures.

  20. [A new type of emergency trauma fracture external fixator--the development of spraying dextran-based polyurethane external splints].

    PubMed

    Miao, Jianyun; Lian, Kejian; Liu, Hui; Lin, Kunshan; Ding, Zhenqi; Linbin; Zhai, Wenliang

    2012-01-01

    A new production method of spraying dextran-based polyurethane external splints is introduced in this paper. The main raw material components are polymethylene polyisocyanate (PAPI), mixed with surfactants, acetone, soluble starch, catalyst, and so on. The splint is used for temporary fixing after fracture, with small size, light weight, easy portability, fine air perviousness, completely transparent to the X-ray. It also needs a shorter fixed operating time. It can not only fix quickly and effectively the vertebral column and limbs, but also significantly shorten the time of pre-hospital care. PMID:22571158

  1. External fixator configurations in tibia fractures: 1D optimization and 3D analysis comparison.

    PubMed

    Roseiro, Luis M; Neto, M Augusta; Amaro, Ana; Leal, Rogerio P; Samarra, Miguel C

    2014-01-01

    The use of external fixation devices in orthopedic surgery is very common in open tibial fractures. A properly applied fixator may improve the healing process while one improperly applied might delay the healing process. The several external fixator systems used in clinical today, can be categorized into uniplanar-unilateral, uniplanar-bilateral, biplanar and multiplanar. The stability on the fracture focus and, therefore, the fracture healing process, is related with the type of external fixator configuration that is selected. The aim of this study is to discuss the principles for the successful application of unilateral-uniplanar external fixation, the assembly of its components, for the case of a transverse fractures using computational models. In this context, the fixation stiffness characteristics are evaluated using a simplified 1D finite element model for the tibia and external fixator. The beams are modeled with realistic cross-sectional geometry and material properties instead of a simplified model. The VABS (the Variational Asymptotic Beam Section analysis) methodology is used to compute the cross-sectional model for the generalized Timoshenko model, which was embedded in the finite element solver FEAP. The use of Timoshenko beam theory allows accounting for several kinds of loads, including torsion moments. Optimal design is performed with respect to the assembly of fixator components using a genetic algorithm. The optimization procedure is based on the evaluation of an objective function, which is dependent on the displacement at the fracture focus. The initial and optimal results are compared by performing a 3D analysis, for which different three-dimensional finite element models are created. The geometrical model of a tibia is created on the basis of data acquired by CAT scan, made for a healthy tibia of a 22 year old male. The 3D comparison of the 1D optimal results show a clear improvement on the objective function for the several load cases and

  2. Management of Proximal Tibia Fractures Using Wire Based Circular External Fixator

    PubMed Central

    Misra, Rakesh Kumar; Kaur, Manjinder

    2015-01-01

    Introduction Management of high grade proximal tibia or tibial plateau fractures is often associated with complications. The use of wire fixators for the definitive treatment of such fractures entails a minimally invasive technique of insertion that gives good fracture reduction and stability combined with minimal postoperative complications. Aim To assess the outcome of treatment of such fractures by the use of Joshi’s external stabilization system (JESS), which is a wire based, circular external fixator system. Materials and Methods A prospective, uncontrolled study was done using JESS on 20 consecutive patients of high energy fractures of the tibial plateau, classified according to the Schatzker’s classification as type VI. Results In this series, road traffic accidents accounted for most of the injuries (n=12), while pedestrian accidents (n=4), injury due to fall from height (n=3) and injury due to fall while playing (n=1) were the other modes of injury. The mean patient age was 39.4 years. The mean follow up period was 24 weeks. In this study, using Knee society score evaluation, excellent results were seen in 12 patients (60%), good results were seen in 5 patients (25%), fair in 2 patients (10%) and bad in 1 patient (5%). Complications seen were, pin tract infections in two cases (10%) which resolved with dressings and oral antibiotics and one case of non-union (5%), in which the tibial plateau fracture extended into proximal 1/3 of the tibial shaft with severe comminution. No other complication was encountered. Conclusion JESS is a simple, inexpensive and useful technique in the management of high grade tibial plateau fractures. PMID:26500969

  3. A mini external fixator for hand and finger fractures constructed from readily available materials.

    PubMed

    Walter, Frank L; Papandrea, Rick F

    2011-12-01

    Phalangeal and metacarpal fractures with severe comminution and/or soft tissue compromise can present a challenge for the orthopedic surgeon. Maintaining viability of the soft tissues while providing rigid fixation of bony injuries is the goal when treating these injuries. Commercially available mini external fixators can help to achieve these goals. However, these devices are costly and are not always available when the surgeon needs them. In this technique study, we discuss the implementation of a mini external fixator using readily available implements in the operating room that is efficient, cost effective, and easy to apply.

  4. Fracture Toughness Evaluation of Space Shuttle External Tank Thermal Protection System Polyurethane Foam Insulation Materials

    NASA Technical Reports Server (NTRS)

    McGill, Preston; Wells, Doug; Morgan, Kristin

    2006-01-01

    Experimental evaluation of the basic fracture properties of Thermal Protection System (TPS) polyurethane foam insulation materials was conducted to validate the methodology used in estimating critical defect sizes in TPS applications on the Space Shuttle External Fuel Tank. The polyurethane foam found on the External Tank (ET) is manufactured by mixing liquid constituents and allowing them to react and expand upwards - a process which creates component cells that are generally elongated in the foam rise direction and gives rise to mechanical anisotropy. Similarly, the application of successive foam layers to the ET produces cohesive foam interfaces (knitlines) which may lead to local variations in mechanical properties. This study reports the fracture toughness of BX-265, NCFI 24-124, and PDL-1034 closed-cell polyurethane foam as a function of ambient and cryogenic temperatures and knitline/cellular orientation at ambient pressure.

  5. CIRCULAR EXTERNAL FIXATOR PLACEMENT FOR REPAIR OF AN OPEN DISTAL TARSOMETATARSAL FRACTURE IN AN AFRICAN SACRED IBIS (THRESKIORNIS AETHIOPICUS).

    PubMed

    Kinney, Matthew E; Gorse, Mary Jean; Anderson, Mark A

    2015-12-01

    An adult male African sacred ibis (Threskiornis aethiopicus) was diagnosed with an open right distal tarsometatarsal fracture on physical examination and radiographs. External coaptation in the form of an L splint failed to stabilize the fracture appropriately and additional fixation options were explored. The location of the fracture near the articulation between the tarsometatarsus and the hallux, the short distal fracture segment, and decreased viability of the foot precluded the use of previously described fixation methods for tarsometatarsal fracture repair. A three-ring external fixator system with modification to the distal-most ring allowed for postoperative weight-bearing with minimal nursing care. The fixator was removed after 41 days, and the bird remained fully weight-bearing. The use of a circular external fixator for distal tarsometatarsal repair in long-legged birds may be a viable option when full return to function with minimal postoperative care is desired. PMID:26667561

  6. External fixation of intra-articular fracture of the distal radius in young and old adults.

    PubMed

    Huch, K; Hünerbein, M; Meeder, P J

    1996-01-01

    Forty patients (18-89 years old, mean 58 years) with comminuted intra-articular fractures of the distal radial end (AO-type C 2 or C 3) treated with external fixation could be followed for an average of 2.3 years. After 3 weeks, the distraction was released, and after another 3 weeks, the device was removed. Complications seen were one malunion, one radial shaft fracture caused by excentric drilling of a Schanz screw, one Sudeck atrophy, and one subcutaneous pin-track infection. Radial and ulnar deviations were reduced to 52% and 71% of the untreated wrist, whereas the range of motion in the other planes reached about 80% or more of the healthy side. In all, 82.5% of the patients showed good or excellent radiological and functional results. This study demonstrates that external fixation of distal radial C 2 and 3 fractures for 6 weeks results in good recovery for young patients and elderly patients with osteoporosis. PMID:8775708

  7. [Original vacuum dressing for the treatment of open femur fracture with gangrene immobilized by external fixation].

    PubMed

    Debarge, R; Pinaroli, A; Caillot, J-L; Voiglio, E-J

    2008-02-01

    We report a case of gangrene, which developed following an open fracture of the femur immobilized with an external fixator in a 45-year-old patient. A conventional vacuum dressing (VAC Therapy) could not be applied with the external fixator in place. An original vacuum dressing was thus fashioned after surgical debridement. Scabs were covered with calcium alginate. The lower limb was enveloped in sterile dressings and vacuum was achieved by suction with gastric tubes under adhesive films. The dressing was redone every 48 h in a surgical setting. Antibiotic prophylaxis enabled cure of the infection. Budding appeared within two weeks enabling skin grafting. Centro-medullary nailing was undertaken on day 30 to accelerate bone healing. At three months from the trauma, the initial loss of sensitivity in the leg and foot noted at the first weight bearing required programmed disarticulation of the knee after femur and wound healing. At six months, the patient had resumed his occupational activities and was pain free. This type of dressing could be useful for tissue loss over a fracture immobilized with an external fixator. This type of assembly can easily be installed in the operating room. PMID:18342034

  8. An external fixation method and device to study fracture healing in rats.

    PubMed

    Mark, Hans; Bergholm, Jan; Nilsson, Anders; Rydevik, Björn; Strömberg, Lennart

    2003-08-01

    We wished to establish a reproducible model for fracture fixation to be used in fracture healing research and therefore developed an external fixation construct and surgical procedure adapted to Sprague-Dawley rats. We evaluated the mechanical properties of the construct in brass rods and rat bone, in an Instron test machine with axial and transverse loading, and the in vivo performance. We found that the mechanical properties of the construct in brass rods were predictable and could be repeated in rat femora. In all tests, the axial load was about 10 times the transverse for the same degree of deformation. The stiffness among fixators was uniform. 1 mm pins caused about 50% less stiffness than 1.2 mm pins in axial loading of rat bone (p < 0.001) and brass rods (p < 0.001) as well as in transverse loading of brass rods (p < 0.001). Loosening of 1 or 2 screws that lock the pins to the fixator reduced stiffness by about 50% in axial loading of rat bone (p = 0.009) and brass rods (p = 0.05). A change in the distance between the bone surface and the fixator was linearly related to the stiffness in axial loading of rat bone (p < 0.001) and brass rods (p < 0.001) and in transverse loading of brass rods (p < 0.001). If the bone ends touched each other, the axial stiffness of the construct increased almost 10 times (265 N/mm), as compared to a fracture gap size of 2 mm (31 N/mm). In vivo experiments had a complication rate of less than 10% when we used 1.2 mm pins, 6 mm offset and rats weighing 350-450 g. Our method and device for experimental external fixation of rat femora are reliable and the findings are reproducible. These can be used in bone repair and fracture healing research. PMID:14521302

  9. Long-term outcome after supination-external rotation type-4 fractures of the ankle.

    PubMed

    Stufkens, S A S; Knupp, M; Lampert, C; van Dijk, C N; Hintermann, B

    2009-12-01

    We have compared the results at a mean follow-up of 13 years (11 to 14) of two groups of supination-external rotation type-4 fractures of the ankle, in one of which there was a fracture of the medial malleolus and in the other the medial deltoid ligament had been partially or completely ruptured. Of 66 patients treated operatively between 1993 and 1997, 36 were available for follow-up. Arthroscopy had been performed in all patients pre-operatively to assess the extent of the intra-articular lesions. The American Orthopaedic Foot and Ankle Society hind-foot score was used for clinical evaluation and showed a significant difference in both the total and the functional scores (p < 0.05), but not in those for pain or alignment, in favour of the group with a damaged deltoid ligament (p < 0.05). The only significant difference between the groups on the short-form 36 quality-of-life score was for bodily pain, again in favour of the group with a damaged deltoid ligament. There was no significant difference between the groups in the subjective visual analogue scores or in the modified Kannus radiological score. Arthroscopically, there was a significant difference with an increased risk of loose bodies in the group with an intact deltoid ligament (p < 0.005), although there was no significant increased risk of deep cartilage lesions in the two groups. At a mean follow-up of 13 years after operative treatment of a supination-external rotation type-4 ankle fracture patients with partial or complete rupture of the medial deltoid ligament tended to have a better result than those with a medial malleolar fracture.

  10. TREATMENT OF POST-TRAUMATIC HUMERAL FRACTURES AND COMPLICATIONS USING THE OSTEOLINE® EXTERNAL FIXATOR: A TREATMENT OPTION

    PubMed Central

    de Azevedo, Marcos Coelho; de Azevedo, Gualter Maldonado; Hayashi, Alexandre Yoshio; Dourado Nascimento, Paulo Emilio

    2015-01-01

    To evaluate the results obtained from treatment of humeral shaft fractures and their complications using the Osteoline® uniplanar external fixator. Methods: The radiographic and functional results from 78 patients with humeral shaft fractures treated using the uniplanar external fixation technique were retrospectively assessed. The patients' ages ranged from 23 to 71 years, with a mean of 47 years. Male patients predominated (79%). Out of the 78 patients, 45 presented open fractures, 14 presented pseudarthrosis and six presented synthesis failure. There were no losses during the follow-up and all the patients were discharged after fracture consolidation and functional recovery. The results were evaluated based on the studies by Catagni, as good, fair or poor. Results: Fracture consolidation was observed in 98% of the cases treated with uniplanar external fixation. Only one pseudarthrosis case required conversion to rigid internal fixation and autologous bone grafting. At the end of the treatment, all the patients were discharged with consolidated fractures, without pain, and good limb function. Conclusion: The external fixation described in this paper was shown to be an efficient and safe method for treating humeral shaft fractures and their complications. It preserved the local biological status and enabled passive and active movement immediately after surgery. PMID:27027026

  11. Hinged external fixation for complex fracture-dislocation of the elbow in elderly people.

    PubMed

    Maniscalco, P; Pizzoli, A L; Renzi Brivio, L; Caforio, M

    2014-12-01

    The authors report their experience of treating complex elbow fracture-dislocations in elderly people, using a minimally-invasive approach with a new articulated external fixator that is associated with minimal internal fixation. The clinical results for 19 patients are presented according to outcome factors, such as range of motion, pain and function, rate and type of complications, and reoperation rate. The results indicate that this treatment strategy should be considered as a good alternative to other treatment options reported in the literature, including conservative treatment, ORIF with angular stable plates and total elbow arthroplasty. PMID:25457320

  12. [Meaning of living with external fixation for grade III open fracture of lower limbs: patient view].

    PubMed

    Lopez, Catia Cristina Gomes; Gamba, Mônica Antar; Matheus, Maria Clara Cassuli

    2013-06-01

    The present study is aimed to understand the meaning of living with an external fixation device for grade III open fractures of the lower limbs from the perspective of the patient. The data were collected with six young adults who were undergoing outpatient orthopedic treatment in a public hospital in the city of São Paulo, through semi-structured interviews with open questions, between June and August 2010. Seeking to understand the meaning of this experience, we have maintained a phenomenological attitude during the analysis, which made it possible to reveal the phenomenon "try to live in spite of feeling trapped in a cage." Patients said that their personal desire and support from others helped them reorganize their lives, despite the several challenges they had to overcome to adapt to the fastener attached to their body and the fear of the future and doubts about the success of treatment.

  13. Closed reduction of displaced or dislocated mandibular condyle fractures in children using threaded Kirschner wire and external rubber traction.

    PubMed

    Kim, J H; Nam, D H

    2015-10-01

    Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction. From March 1, 2005 to December 25, 2011, 11 children aged between 4 and 12 years with displaced or dislocated mandibular condyle fractures were treated using threaded Kirschner wire and external rubber traction under portable C-arm fluoroscopy. All patients had unilateral displaced or dislocated condylar fractures. The follow-up period ranged from 24 to 42 months (mean 29.3 months). Normal occlusion and pain-free function of the temporomandibular joint, without deviation or limitation of jaw opening, was achieved in all patients. This closed reduction technique in displaced or dislocated condylar fractures in children offers a reliable solution in preventing the unfavourable sequelae of closed treatment and the open technique, such as altered morphology, functional disturbances, and facial nerve damage.

  14. Assessment of the Potential Impacts of Hydraulic Fracturing for Oil and Gas on Drinking Water Resources (External Review Draft)

    EPA Science Inventory

    Cover of the <span class=external review draft of the hydraulic fracturing drinking water research report"> This assessment provides a review and synthesi...

  15. Use of external fixation and primary wound closure in an open comminuted first metatarsal fracture: a case report.

    PubMed

    Miller, Jason C; Shever, Sepideh

    2008-01-01

    Management of open, comminuted fractures presents a challenge for the foot and ankle surgeon. Reconstructive surgery for such injuries has a high potential for the development of serious complications, and factors such as the extent of soft tissue injury, neurovascular status to the foot, and fracture stability must be taken into consideration before determining a surgical plan. This article describes the case of a patient who presented with an open, comminuted first metatarsal fracture as a result of a chainsaw injury. The patient was treated with a uniplanar mini-external fixator, demineralized bone matrix, primary wound closure, and external bone growth stimulation. At 1-year follow-up, the interview and examination revealed the patient to be pain free with a functional first ray. ACFAS Level of Clinical Evidence: 4.

  16. Osteosynthesis in Distal Radius Fractures with Conventional Bridging External Fixator; Tips and Tricks for Getting Them Right

    PubMed Central

    Chilakamary, Vamshi Krishna; Koppolu, Kiran Kumar; Rapur, Shivaprasad

    2016-01-01

    Background Distal radius fractures are the commonest fractures occurring in the upper extremity, accounting for 15-20% of patients treated in emergency department. Although distal radial fractures were described 200 years ago, they still remain as unsolved fractures with no clear guidelines. It is often reported that anatomical reduction has a bearing on the functional outcome. Aim To study the management of distal end radius fracture by utilizing the principle of ligamentotaxis where in the reduction obtained by closed means is maintained by external fixator till solid bony union occurs. Materials and Methods A total of 26 cases were selected for study by scrutiny of the inclusion and exclusion criteria. Most of our cases were treated with external fixator within 8 hrs of injury. Small A.O external fixator (bridging ex-fix) with 2 pins each in radius and 2nd metacarpal percutaneously was used for all the cases. Selective k wire fixation was done in cases of instability. Fixator was removed after 6 weeks. Guided physiotherapy was ensured in all the cases. Patients were followed up for an average of 9 months. Results Modified Gartland and Werley scoring system was used to evaluate the overall functional results. Excellent to good results were achieved in 88.45% of our cases while fair result was in 11.54 %. One case had pin loosening and two other cases had malunion. Conclusion External fixator used for ligamentotaxis is an effective method of treating unstable extraarticular and complex intraarticular fractures of distal radius. Improved anatomical restoration with early rehabilitation has produced favourable functional outcome in our series. The complications like pin tract infection is rare due to the availability of superior antibiotics and sterile surgical technique. complications like wrist and finger stiffness has improved with physiotherapy. PMID:26894133

  17. Temporary Stabilization with External Fixator in ‘Tripolar’ Configuration in Two Steps Treatment of Tibial Pilon Fractures

    PubMed Central

    Daghino, Walter; Messina, Marco; Filipponi, Marco; Alessandro, Massè

    2016-01-01

    Background: The tibial pilon fractures represent a complex therapeutic problem for the orthopedic surgeon, given the frequent complications and outcomes disabling. The recent medical literature indicates that the best strategy to reduce amount of complications in tibial pilon fractures is two-stages procedure. We describe our experience in the primary stabilization of these fractures. Methods: We treated 36 cases with temporary external fixation in a simple configuration, called "tripolar": this is an essential structure (only three screws and three rods), that is possible to perform even without the availability of X-rays and with simple anesthesia or sedation. Results: We found a sufficient mechanical stability for the nursing post-operative, in absence of intraoperative and postoperative problems. The time between trauma and temporary stabilization ranged between 3 and 144 hours; surgical average time was 8.4 minutes. Definitive treatment was carried out with a delay of a minimum of 4 and a maximum of 15 days from the temporary stabilization, always without problems, both in case of ORIF (open reduction, internal fixation) or circular external fixation Conclusion: Temporary stabilization with external fixator in ‘tripolar’ configuration seems to be the most effective strategy in two steps treatment of tibial pilon fractures. These preliminary encouraging results must be confirmed by further studies with more cases. PMID:27123151

  18. Surgical stabilization for open tibial fractures in children: External fixation or elastic stable intramedullary nail - which method is optimal?

    PubMed Central

    Ramasubbu, Rohan A; Ramasubbu, Benjamin M

    2016-01-01

    Background: Management of open tibial fractures is well documented in adults, with existing protocols outlining detailed treatment strategies. No clear guidelines exist for children. Surgical stabilization of tibial fractures in the pediatric population requires implants that do not disrupt the open epiphyses (growth plate). Both elastic stable intramedullary nails and external fixation can be used. The objective of this study was to identify the optimal method of surgical stabilization in the treatment of open tibial fractures in children. Materials and Methods: MEDLINE and Embase were searched from their inception to March 2014 using the following advanced search terms (Key words): “open tibia fracture,” “fracture fixation,” “external fixation,” “intramedullary,” and “bone nail.” Only studies in English and pertaining to children with open fractures treated with elastic stable intramedullary nails or external fixation between 1994 and 2014 were included. Twelve clinical studies were critically appraised. Results: Due to a paucity in the literature coupled with a nonsystematic presentation of results, it proved to be very difficult in extracting relevant results from the studies. This was further added by a variation in outcome measures. Consequently, the results we obtained were difficult to draw conclusions from. Conclusion: There is no conclusive evidence or best practice guidelines for their management. Thus, as is highlighted in this study, more research is needed to determine the optimum treatment strategy for this common pediatric injury. The existing literature is of poor quality; consisting mainly of retrospective reviews of patients’ medical records, charts, and radiographs. Carefully designed, high-quality prospective cohort studies utilizing a nationalized multi-hospital approach are needed to improve understanding before protocols and guidelines can be developed and implemented. PMID:27746486

  19. Epoxy putty external skeletal fixation for fractures of the four main metacarpal and metatarsal bones in cats and dogs.

    PubMed

    De La Puerta, B; Emmerson, T; Moores, A P; Pead, M J

    2008-01-01

    The objective of this retrospective study was to report the clinical use, advantages, disadvantages, complications and outcome of an epoxy putty external skeletal fixator (EPESF) used for the repair of fractures of all four main metatarsal or metacarpal bones in a single limb in 11 dogs and 11 cats. The aim of this technique was to achieve satisfactory alignment of the proximal and distal joints and the digits, rather than anatomical reconstruction of the metacarpal/metatarsal bones themselves. All of the cases achieved fracture union and they all recovered fully without any residual lameness.

  20. Use of a locking compression plate as an external fixator for repair of a tarsometatarsal fracture in a bald eagle (Haliaeetus leucocephalus).

    PubMed

    Montgomery, Ronald D; Crandall, Elizabeth; Bellah, Jamie R

    2011-06-01

    We describe the successful treatment of a tarsometatarsal fracture in a mature bald eagle (Haliaeetus leucocephalus) using a locking compression plate as an external fixator. The anatomy of the area (inelastic dermis and minimal subcutaneous space) and the high forces placed on a fracture at that site necessitated a unique approach to fixation. The unconventional use of a locking compression plate as an external fixator was minimally invasive, well tolerated by the eagle, and provided adequate stability in opposing fracture forces. This technique may serve as a method of fixation for tarsometatarsal fractures in other large avian species.

  1. Use of a locking compression plate as an external fixator for repair of a tarsometatarsal fracture in a bald eagle (Haliaeetus leucocephalus).

    PubMed

    Montgomery, Ronald D; Crandall, Elizabeth; Bellah, Jamie R

    2011-06-01

    We describe the successful treatment of a tarsometatarsal fracture in a mature bald eagle (Haliaeetus leucocephalus) using a locking compression plate as an external fixator. The anatomy of the area (inelastic dermis and minimal subcutaneous space) and the high forces placed on a fracture at that site necessitated a unique approach to fixation. The unconventional use of a locking compression plate as an external fixator was minimally invasive, well tolerated by the eagle, and provided adequate stability in opposing fracture forces. This technique may serve as a method of fixation for tarsometatarsal fractures in other large avian species. PMID:21877449

  2. Ultrasonography as a diagnostic tool in assessing deltoid ligament injury in supination external rotation fractures of the ankle.

    PubMed

    Henari, Shwan; Banks, Louisa N; Radovanovic, Ingrid; Radiovanovic, Ingrid; Queally, Joseph; Morris, Seamus

    2011-10-01

    The medial deltoid ligament is the primary stabilizing structure in the ankle joint following lateral malleolar fracture. However, medial deltoid ligament ruptures are difficult to diagnose using current imaging modalities. We hypothesized that ultrasonography can be used to accurately allow early clinical assessment of ankle fracture stability, thereby negating the need to perform plain film stress views of the acutely injured ankle. This prospective study included 12 patients (age range, 18-72) with supination external rotation fractures requiring operative fixation. Following induction of anesthesia, ultrasonography examination was performed, followed by an arthrogram under fluoroscopic screening. Radiographs, ultrasonography, and arthrographic findings were compared. There was 100% correlation between ultrasonography and arthrogram findings. Ultrasonography accurately diagnosed medial deltoid rupture with a sensitivity of 100% and specificity of 100%. Plain film radiographs of the ankle had a sensitivity of 57.1% and a specificity of 60%. The difference between these was significant (χ(2)=.0091). This study demonstrates diagnostic ultrasonography to be an accurate diagnostic modality in assessing medial deltoid ligament integrity in patients with supination external rotation fractures. It offers the same sensitivity and specificity as arthrography without the need for additional invasive procedures. Its relative ease of use and lack of ionizing radiation make it a potentially useful tool, particularly in a busy trauma service.

  3. [Retrospective analysis of consecutively treated distal radius fractures with the external fixator].

    PubMed

    Melik, N; Togninalli, D; Biegger, P

    1994-12-01

    The purpose of this study was to determine retrospectively some subjective and objective parameters following the operative treatment of 32 patients with "complex" (intraarticular and/or comminuted) fractures of the distal radius using the small AO external fixation device. The mean follow-up period was 20 months (minimum 4, maximum 48) and the mean age of the subjects was 62 years (minimum 27, maximum 91). Subjective results such as "general feeling", mobility, strength and pain, expressed with a scoring system (% of maximum obtainable points), showed an overall good result and ranged between 71% (pain), 81% (strength) and 91% (mobility and "general feeling"). Regarding the objective results, no major skin or soft tissue distress (Sudeck dystrophy) was noted. However, there was a general tendency towards a mobility deficit of the wrist operated on, which was statistically significant (P < 0.01) for flexion, extension, supination and abduction (respectively, -17.7%, -12.4%, -7.1% and -12.5%). The late standard radiological and lateral controls showed a mean radial angle of +2.13 degrees (B or lateral radial angle) and +23.13 degrees (A or AP angle), respectively. The analysis of data, as expressed by time after operation (< or > than 10 months), showed no relevant difference between the two groups (age of both similar), as expressed by age (< or > than 60 years); the data only showed differences in strength and pain (scores by 92% vs 82% for force and 92% vs 76% for pain) and in flexion and extension (-22.8% and -14%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7855610

  4. Integrins mediate mechanical compression-induced endothelium-dependent vasodilation through endothelial nitric oxide pathway.

    PubMed

    Lu, Xiao; Kassab, Ghassan S

    2015-09-01

    Cardiac and skeletal muscle contraction lead to compression of intramuscular arterioles, which, in turn, leads to their vasodilation (a process that may enhance blood flow during muscle activity). Although endothelium-derived nitric oxide (NO) has been implicated in compression-induced vasodilation, the mechanism whereby arterial compression elicits NO production is unclear. We cannulated isolated swine (n = 39) myocardial (n = 69) and skeletal muscle (n = 60) arteriole segments and exposed them to cyclic transmural pressure generated by either intraluminal or extraluminal pressure pulses to simulate compression in contracting muscle. We found that the vasodilation elicited by internal or external pressure pulses was equivalent; moreover, vasodilation in response to pressure depended on changes in arteriole diameter. Agonist-induced endothelium-dependent and -independent vasodilation was used to verify endothelial and vascular smooth muscle cell viability. Vasodilation in response to cyclic changes in transmural pressure was smaller than that elicited by pharmacological activation of the NO signaling pathway. It was attenuated by inhibition of NO synthase and by mechanical removal of the endothelium. Stemming from previous observations that endothelial integrin is implicated in vasodilation in response to shear stress, we found that function-blocking integrin α5β1 or αvβ3 antibodies attenuated cyclic compression-induced vasodilation and NOx (NO(-)2 and NO(-)3) production, as did an RGD peptide that competitively inhibits ligand binding to some integrins. We therefore conclude that integrin plays a role in cyclic compression-induced endothelial NO production and thereby in the vasodilation of small arteries during cyclic transmural pressure loading.

  5. [Treatment of the femoral, tibia and humeral shaft fractures in children with the use of intramedullary nailing or external fixation, a long term study].

    PubMed

    Kołecka, Ewa; Niedzielski, Kryspin Ryszard; Lipczyk, Zbigniew; Flont, Paweł

    2009-01-01

    The treatment of long bones shaft fractures with intramedullary nailing and external fixation is gaining popularity nowadays. The aim of this study was to analyze operative methods of treatment of the long bones shafts fractures in children. We compared outcomes of surgical treatment with the use of external fixation and flexible nails. The study group consisted of 127 patients (4 to 18 years old) who were operated on in our hospital during the period 1990-2005: 90 patients with femoral shaft fractures, 31 with tibia fractures and 6 with humeral fractures. In 81 children we performed fixation with Wagner's tool and in 46 cases we used Prevot or Ender nails. The follow up (performed at least one year after treatment cessation) included clinical examination and X-ray imaging. Union in an almost anatomical position was obtained in 126 patients. There was one fracture-healing complication ( nonunion- due to to early hardware removal). The study showed many advantages of the surgical treatment: minimal invasiveness, short hospitalization period, early rehabilitation. In our group both methods of management were comparable. We recommend intramedullary nailing in closed, transverse fractures and external fixator in open, multifragmentary and possibly unstable fractures. PMID:19777945

  6. External fixation is more suitable for intra-articular fractures of the distal radius in elderly patients.

    PubMed

    Ma, Chuang; Deng, Qiang; Pu, Hongwei; Cheng, Xinchun; Kan, Yuhua; Yang, Jing; Yusufu, Aihemaitijiang; Cao, Li

    2016-01-01

    The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius (IFDR) in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after 1 week and 3, 6 and 12 months. After 3 months, the plating group had better pronation (P=0.001), supination, (P=0.047) and extension (P=0.043) scores. These differences were somewhat attenuated by 6 months and disappeared at 1 year. The plating group had a greater occurrence of wound infection (P=0.043), tendonitis, (P=0.024) and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the "gross motor" category (walking upstairs, bending over, walking 500 yards; P=0.023). Internal fixation was more advantageous than external fixation in the early rehabilitation period; after 1 year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries. PMID:27408765

  7. External fixation is more suitable for intra-articular fractures of the distal radius in elderly patients

    PubMed Central

    Ma, Chuang; Deng, Qiang; Pu, Hongwei; Cheng, Xinchun; Kan, Yuhua; Yang, Jing; Yusufu, Aihemaitijiang; Cao, Li

    2016-01-01

    The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius (IFDR) in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after 1 week and 3, 6 and 12 months. After 3 months, the plating group had better pronation (P=0.001), supination, (P=0.047) and extension (P=0.043) scores. These differences were somewhat attenuated by 6 months and disappeared at 1 year. The plating group had a greater occurrence of wound infection (P=0.043), tendonitis, (P=0.024) and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the “gross motor” category (walking upstairs, bending over, walking 500 yards; P=0.023). Internal fixation was more advantageous than external fixation in the early rehabilitation period; after 1 year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries. PMID:27408765

  8. Fractures

    PubMed Central

    Hall, Michael C.

    1963-01-01

    Recent studies on the epidemiology and repair of fractures are reviewed. The type and severity of the fracture bears a relation to the age, sex and occupation of the patient. Bone tissue after fracture shows a process of inflammation and repair common to all members of the connective tissue family, but it repairs with specific tissue. Cartilage forms when the oxygen supply is outgrown. After a fracture, the vascular bed enlarges. The major blood supply to healing tissue is from medullary vessels and destruction of them will cause necrosis of the inner two-thirds of the cortex. Callus rapidly mineralizes, but full mineralization is achieved slowly; increased mineral metabolism lasts several years after fracture. PMID:13952119

  9. Incidence of Peroneal Tendinopathy After Application of a Posterior Antiglide Plate for Repair of Supination External Rotation Lateral Malleolar Fractures.

    PubMed

    Ahn, Jungtae; Kim, Sehun; Lee, Jung-Soo; Woo, Kyungjei; Sung, Ki-Sun

    2016-01-01

    Posterior antiglide plating is widely used to treat lateral malleolar fractures caused by supination-external rotation injuries. Despite its widespread use, this technique can be associated with postoperative peroneal tendinopathy. The purpose of the present observational review was to report the incidence of peroneal tendinopathy after the use of posterior antiglide plating to treat lateral malleolar fractures caused by a supination-external rotation injury. A total of 70 patients were followed up for a minimum of 12 (mean 55, range 12 to 109) months. Bony union was obtained in all cases after a mean of 57 (range 37 to 81) days. The median number of screw holes in the plate was 4.9 (range 4 to 7), and the median number of screws used to fixate the fibula was 6.58 (range 5 to 10). The mean American Orthopaedic Foot and Ankle Society hindfoot-ankle score at the final follow-up examination was 90.8 (range 55 to 100). Clinically, 3 (4.29%) of the 70 patients had lateral or posterolateral ankle pain indicative of peroneal tendinopathy after the index surgery, without any objective evidence. Of the 70 patients, 41 (58.57%) underwent surgical removal of the fibular hardware, 2 (4.87%) because of lateral ankle discomfort. At removal, inspection of the peroneal tendon sheath and/or tendons showed no gross evidence of tendinopathy in any of the patients. We concluded that the incidence of clinically evident peroneal tendon symptoms associated with posterior antiglide plating is low (4.3%), and direct operative inspection revealed no gross evidence of tendinopathy.

  10. Less invasive surgery using external fixator for the treatment of subtrochanteric femur fracture in a high-risk geriatric patient.

    PubMed

    Atik, O Şahap; Can, Fatih I; Şenol, M Selçuk; Eren, Toygun K

    2016-08-01

    A 90-year-old female patient was admitted to our clinic complaining of pain in her left hip which occurred due to fall from a chair. Her medical history included memory loss and mental changes associated with Alzheimer's disease and depression. Patient's cooperation and orientation were weak. Range of motion of the left hip was restricted and painful. Radiographs of the left hip demonstrated subtrochanteric comminuted fracture of femur. Laboratory tests revealed anemia and liver insufficiency. Departments of internal medicine and anesthesiology reported high risk for surgery. Surgery was performed under spinal anesthesia on radiolucent table and in supine position. Using fluoroscopy, subtrochanteric comminuted fracture of femur was reduced. Proximally, two Schanz screws were placed through femoral neck and head in axial plane, and distally, three Schanz screws were placed through femoral shaft in coronal plane. Finally, fixation of the screws was achieved with an external fixator which was made of carbon fiber rods. Patient was allowed to sit in the bed and move around with a wheelchair as of the day of surgery. No infection or loosening of fixator occurred. PMID:27499322

  11. Fractures

    MedlinePlus

    ... commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the ...

  12. Displaced Intra-Articular Fractures of the Distal Radius: Open Reduction With Internal Fixation Versus Bridging External Fixation

    PubMed Central

    Fakoor, Mohammad; Fakoor, Morteza; Mohammadhoseini, Payam

    2015-01-01

    Background: Distal radius fracture is common in all ages. Mobility and wrist function is important. The choice of treatment should aim for optimal function with minimal complications. Objectives: In this study we compared two surgical approaches, open reduction and internal fixation (ORIF) and closed reduction with external fixation (CR + EF), for treatment of intra-articular distal radius fractures. Patients and Methods: Ninety-four patients with distal radius fracture (type 3, 4 and 5 Fernandez classification) were treated with two surgical methods (ORIF and CR + EF); 55 were treated with CR + EF and 39 were treated with ORIF by different surgeons. All patients were assessed at the end of the first, third and sixth week; and then after the third, sixth and 12th month. At the end of the follow-up, all patients completed the Michigan hand outcome questionnaire (MHOQ). We compared radiological parameters of distal radius, range of motion (ROM) of the wrist, duration of rehabilitation, complication and patient satisfaction of the methods. Results: In our study, radiological findings for the ORIF group were radial inclination (RI): 19.35, radial length (RL): 10.35, radial tilt (RT): 8.92, and ulnar variance (UV): 1.64, while for the CR + EF group these were RI: 15.13, RL: 8, RT: 4.78, and UV: 0.27. The ROM for ORIF were flexion/extension (F/E): 137, Radial/Ulnar deviation (R/U): 52, and Supination/Pronation (S/P): 141, while for the CR + EF group these were F/E: 117, R/U: 40 and S/P: 116. Michigan hand outcome score for ORIF was 75% and for Ext. fix was 60%. The rate of complication with the ORIF method was 58% and in Ext. fix this was 69%. The patients in CR + EF had more than the ORIF course of physiotherapy and rehabilitation. Conclusions: In comparison of ORIF and CR + EF, all results including functional score, clinical and radiologic criteria were in favor of the ORIF method while there were less complications with this method. We believe that ORIF is a better

  13. No Higher Risk of CRPS After External Fixation of Distal Radial Fractures – Subgroup Analysis Under Randomised Vitamin C Prophylaxis§

    PubMed Central

    Zollinger, Paul E.; Kreis, Robert W.; van der Meulen, Hub G.; van der Elst, Maarten; Breederveld, Roelf S.; Tuinebreijer, Wim E.

    2010-01-01

    Operative and conservative treatment of wrist fractures might lead to complex regional pain syndrome (CRPS) type I. In our multicenter dose response study in which patients with distal radial fractures were randomly allocated to placebo or vitamin C in a daily dose of 200mg, 500mg or 1500mg during 50 days, an operated subgroup was analyzed. 48 (of 427) fractures) were operated (11.2%). Twenty-nine patients (60%) were treated with external fixation, 14 patients (29%) with K-wiring according to Kapandji and five patients (10%) with internal plate fixation. The 379 remaining patients were treated with a plaster. In the operated group of patients who received vitamin C no CRPS (0/37) was seen in comparison with one case of CRPS (Kapandji technique) in the operated group who received placebo (1/11 = 9%, p=.23). There was no CRPS after external fixation. In the conservatively treated group 17 cases of CRPS (17/379 = 4.5%) occurred in comparison with one in case of CRPS in the operated group (1/48 = 2.1%, p=.71). External fixation doesn’t necessarily lead to a higher incidence of CRPS in distal radial fractures. Vitamin C may also play a role in this. This subgroup analysis in operated distal radial fractures showed no CRPS occurrence with vitamin C prophylaxis. PMID:20309405

  14. Complications encountered while using thin-wire-hybrid-external fixation modular frames for fracture fixation. A retrospective clinical analysis and possible support for "Damage Control Orthopaedic Surgery".

    PubMed

    Lerner, A; Chezar, A; Haddad, M; Kaufman, H; Rozen, N; Stein, H

    2005-05-01

    One hundred ninety eight adult patients who had sustained long bone fractures were treated by external fixation from admission to bone healing and consolidation. Of these, 135 had sustained high-energy injuries, 39 of them had suffered multi-system injuries. Superficial pin track infection was the most common complication, occurring predominantly in pins located in the femur, upper tibia and upper humerus. There were no cases of deep infection or osteomyelitis. One patient with a femoral shaft fracture developed a DVT although he was on preventive low molecular weight heparin, i.e. sc Clexane 40 mg daily. There were no cases of PE or ARDS. External fixation systems are a minimal invasive surgical modality, which allow three-dimensional fracture fixation after closed or minimal open reduction. They require a good command of surgical anatomy, but provide an optimal preservation of the fracture's soft tissue envelope, the critical biological factor for new bone formation and fracture healing. Recent publications have suggested that in the critically ill patient, minimally invasive fracture fixation surgery may prevent the perpetuation of a reactive, life threatening inflammatory reaction (the "second hit") which may induce the development of multiple organ dysfunction (MODS).

  15. The Use of the S-Quattro Dynamic External Fixator for the Treatment of Intra-Articular Phalangeal Fractures: A Review of the Literature

    PubMed Central

    Bhamra, J.S; Khan, W.S; Pastides, P

    2012-01-01

    Intra-articular phalangeal fractures are a common injury. If left untreated, these injuries can lead to poor functional outcome with severe dehabilitating consequences, especially in younger patients. The S-Quattro external fixator device (Surgicraft®, UK) can be used to treat such injuries. Its use has been widely documented and has shown many advantages in comparison to other conventional treatments. Advantages include reduced operative time, rigid fixation and early range of motion. We present a review of the current literature and use of the S-Quattro serpentine system in the management of intraarticular phalangeal fractures. PMID:22431950

  16. Early Conversion of External Fixation to Interlocked Nailing in Open Fractures of Both Bone Leg Assisted with Vacuum Closure (VAC) - Final Outcome

    PubMed Central

    Raj, Manish; Kumar, Sunil; Singh, Pulkesh; Kumar, Dinesh; Singh, Jasveer; Deep, Akash

    2016-01-01

    Introduction Management of compound grade III fractures of both bone leg includes external stabilization for long period, followed by various soft tissue coverage procedures. Primary interlocking of tibia had been also done with variable results. External fixation for long time without any bone loss often leads to infected nonunion, loss of reduction, pin tract infection and failure of fixation, primary interlocking in compound grade III fractures had shown high medullary infection rate. We managed all cases of compound grade III A/B fractures with primary external fixation, simultaneous wound management using vacuum assisted closure (VAC) followed by early conversion to interlocking within 2 weeks of fixator application. Aim To determine the effectiveness of vacuum assisted closure (VAC) for the early conversion of external fixator to definitive interlocking in open fractures of the both bone leg. Materials and Methods In current study we selected 84 cases of compound grade IIIA/B diaphyseal fractures of both bone leg during period of May 2010 to September 2013. We managed these cases by immediate debridement and application of external fixation followed by repeated debridement, application of vacuum assisted closure (VAC) and conversion to interlocking within two weeks. Results Out of 84 cases union was achieved in 80(95%) of cases with definitive tibial interlocking. Excellent to good result were obtained in 77(91.8%) of cases and fair to poor result seen in rest of 7(8.2%) of cases according to modified Ketenjian’s criteria. 5 out of these 7 poor result group cases were from Compound Grade III B group to start with. Deep infection rate in our series were 7% i.e. total 6 cases and 4 out of these were from compound Grade III B group to start with. Conclusion Vacuum assisted closure (VAC) give a good help for rapid closure of the wound and help in early conversion to definitive intramedullary nailing. Reamed nail could well be used in compound grade IIIA

  17. Intra-articular fractures of the distal radius: bridging external fixation in slight flexion and ulnar deviation along articular surface instead of radial shaft.

    PubMed

    Moradi, Ali; Ebrahimzadeh, Mohammad H; Jupiter, Jess B

    2014-03-01

    Forty-one patients with intra-articular fracture of the distal radius (AO Type C) were treated with a double joint-bridging external fixator placed radial side of the fracture site and the wrist placed in slight flexion and ulnar deviation equal to the palmar tilt and radial inclination of the uninjured wrist. The patients were evaluated according to the system of Gartland and Werley an average of 43 months (range, 34 to 53 mo) after surgery. There were 14 excellent, 18 good, 7 fair, and 2 poor results. The average flexion was 94% of the normal side, extension 91%, pronation 95%, and supination 84%. The average radial inclination was 22 ± 10 degrees, palmar tilt 8 ± 14 degrees, and maximum articular step or gap was 2 mm. Bridging external fixation with slight wrist flexion and ulnar deviation equal to preinjured palmar tilt and radial inclination provides acceptable clinical and radiologic results.

  18. Treatment of unstable distal radius fractures: non-invasive dynamic external fixator versus volar locking plate – functional and radiological outcome in a prospective case-controlled series

    PubMed Central

    Bajwa, Ali S.; Rammappa, Manju; Lee, Ling; Nanda, Rajesh

    2015-01-01

    Introduction: Distal radius fracture (DRF) is a common injury and various treatment modalities including open reduction and internal fixation (ORIF) with volar locking plate are available. More recently, a non-invasive external fixator has been used. Aims: To prospectively compare the use of a non-invasive external fixator with early dynamisation for DRF against ORIF with volar locking plate control group. Methods: Consecutive patients with closed DRF were included in a prospective case-controlled study. Patients were assigned to non-invasive external fixator or ORIF. Minimum follow-up was two years. Follow-up was at weeks 2, 4, 6, 8, 12, 26 and at one and two-year post-operatively. The outcome measures included demographic details, injury mechanism, AO fracture type, risk factors, body mass index (BMI), ulnar styloid fracture and dorsal comminution, radiographs, grip strength and DASH score. Results: Consecutive 50 patients were treated either with non-invasive external fixator (25/50) or with ORIF (25/50) and the mean age of the two groups was 53 years (SD 17.1) and 49 years (SD 19.5), respectively. Demographics were matched in two groups. In the non-invasive external fixator group, there were 10 AO Type-A, 5 Type-B and 10 Type-C fractures. The ORIF group included 8 Type-A, 6 Type-B and 11 Type-C fractures. The mean DASH score at three-months and one-year post-injury in non-invasive fixator group was 12.2 (SD 3.1) and 3.5 (SD 0.7), respectively, significantly greater than those of ORIF group 14.5 (SD 5.6) and 11.2 (SD 4.4), respectively (p < 0.05). Conclusion: DRF treated with non-invasive external fixator can give functional results superior to ORIF at three-months and the trend is maintained at one and two-year post-operatively. PMID:27163089

  19. A Meta-Analysis for Postoperative Complications in Tibial Plafond Fracture: Open Reduction and Internal Fixation Versus Limited Internal Fixation Combined With External Fixator.

    PubMed

    Wang, Dong; Xiang, Jian-Ping; Chen, Xiao-Hu; Zhu, Qing-Tang

    2015-01-01

    The treatment of tibial plafond fractures is challenging to foot and ankle surgeons. Open reduction and internal fixation and limited internal fixation combined with an external fixator are 2 of the most commonly used methods of tibial plafond fracture repair. However, conclusions regarding the superior choice remain controversial. The present meta-analysis aimed to quantitatively compare the postoperative complications between open reduction and internal fixation and limited internal fixation combined with an external fixator for tibial plafond fractures. Nine studies with 498 fractures in 494 patients were included in the present study. The meta-analysis found no significant differences in bone healing complications (risk ratio [RR] 1.17, 95% confidence interval [CI] 0.68 to 2.01, p = .58], nonunion (RR 1.09, 95% CI 0.51 to 2.36, p = .82), malunion or delayed union (RR 1.24, 95% CI 0.57 to 2.69, p = .59), superficial (RR 1.56, 95% CI 0.43 to 5.61, p = .50) and deep (RR 1.89, 95% CI 0.62 to 5.80) infections, arthritis symptoms (RR 1.20, 95% CI 0.92 to 1.58, p = .18), or chronic osteomyelitis (RR 0.31, 95% CI 0.05 to 1.84, p = .20) between the 2 groups.

  20. Comparison of outcome of tibial plafond fractures managed by hybrid external fixation versus two-stage management with final plate fixation

    PubMed Central

    Cisneros, Luis Natera; Gómez, Mireia; Alvarez, Carlos; Millán, Angélica; De Caso, Julio; Soria, Laura

    2016-01-01

    Background: Tibial platfond fractures are usually associated with massive swelling of the foot and ankle, as well as with open wounds. This swelling may cause significant decrease of the blood flow, so the state of the soft tissue is determinant for the surgical indication and the type of implant. This retrospective study compares the union times in cases of tibial plafond fractures managed with a hybrid external fixation as a definitive procedure versus those managed with a two stage strategy with final plate fixation. Materials and Methods: A retrospective study in a polytrauma referral hospital was performed between 2005 and 2011. Patients with a tibial plafond fracture, managed with a hybrid external fixation as a definitive procedure or managed with a two stage strategy with the final plate fixation were included in the study. Postoperative radiographs were evaluated by two senior surgeons. Fracture healing was defined as callus bridging of one cortex, seen on both lateral and anteroposterior X-ray. The clinical outcome was evaluated by means of 11 points Numerical Rating Scale for pain and The American Orthopedic Foot and Ankle Society ankle score, assessed at the last followup visit. Thirteen patients had been managed with a hybrid external fixation and 18 with a two-stage strategy with the final plate fixation. There were 14 males and 17 females with a mean age of 48 years (range 19–82 years). The mean followup was 24 months (range 24–70 months). Results: The mean time from surgery to weight bearing was 7 ± 6.36 days for the hybrid fixation group and 57.43 ± 15.46 days for the plate fixation group (P < 0.0001); and the mean time from fracture to radiological union was 133.82 ± 37.83) and 152.8 ± 72.33 days respectively (P = 0.560). Conclusion: Besides the differences between groups regarding the baseline characteristics of patients, the results of this study suggest that in cases of tibial plafond fractures, the management with a hybrid external

  1. Assessment of the Potential Impacts of Hydraulic Fracturing for Oil and Gas on Drinking Water Resources (External Review Draft)

    EPA Science Inventory

    This assessment provides a review and synthesis of available scientific literature and data to assess the potential for hydraulic fracturing for oil and gas to impact the quality or quantity of drinking water resources, and identifies factors affecting the frequency or severity o...

  2. Antiamnesic effect of acyl-prolyl-containing dipeptide (GVS-111) in compression-induced damage to frontal cortex.

    PubMed

    Romanova, G A; Mirzoev, T K; Barskov, I V; Victorov, I V; Gudasheva, T A; Ostrovskaya, R U

    2000-09-01

    Antiamnestic effect of acyl-prolyl-containing dipeptide GVS-111 was demonstrated in rats with bilateral compression-induced damage to the frontal cortex. Both intraperitoneal and oral administration of the dipeptide improved retrieval of passive avoidance responses in rats with compression-induced cerebral ischemia compared to untreated controls. PMID:11177261

  3. Treatment of reducible unstable fractures of the distal radius in adults: a randomised controlled trial of De Palma percutaneous pinning versus bridging external fixation

    PubMed Central

    2010-01-01

    Background At present, there is no conclusive evidence regarding the best treatment method for reducible unstable fractures of the distal radius. This study compared the effectiveness of two methods used in surgical treatment of such fractures: percutaneous pinning and external fixation. Methods We randomly allocated 100 patients into two groups treated surgically with modified De Palma percutaneous pinning and bridging external fixation. Independent but not blinded evaluators administered the DASH quality-of-life questionnaire at postoperative months 6 and 24, performed functional assessment of pain, range of motion, and palm grip strength, and radiographic examinations (volar and radial angle, and height of the radius) before the operation, immediately afterwards, and at 6 and 24 months postoperative. Modified De Palma percutaneous pinning patients used an above-elbow cast whereas external fixation group had unrestricted elbow motion after surgery. Patients who for any reason demonstrated treatment failure or required additional interventions were followed up and their results were included in the group into which these patients had initially been randomised according to the intention-to-treat principle. A significance level of 5% (alpha = 0.05). was used for all statistical tests, such that tests presenting a p-value less than 0.05 were considered statistically significant. Results Ninety one (58.8 mean age and 66 participants were female) were included in the final assessment at 24 months. The DASH questionnaire evaluation showed a statistically significant result favouring the De Palma group (mean difference = -7.1 p = 0.044) after six months, but this was not maintained at 24 months. There were no statistically differences between the groups with respect to palm grip strength. Analysis of the range-of-motion limitation index (uninjured side minus affected side motion of) showed a statistical difference (mean difference = 2.4 p = 0.043) favoring the external

  4. The use of gravity or manual-stress radiographs in the assessment of supination-external rotation fractures of the ankle.

    PubMed

    Schock, H J; Pinzur, M; Manion, L; Stover, M

    2007-08-01

    Supination-external rotation (SER) fractures of the ankle may present with a medial ligamentous injury that is not apparent on the initial radiographs. A cadaver gravity-stress view has been described, but the manual-stress view is considered to be the examination of choice for the diagnosis of medial injuries. We prospectively compared the efficacy of these two examinations. We undertook both examinations in 29 patients with SER fractures. Of these, 16 (55%) were stress-positive, i.e. and had widening of the medial clear space of > 4 mm with a mean medial clear space of 6.09 mm (4.4 to 8.1) on gravity-stress and 5.81 mm (4.0 to 8.2) on manual-stress examination, and 13 patients (45%) were stress-negative with a mean medial clear space of 3.91 mm (3.3 to 5.1) and 3.61 mm (2.6 to 4.5) on examination of gravity- and manual-stress respectively. The mean absolute visual analgoue scale score for discomfort in the examination of gravity stress was 3.45 (1 to 6) and in the manual-stress procedure 6.14 (3 to 10). We have shown that examination of gravity-stress is as reliable and perceived as more comfortable than that of manual stress. We recommend using it as the initial diagnostic screening examination for the detection of occult medial ligamentous injuries in SER fractures of the ankle.

  5. Endovascular Treatment to Stop Life-threatening Bleeding from Branches of the External Carotid Artery in Patients with Traumatic Maxillofacial Fracture

    PubMed Central

    Lee, Woosung; Shim, Yu Shik

    2016-01-01

    Objective The purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures. Materials and Methods A total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria: 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding. Various clinical factors were recorded for each patient and the correlations between those factors and clinical outcome (Glasgow Outcome Scale, GOS) were evaluated. Results Four patients were injured in traffic accidents, five in falls, and three by assaults. Mean initial Glasgow Coma Scale (GCS) was 6.9 ± 2.1 and the lowest hemoglobin measured was mean 6.3 ± 0.9 g/dL. GOS at discharge was 4 in five patients, 3 in three patients, and 1 (death) in four patients. GOS on follow-up (mean 13.7 months) was 5 in two patients, 4 in three patients, and 3 in three patients. Initial GCS (p = 0.016), lowest systolic blood pressure (p = 0.011), and lowest body temperature (p = 0.012) showed a significant positive correlation with good clinical outcomes. The number of units of red blood cells transfused (p = 0.030), the number of units of fresh frozen plasma transfused (p = 0.013), and the time from arrival to groin puncture (p < 0.001) showed significant negative correlation with good clinical outcomes. Conclusion It might be suggested that rapid transition to EVT could be preferable to struggling with other rescue strategies to stop life-threatening bleeding from branches of the ECA in patients with traumatic maxillofacial fractures.

  6. Diagnostic accuracy of the gravity stress test and clinical signs in cases of isolated supination-external rotation-type lateral malleolar fractures.

    PubMed

    Nortunen, S; Flinkkilä, T; Lantto, I; Kortekangas, T; Niinimäki, J; Ohtonen, P; Pakarinen, H

    2015-08-01

    We prospectively assessed the diagnostic accuracy of the gravity stress test and clinical findings to evaluate the stability of the ankle mortise in patients with supination-external rotation-type fractures of the lateral malleolus without widening of the medial clear space. The cohort included 79 patients with a mean age of 44 years (16 to 82). Two surgeons assessed medial tenderness, swelling and ecchymosis and performed the external rotation (ER) stress test (a reference standard). A diagnostic radiographer performed the gravity stress test. For the gravity stress test, the positive likelihood ratio (LR) was 5.80 with a 95% confidence interval (CI) of 2.75 to 12.27, and the negative LR was 0.15 (95% CI 0.07 to 0.35), suggesting a moderate change from the pre-test probability. Medial tenderness, both alone and in combination with swelling and/or ecchymosis, indicated a small change (positive LR, 2.74 to 3.25; negative LR, 0.38 to 0.47), whereas swelling and ecchymosis indicated only minimal changes (positive LR, 1.41 to 1.65; negative LR, 0.38 to 0.47). In conclusion, when gravity stress test results are in agreement with clinical findings, the result is likely to predict stability of the ankle mortise with an accuracy equivalent to ER stress test results. When clinical examination suggests a medial-side injury, however, the gravity stress test may give a false negative result.

  7. Diagnostic accuracy of the gravity stress test and clinical signs in cases of isolated supination-external rotation-type lateral malleolar fractures.

    PubMed

    Nortunen, S; Flinkkilä, T; Lantto, I; Kortekangas, T; Niinimäki, J; Ohtonen, P; Pakarinen, H

    2015-08-01

    We prospectively assessed the diagnostic accuracy of the gravity stress test and clinical findings to evaluate the stability of the ankle mortise in patients with supination-external rotation-type fractures of the lateral malleolus without widening of the medial clear space. The cohort included 79 patients with a mean age of 44 years (16 to 82). Two surgeons assessed medial tenderness, swelling and ecchymosis and performed the external rotation (ER) stress test (a reference standard). A diagnostic radiographer performed the gravity stress test. For the gravity stress test, the positive likelihood ratio (LR) was 5.80 with a 95% confidence interval (CI) of 2.75 to 12.27, and the negative LR was 0.15 (95% CI 0.07 to 0.35), suggesting a moderate change from the pre-test probability. Medial tenderness, both alone and in combination with swelling and/or ecchymosis, indicated a small change (positive LR, 2.74 to 3.25; negative LR, 0.38 to 0.47), whereas swelling and ecchymosis indicated only minimal changes (positive LR, 1.41 to 1.65; negative LR, 0.38 to 0.47). In conclusion, when gravity stress test results are in agreement with clinical findings, the result is likely to predict stability of the ankle mortise with an accuracy equivalent to ER stress test results. When clinical examination suggests a medial-side injury, however, the gravity stress test may give a false negative result. PMID:26224832

  8. Fracture problem for an external circumferential crack in a functionally graded superconducting cylinder subjected to a parallel magnetic field

    NASA Astrophysics Data System (ADS)

    Yan, Z.; Gao, S. W.; Feng, W. J.

    2016-02-01

    In this study, the multiple isoparametric finite element method (MIFEM) is used to investigate external circumferential crack problem of a functionally graded superconducting cylinder subjected to electromagnetic forces. The superconducting cylinder is composed by Bi2223/Ag composite with material parameters varying. A crack reference region is defined to reflect the effects of crack on flux and current densities, and the magnetically impermeable crack surface condition and the generalized Irie-Yamafuji critical state model outside the crack region are adopted. The distributions of magnetic flux density in the superconducting cylinder are obtained analytically for both the zero-field cooling (ZFC) and the field cooling (FC) activation processes. Based on the MIFEM, the stress intensity factors (SIFs) at crack fronts in the process of field ascent and/or descent are then numerically calculated. It is interesting to note from numerical results that for the present crack model in the ZFC activation process, the crack is easily propagate and grow with the applied field increases, and that in the field descent process of either the ZFC case or FC case, the crack generally does not propagate. In addition, in the field ascent process of the ZFC case, the SIFs depend on not only the crack depths and model parameters but also the applied field. The present study should be helpful to the design and application of high-temperature superconductors with external edge cracks.

  9. Origin of compression-induced failure in brittle solids under shock loading

    NASA Astrophysics Data System (ADS)

    Huang, J. Y.; Li, Y.; Liu, Q. C.; Zhou, X. M.; Liu, L. W.; Liu, C. L.; Zhu, M. H.; Luo, S. N.

    2015-10-01

    The origin of compression-induced failure in brittle solids has been a subject of debate. Using in situ, high-speed, strain field mapping of a representative material, polymethylmethacrylate, we reveal that shock loading leads to heterogeneity in a compressive strain field, which in turn gives rise to localized lateral tension and shear through Poisson's effects, and, subsequently, localized microdamage. A failure wave nucleates from the impact surface and its propagation into the microdamage zone is self-sustained, triggering interior failure. Its velocity increases with increasing shock strength and eventually approaches the shock velocity. The seemingly puzzling phenomena observed in previous experiments, including incubation time, failure wave velocity variations, and surface roughness effects, can all be explained consistently with the nucleation and growth of the microdamage, and the effects of loading strength and preexisting defects.

  10. Bone Fractures Following External Beam Radiotherapy and Limb-Preservation Surgery for Lower Extremity Soft Tissue Sarcoma: Relationship to Irradiated Bone Length, Volume, Tumor Location and Dose

    SciTech Connect

    Dickie, Colleen I.; Parent, Amy L.; Griffin, Anthony M.; Fung, Sharon; Chung, Peter W.M.; Catton, Charles N.; Ferguson, Peter C.; Wunder, Jay S.; Bell, Robert S.; Sharpe, Michael B.; O'Sullivan, Brian

    2009-11-15

    Purpose: To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Methods and Materials: Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to >=40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. Results: For fracture patients, mean dose to bone was 45 +- 8 Gy (mean dose at fracture site 59 +- 7 Gy), mean FS was 37 +- 8 cm, maximum dose was 64 +- 7 Gy, and V40 was 76 +- 17%, compared with 37 +- 11 Gy, 32 +- 9 cm, 59 +- 8 Gy, and 64 +- 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. Conclusions: The risk of radiation-induced fracture appears to be reduced if V40 <64%. Fracture incidence was lower when the mean dose to bone was <37 Gy or maximum dose anywhere along the length of bone was <59 Gy. There was a trend toward lower mean FS for nonfracture patients.

  11. Nose fracture

    MedlinePlus

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It ... with other fractures of the face. Sometimes a blunt injury can ...

  12. Chronic nerve compression induces concurrent apoptosis and proliferation of Schwann cells.

    PubMed

    Gupta, Ranjan; Steward, Oswald

    2003-06-23

    Chronic nerve compression (CNC), as in carpal tunnel syndrome, is a common cause of peripheral nerve dysfunction in humans. Previous studies using animal models have demonstrated progressive demyelination and a slowing of nerve conduction velocity. To characterize the Schwann cell response to CNC, we evaluated total Schwann cell number, apoptosis, and proliferation in an animal model of CNC. Design-based stereologic techniques revealed a striking transient increase in Schwann cell number following CNC. Schwann cell number increased sixfold relative to the normal nerve at the site of compression at 1 month and then slowly declined toward control levels. Nevertheless, assays of apoptosis (TUNEL and an antipoly-ADP-ribose polymerase labeling assays) revealed extensive Schwann cell apoptosis at 2 weeks postcompression, which is during the time when Schwann cell number was increasing. Electron microscopic analysis confirmed that these dramatic changes in Schwann cells occurred in the absence of axon degeneration and axonal swelling and before there were any detectable alterations in nerve conduction velocity. Counts of bromodeoxyuridine-labeled Schwann cells revealed that proliferation occurred concurrently with ongoing apoptosis. To define further the possible mitogenic properties of mechanical stimuli on Schwann cells, we used an in-vitro model to deliver shear stress in the form of laminar fluid flow to pure populations of Schwann cells and confirmed that mechanical stimuli induce Schwann cell proliferation. Our findings indicate that chronic nerve compression induces Schwann cell turnover with minimal axonal injury and support the idea that mechanical stimuli have a direct mitogenic effect on Schwann cells. PMID:12724836

  13. Paratrooper's Ankle Fracture: Posterior Malleolar Fracture

    PubMed Central

    Young, Ki Won; Cho, Jae Ho; Kim, Hyung Seuk; Cho, Hun Ki; Lee, Kyung Tai

    2015-01-01

    Background We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. Methods Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. Results The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. Conclusions Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were

  14. Compression-induced crystallization of amorphous indomethacin in tablets: characterization of spatial heterogeneity by two-dimensional X-ray diffractometry.

    PubMed

    Thakral, Naveen K; Mohapatra, Sarat; Stephenson, Gregory A; Suryanarayanan, Raj

    2015-01-01

    Tablets of amorphous indomethacin were compressed at 10, 25, 50, or 100 MPa using either an unlubricated or a lubricated die and stored individually at 35 °C in sealed Mylar pouches. At selected time points, tablets were analyzed by two-dimensional X-ray diffractometry (2D-XRD), which enabled us to profile the extent of drug crystallization in tablets, in both the radial and axial directions. To evaluate the role of lubricant, magnesium stearate was used as "internal" and/or "external" lubricant. Indomethacin crystallization propensity increased as a function of compression pressure, with 100 MPa pressure causing crystallization immediately after compression (detected using synchrotron radiation). However, the drug crystallization was not uniform throughout the tablets. In unlubricated systems, pronounced crystallization at the radial surface could be attributed to die wall friction. The tablet core remained substantially amorphous, irrespective of the compression pressure. Lubrication of the die wall with magnesium stearate, as external lubricant, dramatically decreased drug crystallization at the radial surface. The spatial heterogeneity in drug crystallization, as a function of formulation composition and compression pressure, was systematically investigated. When formulating amorphous systems as tablets, the potential for compression induced crystallization warrants careful consideration. Very low levels of crystallization on the tablet surface, while profoundly affecting product performance (decrease in dissolution rate), may not be readily detected by conventional analytical techniques. Early detection of crystallization could be pivotal in the successful design of a dosage form where, in order to obtain the desired bioavailability, the drug may be in a high energy state. Specialized X-ray diffractometric techniques (2D; use of high intensity synchrotron radiation) enabled detection of very low levels of drug crystallization and revealed the heterogeneity in

  15. Transcriptome-wide analysis of compression-induced microRNA expression alteration in breast cancer for mining therapeutic targets

    PubMed Central

    Kim, Baek Gil; Kang, Suki; Han, Hyun Ho; Lee, Joo Hyun; Kim, Ji Eun; Lee, Sung Hwan; Cho, Nam Hoon

    2016-01-01

    Tumor growth–generated mechanical compression may increase or decrease expression of microRNAs, leading to tumor progression. However, little is known about whether mechanical compression induces aberrant expression of microRNAs in cancer and stromal cells. To investigate the relationship between compression and microRNA expression, microRNA array analysis was performed with breast cancer cell lines and cancer-associated fibroblasts (CAFs) exposed to different compressive conditions. In our study, mechanical compression induced alteration of microRNA expression level in breast cancer cells and CAFs. The alteration was greater in the breast cancer cells than CAFs. Mechanical compression mainly induced upregulation of microRNAs rather than downregulation. In a parallel mRNA array analysis, more than 25% of downregulated target genes were functionally involved in tumor suppression (apoptosis, cell adhesion, and cell cycle arrest), whereas generally less than 15% were associated with tumor progression (epithelial-mesenchymal transition, migration, invasion, and angiogenesis). Of all cells examined, MDA-MB-231 cells showed the largest number of compression-upregulated microRNAs. miR-4769-5p and miR-4446-3p were upregulated by compression in both MDA-MB-231 cells and CAFs. Our results suggest that mechanical compression induces changes in microRNA expression level, which contribute to tumor progression. In addition, miR-4769-5p and miR-4446-3p may be potential therapeutic targets for incurable cancers, such as triple negative breast cancer, in that this would reduce or prevent downregulation of tumor-suppressing genes in both the tumor and its microenvironment simultaneously. PMID:27027350

  16. Energy-shunting external hip protector attenuates the peak femoral impact force below the theoretical fracture threshold: an in vitro biomechanical study under falling conditions of the elderly.

    PubMed

    Parkkari, J; Kannus, P; Heikkilä, J; Poutala, J; Sievänen, H; Vuori, I

    1995-10-01

    The first objective of this study was to design a hip protector that would effectively attenuate and shunt away from the greater trochanter the impact energies created in typical falls of the elderly. As the shock absorption material, the protector included the 12 mm-thick Plastazote, which was found to be the most efficient energy-absorbing material in our previous in vitro biomechanical tests. With an anatomically designed semiflexible outer shield of the protector (high density polyethylene), the impact surface was increased and the impact energy shunted away from the greater trochanter. In the second phase of the study, we determined the force attenuation capacity of this device in realistic (in vitro) falling conditions of the elderly. With the impact force of 6940 N used (a typical hip impact force measured in in vitro falling tests), the trochanteric soft tissue (25 mm-thick polyethylene foam) attenuated the peak femoral impact force to 5590 N and the tested protector to 1040 N. In the second series of this experiment, the peak femoral impact force was set to be so high (13,130 N) that the protector, if effective, should prevent the hip fracture in almost all cases. The trochanteric soft tissue attenuated this peak impact force to 10,400 N and the tested protector to 1810 N. Thus, the force received by the proximal femur still remained clearly below 4170 N, the average force required to fracture in vitro the proximal femur of the elderly in a fall loading configuration. In conclusion, our test results suggest that an anatomically designed energy-shunting and energy-absorbing hip protector can provide an effective impact force attenuation in typical falling conditions of the elderly. However, the efficacy of the protector in the prevention of hip fractures can only be evaluated in randomized clinical trials.

  17. Fractures in anisotropic media

    NASA Astrophysics Data System (ADS)

    Shao, Siyi

    Rocks may be composed of layers and contain fracture sets that cause the hydraulic, mechanical and seismic properties of a rock to be anisotropic. Coexisting fractures and layers in rock give rise to competing mechanisms of anisotropy. For example: (1) at low fracture stiffness, apparent shear-wave anisotropy induced by matrix layering can be masked or enhanced by the presence of a fracture, depending on the fracture orientation with respect to layering, and (2) compressional-wave guided modes generated by parallel fractures can also mask the presence of matrix layerings for particular fracture orientations and fracture specific stiffness. This report focuses on two anisotropic sources that are widely encountered in rock engineering: fractures (mechanical discontinuity) and matrix layering (impedance discontinuity), by investigating: (1) matrix property characterization, i.e., to determine elastic constants in anisotropic solids, (2) interface wave behavior in single-fractured anisotropic media, (3) compressional wave guided modes in parallel-fractured anisotropic media (single fracture orientation) and (4) the elastic response of orthogonal fracture networks. Elastic constants of a medium are required to understand and quantify wave propagation in anisotropic media but are affected by fractures and matrix properties. Experimental observations and analytical analysis demonstrate that behaviors of both fracture interface waves and compressional-wave guided modes for fractures in anisotropic media, are affected by fracture specific stiffness (controlled by external stresses), signal frequency and relative orientation between layerings in the matrix and fractures. A fractured layered medium exhibits: (1) fracture-dominated anisotropy when the fractures are weakly coupled; (2) isotropic behavior when fractures delay waves that are usually fast in a layered medium; and (3) matrix-dominated anisotropy when the fractures are closed and no longer delay the signal. The

  18. Compression-induced HIF-1 enhances thrombosis and PAI-1 expression in mouse skin.

    PubMed

    Kaneko, Maki; Minematsu, Takeo; Yoshida, Mikako; Nishijima, Yoshimi; Noguchi, Hiroshi; Ohta, Yasunori; Nakagami, Gojiro; Mori, Taketoshi; Sanada, Hiromi

    2015-09-01

    Pressure ulcers result from tissue hypoxia caused by external forces. Thrombosis due to external forces is considered important, and hypoxia inducible factor-1 (HIF-1) is a master regulator of pressure ulcer development. To date, however, their causal relationship has not been determined. This study therefore investigated the mutual relationship between thrombosis and HIF-1 activation in compressed mouse skin, based on a hypothesis that HIF-1 regulation by plasminogen activator inhibitor-1 (PAI-1) enhances thrombosis. Compression of mouse skin significantly increased the numbers of thrombi and HIF-1α-positive cells compared with control skin. A thrombosis inhibitor significantly reduced the numbers of HIF-1α-positive cells and an HIF-1 inhibitor significantly inhibited thrombosis in compressed skin tissue, suggesting a mutual relationship between thrombosis and HIF-1 activation. Compression of mouse skin also enhanced the level of Pai-1 messenger RNA expression, but this increase was significantly reduced by treatment with an HIF-1 inhibitor, whereas a thrombosis inhibitor had no effect. These results suggested the involvement of PAI-1 in HIF-1-enhanced thrombosis and that an additional factor participates in regulating Pai-1 expression in compressed skin. These findings may suggest new strategies in pressure ulcer management.

  19. Bending fracture in carbon nanotubes.

    PubMed

    Kuo, Wen-Shyong; Lu, Hsin-Fang

    2008-12-10

    A novel approach was adopted to incur bending fracture in carbon nanotubes (CNTs). Expanded graphite (EG) was made by intercalating and exfoliating natural graphite flakes. The EG was deposited with nickel particles, from which CNTs were grown by chemical vapor deposition. The CNTs were tip-grown, and their roots were fixed on the EG flakes. The EG flakes were compressed, and many CNTs on the surface were fragmented due to the compression-induced bending. Two major modes of the bending fracture were observed: cone-shaped and shear-cut. High-resolution scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to examine the crack growth within the graphene layers. The bending fracture is characterized by two-region crack growth. An opening crack first appears around the outer-tube due to the bending-induced tensile stress. The crack then branches to grow along an inclined direction toward the inner-tube due to the presence of the shear stress in between graphene layers. An inner-tube pullout with inclined side surface is formed. The onset and development of the crack in these two regions are discussed. PMID:21730690

  20. Compression induced phase transition of nematic brush: A mean-field theory study

    SciTech Connect

    Tang, Jiuzhou; Zhang, Xinghua; Yan, Dadong

    2015-11-28

    Responsive behavior of polymer brush to the external compression is one of the most important characters for its application. For the flexible polymer brush, in the case of low grafting density, which is widely studied by the Gaussian chain model based theory, the compression leads to a uniform deformation of the chain. However, in the case of high grafting density, the brush becomes anisotropic and the nematic phase will be formed. The normal compression tends to destroy the nematic order, which leads to a complex responsive behaviors. Under weak compression, chains in the nematic brush are buckled, and the bending energy and Onsager interaction give rise to the elasticity. Under deep compression, the responsive behaviors of the nematic polymer brush depend on the chain rigidity. For the compressed rigid polymer brush, the chains incline to re-orientate randomly to maximize the orientational entropy and its nematic order is destroyed. For the compressed flexible polymer brush, the chains incline to fold back to keep the nematic order. A buckling-folding transition takes place during the compressing process. For the compressed semiflexible brush, the chains are collectively tilted to a certain direction, which leads to the breaking of the rotational symmetry in the lateral plane. These responsive behaviors of nematic brush relate to the properties of highly frustrated worm-like chain, which is hard to be studied by the traditional self-consistent field theory due to the difficulty to solve the modified diffusion equation. To overcome this difficulty, a single chain in mean-field theory incorporating Monte Carlo simulation and mean-field theory for the worm-like chain model is developed in present work. This method shows high performance for entire region of chain rigidity in the confined condition.

  1. Compression induced phase transition of nematic brush: A mean-field theory study

    NASA Astrophysics Data System (ADS)

    Tang, Jiuzhou; Zhang, Xinghua; Yan, Dadong

    2015-11-01

    Responsive behavior of polymer brush to the external compression is one of the most important characters for its application. For the flexible polymer brush, in the case of low grafting density, which is widely studied by the Gaussian chain model based theory, the compression leads to a uniform deformation of the chain. However, in the case of high grafting density, the brush becomes anisotropic and the nematic phase will be formed. The normal compression tends to destroy the nematic order, which leads to a complex responsive behaviors. Under weak compression, chains in the nematic brush are buckled, and the bending energy and Onsager interaction give rise to the elasticity. Under deep compression, the responsive behaviors of the nematic polymer brush depend on the chain rigidity. For the compressed rigid polymer brush, the chains incline to re-orientate randomly to maximize the orientational entropy and its nematic order is destroyed. For the compressed flexible polymer brush, the chains incline to fold back to keep the nematic order. A buckling-folding transition takes place during the compressing process. For the compressed semiflexible brush, the chains are collectively tilted to a certain direction, which leads to the breaking of the rotational symmetry in the lateral plane. These responsive behaviors of nematic brush relate to the properties of highly frustrated worm-like chain, which is hard to be studied by the traditional self-consistent field theory due to the difficulty to solve the modified diffusion equation. To overcome this difficulty, a single chain in mean-field theory incorporating Monte Carlo simulation and mean-field theory for the worm-like chain model is developed in present work. This method shows high performance for entire region of chain rigidity in the confined condition.

  2. Stabilization and treatment of Colles' fractures in elderly patients.

    PubMed

    Blakeney, William G

    2010-01-01

    Colles' fractures (fractures of the distal radius) are extremely common in the elderly. These fractures tend to result in displacement in elderly people because they have osteoporotic bone. Fracture displacement in the elderly, however, does not necessarily result in functional impairment. This review looks at the current literature on distal radius fractures in the elderly and the treatment options for stabilization of these fractures. These include conservative management with cast immobilization or surgical options: internal fixation, external fixation, percutaneous pinning, and bone substitutes.

  3. Quantitative characterization of the interfacial adhesion of Ni thin film on steel substrate: A compression-induced buckling delamination test

    NASA Astrophysics Data System (ADS)

    Zhu, W.; Zhou, Y. C.; Guo, J. W.; Yang, L.; Lu, C.

    2015-01-01

    A compression-induced buckling delamination test is employed to quantitatively characterize the interfacial adhesion of Ni thin film on steel substrate. It is shown that buckles initiate from edge flaws and surface morphologies exhibit symmetric, half-penny shapes. Taking the elastoplasticity of film and substrate into account, a three-dimensional finite element model for an edge flaw with the finite size is established to simulate the evolution of energy release rates and phase angles in the process of interfacial buckling-driven delamination. The results show that delamination propagates along both the straight side and curved front. The mode II delamination plays a dominant role in the process with a straight side whilst the curved front experiences almost the pure mode I. Based on the results of finite element analysis, a numerical model is developed to evaluate the interfacial energy release rate, which is in the range of 250-315 J/m2 with the corresponding phase angle from -41° to -66°. These results are in agreement with the available values determined by other testing methods, which confirms the effectiveness of the numerical model.

  4. External Fixation: Principles and Applications.

    PubMed

    Bible, Jesse E; Mir, Hassan R

    2015-11-01

    The modularity and ease of application of modern external fixation has expanded its potential use in the management of fractures and other musculoskeletal conditions. In fracture care, it can be used for provisional and definitive fixation. Short-term provisional applications include "damage control" and periarticular fracture fixation. The risk:benefit ratio of added stability needs to be assessed with each fixator. Soft-tissue management is critical during pin insertion to lessen the risk of loosening and infection. Although provisional fixation is safe for early conversion to definitive fixation, several factors affect the timing of definitive surgery, including the initial injury, external fixator stability, infection, and the physiologic state of the patient. PMID:26306568

  5. Elbow Fractures

    MedlinePlus

    ... and held together with pins and wires or plates and screws. Fractures of the distal humerus (see ... doctor. These fractures usually require surgical repair with plates and/or screw, unless they are stable. SIGNS ...

  6. Facial fractures.

    PubMed Central

    Carr, M. M.; Freiberg, A.; Martin, R. D.

    1994-01-01

    Emergency room physicians frequently see facial fractures that can have serious consequences for patients if mismanaged. This article reviews the signs, symptoms, imaging techniques, and general modes of treatment of common facial fractures. It focuses on fractures of the mandible, zygomaticomaxillary region, orbital floor, and nose. Images p520-a p522-a PMID:8199509

  7. Fracture of the cuboid.

    PubMed

    Borrelli, Joseph; De, Sayan; VanPelt, Michael

    2012-07-01

    Cuboid fracture accounts for a minority of all foot fractures in adults and often is indicative of a multiply injured foot. Understanding the normal anatomy and function of the cuboid and its relation to foot biomechanics is necessary for appropriate management. Clinical evaluation includes history, physical examination, and thorough assessment of the skin and soft tissues. Plain radiographs and CT are helpful in preoperative planning. Cuboid fractures may be managed either nonsurgically (splinting or casting) or surgically (closed reduction and external fixation or open reduction and internal fixation). Careful handling of the soft tissues is important, as is restoration of articular congruity, lateral column length, and a stable midfoot. Postoperative care consists of prolonged immobilization followed by 3 months of progressive weight bearing. Published reports of long-term outcomes and functional postoperative assessments are lacking. PMID:22751166

  8. Metatarsal fractures.

    PubMed

    Rammelt, Stefan; Heineck, Jan; Zwipp, Hans

    2004-09-01

    Metatarsal fractures are relatively common and if malunited, a frequent source of pain and disability. Nondisplaced fractures and fractures of the second to fourth metatarsal with displacement in the horizontal plane can be treated conservatively with protected weight bearing in a cast shoe for 4-6 weeks. In most displaced fractures, closed reduction can be achieved but maintenance of the reduction needs internal fixation. Percutaneous pinning is suitable for most fractures of the lesser metatarsals. Fractures with joint involvement and multiple fragments frequently require open reduction and plate fixation. Transverse fractures at the metaphyseal-diaphyseal junction of the fifth metatarsal ("Jones fractures") require an individualized approach tailored to the level of activity and time to union. Avulsion fractures of the fifth metatarsal bone are treated by open reduction and tension-band wiring or screw fixation if displaced more than 2 mm or with more that 30% of the joint involved. The metatarsals are the most common site of stress fractures, most of which are treated nonoperatively. Symptomatic posttraumatic deformities need adequate correction, in most cases by osteotomy across the former fracture site.

  9. Spontaneous fractures in the differential diagnosis of fractures in children.

    PubMed

    Torwalt, Carla R; Balachandra, A Thambirajah; Youngson, Carol; de Nanassy, Joseph

    2002-11-01

    A four-year-old male with cerebral palsy and spasticity, as a result of a non-accidental head injury sustained when he was two years old, died of pneumonia. Postmortem full body X-rays revealed fractures of varying ages of the left humerus and both femora, tibiae, and fibulae. This led to a thorough investigation of the case by the Office of the Chief Medical Examiner. Child abuse, accidents, metabolic bone disorders, other primary or secondary diseases of the bones, and pathological fractures were ruled out. The final diagnosis was spontaneous fractures secondary to osteopenia. The term spontaneous fractures is used to define fractures that occur without any known external cause, especially in cerebral palsy patients with spasticity.

  10. Metacarpal and metatarsal fractures in dogs.

    PubMed

    Muir, P; Norris, J L

    1997-08-01

    Metacarpal fractures were more common than metatarsal fractures in this retrospective study of 37 dogs. Fractures of one metacarpal or metatarsal bone occurred in 24 per cent of the dogs, two metacarpal bones in 16 per cent, three metacarpal or metatarsal bones in 19 per cent, and four metacarpal or metatarsal bones in 41 per cent. Eighty-seven per cent of the dogs with fractures of four bones had fracture displacement or malalignment of at least one digit. Progressive fracture healing usually occurred irrespective of stabilisation method. For malaligned fractures, however, external coaptation did not consistently improve alignment. Fracture alignment was consistently improved by open reduction and internal fixation of acute fractures with bone plates. Fractures of four bones occurred most often in the distal metacarpus as opposed to the proximal metatarsus. Therefore, open reduction and internal fixation may be more commonly indicated for severe metacarpal fractures, because fracture displacement or axial malalignment was significantly associated with fractures of the mid or distal regions of the metacarpus or metatarsus (P = 0.052).

  11. Fractures of Distal Radius: An Overview

    PubMed Central

    Meena, Sanjay; Sharma, Pankaj; Sambharia, Abhishek Kumar; Dawar, Ashok

    2014-01-01

    Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Treatment options include conservative management, internal fixation with pins, bridging and non-bridging external fixation, dorsal or volar plating with/without arthroscopy assistance. However, many questions regarding these fractures remain unanswered and good prospective randomized trials are needed. PMID:25657938

  12. Fatigue Fractures

    PubMed Central

    Morris, James M.

    1968-01-01

    Fatigue (or stress) fracture of bone in military recruits has been recognized for many years. Most often it is a metatarsal bone that is involved but the tarsal bones, calcaneus, tibia, fibula, femur, and pelvis are occasionally affected. Reports of such fractures in the ribs, ulna and vertebral bodies may be found in the literature. In recent years, there has been increasing awareness of the occurrence of fatigue fractures in the civilian population. Weekend sportsmen, athletes in an early phase of training, and persons engaged in unaccustomed, repetitive, vigorous activity are potential victims of such a fracture. The signs and symptoms, roentgenographic findings, treatment and etiology of fatigue fractures are dealt with in this presentation. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:5652745

  13. Statistical Physics of Fracture

    SciTech Connect

    Alava, Mikko; Nukala, Phani K; Zapperi, Stefano

    2006-05-01

    Disorder and long-range interactions are two of the key components that make material failure an interesting playfield for the application of statistical mechanics. The cornerstone in this respect has been lattice models of the fracture in which a network of elastic beams, bonds, or electrical fuses with random failure thresholds are subject to an increasing external load. These models describe on a qualitative level the failure processes of real, brittle, or quasi-brittle materials. This has been particularly important in solving the classical engineering problems of material strength: the size dependence of maximum stress and its sample-to-sample statistical fluctuations. At the same time, lattice models pose many new fundamental questions in statistical physics, such as the relation between fracture and phase transitions. Experimental results point out to the existence of an intriguing crackling noise in the acoustic emission and of self-affine fractals in the crack surface morphology. Recent advances in computer power have enabled considerable progress in the understanding of such models. Among these partly still controversial issues, are the scaling and size-effects in material strength and accumulated damage, the statistics of avalanches or bursts of microfailures, and the morphology of the crack surface. Here we present an overview of the results obtained with lattice models for fracture, highlighting the relations with statistical physics theories and more conventional fracture mechanics approaches.

  14. [Recent progress in orthopaedic managements of osteoporosis-related fractures].

    PubMed

    Yamamoto, Seizo

    2011-07-01

    Recent progress in orthopaedic treatment of osteoporosis-related fractures was reviewed. In the treatment of femoral neck fractures, impacted or nondisplaced type is treated by three cannulated cancellous pins. Displaced type of femoral neck fracture is treated by bipolar prosthesis. Results of femoral neck fractures are influenced by the complications of each patients. Osteoporotic spine fractures are commonly healed within 2 or 3 months. Spinal compression with paraparesis or paraplegia is unusual complication in burst type of spine fractures. Surgical decompression, bone grafting and stabilization with instrumentation can result in some correction of deformity and neurogenic recovery. Distal radius fractures are common fractures in the eldery. Recently advances includes external fixation and plate fixation for the comminuted fractures in the distal radius. Treatments of osteoporosis-related fractures are still difficult problems to be resolved. PMID:21774371

  15. External Fixation of Open Humerus Factures

    PubMed Central

    Marsh, JL; Mahoney, Craig R; Steinbronn, Dave

    1999-01-01

    Fifteen patients with open shaft of humerus fractures were treated with a monolateral external fixator. Nine patients presented with nerve palsies. Two radial nerves were disrupted and required grafting. Of the seven others, six spontaneously recovered and one brachial plexus partially improved. All fractures healed. The average duration of external fixation was 21 weeks. Four patients required additional procedures prior to healing (external fixator reapplication - 2, plating and bone grafting - 2). Two of these four experienced breakage of 4.5 mm external fixation pins. Eight patients developed pin tract infections, which all resolved with local care and antibiotics. Thirteen patients were contacted at an average of 63 months after injury. Eleven reported they were satisfied with their result, nine had no functional limits, and eight reported no pain. PMID:10847515

  16. Fracture Management

    MedlinePlus

    ... to hold the fracture in the correct position. • Fiberglass casting is lighter and stronger and the exterior ... with your physician if this occurs. • When a fiberglass cast is used in conjunction with a GORE- ...

  17. Lisfranc fractures.

    PubMed

    Wright, Amanda; Gerhart, Ann E

    2009-01-01

    Injuries of the tarsometatarsal, or Lisfranc, joint are rarely seen. Lisfranc fractures and fracture dislocations are among the most frequently misdiagnosed foot injuries in the emergency department. A misdiagnosed injury may have severe consequences including chronic pain and loss of foot biomechanics. Evaluation of a foot injury should include a high level of suspicion of a Lisfranc injury, and a thorough work-up is needed for correct diagnosis.

  18. [Distal radius fractures: conservative or surgical treatment?].

    PubMed

    Mark, G; Ryf, C

    1993-07-01

    The "classical" Colles fracture of the distal radius is the most common fracture in the adult. In order to reduce the still rather high rate of permanent disability, this fracture involving a functionally important joint requires accurate reduction. The AO-fracture classification introduced by Müller not only defines the severity of an injury, but also allows for decision-making as to the most adequate treatment. Besides the purely conservative management by closed reduction and plaster cast for the type-A fractures, we have a number of other treatment modalities for the more complex-B and C-type fractures, such as closed reduction and percutaneous K-wire application or the use of the small external fixator as well as open reduction and internal fixation by plates and screws for a few selected indications. PMID:8211844

  19. Dowel pinning for feline metacarpal and metatarsal fractures.

    PubMed

    Zahn, K; Kornmayer, M; Matis, U

    2007-01-01

    The goal of this retrospective study was to describe dowel pinning, and to compare the results of osteosynthesis and external coaptation of metacarpal and metatarsal fractures in cats. Evaluation of the medical records of 351 cats yielded 63 cats treated with dowel pinning, 35 cats treated with external coaptation and 14 cats treated with both methods within the same limb. All of the cats had been re-evaluated at an average of 2.8 years (six months - 15 years) postoperatively. Dowel pinning was superior to external coaptation when all fractured bones of a limb could be pinned. When internal fixation of multiple fractures was not feasible in all fractured bones due to comminution or fragments that were too short to pin, the outcome was not significantly different from cases treated with external coaptation alone. Malunion was seen in 16% of fractured bones in cats treated with external coaptation and occurred secondary to implant bending in 3% of fractured bones treated with dowel pinning. The latter refers to one operated cat, which had four metacarpal fractures in the same limb. Radiographs taken at re-evaluation showed implant migration within the medullary canal in two cats, although neither showed any signs of non-union or lameness. Non-union was seen in one operated cat, in which the fracture (MC IV) could not be completely reduced with a K-wire. Osteomyelitis did not occur. Dowel pinning is an easy, inexpensive and effective technique for repair of metacarpal and metatarsal fractures in cats.

  20. External Beam Therapy (EBT)

    MedlinePlus

    ... Physician Resources Professions Site Index A-Z External Beam Therapy (EBT) External beam therapy (EBT) is a ... follow-up should I expect? What is external beam therapy and how is it used? External beam ...

  1. Galeazzi fracture.

    PubMed

    Atesok, Kivanc I; Jupiter, Jesse B; Weiss, Arnold-Peter C

    2011-10-01

    Galeazzi fracture is a fracture of the radial diaphysis with disruption at the distal radioulnar joint (DRUJ). Typically, the mechanism of injury is forceful axial loading and torsion of the forearm. Diagnosis is established on radiographic evaluation. Underdiagnosis is common because disruption of the ligamentous restraints of the DRUJ may be overlooked. Nonsurgical management with anatomic reduction and immobilization in a long-arm cast has been successful in children. In adults, nonsurgical treatment typically fails because of deforming forces acting on the distal radius and DRUJ. Open reduction and internal fixation is the preferred surgical option. Anatomic reduction and rigid fixation should be followed by intraoperative assessment of the DRUJ. Further intraoperative interventions are based on the reducibility and postreduction stability of the DRUJ. Misdiagnosis or inadequate management of Galeazzi fracture may result in disabling complications, such as DRUJ instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis.

  2. Holographic Interferometry Applied To External Osteosynthesis : Comparative Analysis Of The Performances Of External Fixation Prototypes

    NASA Astrophysics Data System (ADS)

    Jacquot, Pierre; Rastogi, Pramod K.; Pflug, Leopold

    1983-10-01

    The use of external osteosynthesis in the healing and the management of fractured bones is in rapid progression. The method employs an external rigid frame which is mounted to keep the fractured bones in state of immobilisation by means of percutaneous transfixing pins traversing the bones. In this paper, holographic interferometry is used to investigate the mechanical behaviour of the ball-joint - a central element in the fixation frame - sub-jected to realistic loads. Besides, the work has permitted to compare several models of this piece (of comparable handiness) as to their characteristics of rigidity and of resistance to slipping.

  3. Pediatric Thighbone (Femur) Fracture

    MedlinePlus

    ... fractures in infants under 1 year old is child abuse. Child abuse is also a leading cause of thighbone fracture ... contact sports • Being in a motor vehicle accident • Child abuse Types of Femur Fractures (Classification) Femur fractures vary ...

  4. Arcuate Fractures

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site]

    In the upper left corner of this VIS image are a series of fractures. Where the fractures are exposed on the surface it is impossible to tell the plane of the fracture; however where the fractures are visible in the cliff wall it is possible to see that the fractures dip to the north. This image shows part of the caldera of Tharsis Tholus.

    Image information: VIS instrument. Latitude 1.7, Longitude 176.5 East (183.5 West). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  5. Coupled waves at fracture intersections

    NASA Astrophysics Data System (ADS)

    Abell, B.; Pyrak-Nolte, L. J.

    2014-12-01

    Fracture intersections play a crucial role in the hydraulic connectivity of flow paths in rock, yet no current techniques exist for characterizing the conditions of an intersection. We demonstrate experimentally and theoretically that elastic waves propagated along fracture intersections are affected by the amount of contact among the blocks forming an intersection. Surface fractures and fracture intersections can be viewed as wedges (corners) coupled through the points of contact along the intersection. An eigenvalue secular equation was derived using displacement discontinuity theory along with the solution for a wedge wave. The velocity and motion of intersection waves are a function of the frequency, material impedance, and specific stiffness of the intersection. For an intersection, several modes are present that represent the coupling between different sets of the wedges and exhibit wave speeds between a single wedge mode and the bulk S wave. A surface fracture supports only one mode of propagation with speeds that range from the single wedge wave to that of the Rayleigh wave. Experiments were performed on intersections made from two or four aluminum samples (0.29 x 0.076 x 0.076 m) to detect intersection waves. Measurements were made under uniaxial and biaxial loading conditions to change the contact area along an intersection. At low loads both the surface fracture and intersection excite wedge waves because the stress between the wedges was not sufficiently high to couple the wedges. As the external load was increased, the wave coupled the wedges and propagated as a Rayleigh wave for the surface fracture, or as a bulk S wave for the intersection. These results indicate that the specific stiffness of the fracture intersection can be estimated based upon the velocity of the wave propagating along the intersection or surface fracture. Using this estimation the flow path(s) along or through the fracture intersection or surface fracture can be characterized and

  6. Which ankle fractures require syndesmotic stabilization?

    PubMed

    van den Bekerom, Michel P J; Lamme, Bas; Hogervorst, Mike; Bolhuis, Hugo W

    2007-01-01

    Syndesmotic ruptures associated with ankle fractures are most commonly caused by external rotation of the foot, eversion of the talus within the ankle mortise, and excessive dorsiflexion. The distal tibiofibular syndesmosis consists of the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, and interosseous ligament, and it is essential for stability of the ankle mortise. Despite the numerous biomechanical and clinical studies pertaining to ankle fractures, there are no uniform recommendations regarding the use of the syndesmotic screw for specific injury patterns and fracture types. The objective of this review was to formulate recommendations for clinical practice related to the use of syndesmotic screw placement. PMID:17980843

  7. Tibial Plateau Fractures in Elderly Patients.

    PubMed

    Rozell, Joshua C; Vemulapalli, Krishna C; Gary, Joshua L; Donegan, Derek J

    2016-09-01

    Tibial plateau fractures are common in the elderly population following a low-energy mechanism. Initial evaluation includes an assessment of the soft tissues and surrounding ligaments. Most fractures involve articular depression leading to joint incongruity. Treatment of these fractures may be complicated by osteoporosis, osteoarthritis, and medical comorbidities. Optimal reconstruction should restore the mechanical axis, provide a stable construct for mobilization, and reestablish articular congruity. This is accomplished through a variety of internal or external fixation techniques or with acute arthroplasty. Regardless of the treatment modality, particular focus on preservation and maintenance of the soft tissue envelope is paramount. PMID:27551570

  8. Are Carotid Stent Fractures Clinically Significant?

    SciTech Connect

    Garcia-Toca, Manuel; Rodriguez, Heron E.; Naughton, Peter A.; Keeling, Aiofee; Phade, Sachin V.; Morasch, Mark D.; Kibbe, Melina R.; Eskandari, Mark K.

    2012-04-15

    Purpose: Late stent fatigue is a known complication after carotid artery stenting (CAS) for cervical carotid occlusive disease. The purpose of this study was to determine the prevalence and clinical significance of carotid stent fractures. Materials and Methods: A single-center retrospective review of 253 carotid bifurcation lesions treated with CAS and mechanical embolic protection from April 2001 to December 2009 was performed. Stent integrity was analyzed by two independent observers using multiplanar cervical plain radiographs with fractures classified into the following types: type I = single strut fracture; type II = multiple strut fractures; type III = transverse fracture; and type IV = transverse fracture with dislocation. Mean follow-up was 32 months. Results: Follow-up imaging was completed on 106 self-expanding nitinol stents (26 closed-cell and 80 open-cell stents). Eight fractures (7.5%) were detected (type I n = 1, type II n = 6, and type III n = 1). Seven fractures were found in open-cell stents (Precise n = 3, ViVEXX n = 2, and Acculink n = 2), and 1 fracture was found in a closed-cell stent (Xact n = 1) (p = 0.67). Only a previous history of external beam neck irradiation was associated with fractures (p = 0.048). No associated clinical sequelae were observed among the patients with fractures, and only 1 patient had an associated significant restenosis ({>=}80%) requiring reintervention. Conclusions: Late stent fatigue after CAS is an uncommon event and rarely clinically relevant. Although cell design does not appear to influence the occurrence of fractures, lesion characteristics may be associated risk factors.

  9. Radial head fracture - aftercare

    MedlinePlus

    Elbow fracture - radial head - aftercare ... to 2 weeks. If you have a small fracture and your bones did not move around much, ... to see a bone doctor (orthopedic surgeon). Some fractures require surgery to: Insert pins and plates to ...

  10. The External Degree.

    ERIC Educational Resources Information Center

    Houle, Cyril O.

    This book examines the external degree in relation to the extremes of attitudes, myths, and data. Emphasis is placed on the emergence of the American external degree, foreign external-degree programs, the purpose of the external degree, the current scene, institutional issues, and problems of general policy. (MJM)

  11. Splinting of Longitudinal Fracture: An Innovative Approach

    PubMed Central

    Bansal, Rashmi; Chowdhary, Priyanka; Gurtu, Anuraag; Mehrotra, Nakul; Kishore, Abhinav

    2016-01-01

    Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth. PMID:27247808

  12. Fractured Surface

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03084 Fractured Surface

    These fractures and graben are part of Gordii Fossae, a large region that has undergone stresses which have cracked the surface.

    Image information: VIS instrument. Latitude 16.6S, Longitude 234.3E. 18 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  13. Multiwell fracturing experiments. [Nitrogen foam fracture treatment

    SciTech Connect

    Warpinski, N.

    1985-01-01

    The objective of the Multiwell fracturing experiments is to test and develop the technology for the efficient stimulation of tight, lenticular gas sands. This requires basic understanding of: (1) fracture behavior and geometry in this complex lithologic environment, and (2) subsequent production into the created fracture. The intricate interplay of the hydraulic fracture with the lens geometry, the internal reservoir characteristics (fractures, reservoir breaks, etc.), the in situ stresses, and the mechanical defects (fracture, bedding, etc.) need to be defined in order to develop a successful stimulation program. The stimulation phase of the Multiwell Experiment is concerned with: (1) determining important rock/reservoir properties that influence or control fracture geometry and behavior, (2) designing fracture treatments to achieve a desired size and objectives, and (3) conducting post-treatment analyses to evaluate the effectiveness of the treatment. Background statement, project description, results and evaluation of future plans are presented. 5 refs., 2 figs., 2 tabs.

  14. [The surgical treatment of calcaneus fractures].

    PubMed

    Brunner, U H; Betz, A; Halama, R

    1991-03-01

    The treatment of intra-articular fractures of os calcis has so far been controversial. For reconstruction of static and dynamic conditions of the foot, complex deformities must be corrected. Besides intra-articular malformation of the talocalcaneal joint that is supposed to lead to posttraumatic arthritis, there are malalignments like lateral displacement, widening and shortening of the heel, depression of talocalcaneal angles and deviation of talocalcaneal or talocuboidal axes. Even if perfect reconstruction of the talocalcaneal joint is not attained, reconstruction of form will provide a better chance for later function. ORIF is therefore superior to conservative techniques. For indication and planning of the procedure fracture analysis including CT is necessary. A lateral approach allows reconstruction and plate fixation of all intra-articular fracture types. For repositioning, temporary lateral external distraction by external fixation is recommended. The operative technique and results are discussed.

  15. Fracturing of ductile anisotropic multilayers: influence of material strength

    NASA Astrophysics Data System (ADS)

    Gomez-Rivas, E.; Griera, A.; Llorens, M.-G.

    2015-01-01

    Fractures in rocks deformed under dominant ductile conditions typically form simultaneously with viscous flow. Material strength plays a fundamental role on fracture development in such cases, since fracture propagation can be strongly reduced by the high energy absorption of the material. Additionally, the degree and nature of anisotropy can influence the orientation and type of resulting fractures. In this study, four plasticine multilayer models have been deformed under coaxial boundary conditions to investigate the influence of strength and anisotropy on the formation of fracture networks. The experiments were made of different mixtures and presented two types of anisotropy: composite and composite-intrinsic. The transition from non-localised deformation to systems where fracture networks control deformation accommodation is determined by the ability of the material to dissipate the external work and relax the elastic strain during loading, either by viscous flow or by coeval flow and failure. Tension cracks grow in experiments with composite anisotropy, giving rise to a network of shear fractures when they collapse and coalesce with progressive deformation. The presence of an additional intrinsic anisotropy enhances the direct nucleation of shear fractures, whose propagation and final length depend on the rigidity of the medium. Material strength increases the fracture maximum displacement (dmax) to fracture length (L) ratio, and the resulting values are significantly higher than those from fractures in elastic-brittle rocks. This is associated with the low propagation rates of fractures in rocks undergoing ductile deformation.

  16. Fracturing of ductile anisotropic multilayers: influence of material strength

    NASA Astrophysics Data System (ADS)

    Gomez-Rivas, E.; Griera, A.; Llorens, M.-G.

    2015-05-01

    Fractures in rocks deformed under dominant ductile conditions typically form simultaneously with viscous flow. Material strength plays a fundamental role during fracture development in such systems, since fracture propagation can be strongly reduced if the material accommodates most of the deformation by viscous flow. Additionally, the degree and nature of anisotropy can influence the orientation and type of resulting fractures. In this study, four plasticine multilayer models have been deformed under coaxial boundary conditions to investigate the influence of strength and anisotropy on the formation of fracture networks. The experiments were made of different mixtures and had two types of anisotropy: composite and composite-intrinsic. The transition from non-localised deformation to systems where fracture networks control deformation accommodation is determined by the ability of the material to dissipate the external work and relax the elastic strain during loading either by viscous flow or by coeval flow and failure. Tension cracks grow in experiments with composite anisotropy, giving rise to a network of shear fractures when they collapse and coalesce with progressive deformation. The presence of an additional intrinsic anisotropy enhances the direct nucleation of shear fractures, the propagation and final length of which depend on the rigidity of the medium. Material strength increases the fracture maximum displacement (dmax) to fracture length (L) ratio, and the resulting values are significantly higher than those from fractures in elastic-brittle rocks. This can be related to the low propagation rates of fractures in rocks undergoing ductile deformation.

  17. Proximal fifth metatarsal fractures.

    PubMed

    Ramponi, Denise R

    2013-01-01

    The most common fracture of the foot is a fracture of the proximal fifth metatarsal. In general, there are 3 types of fractures involving the proximal fifth metatarsal area, including a proximal diaphyseal stress fracture, a Jones fracture, and an avulsion fracture of the tuberosity. Some fractures of the fifth metatarsal heal without difficulty, whereas some have the potential for nonunion or delayed healing. Each fracture has some variation in the anatomical location on the fifth metatarsal, the mechanism of injury, the radiographic findings, and the treatment plan. Avulsion fractures of the tuberosity often heal without difficulty, yet fractures distal to the area of insertion of the peroneus brevis tendon are prone to nonunion and delayed healing (). Differential diagnosis of a fifth metatarsal midfoot injury includes ankle sprains, midfoot sprains, plantar facial ruptures, peroneus tendon ruptures, and other foot fractures.

  18. Transverse Stress Fracture of the Proximal Patella

    PubMed Central

    Atsumi, Satoru; Arai, Yuji; Kato, Ko; Nishimura, Akinobu; Nakazora, Shigeto; Nakagawa, Shuji; Ikoma, Kazuya; Fujiwara, Hiroyoshi; Sudo, Akihiro; Kubo, Toshikazu

    2016-01-01

    Abstract Among stress fractures associated with sports activities, patellar stress fracture is rare. Regarding patella stress fractures, so far only distal transverse or lateral longitudinal fractures have been reported, but there are no reports of transverse fractures occurring in the proximal patella. We describe an extremely rare case of transverse stress fracture of proximal patella in a 9-year-old athlete. A 9-year old boy, who participated in sports (sprints and Kendo) presented with left knee pain without any external injury. In plain radiographs, a fracture line was observed in the proximal 1/3 of the left patella, and a patella stress fracture was diagnosed. For treatment, because 7 months of conservative therapy showed no improvement, internal fixation was carried out using Acutrak screws, and bone union was thus achieved. Three months after the operation, he was able to return to his previous level of athletic sports activity. Regarding the mechanism of onset, it is believed that the causes are longitudinal traction force and patellofemoral contact pressure. On the other hand, the contact region of the patella with the femur changes with the flexion angle of the knee. In the current case, the fracture occurred at a site where the patella was in contact with the femur at a flexion angle of >90°, so it is believed that it occurred as a clinical condition from being subjected to repeated longitudinal traction force and patellofemoral contact pressure at a flexion angle of >90°, during the sports activities of sprints and Kendo. The nonunion of the transverse stress fracture of his proximal patella was successfully treated with internal fixation using Acutrak screws. PMID:26871789

  19. Surgical management for isolated cricoid fracture causing arytenoid immobility.

    PubMed

    Chitose, Shun-ichi; Sato, Kiminori; Nakazono, Hideki; Fukahori, Mioko; Umeno, Hirohito; Nakashima, Tadashi

    2014-04-01

    Cricoid cartilage fractures usually occur concurrently with disorders of laryngeal function. In, particular, displaced cricoid lamina fractures can affect arytenoid movement. However, functional, recovery may require proper repositioning of the cricoid lamina, which is associated with a high rate of, complications. Here we present a case in which an isolated cricoid cartilage fracture with arytenoid, immobility due to displacement of the fracture in the cricoarytenoid joint space was successfully, treated. Our findings suggest that a combination of external approaches with temporary, cricothyrotomy and wide suturing of the entire cricoid framework has the potential to improve, arytenoid movement and prevent associated complications.

  20. Humidity-dependent compression-induced glass transition of the air-water interfacial Langmuir films of poly(D,L-lactic acid-ran-glycolic acid) (PLGA).

    PubMed

    Kim, Hyun Chang; Lee, Hoyoung; Jung, Hyunjung; Choi, Yun Hwa; Meron, Mati; Lin, Binhua; Bang, Joona; Won, You-Yeon

    2015-07-28

    Constant rate compression isotherms of the air-water interfacial Langmuir films of poly(D,L-lactic acid-ran-glycolic acid) (PLGA) show a distinct feature of an exponential increase in surface pressure in the high surface polymer concentration regime. We have previously demonstrated that this abrupt increase in surface pressure is linked to the glass transition of the polymer film, but the detailed mechanism of this process is not fully understood. In order to obtain a molecular-level understanding of this behavior, we performed extensive characterizations of the surface mechanical, structural and rheological properties of Langmuir PLGA films at the air-water interface, using combined experimental techniques including the Langmuir film balance, X-ray reflectivity and double-wall-ring interfacial rheometry methods. We observed that the mechanical and structural responses of the Langmuir PLGA films are significantly dependent on the rate of film compression; the glass transition was induced in the PLGA film only at fast compression rates. Surprisingly, we found that this deformation rate dependence is also dependent on the humidity of the environment. With water acting as a plasticizer for the PLGA material, the diffusion of water molecules through the PLGA film seems to be the key factor in the determination of the glass transformation properties and thus the mechanical response of the PLGA film against lateral compression. Based on our combined results, we hypothesize the following mechanism for the compression-induced glass transformation of the Langmuir PLGA film; (1) initially, a humidified/non-glassy PLGA film is formed in the full surface-coverage region (where the surface pressure shows a plateau) during compression; (2) further compression leads to the collapse of the PLGA chains and the formation of new surfaces on the air side of the film, and this newly formed top layer of the PLGA film is transiently glassy in character because the water evaporation rate

  1. Humidity-dependent compression-induced glass transition of the air-water interfacial Langmuir films of poly(D,L-lactic acid-ran-glycolic acid) (PLGA).

    PubMed

    Kim, Hyun Chang; Lee, Hoyoung; Jung, Hyunjung; Choi, Yun Hwa; Meron, Mati; Lin, Binhua; Bang, Joona; Won, You-Yeon

    2015-07-28

    Constant rate compression isotherms of the air-water interfacial Langmuir films of poly(D,L-lactic acid-ran-glycolic acid) (PLGA) show a distinct feature of an exponential increase in surface pressure in the high surface polymer concentration regime. We have previously demonstrated that this abrupt increase in surface pressure is linked to the glass transition of the polymer film, but the detailed mechanism of this process is not fully understood. In order to obtain a molecular-level understanding of this behavior, we performed extensive characterizations of the surface mechanical, structural and rheological properties of Langmuir PLGA films at the air-water interface, using combined experimental techniques including the Langmuir film balance, X-ray reflectivity and double-wall-ring interfacial rheometry methods. We observed that the mechanical and structural responses of the Langmuir PLGA films are significantly dependent on the rate of film compression; the glass transition was induced in the PLGA film only at fast compression rates. Surprisingly, we found that this deformation rate dependence is also dependent on the humidity of the environment. With water acting as a plasticizer for the PLGA material, the diffusion of water molecules through the PLGA film seems to be the key factor in the determination of the glass transformation properties and thus the mechanical response of the PLGA film against lateral compression. Based on our combined results, we hypothesize the following mechanism for the compression-induced glass transformation of the Langmuir PLGA film; (1) initially, a humidified/non-glassy PLGA film is formed in the full surface-coverage region (where the surface pressure shows a plateau) during compression; (2) further compression leads to the collapse of the PLGA chains and the formation of new surfaces on the air side of the film, and this newly formed top layer of the PLGA film is transiently glassy in character because the water evaporation rate

  2. Automated External Defibrillator

    MedlinePlus

    ... from the NHLBI on Twitter. What Is an Automated External Defibrillator? An automated external defibrillator (AED) is a portable device that ... Institutes of Health Department of Health and Human Services USA.gov

  3. Fractures of the forefoot.

    PubMed

    Mandracchia, Vincent J; Mandi, Denise M; Toney, Patris A; Halligan, Jennifer B; Nickles, W Ashton

    2006-04-01

    Fractures of the forefoot are common injuries of various causes. Although not crippling, forefoot fractures can be debilitating if they go undiagnosed or are mistreated. Whenever patients complain of foot pain with ambulation or difficulty ambulating, radiographs should be taken as part of a standard routine to assess for bony pathology. This article discusses the classification and treatment of metatarsal fractures, digital and sesamoid fractures, and open fractures about the forefoot.

  4. Fracture dynamics in implanted silicon

    NASA Astrophysics Data System (ADS)

    Massy, D.; Mazen, F.; Tardif, S.; Penot, J. D.; Ragani, J.; Madeira, F.; Landru, D.; Kononchuk, O.; Rieutord, F.

    2015-08-01

    Crack propagation in implanted silicon for thin layer transfer is experimentally studied. The crack propagation velocity as a function of split temperature is measured using a designed optical setup. Interferometric measurement of the gap opening is performed dynamically and shows an oscillatory crack "wake" with a typical wavelength in the centimetre range. The dynamics of this motion is modelled using beam elasticity and thermodynamics. The modelling demonstrates the key role of external atmospheric pressure during crack propagation. A quantification of the amount of gas trapped inside pre-existing microcracks and released during the fracture is made possible, with results consistent with previous studies.

  5. Fracture dynamics in implanted silicon

    SciTech Connect

    Massy, D.; Tardif, S.; Penot, J. D.; Ragani, J.; Rieutord, F.; Mazen, F.; Madeira, F.; Landru, D.; Kononchuk, O.

    2015-08-31

    Crack propagation in implanted silicon for thin layer transfer is experimentally studied. The crack propagation velocity as a function of split temperature is measured using a designed optical setup. Interferometric measurement of the gap opening is performed dynamically and shows an oscillatory crack “wake” with a typical wavelength in the centimetre range. The dynamics of this motion is modelled using beam elasticity and thermodynamics. The modelling demonstrates the key role of external atmospheric pressure during crack propagation. A quantification of the amount of gas trapped inside pre-existing microcracks and released during the fracture is made possible, with results consistent with previous studies.

  6. External artery heat pipe

    NASA Technical Reports Server (NTRS)

    Gernert, Nelson J. (Inventor); Ernst, Donald M. (Inventor); Shaubach, Robert M. (Inventor)

    1989-01-01

    An improved heat pipe with an external artery. The longitudinal slot in the heat pipe wall which interconnects the heat pipe vapor space with the external artery is completely filled with sintered wick material and the wall of the external artery is also covered with sintered wick material. This added wick structure assures that the external artery will continue to feed liquid to the heat pipe evaporator even if a vapor bubble forms within and would otherwise block the liquid transport function of the external artery.

  7. [Fractures of the forefoot].

    PubMed

    Richter, M

    2011-10-01

    Fractures of the forefoot are common and comprise approximately two thirds of all foot fractures. Forefoot fractures are caused by direct impact or the effect of indirect force. The forces exerted can range from repetitive minor load (stress fractures) to massive destructive forces (complex trauma). The clinical course in forefoot fractures is typically more favourable than in fractures of the mid- and hindfoot. The incidence of complications like infection or pseudarthrosis is low. Exceptions are rare fractures of the proximal shaft of the fifth metatarsal and the sesamoids with higher pseudarthrosis rates. Malunited metatarsal fractures can cause painful conditions that should even be treated operatively. Differences in structure and function of the different forefoot areas and specific fracture types require an adapted management of these special injuries.

  8. Basilar Fracture Due to Frozen Corpse: A Case Report.

    PubMed

    Zhang, Junchao; Yan, Yibo; Chen, Yiqun; Huang, Sizhe; Liu, Liang

    2016-09-01

    Basilar fractures are one of the consequences of craniocerebral injury, which is serious enough to cause death. Legal examiners often pay attention to basilar fractures at autopsy and analyze the relationship between them and death. It is noteworthy whether the fracture is premortem or postmortem. Here, we describe a rarely reported case of basilar fracture due to freezing. In this case, a 30-year-old man was frozen (-18°C) for 6 months after death. At autopsy, external examination showed no trauma. However, on internal examination, there was a basilar fracture which caused controversy but turned out to be a postmortem injury. We provide the case description and discussion on antemortem or postmortem basilar fractures as a differential for these cases. PMID:27400253

  9. A universal fracture criterion for high-strength materials

    PubMed Central

    Qu, Rui Tao; Zhang, Zhe Feng

    2013-01-01

    Recently developed advanced high-strength materials like metallic glasses, nanocrystalline metallic materials, and advanced ceramics usually fracture in a catastrophic brittle manner, which makes it quite essential to find a reasonable fracture criterion to predict their brittle failure behaviors. Based on the analysis of substantial experimental observations of fracture behaviors of metallic glasses and other high-strength materials, here we developed a new fracture criterion and proved it effective in predicting the critical fracture conditions under complex stress states. The new criterion is not only a unified one which unifies the three classical failure criteria, i.e., the maximum normal stress criterion, the Tresca criterion and the Mohr-Coulomb criterion, but also a universal criterion which has the ability to describe the fracture mechanisms of a variety of different high-strength materials under various external loading conditions.

  10. An unusual stress fracture in a multiple sport athlete.

    PubMed

    Sterling, J C; Calvo, R D; Holden, S C

    1991-03-01

    Most overuse injuries are a direct result of repetitive stresses which may create a condition of maltraining. Young athletes are no exception to this rule. Swimming and baseball both create stresses to the humerus which may result in injuries to the shoulder and upper extremity. Stress fractures (fatigue fractures) are usually limited to the lower extremity (i.e., tibia or metatarsal). Upper extremity stress fractures, especially of the humerus, are very uncommon. Precipitating factors include repetitive stresses, low grade external forces, rapid application of muscular force to the bone, or an underlying disease or pathologic weakness of the bone. The majority of these fractures are primarily due to abnormal and repetitive stresses to bones. This case study examines the mechanism of injury, clinical presentation, and treatment of a clinically apparent stress fracture which ultimately converted to an overt humerus fracture in a 14-yr-old cross-trained athlete.

  11. Epidemiology of fragility fractures.

    PubMed

    Friedman, Susan M; Mendelson, Daniel Ari

    2014-05-01

    As the world population of older adults-in particular those over age 85-increases, the incidence of fragility fractures will also increase. It is predicted that the worldwide incidence of hip fractures will grow to 6.3 million yearly by 2050. Fractures result in significant financial and personal costs. Older adults who sustain fractures are at risk for functional decline and mortality, both as a function of fractures and their complications and of the frailty of the patients who sustain fractures. Identifying individuals at high risk provides an opportunity for both primary and secondary prevention.

  12. External radiation surveillance

    SciTech Connect

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  13. [Stress shielding and fracture healing].

    PubMed

    Liu, J G; Xu, X X

    1994-08-01

    The influence of stress shielding after fracture fixation with plate on fracture healing was studied. The results of animal and biomechanical experiments as well as the clinical observations demonstrated that rigidity of the plate was not the only factor causing stress redistribution and stress shielding effects of bone. Either the internal fixation with different implants or external fixation with fixators all might lead to physical and chemical characteristic changes of bone tissue. In the early stage, the disturbance of blood supply and the bone structure remodeling may be the main reasons. Reaction to the implant was another cause in the middle stage. If the affected limb can take weight-bearing normally at late stage, the influences of plate on fracture healing mechanical properties of bone and the osteoporosis cause by stress shielding effects will become much less. The tissue of the affected limb was the most important factor which may cause osteoporosis and refracture. Osteoporosis, bone atrophy and immobilization syndrome of bone and joint can be prevented and treated by taking normal weight-bearing and overcoming infection and implant reaction. PMID:7994658

  14. Compendium of fracture mechanics problems

    NASA Technical Reports Server (NTRS)

    Stallworth, R.; Wilson, C.; Meyers, C.

    1990-01-01

    Fracture mechanics analysis results are presented from the following structures/components analyzed at Marshall Space Flight Center (MSFC) between 1982 and 1989: space shuttle main engine (SSME), Hubble Space Telescope (HST), external tank attach ring, B-1 stand LOX inner tank, and solid rocket booster (SRB). Results from the SSME high pressure fuel turbopump (HPFTP) second stage blade parametric analysis determine a critical flaw size for a wide variety of stress intensity values. The engine 0212 failure analysis was a time dependent fracture life assessment. Results indicated that the disk ruptured due to an overspeed condition. Results also indicated that very small flaws in the curvic coupling area could propagate and lead to failure under normal operating conditions. It was strongly recommended that a nondestructive evaluation inspection schedule be implemented. The main ring of the HST, scheduled to launch in 1990, was analyzed by safe-life and fail-safe analyses. First safe-life inspection criteria curves for the ring inner and outer skins and the fore and aft channels were derived. Afterwards the skins and channels were determined to be fail-safe by analysis. A conservative safe-life analysis was done on the 270 redesign external tank attach ring. Results from the analysis were used to determine the nondestructive evaluation technique required.

  15. Polyvinyl siloxane: novel material for external nasal splinting.

    PubMed

    Jayakumar, N K; Rathnaprabhu, V; Ramesh, S; Parameswaran, A

    2016-01-01

    External nasal splinting is performed routinely after nasal bone fracture reductions, osteotomies, and rhinoplasties. Materials commonly used include plaster of Paris (POP), thermoplastic splints, self-adhesive padded aluminium splints, and Orthoplast, among many others. The disadvantages of these materials are described in this paper, and polyvinyl siloxane is recommended as an effective and more readily available alternative material to counter these pitfalls.

  16. Infant skull fracture (image)

    MedlinePlus

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent ... or blow can result in fracture of the skull and may be accompanied by injury to the ...

  17. Nasal fracture (image)

    MedlinePlus

    A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt ... and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood ...

  18. Metatarsal stress fractures - aftercare

    MedlinePlus

    The metatarsal bones are the long bones in your foot that connect your ankle to your toes. A stress fracture is a break in the bone that happens with repeated injury or stress. Stress fractures are caused ...

  19. Displaced patella fractures.

    PubMed

    Della Rocca, Gregory J

    2013-10-01

    Displaced patella fractures often result in disruption of the extensor mechanism of the knee. An intact extensor mechanism is a requirement for unassisted gait. Therefore, operative treatment of the displaced patella fracture is generally recommended. The evaluation of the patella fracture patient includes examination of extensor mechanism integrity. Operative management of patella fractures normally includes open reduction with internal fixation, although partial patellectomy is occasionally performed, with advancement of quadriceps tendon or patellar ligament to the fracture bed. Open reduction with internal fixation has historically been performed utilizing anterior tension band wiring, although comminution of the fracture occasionally makes this fixation construct inadequate. Supplementation or replacement of the tension band wire construct with interfragmentary screws, cerclage wire or suture, and/or plate-and-screw constructs may add to the stability of the fixation construct. Arthrosis of the patellofemoral joint is very common after healing of patella fractures, and substantial functional deficits may persist long after fracture healing has occurred.

  20. Hydraulic fracture design optimization

    SciTech Connect

    Lee, Tae-Soo; Advani, S.H.

    1992-01-01

    This research and development investigation, sponsored by US DOE and the oil and gas industry, extends previously developed hydraulic fracture geometry models and applied energy related characteristic time concepts towards the optimal design and control of hydraulic fracture geometries. The primary objective of this program is to develop rational criteria, by examining the associated energy rate components during the hydraulic fracture evolution, for the formulation of stimulation treatment design along with real-time fracture configuration interpretation and control.

  1. Hydraulic fracture design optimization

    SciTech Connect

    Lee, Tae-Soo; Advani, S.H.

    1992-06-01

    This research and development investigation, sponsored by US DOE and the oil and gas industry, extends previously developed hydraulic fracture geometry models and applied energy related characteristic time concepts towards the optimal design and control of hydraulic fracture geometries. The primary objective of this program is to develop rational criteria, by examining the associated energy rate components during the hydraulic fracture evolution, for the formulation of stimulation treatment design along with real-time fracture configuration interpretation and control.

  2. Healing of fractures with freeze-dried cortical bone plates. Comparison with compression plating.

    PubMed

    Malinin, T; Latta, L L; Wagner, J L; Brown, M D

    1984-11-01

    The healing of fractures of the radius with internal fixation by stainless-steel compression plates was compared with fractures fixed with freeze-dried bone-plate allografts. Fractures fixed with metallic plates gained slightly less than half the biomechanical strength of the contralateral control bone and healed without noticeable external callus formation. Bone-plated fractures regained three-fourths of the biomechanical strength of controls and healed by forming an external callus. Bone-plate allografts were eventually incorporated in the host bone. Allograft plates were vascularized and remodeled into cancellous bone in the process of incorporation in the host bones.

  3. Clavicle fractures: individualizing treatment for fracture type.

    PubMed

    Housner, Jeffrey A; Kuhn, John E

    2003-12-01

    Clavicle fractures are common injuries in both children and adults. In most cases, the diagnosis can be made readily from the patient's history and physical examination. X-rays are helpful to confirm the diagnosis, to assess the severity of the fracture, and to follow interval healing. Most fractures are treated nonoperatively, and surgical intervention is typically reserved for unstable distal clavicle fractures. Nonoperative options involve either a sling-and-swathe or figure-of-eight splint. Return-to-play decisions should be individualized based on the age of the patient, location and severity of the fracture, degree of clinical and radiographic healing, and the sport in which the athlete will be participating.

  4. External approach to rhinoplasty.

    PubMed

    Goodman, Wilfred S; Charbonneau, Paul A

    2015-07-01

    The technique of external rhinoplasty is outlined. Having reviewed 74 cases, its advantages and disadvantages are discussed. Reluctance to use this external approach seems to be based on emotional rather than radical grounds, for its seems to be the procedure of choice for many problems.

  5. External Cargo Integration Overview

    NASA Technical Reports Server (NTRS)

    Gueera, Alan

    2005-01-01

    This viewgraph presentation reviews the system integration efforts for external cargo for the International Space Station (ISS). The role and responsibility of the External Carriers Ofice is reviewed. The presentation also reviews the application of the office to the Commercial Cargo Services contract.

  6. Osteoporotic vertebral fractures redux.

    PubMed

    Lentle, B C; Gordon, P; Ward, L

    2008-02-01

    Osteoporosis remains an important cause of morbidity and mortality especially in the elderly. This fact is largely due to fractures of the proximal femur and spine. As recently recognized, vertebral fractures are as much a threat to health and longevity as fractures of the proximal femur. In recent decades, the development of tools to evaluate fracture risk as well as medications to treat osteoporosis has altered the management of people who are at fracture risk. At the same time identification and management procedures concerning spinal fracturing are not very clear. Besides there is not even clear consensus about what exactly constitutes a vertebral fracture, particularly those of minor degree. While height loss is a simple and valuable tool to detect vertebral fractures, it is neither sensitive nor specific enough to replace radiographs. Some 65% of fractures cause no symptoms. Often vertebral fractures are misdiagnosed, especially if they have occurred silently and if the opportunity for diagnosis arises fortuitously. It is to the patient's benefit that radiologists report and physicians identify vertebral fractures evident on a chest or other radiograph, no matter how incidental to the immediate clinical indication for the examination. Technological evolution now allows dual-energy x-ray absorptiometry machines to be used to take spine images while doing a densitometry. The images are adequate, even if not of high radiographic quality, and, more important, the patient undergoes a smaller radiation dose than with conventional spinal radiographs. Such technology may promote fracture recognition. The recognition of vertebral fractures, as well as the prevention and treatment of further fractures, will likely do much to reduce both the burden of osteoporosis-related morbidity and mortality, as well as fracture-related costs to healthcare systems.

  7. [Surgical treatment of subtrochanteric fractures in children].

    PubMed

    Guzmán-Vargas, R; Rincón-Cardozo, D F; Camacho-Casas, J A

    2016-01-01

    Subtrochanteric fractures in children are rare events, occur in only 4% of all femur fractures, most injuries occur as a result of high energy trauma, being young males patient the most affected. The management of this type of injury is controversial, there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement and external fixators. Most suggest that children under 10 should be preferred non-operative and for older than 12 surgical management is indicated, but the discussion is between 6 and 12 years old. Through this article we present the treatment of such entity with a proximal fracture plate using a minimally invasive technique. PMID:27627774

  8. [Surgical treatment of subtrochanteric fractures in children].

    PubMed

    Guzmán-Vargas, R; Rincón-Cardozo, D F; Camacho-Casas, J A

    2016-01-01

    Subtrochanteric fractures in children are rare events, occur in only 4% of all femur fractures, most injuries occur as a result of high energy trauma, being young males patient the most affected. The management of this type of injury is controversial, there are many forms of treatment, including the use of plaster spica 90-90, closed reduction and use of elastic or rigid intramedullary nails, open reduction and plate placement and external fixators. Most suggest that children under 10 should be preferred non-operative and for older than 12 surgical management is indicated, but the discussion is between 6 and 12 years old. Through this article we present the treatment of such entity with a proximal fracture plate using a minimally invasive technique.

  9. Proximal humerus fractures.

    PubMed

    Price, Matthew C; Horn, Pamela L; Latshaw, James C

    2013-01-01

    Proximal humerus fractures are among the most common fractures associated with osteoporosis. With an aging population, incidence of these fractures will only increase. The proximal humerus not only forms the lateral portion of the shoulder articulation but also has significant associations with musculoskeletal and neurovascular structures. As a result, fractures of the proximal humerus can significantly impact not only the function of the shoulder joint, but the health and function of the entire upper extremity as well. Understanding of these fractures, the management options, and associated nursing care, can help reduce morbidity rate and improve functional outcomes.

  10. Talus fractures: surgical principles.

    PubMed

    Rush, Shannon M; Jennings, Meagan; Hamilton, Graham A

    2009-01-01

    Surgical treatment of talus fractures can challenge even the most skilled foot and ankle surgeon. Complicated fracture patterns combined with joint dislocation of variable degrees require accurate assessment, sound understanding of principles of fracture care, and broad command of internal fixation techniques needed for successful surgical care. Elimination of unnecessary soft tissue dissection, a low threshold for surgical reduction, liberal use of malleolar osteotomy to expose body fracture, and detailed attention to fracture reduction and joint alignment are critical to the success of treatment. Even with the best surgical care complications are common and seem to correlate with injury severity and open injuries. PMID:19121756

  11. Epidemiology of clavicle fractures.

    PubMed

    Postacchini, Franco; Gumina, Stefano; De Santis, Pierfrancesco; Albo, Francesco

    2002-01-01

    An epidemiologic study of 535 isolated clavicle fractures treated in a hospital of a large metropolis during an 11-year period was performed. Data regarding patient's age and sex, side involved, mechanism of injury, and season in which the fracture occurred were obtained from the clinical records. Radiographic classification was performed with the Allman system. Clavicle fractures represented 2.6% of all fractures and 44% of those in the shoulder girdle. Most patients were men (68%), and the left side was involved in 61% of cases. Fractures of the middle third of the clavicle, which were the most common (81%), were displaced in 48% of cases and comminuted in 19%. Fractures of the medial third were the least common (2%). The prevalence of midclavicular fractures was found to decrease progressively with age, starting from the first decade of life when they represented 88.2% of all clavicle fractures and were undisplaced in 55.5% of cases. In adults, the incidence of displaced fractures, independent of location, was higher than that of undisplaced fractures. Traffic accidents were the most common cause of the injury. In the period under study, the incidence of fractures showed no significant change over time and no seasonal variation. PMID:12378163

  12. Subsurface fracture spacing

    SciTech Connect

    Lorenz, J.C. ); Hill, R.E. )

    1991-01-01

    This study was undertaken in order to document and analyze the unique set of data on subsurface fracture characteristics, especially spacing, provided by the US Department of Energy's Slant Hole Completion Test well (SHCT-1) in the Piceance Basin, Colorado. Two hundred thirty-six (236) ft (71.9 m) of slant core and 115 ft (35.1 m) of horizontal core show irregular, but remarkably close, spacings for 72 natural fractures cored in sandstone reservoirs of the Mesaverde Group. Over 4200 ft (1280 m) of vertical core (containing 275 fractures) from the vertical Multiwell Experiment wells at the same location provide valuable information on fracture orientation, termination, and height, but only data from the SHCT-1 core allow calculations of relative fracture spacing. Within the 162-ft (49-m) thick zone of overlapping core from the vertical and deviated wellbores, only one fracture is present in vertical core whereas 52 fractures occur in the equivalent SHCT-1 core. The irregular distribution of regional-type fractures in these heterogeneous reservoirs suggests that measurements of average fracture spacing'' are of questionable value as direct input parameters into reservoir engineering models. Rather, deviated core provides data on the relative degree of fracturing, and confirms that cross fractures can be rare in the subsurface. 13 refs., 11 figs.

  13. In-vitro Evaluation of Fracture Strength Recovery of Reattached Anterior Fractured Tooth Fragment Using Different Re-Attachment Techniques

    PubMed Central

    Abdulkhayum, Abdulmujeeb; Munjal, Sumit; Babaji, Prashant; Chaurasia, Vishwajit Rampratap; Munjal, Seema; Lau, Himani; Olekar, Santosh T; Lau, Mayank

    2014-01-01

    Background: Traumatic injuries caused to anterior teeth are most common. Emergency management of fractured fragments is necessary, for preserving their vitalities and for retaining aesthetics in an economical way. Various methods are available for restoring fractured, uncomplicated teeth, such as reattachment of fractured fragments, composite restoration. But only limited data is available on evaluation of the strength of reattached fractured fragments. Hence, the present study was designed. Objectives: The objective of this study was to evaluate the fracture strength recovery of re-attached anterior fractured tooth fragment by using different re-attachment techniques. Methodology: Forty human upper central incisions were used in this study. The roots of the teeth were confined in a special device (holder) and adapted in a Universal Testing Machine. Load was applied to each tooth in bucco-lingual direction, by using a small stainless steel ball. The force which was required to fracture the tooth was recorded. Both the fragment and remaining fractured tooth was restored by using four reattachment techniques - simple reattachment, external chamfer, over contour and internal dentinal groove. Specimens were loaded in same pre-determined area which was used in procedure to obtain fragments. The force required to detach each fragment was recorded and it was correlated with the fracture strength of an intact tooth and that which was obtained after doing restorative procedures for all groups i.e. fracture strength recovery. Results: Technique I (simple reattachment) and Technique 2 (external chamfer) showed fracture strength recoveries of 44.3% and 60.6% respectively. However, these values were lower than those which were obtained by usingTechnique 3 (Over contour) -86.8% and Technique 4 (internal dentinal groove) -89.5%. Conclusion: Over contour and internal dentinal groove reattachment is a preferred technique as compared to the other reattachment techniques which were

  14. Atraumatic sternum fracture

    PubMed Central

    Abrahamsen, Sebastian Ørskov; Madsen, Christina Friis

    2014-01-01

    The spine, pelvic bones and long bones of the lower extremities are common sites for insufficiency fractures. Cases of sternum insufficiency fractures have rarely been reported among elderly patients. Insufficiency fractures tend to occur in bones with decreased mechanical strength especially among elderly patients, in postmenopausal women and patients with underlying diseases. We describe a case of spontaneous sternum insufficiency fracture in a healthy man, with no known risk factors to fracture, or previous history of fractures. Sternum insufficiency fracture is a rare cause of chest pain. This case serves to remind the emergency physician to remain vigilant for other non-cardiac, non-pulmonary and non-traumatic causes of chest pain, especially among patients with known risk factors such as osteoporosis, chronic obstructive pulmonary disease, rheumatoid arthritis, systemic lupus erythematosus and patients on long-term steroid treatment. If diagnosed correctly, these patients can be discharged and treated as outpatients as this case emphasises. PMID:25326566

  15. [Fractures of carpal bones].

    PubMed

    Lögters, T; Windolf, J

    2016-10-01

    Fractures of the carpal bones are uncommon. On standard radiographs fractures are often not recognized and a computed tomography (CT) scan is the diagnostic method of choice. The aim of treatment is to restore pain-free and full functioning of the hand. A distinction is made between stable and unstable carpal fractures. Stable non-displaced fractures can be treated conservatively. Unstable and displaced fractures have an increased risk of arthritis and non-union and should be stabilized by screws or k‑wires. If treated adequately, fractures of the carpal bones have a good prognosis. Unstable and dislocated fractures have an increased risk for non-union. The subsequent development of carpal collapse with arthrosis is a severe consequence of non-union, which has a heterogeneous prognosis.

  16. Posterior malleolus fracture.

    PubMed

    Irwin, Todd A; Lien, John; Kadakia, Anish R

    2013-01-01

    Posterior malleolus fractures are a common component of ankle fractures. The morphology is variable; these fractures range from small posterolateral avulsion injuries to large displaced fracture fragments. The integrity of the posterior malleolus and its ligamentous attachment is important for tibiotalar load transfer, posterior talar stability, and rotatory ankle stability. Fixation of posterior malleolus fractures in the setting of rotational ankle injuries has certain benefits, such as restoring articular congruity and rotatory ankle stability, as well as preventing posterior talar translation, but current indications are unclear. Fragment size as a percentage of the anteroposterior dimension of the articular surface is often cited as an indication for fixation, although several factors may contribute to the decision, such as articular impaction, comminution, and syndesmotic stability. Outcome studies show that, in patients with ankle fractures, the presence of a posterior malleolus fracture negatively affects prognosis. Notable variability is evident in surgeon practice. PMID:23281469

  17. [Fracture endoprosthesis of distal humerus fractures].

    PubMed

    Müller, L P; Wegmann, K; Burkhart, K J

    2013-08-01

    The treatment of choice for fractures of the distal humerus is double plate osteosynthesis. Due to anatomical preshaped angle stable plates the primary stability and management of soft tissues has been improved. However, osteoporotic comminuted fractures in the elderly are often not amenable to stable osteosynthesis and total elbow arthroplasty has been established as an alternative therapy. Although complication rates have been reduced, complications of total elbow arthroplasty are still much more frequent than in total hip replacement. Furthermore, patients are advised not to exceed a weight bearing of 5 kg. Therefore, the indications for elbow arthroplasty must be evaluated very strictly and should be reserved for comminuted distal humeral fractures in the elderly with poor bone quality that are not amenable to stable osteosynthesis or for simple fractures in cases of preexisting symptomatic osteoarthritis. This article introduces and discusses modern concepts of elbow arthroplasty, such as modular convertible prosthesis systems, hemiarthroplasty and radial head replacement in total elbow arthroplasty.

  18. Fracture corridors in carbonates

    NASA Astrophysics Data System (ADS)

    Chatelée, Sébastien; Lamarche, Juliette; Gauthier, Bertrand D. M.

    2015-04-01

    Among fractures, Fracture Corridors (FC) are anomalous structures made of highly persistent fracture clusters having a strong effect on multi-phase fluid flow in the subsurface. While mechanical and geological conditions for diffuse fracture systems are well constrained, FC genetic conditions remain a matter of questioning. FC can be localized in larger structures such as folds and fault zones but recent studies suggest that a large amount of fractures and FC also arise as distributed in the host rock and formed in tabular layers during burial with early rock mechanical differentiation. In addition, while the mechanical stratigraphy is of prime importance for fracture stratigraphy, it is still unknown which factor prevails on FC genesis among the local versus regional stress-state, the host rock mechanical stratigraphy or the sedimentary facies. We present a study of fractures in a 400×300 m wide quarry (Calvisson, SE France) dug in homogeneous marly limestones of Hauterivian age. The quarry exhibits diffuse fractures as well as 16 FC. The aim of this study is to reveal the genetics factor for FC development, their global geometry and internal morphologic variations, but also to clear the impact of fracture corridors on diffuse fracture. For that, we measured >2500 fractures (strike, dip, spacing, filling, aperture, etc.) and studied microstructures in 80 thin sections. We calculated fracture density and acquired LiDAR data with >90 million points with a resolution of 4 to 15mm. Diffuse fractures are organized as two perpendicular sets, a main set NE-SW-trending and minor set NW-SE-trending. The FC have the same trend, but the NW-SE trend prevail on the NE-SW one. The LiDAR acquisition allows to visualize the 3D lateral continuity with corridors with a minimal extension of 30m. We distinguish 4 internal morphologic types in FC, depending on fracture morphology, occurrence of breccia and number of zones. The types may occur in a single FC with a lateral transition

  19. Future of External Reporting

    ERIC Educational Resources Information Center

    Powers, Kristina

    2015-01-01

    This chapter builds on prior chapters and focuses on higher education trends on the horizon and the resulting impact on external reporting for institutional researchers. Three practical recommendations and examples for institutional researchers are also presented.

  20. Multiple seizure-induced thoracic vertebral compression fractures: a case report

    PubMed Central

    Stilwell, Peter; Harman, Katherine; Hsu, William; Seaman, Brian

    2016-01-01

    Background: Musculoskeletal injuries stemming from forceful muscular contractions during seizures have been documented in the literature. Reports of multiple seizure-induced spinal fractures, in the absence of external trauma and without risk factors for fracture, are rare. Case Presentation: A 28-year-old male, newly diagnosed with epilepsy, presented to a chiropractic clinic with the complaint of mid-thoracic pain beginning after a tonic-clonic seizure with no associated external trauma. Radiographs revealed the impression of five new vertebral compression fractures from T4 to T8. Discussion: This report highlights the importance of a complete history and examination of patients with a history of tonic-clonic seizures and back pain, especially when considering spinal adjustments. Summary: This case report presents an argument that a tonic-clonic seizure, in the absence of external trauma or significant risk factors for fracture, resulted in multiple vertebral compression fractures. PMID:27713581

  1. Stress fractures in athletes.

    PubMed

    Fredericson, Michael; Jennings, Fabio; Beaulieu, Christopher; Matheson, Gordon O

    2006-10-01

    A stress fracture is a partial or complete bone fracture that results from repeated application of stress lower than the stress required to fracture the bone in a single loading. Otherwise healthy athletes, especially runners, sustain stress injuries or fractures. Prevention or early intervention is the preferable treatment. However, it is difficult to predict injury because runners vary with regard to biomechanical predisposition, training methods, and other factors such as diet, muscle strength, and flexibility. Stress fractures account for 0.7% to 20% of all sports medicine clinic injuries. Track-and-field athletes have the highest incidence of stress fractures compared with other athletes. Stress fractures of the tibia, metatarsals, and fibula are the most frequently reported sites. The sites of stress fractures vary from sport to sport (eg, among track athletes, stress fractures of the navicular, tibia, and metatarsal are common; in distance runners, it is the tibia and fibula; in dancers, the metatarsals). In the military, the calcaneus and metatarsals were the most commonly cited injuries, especially in new recruits, owing to the sudden increase in running and marching without adequate preparation. However, newer studies from the military show the incidence and distribution of stress fractures to be similar to those found in sports clinics. Fractures of the upper extremities are relatively rare, although most studies have focused only on lower-extremity injuries. The ulna is the upper-extremity bone injured most frequently. Imaging plays a key role in the diagnosis and management of stress injuries. Plain radiography is useful when positive, but generally has low sensitivity. Radionuclide bone scanning is highly sensitive, but lacks specificity and the ability to directly visualize fracture lines. In this article, we focus on magnetic resonance imaging, which provides highly sensitive and specific evaluation for bone marrow edema, periosteal reaction as well

  2. Migration with fiscal externalities.

    PubMed

    Hercowitz, Z; Pines, D

    1991-11-01

    "This paper analyses the distribution of a country's population among regions when migration involves fiscal externalities. The main question addressed is whether a decentralized decision making [by] regional governments can produce an optimal population distribution...or a centralized intervention is indispensable, as argued before in the literature.... It turns out that, while with costless mobility the fiscal externality is fully internalized by voluntary interregional transfers, with costly mobility, centrally coordinated transfers still remain indispensable for achieving the socially optimal allocation."

  3. Externally modulated theranostic nanoparticles

    PubMed Central

    Urban, Cordula; Urban, Alexander S.; Charron, Heather; Joshi, Amit

    2013-01-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites. PMID:24834381

  4. Externally modulated theranostic nanoparticles.

    PubMed

    Urban, Cordula; Urban, Alexander S; Charron, Heather; Joshi, Amit

    2013-08-01

    Externally modulated nanoparticles comprise a rapidly advancing class of cancer nanotherapeutics, which combine the favorable tumor accumulation of nanoparticles, with external spatio-temporal control on therapy delivery via optical, magnetic, or ultrasound modalities. The local control on therapy enables higher tumor treatment efficacy, while simultaneously reducing off-target effects. The nanoparticle interactions with external fields have an additional advantage of frequently generating an imaging signal, and thus such agents provide theranostic (both diagnostic and therapeutic) capabilities. In this review, we classify the emerging externally modulated theranostic nanoparticles according to the mode of external control and describe the physiochemical mechanisms underlying the external control of therapy, and illustrate the major embodiments of nanoparticles in each class with proven biological efficacy: (I) electromagnetic radiation in visible and near-infrared range is being exploited for gold based and carbon nanostructures with tunable surface plasmon resonance (SPR) for imaging and photothermal therapy (PTT) of cancer, photochemistry based manipulations are employed for light sensitive liposomes and porphyrin based nanoparticles; (II) Magnetic field based manipulations are being developed for iron-oxide based nanostructures for magnetic resonance imaging (MRI) and magnetothermal therapy; (III) ultrasound based methods are primarily being employed to increase delivery of conventional drugs and nanotherapeutics to tumor sites.

  5. Natural fracturing, by depth

    NASA Astrophysics Data System (ADS)

    Hooker, John; Laubach, Stephen

    2013-04-01

    Natural opening-mode fractures commonly fall upon a spectrum whose end-members are veins, which have wide ranges of sizes and are mostly or thoroughly cemented, and joints, which have little opening displacement and little or no cement. The vein end-member is common in metamorphic rocks, whose high temperature and pressure of formation place them outside typical reservoir settings; conversely, many uncemented joints likely form near the surface and so too have limited relevance to subsurface exploration. Sampling of cores retrieved from tight-gas sandstone reservoirs suggest that it is intermediate fractures, not true joints or veins, that provide natural porosity and permeability. Such fractures have abundant pore space among fracture-bridging cements, which may hold fractures open despite varying states of stress through time. Thus the more sophisticated our understanding of the processes that form veins and joints, i.e., how natural fracturing varies by depth, the better our ability to predict intermediate fractures. Systematic differences between veins and joints, in terms of size-scaling and lateral and stratigraphic spatial arrangement, have been explained in the literature by the mechanical effects of sedimentary layering, which likely exert more control over fracture patterns at shallower depths. Thus stratabound joints commonly have narrow size ranges and regular spacing; non-stratabound veins have a wide range of sizes and spacings. However, new fieldwork and careful literature review suggest that the effects of mechanical layering are only half the story. Although atypical, veins may be highly stratabound and yet spatially clustered; non-stratabound fractures may nonetheless feature narrow size ranges. These anomalous fracture arrangements are better explained by the presence of precipitating cements during fracture opening than by mechanical layering. Cement is thought to be highly important for fracture permeability, but potential effects of

  6. Multiple noncontiguous spine fractures.

    PubMed

    Henderson, R L; Reid, D C; Saboe, L A

    1991-02-01

    The data from a prospective study of 508 spine injuries were reviewed to determine the incidence of multiple noncontiguous spine fractures. All patients were examined at admission and at 1 and 2 years postinjury. This series identified 77 (15.2%) multilevel fractures. Motor vehicle accidents were the primary cause of these fractures. The incidence of neurologic injury was not significantly different between multiple noncontiguous and single fractures. Failure to use seat belts and ejection from the vehicle were the main factors associated with multiple noncontiguous spine injuries. Seven major fracture patterns were identified, which accounted for 60% of these injuries. The prognosis for multilevel spine fractures was not significantly worse that that for single-level injuries. PMID:2011766

  7. [Femoral neck fracture].

    PubMed

    Gierer, P; Mittlmeier, T

    2015-03-01

    The incidence of femoral neck fractures increases exponentially with rising age. Young patients are rarely affected but when they are it is mostly due to high energy accidents, whereas older patients suffer from femoral neck fractures by low energy trauma due to osteoporotic changes of the bone mineral density. Treatment options have not essentially changed over the last few years. Non-operative treatment may be a choice in non-dislocated and impacted fractures. Due to the high risk of secondary fracture displacement prophylactic screw osteosynthesis is recommended even in Garden type I fractures. Osteosynthetic fracture stabilization with cannulated screws or angle stable sliding screws, is usually applied in non-displaced fractures and fractures in younger patients. Older patients need rapid mobilization after surgery; therefore, total hip arthroplasty and hemiarthroplasty are commonly used with a low incidence of secondary complications. In addition to sufficient operative treatment a guideline conform osteoprosis therapy should be initiated for the prophylaxis of further fractures and patients should undertake a suitable rehabilitation.

  8. Pathological fractures in children

    PubMed Central

    De Mattos, C. B. R.; Binitie, O.; Dormans, J. P.

    2012-01-01

    Pathological fractures in children can occur as a result of a variety of conditions, ranging from metabolic diseases and infection to tumours. Fractures through benign and malignant bone tumours should be recognised and managed appropriately by the treating orthopaedic surgeon. The most common benign bone tumours that cause pathological fractures in children are unicameral bone cysts, aneurysmal bone cysts, non-ossifying fibromas and fibrous dysplasia. Although pathological fractures through a primary bone malignancy are rare, these should be recognised quickly in order to achieve better outcomes. A thorough history, physical examination and review of plain radiographs are crucial to determine the cause and guide treatment. In most benign cases the fracture will heal and the lesion can be addressed at the time of the fracture, or after the fracture is healed. A step-wise and multidisciplinary approach is necessary in caring for paediatric patients with malignancies. Pathological fractures do not have to be treated by amputation; these fractures can heal and limb salvage can be performed when indicated. PMID:23610658

  9. Fracture detection logging tool

    DOEpatents

    Benzing, William M.

    1992-06-09

    A method and apparatus by which fractured rock formations are identified and their orientation may be determined includes two orthogonal motion sensors which are used in conjunction with a downhole orbital vibrator. The downhole vibrator includes a device for orienting the sensors. The output of the sensors is displayed as a lissajou figure. The shape of the figure changes when a subsurface fracture is encountered in the borehole. The apparatus and method identifies fractures rock formations and enables the azimuthal orientation of the fractures to be determined.

  10. Natural fracture systems studies

    SciTech Connect

    Lorenz, J.C.; Warpinski, N.R.

    1992-09-01

    The objectives of this program are (1) to develop a basinal-analysis methodology for natural fracture exploration and exploitation, and (2) to determine the important characteristics of natural fracture systems for use in completion, stimulation, and production operations. Natural-fracture basinal analysis begins with studies of fractures in outcrop, core and logs in order to determine the type of fracturing and the relationship of the fractures to the lithologic environment. Of particular interest are the regional fracture systems that are pervasive in western US tight sand basins. A Methodology for applying this analysis is being developed, with the goal of providing a structure for rationally characterizing natural fracture systems basin-wide. Such basin-wide characterizations can then be expanded and supplemented locally, at sites where production may be favorable. Initial application of this analysis is to the Piceance basin where there is a wealth of data from the Multiwell Experiment (MWX), DOE cooperative wells, and other basin studies conducted by Sandia, CER Corporation, and the USGS (Lorenz and Finley, 1989, Lorenz et aI., 1989, and Spencer and Keighin, 1984). Such a basinal approach has been capable of explaining the fracture characteristics found throughout the southern part of the Piceance basin and along the Grand Hogback.

  11. Compilation of Physicochemical and Toxicological Information About Hydraulic Fracturing-Related Chemicals (Draft Database)

    EPA Science Inventory

    The purpose of this product is to make accessible the information about the 1,173 hydraulic fracturing-related chemicals that were listed in the external review draft of the Hydraulic Fracturing Drinking Water Assessment that was released recently. The product consists of a serie...

  12. Metasurface external cavity laser

    NASA Astrophysics Data System (ADS)

    Xu, Luyao; Curwen, Christopher A.; Hon, Philip W. C.; Chen, Qi-Sheng; Itoh, Tatsuo; Williams, Benjamin S.

    2015-11-01

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  13. Metasurface external cavity laser

    SciTech Connect

    Xu, Luyao Curwen, Christopher A.; Williams, Benjamin S.; Hon, Philip W. C.; Itoh, Tatsuo; Chen, Qi-Sheng

    2015-11-30

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  14. Pneumothorax complicating isolated clavicle fracture.

    PubMed

    Hani, Redouane; Ennaciri, Badr; Jeddi, Idriss; El Bardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohamed Saleh

    2015-01-01

    Isolated clavicle fractures are among the commonest of traumatic fractures in the emergency department. Complications of isolated clavicle fractures are rare. Pneumothorax has been described as a complication of a fractured clavicle only rarely in English literature. In all the reported cases, the pneumothorax was treated by a thoracostomy and the clavicle fracture was treated conservatively. In our case, the pneumothorax required a chest drain insertion and the clavicle fracture was treated surgically with good result.

  15. Pediatric and adolescent intra-articular fractures of the calcaneus.

    PubMed

    Dudda, Marcel; Kruppa, Christiane; Geßmann, Jan; Seybold, Dominik; Schildhauer, Thomas A

    2013-06-01

    Calcaneal fractures in childhood are very rare, whereas particularly intra-articular displaced fractures are not typical in skeletally immature children. Various techniques of osteosynthesis have been described. This study aimed to determine clinical and radiological outcome after surgical treatment of intraarticular calcaneal fractures. Fourteen intraarticular fractures of the calcaneus were included in this retrospective study. Eleven children (2 girls and 9 boys) aged 6-16 years (average age 11.5 years) underwent surgical treatment. One child sustained a Type II open fracture of both calcanei. All injuries occurred after a high-energy trauma; 3 patients had multiple additional fractures. The clinical and radiological postoperative follow up was an average 44 months. In 4 cases, a reduction through a minimally invasive approach and fixation with K-wires or screws could be achieved. Eleven fractures were treated with open reduction and internal fixation with plate osteosynthesis, K-wires or screws. In one case with open fractures of both heel bones, an additional external fixator was applied. The surgical treatment approach adopted enabled the pre-operative Böhler's angle (average 16°) to be improved to an average 30°. In all cases, except for the patient with open fractures, a good functional result and outcome could be achieved. In calcaneal fractures in childhood, anatomical reduction is the determining factor, as in fractures in adults, whereas the surgical technique seems to have no influence on clinical outcome in children. The wound healing problems that have often been described were not observed in this age group.

  16. Pediatric and Adolescent Intra-Articular Fractures of the Calcaneus

    PubMed Central

    Dudda, Marcel; Kruppa, Christiane; Geßmann, Jan; Seybold, Dominik; Schildhauer, Thomas A.

    2013-01-01

    Calcaneal fractures in childhood are very rare, whereas particularly intra-articular displaced fractures are not typical in skeletally immature children. Various techniques of osteosynthesis have been described. This study aimed to determine clinical and radiological outcome after surgical treatment of intraarticular calcaneal fractures. Fourteen intraarticular fractures of the calcaneus were included in this retrospective study. Eleven children (2 girls and 9 boys) aged 6-16 years (average age 11.5 years) underwent surgical treatment. One child sustained a Type II open fracture of both calcanei. All injuries occurred after a high-energy trauma; 3 patients had multiple additional fractures. The clinical and radiological postoperative follow up was an average 44 months. In 4 cases, a reduction through a minimally invasive approach and fixation with K-wires or screws could be achieved. Eleven fractures were treated with open reduction and internal fixation with plate osteosynthesis, K-wires or screws. In one case with open fractures of both heel bones, an additional external fixator was applied. The surgical treatment approach adopted enabled the pre-operative Böhler’s angle (average 16°) to be improved to an average 30°. In all cases, except for the patient with open fractures, a good functional result and outcome could be achieved. In calcaneal fractures in childhood, anatomical reduction is the determining factor, as in fractures in adults, whereas the surgical technique seems to have no influence on clinical outcome in children. The wound healing problems that have often been described were not observed in this age group. PMID:23888207

  17. Osteosynthesis of fragility fractures.

    PubMed

    Tarantino, Umberto; Iundusi, Riccardo; Lecce, Domenico; Tempesta, Valerio; Perrone, Fabio Luigi; Rao, Cecilia; Cerocchi, Irene; Gasbarra, Elena

    2011-04-01

    The deepening knowledge about bone pathophysiology, together with the development of less invasive bone implants, fitted for the treatment of fragility fractures, the continuous advances in the creation of osteoconductive and osteoinductive biomaterials, the availability of bone active agents, capable of modulating fracture healing, actually represent the orthopaedic "weapons" to improve the surgical outcome and quality of life in patients with osteoporosis.

  18. TIBIAL SHAFT FRACTURES

    PubMed Central

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2015-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures. PMID:27026999

  19. Transphyseal Distal Humerus Fracture.

    PubMed

    Abzug, Joshua; Ho, Christine Ann; Ritzman, Todd F; Brighton, Brian

    2016-01-01

    Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal distal humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.

  20. Diplopia following midfacial fractures.

    PubMed

    al-Qurainy, I A; Stassen, L F; Dutton, G N; Moos, K F; el-Attar, A

    1991-10-01

    Over a period of 2 years, 363 patients who had sustained a total of 438 midfacial fractures due to blunt trauma received a full ophthalmological examination within 1 week of injury. Of these, 72 patients (19.8%) developed diplopia. Diplopia was most common following road traffic accidents (31%) and least common with simple falls (10%). Blow-out fractures of the orbit led to double vision in 58% of cases. Eighty two percent of patients recovered from diplopia within 6 months of injury; only 1 patient required squint surgery for double vision. The principal risk factors for diplopia comprise road traffic accidents, blow-out fractures and comminuted malar fractures. Early surgical reconstruction of midfacial fractures with conservative management of concomitant motility disorders has, in our series, resulted in very few patients having diplopia in the long term. PMID:1742259

  1. Literature: External Forms.

    ERIC Educational Resources Information Center

    Regional Curriculum Project, Atlanta, GA.

    This curriculum guide, developed as part of a total English curriculum for pre-kindergarten through grade 10, suggests that students can best understand literature by understanding its recurring external forms or genres, and includes (1) an overview describing the four literary genres of drama, narrative poetry, narrative fiction, and lyric poetry…

  2. External Environmental Forecast.

    ERIC Educational Resources Information Center

    Lapin, Joel D.

    Representing current viewpoints of academics, futures experts, and social observers, this external environmental forecast presents projections and information of particular relevance to the future of Catonsville Community College. The following topics are examined: (1) population changes and implications for higher education; (2) state and local…

  3. External Otitis (Swimmer's Ear)

    MedlinePlus

    ... drops, keeping water out of the ear, and pain relievers are the most common forms of treatment. External otitis may involve the entire canal, as ... does not allow fungus to grow as well. Treatment of boils depends on ... relievers, such as oxycodone with acetaminophen , can be given ...

  4. The effect of a blast on the mandible and teeth: transverse fractures and their management.

    PubMed

    Shuker, Sabri T

    2008-10-01

    Transverse mandibular fractures caused by blast waves have given us a better understanding of the physical and pathophysiological effects on this anatomical region. The external contour of the mandible, being rounded in parts (en face) and flat in others (lateral) will experience different effects of the blast. Impact of a spherical blast wave will inflict transverse lines of fractures on the mandibular body, and may be associated with transverse shearing of teeth at the cementoenamel junction. Fractures of the mandible caused by blast are different from those in the same region caused by any type of civilian trauma; these are the vertical to the longitudinal axis unlike comminuted fractures caused by shrapnel or bullet injuries. Fractures of the mandibular body by blasts are single or multiple parallel fractures in the lower border, between the apices of the roots and the mandibular lower border. Fractures are broken off by acceleration or deceleration of the blast wave. PMID:18440677

  5. Particle Swarms in Fractures: Open Versus Partially Closed Systems

    NASA Astrophysics Data System (ADS)

    Boomsma, E.; Pyrak-Nolte, L. J.

    2014-12-01

    In the field, fractures may be isolated or connected to fluid reservoirs anywhere along the perimeter of a fracture. These boundaries affect fluid circulation, flow paths and communication with external reservoirs. The transport of drop like collections of colloidal-sized particles (particle swarms) in open and partially closed systems was studied. A uniform aperture synthetic fracture was constructed using two blocks (100 x 100 x 50 mm) of transparent acrylic placed parallel to each other. The fracture was fully submerged a tank filled with 100cSt silicone oil. Fracture apertures were varied from 5-80 mm. Partially closed systems were created by sealing the sides of the fracture with plastic film. The four boundary conditions study were: (Case 1) open, (Case 2) closed on the sides, (Case 3) closed on the bottom, and (Case 4) closed on both the sides and bottom of the fracture. A 15 μL dilute suspension of soda-lime glass particles in oil (2% by mass) were released into the fracture. Particle swarms were illuminated using a green (525 nm) LED array and imaged with a CCD camera. The presence of the additional boundaries modified the speed of the particle swarms (see figure). In Case 1, enhanced swarm transport was observed for a range of apertures, traveling faster than either very small or very large apertures. In Case 2, swarm velocities were enhanced over a larger range of fracture apertures than in any of the other cases. Case 3 shifted the enhanced transport regime to lower apertures and also reduced swarm speed when compared to Case 2. Finally, Case 4 eliminated the enhanced transport regime entirely. Communication between the fluid in the fracture and an external fluid reservoir resulted in enhanced swarm transport in Cases 1-3. The non-rigid nature of a swarm enables drag from the fracture walls to modify the swarm geometry. The particles composing a swarm reorganize in response to the fracture, elongating the swarm and maintaining its density. Unlike a

  6. Holographic Interferometry Applications In External Osteosynthesis

    NASA Astrophysics Data System (ADS)

    Jacquot, P.; Rastogi, P. K.; Pflug, L.

    1985-08-01

    In order to maintain fragments of fractured bones in a state of immobilization, the use of an external rigid frame has proved to be very advantageous. Confronted by contradictory requirements, the conception of external fixation has, however, been a difficult task. The present paper aims to show, through three examples of varied bearings, the interest of holographic interferometry in external osteosynthesis. The first example deals with the mechanical behavior of a key element of the fixation device the ball joint submitted to realistic loads. The last two examples compare two models of ball joints as to their characteristics of rigidity and of resistance to slipping. Whereas in the former case holographic interferometry primarily fulfills the function of a prelude to the modelization work, in the latter cases it serves to formulate an engineering diagnostic. The findings relate to the remarkable elastic behavior of the ball joint, to the effectiveness of a lightened bowl design, and to the fact that cousin models may behave quite differently as to their resistance to slipping rotations of the bar. In comparison with other experimental methods, holographic interferometry appears to be very competitive and result-oriented and, as such, is expected to multiply applications in similar evaluation tasks.

  7. [Surgical treatment of humerus condylar fracture].

    PubMed

    Gorodnichenko, A I; Guseĭnov, T Sh; Uskov, O N

    2014-01-01

    55 patients with intra-articular condyles fractures of humerus were operated in terms 1998 to 2013 year in the Clinic of Traumatology and Orthopedics of the Presidential Administration. All patients were operated by using of perosseous osteosynthesis method with external fixing device design A.I. Gorodnichenko. Indications for osteosynthesis were open and closed fractures of C1,2,3 types accordingly to AO Classification. Closed, atraumatic and reliable fixation of bone fragments intensifies patients faster, improves their life quality, decreases time of hospitalization and minimizes complications rate. Fractures consolidation was achieved in all cases. It was observed such complications as soft tissue inflammatory around shafts in 4 (7.3%) observations. Long-term results were studied in 51 (92.7%) patients including 9 (17.6%) patients with excellent results, 24 (47.1%) patients with good results and 18 (35.3%) patients with satisfactory results. It was not detected unsatisfactory results. The method permits early reconstructive treatment of patients and improves functional results in case of condyles fractures. This preserves active moving function of damaged elbow from the first day after operation and during all period of treatment.

  8. Metatarsal shaft fractures and fractures of the proximal fifth metatarsal.

    PubMed

    Fetzer, Gary B; Wright, Rick W

    2006-01-01

    Metatarsal fractures represent a relatively common injury, especially in athletes. The pertinent anatomy, evaluation, diagnosis, classification, and treatment of acute and chronic (stress) metatarsal shaft fractures are discussed. Fractures of the proximal fifth metatarsal, which are unique and important injuries, are also discussed. Treatment remains relatively straightforward for the traumatic metatarsal injury, whereas traditional stress fractures typically heal with decreased activity. The problematic proximal fifth metatarsal fracture (Jones fracture) frequently requires surgical intervention in patients who want to avoid non-weight-bearing cast immobilization. The authors' current treatment for this fracture includes the option of intramedullary fixation versus cast immobilization.

  9. Externally heated thermal battery

    NASA Astrophysics Data System (ADS)

    Pracchia, Louis; Vetter, Ronald F.; Rosenlof, Darwin

    1991-04-01

    A thermal battery activated by external heat comprising an anode (e.g., composed of a lithium-aluminum alloy), a cathode (e.g., composed of iron disulfide), and an electrolyte (e.g., a lithium chloride-potassium chloride eutectic) with the electrolyte inactive at ambient temperature but activated by melting at a predetermined temperature when exposed to external heating is presented. The battery can be used as a sensor or to ignite pyrotechnic and power electronic devices in a system for reducing the hazard of ordnance exposed to detrimental heating. A particular application is the use of the battery to activate a squib to function in conjunction with one or more other components to vent an ordnance case in order to prevent its explosion in a fire.

  10. Limb salvage talectomy for 3C Gustilo–Anderson fracture

    PubMed Central

    Mohammad, Hasan Raza; Pillai, Anand

    2016-01-01

    Foot fractures vary in severity with complex midfoot fractures having poor morbidity rates and high amputation rates. Complex midfoot fractures are rarely reported since they are uncommon and only treated in specialist centres. Given the important role of the midfoot in foot function, reconstruction is preferable. Soft tissue management on the dorsal aspect of the foot poses further challenges to reconstructive surgeons. We report a case of a 55-year-old woman who sustained an open 3C Gustilo–Anderson fracture that was initially treated with open reduction internal fixation and free flap. She subsequently developed flap and internal fixation failure with osteomyelitis of the talus. We report a good outcome using primary limb shortening with a talectomy, tibiocalcaneal arthrodesis using external fixation and a combination of vancomycin-loaded calcium sulphate and intravenous antibiotics in our patient. PMID:27173882

  11. Periprosthetic patellar fractures.

    PubMed

    Adigweme, Obinna O; Sassoon, Adam A; Langford, Joshua; Haidukewych, George J

    2013-10-01

    Periprosthetic patellar fractures represent a spectrum of injuries to a patient with a total knee arthroplasty. They range in severity from an inconsequential injury, which does not compromise function, to a severely debilitating injury that may require advanced reconstructive measures. This article will outline the epidemiology and risk factors associated with periprosthetic patellar fractures. Treatment options as they relate to injury mechanism, fracture severity, patellar component stability, and remaining bone stock will also be discussed. Finally, a review of the current literature regarding the results of treatment will be presented.

  12. [Wearable Automatic External Defibrillators].

    PubMed

    Luo, Huajie; Luo, Zhangyuan; Jin, Xun; Zhang, Leilei; Wang, Changjin; Zhang, Wenzan; Tu, Quan

    2015-11-01

    Defibrillation is the most effective method of treating ventricular fibrillation(VF), this paper introduces wearable automatic external defibrillators based on embedded system which includes EGG measurements, bioelectrical impedance measurement, discharge defibrillation module, which can automatic identify VF signal, biphasic exponential waveform defibrillation discharge. After verified by animal tests, the device can realize EGG acquisition and automatic identification. After identifying the ventricular fibrillation signal, it can automatic defibrillate to abort ventricular fibrillation and to realize the cardiac electrical cardioversion.

  13. Externally triggered microcapsules

    NASA Technical Reports Server (NTRS)

    Morrison, Dennis R. (Inventor); Mosier, Benjamin (Inventor)

    2011-01-01

    Disclosed are microcapsules comprising a polymer shell enclosing one or more immiscible liquid phases in which a drug or drug precursor are contained in a liquid phase. The microparticles also contain magnetic particles that can be heated by application of an external magnetic field and thus heated to a predetermined Curie temperature. Heating of the particles melts the polymer shell and releases the drug without causing heating of surrounding tissues.

  14. Surgery for scapula process fractures

    PubMed Central

    Anavian, Jack; Wijdicks, Coen A; Schroder, Lisa K; Vang, Sandy

    2009-01-01

    Background Generally, scapula process fractures (coracoid and acromion) have been treated nonoperatively with favorable outcome, with the exception of widely displaced fractures. Very little has been published, however, regarding the operative management of such fractures and the literature that is available involves very few patients. Our hypothesis was that operative treatment of displaced acromion and coracoid fractures is a safe and effective treatment that yields favorable surgical results. Methods We reviewed 26 consecutive patients (27 fractures) treated between 1998 and 2007. Operative indications for these process fractures included either a painful nonunion, a concomitant ipsilateral operative scapula fracture, ≥ 1 cm of displacement on X-ray, or a multiple disruption of the superior shoulder suspensory complex. All patients were followed until they were asymptomatic, displayed radiographic fracture union, and had recovered full motion with no pain. Patients and results 21 males and 5 females, mean age 36 (18–67) years, were included in the study. 18 patients had more than one indication for surgery. Of the 27 fractures, there were 13 acromion fractures and 14 coracoid fractures. 1 patient was treated for both a coracoid and an acromion fracture. Fracture patterns for the acromion included 6 acromion base fractures and 7 fractures distal to the base. Coracoid fracture patterns included 11 coracoid base fractures and 3 fractures distal to the base. Mean follow-up was 11 (2–42) months. All fractures united and all patients had recovered full motion with no pain at the time of final follow-up. 3 patients underwent removal of hardware due to irritation from hardware components that were too prominent. There were no other complications. Interpretation While most acromion and coracoid fractures can be treated nonoperatively with satisfactory results, operative management may be indicated for displaced fractures and double lesions of the superior shoulder

  15. Mechanical Coal-Face Fracturer

    NASA Technical Reports Server (NTRS)

    Collins, E. R., Jr.

    1984-01-01

    Radial points on proposed drill bit take advantage of natural fracture planes of coal. Radial fracture points retracted during drilling and impacted by piston to fracture coal once drilling halts. Group of bits attached to array of pneumatic drivers to fracture large areas of coal face.

  16. [Treatment of metacarpal and phalangeal fractures--a review].

    PubMed

    Zyluk, Andrzej; Budzyński, Tomasz

    2006-01-01

    Isolated fractures of metacarpals and phalanges are the commonest injuries affected upper extremity, which constitute about 10% of skeletal fractures in general. They occur the most frequently in age between 10 and 40, so affect mostly children and young adults. Based no the literature from last two decades, the results of the treatment of these fractures with various methods are presented. Isolated and undisplaced fractures of the metacarpals and phalanges are usually managed conservatively using a plethora of methods of immobilization including elastic bandage, taping with neighbored finger, thermoplastic and plaster of Paris splints. Stable fractures with angular displacement require reduction or not, if dislocation is acceptable. Unstable and axially displaced fractures are usually treated operatively, however there is no enough scientific evidence that this option is more effective. Surgery for these fractures includes percutaneous fixation with K-wires introduced intramedullary or crossed, K-wires fixation with neighbored, unaffected metacarpal bone, open techniques such as lag screws and plates and external fixation. Phalangeal fractures are more frequently treated operatively, since they are commonly believed unstable what may result in malunion. The results of the treatment of fractures of metacarpals and phalanges are generally good, regardless the method which was used. The failures include nonunion, malunion which disturbs hand function or is cosmetically unacceptable, reduction of finger movement, degenerative changes in neighbored joints and algodystrophy. We stress that contemporary literature provides no evidence that either of the methods of the treatment of these fractures is superior, but rather suggests that they are equally effective. Common drawback of the quoted studies is lack of subjective assessment of the dexterity of the hand in daily and professional activity with standardized questionnaires. PMID:17455531

  17. The significance of incomplete skull fracture in the birth injury.

    PubMed

    Oh, Chang Keun; Yoon, Soo Han

    2010-05-01

    Vaginal delivery is accomplished by the force of the labor overcoming the resistance forces of birth canal. During this process, the fetal head passes through the birth canal and the skull receives pressure on the lateral aspect, resulting in molding, the convex shaping of the cranium. Also, the infant's skull is compressed by the mother's pelvic bony structures. These forces may lead to skull fractures and brain injuries. The hypothesis by the authors is that many skull fractures of the newborn present as incomplete fractures. The bony skull of the newborn is histologically primary bone tissue and which is incomplete in its ossification process. During birth the pressure forces upon the newborn's skull is gradual in one direction, rather than a sudden impact, and therefore it is thought that the skull fracture would be an incomplete fracture. However, it is very hard to ascertain the presence of incomplete fractures especially in incompletely ossified skulls with plain X-ray studies, and therefore it is possible that the real incidence of skull fractures in the newborn are higher than reported in the current and past literature. It is also probable that the external forces upon the skull that are sufficient to cause skull fractures, would also lead to significant brain injury more frequently than actually observed, and subsequently contribute to development of many brain disease later in children. The authors of this study propose that very close examination should be conducted to find incomplete fracture, and increased efforts should be made to establish the presence of possible accompanied brain injuries in babies with incomplete skull fracture. The definitive diagnosis and treatment, as well as close follow up of patients with brain injury will assist the clinician in determining the causes of neurological diseases especially in those with previously unknown etiologies, which may be due to birth injuries. Assistance may be also afforded in the early treatment

  18. Ankle fracture - aftercare

    MedlinePlus

    ... that surgery can allow faster and more reliable healing. In children, the fracture involves the part of ... will use a special walking boot as the healing progresses. You will need to learn: How to ...

  19. Fracture Characterization of Meteorites

    NASA Astrophysics Data System (ADS)

    Bryson, K. L.; Agrawal, P.; Ostrowski, D. R.; Sears, D. W. G.

    2015-07-01

    NASA ARC has been tasked with understanding the behavior of ~100m asteroids entering the atmosphere and quantifying the impact hazard. As part of this task, we report the initial results of a survey of the fracture properties of meteorites.

  20. Geothermal Ultrasonic Fracture Imager

    SciTech Connect

    Patterson, Doug; Leggett, Jim

    2013-07-29

    The Geothermal Ultrasonic Fracture Imager project has a goal to develop a wireline ultrasonic imager that is capable of operating in temperatures up to 300°C (572°F) and depths up to 10 km (32,808 ft). This will address one of the critical needs in any EGS development of understanding the hydraulic flow paths in the reservoir. The ultrasonic imaging is well known in the oil and gas industry as one of the best methods for fracture evaluation; providing both high resolution and complete azimuthal coverage of the borehole. This enables fracture detection and characterization, both natural and induced, providing information as to their location, dip direction and dip magnitude. All of these factors are critical to fully understand the fracture system to enable the optimization of the thermal drainage through injectors and producers in a geothermal resource.

  1. Management of condylar fractures.

    PubMed

    Montazem, André H; Anastassov, George

    2009-03-01

    Management of condylar fractures remains a source of ongoing controversy. While it appears that many condylar fractures can be managed nonsurgically, recognition of cases that require surgical intervention and selection of an appropriate procedure are paramount to success in treating these injuries. There are a variety of special considerations that are peculiar to the condylar region. This article discusses anatomic considerations, classification of condylar fractures, indications for surgery, treatment options, and complications. The goals of treatment include restoration of function and esthetics. Careful consideration and attention to the principles of fracture management, and the role of the condyle as an articulating unit and growth center, must be taken into account for the successful management of these injuries.

  2. Etiology of zygomatic fractures.

    PubMed

    Cotter, C J; Ogunbowale, A; Beirne, C

    2005-01-01

    We report on the etiology of zygomatic fractures in an Irish population. More than half of these injuries are related to interpersonal assault. Treatment of these injuries places a considerable burden on the health service. PMID:16445148

  3. Sprains, Strains and Fractures

    MedlinePlus

    ... are useful for finding soft issue injuries (including torn ligaments) and stress fractures. Treatment will depend on ... weeks. Professional athletes may undergo surgery to repair torn ligaments. Oral anti-inflammatory medication, such as ibuprofen, ...

  4. Lisfranc (Midfoot) Fractures

    MedlinePlus

    ... broken or ligaments that support the midfoot are torn. The severity of the injury can vary from ... bones are broken (fractured) or the ligaments are torn (ruptured). Injuries can vary, from a simple injury ...

  5. Clavicle Fracture (Broken Collarbone)

    MedlinePlus

    ... place and the fragments are severely out of alignment. A large bump over the fracture site may ... bone fragments are first repositioned into their normal alignment, and then held in place with special screws ...

  6. Hay balers' fractures.

    PubMed

    Mayba, I I

    1984-03-01

    Two cases of fractures of the sternum and T12 vertebra are presented, which appear to be a characteristic combination of injuries to farmers when hay bales fall on them. The mechanism of injury proposed is a severe forward flexion, producing vertebral collapse at the dorsolumbar junction, and fracture of the sternum from direct trauma against the steering wheel. These fractures should always be suspected in persons injured while baling hay. It is proposed to call this complex of injuries hay balers' fractures. Preventive measures suggested are: operator caution when hay bales are lifted; addition of locks to the loader forks; increasing the size of the loader, or placing a screen or cage over the operators to keep hay bales from falling on them.

  7. Adult orbital trapdoor fracture.

    PubMed

    Kum, Clarissa; McCulley, Timothy J; Yoon, Michael K; Hwang, Thomas N

    2009-01-01

    Trapdoor fractures occur almost exclusively in the pediatric population. The authors describe an adult with an entrapped inferior rectus muscle sheath in a trapdoor fracture. A 37-year-old man presented with persistent diplopia 3 weeks after blunt right orbital trauma. The only abnormal findings on clinical examination were limited vertical ductions. No bony defect or displacement was evident on CT. However, several small pockets of air were visible adjacent to the inferior rectus muscle. On surgical exploration, a linear nondisplaced orbital floor fracture was confirmed, and the entrapped inferior rectus muscle was released. One month postoperatively, extraocular motility had improved with no diplopia in primary or reading positions. This case demonstrates that trapdoor fractures can occur in adults and should be considered when suggestive findings are encountered. Clinicians should be aware of this because timely diagnosis and treatment might achieve more favorable outcomes.

  8. Hay balers' fractures.

    PubMed

    Mayba, I I

    1984-03-01

    Two cases of fractures of the sternum and T12 vertebra are presented, which appear to be a characteristic combination of injuries to farmers when hay bales fall on them. The mechanism of injury proposed is a severe forward flexion, producing vertebral collapse at the dorsolumbar junction, and fracture of the sternum from direct trauma against the steering wheel. These fractures should always be suspected in persons injured while baling hay. It is proposed to call this complex of injuries hay balers' fractures. Preventive measures suggested are: operator caution when hay bales are lifted; addition of locks to the loader forks; increasing the size of the loader, or placing a screen or cage over the operators to keep hay bales from falling on them. PMID:6708148

  9. Relative permeability through fractures

    SciTech Connect

    Diomampo, Gracel, P.

    2001-08-01

    The mechanism of two-phase flow through fractures is of importance in understanding many geologic processes. Currently, two-phase flow through fractures is still poorly understood. In this study, nitrogen-water experiments were done on both smooth and rough parallel plates to determine the governing flow mechanism for fractures and the appropriate methodology for data analysis. The experiments were done using a glass plate to allow visualization of flow. Digital video recording allowed instantaneous measurement of pressure, flow rate and saturation. Saturation was computed using image analysis techniques. The experiments showed that gas and liquid phases flow through fractures in nonuniform separate channels. The localized channels change with time as each phase path undergoes continues breaking and reforming due to invasion of the other phase. The stability of the phase paths is dependent on liquid and gas flow rate ratio. This mechanism holds true for over a range of saturation for both smooth and rough fractures. In imbibition for rough-walled fractures, another mechanism similar to wave-like flow in pipes was also observed. The data from the experiments were analyzed using Darcy's law and using the concept of friction factor and equivalent Reynold's number for two-phase flow. For both smooth- and rough-walled fractures a clear relationship between relative permeability and saturation was seen. The calculated relative permeability curves follow Corey-type behavior and can be modeled using Honarpour expressions. The sum of the relative permeabilities is not equal one, indicating phase interference. The equivalent homogeneous single-phase approach did not give satisfactory representation of flow through fractures. The graphs of experimentally derived friction factor with the modified Reynolds number do not reveal a distinctive linear relationship.

  10. Interlaminar fracture of composites

    NASA Technical Reports Server (NTRS)

    Obrien, T. K.

    1984-01-01

    Fracture mechanics has been found to be a useful tool for understanding composite delamination. Analyses for calculating strain energy release rates associated with delamination growth have been developed. These analyses successfully characterized delamination onset and growth for particular sources of delamination. Low velocity impact has been found to be the most severe source of composite delamination. A variety of test methods for measuring interlaminar fracture toughness are being developed to identify new composite materials with enhanced delamination resistance.

  11. Stress generation and hierarchical fracturing in reactive systems

    NASA Astrophysics Data System (ADS)

    Jamtveit, B.; Iyer, K.; Royne, A.; Malthe-Sorenssen, A.; Mathiesen, J.; Feder, J.

    2007-12-01

    Hierarchical fracture patterns are the result of a slowly driven fracturing process that successively divides the rocks into smaller domains. In quasi-2D systems, such fracture patterns are characterized by four sided domains, and T-junctions where new fractures stop at right angles to pre-existing fractures. We describe fracturing of mm to dm thick enstatite layers in a dunite matrix from the Leka ophiolite complex in Norway. The fracturing process is driven by expansion of the dunite matrix during serpentinization. The cumulative distributions of fracture lengths show a scaling behavior that lies between a log - normal and power law (fractal) distribution. This is consistent with a simple fragmentation model in which domains are divided according to a 'top hat' distribution of new fracture positions within unfractured domains. Reaction-assisted hierarchical fracturing is also likely to be responsible for other (3-D) structures commonly observed in serpentinized ultramafic rocks, including the mesh-textures observed in individual olivine grains, and the high abundance of rectangular domains at a wide range of scales. Spectacular examples of 3-D hierarchical fracture patterns also form during the weathering of basaltic intrusions (dolerites). Incipient chemical weathering of dolerites in the Karoo Basin in South Africa occurs around water- filled fractures, originally produced by thermal contraction or by externally imposed stresses. This chemical weathering causes local expansion of the rock matrix and generates elastic stresses. On a mm to cm scale, these stresses lead to mechanical layer-by-layer spalling, producing the characteristic spheroidal weathering patterns. However, our field observations and computer simulations demonstrate that in confined environments, the spalling process alone is unable to relieve the elastic stresses. In such cases, chemical weathering drives a much larger scale hierarchical fracturing process in which fresh dolerite undergoes a

  12. Treatment of Thoracolumbar Fracture

    PubMed Central

    Kim, Byung-Guk; Shin, Dong-Eun

    2015-01-01

    The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity. PMID:25705347

  13. FRACTURING FLUID CHARACTERIZATION FACILITY

    SciTech Connect

    Subhash Shah

    2000-08-01

    Hydraulic fracturing technology has been successfully applied for well stimulation of low and high permeability reservoirs for numerous years. Treatment optimization and improved economics have always been the key to the success and it is more so when the reservoirs under consideration are marginal. Fluids are widely used for the stimulation of wells. The Fracturing Fluid Characterization Facility (FFCF) has been established to provide the accurate prediction of the behavior of complex fracturing fluids under downhole conditions. The primary focus of the facility is to provide valuable insight into the various mechanisms that govern the flow of fracturing fluids and slurries through hydraulically created fractures. During the time between September 30, 1992, and March 31, 2000, the research efforts were devoted to the areas of fluid rheology, proppant transport, proppant flowback, dynamic fluid loss, perforation pressure losses, and frictional pressure losses. In this regard, a unique above-the-ground fracture simulator was designed and constructed at the FFCF, labeled ''The High Pressure Simulator'' (HPS). The FFCF is now available to industry for characterizing and understanding the behavior of complex fluid systems. To better reflect and encompass the broad spectrum of the petroleum industry, the FFCF now operates under a new name of ''The Well Construction Technology Center'' (WCTC). This report documents the summary of the activities performed during 1992-2000 at the FFCF.

  14. Fracture toughness of graphene.

    PubMed

    Zhang, Peng; Ma, Lulu; Fan, Feifei; Zeng, Zhi; Peng, Cheng; Loya, Phillip E; Liu, Zheng; Gong, Yongji; Zhang, Jiangnan; Zhang, Xingxiang; Ajayan, Pulickel M; Zhu, Ting; Lou, Jun

    2014-04-29

    Perfect graphene is believed to be the strongest material. However, the useful strength of large-area graphene with engineering relevance is usually determined by its fracture toughness, rather than the intrinsic strength that governs a uniform breaking of atomic bonds in perfect graphene. To date, the fracture toughness of graphene has not been measured. Here we report an in situ tensile testing of suspended graphene using a nanomechanical device in a scanning electron microscope. During tensile loading, the pre-cracked graphene sample fractures in a brittle manner with sharp edges, at a breaking stress substantially lower than the intrinsic strength of graphene. Our combined experiment and modelling verify the applicability of the classic Griffith theory of brittle fracture to graphene. The fracture toughness of graphene is measured as the critical stress intensity factor of and the equivalent critical strain energy release rate of 15.9 J m(-2). Our work quantifies the essential fracture properties of graphene and provides mechanistic insights into the mechanical failure of graphene.

  15. Subduction of fracture zones

    NASA Astrophysics Data System (ADS)

    Constantin Manea, Vlad; Gerya, Taras; Manea, Marina; Zhu, Guizhi; Leeman, William

    2013-04-01

    Since Wilson proposed in 1965 the existence of a new class of faults on the ocean floor, namely transform faults, the geodynamic effects and importance of fracture zone subduction is still little studied. It is known that oceanic plates are characterized by numerous fracture zones, and some of them have the potential to transport into subduction zones large volumes of water-rich serpentinite, providing a fertile water source for magma generated in subduction-related arc volcanoes. In most previous geodynamic studies, subducting plates are considered to be homogeneous, and there is no clear indication how the subduction of a fracture zone influences the melting pattern in the mantle wedge and the slab-derived fluids distribution in the subarc mantle. Here we show that subduction of serpentinized fracture zones plays a significant role in distribution of melt and fluids in the mantle wedge above the slab. Using high-resolution tree-dimensional coupled petrological-termomechanical simulations of subduction, we show that fluids, including melts and water, vary dramatically in the region where a serpentinized fracture zone enters into subduction. Our models show that substantial hydration and partial melting tend to concentrate where fracture zones are being subducted, creating favorable conditions for partially molten hydrous plumes to develop. These results are consistent with the along-arc variability in magma source compositions and processes in several regions, as the Aleutian Arc, the Cascades, the Southern Mexican Volcanic Arc, and the Andean Southern Volcanic Zone.

  16. Distinct frequency dependent effects of whole-body vibration on non-fractured bone and fracture healing in mice.

    PubMed

    Wehrle, Esther; Wehner, Tim; Heilmann, Aline; Bindl, Ronny; Claes, Lutz; Jakob, Franz; Amling, Michael; Ignatius, Anita

    2014-08-01

    Low-magnitude high-frequency vibration (LMHFV) provokes anabolic effects in non-fractured bone; however, in fracture healing, inconsistent results were reported and optimum vibration conditions remain unidentified. Here, we investigated frequency dependent effects of LMHFV on fracture healing. Twelve-week-old, female C57BL/6 mice received a femur osteotomy stabilized using an external fixator. The mice received whole-body vibrations (20 min/day) with 0.3g peak-to-peak acceleration and a frequency of either 35 or 45 Hz. After 10 and 21 days, the osteotomized femurs and intact bones (contra-lateral femurs, lumbar spine) were evaluated using bending-testing, µ-computed tomography, and histomorphometry. In non-fractured trabecular bone, vibration with 35 Hz significantly increased the relative amount of bone (+28%) and the trabecular number (+29%), whereas cortical bone was not influenced. LMHFV with 45 Hz failed to provoke anabolic effects in trabecular or cortical bone. Fracture healing was not significantly influenced by whole-body vibration with 35 Hz, whereas 45 Hz significantly reduced bone formation (-64%) and flexural rigidity (-34%) of the callus. Although the exact mechanisms remain open, our results suggest that small vibration setting changes could considerably influence LMHFV effects on bone formation in remodeling and repair, and even disrupt fracture healing, implicating caution when treating patients with impaired fracture healing.

  17. Management of malunited mandibular condylar fractures.

    PubMed

    Rubens, B C; Stoelinga, P J; Weaver, T J; Blijdorp, P A

    1990-02-01

    The non-surgical treatment of mandibular condylar fractures, may occasionally result in articular imbalance and temporomandibular joint dysfunction. This may be attributed to condylar head displacement and resorption, resulting in a shortened vertical ramus and lost posterior vertical facial height. Restoring the vertical ramus height is essential in the treatment of such dysfunction, and may be accomplished by unilateral, or bilateral ramus osteotomies. Four examples of patients treated with mandibular ramus osteotomies to restore vertical ramus height, with subsequent improvement in occlusal balance and function are presented. The use of the sagittal split mandibular osteotomy and the external vertical ramus osteotomy, stabilized with small osseous plates, and monocortical screws, is discussed.

  18. Treatment of fractures of the tibial and/or fibular malleoli in 30 cats.

    PubMed

    Roch, S P; Störk, C K; Gemmill, T J; Downes, C; Pink, J; McKee, W M

    2009-08-01

    Five cats were treated for a fracture of the medial malleolus, 10 for a fracture of the lateral malleolus and 15 for fractures of both malleoli. Open reduction and internal fixation with Kirschner wires (K-wires) with or without a tension band wire was applied to 26 of the fractures. Unilateral-uniplanar or bilateral-uniplanar transarticular external skeletal fixators were applied to provide coaptation in 19 cases and appeared to be well tolerated. In 24 cases fracture healing was assessed radiographically between four and eight weeks after treatment. In seven cases fracture healing was good, in 12 cases it was reasonable, in four cases it was poor and in one case with two fractures healing was poor in one and reasonable in the other. The 12 fractures treated by open reduction and internal fixation with K-wires and a tension band wire all showed evidence of good or reasonable healing. The nine fractures treated by open reduction and internal fixation with K-wires without a tension band wire showed evidence of good or reasonable healing in six cases and poor healing in three cases. Complications occurred in nine of the cats and included persistent talocrural instability, soft tissue necrosis, implant migration and external fixator pin breakage. Twenty-one of the cats were followed up by telephone questionnaire for between 5.5 and 84 months; the owner satisfaction was excellent in 17 cases, good in two cases, moderate in one case and poor in one case. PMID:19666914

  19. External split field generator

    DOEpatents

    Thundat, Thomas George; Van Neste, Charles W.; Vass, Arpad Alexander

    2012-02-21

    A generator includes a coil disposed about a core. A first stationary magnetic field source may be disposed on a first end portion of the core and a second stationary magnetic field source may be disposed on a second end portion of core. The first and second stationary magnetic field sources apply a stationary magnetic field to the coil. An external magnetic field source may be disposed outside the coil to apply a moving magnetic field to the coil. Electrical energy is generated in response to an interaction between the coil, the moving magnetic field, and the stationary magnetic field.

  20. DIRBE External Calibrator (DEC)

    NASA Technical Reports Server (NTRS)

    Wyatt, Clair L.; Thurgood, V. Alan; Allred, Glenn D.

    1987-01-01

    Under NASA Contract No. NAS5-28185, the Center for Space Engineering at Utah State University has produced a calibration instrument for the Diffuse Infrared Background Experiment (DIRBE). DIRBE is one of the instruments aboard the Cosmic Background Experiment Observatory (COBE). The calibration instrument is referred to as the DEC (Dirbe External Calibrator). DEC produces a steerable, infrared beam of controlled spectral content and intensity and with selectable point source or diffuse source characteristics, that can be directed into the DIRBE to map fields and determine response characteristics. This report discusses the design of the DEC instrument, its operation and characteristics, and provides an analysis of the systems capabilities and performance.

  1. Membranebioreactor with external membranes.

    PubMed

    Jonkers, C; Carrette, R; De Lathouwer, J; Thoeye, C

    2001-01-01

    The recent development of less expensive and more performant ultrafiltration membranes has generated a new concept in biological treatment known as membrane bioreactors (MBR). In the field of wastewater treatment, the MBR process is used as a modification of the conventional activated sludge (CAS) process, where the clarifier is replaced by a membrane module for the separation of the solid and the liquid phase. Membrane technology can, amongst others, be applied for the fast retrofit of relatively high loaded activated sludge systems to nutrient removal. In the last year Aquafin has built up extensive experience with submerged membrane systems. The research presented here was aimed at evaluating a particular external tubular membrane unit for MBR. More specifically it was evaluated whether higher stable flux levels could compensate the higher energy consumption, typical for external membrane systems. Both (1) treatment performance and (2) possible operational drawbacks were tested on a 5 m3/h activated sludge pilot-scale. The membrane bioreactor was tested in parallel with a conventional activated sludge system.

  2. Bilateral Galeazzi fracture-dislocations: a case report of early rehabilitation.

    PubMed

    Komura, Shingo; Nonomura, Hidehiko; Satake, Takashi; Yokoi, Tatsuo

    2012-08-01

    A 24-year-old man had bilateral Galeazzi fracture-dislocations due to a motorcycle accident. The right radius fracture was a simple fracture and was fixed with a limited contact dynamic compression plate. The left radius fracture was a comminuted fracture and was fixed with a long locking compression plate in the bridging plate fashion while maintaining reduction with a temporary external fixator. Postoperative computed tomography under passive rotation of both forearms showed acceptable congruency of the distal radioulnar joints, and early rehabilitation of forearm rotation was started at 2 weeks after the operation. At 13-month follow-up, bone union of both fractures was achieved, and forearm motion was almost restored to normal. Moreover, no subluxation or dislocation of either distal radioulnar joint was observed.

  3. Diagnosis, treatment, and rehabilitation of stress fractures in the lower extremity in runners

    PubMed Central

    Kahanov, Leamor; Eberman, Lindsey E; Games, Kenneth E; Wasik, Mitch

    2015-01-01

    Stress fractures account for between 1% and 20% of athletic injuries, with 80% of stress fractures in the lower extremity. Stress fractures of the lower extremity are common injuries among individuals who participate in endurance, high load-bearing activities such as running, military and aerobic exercise and therefore require practitioner expertise in diagnosis and management. Accurate diagnosis for stress fractures is dependent on the anatomical area. Anatomical regions such as the pelvis, sacrum, and metatarsals offer challenges due to difficulty differentiating pathologies with common symptoms. Special tests and treatment regimes, however, are similar among most stress fractures with resolution between 4 weeks to a year. The most difficult aspect of stress fracture treatment entails mitigating internal and external risk factors. Practitioners should address ongoing risk factors to minimize recurrence. PMID:25848327

  4. Ischial Tuberosity Avulsion Stress Fracture after Short Period of Repetitive Training

    PubMed Central

    Yang, Bo-Kyu; Ahn, Young-Joon; Im, Se-Hyuk; Park, Sang-Hyun

    2016-01-01

    Fatigue fracture of the pelvis is the form of fracture due to repetitive micro-stress accumulation, can be affected by a number of factors such as patient's nutritional status, biomechanics, social status and so on. Still there is no study about precise standard degree of external force that lead to stress fracture, but it may caused by compression force, traction force or complex force and others. Avulsion stress to ischial tuberosity or anterior superior iliac spine by attached muscle is known as the main factor for the avulsion fracture. This report will deal with 19 years old conscripted policeman who occurred ischial tuberosity avulsion fracture after training of 6-hour running for 5 days accompanying hip hyper-flexion motion. This reports aims to provide case study of stress fracture occurred after 5 days of exercise which is relatively short period who had no specific trauma history or pain. PMID:27777924

  5. Reverse Total Shoulder Arthroplasty for a 4-Part Proximal Humerus Fracture.

    PubMed

    Stahl, Dan; Fuente, Guadalupe de la

    2016-08-01

    Proximal humerus fractures account for approximately 5% of all fractures and they are the third most common fracture seen in the elderly population. Complex fracture patterns, including 3-parts and 4-parts, have traditionally been amendable to shoulder hemiarthroplasty. However, several limiting factors, including poor patient satisfaction and low functional outcomes have guided further exploration for other treatment options. Reverse shoulder arthroplasty (RSA) has began to expand its traditional indications of rotator cuff arthropathy, massive rotator cuff tears, failed shoulder arthroplasties, and proximal humerus fracture sequelae. Overall, consistently improved functional outcomes are reported in RSA studies, including an increased postoperative range of motion, specifically external rotation. RSA has began to have a clinically significant role in the management of acute, complex proximal humerus fractures. Our video demonstrates the key features associated with positive patient outcomes, concluding with postoperative clinical videos. PMID:27441943

  6. Thrower's fracture of the humerus.

    PubMed

    Miller, Andrew; Dodson, Christopher C; Ilyas, Asif M

    2014-10-01

    Thrower's fractures are spiral fractures of the humerus caused by forceful throwing of a ball. Although these fractures have been cited in the literature, little research exists regarding the significance of stress fractures and fatigue injuries that may precede these injuries. This article presents 3 cases of middle-aged recreational baseball pitchers who sustained mid to distal third spiral humerus fractures, reviews the biomechanics of a thrower's fracture, and provides a detailed review of the literature to help better understand this condition and guide treatment.

  7. Pelvic Insufficiency Fractures

    PubMed Central

    O’Connor, Timothy J.

    2014-01-01

    Pelvic insufficiency fractures may occur in the absence of trauma or as a result of low-energy trauma in osteoporotic bone. With a growing geriatric population, the incidence of pelvic insufficiency fracture has increased over the last 3 decades and will continue to do so. These fractures can cause considerable pain, loss of independence, and economic burden to both the patient and the health care system. While many of these injuries are identified and treated based on plain radiographs, some remain difficult to diagnose. The role of advanced imaging in these cases is discussed. In addition to treating the fracture, medical comorbidities contributing to osteoporosis should be identified and corrected. Specific attention has been given to 25-OH serum vitamin D screening and repletion. Treatment generally consists of providing pain control and assisting patients with mobilization while allowing weight bearing as tolerated. In those unable to do so, invasive techniques such as sacroplasty as well as internal fixation may be beneficial. The role of operative fixation in insufficiency fractures is also discussed. PMID:26246940

  8. Frontal bone fractures.

    PubMed

    Marinheiro, Bruno Henrique; de Medeiros, Eduardo Henrique Pantosso; Sverzut, Cássio Edvard; Trivellato, Alexandre Elias

    2014-11-01

    The aim of this retrospective study was to evaluate the epidemiology, treatment, and complications of frontal bone fractures associated, or not, with other facial fractures. This evaluation also sought to minimize the influence of the surgeon's skills and the preference for any rigid internal fixation system. The files from 3758 patients who attended the Oral and Maxillofacial Surgery Department of the School of Dentistry of Ribeirao Preto, University of Sao Paulo, from March 2004 to November 2011 and presented with facial trauma were scanned, and 52 files were chosen for the review. Eleven (21.15%) of these patients had pure fractures of the frontal bone, and trauma incidence was more prevalent in men (92.3%), whites (61.53%), and adults (50%). Despite the use of helmets at the moment of the trauma, motorcycle crashes were the most common etiological factor (32.69%). Fracture of the anterior wall of the frontal sinus with displacement was the main injury observed (54.9%), and the most common treatment was internal fixation with a plate and screws (45.09%). Postoperative complications were observed in 35.29% of the cases. The therapy applied was effective in handling this type of fracture, and the success rate was comparable to that reported in other published studies. PMID:25377971

  9. Advantages and disadvantages of pinless external fixation.

    PubMed

    Thomas, S R; Giele, H; Simpson, A H

    2000-12-01

    The AO pinless external fixator (PEF) uses trocar tipped clamps to grip the outer tibial cortex rather than pins to transfix it. Its main advantage is to avoid further contamination of the medullary canal in open tibial fractures where a nail may subsequently be used. We tested the anatomical safety of this device and its effect on plastic surgical procedures compared with a standard unilateral external fixator (UEF).The PEF and UEF were placed on two amputated limbs which were then dissected. Structures at risk were traced on ten cadaver limbs. We found that important anatomical structures were endangered by the PEF and that safe zones could not always be defined. The UEF avoided these structures. Plastic surgical approaches were made more difficult by the PEF which imposed limitations on local flap design and endangered the arterial perforators which supply them. We conclude that safety is compromised by the PEF because margins for error are small. It poses additional problems in soft tissue reconstruction and highlights the need for co-operation between plastic surgical and orthopaedic teams in choice of fixation device.

  10. Imaging 3D strain field monitoring during hydraulic fracturing processes

    NASA Astrophysics Data System (ADS)

    Chen, Rongzhang; Zaghloul, Mohamed A. S.; Yan, Aidong; Li, Shuo; Lu, Guanyi; Ames, Brandon C.; Zolfaghari, Navid; Bunger, Andrew P.; Li, Ming-Jun; Chen, Kevin P.

    2016-05-01

    In this paper, we present a distributed fiber optic sensing scheme to study 3D strain fields inside concrete cubes during hydraulic fracturing process. Optical fibers embedded in concrete were used to monitor 3D strain field build-up with external hydraulic pressures. High spatial resolution strain fields were interrogated by the in-fiber Rayleigh backscattering with 1-cm spatial resolution using optical frequency domain reflectometry. The fiber optics sensor scheme presented in this paper provides scientists and engineers a unique laboratory tool to understand the hydraulic fracturing processes in various rock formations and its impacts to environments.

  11. Bevalac external beamline optics

    SciTech Connect

    Kalnins, J.G.; Krebs, G.F.; Tekawa, M.M.; Alonso, J.R.

    1987-04-01

    This handbook is intended as an aid for tuning the external particle beam (EPB) lines at the Lawrence Berkeley Laboratory's Bevalac. The information contained within will be useful to the Bevalac's Main Control Room and experimenters alike. First, some general information is given concerning the EPB lines and beam optics. Next, each beam line is described in detail: schematics of the beam line components are shown, all the variables required to run a beam transport program are presented, beam envelopes are given with wire chamber pictures and magnet currents, focal points and magnifications. Some preliminary scaling factors are then presented which should aid in choosing a given EPB magnet's current for a given central Bevalac field. Finally, some tuning hints are suggested.

  12. External Tank Assembly

    NASA Technical Reports Server (NTRS)

    1977-01-01

    This photograph shows the liquid hydrogen tank and liquid oxygen tank for the Space Shuttle external tank (ET) being assembled in the weld assembly area of the Michoud Assembly Facility (MAF). The ET provides liquid hydrogen and liquid oxygen to the Shuttle's three main engines during the first eight 8.5 minutes of flight. At 154-feet long and more than 27-feet in diameter, the ET is the largest component of the Space Shuttle, the structural backbone of the entire Shuttle system, and the only part of the vehicle that is not reusable. The ET is manufactured at the Michoud Assembly Facility near New Orleans, Louisiana, by the Martin Marietta Corporation under management of the Marshall Space Flight Center.

  13. Automated external defibrillators (AEDs).

    PubMed

    2003-06-01

    Automated external defibrillators, or AEDs, will automatically analyze a patient's ECG and, if needed, deliver a defibrillating shock to the heart. We sometimes refer to these devices as AED-only devices or stand-alone AEDs. The basic function of AEDs is similar to that of defibrillator/monitors, but AEDs lack their advanced capabilities and generally don't allow manual defibrillation. A device that functions strictly as an AED is intended to be used by basic users only. Such devices are often referred to as public access defibrillators. In this Evaluation, we present our findings for a newly evaluated model, the Zoll AED Plus. We also summarize our findings for the previously evaluated model that is still on the market and describe other AEDs that are also available but that we haven't evaluated. We rate the models collectively for first-responder use and public access defibrillation (PAD) applications.

  14. External Measures of Cognition

    PubMed Central

    Cairό, Osvaldo

    2011-01-01

    The human brain is undoubtedly the most impressive, complex, and intricate organ that has evolved over time. It is also probably the least understood, and for that reason, the one that is currently attracting the most attention. In fact, the number of comparative analyses that focus on the evolution of brain size in Homo sapiens and other species has increased dramatically in recent years. In neuroscience, no other issue has generated so much interest and been the topic of so many heated debates as the difference in brain size between socially defined population groups, both its connotations and implications. For over a century, external measures of cognition have been related to intelligence. However, it is still unclear whether these measures actually correspond to cognitive abilities. In summary, this paper must be reviewed with this premise in mind. PMID:22065955

  15. External Community Review Committee:

    PubMed Central

    Smith, Maureen A.; Kaufman, Nancy J.; Dearlove, Andrea J.

    2013-01-01

    Background: Major gaps exist between what we know and what we do in clinical practice and community health programs and narrowing this gap will require substantive partnerships between academic researchers and the communities they serve. Objectives: We describe a research pilot award program that makes a unique commitment to community engagement through the addition of an External Community Review Committee to the typical research review process that gives external stakeholders decision-making power over research funding. Methods: Whereas engaging community reviewers in discussion and rating of research proposals is not novel, the ICTR ECRC review process is distinct in that it is subsequent to peer review and uses different criteria and methodology. This method of engagement allows for the community review panel to re-rank scientifically meritorious proposals—such that proposals funded do not necessarily follow the rank order from scientific peer review. The approach taken by UW ICTR differs from those discussed in the literature that present a model of community-academic co-review. Results: This article provides guidance for others interested in this model of community engagement and reviews insights gained during the evolution of this strategy; including how we addressed conflict, how the committee was able to change the pilot award program over time, and individual roles that were crucial to the success of this approach. Conclusions: The advantages of this approach include success through traditional academic metrics while achieving an innovative shared-power mechanism for community engagement which we believe is critical for narrowing the gap between knowledge and practice.

  16. Fracture-Flow-Enhanced Solute Diffusion into Fractured Rock

    SciTech Connect

    Wu, Yu-Shu; Ye, Ming; Sudicky, E.A.

    2007-12-15

    We propose a new conceptual model of fracture-flow-enhanced matrix diffusion, which correlates with fracture-flow velocity, i.e., matrix diffusion enhancement induced by rapid fluid flow within fractures. According to the boundary-layer or film theory, fracture flow enhanced matrix diffusion may dominate mass-transfer processes at fracture-matrix interfaces, because rapid flow along fractures results in large velocity and concentration gradients at and near fracture-matrix interfaces, enhancing matrix diffusion at matrix surfaces. In this paper, we present a new formulation of the conceptual model for enhanced fracture-matrix diffusion, and its implementation is discussed using existing analytical solutions and numerical models. In addition, we use the enhanced matrix diffusion concept to analyze laboratory experimental results from nonreactive and reactive tracer breakthrough tests, in an effort to validate the new conceptual model.

  17. Fracture Genesis and Fracture Filling In Hydrate Systems

    NASA Astrophysics Data System (ADS)

    Daigle, H.; Dugan, B.

    2009-12-01

    Steady-state models of coupled flow through fractures and porous media predict that millions of years are required to accumulate the very high hydrate saturation (>50%) necessary to form hydraulic fractures by fluid pressure buildup; however, once a fracture system is formed, it will fill with hydrate in roughly 15 kyr. This modeling is a first step towards understanding heterogeneous, fracture-hosted methane hydrate deposits that have been observed in marine hydrate systems worldwide. In fine-grained sediments, methane hydrate is frequently observed in pores as well as in veins and fractures. One possible explanation is hydrate forms in pores and fluid pressure increases until fractures form. Fluid then flows through the fractures and forms hydrate-filled fractures. To study this, we ran 1-D numerical simulations with a prescribed flow rate of methane-charged fluid through a porous medium. As hydrate forms, pores are occluded and permeability is reduced, causing an increase in fluid pressure to maintain the constant flow rate. We assume that hydraulic fractures form when the fluid pressure reaches 90% of the overburden stress. Simulations of Blake Ridge (offshore South Carolina) indicate that fractures occur after 7.4 million years with a hydrate saturation (Sh) of 95% at the base of the methane hydrate stability zone (MHSZ). Simulations of Keathley Canyon (Gulf of Mexico) achieve the fracture criterion after 7.9 million years with Sh = 54% at the base of the MHSZ. Once fractures are formed they fill with hydrate after 15,000 years. Our results indicate that the time scale of pressure buildup assuming present-day fluxes is very long, and that lower-permeability sediments require lower hydrate saturations to reach the fracture criterion. However, once fractures form, they are filled with hydrate rapidly. This suggests that fractures may provide short-term migration pathways between higher-permeability layers, but also that additional research is needed to constrain

  18. Estimating fracture geometry in the naturally fractured Antrim Shale

    SciTech Connect

    Hopkins, C.W.; Frantz, J.H. Jr.; Hill, D.G.

    1995-12-31

    The Antrim Shale of the Michigan Basin has been an active gas play with over 3,500 wells drilled over the last 5 years. There is substantial evidence that the Antrim must be fracture stimulated to be economical and that two-stage treatments provide the best results. However, due to the shallow depths (500-2300 ft) and naturally fractured nature of the Antrim, fracture geometry is complex, and determination of optimal fracture treatments is not straight forward. Because historical field comparisons did not provide insight on the optimal fracture treatments, the Gas Research Institute (GRI) instituted a field-based project for the specific purpose of evaluating the geometry of hydraulic fractures in the Antrim. Open- and cased-hole tests were performed on two separate Antrim wells - a shallow producer (600 {+-} ft) and a deep producer (1550 {+-} ft). Open-hole testing and data collection consisted of in-situ stress and mechanical property testing with Halliburton`s THE{trademark} Tool (9 tests) and a detailed suite of geophysical logs including dipole sonic logs and natural fracture detection logs. Cased-hole testing consisted of pre- and post-fracture injection/falloff tests, minifracture treatments, multiple isotope tracer and tracer logs, and treating pressure and production data analysis. The shallow depths, low in-situ stresses, and extremely fractured nature of the Antrim probably results in the preferential opening of existing fractures instead of the creation of new fracture planes. As a result, the creation of multiple fractures and severe near wellbore tortuosity is likely. Therefore, the natural fractures are responsible for increased leakoff and will greatly impact created fracture geometry. The results also suggest that creating long propped hydraulic fractures in the Antrim is not likely due to the creation of multiple fractures.

  19. Treatment of Clavicle Fractures

    PubMed Central

    Paladini, P; Pellegrini, A; Merolla, G; Campi, F; Porcellini, G

    2012-01-01

    Summary Clavicle fractures are very common injuries in adults (2–5%) and children (10–15%) (1) and represent the 44–66% of all shoulder fractures (2). Despite the high frequency the choice of proper treatment is still a challenge for the orthopedic surgeon. With this review we wants to focus the attention on the basic epidemiology, anatomy, classification, evaluation and management of surgical treatments in relationship with the gravity of injuries. Both conservative and surgical management are possible, and surgeons must choose the most appropriate management modality according to the biologic age, functional demands, and type of lesion. We performed a review of the English literature thought PubMed to produce an evidence-based review of current concept and management of clavicle fracture. We finished taking a comparison with our survey in order to underline our direct experience. PMID:23905044

  20. Pediatric foot fractures.

    PubMed

    Ribbans, William J; Natarajan, Ramanathan; Alavala, Sairam

    2005-03-01

    Fractures of the foot in children usually have a good prognosis and generally are treated nonoperatively. Displaced fractures of the talus and calcaneus and tarsometatarsal dislocations are rare in children and their outcome is generally good in the younger child. Older adolescents with these injuries need treatment similar to how an adult would be treated for the same injury in order to achieve a good result. Foot fractures in children may pose a diagnostic challenge particularly in the absence of obvious radiographic changes. Repeated clinical examination and judicious use of imaging techniques such as isotope bone scans and magnetic resonance imaging are needed to establish a diagnosis. Knowledge of the anatomy and significance of accessory bones of the foot and disorders of the growing foot skeleton are helpful in managing injuries of child's foot. In this study, we review common injuries of a child's foot and include a discussion on differential diagnosis.

  1. DEM Particle Fracture Model

    SciTech Connect

    Zhang, Boning; Herbold, Eric B.; Homel, Michael A.; Regueiro, Richard A.

    2015-12-01

    An adaptive particle fracture model in poly-ellipsoidal Discrete Element Method is developed. The poly-ellipsoidal particle will break into several sub-poly-ellipsoids by Hoek-Brown fracture criterion based on continuum stress and the maximum tensile stress in contacts. Also Weibull theory is introduced to consider the statistics and size effects on particle strength. Finally, high strain-rate split Hopkinson pressure bar experiment of silica sand is simulated using this newly developed model. Comparisons with experiments show that our particle fracture model can capture the mechanical behavior of this experiment very well, both in stress-strain response and particle size redistribution. The effects of density and packings o the samples are also studied in numerical examples.

  2. Fracking, fracture, and permeability

    NASA Astrophysics Data System (ADS)

    Turcotte, D. L.; Norris, J.; Rundle, J. B.

    2013-12-01

    Injections of large volumes of water into tight shale reservoirs allows the extraction of oil and gas not previously accessible. This large volume 'super' fracking induces damage that allows the oil and/or gas to flow to an extraction well. The purpose of this paper is to provide a model for understanding super fracking. We assume that water is injected from a small spherical cavity into a homogeneous elastic medium. The high pressure of the injected water generates hoop stresses that reactivate natural fractures in the tight shales. These fractures migrate outward as water is added creating a spherical shell of damaged rock. The porosity associated with these fractures is equal to the water volume injected. We obtain an analytic expression for this volume. We apply our model to a typical tight shale reservoir and show that the predicted water volumes are in good agreement with the volumes used in super fracking.

  3. Semiautomatic fracture zone tracking

    NASA Astrophysics Data System (ADS)

    Wessel, Paul; Matthews, Kara J.; Müller, R. Dietmar; Mazzoni, Aline; Whittaker, Joanne M.; Myhill, Robert; Chandler, Michael T.

    2015-07-01

    Oceanic fracture zone traces are widely used in studies of seafloor morphology and plate kinematics. Satellite altimetry missions have resulted in high-resolution gravity maps in which all major fracture zones and other tectonic fabric can be identified, and numerous scientists have digitized such lineaments. We have initiated a community effort to maintain low-cost infrastructure that allows seafloor fabric lineaments to be stored, accessed, and updated. A key improvement over past efforts is our processing software (released as a GMT5 supplement) that allows for semiautomatic corrections to previously digitized fracture zone traces given improved gridded data sets. Here we report on our seafloor fabric processing tools, which complement our database of seafloor fabric lineations, magnetic anomaly identifications, and plate kinematic models.

  4. Talar neck fractures.

    PubMed

    Berlet, G C; Lee, T H; Massa, E G

    2001-01-01

    Clinical management of talar neck fractures is complex and fraught with complications. As Gaius Julius Caesar stated: "The die is cast"; often the outcome of a talar neck fracture is determined at the time of injury. The authors believe, however, that better results can be achieved by following some simple guidelines. The authors advocate prompt and precise anatomic surgical reduction, preferring the medial approach with secondary anterolateral approach. Preservation of blood supply can be achieved by a thorough understanding of vascular pathways and efforts to stay within appropriate surgical intervals. The authors advocate bone grafting of medial neck comminution (if present) to prevent varus malalignment and rigid internal fixation to allow for joint mobilization postoperatively. These guidelines may seem simple, but when dealing with the complexity of talar neck fractures, the foot and ankle surgeon needs to focus and rely on easily grasped concepts to reduce poor outcomes. PMID:11465133

  5. [Supracondylar fractures in children].

    PubMed

    Petrov, N; Gucev, S; Kirkov, Lj; Dajljevik, S; Ruso, B

    1982-01-01

    In the Department of Pediatric surgery, during the last ten years, 190 patients with supracondylar fractures (second and third degree, according to Bauman's classification) have been treated. The operation was performed in only 5% of all hospitalized cases. There were only one patient with neurological and vascular complications in the early stage, but without any complications in the late stage. The presented cases showed a high percentage of flexion type of fractures. The conservative treatment by a reposition has given the most satisfactory results.

  6. Complications of mandibular fractures.

    PubMed

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  7. Fractured Petroleum Reservoirs

    SciTech Connect

    Firoozabadi, Dr. Abbas

    2000-01-18

    In this report the results of experiments of water injection in fractured porous media comprising a number of water-wet matrix blocks are reported for the first time. The blocks experience an advancing fracture-water level (FWL). Immersion-type experiments are performed for comparison; the dominant recovery mechanism changed from co-current to counter-current imbibition when the boundary conditions changed from advancing FWL to immersion-type. Single block experiments of co-current and counter-current imbibition was performed and co-current imbibition leads to more efficient recovery was found.

  8. Pediatric Orbital Fractures

    PubMed Central

    Oppenheimer, Adam J.; Monson, Laura A.; Buchman, Steven R.

    2013-01-01

    It is wise to recall the dictum “children are not small adults” when managing pediatric orbital fractures. In a child, the craniofacial skeleton undergoes significant changes in size, shape, and proportion as it grows into maturity. Accordingly, the craniomaxillofacial surgeon must select an appropriate treatment strategy that considers both the nature of the injury and the child's stage of growth. The following review will discuss the management of pediatric orbital fractures, with an emphasis on clinically oriented anatomy and development. PMID:24436730

  9. [Clinical practice guideline on closed tibial plateau fractures in adulthood].

    PubMed

    Ocegueda-Sosa, Miguel Ángel; Valenzuela-Flores, Adriana Abigail; Aldaco-García, Víctor Daniel; Flores-Aguilar, Sergio; Manilla-Lezama, Nicolás; Pérez-Hernández, Jorge

    2013-01-01

    Closed tibiae plateau fractures are common injuries in the emergency room. The optimal treatment is not well defined or established. For this reason, there are several surgical management options: open reduction and internal fixation, closed reduction and percutaneous synthesis, external fixation, and even conservative treatment for this kind of fracture. The mechanism of production of this fracture is through large varus or valgus deformation to which is added a factor of axial load. The trauma may be direct or indirect. The degree of displacement, fragmentation and involvement of soft tissues like ligaments, menisci, vascular and nerve structures are determined by the magnitude of the force exerted. Any intra-articular fracture treatment can lead to an erroneous instability, deformity and limitation of motion with subsequent arthritic changes, leading to joint incongruity, limiting activity and significantly altering the quality of life. Open reduction and internal fixation with anatomic restitution is the method used in this type of fracture. However, the results of numerous publications can be questioned due to the inclusion in the same study of fractures treated with very different methods.

  10. Bone fracture repair - series (image)

    MedlinePlus

    The three main treatment options for bone fractures are: Casting Open reduction, and internal fixation- this involves a surgery to repair the fracture-frequently, metal rods, screws or plates are used to repair the ...

  11. Fracture After Total Hip Replacement

    MedlinePlus

    ... er Total Hip Replacement cont. • Dislocation • Limb length inequality • Poor fracture healing • Repeat fracture • Lack of in- ... Surgeons (AAOS). To learn more about your orthopaedic health, please visit orthoinfo.org. Page ( 5 ) AAOS does ...

  12. Distal Radius Fracture (Broken Wrist)

    MedlinePlus

    ... choice depends on many factors, such as the nature of the fracture, your age and activity level, ... causing the cast to loosen. Depending on the nature of the fracture, your doctor may closely monitor ...

  13. Progressive Fracture of Composite Structures

    NASA Technical Reports Server (NTRS)

    Chamis, Christos C.; Minnetyan, Levon

    2008-01-01

    A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells and the built-up composite structure global fracture are enhanced when internal pressure is combined with shear loads.

  14. Vertebroplasty for Spine Fracture Pain

    MedlinePlus

    MENU Return to Web version Vertebroplasty for Spine Fracture Pain Vertebroplasty for Spine Fracture Pain More than 40 million people in the United States have osteoporosis (a decrease in the amount ...

  15. Correlation of Hip Fracture with Other Fracture Types: Toward a Rational Composite Hip Fracture Endpoint

    PubMed Central

    Colón-Emeric, Cathleen; Pieper, Carl F.; Grubber, Janet; Van Scoyoc, Lynn; Schnell, Merritt L; Van Houtven, Courtney Harold; Pearson, Megan; Lafleur, Joanne; Lyles, Kenneth W.; Adler, Robert A.

    2016-01-01

    Purpose With ethical requirements to the enrollment of lower risk subjects, osteoporosis trials are underpowered to detect reduction in hip fractures. Different skeletal sites have different levels of fracture risk and response to treatment. We sought to identify fracture sites which cluster with hip fracture at higher than expected frequency; if these sites respond to treatment similarly, then a composite fracture endpoint could provide a better estimate of hip fracture reduction. Methods Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between1999-2009 were included. Fractures were ascertained using ICD9 and CPT codes and classified by skeletal site. Pearson correlation coefficients, logistic regression and kappa statistics, were used to describe the correlation between each fracture type and hip fracture within individuals, without regards to the timing of the events. Results 595,579 (11.8%) men suffered 1 or more fractures and 179,597 (3.6%) suffered 2 or more fractures during the time under study. Of those with one or more fractures, rib was the most common site (29%), followed by spine (22%), hip (21%) and femur (20%). The fracture types most highly correlated with hip fracture were pelvic/acetabular (Pearson correlation coefficient 0.25, p<0.0001), femur (0.15, p<0.0001), and shoulder (0.11, p<0.0001). Conclusions Pelvic, acetabular, femur, and shoulder fractures cluster with hip fractures within individuals at greater than expected frequency. If we observe similar treatment risk reductions within that cluster, subsequent trials could consider use of a composite endpoint to better estimate hip fracture risk. PMID:26151123

  16. Osteoporotic Hip and Spine Fractures

    PubMed Central

    Hill, Brian W.

    2014-01-01

    Hip and spine fractures represent just a portion of the burden of osteoporosis; however, these fractures require treatment and often represent a major change in lifestyle for the patient and their family. The orthopedic surgeon plays a crucial role, not only in the treatment of these injuries but also providing guidance in prevention of future osteoporotic fractures. This review provides a brief epidemiology of the fractures, details the surgical techniques, and outlines the current treatment guidelines for orthopedic surgeons. PMID:26246944

  17. Clinical consequences of vertebral fractures.

    PubMed

    Ross, P D

    1997-08-18

    People with vertebral fractures have greater pain, disability, and healthcare utilization, on average, than those without fractures. Most studies of acute pain and disability have been limited to patients with clinically diagnosed fractures (a subset of all symptomatic patients), representing about one third of all patients with fractures identified radiographically. Acute symptoms vary widely. Some patients experience intolerable pain that can be completely debilitating for several weeks or months, whereas about half of all patients with radiographically identified fractures report having had no symptoms. The reasons for this variability are unknown. Chronic pain and disability among patients with vertebral fractures are significantly greater on average than among people without fractures, even after adjusting for comorbid conditions that are common among the elderly. Similar to acute symptoms, chronic symptoms vary widely and often persist for at least several years. The risk of pain and disability increases progressively with the number and severity of vertebral deformities: the risk is multiplied several times with each additional fracture. On average, physical function is impaired among people with vertebral fractures, whether or not they currently report back pain. Declines in physical function and changes in appearance contribute to social isolation and loss of self-esteem, impairing quality of life. The cumulative impact of vertebral fractures on quality of life may rival that of hip fractures because hip fractures are less frequent and occur later in life. As many as 40% of symptomatic vertebral fractures are initially misdiagnosed, signaling a need for greater awareness among physicians and patients. Prevention of initial vertebral fractures should be actively encouraged; even if the initial fracture is asymptomatic, it indicates a greatly increased risk of subsequent fractures, pain, and physical impairment. PMID:9302895

  18. Talar fractures: three case studies.

    PubMed

    Jimenez, A L; Morgan, J H

    2001-09-01

    Three case studies of fractures are presented that demonstrate the potential morbidity that these injuries can cause as well as the acceptable outcomes if treated appropriately. Two of the cases are talar fracture dislocations; the third is an osteochondral fracture of the talus. The importance of early treatment with open reduction and internal fixation is demonstrated. Success following surgical intervention in a nonhealed osteochondral fracture of the talus is also demonstrated.

  19. Numerical Modeling of Fracture Propagation in Naturally Fractured Formations

    NASA Astrophysics Data System (ADS)

    Wang, W.; Prodanovic, M.; Olson, J. E.; Schultz, R.

    2015-12-01

    Hydraulic fracturing consists of injecting fluid at high pressure and high flowrate to the wellbore for the purpose of enhancing production by generating a complex fracture network. Both tensile failure and shear failure occur during the hydraulic fracturing treatment. The shear event can be caused by slip on existing weak planes such as faults or natural fractures. From core observation, partially cemented and fully cemented opening mode natural fractures, often with considerable thickness are widely present. Hydraulic fractures can propagate either within the natural fracture (tensile failure) or along the interface between the natural fracture and the rock matrix (tensile/shear failure), depending on the relative strength of cement and rock matrix materials, the bonding strength of interface, as well as the presence of any heterogeneities. In this study, we evaluate the fracture propagation both experimentally and numerically. We embed one or multiple inclusions of different mechanical properties within synthetic hydrostone samples in order to mimic cemented natural fractures and rock. A semi-circular bending test is performed for each set of properties. A finite element model built with ABAQUS is used to mimic the semi-circular bending test and study the fracture propagation path, as well as the matrix-inclusion bonding interface status. Mechanical properties required for the numerical model are measured experimentally. The results indicate that the match between experiment and modeling fracture path are extremely sensitive to the chosen interface (bonding) model and related parameters. The semi-circular bending test is dry and easily conducted, providing a good platform for validating numerical approaches. A validated numerical model will enable us to add pressurized fluid within the crack and simulate hydraulic fracture-natural fracture interaction in the reservoir conditions, ultimately providing insights into the extent of the fracture network.

  20. Reaction-driven fracturing during replacement processes and metamorphism

    NASA Astrophysics Data System (ADS)

    Jamtveit, B.; Austrheim, H.; Raufaste, C.; Royne, A.; Malthe-Sorenssen, A.

    2008-12-01

    Hydration reactions involving igneous or high-grade metamorphic rocks often cause a significant increase in local volume at the site of reaction. Because such volatilization reactions are triggered by infiltration of external fluids and occur relatively far from thermodynamic equilibrium, they are often fast enough to produce sufficient stress perturbations to drive local fracturing. Microstructural studies show numerous examples of such small scale reaction-driven fracturing both within the reacting mineral grains and in the surrounding rock matrix. Small scale fractures often link up to form fracture networks that promotes further fluid infiltration, more reaction, more stress build up, more fracturing etc. etc. We believe that such self-accelerating coupling between reactions, fracturing, and fluid migration provides a first-order control on the rate of hydration of the Earth's crust both during metamorphism and during lower-temperature processes such as weathering. We present experimental studies that constrain under what conditions replacement reactions may cause fracturing near the reacting interface, both in synthetic and natural materials. Examples of natural reaction- driven fracturing at a wide range of scales will be presented with focus on serpentinization. Finally, a simple mechanical model will be presented to illustrate the most pertinent features of the hierarchical fragmentation process that arise from reaction-driven fracturing and demonstrate how this process may cause an overall acceleration of the hydration process. Relevant references Iyer, K., Jamtveit, B., Mathiesen, J., Malthe- Sørenssen, A., and Feder, J., 2007. Reaction-assisted hierarchical fracturing during serpentinization. Earth and Planetary Science Letters, 267, 503-516. Jamtveit, B, Austrheim, H., and Malthe-Sørensen, A., 2000. Accelerated hydration of the Earth's deep crust induced by stress perturbations. Nature, 408, 75-79 Jamtveit, B., Malthe-Sørenssen, A., and Kostenko, O

  1. Management of osteoporotic vertebral fractures

    PubMed Central

    Dionyssiotis, Yannis

    2010-01-01

    Osteoporotic vertebral fractures are associated with considerable reduction of quality of life, morbidity, and mortality. The management of patients with vertebral fractures should include treatment for osteoporosis and measures to reduce pain and improve mobility. This article provides information for management and rehabilitation of vertebral fractures based on clinical experience and literature. PMID:20689689

  2. External auditory osteoma.

    PubMed

    Carbone, Peter N; Nelson, Brenda L

    2012-06-01

    External auditory canal (EAC) osteomas are rare, benign bony neoplasms that occur in wide range of patients. While chronic irritation and inflammation have been suggested as causal factors in several cases, significant data is lacking to support these suspicions. Symptoms are rare and can include hearing loss, vertigo, pain and tinnitus. Diagnosis is made based on a combination of clinical history and examination, radiographic imaging, and histopathology. Osteomas of the EAC are usually found incidentally and are unilateral and solitary. Computed tomography reveals a hyperdense, pedunculated mass arising from the tympanosquamous suture and lateral of the isthmus. Histopathologically, EAC osteomas are covered with periosteum and squamous epithelium, and consist of lamalleted bone surrounding fibrovascular channels with minimal osteocysts. Osteomas have historically been compared and contrasted with exostoses of the EAC. While they share similarities, more often than not it is possible to distinguish the two bony neoplasms based on clinical history and radiographic studies. Debate remains in the medical literature as to whether basic histopathology can distinguish osteomas of the EAC from exostoses. Surgical excision is the standard treatment for EAC osteomas, however close observation is considered acceptable in asymptomatic patients.

  3. The Mechanics of External Fixation

    PubMed Central

    Rozbruch, S. Robert

    2006-01-01

    External fixation has evolved from being used primarily as a last resort fixation method to becoming a main stream technique used to treat a myriad of bone and soft tissue pathologies. Techniques in limb reconstruction continue to advance largely as a result of the use of these external devices. A thorough understanding of the biomechanical principles of external fixation is useful for all orthopedic surgeons as most will have to occasionally mount a fixator throughout their career. In this review, various types of external fixators and their common clinical applications are described with a focus on unilateral and circular frames. The biomechanical principles that govern bony and fixator stability are reviewed as well as the recommended techniques for applying external fixators to maximize stability. Additionally, we have illustrated methods for managing patients while they are in the external frames to facilitate function and shorten treatment duration. PMID:18751766

  4. Injection through fractures

    SciTech Connect

    Johns, R.A.

    1987-05-01

    Tracer tests are conducted in geothermal reservoirs as an aid in forecasting thermal breakthrough of reinjection water. To interpret tracer tests, mathematical models have been developed based on the various transport mechanisms in these highly fractured reservoirs. These tracer flow models have been applied to interpret field tests. The resulting matches between the model and field data were excellent and the model parameters were used to estimate reservoir properties. However, model fitting is an indirect process and the model's ability to estimate reservoir properties cannot be judged solely on the quality of the match between field data and model predictions. The model's accuracy in determining reservoir characteristics must be independently verified in a closely controlled environment. In this study, the closely controlled laboratory environment was chosen to test the validity and accuracy of tracer flow models developed specifically for flow in fractured rocks. The laboratory tracer tests were performed by flowing potassium iodide (KI) through artificially fractured core samples. The tracer test results were then analyzed with several models to determine which best fit the measured data. A Matrix Diffusion model was found to provide the best match of the tracer experiments. The core properties, as estimated by the Matrix Diffusion model parameters generated from the indirect matching process, were then determined. These calculated core parameters were compared to the measured core properties and were found to be in agreement. This verifies the use of the Matrix Diffusion flow model in estimating fracture widths from tracer tests.

  5. Hip fracture surgery

    MedlinePlus

    ... thigh bone. The thigh bone is called the femur. It is part of the hip joint. Hip pain is a related topic. ... to 4 hours. If you have an intertrochanteric fracture (the area below the femur neck), your surgeon will use a special metal ...

  6. Femur fracture repair - discharge

    MedlinePlus

    ... surgery, your surgeon will make a cut to open your fracture. Your surgeon will then use special metal devices to hold your bones in place while they heal. These devices are called ... is open reduction and internal fixation (ORIF). In the most ...

  7. Fracture design modelling

    SciTech Connect

    Crichlow, H.B.; Crichlow, H.B.

    1980-02-07

    A design tool is discussed whereby the various components that enter the design process of a hydraulic fracturing job are combined to provide a realistic appraisal of a stimulation job in the field. An interactive computer model is used to solve the problem numerically to obtain the effects of various parameters on the overall behavior of the system.

  8. Infiltration into Fractured Bedrock

    SciTech Connect

    Salve, Rohit; Ghezzehei, Teamrat A.; Jones, Robert

    2007-09-01

    One potential consequence of global climate change and rapid changes in land use is an increased risk of flooding. Proper understanding of floodwater infiltration thus becomes a crucial component of our preparedness to meet the environmental challenges of projected climate change. In this paper, we present the results of a long-term infiltration experiment performed on fractured ash flow tuff. Water was released from a 3 x 4 m{sup 2} infiltration plot (divided into 12 square subplots) with a head of {approx}0.04 m, over a period of {approx}800 days. This experiment revealed peculiar infiltration patterns not amenable to current infiltration models, which were originally developed for infiltration into soils over a short duration. In particular, we observed that in part of the infiltration plot, the infiltration rate abruptly increased a few weeks into the infiltration tests. We suggest that these anomalies result from increases in fracture permeability during infiltration, which may be caused by swelling of clay fillings and/or erosion of infill debris. Interaction of the infiltration water with subsurface natural cavities (lithophysal cavities) could also contribute to such anomalies. This paper provides a conceptual model that partly describes the observed infiltration patterns in fractured rock and highlights some of the pitfalls associated with direct extension of soil infiltration models to fractured rock over a long period.

  9. Bipartite patella fracture.

    PubMed

    Canizares, George H; Selesnick, F Harlan

    2003-02-01

    Bipartite patella fracture is an uncommon injury that has rarely been described in the literature. It can be quite debilitating in the competitive athlete and is often overlooked by the treating physician. A bone scan can be helpful in confirming the diagnosis, and appropriate treatment often results in a successful outcome.

  10. Dorsal radiocarpal fracture dislocation.

    PubMed

    Tanzer, T L; Horne, J G

    1980-11-01

    A case of a rare radiocarpal fracture dislocation in a 17-year-old girl, with persisting loss of radiocarpal joint space following reduction under hematoma block, is described. The wrist joint was exposed, and two osteochondral fragments were rotated 90 degrees and secured with 2.7-mm AO screws. Satisfactory healing followed 3 months postinjury.

  11. Externalities of oil imports revisited

    SciTech Connect

    Lemon, R.

    1980-09-01

    A re-analysis of the externalities associated with oil imports reaffirms the major findings of an earlier study: (1) The current externalities of oil imports are large even after several favorable assumptions are made, including the existence of a large buffer stock and enlightened monetary and fiscal policy. (2) The large externalities of oil imports call for increased domestic supplies, including conservation, if they are cost-effective and based on marginal social costs. (3) A corrective public policy could involve oil-import taxes and the subsidization of new domestic energy sources without large government externalities. 20 references.

  12. Fractures in Tharsis Tholus

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site]

    In the upper left corner of this VIS image are a series of fractures. Where the fractures are exposed on the surface it is impossible to tell the plane of the fracture; however where the fractures are visible in the cliff wall it is possible to see that the fractures dip to the north. This image shows part of the caldera of Tharsis Tholus.

    Image information: VIS instrument. Latitude 13.5, Longitude 268.9 East (91.1 West). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  13. Entablature: fracture types and mechanisms

    NASA Astrophysics Data System (ADS)

    Forbes, A. E. S.; Blake, S.; Tuffen, H.

    2014-05-01

    Entablature is the term used to describe zones or tiers of irregular jointing in basaltic lava flows. It is thought to form when water from rivers dammed by the lava inundates the lava flow surface, and during lava-meltwater interaction in subglacial settings. A number of different fracture types are described in entablature outcrops from the Búrfell lava and older lava flows in Þjórsárdalur, southwest Iceland. These are: striae-bearing, column-bounding fractures and pseudopillow fracture systems that themselves consist of two different fracture types—master fractures with dimpled surface textures and subsidiary fractures with curved striae. The interaction of pseudopillow fracture systems and columnar jointing in the entablature produces the chevron fracture patterns that are commonly observed in entablature. Cube-jointing is a more densely fractured version of entablature, which likely forms when more coolant enters the hot lava. The entablature tiers display closely spaced striae and dendritic crystal shapes which indicate rapid cooling. Master fracture surfaces show a thin band with an evolved composition at the fracture surface; mineral textures in this band also show evidence of quenching of this material. This is interpreted as gas-driven filter pressing of late-stage residual melt that is drawn into an area of low pressure immediately preceding or during master fracture formation by ductile extensional fracture of hot, partially crystallised lava. This melt is then quenched by an influx of water and/or steam when the master fracture fully opens. Our findings suggest that master fractures are the main conduit for coolant entering the lava flow during entablature formation.

  14. PreFix™ external fixator used to treat a floating shoulder injury caused by gunshot wound.

    PubMed

    Vogels, J; Pommier, N; Cursolle, J-C; Belin, C; Tournier, C; Durandeau, A

    2014-10-01

    Open fractures of the shoulder are extremely rare, and their treatment is a major challenge for surgeons. Only cases encountered in military settings have been reported thus far. Such fractures are often the result of ballistic trauma, which causes extensive damage to both bony and soft tissues. Since these injuries are associated with a high risk of infection and the presence of comminuted fractures, external fixation is necessary for repair. Use of external fixators and revascularization techniques has reduced the number of cases requiring shoulder amputation or disarticulation. Injury to the proximal extremity of the humerus, acromion, and clavicle further complicates the treatment. No published studies have described the assembly of external fixators for fractures in the scapular region with significant bone loss. In addition, no cases have been described in civilian settings. However, with an increase in urban violence and the traffic of illegal arms, civilian surgeons are now encountering an increasing number of patients with these injuries. In this report, we not only present a rare case of floating shoulder injury in a civilian setting but also provide an overview of the existing treatment strategies for this type of trauma, with special focus on the use of external fixators in elective shoulder arthrodesis and on military cases. PMID:25267396

  15. [Pathogenesis of atypical femoral fracture].

    PubMed

    Iwata, Ken; Mashiba, Tasuku

    2016-01-01

    We demonstrated microdamage accumulation in the fracture sites in the patients of subtrochanteric atypical femoral fracture with long term bisphosphonate therapy and of incomplete shaft fracture of lateral femoral bowing without bisphosphonate therapy. Based on these findings, pathogenesis of atypical femoral fracture is revealed stress fracture caused by accumulation of microdamages between distal to the lesser trochanter and proximal to the supracondylar flare in the femur in association with severely suppressed bone turnover and/or abnormal lower limb alignment, that causes stress concentration on the lateral side cortex of the femur. PMID:26728533

  16. Tibial Stress Fractures in Athletes.

    PubMed

    Feldman, John J; Bowman, Eric N; Phillips, Barry B; Weinlein, John C

    2016-10-01

    Tibial stress fractures are common in the athlete. There are various causes of these fractures, the most common being a sudden increase in training intensity. Most of these injuries are treated conservatively; however, some may require operative intervention. Intervention is mostly dictated by location of the fracture and failure of conservative treatment. There are several surgical options available to the treating surgeon, each with advantages and disadvantages. The physician must understand the nature of the fracture and the likelihood for it to heal in a timely manner in order to best treat these fractures in this patient subset. PMID:27637660

  17. Biomechanical Concepts for Fracture Fixation.

    PubMed

    Bottlang, Michael; Schemitsch, Christine E; Nauth, Aaron; Routt, Milton; Egol, Kenneth A; Cook, Gillian E; Schemitsch, Emil H

    2015-12-01

    Application of the correct fixation construct is critical for fracture healing and long-term stability; however, it is a complex issue with numerous significant factors. This review describes a number of common fracture types and evaluates their currently available fracture fixation constructs. In the setting of complex elbow instability, stable fixation or radial head replacement with an appropriately sized implant in conjunction with ligamentous repair is required to restore stability. For unstable sacral fractures with vertical or multiplanar instabilities, "standard" iliosacral screw fixation is not sufficient. Periprosthetic femur fractures, in particular Vancouver B1 fractures, have increased stability when using 90/90 fixation versus a single locking plate. Far cortical locking combines the concept of dynamization with locked plating to achieve superior healing of a distal femur fracture. Finally, there is no ideal construct for syndesmotic fracture stabilization; however, these fractures should be fixed using a device that allows for sufficient motion in the syndesmosis. In general, orthopaedic surgeons should select a fracture fixation construct that restores stability and promotes healing at the fracture site, while reducing the potential for fixation failure.

  18. Linear elastic fracture mechanics primer

    NASA Technical Reports Server (NTRS)

    Wilson, Christopher D.

    1992-01-01

    This primer is intended to remove the blackbox perception of fracture mechanics computer software by structural engineers. The fundamental concepts of linear elastic fracture mechanics are presented with emphasis on the practical application of fracture mechanics to real problems. Numerous rules of thumb are provided. Recommended texts for additional reading, and a discussion of the significance of fracture mechanics in structural design are given. Griffith's criterion for crack extension, Irwin's elastic stress field near the crack tip, and the influence of small-scale plasticity are discussed. Common stress intensities factor solutions and methods for determining them are included. Fracture toughness and subcritical crack growth are discussed. The application of fracture mechanics to damage tolerance and fracture control is discussed. Several example problems and a practice set of problems are given.

  19. Periodontal surgery as an aid to restoring fractured teeth.

    PubMed

    McDonald, F L; Davis, S S; Whitbeck, P

    1982-04-01

    The periodontal, orthodontic, and prosthetic management of four indications for subgingival or subosseous tooth fractures has been discussed. The importance of having the aveolar crest a minimal distance of 2.5 mm from the margin of the restoration has been explained. The pitfalls of an external, rather than internal, bevel and flap procedure were assessed. Coordinated interspecialty therapy provides diverse, conservative treatment for the general practitioner and successful restorations for the patient. PMID:6951035

  20. Fracture of composite plates containing periodic buffer strips

    NASA Technical Reports Server (NTRS)

    Erdogan, F.; Bakioglu, M.

    1974-01-01

    Fracture of a composite plate which consists of perfectly bonded parallel load carrying laminates and buffer strips is considered. Fatigue cracks appear and spread in main laminates or in buffer strips or in both perpendicular to the interfaces. The external load is applied to the plate parallel to the strips and away from the crack region. The problem is solved for fully imbedded cracks and for broken laminates or strips. Corresponding stress intensity factors are calculated.

  1. Hydraulic fracture propagation modeling and data-based fracture identification

    NASA Astrophysics Data System (ADS)

    Zhou, Jing

    Successful shale gas and tight oil production is enabled by the engineering innovation of horizontal drilling and hydraulic fracturing. Hydraulically induced fractures will most likely deviate from the bi-wing planar pattern and generate complex fracture networks due to mechanical interactions and reservoir heterogeneity, both of which render the conventional fracture simulators insufficient to characterize the fractured reservoir. Moreover, in reservoirs with ultra-low permeability, the natural fractures are widely distributed, which will result in hydraulic fractures branching and merging at the interface and consequently lead to the creation of more complex fracture networks. Thus, developing a reliable hydraulic fracturing simulator, including both mechanical interaction and fluid flow, is critical in maximizing hydrocarbon recovery and optimizing fracture/well design and completion strategy in multistage horizontal wells. A novel fully coupled reservoir flow and geomechanics model based on the dual-lattice system is developed to simulate multiple nonplanar fractures' propagation in both homogeneous and heterogeneous reservoirs with or without pre-existing natural fractures. Initiation, growth, and coalescence of the microcracks will lead to the generation of macroscopic fractures, which is explicitly mimicked by failure and removal of bonds between particles from the discrete element network. This physics-based modeling approach leads to realistic fracture patterns without using the empirical rock failure and fracture propagation criteria required in conventional continuum methods. Based on this model, a sensitivity study is performed to investigate the effects of perforation spacing, in-situ stress anisotropy, rock properties (Young's modulus, Poisson's ratio, and compressive strength), fluid properties, and natural fracture properties on hydraulic fracture propagation. In addition, since reservoirs are buried thousands of feet below the surface, the

  2. Fracture mechanics validity limits

    NASA Technical Reports Server (NTRS)

    Lambert, Dennis M.; Ernst, Hugo A.

    1994-01-01

    Fracture behavior is characteristics of a dramatic loss of strength compared to elastic deformation behavior. Fracture parameters have been developed and exhibit a range within which each is valid for predicting growth. Each is limited by the assumptions made in its development: all are defined within a specific context. For example, the stress intensity parameters, K, and the crack driving force, G, are derived using an assumption of linear elasticity. To use K or G, the zone of plasticity must be small as compared to the physical dimensions of the object being loaded. This insures an elastic response, and in this context, K and G will work well. Rice's J-integral has been used beyond the limits imposed on K and G. J requires an assumption of nonlinear elasticity, which is not characteristic of real material behavior, but is thought to be a reasonable approximation if unloading is kept to a minimum. As well, the constraint cannot change dramatically (typically, the crack extension is limited to ten-percent of the initial remaining ligament length). Rice, et al investigated the properties required of J-type parameters, J(sub x), and showed that the time rate, dJ(sub x)/dt, must not be a function of the crack extension rate, da/dt. Ernst devised the modified-J parameter, J(sub M), that meets this criterion. J(sub M) correlates fracture data to much higher crack growth than does J. Ultimately, a limit of the validity of J(sub M) is anticipated, and this has been estimated to be at a crack extension of about 40-percent of the initial remaining ligament length. None of the various parameters can be expected to describe fracture in an environment of gross plasticity, in which case the process is better described by deformation parameters, e.g., stress and strain. In the current study, various schemes to identify the onset of the plasticity-dominated behavior, i.e., the end of fracture mechanics validity, are presented. Each validity limit parameter is developed in

  3. External Examining: Fit for Purpose?

    ERIC Educational Resources Information Center

    Bloxham, Sue; Price, Margaret

    2015-01-01

    In a context of international concern about academic standards, the practice of external examining is widely admired for its role in defending standards. Yet a contradiction exists between this faith in examining and continuing concerns about standards. This article argues that external examining rests on assumptions about standards which are…

  4. Changing Systems of External Examination

    ERIC Educational Resources Information Center

    Stensaker, Bjorn; Brandt, Ellen; Solum, Nils Henrik

    2008-01-01

    Purpose: The purpose of this paper is to review and identify changes in systems of external examinations in Denmark, the UK and Norway. Design/methodology/approach: Comparative analysis of studies, reviews and documents concerning the purpose and functioning of systems of external examination in three selected countries. Findings: The paper…

  5. Choosing a Truly External Evaluator

    ERIC Educational Resources Information Center

    Ray, Marilyn

    2006-01-01

    This scenario discusses a situation in which a proposal has been published by a consortium of foundations for an "external" evaluator to evaluate a replication at two new sites of a program they have been funding for many years. A proposal is received from Dr. Porto-Novo, who has been the external evaluator of the initial program for about 10…

  6. [Differential treatment of fractures of the distal radius].

    PubMed

    Oestern, H J; Hüls, E

    1994-01-01

    Treatment of distal fractures of the radius has undergone considerable change during recent years. The cause for this lies primarily in the poor results of conservative treatments. In addition to osseous instability, the fractures of the radius are frequently combined with ligamentary instability as well, thereby exceeding the ability of conservative treatment. Among the many classifications, the AO classification of these fractures has proven to be the best and most widely accepted. This classification allows the recommendation of suitable procedures of treatment. The problem with inadequately healed fractures of the radius lies in the inherent unphysiological loading of the joint in the characteristic dorsal tilted position. This leads to a pathological displacement of the radius of flexion and extension and thereby to an overloading of the dorsal joint cartilage. The shortening of the radius leads to a mechanical impingement of the triangular fibrocartilagenous complex. The Kirschner wire fixation is particularly indicated in type A and type C fractures when combined with an external fixator. Of great importance here is the crossing of the K-wires, best accomplished by inserting an additional wire in a proximal to distal direction to achieve maximal mechanical stability. Biodegradable fixation devices are not yet in widespread use, as high costs and possible foreign body reactions have prevented their acceptance. The plate osteosynthesis has its domain in the treatment of volar luxation fractures (B3) and the partially articular fractures of the radius (B2). The domain of the external fixator, on the other hand, lies in the C2 and C3 fractures in combination with the K-wire osteosynthesis. Changing the mode of treatment to a plate osteosynthesis after two to three weeks allows a functional postoperative treatment. By use of a differentiated treatment regimen, the complication rate can be significantly reduced whose cause frequently lies in repeatedly attempted

  7. Leiomyoma of External Auditory Canal.

    PubMed

    George, M V; Puthiyapurayil, Jamsheeda

    2016-09-01

    This article reports a case of piloleiomyoma of external auditory canal, which is the 7th case of leiomyoma of the external auditory canal being reported and the 2nd case of leiomyoma arising from arrectores pilorum muscles, all the other five cases were angioleiomyomas, arising from blood vessels. A 52 years old male presented with a mass in the right external auditory canal and decreased hearing of 6 months duration. Tumor excision done by end aural approach. Histopathological examination report was leiomyoma. It is extremely rare for leiomyoma to occur in the external auditory canal because of the non-availability of smooth muscles in the external canal. So it should be considered as a very rare differential diagnosis for any tumor or polyp in the ear canal. PMID:27508144

  8. Malignant external otitis: CT evaluation

    SciTech Connect

    Curtin, H.D.; Wolfe, P.; May, M.

    1982-11-01

    Malignant external otitis is an aggressive infection caused by Pseudomonas aeruginosa that most often occurs in elderly diabetics. Malignant external otitis often spreads inferiorly from the external canal to involve the subtemporal area and progresses medially towards the petrous apex leading to multiple cranial nerve palsies. The computed tomographic (CT) findings in malignant external otitis include obliteration of the normal fat planes in the subtemporal area as well as patchy destruction of the bony cortex of the mastoid. The point of exit of the various cranial nerves can be identified on CT scans, and the extent of the inflammatory mass correlates well with the clinical findings. Four cases of malignant external otitis are presented. In each case CT provided a good demonstration of involvement of the soft tissues at the base of the skull.

  9. A PTH-responsive circadian clock operates in ex vivo mouse femur fracture healing site

    PubMed Central

    Kunimoto, Tatsuya; Okubo, Naoki; Minami, Yoichi; Fujiwara, Hiroyoshi; Hosokawa, Toshihiro; Asada, Maki; Oda, Ryo; Kubo, Toshikazu; Yagita, Kazuhiro

    2016-01-01

    The circadian clock contains clock genes including Bmal1 and Period2, and it maintains an interval rhythm of approximately 24 hours (the circadian rhythm) in various organs including growth plate and articular cartilage. As endochondral ossification is involved not only in growth plate but also in fracture healing, we investigated the circadian clock functions in fracture sites undergoing healing. Our fracture models using external fixation involved femurs of Period2::Luciferase knock-in mice which enables the monitoring of endogenous circadian clock state via bioluminescence. Organ culture was performed by collecting femurs, and fracture sites were observed using bioluminescence imaging systems. Clear bioluminescence rhythms of 24-hour intervals were revealed in fracture healing sites. When parathyroid hormone (PTH) was administered to fractured femurs in organ culture, peak time of Period2::Luciferase activity in fracture sites and growth plates changed, indicating that PTH-responsive circadian clock functions in the mouse femur fracture healing site. While PTH is widely used in treating osteoporosis, many studies have reported that it contributes to improvement of fracture healing. Future studies of the role of this local clock in wound healing may reveal a novel function of the circadian timing mechanism in skeletal cells. PMID:26926165

  10. Vertebral fracture classification

    NASA Astrophysics Data System (ADS)

    de Bruijne, Marleen; Pettersen, Paola C.; Tankó, László B.; Nielsen, Mads

    2007-03-01

    A novel method for classification and quantification of vertebral fractures from X-ray images is presented. Using pairwise conditional shape models trained on a set of healthy spines, the most likely unfractured shape is estimated for each of the vertebrae in the image. The difference between the true shape and the reconstructed normal shape is an indicator for the shape abnormality. A statistical classification scheme with the two shapes as features is applied to detect, classify, and grade various types of deformities. In contrast with the current (semi-)quantitative grading strategies this method takes the full shape into account, it uses a patient-specific reference by combining population-based information on biological variation in vertebra shape and vertebra interrelations, and it provides a continuous measure of deformity. Good agreement with manual classification and grading is demonstrated on 204 lateral spine radiographs with in total 89 fractures.

  11. Fracture in Electronics

    NASA Astrophysics Data System (ADS)

    Plumbridge, William J.

    Although the World’s largest industrial sector, Electronics has received relatively little attention with regard to mechanical failure of its equipment. Design strategies against fracture are advanced for applications, such as aerospace, automotive, pressure vessel and engine applications. So a fundamental question arises as to the extent to which these can be applied to Electronics. The paper describes the special characteristics of electronics equipment in service, and outlines common modes of failure, with emphasis on thermomechanical fatigue. The particular challenge of size is considered when behaviour determined from conventional bulk samples is no longer representative of actual components. Two case studies are presented that illustrate the special nature of electronics. It is suggested that as miniaturisation continues, fracture will become a major cause of failure.

  12. HUMERAL SHAFT FRACTURES

    PubMed Central

    Benegas, Eduardo; Ferreira Neto, Arnaldo Amado; Neto, Raul Bolliger; Santis Prada, Flavia de; Malavolta, Eduardo Angeli; Marchitto, Gustavo Oliveira

    2015-01-01

    Humeral shaft fractures (HSFs) represent 3% of the fractures of the locomotor apparatus, and the middle third of the shaft is the section most affected. In the majority of cases, it is treated using nonsurgical methods, but surgical indications in HSF cases are increasingly being adopted. The diversity of opinions makes it difficult to reach a consensus regarding the types of osteosynthesis, surgical technique and quantity and quality of synthesis materials that should be used. It would appear that specialists are far from reaching a consensus regarding the best method for surgical treatment of HSFs. We believe that less invasive methods, which favor relative stability, are the most appropriate methods, since the most feared complications are less frequent. PMID:27019833

  13. [Clinical experiences in the treatment of humeral shaft fractures with the Sarmiento brace].

    PubMed

    Kulenkampff, H A; Rustemeier, M

    1988-08-01

    13 humeral shaft fractures were treated by Sarmiento-brace. Fracture-bracing is a special conservative traumatological management, that permits early remedial gymnastics. Light weight, optimal cosmetic results and quickly rehabilitation of the injured arm are favorable. Cooperation in gymnastics and controls within short times by the doctor are necessary. All our patients of ages under 45 years achieved nearly normal articular function, that increases 95% in comparison to the opposite arm. External rotation and abduction of the shoulder decreased in elder persons. Loss of function could not be avoided completely in critical cases (upper and lower part of the humeral shaft). Side effects were swelling, angulation deficiencies up to 16 degrees and skin lesions. The rate of pseudarthrosis seems very small. In advanced cases of malignomas pathologic fractures were treated by bracing palliatively. Open fractures, vascular damage, nerve palsy, fractures that cannot be controlled by non operative means and multiple injured patients should be treated by operation. PMID:3176188

  14. Phase Field Fracture Mechanics.

    SciTech Connect

    Robertson, Brett Anthony

    2015-11-01

    For this assignment, a newer technique of fracture mechanics using a phase field approach, will be examined and compared with experimental data for a bend test and a tension test. The software being used is Sierra Solid Mechanics, an implicit/explicit finite element code developed at Sandia National Labs in Albuquerque, New Mexico. The bend test experimental data was also obtained at Sandia Labs while the tension test data was found in a report online from Purdue University.

  15. Melt fracture revisited

    SciTech Connect

    Greenberg, J. M.

    2003-07-16

    In a previous paper the author and Demay advanced a model to explain the melt fracture instability observed when molten linear polymer melts are extruded in a capillary rheometer operating under the controlled condition that the inlet flow rate was held constant. The model postulated that the melts were a slightly compressible viscous fluid and allowed for slipping of the melt at the wall. The novel feature of that model was the use of an empirical switch law which governed the amount of wall slip. The model successfully accounted for the oscillatory behavior of the exit flow rate, typically referred to as the melt fracture instability, but did not simultaneously yield the fine scale spatial oscillations in the melt typically referred to as shark skin. In this note a new model is advanced which simultaneously explains the melt fracture instability and shark skin phenomena. The model postulates that the polymer is a slightly compressible linearly viscous fluid but assumes no slip boundary conditions at the capillary wall. In simple shear the shear stress {tau}and strain rate d are assumed to be related by d = F{tau} where F ranges between F{sub 2} and F{sub 1} > F{sub 2}. A strain rate dependent yield function is introduced and this function governs whether F evolves towards F{sub 2} or F{sub 1}. This model accounts for the empirical observation that at high shears polymers align and slide more easily than at low shears and explains both the melt fracture and shark skin phenomena.

  16. Maxillofacial fracture repairs.

    PubMed

    Legendre, Loïc

    2005-07-01

    Oral trauma remains a common presentation in a small animal practice. Most fractures are the result of vehicular accidents. Among other causes are falls, kicks, gunshots wounds, and encounters with various hard objects ranging from baseball bats and golf clubs to horse hooves and car doors. Next in popularity are dog fights, especially when a large dog and a small dog are involved, and fights with other animals. With cats, falls from various heights are responsible for a large percentage of presentations.

  17. Comminuted long bone fractures in children. Could combined fixation improve the results?

    PubMed

    El-Alfy, Barakat; Ali, Ayman M; Fawzy, Sallam I

    2016-09-01

    Comminuted diaphyseal fractures in the pediatric age group represent a major orthopedic problem. It is associated with a high incidence of complications and poor outcomes because of the instability and difficulty in treatment. The aim of this study was to evaluate the efficacy of combined external skeletal fixation and flexible intramedullary nails in reconstruction of comminuted diaphyseal fracture in skeletally immature patients. Combined external fixator and elastic stable intramedullary nails were used in the management of 27 pediatric patients (15 males and 12 females) with unstable comminuted diaphyseal fractures of the tibia and femur. There were 19 fractures of the femur and eight fractures of the tibia. The average age of the patients was 8.7 years (range 7-14 years) for the femur and 10.8 years (range 6-15 years) for the tibia. Fractures were classified according to the system of Winquist and Hansen as grade II (five cases), grade III (nine cases), and grade IV (13 cases). All cases were operated within 6 days (range 0-6 days) after injury. The mean follow-up period was 2.8 years (range 2-3.5 years). The average duration of the external fixation was 1.6 months for fractures of the tibia, whereas it was 1.4 months for fractures of the femur. The average time for tibia fracture union was 2.8 months for fractures of the tibia, whereas it was 1.9 months for fractures of the femur. Malalignment in varus less than 5° was noted in one patient. One patient had a limb-length discrepancy of 1.5 cms. There were five cases (18.5%) with pin-tract infection. According to the Association for the Study and Application of the Methods of Ilizarov evaluation system, bone results were excellent in 23 cases (85.2%), good in three cases (11.1%), and poor in one case (3.7%). Functional results were excellent in 22 (81.5%) cases and good in five (18.5%) cases. Combined use of external fixators and elastic intramedullary nails is a good method for the treatment of comminuted

  18. Fractured Craters on Ganymede

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Two highly fractured craters are visible in this high resolution image of Jupiter's moon, Ganymede. NASA's Galileo spacecraft imaged this region as it passed Ganymede during its second orbit through the Jovian system. North is to the top of the picture and the sun illuminates the surface from the southeast. The two craters in the center of the image lie in the ancient dark terrain of Marius Regio, at 40 degrees latitude and 201 degrees longitude, at the border of a region of bright grooved terrain known as Byblus Sulcus (the eastern portion of which is visible on the left of this image). Pervasive fracturing has occurred in this area that has completely disrupted these craters and destroyed their southern and western walls. Such intense fracturing has occurred over much of Ganymede's surface and has commonly destroyed older features. The image covers an area approximately 26 kilometers (16 miles) by 18 kilometers (11 miles) across at a resolution of 86 meters (287 feet) per picture element. The image was taken on September 6, 1996 by the solid state imaging (CCD) system on NASA's Galileo spacecraft.

    The Jet Propulsion Laboratory, Pasadena, CA manages the Galileo mission for NASA's Office of Space Science, Washington, DC. JPL is an operating division of California Institute of Technology (Caltech).

    This image and other images and data received from Galileo are posted on the World Wide Web, on the Galileo mission home page at URL http://galileo.jpl.nasa.gov.

  19. Opportunistic Identification of Vertebral Fractures.

    PubMed

    Adams, Judith E

    2016-01-01

    Vertebral fractures are powerful predictors of future fracture, so, their identification is important to ensure that patients are commenced on appropriate bone protective or bone-enhancing therapy. Risk factors (e.g., low bone mineral density and increasing age) and symptoms (back pain, loss of height) may herald the presence of vertebral fractures, which are usually confirmed by performing spinal radiographs or, increasingly, using vertebral fracture assessment with dual-energy X-ray absorptiometry scanners. However, a large number (30% or more) of vertebral fractures are asymptomatic and do not come to clinical attention. There is, therefore, scope for opportunistic (fortuitous) identification of vertebral fractures from various imaging modalities (radiographs, computed tomography, magnetic resonance imaging, and radionuclide scans) performed for other clinical indications and which include the spine in the field of view, with midline sagittal reformatted images from computed tomography having the greatest potential for such opportunistic detection. Numerous studies confirm this potential for identification but consistently find underreporting of vertebral fractures. So, a valuable opportunity to improve the management of patients at increased risk of future fracture is being squandered. Educational training programs for all clinicians and constant reiteration, stressing the importance of the accurate and clear reporting of vertebral fractures ("you only see what you look for"), can improve the situation, and automated computer-aided diagnostic tools also show promise to solve the problem of this underreporting of vertebral fractures.

  20. Opportunistic Identification of Vertebral Fractures.

    PubMed

    Adams, Judith E

    2016-01-01

    Vertebral fractures are powerful predictors of future fracture, so, their identification is important to ensure that patients are commenced on appropriate bone protective or bone-enhancing therapy. Risk factors (e.g., low bone mineral density and increasing age) and symptoms (back pain, loss of height) may herald the presence of vertebral fractures, which are usually confirmed by performing spinal radiographs or, increasingly, using vertebral fracture assessment with dual-energy X-ray absorptiometry scanners. However, a large number (30% or more) of vertebral fractures are asymptomatic and do not come to clinical attention. There is, therefore, scope for opportunistic (fortuitous) identification of vertebral fractures from various imaging modalities (radiographs, computed tomography, magnetic resonance imaging, and radionuclide scans) performed for other clinical indications and which include the spine in the field of view, with midline sagittal reformatted images from computed tomography having the greatest potential for such opportunistic detection. Numerous studies confirm this potential for identification but consistently find underreporting of vertebral fractures. So, a valuable opportunity to improve the management of patients at increased risk of future fracture is being squandered. Educational training programs for all clinicians and constant reiteration, stressing the importance of the accurate and clear reporting of vertebral fractures ("you only see what you look for"), can improve the situation, and automated computer-aided diagnostic tools also show promise to solve the problem of this underreporting of vertebral fractures. PMID:26412139

  1. Fractures of the cervical spine

    PubMed Central

    Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

    2013-01-01

    OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

  2. Procedure for estimating fracture energy from fracture surface roughness

    DOEpatents

    Williford, Ralph E.

    1989-01-01

    The fracture energy of a material is determined by first measuring the length of a profile of a section through a fractured surface of the material taken on a plane perpendicular to the mean plane of that surface, then determining the fractal dimensionality of the surface. From this, the yield strength of the material, and the Young's Modulus of that material, the fracture energy is calculated.

  3. Fracture faces of frozen membranes: 50th anniversary

    PubMed Central

    Branton, Daniel

    2016-01-01

    In 1961, the development of an improved freeze-etching (FE) procedure to prepare rapidly frozen biological cells or tissues for electron microscopy raised two important questions. How does a frozen cell membrane fracture? What do the extensive face views of the cell’s membranes exposed by the fracture process of FE tell us about the overall structure of biological membranes? I discovered that all frozen membranes tend to split along weakly bonded lipid bilayers. Consequently, the fracture process exposes internal membrane faces rather than either of the membrane’s two external surfaces. During etching, when ice is allowed to sublime after fracturing, limited regions of the actual membrane surfaces are revealed. Examination of the fractured faces and etched surfaces provided strong evidence that biological membranes are organized as lipid bilayers with some proteins on the surface and other proteins extending through the bilayer. Membrane splitting made it possible for electron microscopy to show the relative proportion of a membrane’s area that exists in either of these two organizational modes. PMID:26823391

  4. History of operative treatment of forearm diaphyseal fractures.

    PubMed

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B

    2014-02-01

    Diaphyseal fractures of the forearm have accompanied humanity throughout its history. Nonsurgical techniques dominated the treatment for centuries, and complications including nonunion and malunion were common. The 19th century featured the recognition of distinct injury patterns. With the development of anesthesia and antisepsis, the operative treatment became widespread. In 1878, Heine described fixation of the diaphyseal nonunion of the distal ulna using an intramedullary ivory peg. Parkhill reported on the application of external fixation for forearm fractures in 1897-1898. Hansmann published the case of plate osteosynthesis of an acute fracture of the radius in 1886. In 1913, Schöne published the technique of closed intramedullary fixation of diaphyseal fractures of the forearm using a silver wire. During the first 2 decades of the 20th century, plate osteosynthesis quickly spread across Europe and North America owing to the influence of Lambotte and Lane. After the World War II, plate osteosynthesis became the surgical treatment of choice for forearm diaphyseal fractures.

  5. Has Clinton made externalities extraneous

    SciTech Connect

    Haites, E.

    1993-08-01

    Over the past several years state utility regulators have become increasingly concerned with the environmental externalities associated with electricity generation. Currently, 26 states have requirements in place, although these vary considerably in scope and complexity. The vast majority apply only to the selection of new resources; the most detailed specify a monetary value for each discharge to the environment. Regulatory concern with environmental externalities stems from the desire to minimize the cost of electricity service to society. Externalities requirements focus on the residual discharges after environmental regulations are complied with. Ignoring externalities leads to inefficient use of resources and environmental damage beyond with may be called a [open quotes]socially optimal[close quotes] level of pollution. Adjusting to the cost options for environmental externalities should lead utilities to select a combination of resources that is closer to the socially optimal mix. President Bill Clinton's recent announcement that the United States will limit its emissions of carbon dioxide (CO[sub 2]) to 1990 levels by 2000 may make externalities regulation superfluous. National limits on sulfur dioxide (SO[sub 2]), nitrogen oxide (NO[sub x]), and CO[sub 2] emissions by utilities will likely be in effect by 2000. It will not be possible to comply with emissions limits solely through changes to the mix of resource additions, even though consideration of environmental externalities in resource addition decisions can reduce incremental emissions. Other strategies to reduce the emissions of existing generating stations, as well as new sources, will be needed.

  6. Evaluation of five fracture models in Taylor impact fracture

    NASA Astrophysics Data System (ADS)

    Zhang, Wei; Xiao, Xin-Ke; Wei, Gang; Guo, Zitao

    2012-03-01

    Taylor impact test presented in a previous study on a commercial high strength and super hard aluminum alloy 7A04-T6 are numerically evaluated using the finite element code ABAQUS/Explicit. In the present study, the influence of fracture criterion in numerical simulations of the deformation and fracture behavior of Taylor rod has been studied. Included in the paper are a modified version of Johnson-Cook, the Cockcroft-Latham(C-L), the constant fracture strain, the maximum shear stress and the maximum principle stress fracture models. Model constants for each criterion are calibrated from material tests. The modified version of Johnson-Cook fracture criterion with the stress triaxiality cut off idea is found to give good prediction of the Taylor impact fracture behavior. However, this study will also show that the C-L fracture criterion where only one simple material test is required for calibration is found to give reasonable predictions. Unfortunately, the other three criteria are not able to repeat the experimentally obtained fracture behavior. The study indicates that the stress triaxiality cut off idea is necessary to predict the Taylor impact fracture.

  7. Evaluation of Five Fracture Models in Taylor Impact Fracture

    NASA Astrophysics Data System (ADS)

    Zhang, Wei; Xiao, Xinke; Wei, Gang; Guo, Zitao

    2011-06-01

    Taylor impact test presented in a previous study on a commercial high strength and super hard aluminum alloy 7A04-T6 are numerically evaluated using the finite element code ABAQUS/Explicit. In the present study, the influence of fracture criterion in numerical simulations of the deformation and fracture behavior of Taylor rod has been studied. Included in the paper are a modified version of Johnson-Cook, the Cockcroft-Latham(C-L), the constant fracture strain, the maximum shear stress and the maximum principle stress fracture models. Model constants for each criterion are calibrated from material tests. The modified version of Johnson-Cook fracture criterion with the stress triaxiality cut off idea is found to give good prediction of the Taylor impact fracture behavior. However, this study will also show that the C-L fracture criterion where only one simple material test is required for calibration, is found to give reasonable predictions. Unfortunately, the other three criteria are not able to repeat the experimentally obtained fracture behavior. The study indicates that the stress triaxiality cut off idea is necessary to predict the Taylor impact fracture. The National Natural Science Foundation of China (No.: 11072072).

  8. MECHANICAL STUDY ON DORSAL STABILITY OF INTRAMEDULLARY OSTEOSYNTHESIS ASSOCIATED WITH EXTERNAL FIXATION (ULSON'S METHOD)

    PubMed Central

    Sardenberg, Trajano; Muller, Sérgio Swain; Medeiros, Daniel Ricardo; Baptistão, Pablo Luiz

    2015-01-01

    Objective: To evaluate the Ulson intramedullary fixation method, with external fixation in which the level of the external locking of the Kirschner wires is varied, and without external fixation. Methods: Eighteen porcine tibias were used. Transverse osteotomy was performed in the region of the tuberosity, and two intramedullary Kirschner wires were inserted into each specimen, using three different assembly patterns: Group I: locking with external minifixator at a height of 3.0 cm; Group II: locking at a height of 4.5 cm; Group III: without external locking. Mechanical shear tests were then conducted, to determine the maximum load, proportionality limit and coefficient of rigidity. Results: There were no significant differences in maximum load or proportionality limit between the groups. The coefficient of rigidity was higher in Group II. Conclusion: The locking height for the Kirschner wires in Ulson's method, within the limits evaluated, did not harm the stability of the fracture fixation system. PMID:27027069

  9. Staged Columnar Fixation of Bicondylar Tibial Plateaus: A Cheaper Alternative to External Fixation.

    PubMed

    Perdue, Aaron; Greenberg, Sarah E; Sathiyakumar, Vasanth; Thakore, Rachel V; Mir, Hassan R; Obremskey, William T; Sethi, Manish K

    2016-01-01

    The objective of this study was to compare complication rates and costs of staged columnar fixation (SCF) to external fixation for bicondylar tibial plateau fractures. Patients who received SCF or temporary external fixation across a 3-year period at a major level I trauma center underwent a retrospective chart review for associated complications. Fisher's exact analysis was used to determine any statistical difference in complication rates between both groups. However, there was no significant difference in complication rates between the SCF and external fixator groups. Average medial plate costs for SCF were $2131 compared with an average external fixator cost of $4070 (p < .0001). Given that all patients with external fixation undergo eventual medial and lateral plating, savings with SCF include $4070 plus operative costs for removing the fixator. As our health care system focuses on cost-cutting efforts, orthopaedic trauma surgeons must explore cheaper and equally effective treatment alternatives. PMID:27082883

  10. Constraints on bed scale fracture chronology with a FEM mechanical model of folding: The case of Split Mountain (Utah, USA)

    NASA Astrophysics Data System (ADS)

    Sassi, W.; Guiton, M. L. E.; Leroy, Y. M.; Daniel, J.-M.; Callot, J.-P.

    2012-11-01

    A technique is presented for improving the structural analysis of natural fractures development in large scale fold structures. A 3D restoration of a fold provides the external displacement loading conditions to solve, by the finite element method, the forward mechanical problem of an idealized rock material with a stress-strain relationship based on the activation of pervasive fracture sets. In this elasto-plasticity constitutive law, any activated fracture set contributes to the total plastic strain by either an opening or a sliding mode of rock failure. Inherited versus syn-folding fracture sets development can be studied using this mechanical model. The workflow of this methodology was applied to the Weber sandstone formation deformed by forced folding at Split Mountain Anticline, Utah for which the different fracture sets were created and developed successively during the Sevier and the syn-folding Laramide orogenic phases. The field observations at the top stratigraphic surface of the Weber sandstone lead to classify the fracture sets into a pre-fold WNW-ESE fracture set, and a NE-SW fracture set post-dating the former. The development and relative chronology of the fracture sets are discussed based on the geomechanical modeling results. Starting with a 3D restoration of the Split Mountain Anticline, three fold-fracture development models were generated, alternately assuming that the WNW-ESE fracture set is either present or absent prior to folding process. Depending on the initial fracture configuration, the calculated fracture patterns are markedly different, showing that assuming a WNW-ESE joint set to predate the fold best correlates with field observations. This study is a first step addressing the complex problem of identification of fold-related fracturing events using an elementary concept of rock mechanics. When tight to complementary field observations, including petrography, diagenesis and burial history, the approach can be used to better

  11. FRACTURED PETROLEUM RESERVOIRS

    SciTech Connect

    Abbas Firoozabadi

    1999-06-11

    The four chapters that are described in this report cover a variety of subjects that not only give insight into the understanding of multiphase flow in fractured porous media, but they provide also major contribution towards the understanding of flow processes with in-situ phase formation. In the following, a summary of all the chapters will be provided. Chapter I addresses issues related to water injection in water-wet fractured porous media. There are two parts in this chapter. Part I covers extensive set of measurements for water injection in water-wet fractured porous media. Both single matrix block and multiple matrix blocks tests are covered. There are two major findings from these experiments: (1) co-current imbibition can be more efficient than counter-current imbibition due to lower residual oil saturation and higher oil mobility, and (2) tight fractured porous media can be more efficient than a permeable porous media when subjected to water injection. These findings are directly related to the type of tests one can perform in the laboratory and to decide on the fate of water injection in fractured reservoirs. Part II of Chapter I presents modeling of water injection in water-wet fractured media by modifying the Buckley-Leverett Theory. A major element of the new model is the multiplication of the transfer flux by the fractured saturation with a power of 1/2. This simple model can account for both co-current and counter-current imbibition and computationally it is very efficient. It can be orders of magnitude faster than a conventional dual-porosity model. Part II also presents the results of water injection tests in very tight rocks of some 0.01 md permeability. Oil recovery from water imbibition tests from such at tight rock can be as high as 25 percent. Chapter II discusses solution gas-drive for cold production from heavy-oil reservoirs. The impetus for this work is the study of new gas phase formation from in-situ process which can be significantly

  12. Complex Fluids and Hydraulic Fracturing.

    PubMed

    Barbati, Alexander C; Desroches, Jean; Robisson, Agathe; McKinley, Gareth H

    2016-06-01

    Nearly 70 years old, hydraulic fracturing is a core technique for stimulating hydrocarbon production in a majority of oil and gas reservoirs. Complex fluids are implemented in nearly every step of the fracturing process, most significantly to generate and sustain fractures and transport and distribute proppant particles during and following fluid injection. An extremely wide range of complex fluids are used: naturally occurring polysaccharide and synthetic polymer solutions, aqueous physical and chemical gels, organic gels, micellar surfactant solutions, emulsions, and foams. These fluids are loaded over a wide range of concentrations with particles of varying sizes and aspect ratios and are subjected to extreme mechanical and environmental conditions. We describe the settings of hydraulic fracturing (framed by geology), fracturing mechanics and physics, and the critical role that non-Newtonian fluid dynamics and complex fluids play in the hydraulic fracturing process. PMID:27070765

  13. [Distal humerus fractures in children].

    PubMed

    Schneidmueller, D; Boettger, M; Laurer, H; Gutsfeld, P; Bühren, V

    2013-11-01

    Fractures of the distal humerus belong to the most common injuries of the upper arm in childhood. Most frequently occurring is the supracondylar fracture of the distal humerus. In these cases and in the second most common epicondylar fractures, the metaphysis is affected and these fractures are therefore extra-articular. They have to be distinguished from articular fractures regarding therapy and prognosis. The growth potential of the distal epiphysis is very limited as is the possibility of spontaneous correction so that major dislocations should not be left uncorrected. Unstable and especially dislocated articular fractures must be anatomically reconstructed employing various osteosynthetic techniques, mostly combined with immobilization. Insufficient reconstruction, growth disturbance and non-union can result in axial deformities, such as cubitus valgus and varus, restriction of motion, pain and nerve palsy.

  14. Fracture healing: mechanisms and interventions

    PubMed Central

    Einhorn, Thomas A.; Gerstenfeld, Louis C.

    2015-01-01

    Fractures are the most common large-organ, traumatic injuries to humans. The repair of bone fractures is a postnatal regenerative process that recapitulates many of the ontological events of embryonic skeletal development. Although fracture repair usually restores the damaged skeletal organ to its pre-injury cellular composition, structure and biomechanical function, about 10% of fractures will not heal normally. This article reviews the developmental progression of fracture healing at the tissue, cellular and molecular levels. Innate and adaptive immune processes are discussed as a component of the injury response, as are environmental factors, such as the extent of injury to the bone and surrounding tissue, fixation and the contribution of vascular tissues. We also present strategies for fracture treatment that have been tested in animal models and in clinical trials or case series. The biophysical and biological basis of the molecular actions of various therapeutic approaches, including recombinant human bone morphogenetic proteins and parathyroid hormone therapy, are also discussed. PMID:25266456

  15. Complex Fluids and Hydraulic Fracturing.

    PubMed

    Barbati, Alexander C; Desroches, Jean; Robisson, Agathe; McKinley, Gareth H

    2016-06-01

    Nearly 70 years old, hydraulic fracturing is a core technique for stimulating hydrocarbon production in a majority of oil and gas reservoirs. Complex fluids are implemented in nearly every step of the fracturing process, most significantly to generate and sustain fractures and transport and distribute proppant particles during and following fluid injection. An extremely wide range of complex fluids are used: naturally occurring polysaccharide and synthetic polymer solutions, aqueous physical and chemical gels, organic gels, micellar surfactant solutions, emulsions, and foams. These fluids are loaded over a wide range of concentrations with particles of varying sizes and aspect ratios and are subjected to extreme mechanical and environmental conditions. We describe the settings of hydraulic fracturing (framed by geology), fracturing mechanics and physics, and the critical role that non-Newtonian fluid dynamics and complex fluids play in the hydraulic fracturing process.

  16. Unusual presentation of a femoral stress fracture

    PubMed Central

    Ejnisman, Leandro; Wajnsztejn, Andre; Queiroz, Roberto Dantas; Ejnisman, Benno

    2013-01-01

    Stress fractures are common injuries in sports medicine. Among these fractures, femoral neck stress fractures frequently have a benign course, especially when it happens in the medial aspect of the neck. This case report describes a stress fracture of the medial aspect of the femoral neck that developed a complete fracture and underwent surgical fixation. PMID:23283621

  17. Seismic determination of saturation in fractured reservoirs

    USGS Publications Warehouse

    Brown, R.L.; Wiggins, M.L.; Gupta, A.

    2002-01-01

    Detecting the saturation of a fractured reservoir using shear waves is possible when the fractures have a geometry that induces a component of movement perpendicular to the fractures. When such geometry is present, vertically traveling shear waves can be used to examine the saturation of the fractured reservoir. Tilted, corrugated, and saw-tooth fracture models are potential examples.

  18. Nonunion of fifth metatarsal fractures.

    PubMed

    Solan, Matthew; Davies, Mark

    2014-09-01

    Metatarsal fractures are those most frequently encountered in the foot. More than half of these are of the 5th metatarsal. The incidence is increasing, along with the activity levels of the general population. Fractures of the 5th metatarsal require careful evaluation and classification to ensure selection of the optimum treatment plan. Distal fractures rarely require fixation, even when displacement is wide. Cases of established nonunion or refracture require fixation.

  19. Insufficiency fractures of the sacrum

    SciTech Connect

    Cooper, K.L.; Beabout, J.W.; Swee, R.G.

    1985-07-01

    Insufficiency stress fractures may occur in the sacrum after radiation therapy or secondary to postmenopausal or steroid-induced osteoporosis. These fractures are often either overlooked or confused both clinically and radiographically with metastatic disease. Findings on plain films and conventional tomograms are often subtle. Radionuclide bone scans show a characteristic distribution of increased uptake. Computed tomography is the definitive technique for demonstrating the fractures.

  20. Method for fracturing subterranean formations

    SciTech Connect

    Almond, S. W.; Conway, M. W.

    1985-11-19

    The present invention relates to a thermally stable crosslinked gel fracturing fluid for use in the treatment of subterranean formations penetrated by a well bore. The fracturing fluid comprises an aqueous liquid, a gelling agent comprising a selected modified cellulose ether, a crosslinking agent and any additional additives that may be present. The fracturing fluid is thermally stable under shear at temperatures in excess of about 200/sup 0/ F.

  1. In vivo measurement of bending stiffness in fracture healing

    PubMed Central

    Hente, Reiner; Cordey, Jacques; Perren, Stephan M

    2003-01-01

    Background Measurement of the bending stiffness a healing fracture represents a valid variable in the assessment of fracture healing. However, currently available methods typically have high measurement errors, even for mild pin loosening. Furthermore, these methods cannot provide actual values of bending stiffness, which precludes comparisons among individual fractures. Thus, even today, little information is available with regards to the fracture healing pattern with respect to actual values of bending stiffness. Our goals were, therefore: to develop a measurement device that would allow accurate and sensitive measurement of bending stiffness, even in the presence of mild pin loosening; to describe the course of healing in individual fractures; and help to evaluate whether the individual pattern of bending stiffness can be predicted at an early stage of healing. Methods A new measurement device has been developed to precisely measure the bending stiffness of the healing fracture by simulating four-point-bending. The system was calibrated on aluminum models and intact tibiae. The influence of pin loosening on measurement error was evaluated. The system was tested at weekly intervals in an animal experiment to determine the actual bending stiffness of the fracture. Transverse fractures were created in the right tibia of twelve sheep, and then stabilized with an external fixator. At ten weeks, bending stiffness of the tibiae were determined in a four-point-bending test device to validate the in-vivo-measurement data. Results In-vivo bending stiffness can be measured accurately and sensitive, even in the early phase of callus healing. Up to a bending stiffness of 10 Nm/degree, measurement error was below 3.4% for one pin loose, and below 29.3% for four pins loose, respectively. Measurement of stiffness data over time revealed a significant logarithmic increase between the third and seventh weeks, whereby the logarithmic rate of change among sheep was similar, but

  2. [METHOD OF OSTEOSYNTHESIS OF SUPRACONDULAR FRACTURES OF THE HUMERUS].

    PubMed

    Neverov, V A; Chernyaev, S N; Shinkarenko, D V

    2015-01-01

    A treatment of fractures of distal metadiaphysis of the humeral bone remains an actual problem of modern traumatology at present time. This is associated with immediate proximity of the radial nerve and risk of iatrogenic injury in external fixation, presence of short distal fragment, comminuted nature of fracture, complexity of treatment method selection, need of extensible approach. Biomechanical features of different fixators were analyzed in consideration of presence of short distal fragment, traumatic of. external fixation and risk of iatrogenic injury of the nerve. The authors suggested the method of osteosynthesis of the humerus by using blocking osteosynthesis with preliminary extension of intra-medullary canal of distal fragment for obtaining stable osteosynthesis (priority No 2014105323 from 14.02.2014). The proposed method allowed avoiding the iatrogenic neuropathy of the radial nerve, providing the stability of fixation higher, than in case of external fixation. It excludes the need of external immobilization and combines the period of bony union with the period of rehabilitation and socially integrates the patient in minimal terms.

  3. Coupled Fracture and Flow in Shale in Hydraulic Fracturing

    NASA Astrophysics Data System (ADS)

    Carey, J. W.; Mori, H.; Viswanathan, H.

    2014-12-01

    Production of hydrocarbon from shale requires creation and maintenance of fracture permeability in an otherwise impermeable shale matrix. In this study, we use a combination of triaxial coreflood experiments and x-ray tomography characterization to investigate the fracture-permeability behavior of Utica shale at in situ reservoir conditions (25-50 oC and 35-120 bars). Initially impermeable shale core was placed between flat anvils (compression) or between split anvils (pure shear) and loaded until failure in the triaxial device. Permeability was monitored continuously during this process. Significant deformation (>1%) was required to generate a transmissive fracture system. Permeability generally peaked at the point of a distinct failure event and then dropped by a factor of 2-6 when the system returned to hydrostatic failure. Permeability was very small in compression experiments (< 1 mD), possibly because of limited fracture connectivity through the anvils. In pure share experiments, shale with bedding planes perpendicular to shear loading developed complex fracture networks with narrow apertures and peak permeability of 30 mD. Shale with bedding planes parallel to shear loading developed simple fractures with large apertures and a peak permeability as high as 1 D. Fracture systems held at static conditions for periods of several hours showed little change in effective permeability at hydrostatic conditions as high as 140 bars. However, permeability of fractured systems was a function of hydrostatic pressure, declining in a pseudo-linear, exponential fashion as pressure increased. We also observed that permeability decreased with increasing fluid flow rate indicating that flow did not follow Darcy's Law, possibly due to non-laminar flow conditions, and conformed to Forscheimer's law. The coupled deformation and flow behavior of Utica shale, particularly the large deformation required to initiate flow, indicates the probable importance of activation of existing

  4. Fracture Control in Engineering Structures

    NASA Astrophysics Data System (ADS)

    Weatherly, G. C.

    1980-07-01

    The three-day meeting "Fracture Control in Engineering Structures" was held at the 1979 C.I.M. Annual Conference of Metallurgists in Sudbury, Ontario, August 19-21, 1979. The meeting was organized by the Materials Engineering Section of C.I.M. and the Canadian Fracture Research Committee (CFRC), a non-profit organization and the national arm of the International Congress on Fracture. The objectives of CFRC are to promote research and conferences in Canada on the Strength & Fracture of Materials. To this end, CFRC holds (sometimes jointly) conferences every year.

  5. Postpartal sacral fracture without osteoporosis.

    PubMed

    Rousière, M; Kahan, A; Job-Deslandre, C

    2001-02-01

    Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. Vitamin D levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. Magnetic resonance imaging is the diagnostic investigation of choice.

  6. Acute tibial tubercle avulsion fractures.

    PubMed

    McKoy, Brodie E; Stanitski, Carl L

    2003-07-01

    Acute tibial tubercle avulsion fractures are uncommon, and these injuries typically occur in mature-appearing adolescent boys involved in jumping sports, particularly basketball. The developmental anatomy of the tibial tuberosity and the changes surrounding normal physiologic epiphysiodesis render this structure susceptible to acute avulsion fractures. Possible associated injuries include patellar and quadriceps avulsions, collateral and cruciate ligament tears, and meniscal damage. The treatment of this injury is based on the amount of displacement and associated injuries. Nondisplaced fractures are treated nonoperatively with cast immobilization. Displaced fractures require open reduction and internal fixation. Even in Type III injuries, the outcome is usually excellent.

  7. Externality and burnout among dentists.

    PubMed

    St-Yves, A; Freeston, M H; Godbout, F; Poulin, L; St-Amand, C; Verret, M

    1989-12-01

    This study investigates the relationship between burnout as measured by the Maslach Burnout Inventory and locus of control as measured by the Adult Nowicki-Strickland Internal-External Locus of Control (ANS-IE) for 82 dentists. Significant Pearson correlations between two Maslach subscales and locus of control show Personal Accomplishment to be negatively associated -.31 and Emotional Exhaustion to be positively correlated .21 to externality.

  8. [Contact sensitization to external agents].

    PubMed

    Erdmann, S M; Merk, H-F

    2003-04-01

    The following review describes contact sensitization to topically applied medications--especially topical dermatological agents--and to external agents in the broadest sense. Particularly skin care products constitute a special source for sensitization due to their widespread use. Especially fragrances and preservatives in cosmetics play an important global role in eliciting contact allergies. Because of the extremely broad spectrum covered by the active and adjuvant ingredients contained in external agents, the following discussion focuses on specific substance groups.

  9. External dacryocystorhinostomy: Tips and tricks

    PubMed Central

    Ali, Mohammad Javed; Naik, Milind N.; Honavar, Santosh G.

    2012-01-01

    Dacryocystorhinostomy or DCR is one of the most common oculoplastics surgery performed. It is a bypass procedure that creates an anastomosis between the lacrimal sac and the nasal mucosa via a bony ostium. It may be performed through an external skin incision or intranasally with or without endoscopic visualization. This article will discuss the indications, goals, and simple techniques for a successful outcome of an external DCR. PMID:23440476

  10. [Rehabilitation after periprosthetic fractures].

    PubMed

    Schmitt-Sody, M; Valle, C

    2016-03-01

    Periprosthetic fractures of the upper and lower extremities not only represent a challenge for surgeons but also for the rehabilitation team. The sometimes multimorbid patients have often undergone several surgical operations and need special planning and cooperation between an interdisciplinary team in order to achieve the best possible functional result and social reintegration. A structured rehabilitation planning after surgical treatment is a prerequisite for the patient to return to life as normal as possible. The aim is always rapid mobilization to achieve independence in activities of daily living. Special attention should be paid to postoperative immobilization and weight bearing. PMID:26923872

  11. Permeability damage to natural fractures caused by fracturing fluid polymers

    SciTech Connect

    Gall, B.L.; Sattler, A.R.; Maloney, D.R.; Raible, C.J.

    1988-04-01

    Formation damage studies using artificially fractured, low-permeability sandstone cores indicate that viscosified fracturing fluids can severely restrict gas flow through these types of narrow fractures. These studies were performed in support of the Department of Energy's Multiwell Experiment (MWX). Extensive geological and production evaluations at the MWX site indicate that the presence of a natural fracture system is largely responsible for unstimulated gas production. The laboratory formation damage studies were designed to examine changes in cracked core permeability to gas caused by fracturing fluid residues introduced into such narrow fractures during fluid leakoff. Polysaccharide polymers caused significant reduction (up to 95%) to gas flow through cracked cores. Polymer fracturing fluid gels used in this study included hydroxypropyl guar, hydroxyethyl cellulose, and xanthan gum. In contrast, polyacrylamide gels caused little or no reduction in gas flow through cracked cores after liquid cleanup. Other components of fracturing fluids (surfactants, breakers, etc.) caused less damage to gas flows. Other factors affecting gas flow through cracked cores were investigated, including the effects of net confining stress and non-Darcy flow parameters. Results are related to some of the problems observed during the stimulation program conducted for the MWX. 24 refs., 4 figs., 7 tabs.

  12. Gravity-Driven Hydraulic Fractures

    NASA Astrophysics Data System (ADS)

    Germanovich, L. N.; Garagash, D.; Murdoch, L. C.; Robinowitz, M.

    2014-12-01

    This study is motived by a new method for disposing of nuclear waste by injecting it as a dense slurry into a hydraulic fracture that grows downward to great enough depth to permanently isolate the waste. Disposing of nuclear waste using gravity-driven hydraulic fractures is mechanically similar to the upward growth of dikes filled with low density magma. A fundamental question in both applications is how the injected fluid controls the propagation dynamics and fracture geometry (depth and breadth) in three dimensions. Analog experiments in gelatin [e.g., Heimpel and Olson, 1994; Taisne and Tait, 2009] show that fracture breadth (the short horizontal dimension) remains nearly stationary when the process in the fracture "head" (where breadth is controlled) is dominated by solid toughness, whereas viscous fluid dissipation is dominant in the fracture tail. We model propagation of the resulting gravity-driven (buoyant or sinking), finger-like fracture of stationary breadth with slowly varying opening along the crack length. The elastic response to fluid loading in a horizontal cross-section is local and can be treated similar to the classical Perkins-Kern-Nordgren (PKN) model of hydraulic fracturing. The propagation condition for a finger-like crack is based on balancing the global energy release rate due to a unit crack extension with the rock fracture toughness. It allows us to relate the net fluid pressure at the tip to the fracture breadth and rock toughness. Unlike the PKN fracture, where breadth is known a priori, the final breadth of a finger-like fracture is a result of processes in the fracture head. Because the head is much more open than the tail, viscous pressure drop in the head can be neglected leading to a 3D analog of Weertman's hydrostatic pulse. This requires relaxing the local elasticity assumption of the PKN model in the fracture head. As a result, we resolve the breadth, and then match the viscosity-dominated tail with the 3-D, toughness

  13. Pseudopathologic fracture of the femoral neck

    SciTech Connect

    Pope, T.L. Jr.; Keats, T.E.; Goldner, R.; Stelling, C.B.; Logan, M.

    1981-11-01

    We have seen two cases of traumatic subcapital fractures of the femoral neck which resembled pathologic fractures on plain radiography. We have named this entity pseudopathologic fracture of the femoral neck and offer suggestions for why it occurs.

  14. Closed reduction of a fractured bone

    MedlinePlus

    Fracture reduction - closed ... pain medicine you receive. There may be new fractures that occur with the reduction. If the reduction ... BD, Jupiter JBl, Krettek C, Anderson PA. Closed fracture management. In: Browner BD, Jupiter JB, Krettek C, ...

  15. Traumatic cervical spine fractures in the adult.

    PubMed

    Copley, Phillip; Tilliridou, Vicky; Jamjoom, Aimun

    2016-09-01

    This article reviews fractures of the cervical spine, highlighting the pertinent goals of initial management, the indications for different imaging modalities and the different fracture patterns. Basic principles of management of these different fracture patterns are outlined. PMID:27640656

  16. Combining free vascularized fibula graft and the Ilizarov external fixator: recent approaches to congenital pseudarthrosis of the tibia.

    PubMed

    Toh, S; Harata, S; Tsubo, K; Inoue, S; Narita, S

    2001-10-01

    The present study compares a recent approach for congenital pseudarthrosis of the tibia, combining a free vascularized fibula graft and an Ilizarov external fixator. Between 1984 and 1993, seven vascularized fibula grafts were performed. In the first six cases, casts or unilateral external fixators were applied, and five of these cases were complicated by fractures of the graft, necessitating secondary procedures or long-term immobilization. The mean follow-up was 12.1 years. Five patients can now walk unassisted, and one uses a brace only outdoors. On average, a brace was required for 18 months. In the recent Ilizarov external fixator case, the fixator was removed after 4 months and a brace was unnecessary at 10 months. There was no leg-length discrepancy, severe ankle deformity, or fracture of the grafted fibula 7 years postoperatively. Combining a free vascularized fibula graft with an Ilizarov external fixator is recommended for this condition.

  17. Acute Tibialis Posterior Tendon Rupture With Pronation-Type Ankle Fractures.

    PubMed

    Bernstein, Derek T; Harris, Joshua D; Cosculluela, Pedro E; Varner, Kevin E

    2016-09-01

    Tibialis posterior tendon rupture in the setting of pronation-type ankle fractures can lead to long-term debility as a result of chronic tendon dysfunction. This rare injury pattern presents a diagnostic challenge because thorough preoperative examination of the function of the tendon is limited by pain, swelling, and inherent instability of the fracture. As such, a high index of suspicion is necessary in ankle fractures with radiographs showing a medial malleolus fracture with an associated suprasyndesmotic fibula fracture. This report describes 3 cases of tibialis posterior tendon rupture associated with pronation-type ankle fractures treated acutely with open reduction and internal fixation and primary tendon repair. Additionally, common features of this injury pattern are discussed based on the current literature. In accordance with this report, the typical mechanism of injury is high energy and includes forced pronation, external rotation, and dorsiflexion of the ankle, which places maximal stress on the tibialis posterior tendon. Rupture most commonly occurs in a relatively hypovascular area of the tendon located at the posteromedial extent of the medial malleolus fracture. In the operative treatment of pronation-type ankle fractures, direct inspection of the tibialis posterior tendon allows for timely diagnosis and treatment of associated ruptures. [Orthopedics.2016; 39(5):e970-e975.]. PMID:27248337

  18. Throwing fracture of the humeral shaft. An analysis of 90 patients.

    PubMed

    Ogawa, K; Yoshida, A

    1998-01-01

    Ninety patients with humeral shaft fractures sustained during throwing were analyzed to determine what caused their injuries. All patients were recreational baseball players: 89 were men and 1 was a woman. The average age was 25 years (range, 12 to 43). The throwing style, type of pitch, fielding position, and type of ball used varied; however, the patients sustained their fractures while performing a hard throw in 87 (97%) of the occurrences. The actual courses of the balls thrown ranged from sideways to straight forward. All fractures were external rotation spiral fractures; 25 patients (28%) had a medial butterfly fragment, and 14 patients (16%) had radial nerve palsy. Fractures were most likely to have occurred in the distal half of the humerus, although they occurred frequently in the proximal half in patients in their early teens. We conclude that 1) the fracture can occur at any time during the acceleration phase before ball release, 2) this type of fracture can occur in any recreational baseball player attempting to perform a hard throw, and 3) the cause of this fracture is the throwing action itself.

  19. Factors influencing infection in 10 years of battlefield open tibia fractures.

    PubMed

    Penn-Barwell, J G; Bennett, P M; Mortiboy, D E; Fries, C A; Groom, A F G; Sargeant, I D

    2016-04-01

    The aim of this study was to characterise severe open tibial shaft fractures sustained by the UK military personnel over 10 years of combat in Iraq and Afghanistan. The UK military Joint Theatre Trauma Registry was searched for all such injuries, and clinical records were reviewed for all patients. One hundred Gustilo-Anderson III tibia fractures in 89 patients were identified in the 10 year study period; the majority sustained injuries through explosive weapons (63, 68 %) with the remainder being injured from gunshot wounds. Three fractures were not followed up for 12 months and were therefore excluded. Twenty-two (23 %) of the remaining 97 tibial fractures were complicated by infection, with S. aureus being the causative agent in 13/22 infected fractures (59 %). Neither injury severity, mechanism, the use of an external fixator, the need for vascularised tissue transfer nor smoking status was associated with subsequent infection. Bone loss was significantly associated with subsequent infection (p < 0.0001, Fisher's exact test). This study presents 10 years of open tibial fractures sustained in Iraq and Afghanistan. Most infection in combat open tibia fractures is caused by familiar organisms, i.e. S. aureus. While the overall severity of a casualty's injuries was not associated with infection, the degree of bone loss from the fracture was. PMID:26993111

  20. Thoracolumbar Spine Fractures in the Geriatric Fracture Center

    PubMed Central

    Folbert, E. C.; Kraai, M.; Smit, R. S.; Hegeman, J. H.; van der Velde, D.

    2014-01-01

    Introduction: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a vertebral fracture. Methods: This study is a retrospective cohort study, which included all patients with an age of 65 years and older, who were diagnosed with a vertebral fracture and where therefore admitted to the Geriatric Fracture Center over a period of 2 years. Primary outcome was the level of functioning 6 weeks and 3 months after admission. Results: We included 106 patients with 143 vertebral fractures, of which 61 patients were evaluated after 3 months. In our population, 53% of the patients had a fracture involving both middle and anterior columns. The majority of the patients functioned sufficiently 6 weeks and 3 months after admission. Analysis showed that age <80 years is an independent predictor of a sufficient level of functioning after 6 weeks. Discussion: The nonoperative treatment of elderly patients with a vertebral fracture leads to a sufficient level of functioning 6 weeks and 3 months after admission. In our population, only age <80 years is an independent predictor for a sufficient level of functioning 6 weeks after admission. The level of functioning at 6 weeks predicts the level of functioning 3 months after admission. On comparison, the level of functioning after early ambulation is equal to the level of functioning after immobilization. Where immobilization may lead to complications, early ambulation was not associated with new complications or neurological damage. Based on these advantages, the treatment of elderly patients with a fracture involving both middle and anterior columns may be altered from immobilization to mobilization in the future. PMID:25360330

  1. Rock fracture processes in chemically reactive environments

    NASA Astrophysics Data System (ADS)

    Eichhubl, P.

    2015-12-01

    Rock fracture is traditionally viewed as a brittle process involving damage nucleation and growth in a zone ahead of a larger fracture, resulting in fracture propagation once a threshold loading stress is exceeded. It is now increasingly recognized that coupled chemical-mechanical processes influence fracture growth in wide range of subsurface conditions that include igneous, metamorphic, and geothermal systems, and diagenetically reactive sedimentary systems with possible applications to hydrocarbon extraction and CO2 sequestration. Fracture processes aided or driven by chemical change can affect the onset of fracture, fracture shape and branching characteristics, and fracture network geometry, thus influencing mechanical strength and flow properties of rock systems. We are investigating two fundamental modes of chemical-mechanical interactions associated with fracture growth: 1. Fracture propagation may be aided by chemical dissolution or hydration reactions at the fracture tip allowing fracture propagation under subcritical stress loading conditions. We are evaluating effects of environmental conditions on critical (fracture toughness KIc) and subcritical (subcritical index) fracture properties using double torsion fracture mechanics tests on shale and sandstone. Depending on rock composition, the presence of reactive aqueous fluids can increase or decrease KIc and/or subcritical index. 2. Fracture may be concurrent with distributed dissolution-precipitation reactions in the hostrock beyond the immediate vicinity of the fracture tip. Reconstructing the fracture opening history recorded in crack-seal fracture cement of deeply buried sandstone we find that fracture length growth and fracture opening can be decoupled, with a phase of initial length growth followed by a phase of dominant fracture opening. This suggests that mechanical crack-tip failure processes, possibly aided by chemical crack-tip weakening, and distributed

  2. Fracture detection and mapping

    SciTech Connect

    Goldstein, N.E.; Iovenitti, J.L.

    1986-03-01

    Because the costs of drilling, completing, and testing a well can be extremely high, it is important to develop better tools and methods for locating high permeability zones prior to drilling, and to develop better tools and methods for identifying and characterizing major fracture zones during the drilling and well testing stages. At the recommendation of the LBL Industry Review Panel on Geothermal Reservoir Technology, we organized and convened a one-day workshop this past July to discuss various aspects of DOE's current and planned activities in fracture detection, to review the geothermal industry's near-term and long-term research needs, to determine the priority of those needs, to disseminate to industry the status of research in progress, and to discuss the possibility of future joint research between industry and DOE. In this paper we present a brief overview of the workshop from the perspective of those who participated in it and provided us with written comments to a questionnaire that was distributed.

  3. Fracture Detection and Mapping

    SciTech Connect

    Goldstein, Norman E.; Iovenitti, Joseph L.

    1986-01-21

    Because the costs of drilling, completing, and testing a well can be extremely high, it is important to develop better tools and methods for locating high permeability zones prior to drilling, and to develop better tools and methods for identifying and characterizing major fracture zones during the drilling and well testing stages. At the recommendation of the LBL Industry Review Panel on Geothermal Reservoir Technology, we organized and convened a one-day workshop this past July to discuss various aspects of DOE's current and planned activities in fracture detection, to review the geothermal industry's near-term and long-term research needs, to determine the priority of those needs, to disseminate to industry the status of research in progress, and to discuss the possibility of future joint research between industry and DOE. In this paper we present a brief overview of the workshop from the perspective of those who participated in it and provided us with written comments to a questionnaire that was distributed.

  4. Modeling and simulation of physical performance of a external unilateral mechatronic orthopaedic fixator - bone system.

    PubMed

    Lesniewska, A; Choromanski, W; Deszczynski, J; Dobrzynski, G

    2006-01-01

    Restricted element study of the fracture healing by external fixation device was investigated. The analyses were performed under an axial and variable loaded boundary conditions. The effect of different fracture size and different distance between bone and the external fixator device on the stress distribution was investigated. The results show that stresses in the external fixator device are highest at the beginning of the fracture healing process, and are gradually decreasing with the time of the treatment. The analyses were carried out using the commercial package CATIA P3 V5R11. This allowed to build a three-dimensional model more similar to the geometrical architecture of the long bone as well as of the external fixator. Three-dimensional restricted element model also allowed a collection of more realistic results. However, the accuracy of the results depends not only on the quality of the model geometry but also on the material properties assigned to the model components. It also depends on the accuracy in the simulation of the finite element model and the optimized mesh generation.

  5. Discrete element modeling of rock deformation, fracture network development and permeability evolution under hydraulic stimulation

    SciTech Connect

    Shouchun Deng; Robert Podgorney; Hai Huang

    2011-02-01

    Key challenges associated with the EGS reservoir development include the ability to reliably predict hydraulic fracturing and the deformation of natural fractures as well as estimating permeability evolution of the fracture network with time. We have developed a physics-based rock deformation and fracture propagation simulator by coupling a discrete element model (DEM) for fracturing with a network flow model. In DEM model, solid rock is represented by a network of discrete elements (often referred as particles) connected by various types of mechanical bonds such as springs, elastic beams or bonds that have more complex properties (such as stress-dependent elastic constants). Fracturing is represented explicitly as broken bonds (microcracks), which form and coalesce into macroscopic fractures when external and internal load is applied. The natural fractures are represented by a series of connected line segments. Mechanical bonds that intersect with such line segments are removed from the DEM model. A network flow model using conjugate lattice to the DEM network is developed and coupled with the DEM. The fluid pressure gradient exerts forces on individual elements of the DEM network, which therefore deforms the mechanical bonds and breaks them if the deformation reaches a prescribed threshold value. Such deformation/fracturing in turn changes the permeability of the flow network, which again changes the evolution of fluid pressure, intimately coupling the two processes. The intimate coupling between fracturing/deformation of fracture networks and fluid flow makes the meso-scale DEM- network flow simulations necessary in order to accurately evaluate the permeability evolution, as these methods have substantial advantages over conventional continuum mechanical models of elastic rock deformation. The challenges that must be overcome to simulate EGS reservoir stimulation, preliminary results, progress to date and near future research directions and opportunities will be

  6. Locking plate fixation of distal femoral fractures is a challenging technique: a retrospective review

    PubMed Central

    Toro, Giuseppe; Calabrò, Giampiero; Toro, Antonio; de Sire, Alessandro; Iolascon, Giovanni

    2015-01-01

    Summary Distal femoral fractures have typically a bimodal occurrence: in young people due to a high-energy trauma and in older people related to a low-energy trauma. These fractures are associated to a very high morbidity and mortality in elderly. Distal femoral fractures might be treated with plates, intramedullary nails, external fixations, and prosthesis. However, difficulties in fracture healing and the rate of complications are important clinical issues. The purpose of this retrospective review was to present our experience in treatment of distal femoral fracture in a sample of older people in order to evaluate the technical pitfalls and strategies used to face up the fractures unsuccessfully treated with locking plates. We included people aged more than 65 years, with a diagnosis of distal femoral fracture, treated with locking plates. We considered ‘unsuccessfully treated’ the cases with healing problems or hardware failures. Of the 12 patients (9 females and 3 males; mean aged 68.75 ± 3.31 years) included, we observed 3 ‘unsuccessfully cases’, 2 due to nonunions and 1 due to an early hardware failure, all treated using a condylar blade plate with a bone graft. One patient obtained a complete fracture healing after 1 year and in the other cases there was a nonunion. We observed as most common technical pitfalls: inadequate plate lengthening, fracture bridging, and number of locking screws. The use of locking plates is an emerging technique to treat these fractures but it seems more challenging than expected. In literature there is a lack of evidences about the surgical management of distal femoral fractures that is still an important challenge for the orthopaedic surgeon that has to be able to use all the fixation devices available. PMID:27134634

  7. Fracture toughness of anisotropic graphites

    SciTech Connect

    Kennedy, C.R.; Kehne, M.T.

    1985-01-01

    Fracture toughness measurements have been made at 0, 30, 45, 60, and 90/sup 0/ from the extrusion axis on a reasonably anisotropic graphite, grade AGOT. It was found that the fracture toughness did not vary appreciably with orientation. An observed variation in strength was found to be the result of defect orientation.

  8. Management of pediatric mandible fractures.

    PubMed

    Goth, Stephen; Sawatari, Yoh; Peleg, Michael

    2012-01-01

    The pediatric mandible fracture is a rare occurrence when compared with the number of mandible fractures that occur within the adult population. Although the clinician who manages facial fractures may never encounter a pediatric mandible fracture, it is a unique injury that warrants a comprehensive discussion. Because of the unique anatomy, dentition, and growth of the pediatric patient, the management of a pediatric mandible fracture requires true diligence with a variance in treatment ranging from soft diet to open reduction and internal fixation. In addition to the variability in treatment, any trauma to the face of a child requires additional management factors including child abuse issues and long-term sequelae involving skeletal growth, which may affect facial symmetry and occlusion. The following is a review of the incidence, relevant anatomy, clinical and radiographic examination, and treatment modalities for specific fracture types of the pediatric mandible based on the clinical experience at the University of Miami/Jackson Memorial Hospital Oral and Maxillofacial Surgery program. In addition, a review of the literature regarding the management of the pediatric mandible fracture was performed to offer a more comprehensive overview of this unique subset of facial fractures. PMID:22337373

  9. Test-Free Fracture Toughness

    NASA Technical Reports Server (NTRS)

    Minnetyan, Levon; Chamis, Christos C. (Technical Monitor)

    2003-01-01

    Computational simulation results can give the prediction of damage growth and progression and fracture toughness of composite structures. The experimental data from literature provide environmental effects on the fracture behavior of metallic or fiber composite structures. However, the traditional experimental methods to analyze the influence of the imposed conditions are expensive and time consuming. This research used the CODSTRAN code to model the temperature effects, scaling effects and the loading effects of fiberbraided composite specimens with and without fiber-optic sensors on the damage initiation and energy release rates. The load-displacement relationship and fracture toughness assessment approach is compared with the test results from literature and it is verified that the computational simulation, with the use of established material modeling and finite element modules, adequately tracks the changes of fracture toughness and subsequent fracture propagation for any fiberbraided composite structure due to the change of fiber orientations, presence of large diameter optical fibers, and any loading conditions.

  10. Atypical fractures, a biased perspective.

    PubMed

    Aspenberg, Per

    2016-01-01

    When stress fractures started to show up in the femurs of elderly ladies, it was soon evident that bisphosphonate use lay behind, and the absolute risk increase due to bisphosphonate use was reasonably well estimated already in 2008. Thereafter followed a period of confusion: the term atypical fracture was introduced, with a definition so vague that the true stress fractures tended to disappear in a cloud of ambiguity. This cast doubt on the association with bisphosphonates. The association was then re-established by large epidemiological studies based on radiographic adjudication. Atypical fractures are largely caused by bisphosphonates. With a correct indication, bisphosphonates prevent many more fractures than they cause, at least during the first years of use. With an incorrect indication they are likely to cause more harm than good. PMID:26768286

  11. Distal clavicle fractures in children☆

    PubMed Central

    Labronici, Pedro José; da Silva, Ricardo Rodrigues; Franco, Marcos Vinícius Viana; Labronici, Gustavo José; Pires, Robinson Esteves Santos; Franco, José Sergio

    2015-01-01

    Objective To analyze fractures of the distal clavicle region in pediatric patients. Methods Ten patients between the ages of five to eleven years (mean of 7.3 years) were observed. Nine patients were treated conservatively and one surgically. All the fractures were classified using the Nenopoulos classification system. Results All the fractures consolidated without complications. Conservative treatment was used for nine patients, of whom three were in group IIIB, three IIb, two IIa and one IV. The only patient who was treated surgically was a female patient of eleven years of age with a group IV fracture. Conclusion The treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments. PMID:26962489

  12. Fractures of the Radial Head.

    PubMed

    Burkhart, Klaus Josef; Wegmann, Kilian; Müller, Lars P; Gohlke, Frank E

    2015-11-01

    Radial head fractures are the most common fractures around the elbow. Because they are often accompanied by ligamentous injuries, we recommend considering them to be osteoligamentous injuries rather than simple fractures, even in undisplaced or minimally displaced fractures. Surgeons should always suspect and actively exclude concomitant ligament tears. The incidence of these associated injuries increases with greater severity of the radial head fracture. However, the standard Mason classification system does not adequately address this problem, and all attempts to establish a new classification system that provides concise treatment algorithms have failed. This article discusses the current treatment options and the current controversies in nonsurgical therapy, open reduction and internal fixation (ORIF) and radial head replacement. PMID:26498543

  13. Acute tibial tubercle avulsion fractures.

    PubMed

    Mosier, Susan M; Stanitski, Carl L

    2004-01-01

    A retrospective analysis of 18 patients with 19 acute tibial tubercle avulsion fractures was performed. Mean age at injury was 13 years 8 months. Mean follow-up time was 2 years 8 months. A group of four preadolescent patients ages 9 to 12 years at injury was identified. Participation in athletics, particularly basketball, resulted in 77% of fractures. There were one type IA, three type IB, two type IIA, six type IIB, two type IIIA, four type IIIB, and one type IV fractures. Fifteen fractures were treated with open reduction and internal fixation and four by closed reduction and cylinder cast immobilization. Three cases (15.7%) of extensor mechanism disruption were noted, two patellar tendon avulsions and one quadriceps avulsion. Final outcome was good in all patients regardless of fracture type or treatment. There were no complications.

  14. Patterns of Intracranial Hemorrhage in Pediatric Patients with Facial Fractures.

    PubMed

    Marano, Andrew A; Hoppe, Ian C; Halsey, Jordan N; Kordahi, Anthony M; Granick, Mark S; Lee, Edward S

    2016-03-01

    ) monitoring or EVD (external ventricular drain) placement, suffered intraventricular hemorrhage, experienced worsening of hemorrhage on repeat imaging, and suffered fatal injuries. Our data also showed a significant association between the need for intubation in the emergency department and fatality. Because the consequence of ICH can be life threatening, proper diagnosis and management are imperative. The purpose of this study is to describe patterns associated with ICH in pediatric facial fracture patients to promote early recognition of the injury and understanding of poor prognostic signs. PMID:26889346

  15. Relative Permeability of Fractured Rock

    SciTech Connect

    Mark D. Habana

    2002-06-30

    Contemporary understanding of multiphase flow through fractures is limited. Different studies using synthetic fractures and various fluids have yielded different relative permeability-saturation relations. This study aimed to extend the understanding of multiphase flow by conducting nitrogen-water relative permeability experiments on a naturally-fractured rock from The Geysers geothermal field. The steady-state approach was used. However, steady state was achieved only at the endpoint saturations. Several difficulties were encountered that are attributed to phase interference and changes in fracture aperture and surface roughness, along with fracture propagation/initiation. Absolute permeabilities were determined using nitrogen and water. The permeability values obtained change with the number of load cycles. Determining the absolute permeability of a core is especially important in a fractured rock. The rock may change as asperities are destroyed and fractures propagate or st rain harden as the net stresses vary. Pressure spikes occurred in water a solute permeability experiments. Conceptual models of an elastic fracture network can explain the pressure spike behavior. At the endpoint saturations the water relative permeabilities obtained are much less than the nitrogen gas relative permeabilities. Saturations were determined by weighing and by resistivity calculations. The resistivity-saturation relationship developed for the core gave saturation values that differ by 5% from the value determined by weighing. Further work is required to complete the relative permeability curve. The steady-state experimental approach encountered difficulties due to phase interference and fracture change. Steady state may not be reached until an impractical length of time. Thus, unsteady-state methods should be pursued. In unsteady-state experiments the challenge will be in quantifying rock fracture change in addition to fluid flow changes.

  16. Pentagon chain in external fields

    NASA Astrophysics Data System (ADS)

    Kovács, György; Gulácsi, Zsolt

    2015-11-01

    We consider a pentagon chain described by a Hubbard type of model considered under periodic boundary conditions. The system (i) is placed in an external magnetic field perpendicular to the plane of the cells, and (ii) is in a site-selective manner under the action of an external electric potential. In these conditions, we show in an exact manner that the physical properties of the system can be qualitatively changed. The changes cause first strong modifications of the band structure of the system created by the one-particle part of the Hamiltonian, and second, produce marked changes of the phase diagram. We exemplify this by deducing ferromagnetic ground states in the presence of external fields in two different domains of the parameter space.

  17. Experimental study of high-energy fractures delayed operation in promote bone healing

    PubMed Central

    Pan, Zhi-Jun; Li, Zhong; Li, Jing

    2015-01-01

    To investigate role of delayed operation to stimulate growth of strong external callus in high-energy fractures, and explore a new way for bone healing. Twenty adult dogs were employed, and randomly divided into four groups, including group A-D. The dogs underwent osteotomy by wire saw in middle of femur, electric coagulation damaged surrounding periosteum, forming a 1 cm defect. Group A were internal fixed 14 days after osteotomy (higher-energy fractures delayed operation), Group B and C were internal fixed immediately (no delayed operation), Group D were internal fixed 14 days after osteotomy (delayed operation, but resected granulations around extremities). The results showed that groups of early fixed have no external callus growth and almost no growth in internal callus, these conditions leads to atrophy nonunion. On contrary, the porosis was strong and callus union was steady in group A and D, which have a delayed operation. In conclusion, early surgical fixation of high-energy fracture restrains external callus growth, easily lead to poor callus healing phenomenon of low-quality. Delayed surgical fixation can begin to repair soft tissues injury, stimulate external callus growth and improve fracture healing, so a small incision open reduction produce more robust growth effect than closed reduction. PMID:26379852

  18. Space station neutral external environment

    NASA Technical Reports Server (NTRS)

    Ehlers, H.; Leger, L.

    1988-01-01

    Molecular contamination levels arising from the external induced neutral environment of the Space Station (Phase 1 configuration) were calculated using the MOLFLUX model. Predicted molecular column densities and deposition rates generally meet the Space Station contamination requirements. In the doubtful cases of deposition due to materials outgassing, proper material selection, generally excluding organic products exposed to the external environment, must be considered to meet contamination requirements. It is important that the Space Station configuration, once defined, is not significantly modified to avoid introducing new unacceptable contamination sources.

  19. Multisystemic Therapy for Externalizing Youth.

    PubMed

    Zajac, Kristyn; Randall, Jeff; Swenson, Cynthia Cupit

    2015-07-01

    Externalizing problems are multidetermined and related to individual, family, peer, school, and community risk factors. Multisystemic therapy (MST) was originally developed to address these risk factors among youth with serious conduct problems who are at-risk for out-of-home placement. Several decades of research have established MST as an evidence-based intervention for adolescents with serious clinical problems, including serious offending, delinquency, substance abuse, and parental physical abuse and neglect. This article presents an overview of the clinical procedures and evidence base of MST for externalizing problems as well as 2 adaptations: MST for Substance Abuse and MST for Child Abuse and Neglect. PMID:26092742

  20. The incidence of fragility fractures in Italy.

    PubMed

    Ratti, Chiara; Vulcano, Ettore; La Barbera, Giuseppe; Canton, Gianluca; Murena, Luigi; Cherubino, Paolo

    2013-10-01

    Osteoporosis can significantly impact on the risk of developing a fracture. Thus, fragility fractures represent a challenge for health professionals and decision makers of the twenty-first century. The aim of this work is to review the literature concerning osteoporotic fractures in Italy in terms of incidence, rate of hospitalization, relative risk of a new fragility fracture, and costs for the national health system. It was estimated that the costs of treating proximal femur fragility fractures in 2002 summed up to 1 billion Euros. The number of fragility fractures in Italy was calculated as follows: 91.494 hip fractures, 61.009 clinical vertebral fractures, 57.401 humeral fragility fractures, and 94.045 forearm/wrist fragility fractures. The incidence of fragility fractures in Italy is very high, and osteoporosis is the leading cause of morbidity in the Italian population. PMID:24046040

  1. Mode 2 fracture mechanics

    NASA Technical Reports Server (NTRS)

    Buzzard, Robert J.; Ghosn, Louis

    1988-01-01

    Current development of high-performance rolling element bearings for aircraft engines (up to 3 million DN, where DN is the product of shaft diameter in millimeters and speed in revolutions per minute) has aroused concern about fatigue crack growth in the inner bearing race that leads to catastrophic failure of the bearing and the engine. A failure sequence was postulated by Srawley, and an analytical program was undertaken to simulate fatigue crack propagation in the inner raceway of such a bearing. A fatigue specimen was developed at NASA by which fatigue data may be obtained relative to the cracking problems. The specimen may be used to obtain either mode 2 data alone or a combination of mixed-mode (1 and 2) data as well and was calibrated in this regard. Mixed-mode fracture data for M-50 bearing steel are presented, and a method for performing reversed-loading tests is described.

  2. Cerberus Fossae Fractures

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site]

    Released 29 October 2003

    The fractured surface of the Cerberus region southeast of the Elysium volcanoes provides an impressive example of the powerful tectonic forces that have shaped the region. Both the smooth lava plains and the mountains that poke through the lava are subject to the extensional forces that rip open the landscape. The fractures are radial to the Elysium complex, suggesting a relationship to the volcanic processes that have built it.

    Image information: VIS instrument. Latitude 8.6, Longitude 160.6 East (199.4 West). 19 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  3. Fracturing driven by gas exsolution

    NASA Astrophysics Data System (ADS)

    Hafver, A.; Kobchenko, M. E.; Malthe-Sørenssen, A.; Meakin, P.

    2012-04-01

    The formation and dynamics of fractures due to uniform fluid production is important for many geological systems, such as for primary migration of hydrocarbons, dehydration and devolatilization reactions. However, the basic mechanism of the process or the key signature in the form of fracture network geometries are not understood. We have therefore developed a set of analogue experiments addressing the fracturing of a thin, confined layer of gelatin which consumes sugar to generate CO2. Exploratory experimental studies show that the system exhibits a complex dynamics with clear fracture-fracture interactions during fluid production and expulsion. Here, we introduce a model to address the dynamics observed in the experiment by focusing on the material failure process induced by bubble formation during CO2 production. We use a discrete element model to address the elastic gel matrix with a coupled representation of the dissolved gas. The failure of individual bonds is modeled as a thermally activated processes - where the transition probability depends on the local stress as well as the local saturation of the dissolved gas. The model is used to address the phase-diagram for the fracture patterns, with a particular focus on hierarchical fracture system and drainage dynamics during fluid expulsion.

  4. Early history of scapular fractures.

    PubMed

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B

    2016-01-01

    The first to use the term Scapula was Vesalius (1514-1564) and thus it has remained ever since. Probably the oldest injured scapula, from 250 million years ago, was described by Chinese authors of a skeletal examination of a fossilised remains of a dinosaur Yangchuanosaurus hepingensis. In humans, the oldest known scapular fractures date back to the prehistoric and early historic times. In ancient times, a fracture of acromion was described in the treatises of Hippocrates. Early modern history of the treatment of scapular fractures is closely interlinked with the history of the French surgery. The first to point out the existence of these fractures were Petit, Du Verney and Desault in the 18th century. The first study devoted solely to scapular fractures was published by Traugott Karl August Vogt in 1799. Thomas Callaway published in 1849 an extensive dissertation on injuries to the shoulder girdle, in which he discussed a number of cases known at that time. The first radiograph of a scapular fracture was published by Petty in 1907. Mayo Robson (1884), Lambotte (1913) and Lane (1914) were pioneers in the surgical treatment of these fractures, followed in 1923 by the French surgeons Lenormat, Dujarrier and Basset. The first internal fixation of the glenoid fossa, including a radiograph, was published by Fischer in 1939. PMID:26133287

  5. Early history of scapular fractures.

    PubMed

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B

    2016-01-01

    The first to use the term Scapula was Vesalius (1514-1564) and thus it has remained ever since. Probably the oldest injured scapula, from 250 million years ago, was described by Chinese authors of a skeletal examination of a fossilised remains of a dinosaur Yangchuanosaurus hepingensis. In humans, the oldest known scapular fractures date back to the prehistoric and early historic times. In ancient times, a fracture of acromion was described in the treatises of Hippocrates. Early modern history of the treatment of scapular fractures is closely interlinked with the history of the French surgery. The first to point out the existence of these fractures were Petit, Du Verney and Desault in the 18th century. The first study devoted solely to scapular fractures was published by Traugott Karl August Vogt in 1799. Thomas Callaway published in 1849 an extensive dissertation on injuries to the shoulder girdle, in which he discussed a number of cases known at that time. The first radiograph of a scapular fracture was published by Petty in 1907. Mayo Robson (1884), Lambotte (1913) and Lane (1914) were pioneers in the surgical treatment of these fractures, followed in 1923 by the French surgeons Lenormat, Dujarrier and Basset. The first internal fixation of the glenoid fossa, including a radiograph, was published by Fischer in 1939.

  6. Lupus vulgaris of external nose.

    PubMed

    Bhandary, Satheesh Kumar; Ranganna, B Usha

    2008-12-01

    Lupus vulgaris is the commonest form of cutaneous tuberculosis which commonly involve trunk and buttocks. Lupus vulgaris affecting nose and face, are rarely reported in India. This study reports an unusual case of lupus vulgaris involving the external nose that showed dramatic outcome after six months of anti- tubercular treatment.

  7. Internal to external wavelength calibration

    NASA Astrophysics Data System (ADS)

    Sahu, Kailash C.

    1999-01-01

    The spectra of Hen 1357 (the Stingray nebula) were used to check the internal to external wavelength calibration of the STIS first order CCD modes. The radial velocity of the Stingray nebula is known to high accuracy (< 1 km/sec) and the line with of the nebular line is very narrow (< 8 km/sec for the integrated nebula). Thus the observations of the Stingray nebula are ideal to check the internal to external wavelength calibration of the first order modes. The observations were taken in G430L and G750M modes using a 52 x 0.05 arcsec slit covering the wavelength range 2900 to 5700 A and 6295 to 6867 A, respectively. The observed wavelength range includes many nebular emission lines. The wavelengths of the nebular lines derived using the pipeline internal wavelength calibration were compared with the wavelengths derived from other ground based observations. In all cases, the wavelength match between the two is of the same order as the accuracy to which the line center can be measured. These results imply that there is no significant offset between the internal and external wavelength calibrations for these modes. The HDF-S QSO observations were also used for this test both for the first order and the Echelle modes. The results of the HDF-S QSO observations further confirm the above finding for the first order modes, and imply that there is no significant offset between the internal and external wavelength calibration for the Echelle modes.

  8. Metacarpal fractures in the athlete.

    PubMed

    Rettig, A C; Ryan, R; Shelbourne, K D; McCarroll, J R; Johnson, F; Ahlfeld, S K

    1989-01-01

    Fifty-six fractures of the metacarpal occurring in 53 athletes were studied from September 1985 to December 1986, regarding mechanism of injury, type of fracture, type of treatment, and time lost from sport. Age range of the patients was 8 to 28 years with greater than 77% being in the 14 to 18 year age range, the high school athlete. Twenty-nine of the fractures occurred in football, 14 in basketball, and the remainder were divided between various other sports. The most common mechanism of injury involved falls or hitting an object such as a helmet or another player. Fractures were evenly divided regarding which digit was involved in football, whereas most basketball injuries occurred in the fourth and fifth metacarpal. Fractures were analyzed as to type of radiographic appearance and this was correlated with time lost from competition or participation. No significant difference among fracture type regarding time lost was noted. Forty-six of the fractures (82%) were minimally displaced or undisplaced and were treated by means of simple casting and/or splinting whereas 10 were displaced. Two of the 10 underwent closed reduction and casting; 3 underwent closed reduction and percutaneous pin fixation; and 5 (9%) underwent open reduction internal fixation using AO type plates and screws. All fractures healed primarily clinically and radiographically. The average time lost from practice or competition in this group overall was 13.7 days, (range, 0 to 56 days). Average time lost from basketball was 19.8 days and from football 10.63 days overall. Average time lost from sport in stable fractures treated with casting or splinting was 12.3 days.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Progressive fracture of fiber composites

    NASA Technical Reports Server (NTRS)

    Irvin, T. B.; Ginty, C. A.

    1983-01-01

    Refined models and procedures are described for determining progressive composite fracture in graphite/epoxy angleplied laminates. Lewis Research Center capabilities are utilized including the Real Time Ultrasonic C Scan (RUSCAN) experimental facility and the Composite Durability Structural Analysis (CODSTRAN) computer code. The CODSTRAN computer code is used to predict the fracture progression based on composite mechanics, finite element stress analysis, and fracture criteria modules. The RUSCAN facility, CODSTRAN computer code, and scanning electron microscope are used to determine durability and identify failure mechanisms in graphite/epoxy composites.

  10. Stress Fractures of the Foot.

    PubMed

    Hossain, Munier; Clutton, Juliet; Ridgewell, Mark; Lyons, Kathleen; Perera, Anthony

    2015-10-01

    Stress fractures of the foot and ankle may be more common among athletes than previously reported. A low threshold for investigation is warranted and further imaging may be appropriate if initial radiographs remain inconclusive. Most of these fractures can be treated conservatively with a period of non-weight-bearing mobilization followed by gradual return to activity. Early surgery augmented by bone graft may allow athletes to return to sports earlier. Risk of delayed union, nonunion, and recurrent fracture is high. Many of the patients may also have risk factors for injury that should be modified for a successful outcome.

  11. Electronics reliability fracture mechanics. Volume 2: Fracture mechanics

    NASA Astrophysics Data System (ADS)

    Kallis, J.; Duncan, L.; Buechler, D.; Backes, P.; Sandkulla, D.

    1992-05-01

    This is the second of two volumes. The other volume (WL-TR-92-3015) is 'Causes of Failures of Shop Replaceable Units and Hybrid Microcircuits.' The objective of the Electronics Reliability Fracture Mechanics (ERFM) program was to develop and demonstrate a life prediction technique for electronic assemblies, when subjected to environmental stresses of vibration and thermal cycling, based upon the mechanical properties of the materials and packaging configurations which make up an electronic system. The application of fracture mechanics to microscale phenomena in electronic assemblies was a pioneering research effort. The small scale made the experiments very difficult; for example, the 1-mil-diameter bond wires in microelectronic devices are 1/3 the diameter of a human hair. A number of issues had to be resolved to determine whether a fracture mechanics modelling approach is correct for the selected failures; specifically, the following two issues had to be resolved: What fraction of the lifetime is spent in crack initiation? Are macro fracture mechanics techniques, used in large structures such as bridges, applicable to the tiny structures in electronic equipment? The following structural failure mechanisms were selected for modelling: bondwire fracture from mechanical cycling; bondwire fracture from thermal (power) cycling; plated through hole (PTH) fracture from thermal cycling. The bondwire fracture test specimens were A1-1 percent Si wires, representative of wires used in the parts in the modules selected for detailed investigation in this program (see Vol. 1 of this report); 1-mil-diameter wires were tested in this program. The PTH test specimens were sections of 14-layer printed wiring boards of the type used.

  12. Juvenile tillaux fracture in an adolescent basketball player.

    PubMed

    Cassas, Kyle J; Jamison, John P

    2005-02-01

    Forced external rotation of the foot may cause a syndesmosis or high ankle sprain in an adult, but in a teenage patient, a juvenile Tillaux fracture may occur if the tibial physis has not yet closed. Diagnosis is made with plain radiographs, but CT may be necessary to determine the true articular displacement. Closed reduction with casting for 6 weeks is usually sufficient for most nondisplaced or minimally displaced fractures. Patients with more than 2 mm of displacement, as in this case of a 16-year-old basketball player, should be referred to an orthopedic surgeon. Complications include residual angular deformity and premature osteoarthritis. Most patients are able to return to full activity at 3 months postinjury.

  13. Pediatric fractures of the foot and ankle.

    PubMed

    Polyzois, Vasilios D; Vasiliadis, Elias; Zgonis, Thomas; Ayazi, Angelos; Gkiokas, Andreas; Beris, Alexandros E

    2006-04-01

    Distal tibial physeal injuries are common in children, accounting for 10% to 40% of all injuries to skeletally immature patients. This article describes the classification, treatment, and complications of distal tibial fractures, fractures of the talus and calcaneus, midfoot and tarsometatarsal injuries, metatarsal fractures, and fractures of the phalanges in children.

  14. Incorporating Discrete Irregular Fracture Zone Networks into 3D Paleohydrogeologic Simulations

    NASA Astrophysics Data System (ADS)

    Normani, S. D.

    2015-12-01

    Dual continuum computational models which include both porous media and discrete fracture zones are valuable tools in assessing groundwater migration and pathways in fractured rock systems. Fracture generation models can produce stochastic realizations of fracture networks which honor geological structures and fracture propagation behaviors. Surface lineament traces can be propagated to depth based on fracture zone statistics to produce representations of geological structures in rock. The generated discrete, complex and irregular fracture zone networks, represented as a triangulated mesh, are embedded using orthogonal quadrilateral elements within a three-dimensional hexahedral finite element mesh. A detailed coupled density-dependent paleohydrogeologic groundwater analysis of a hypothetical 104 km2 portion of the Canadian Shield has been conducted using the discrete-fracture dual continuum finite element model FRAC3DVS to investigate the characterization of large-scale fracture zone networks on groundwater and tracer movement during a 120,000 year paleoclimate cycle. Permeability reduction due to permafrost was also applied. Time series data for the depth of permafrost, along with ice thickness and lake depth, were provided by the University of Toronto (UofT) Glacial Systems Model. The crystalline rock between fracture zones was assigned properties characteristic of those reported for the Canadian Shield. Total dissolved solids concentrations of 300 g/L are encountered at depth. Surface water features and a Digital Elevation Model (DEM) were used in a GIS framework to define the watershed boundaries at surface water divides and to populate the finite element mesh. This work will illustrate the long-term evolution and stability of the geosphere and groundwater systems to external perturbations caused by glaciation through the use of performance measures such as Mean Life Expectancy and the migration of a unit tracer to depth over a paleoclimate cycle.

  15. Cost effectiveness of external hip protectors in the hospital setting: a modeling study.

    PubMed

    Stollenwerk, Björn; Waldeyer, Regina; Klein-Meding, Christiane; Müller, Dirk; Stock, Stephanie

    2014-01-01

    Chronic illnesses, for which many patients are admitted to hospitals, substantially increase the risk of falling, and hence the likelihood of incurring a hip fracture. Hip fractures not only have devastating consequences on an individual's quality of life but may also affect a hospital's reputation in the community. In addition, hospitals may face litigation claims and increased costs for patients who fall and suffer a major injury as a consequence. External hip protectors are comparable to padded undergarments and shield the trochanter, reducing the detrimental effects and force impacting the bone during a fall. Screening for patients at high risk of falling and providing high-risk patients with hip protectors as a preventive measure to avoid hip fractures, not only improves public health, but can also save hospitals care and litigation costs. PMID:24834633

  16. Defensive externality and blame projection following failure.

    PubMed

    Hochreich, D J

    1975-09-01

    This study focuses upon the relationship between internal-external control and defensive blame projection. Trust was used as a moderator variable for making differential predictions concerning the behavior of two subgroups of externals: defensive externals, whose externality is presumed to reflect primarily a verbal technique of defense, and congruent externals, whose externality reflects a more genuine belief that most outcomes are determined by forces beyond their personal control. As predicted, defensive externals showed a stronger tendency than did congruent externals and internals to resort to blame projection following failure at an achievement task. There were no group differences in attribution following task success. Defensive externals were found to be more responsive to negative feedback than were congruent externals.

  17. A new mixed-mode fracture criterion for large-scale lattice models

    NASA Astrophysics Data System (ADS)

    Sachau, T.; Koehn, D.

    2014-01-01

    Reasonable fracture criteria are crucial for the modeling of dynamic failure in computational lattice models. Successful criteria exist for experiments on the micro- and on the mesoscale, which are based on the stress that a bond experiences. In this paper, we test the applicability of these failure criteria to large-scale models, where gravity plays an important role in addition to the externally applied deformation. Brittle structures, resulting from these criteria, do not resemble the outcome predicted by fracture mechanics and by geological observations. For this reason we derive an elliptical fracture criterion, which is based on the strain energy stored in a bond. Simulations using the new criterion result in realistic structures. It is another great advantage of this fracture model that it can be combined with classic geological material parameters: the tensile strength σ0 and the shear cohesion τ0. The proposed fracture criterion is much more robust with regard to numerical strain increments than fracture criteria based on stress (e.g., Drucker-Prager). While we tested the fracture model only for large-scale structures, there is strong reason to believe that the model is equally applicable to lattice simulations on the micro- and on the mesoscale.

  18. UPPER LIMB TRACTION DEVICE FOR ANTEROGRADE INTRAMEDULLARY LOCKED NAIL OF HUMERAL SHAFT FRACTURES

    PubMed Central

    Corrêa, Mário Chaves; Gomes, Felipe Antônio; Linhares, Daniel Campos; Gonçalves, Lucas Braga Jacques; Vilela, José Carlos Souza; de Andrade, Ronaldo Percopi

    2015-01-01

    Diaphyseal fractures of the femur and tibia in adults are mostly treated surgically, usually by means of intramedullary locked-nail osteosynthesis. Some comminuted and/or highly deviated shaft fractures may present a veritable technical challenge. Fracture (or orthopedic) tables, which enable vertical, horizontal and rotational instrumental stabilization of the limb, greatly facilitate reduction and implant placement maneuvers and are widely used by orthopedic surgeons. Humeral shaft fractures are mostly treated nonsurgically. However, some cases with indications that are well defined in the literature require surgical treatment. They can be fixed by means of plates or intramedullary nails, using anterograde or retrograde routes. In the humerus, fracture reduction and limb stabilization maneuvers for implantation of intramedullary nails are done manually, usually by two assistants. Because muscle fatigue may occur, this option may be less efficient. The aim of this paper is to present an external upper-limb traction device for use in anterograde intramedullary locked-nail osteosynthesis of humeral shaft fractures that enables vertical, horizontal and rotational stabilization of the upper limb, in a manner similar to the device used for the lower limbs. The device is portable, of simple construction, and can be installed on any operating table equipped with side rails. It was used for surgical treatment of 29 humeral shaft fractures using an anterograde locked intramedullary nail. Our experience was extremely positive. We did not have any complications relating to its use and we believe that it notably facilitated the surgical procedures. PMID:27022560

  19. UPPER LIMB TRACTION DEVICE FOR ANTEROGRADE INTRAMEDULLARY LOCKED NAIL OF HUMERAL SHAFT FRACTURES.

    PubMed

    Corrêa, Mário Chaves; Gomes, Felipe Antônio; Linhares, Daniel Campos; Gonçalves, Lucas Braga Jacques; Vilela, José Carlos Souza; de Andrade, Ronaldo Percopi

    2010-01-01

    Diaphyseal fractures of the femur and tibia in adults are mostly treated surgically, usually by means of intramedullary locked-nail osteosynthesis. Some comminuted and/or highly deviated shaft fractures may present a veritable technical challenge. Fracture (or orthopedic) tables, which enable vertical, horizontal and rotational instrumental stabilization of the limb, greatly facilitate reduction and implant placement maneuvers and are widely used by orthopedic surgeons. Humeral shaft fractures are mostly treated nonsurgically. However, some cases with indications that are well defined in the literature require surgical treatment. They can be fixed by means of plates or intramedullary nails, using anterograde or retrograde routes. In the humerus, fracture reduction and limb stabilization maneuvers for implantation of intramedullary nails are done manually, usually by two assistants. Because muscle fatigue may occur, this option may be less efficient. The aim of this paper is to present an external upper-limb traction device for use in anterograde intramedullary locked-nail osteosynthesis of humeral shaft fractures that enables vertical, horizontal and rotational stabilization of the upper limb, in a manner similar to the device used for the lower limbs. The device is portable, of simple construction, and can be installed on any operating table equipped with side rails. It was used for surgical treatment of 29 humeral shaft fractures using an anterograde locked intramedullary nail. Our experience was extremely positive. We did not have any complications relating to its use and we believe that it notably facilitated the surgical procedures.

  20. Production effects of fluid loss in fracturing high-permeability formations

    SciTech Connect

    Elbel, J.L.; Navarrete, R.C.; Poe, B.D. Jr.

    1995-12-31

    When fracturing zones having high permeability there is concern of damage to the matrix due to deeply penetrating fluid leakoff along the fracture and/or due to materials in the fluid that minimize the amount of leakoff. Materials used to minimize leakoff also have the potential to damage the proppant pack conductivity. Previous tests have shown that high shear rates at the tip of the fracture may prevent the formation of external filter cakes, increasing the magnitude of spurt losses in highly permeable formations. This paper provides laboratory data on materials used to control spurt loss of linear gels [HEC],viscoelastic surfactant fluid and crosslinked borate-guars in formations having up to 500 md permeability. The depth of penetration into the matrix and magnitude of the permeability reduction to the matrix and proppant conductivity is shown. This data is then used in a finite fracture conductivity production simulator that includes simulation of fracture face damage. Simulations are made for various fluid-loss additives controlling leakoff with different fracturing fluids over a range of formation permeabilities as well as other reservoir conditions and production modes. The simulations show the production effects of limiting the fluid loss penetration at the expense of permeability reduction in the formation and the propped fracture.

  1. Reaction-induced fracturing during olivine serpentinization: A mechanistic investigation at the interface scale

    NASA Astrophysics Data System (ADS)

    Plümper, O.; Røyne, A.; Malthe-Sørenssen, A.; King, H. E.; Jamtveit, B.

    2012-04-01

    Serpentinization of the Earth's impermeable upper mantle is one of the most fundamental metamorphic hydration reactions. It governs lithospheric weakening, geochemical subduction zone input and possibly even the formation of life-essential building blocks. Serpentinization relies on fluid pathway generation due to low initial permeability and the large positive solid volume change associated with hydration. Although these pathways can be produced as a tectonic stress response, there is substantial evidence that the volume increase during olivine serpentinization itself generates stresses sufficient to fracture the rock. Nonetheless, the actual fracturing mechanism during olivine serpentinization is largely unexplored. Unconstrained batch experiments (Okamoto et al. 2011, this study) produce comparable hierachial fracture patterns to those found in natural samples demonstrating that no external forces (e.g., tensile stress) are required for fracturing to take place. Combining this with the observation that fluid-mediated mineral replacement advances via an interface-coupled dissolution-reprecipitation mechanism (e.g., Putnis 2009) without solid-state diffusion into the dissolving mineral indicates that classical (stress) corrosion cracking mechanisms cannot describe fracturing during olivine serpentinization. By uniting micro- and nanostructural characteristics ubiquitous to serpentinized olivine grains with a coupled diffusion-reaction-deformation model and crack growth theory this study explores the sub-critical fracturing mechanism at the interfacial scale. We present a new multistep reaction process and test the feasibility of a molecular wedge-assisted fracturing mechanism based on the following ubiquitously identified features: (1) no rotation of grain domains during fragmentation, (2) isotropic fracture orientation distribution with a uniform average width of individual finite length serpentine veins, (3) cumulative fragment area distribution with a log

  2. Femur Shaft Fractures (Broken Thighbone)

    MedlinePlus

    ... takes a lot of force to break it. Car crashes, for example, are the number one cause of ... sha fracture is a motor vehicle or motorcycle crash. Being hit by a car as a pedestrian is another common cause, as ...

  3. Bone fractures: assessment and management.

    PubMed

    Lim, L; Sirichai, P

    2016-03-01

    Severe dental traumatic injuries often involve the supporting bone and soft tissues. This article outlines the current concepts in the management of dentoalveolar fractures for the general dental practitioner with case reports to illustrate management principles and techniques. PMID:26923449

  4. Fractures of the growing mandible.

    PubMed

    Kushner, George M; Tiwana, Paul S

    2009-03-01

    Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures. This article details general and special considerations for this surgery including: craniofacial growth & development, surgical anatomy, epidemiology evaluation, various fractures, the role rigid internal fixation and the Risdon cable in pediatric maxillofacial trauma. It concludes with suggestions concerning long-term follow-up care in light of the mobility, insurance obstacles, and family dynamics facing the patient population.

  5. Bone fractures: assessment and management.

    PubMed

    Lim, L; Sirichai, P

    2016-03-01

    Severe dental traumatic injuries often involve the supporting bone and soft tissues. This article outlines the current concepts in the management of dentoalveolar fractures for the general dental practitioner with case reports to illustrate management principles and techniques.

  6. Treatment of Temporal Bone Fractures.

    PubMed

    Diaz, Rodney C; Cervenka, Brian; Brodie, Hilary A

    2016-10-01

    Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Assessment of facial nerve function as soon as possible following injury greatly facilitates clinical decision making. Use of prophylactic antibiotics in the setting of CSF leak is controversial; however, following critical analysis and interpretation of the existing classic and contemporary literature, we believe its use is absolutely warranted.

  7. Fracture in macro-molecules

    NASA Technical Reports Server (NTRS)

    Devries, K. L.

    1976-01-01

    Techniques available for the observation of molecular bond rupture during fracture of polymers are briefly outlined. Additional pertinent information can also often be inferred from microscopic and macroscopic measures.

  8. Microstructural effects in foam fracture

    NASA Astrophysics Data System (ADS)

    Stewart, Peter; Davis, Stephen; Hilgenfeldt, Sascha

    2015-11-01

    We examine the fracture of a quasi two-dimensional aqueous foam under an applied driving pressure, using a network modelling approach developed for metallic foams by Stewart & Davis (J. Rheol., vol. 56, 2012, p. 543). In agreement with experiments, we observe two distinct mechanisms of failure analogous to those observed in a crystalline solid: a slow ductile mode when the driving pressure is applied slowly, where the void propagates as bubbles interchange neighbours through the T1 process, and a rapid brittle mode for faster application of pressures, where the void advances by successive rupture of liquid films driven by Rayleigh-Taylor instability. The simulations allow detailed insight into the mechanics of the fracturing medium and the role of its microstructure. In particular, we examine the stress distribution around the crack tip and investigate how brittle fracture localizes into a single line of breakages. We also confirm that pre-existing microstructural defects can alter the course of fracture.

  9. Treatment of Temporal Bone Fractures.

    PubMed

    Diaz, Rodney C; Cervenka, Brian; Brodie, Hilary A

    2016-10-01

    Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. The most common complications of temporal bone fractures are facial nerve injury, cerebrospinal fluid (CSF) leak, and hearing loss. Assessment of facial nerve function as soon as possible following injury greatly facilitates clinical decision making. Use of prophylactic antibiotics in the setting of CSF leak is controversial; however, following critical analysis and interpretation of the existing classic and contemporary literature, we believe its use is absolutely warranted. PMID:27648399

  10. Acute fracture of the os trigonum.

    PubMed

    Escobedo, Eva M; MacDonald, Taylor L; Hunter, John C

    2006-12-01

    A 21-year-old man presented with ankle pain after a motor vehicle accident. Imaging revealed an acute fracture of the os trigonum in addition to multiple, other lower-extremity fractures. In this case, the fracture of the os trigonum was a result of a significant traumatic injury. Thus, the presence of this fracture in an acute setting should prompt a search for other associated fractures.

  11. Flow upscaling in propped fracture

    NASA Astrophysics Data System (ADS)

    Jasinski, Lukasz; Dabrowski, Marcin

    2016-04-01

    Proppants in combination with hydraulic fracturing are widely used to maintain the production of oil or gas from low permeability formations (i.e. shale rocks). There are also examples of proppants use in geothermal reservoirs. Flow patterns in propped fracture control transport processes and give information about fracture/matrix exchange surface. Our main motivation is to understand flow behavior in such structures using direct numerical simulations and to find a good upscaling technique to be able to investigate models on reservoir scale. We study fracture made of two parallel plane walls, where void space between them is filled with partial monolayer of proppant. As the fracture is affected by closing pressure, the proppant grains are squeezed between two opposite fracture walls which can change the grain shapes or embed the grains into impermeable rock matrix. To take this effect into account and simplify the geometry, the grains are approximated as cylinders. Imposed macroscopic pressure gradient invokes flow in such medium. As the flow is considered in the low Reynolds number regime, a stationary velocity flow field is obtained by solving the Stokes equations in 3D by means of finite element method. Void space between the grains is accurately discretized by using tetrahedral mesh. To reduce computational effort, the Stokes equation is reduced over the fracture aperture to 2D Stokes-Brinkman equation, which is further numerically solved and compared against numerical solution in 3D. Systematic flow calculations using 2D Stokes-Brinkman equation are performed for periodic domain and no slip boundary condition on the grain surface. Results are discussed in terms of effective properties as a function of geometrical parameters of the medium, such as proppant packing fraction and proppant grain diameter to fracture aperture ratio.

  12. Seismic characteristics of tensile fracture growth induced by hydraulic fracturing

    NASA Astrophysics Data System (ADS)

    Eaton, D. W. S.; Van der Baan, M.; Boroumand, N.

    2014-12-01

    Hydraulic fracturing is a process of injecting high-pressure slurry into a rockmass to enhance its permeability. Variants of this process are used for unconventional oil and gas development, engineered geothermal systems and block-cave mining; similar processes occur within volcanic systems. Opening of hydraulic fractures is well documented by mineback trials and tiltmeter monitoring and is a physical requirement to accommodate the volume of injected fluid. Numerous microseismic monitoring investigations acquired in the audio-frequency band are interpreted to show a prevalence of shear-dominated failure mechanisms surrounding the tensile fracture. Moreover, the radiated seismic energy in the audio-frequency band appears to be a miniscule fraction (<< 1%) of the net injected energy, i.e., the integral of the product of fluid pressure and injection rate. We use a simple penny-shaped crack model as a predictive framework to describe seismic characteristics of tensile opening during hydraulic fracturing. This model provides a useful scaling relation that links seismic moment to effective fluid pressure within the crack. Based on downhole recordings corrected for attenuation, a significant fraction of observed microseismic events are characterized by S/P amplitude ratio < 5. Despite the relatively small aperture of the monitoring arrays, which precludes both full moment-tensor analysis and definitive identification of nodal planes or axes, this ratio provides a strong indication that observed microseismic source mechanisms have a component of tensile failure. In addition, we find some instances of periodic spectral notches that can be explained by an opening/closing failure mechanism, in which fracture propagation outpaces fluid velocity within the crack. Finally, aseismic growth of tensile fractures may be indicative of a scenario in which injected energy is consumed to create new fracture surfaces. Taken together, our observations and modeling provide evidence that

  13. Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

    PubMed Central

    Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Sugiura, Tsutomu; Kirita, Tadaaki

    2015-01-01

    Purpose: The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal. Subjects and Methods: The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications. Results: One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications. Conclusions: Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life. PMID:26389039

  14. MGR External Events Hazards Analysis

    SciTech Connect

    L. Booth

    1999-11-06

    The purpose and objective of this analysis is to apply an external events Hazards Analysis (HA) to the License Application Design Selection Enhanced Design Alternative 11 [(LADS EDA II design (Reference 8.32))]. The output of the HA is called a Hazards List (HL). This analysis supersedes the external hazards portion of Rev. 00 of the PHA (Reference 8.1). The PHA for internal events will also be updated to the LADS EDA II design but under a separate analysis. Like the PHA methodology, the HA methodology provides a systematic method to identify potential hazards during the 100-year Monitored Geologic Repository (MGR) operating period updated to reflect the EDA II design. The resulting events on the HL are candidates that may have potential radiological consequences as determined during Design Basis Events (DBEs) analyses. Therefore, the HL that results from this analysis will undergo further screening and analysis based on the criteria that apply during the performance of DBE analyses.

  15. Multisystemic Therapy for Externalizing Youth

    PubMed Central

    Zajac, Kristyn; Randall, Jeff; Swenson, Cynthia Cupit

    2015-01-01

    Synopsis Externalizing problems are multi-determined and related to individual, family, peer, school, and community risk factors. Multisystemic therapy (MST) was originally developed to address these risk factors among youth with serious conduct problems who were at-risk for out-of-home placement. Several decades of research has established MST as an evidence-based intervention for adolescents with serious clinical problems, including serious offending, delinquency, substance abuse, and parental physical abuse and neglect. Further, research points to the importance of maintaining high treatment fidelity through systematic quality assurance procedures to replicate positive clinical outcomes. This paper presents an overview of the clinical procedures and evidence base of MST for externalizing problems as well as two adaptations: MST for Substance Abuse and MST for Child Abuse and Neglect. PMID:26092742

  16. Capillary fracture of soft gels

    NASA Astrophysics Data System (ADS)

    Bostwick, Joshua B.; Daniels, Karen E.

    2013-10-01

    A liquid droplet resting on a soft gel substrate can deform that substrate to the point of material failure, whereby fractures develop on the gel surface that propagate outwards from the contact line in a starburst pattern. In this paper, we characterize (i) the initiation process, in which the number of arms in the starburst is controlled by the ratio of the surface tension contrast to the gel's elastic modulus, and (ii) the propagation dynamics showing that once fractures are initiated they propagate with a universal power law L∝t3/4. We develop a model for crack initiation by treating the gel as a linear elastic solid and computing the deformations within the substrate from the liquid-solid wetting forces. The elastic solution shows that both the location and the magnitude of the wetting forces are critical in providing a quantitative prediction for the number of fractures and, hence, an interpretation of the initiation of capillary fractures. This solution also reveals that the depth of the gel is an important factor in the fracture process, as it can help mitigate large surface tractions; this finding is confirmed with experiments. We then develop a model for crack propagation by considering the transport of an inviscid fluid into the fracture tip of an incompressible material and find that a simple energy-conservation argument can explain the observed material-independent power law. We compare predictions for both linear elastic and neo-Hookean solids, finding that the latter better explains the observed exponent.

  17. Discovery External Tank Connection Check

    NASA Technical Reports Server (NTRS)

    1999-01-01

    In the Vehicle Assembly Building, Ken Strite, NASA Quality Control, inspects the connection between Space Shuttle Discovery and the external tank that will be used to launch mission STS-103 in early December. This 10 day mission is designed to replace aging parts on the nine year old Hubble Space Telescope and to upgrade some of its functioning systems. During the flight, the astronaut crew will replace all six of the observatory's gyroscopes, a fine guidance sensor, its main computer, and other equipment.

  18. [Prostate cancer external beam radiotherapy].

    PubMed

    de Crevoisier, R; Pommier, P; Latorzeff, I; Chapet, O; Chauvet, B; Hennequin, C

    2016-09-01

    The prostate external beam radiotherapy techniques are described, when irradiating the prostate or after prostatectomy, with and without pelvic lymph nodes. The following parts are presented: indications of radiotherapy, total dose and fractionation, planning CT image acquisition, volume of interest delineation (target volumes and organs at risk) and margins, Intensity modulated radiotherapy planning and corresponding dose-volume constraints, and finally Image guided radiotherapy. PMID:27516051

  19. Evaluation and management of toe fractures.

    PubMed

    Hatch, Robert L; Hacking, Scott

    2003-12-15

    Fractures of the toe are one of the most common lower extremity fractures diagnosed by family physicians. Toe fractures most frequently are caused by a crushing injury or axial force such as stubbing a toe. Joint hyperextension and stress fractures are less common. Most patients have point tenderness at the fracture site or pain with gentle axial loading of the digit. Anteroposterior and oblique radiographs generally are most useful for identifying fractures, determining displacement, and evaluating adjacent phalanges and digits. Referral is indicated in patients with circulatory compromise, open fractures, significant soft tissue injury, fracture-dislocations, displaced intra-articular fractures, or fractures of the first toe that are unstable or involve more than 25 percent of the joint surface. Most children with fractures of the physis should be referred, but children with selected nondisplaced Salter-Harris types I and II fractures may be treated by family physicians. Stable, nondisplaced toe fractures should be treated with buddy taping and a rigid-sole shoe to limit joint movement. Displaced fractures of the lesser toes should be treated with reduction and buddy taping. Patients with displaced fractures of the first toe often require referral for stabilization of the reduction.

  20. Epidemiology of fracture risk with advancing age.

    PubMed

    Ensrud, Kristine E

    2013-10-01

    Bone loss and structural damage with advancing age lead to skeletal fragility as manifested by low bone mass and deficits in bone geometry, microarchitecture, and material properties. Skeletal fragility, in combination with a greater propensity to fall, results in an increased susceptibility to fractures with aging, known as fragility fractures. Fragility fractures exceed 2 million per year in number and account for nearly 20 billion dollars per year in health care costs in the United States. Advanced age, low bone mass, and previous fracture are strong risk factors for fractures at nearly all skeletal sites, but each type of fracture also has its own set of unique risk factors. Hip fractures are most strongly associated with adverse consequences, but these account for only a minority of fragility fractures. Vertebral fractures comprise the most common manifestation of fragility fracture, but the majority of these fractures are asymptomatic. Most research has focused on the epidemiology of fractures at the hip, vertebrae, and wrist and less is known about other fracture types, which account for 40% of total fragility fractures that are clinically recognized. Future research focused on identification of older adults at high risk of disabling fractures is warranted. PMID:23833201

  1. Fracturing And Liquid CONvection

    SciTech Connect

    2012-02-29

    FALCON has been developed to enable simulation of the tightly coupled fluid-rock behavior in hydrothermal and engineered geothermal system (EGS) reservoirs, targeting the dynamics of fracture stimulation, fluid flow, rock deformation, and heat transport in a single integrated code, with the ultimate goal of providing a tool that can be used to test the viability of EGS in the United States and worldwide. Reliable reservoir performance predictions of EGS systems require accurate and robust modeling for the coupled thermal-hydrological-mechanical processes. Conventionally, these types of problems are solved using operator-splitting methods, usually by coupling a subsurface flow and heat transport simulator with a solid mechanics simulator via input files. FALCON eliminates the need for using operator-splitting methods to simulate these systems, and the scalability of the underlying MOOSE architecture allows for simulating these tightly coupled processes at the reservoir scale, allowing for examination of the system as a whole (something the operator-splitting methodologies generally cannot do).

  2. Fracturing And Liquid CONvection

    2012-02-29

    FALCON has been developed to enable simulation of the tightly coupled fluid-rock behavior in hydrothermal and engineered geothermal system (EGS) reservoirs, targeting the dynamics of fracture stimulation, fluid flow, rock deformation, and heat transport in a single integrated code, with the ultimate goal of providing a tool that can be used to test the viability of EGS in the United States and worldwide. Reliable reservoir performance predictions of EGS systems require accurate and robust modelingmore » for the coupled thermal-hydrological-mechanical processes. Conventionally, these types of problems are solved using operator-splitting methods, usually by coupling a subsurface flow and heat transport simulator with a solid mechanics simulator via input files. FALCON eliminates the need for using operator-splitting methods to simulate these systems, and the scalability of the underlying MOOSE architecture allows for simulating these tightly coupled processes at the reservoir scale, allowing for examination of the system as a whole (something the operator-splitting methodologies generally cannot do).« less

  3. Fracture, failure, and fragmentation

    SciTech Connect

    Dienes, J.K.

    1984-01-01

    Though continuum descriptions of material behavior are useful for many kinds of problems, particularly those involving plastic flow, a more general approach is required when the failure is likely to involve growth and coalescence of a large number of fractures, as in fragmentation. Failures of this kind appear frequently in rapid dynamic processes such as those resulting from impacts and explosions, particularly in the formation of spall fragments. In the first part of this paper an approach to formulating constitutive relations that accounts for the opening, shear and growth of an ensemble of cracks is discussed. The approach also accounts for plastic flow accompanying fragmentation. The resulting constitutive relations have been incorporated into a Lagrangean computer program. In the second part of this paper a theoretical approach to coalescence is described. The simplest formulation makes use of a linear Liouville equation, with crack growth limited by the mean free path of cracks, assumed constant. This approach allows for an anisotropic distribution of cracks. An alternative approach is also described in which the decrease of the mean free path with increasing crack size is accounted for, but the crack distribution is assumed isotropic. A reduction of the governing Liouville equation to an ordinary differential equation of third order is possible, and the result can be used to determine how mean-free-path decreases with increasing crack size.

  4. Tibial fracture in a basketball player: treatment dilemmas and complications.

    PubMed

    Garl, T C; Alexander, L; Ahlfeld, S K; Rink, L; Bomba, B J

    1997-06-01

    A 19-year-old male basketball player suffered a spiral fracture of the tibia with an intact fibula, an uncommon injury in basketball. Treatment options for these injuries include cast immobilization, external fixation, and internal fixation using an intramedullary rod or plates and screws. Numerous complications can occur in these injuries, possibly including interference with healing by the intact fibula. The player was treated with an intramedullary rod, but delayed union ensued. Treatment of the patient's delayed union with closed exchange intramedullary nailing and fibular osteotomy enabled him to return to basketball participation.

  5. Coupled processes in single fractures, double fractures and fractured porous media

    SciTech Connect

    Tsang, C.F.

    1986-12-01

    The emplacement of a nuclear waste repository in a fractured porous medium provides a heat source of large dimensions over an extended period of time. It also creates a large cavity in the rock mass, changing significantly the stress field. Such major changes induce various coupled thermohydraulic, hydromechanic and hydrochemical transport processes in the environment around a nuclear waste repository. The present paper gives, first, a general overview of the coupled processes involving thermal, mechanical, hydrological and chemical effects. Then investigations of a number of specific coupled processes are described in the context of fluid flow and transport in a single fracture, two intersecting fractures and a fractured porous medium near a nuclear waste repository. The results are presented and discussed.

  6. Human Evolution and Osteoporosis-Related Spinal Fractures

    PubMed Central

    Cotter, Meghan M.; Loomis, David A.; Simpson, Scott W.; Latimer, Bruce; Hernandez, Christopher J.

    2011-01-01

    The field of evolutionary medicine examines the possibility that some diseases are the result of trade-offs made in human evolution. Spinal fractures are the most common osteoporosis-related fracture in humans, but are not observed in apes, even in cases of severe osteopenia. In humans, the development of osteoporosis is influenced by peak bone mass and strength in early adulthood as well as age-related bone loss. Here, we examine the structural differences in the vertebral bodies (the portion of the vertebra most commonly involved in osteoporosis-related fractures) between humans and apes before age-related bone loss occurs. Vertebrae from young adult humans and chimpanzees, gorillas, orangutans, and gibbons (T8 vertebrae, n = 8–14 per species, male and female, humans: 20–40 years of age) were examined to determine bone strength (using finite element models), bone morphology (external shape), and trabecular microarchitecture (micro-computed tomography). The vertebrae of young adult humans are not as strong as those from apes after accounting for body mass (p<0.01). Human vertebrae are larger in size (volume, cross-sectional area, height) than in apes with a similar body mass. Young adult human vertebrae have significantly lower trabecular bone volume fraction (0.26±0.04 in humans and 0.37±0.07 in apes, mean ± SD, p<0.01) and thinner vertebral shells than apes (after accounting for body mass, p<0.01). Since human vertebrae are more porous and weaker than those in apes in young adulthood (after accounting for bone mass), even modest amounts of age-related bone loss may lead to vertebral fracture in humans, while in apes, larger amounts of bone loss would be required before a vertebral fracture becomes likely. We present arguments that differences in vertebral bone size and shape associated with reduced bone strength in humans is linked to evolutionary adaptations associated with bipedalism. PMID:22028933

  7. Optimal scaling in ductile fracture

    NASA Astrophysics Data System (ADS)

    Fokoua Djodom, Landry

    This work is concerned with the derivation of optimal scaling laws, in the sense of matching lower and upper bounds on the energy, for a solid undergoing ductile fracture. The specific problem considered concerns a material sample in the form of an infinite slab of finite thickness subjected to prescribed opening displacements on its two surfaces. The solid is assumed to obey deformation-theory of plasticity and, in order to further simplify the analysis, we assume isotropic rigid-plastic deformations with zero plastic spin. When hardening exponents are given values consistent with observation, the energy is found to exhibit sublinear growth. We regularize the energy through the addition of nonlocal energy terms of the strain-gradient plasticity type. This nonlocal regularization has the effect of introducing an intrinsic length scale into the energy. We also put forth a physical argument that identifies the intrinsic length and suggests a linear growth of the nonlocal energy. Under these assumptions, ductile fracture emerges as the net result of two competing effects: whereas the sublinear growth of the local energy promotes localization of deformation to failure planes, the nonlocal regularization stabilizes this process, thus resulting in an orderly progression towards failure and a well-defined specific fracture energy. The optimal scaling laws derived here show that ductile fracture results from localization of deformations to void sheets, and that it requires a well-defined energy per unit fracture area. In particular, fractal modes of fracture are ruled out under the assumptions of the analysis. The optimal scaling laws additionally show that ductile fracture is cohesive in nature, i.e., it obeys a well-defined relation between tractions and opening displacements. Finally, the scaling laws supply a link between micromechanical properties and macroscopic fracture properties. In particular, they reveal the relative roles that surface energy and microplasticity

  8. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    PubMed Central

    Sahu, Ramji Lal; Ranjan, Rajni; Lal, Ajay

    2015-01-01

    Background: Fracture shaft humerus is a major cause of morbidity in patients with upper extremity injuries. The aim of this study was to evaluate the outcome of interlocking nail in humeral shaft fractures. Methods: This study was conducted in the Department of Orthopedic Surgery in SMS and R Sharda University from January 2010 to November 2013. Seventy-eight patients were recruited from emergency and out-patient department having a close fracture of humerus shaft. All patients were operated under general anesthesia and closed reamed interlocking nailing was done. All patients were followed for 9 months. Results: Out of 78 patients, 69 patients underwent union in 90–150 days with a mean of 110.68 days. Complications found in four patients who had nonunion, and five patients had delayed union, which was treated with bone grafting. All the patients were assessed clinically and radiologically for fracture healing, joint movements and implant failure. The results were excellent in 88.46% and good in 6.41% patients. Complete subjective, functional, and clinical recovery had occurred in almost 100% of the patients. Conclusions: The results of the present study indicates that in the presence of proper indications, reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures. PMID:26021495

  9. Epidemiology and changed surgical treatment methods for fractures of the distal radius

    PubMed Central

    2013-01-01

    Background and purpose The incidence of fractures of the distal radius may have changed over the last decade, and operative treatment has been commoner during that time. We investigated the incidence of fractures of the distal radius and changing trends in surgical treatment during the period 2004–2010. Patients and methods Registry data on 42,583 patients with a fracture of the distal radius from 2004 to 2010 were evaluated regarding diagnosis, age, sex, and surgical treatment. Results The crude incidence rate was 31 per 104 person-years with a bimodal distribution. After the age of 45 years, the incidence rate in women increased rapidly and leveled off first at a very high age. The incidence rate in postmenopausal women was lower than previously reported. In men, the incidence was low and it increased slowly until the age of 80 years, when it amounted to 31 per 104 person-years. The number of surgical procedures increased by more than 40% despite the fact that there was reduced incidence during the study period. In patients ≥ 18 years of age, the proportion of fractures treated with plating increased from 16% to 70% while the use of external fixation decreased by about the same amount. Interpretation The incidence rate of distal radius fractures in postmenopausal women appears to have decreased over the last few decades. There has been a shift in surgical treatment from external fixation to open reduction and plating. PMID:23594225

  10. Temperature effects on the fracture resistance of scales from Cyprinus carpio.

    PubMed

    Murcia, Sandra; McConville, Mikaela; Li, Guihua; Ossa, Alex; Arola, D

    2015-03-01

    In this investigation the fracture resistance of scales from Cyprinus carpio was evaluated as a function of environmental temperature. Tear specimens were prepared from scales obtained from three characteristic regions (i.e. head, mid-length and tail) of multiple fish. The fracture resistance was characterized in Mode III loading and over temperatures ranging from -150°C to 21°C. Results showed that there was a significant reduction in tear resistance with decreasing temperature and the lowest resistance to fracture was obtained at -150°C. There was a significant difference in the relative tear toughness between scales from the three locations at ambient conditions (21°C), but not below freezing. Scales obtained near the head exhibited the largest resistance to fracture (energy ≈ 150 ± 25 kJm(-2)) overall. The fracture resistance was found to be primarily dependent on the thickness of the external mineralized layer and the number of external elasmodine plies, indicating that both the anatomical position and the corresponding microstructure are important to the mechanical behavior of elasmoid fish scales. These variables may be exploited in the design of bioinspired armors and should be considered in future studies concerning the mechanical behavior of these interesting natural materials. PMID:25481741

  11. Surgical management of multiple metatarsal fractures in a chinchilla (Chinchilla lanigera).

    PubMed

    Desprez, Isabelle; Pignon, Charly; Decambron, Adeline; Donnelly, Thomas M

    2016-10-01

    CASE DESCRIPTION A 3-month-old sexually intact female chinchilla (Chinchilla lanigera) was examined for sudden onset of non-weight-bearing lameness of the right hind limb. CLINICAL FINDINGS On physical examination, the right pes was swollen. An open wound on the medial aspect of the metatarsal region exposed the second metatarsal bone, and the pes was displaced laterally. Radiographs of the right pes revealed oblique displaced fractures of the 4 metatarsal bones. TREATMENT AND OUTCOME Surgical treatment was elected, and enrofloxacin was administered prior to surgery. The protruding fragment of the second metatarsal bone was excised, and the third and fourth metatarsal bones were repaired with intramedullary pins and external skeletal fixation. The chinchilla was bearing weight on the affected limb 9 days after surgery with only mild lameness. The implants were removed 35 days after surgery when radiographs showed bony union of the third and fourth metatarsal bones and continued reduction of the fractures of the second and fifth metatarsal bones. Fifty-six days after surgery, the chinchilla was bearing full weight on the limb, and radiographs showed bony union of the third, fourth, and fifth metatarsal bones. CLINICAL RELEVANCE Findings suggested that intramedullary pinning combined with an epoxy resin external fixator may be an effective technique for metatarsal fracture repair in chinchillas. This method allowed physiologic positioning of the limb and functional hind limb use during fracture healing. Prospective studies of fracture healing in exotic small mammals are indicated. PMID:27654167

  12. Surgical management of multiple metatarsal fractures in a chinchilla (Chinchilla lanigera).

    PubMed

    Desprez, Isabelle; Pignon, Charly; Decambron, Adeline; Donnelly, Thomas M

    2016-10-01

    CASE DESCRIPTION A 3-month-old sexually intact female chinchilla (Chinchilla lanigera) was examined for sudden onset of non-weight-bearing lameness of the right hind limb. CLINICAL FINDINGS On physical examination, the right pes was swollen. An open wound on the medial aspect of the metatarsal region exposed the second metatarsal bone, and the pes was displaced laterally. Radiographs of the right pes revealed oblique displaced fractures of the 4 metatarsal bones. TREATMENT AND OUTCOME Surgical treatment was elected, and enrofloxacin was administered prior to surgery. The protruding fragment of the second metatarsal bone was excised, and the third and fourth metatarsal bones were repaired with intramedullary pins and external skeletal fixation. The chinchilla was bearing weight on the affected limb 9 days after surgery with only mild lameness. The implants were removed 35 days after surgery when radiographs showed bony union of the third and fourth metatarsal bones and continued reduction of the fractures of the second and fifth metatarsal bones. Fifty-six days after surgery, the chinchilla was bearing full weight on the limb, and radiographs showed bony union of the third, fourth, and fifth metatarsal bones. CLINICAL RELEVANCE Findings suggested that intramedullary pinning combined with an epoxy resin external fixator may be an effective technique for metatarsal fracture repair in chinchillas. This method allowed physiologic positioning of the limb and functional hind limb use during fracture healing. Prospective studies of fracture healing in exotic small mammals are indicated.

  13. Treatment of seawater immersion-complicated open-knee joint fracture.

    PubMed

    Ai, J G; Zhao, F; Gao, Z M; Dai, W; Zhang, L; Chen, H B; Zhou, J G

    2014-01-01

    The current study aimed to select suitable remedies for seawater immersion-complicated open-knee joint fracture by exploring the effects of different treatment methods. Forty adult rabbits weighing 2.20 ± 0.25 kg were divided equally into internal fracture fixation group (A), seawater-immersed group with primary internal fixation (B), seawater-immersed group with secondary internal fixation (C), and seawater-immersed group with external fixation (D), using the random-digit table method. Open-femoral internal condylar fracture models were established. Group A was left untreated for 2 h, whereas the other three groups were subjected to seawater immersion for 2 h. Afterwards, groups A and B underwent debridement and steel plate and screw internal fixation. Group C underwent debridement and external fixation, which was followed by secondary steel plate and screw internal fixation after the wound healed. Group D underwent transarticular arthrodesis. Wound infection, joint functional rehabilitation, and radiological and histopathological changes in fracture healing in each group were assessed. The results showed that delayed internal fixation effectively reduces the infection rate of seawater immersion-complicated open fracture and benefits joint function rehabilitation. PMID:25117308

  14. International Space Station External Contamination Status

    NASA Technical Reports Server (NTRS)

    Mikatarian, Ron; Soares, Carlos

    2000-01-01

    PResentation slides examine external contamination requirements; International Space Station (ISS) external contamination sources; ISS external contamination sensitive surfaces; external contamination control; external contamination control for pre-launch verification; flight experiments and observations; the Space Shuttle Orbiter waste water dump, materials outgassing, active vacuum vents; example of molecular column density profile, modeling and analysis tools; sources of outgassing induced contamination analyzed to date, quiescent sources, observations on optical degradation due to induced external contamination in LEO; examples of typical contaminant and depth profiles; and status of the ISS system, material outgassing, thruster plumes, and optical degradation.

  15. Fracture process zone in granite

    USGS Publications Warehouse

    Zang, A.; Wagner, F.C.; Stanchits, S.; Janssen, C.; Dresen, G.

    2000-01-01

    In uniaxial compression tests performed on Aue granite cores (diameter 50 mm, length 100 mm), a steel loading plate was used to induce the formation of a discrete shear fracture. A zone of distributed microcracks surrounds the tip of the propagating fracture. This process zone is imaged by locating acoustic emission events using 12 piezoceramic sensors attached to the samples. Propagation velocity of the process zone is varied by using the rate of acoustic emissions to control the applied axial force. The resulting velocities range from 2 mm/s in displacement-controlled tests to 2 ??m/s in tests controlled by acoustic emission rate. Wave velocities and amplitudes are monitored during fault formation. P waves transmitted through the approaching process zone show a drop in amplitude of 26 dB, and ultrasonic velocities are reduced by 10%. The width of the process zone is ???9 times the grain diameter inferred from acoustic data but is only 2 times the grain size from optical crack inspection. The process zone of fast propagating fractures is wider than for slow ones. The density of microcracks and acoustic emissions increases approaching the main fracture. Shear displacement scales linearly with fracture length. Fault plane solutions from acoustic events show similar orientation of nodal planes on both sides of the shear fracture. The ratio of the process zone width to the fault length in Aue granite ranges from 0.01 to 0.1 inferred from crack data and acoustic emissions, respectively. The fracture surface energy is estimated from microstructure analysis to be ???2 J. A lower bound estimate for the energy dissipated by acoustic events is 0.1 J. Copyright 2000 by the American Geophysical Union.

  16. Fracture healing and lipid mediators.

    PubMed

    O'Connor, J Patrick; Manigrasso, Michaele B; Kim, Brian D; Subramanian, Sangeeta

    2014-01-01

    Lipid mediators regulate bone regeneration during fracture healing. Prostaglandins and leukotrienes are well-known lipid mediators that regulate inflammation and are synthesized from the Ω-6 fatty acid, arachidonic acid. Cyclooxygenase (COX-1 or COX-2) and 5-lipoxygenase (5-LO) catalyze the initial enzymatic steps in the synthesis of prostaglandins and leukotrienes, respectively. Inhibition or genetic ablation of COX-2 activity impairs fracture healing in animal models. Genetic ablation of COX-1 does not affect the fracture callus strength in mice, suggesting that COX-2 activity is primarily responsible for regulating fracture healing. Inhibition of cyclooxygenase activity with nonsteroidal anti-inflammatory drugs (NSAIDs) is performed clinically to reduce heterotopic ossification, although clinical evidence that NSAID treatment impairs fracture healing remains controversial. In contrast, inhibition or genetic ablation of 5-LO activity accelerates fracture healing in animal models. Even though prostaglandins and leukotrienes regulate inflammation, loss of COX-2 or 5-LO activity appears to primarily affect chondrogenesis during fracture healing. Prostaglandin or prostaglandin analog treatment, prostaglandin-specific synthase inhibition and prostaglandin or leukotriene receptor antagonism also affect callus chondrogenesis. Unlike the Ω-6-derived lipid mediators, lipid mediators derived from Ω-3 fatty acids, such as resolvin E1 (RvE1), have anti-inflammatory activity. In vivo, RvE1 can inhibit osteoclastogenesis and limit bone resorption. Although Ω-6 and Ω-3 lipid mediators have clear-cut effects on inflammation, the role of these lipid mediators in bone regeneration is more complex, with apparent effects on callus chondrogenesis and bone remodeling. PMID:24795811

  17. Fractures of the proximal humerus.

    PubMed

    Brorson, Stig

    2013-10-01

    Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate. The bandages were further supported by splints made of wood or coarse grass. Healing was expected in forty days. Different fracture patterns have been discussed and classified since Ancient Greece. Current classification of proximal humeral fractures mainly relies on the classifications proposed by Charles Neer and the AO/OTA classification. Since the late 1980's it has been known that intra- and inter-observer variation was high within the two systems. I conducted a series of observer studies to qualify the disagreement further and to study to what extent improvement of agreement could be obtained. No clinically significant differences in observer agreement were found at different levels of clinical experience, by reducing the number of categories, or by adding high quality radiographs, CT or 3D CT scans. A consistently low agreement on the Neer classification within and between untrained orthopaedic doctors was found. However, we also found that inter-observer agreement on treatment recommendation was higher than the agreement on the Neer classification. In a randomized trial we found that agreement could improve significantly by training of doctors, especially among specialists. However, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis or reverse arthroplasty in complex fractures patterns. No randomized trials or well-conducted comparative studies were identified. High failure rates suggest that the use of these

  18. Periprosthetic Atypical Femoral Fracture-like Fracture after Hip Arthroplasty: A Report of Three Cases.

    PubMed

    Lee, Kyung-Jae; Min, Byung-Woo; Jang, Hyung-Kyu; Ye, Hee-Uk; Lim, Kyung-Hwan

    2015-09-01

    Atypical femoral fractures are stress or insufficient fractures induced by low energy trauma or no trauma and have specific X-ray findings. Although the American Society for Bone and Mineral Research has excluded periprosthetic fractures from the definition of an atypical femoral fracture in 2013, this is still a matter of controversy because some authors report periprosthetic fractures showing specific features of atypical fractures around a well-fixed femoral stem. We report 3 cases of periprosthetic femur fractures that had specific radiographic features of atypical femoral fractures in patients with a history of prolonged bisphosphonate use; we also review relevant literature. PMID:27536624

  19. [Bone fracture and the healing mechanisms. Fragility fracture and bone quality].

    PubMed

    Mawatari, Taro; Iwamoto, Yukihide

    2009-05-01

    Fracture occurs in bone having less than normal elastic resistance without any violence. Numerous terms have been used to classify various types of fractures from low trauma events; "fragility fracture", "stress fracture", "insufficiency fracture", "fatigue fracture", "pathologic fracture", etc. The definitions of these terms and clinical characteristics of these fractures are discussed. Also state-of-the-art bone quality assessments; Finite element analysis of clinical CT scans, assessments of the Microdamage, and the Cross-links of Collagen are introduced in this review.

  20. Fracture dimensions in frac&pack stimulation

    SciTech Connect

    Fan, Y.; Economides, M.J.

    1995-12-31

    A model is introduced to predict dynamic fracture dimensions in frac&pack stimulation. Design aspects of the two-in-one step treatment techniques, required by soft and high-permeability reservoirs are discussed. A pressure-dependent leakoff model, based on the transient flow of a non-Newtonian fluid displacing a reservoir fluid has been developed and incorporated with fracture mechanics concepts to simulate the entire process of frac&pack treatments including fracture propagation, inflation, proppant packing and closure. Results obtained in this study indicate the considerable difference between traditional fracturing and frac&pack treatments. In the latter, fracture length is much less important than fracture conductivity. This work shows how to terminate the fracture growth at the appropriate time, and how to design frac&packs resulting in fracture widths several times larger than those for traditional fracturing.

  1. Generating fracture networks using iterated function systems

    NASA Astrophysics Data System (ADS)

    Mohrlok, U.; Liedl, R.

    In order to model flow and transport in fractured rocks it is important to know the geometry of the fracture network. A stochastic approach is commonly used to generate a synthetic fracture network from the statistics measured at a natural fracture network. The approach presented herein is able to incorporate the structures found in a natural fracture network into the synthetic fracture network. These synthetic fracture networks are the images generated by Iterated Function Systems (IFS) as introduced by Barnsley (1988). The conditions these IFS have to fulfil to determine images resembling fracture networks and the effects of their parameters on the images are discussed. It is possible to define the parameters of the IFS in order to generate some properties of a fracture network. The image of an IFS consists of many single points and has to be suitably processed for further use.

  2. Generating fracture networks using iterated function systems

    NASA Astrophysics Data System (ADS)

    Mohrlok, U.; Liedl, R.

    1996-03-01

    In order to model flow and transport in fractured rocks it is important to know the geometry of the fracture network. A stochastic approach is commonly used to generate a synthetic fracture network from the statistics measured at a natural fracture network. The approach presented herein is able to incorporate the structures found in a natural fracture network into the synthetic fracture network. These synthetic fracture networks are the images generated by Iterated Function Systems (IFS) as introduced by Barnsley (1988). The conditions these IFS have to fulfil to determine images resembling fracture networks and the effects of their parameters on the images are discussed. It is possible to define the parameters of the IFS in order to generate some properties of a fracture network. The image of an IFS consists of many single points and has to be suitably processed for further use.

  3. Diagnosis and management of metatarsal fractures.

    PubMed

    Hatch, Robert L; Alsobrook, John A; Clugston, James R

    2007-09-15

    Patients with metatarsal fractures often present to primary care settings. Initial evaluation should focus on identifying any conditions that require emergent referral, such as neurovascular compromise and open fractures. The fracture should then be characterized and treatment initiated. Referral is generally indicated for intra-articular or displaced metatarsal fractures, as well as most fractures that involve the first metatarsal or multiple metatarsals. If the midfoot is injured, care should be taken to evaluate the Lisfranc ligament. Injuries to this ligament require referral or specific treatment based on severity. Nondisplaced fractures of the metatarsal shaft usually require only a soft dressing followed by a firm, supportive shoe and progressive weight bearing. Stress fractures of the first to fourth metatarsal shafts typically heal well with rest alone and usually do not require immobilization. Avulsion fractures of the proximal fifth metatarsal tuberosity can usually be managed with a soft dressing. Proximal fifth metatarsal fractures that are distal to the tuberosity have a poorer prognosis. Radiographs should be carefully examined to distinguish these fractures from tuberosity fractures. Treatment of fractures distal to the tuberosity should be individualized based on the characteristics of the fracture and patient preference. Nondisplaced fractures of the proximal portion of metatarsals 1 through 4 can be managed acutely with a posterior splint followed by a molded, non-weight-bearing, short leg cast. If radiography reveals a normal position seven to 10 days after injury, progressive weight bearing may be started, and the cast may be removed three to four weeks later.

  4. Which Fractures Are Most Attributable to Osteoporosis?

    PubMed Central

    Warriner, Amy H.; Patkar, Nivedita M.; Curtis, Jeffrey R.; Delzell, Elizabeth; Gary, Lisa; Kilgore, Meredith; Saag, Kenneth G.

    2014-01-01

    Background Determining anatomic sites and circumstances under which a fracture may be a consequence of osteoporosis is a topic of ongoing debate and controversy that is important to both clinicians and researchers. Methods We conducted a systematic literature review and generated an evidence report on fracture risk based on specific anatomic bone sites as well as fracture diagnosis codes. Using the RAND/UCLA appropriateness process, we convened a multi-disciplinary panel of 11 experts who rated fractures according to their likelihood of being due to osteoporosis based on the evidence report. Fracture sites (as determined by ICD-CM codes) were stratified by four clinical risk factor categories based on age, sex, race/ethnicity (African- American and Caucasian) and presence or absence of trauma. Results Consistent with current clinical experience, the fractures rated most likely due to osteoporosis were the femoral neck, pathologic fractures of the vertebrae, and lumbar and thoracic vertebral fractures. The fractures rated least likely due to osteoporosis were open proximal humerus fractures, skull, and facial bones. The expert panel rated open fractures of the arm (except proximal humerus) and fractures of the tibia/fibula, patella, ribs, and sacrum as being highly likely due to osteoporosis in older Caucasian women but a lower likelihood in younger African American men. Conclusion Osteoporosis attribution scores for all fracture sites were determined by a multidisciplinary expert panel to provide an evidence-based continuum of the likelihood of a fracture being associated with osteoporosis. PMID:21130353

  5. C2 Body Fracture: Report of Cases Managed Conservatively by Philadelphia Collar

    PubMed Central

    Sadeghian, Homa

    2016-01-01

    Study Design Case series. Purpose To present results of conservative management in patients with pure C2 body fractures. Overview of Literature Axis body fractures, a less common subgroup of C2 fractures, are commonly classified as vertical coronal, vertical sagittal, and transverse subtypes. While the treatment paradigm for other C2 fractures is clear, there is insufficient evidence to support treatment guidelines for C2 body fractures. Methods Eleven patients with pure C2 body fractures were managed with external immobilization and followed thereafter. Results All neurologic examinations were normal. In computed tomography (CT) scans, four, two, three, and two patients had a coronal, sagittal, horizontal, and burst fracture, respectively. Magnetic resonance imaging showed hematoma and partial rupture in the anterior longitudinal ligament in four patients, posterior ligamentous complex injury in one, and normal ligamentous structure in six. All fractures were managed conservatively using the Philadelphia collar, which was continued until complete disappearance of symptoms (within 1–3 months in all patients). The decision to discontinue the neck collar was made by a dynamic neck X-ray and CT scan that showed complete bony fusion. All patients were then followed for an additional 1.5 years (mean follow-up of 21 months for all patients). No patient showed any neurologic symptoms or deficits during the follow-up period. Conclusions In patients with pure C2 body fracture, non-operative management with Philadelphia neck collar is a safe and efficacious option, even in the presence of some sort of ligamentous injury. PMID:27790321

  6. Effect of retention design of artificial teeth and implant-supported titanium CAD-CAM structures on fracture resistance

    PubMed Central

    Ladetzki, Kristin; Mateos-Palacios, Rocío; Pascual-Moscardó, Agustín

    2016-01-01

    Background For implant-supported hybrid prostheses, high mastication forces and reduced acrylic resin thickness over a metal substructure often cause failures arising from tooth or resin fractures. To assay fracture resistance of artificial teeth and resin in implant-supported hybrid prostheses in relation to the titanium structure and retention design supporting teeth. Material and Methods 40 specimens bearing incisors were divided into four groups according to the titanium structure supporting the teeth and the type of load force applied: Group I (Control; n=10): Application of static loading to ten incisors set over a metal structure with internal retention. Group II (Control; n=10): Application of static loading to ten incisors set over a metal structure with external retention. The remaining study specimens (n=20) were subjected to 120,000 masticatory and thermal cycles in a chewing simulator. Afterwards, static loading was applied until the point of fracture using an Instron machine. Group III (Study; n=10): Application of dynamic and static loading to ten incisors set over a metal structure with internal retention. Group IV (Study; n=10): Application of dynamic and static loading to ten incisors set over a metal structure with external retention. Data obtained for the four groups was analyzed and compared, determining the type of fracture (cohesive or adhesive) using a reflected light microscope. Results Statistical analysis confirmed that there were significant differences in fracture resistance between the four groups. External retention was found to have more fracture resistance than the internal retention. Conclusions Hybrid prostheses with titanium substructures and external retention obtained significantly better results than samples with internal retention. Key words:Chewing simulator, thermocycler, fatigue, implant-supported hybrid prosthesis, acrylic teeth, fracture, metal structure design. PMID:27034748

  7. Fracture pain-Traveling unknown pathways.

    PubMed

    Alves, Cecília J; Neto, Estrela; Sousa, Daniela M; Leitão, Luís; Vasconcelos, Daniel M; Ribeiro-Silva, Manuel; Alencastre, Inês S; Lamghari, Meriem

    2016-04-01

    An increase of fracture incidence is expected for the next decades, mostly due to the undeniable increase of osteoporotic fractures, associated with the rapid population ageing. The rise in sports-related fractures affecting the young and active population also contributes to this increased fracture incidence, and further amplifies the economical burden of fractures. Fracture often results in severe pain, which is a primary symptom to be treated, not only to guarantee individual's wellbeing, but also because an efficient management of fracture pain is mandatory to ensure proper bone healing. Here, we review the available data on bone innervation and its response to fracture, and discuss putative mechanisms of fracture pain signaling. In addition, the common therapeutic approaches to treat fracture pain are discussed. Although there is still much to learn, research in fracture pain has allowed an initial insight into the mechanisms involved. During the inflammatory response to fracture, several mediators are released and will putatively activate and sensitize primary sensory neurons, in parallel, intense nerve sprouting that occurs in the fracture callus area is also suggested to be involved in pain signaling. The establishment of hyperalgesia and allodynia after fracture indicates the development of peripheral and central sensitization, still, the underlying mechanisms are largely unknown. A major concern during the treatment of fracture pain needs to be the preservation of proper bone healing. However, the most common therapeutic agents, NSAIDS and opiates, can cause significant side effects that include fracture repair impairment. The understanding of the mechanisms of fracture pain signaling will allow the development of mechanisms-based therapies to effectively and safely manage fracture pain.

  8. Fracture pain-Traveling unknown pathways.

    PubMed

    Alves, Cecília J; Neto, Estrela; Sousa, Daniela M; Leitão, Luís; Vasconcelos, Daniel M; Ribeiro-Silva, Manuel; Alencastre, Inês S; Lamghari, Meriem

    2016-04-01

    An increase of fracture incidence is expected for the next decades, mostly due to the undeniable increase of osteoporotic fractures, associated with the rapid population ageing. The rise in sports-related fractures affecting the young and active population also contributes to this increased fracture incidence, and further amplifies the economical burden of fractures. Fracture often results in severe pain, which is a primary symptom to be treated, not only to guarantee individual's wellbeing, but also because an efficient management of fracture pain is mandatory to ensure proper bone healing. Here, we review the available data on bone innervation and its response to fracture, and discuss putative mechanisms of fracture pain signaling. In addition, the common therapeutic approaches to treat fracture pain are discussed. Although there is still much to learn, research in fracture pain has allowed an initial insight into the mechanisms involved. During the inflammatory response to fracture, several mediators are released and will putatively activate and sensitize primary sensory neurons, in parallel, intense nerve sprouting that occurs in the fracture callus area is also suggested to be involved in pain signaling. The establishment of hyperalgesia and allodynia after fracture indicates the development of peripheral and central sensitization, still, the underlying mechanisms are largely unknown. A major concern during the treatment of fracture pain needs to be the preservation of proper bone healing. However, the most common therapeutic agents, NSAIDS and opiates, can cause significant side effects that include fracture repair impairment. The understanding of the mechanisms of fracture pain signaling will allow the development of mechanisms-based therapies to effectively and safely manage fracture pain. PMID:26851411

  9. Estimating Location without External Cues

    PubMed Central

    Cheung, Allen

    2014-01-01

    The ability to determine one's location is fundamental to spatial navigation. Here, it is shown that localization is theoretically possible without the use of external cues, and without knowledge of initial position or orientation. With only error-prone self-motion estimates as input, a fully disoriented agent can, in principle, determine its location in familiar spaces with 1-fold rotational symmetry. Surprisingly, localization does not require the sensing of any external cue, including the boundary. The combination of self-motion estimates and an internal map of the arena provide enough information for localization. This stands in conflict with the supposition that 2D arenas are analogous to open fields. Using a rodent error model, it is shown that the localization performance which can be achieved is enough to initiate and maintain stable firing patterns like those of grid cells, starting from full disorientation. Successful localization was achieved when the rotational asymmetry was due to the external boundary, an interior barrier or a void space within an arena. Optimal localization performance was found to depend on arena shape, arena size, local and global rotational asymmetry, and the structure of the path taken during localization. Since allothetic cues including visual and boundary contact cues were not present, localization necessarily relied on the fusion of idiothetic self-motion cues and memory of the boundary. Implications for spatial navigation mechanisms are discussed, including possible relationships with place field overdispersion and hippocampal reverse replay. Based on these results, experiments are suggested to identify if and where information fusion occurs in the mammalian spatial memory system. PMID:25356642

  10. Heat regenerative external combustion engine

    NASA Astrophysics Data System (ADS)

    Duva, Anthony W.

    1993-10-01

    A heat regenerative external combustion engine is disclosed. The engine includes fuel inlet means which extends along the exhaust passage and/or combustion chamber in order to preheat the fuel, To provide for preheating by gases in both the combustion chamber and the exhaust passage, the combustion chamber is arranged annularly around the drive shaft and between the cylinders. This configuration also is advantageous in that it reduces the noise of combustion. The engine of the invention is particularly well-suited for use in a torpedo.

  11. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  12. Fracture and Medium Modeling, by Analizing Hidraulic Fracturing Induced Microseismicity

    NASA Astrophysics Data System (ADS)

    Gomez Alba, S.; Vargas Jiménez, C. A.

    2014-12-01

    Hydraulic fracturing is an essential technology for most unconventional hydrocarbon resources and many conventional ones as well. The primary limitation on the improvement and optimization of the fracturing process is the minimal access to observe the behavior of the fracture in the subsurface. Without direct observational evidence, hypothetical mechanisms must be assumed and then tested for their validity with indirect information such as wellbore measurements, indirect production and pressure behavior. One of the most important sources of information today is the relation made between micro seismic source mechanisms and fracture behavior. Hydraulic fractures induce some level of micro seismicity when the stress conditions in the Earth are altered by changes in stress during the operations. The result is the sudden movement between rock elements and the radiation of both compressional and shear energy in a seismic range that can be detected and recorded with sensitive receivers. The objective of this work is to provide reasonable information when applying inversion methods in order to estimate the vertical and horizontal spatial heterogeneities in medium and energy radiation distribution of microseisms while fracking operations. The method consist in record microseisms at a previous lineal array of stations (triaxial accelerometers) which are located close to the source coordinates and cover the area of study. The analysis clarify some ideas about what information can be gained from the micro seismic source data and according to the obtained results, what kind of comparisons and associations might be done to evaluate the fracking performance operation. Non uniformities in medium such as faults would be revealed by interpreted scattering coefficients. Fracture properties like distance, velocity and orientation would be also determined by analyzing energy radiation.

  13. Foot and Ankle Stress Fractures in Athletes.

    PubMed

    Greaser, Michael C

    2016-10-01

    The incidence of stress fractures in the general athletic population is less than 1%, but may be as high as 15% in runners. Stress fractures of the foot and ankle account for almost half of bone stress injuries in athletes. These injuries occur because of repetitive submaximal stresses on the bone resulting in microfractures, which may coalesce to form complete fractures. Advanced imaging such as MRI and triple-phase bone scans is used to evaluate patients with suspected stress fracture. Low-risk stress fractures are typically treated with rest and protected weight bearing. High-stress fractures more often require surgical treatment. PMID:27637667

  14. Intra-articular fractures of the hand.

    PubMed

    Oak, Nikhil; Lawton, Jeffrey N

    2013-11-01

    Fractures of the hand are common injuries and in particular, fractures involving the articular surfaces can present difficulties to the orthopedic surgeon in practice. Although the treatment of these fractures needs to be individualized based on fracture pattern and location, the goals for these fractures are to restore the alignment, stability, and congruity and to allow for early motion to prevent stiffness and traumatic arthritis. This article classifies the various types of intra-articular hand fractures as well as the workup and management of these injuries. PMID:24209952

  15. Test-Free Fracture Toughness

    NASA Technical Reports Server (NTRS)

    Minnetyan, Levon; Chamis, Christos C. (Technical Monitor)

    2003-01-01

    Computational simulation results can give the prediction of damage growth and progression and fracture toughness of composite structures. The experimental data from literature provide environmental effects on the fracture behavior of metallic or fiber composite structures. However, the traditional experimental methods to analyze the influence of the imposed conditions are expensive and time consuming. This research used the CODSTRAN code to model the temperature effects, scaling effects and the loading effects of fiber/braided composite specimens with and without fiber-optic sensors on the damage initiation and energy release rates. The load-displacement relationship and fracture toughness assessment approach is compared with the test results from literature and it is verified that the computational simulation, with the use of established material modeling and finite element modules, adequately tracks the changes of fracture toughness and subsequent fracture propagation for any fiber/braided composite structure due to the change of fiber orientations, presence of large diameter optical fibers, and any loading conditions.

  16. Fracture toughness of Antrim shale

    SciTech Connect

    Kim, K.; Mubeen, A.

    1980-05-01

    Fracture toughness of Antrim shale cores from Dow Chemical's Sanilac County test site in Michigan were measured by the burst test method developed by Clifton et al. (1976). These tests were conducted to establish a preliminary data base to be used for the designing of a bed preparation method and prediction of rock fracture behavior under various loading conditions such as explosives and hydraulic fracturing for in-situ processing of oil shale. The test method was chosen because the thick-walled cylinder provides a loading and specimen configuration similar to in-situ hydraulic fracturing operations and the specimens can be conveniently prepared from diamond drill cores for laboratory tests. Further, the nature of variation of crack tip stress intensity in this specimen is such that K/sub IC/ does not depend on initial crack length, and crack propagation need not be monitored. The test results show that the fracture toughness of typical Antrim shale core range from 930 to 1080 psi ..sqrt..in. while the limestone specimens, a basement rock, range from 1240 to 1430 psi ..sqrt..in. These values are close to that of lean Western oil shale from Anvil point, Colorado (Schmidt, 1977), i.e., 980 psi ..sqrt..in.

  17. Selective perceptions of hydraulic fracturing.

    PubMed

    Sarge, Melanie A; VanDyke, Matthew S; King, Andy J; White, Shawna R

    2015-01-01

    Hydraulic fracturing (HF) is a focal topic in discussions about domestic energy production, yet the American public is largely unfamiliar and undecided about the practice. This study sheds light on how individuals may come to understand hydraulic fracturing as this unconventional production technology becomes more prominent in the United States. For the study, a thorough search of HF photographs was performed, and a systematic evaluation of 40 images using an online experimental design involving N = 250 participants was conducted. Key indicators of hydraulic fracturing support and beliefs were identified. Participants showed diversity in their support for the practice, with 47 percent expressing low support, 22 percent high support, and 31 percent undecided. Support for HF was positively associated with beliefs that hydraulic fracturing is primarily an economic issue and negatively associated with beliefs that it is an environmental issue. Level of support was also investigated as a perceptual filter that facilitates biased issue perceptions and affective evaluations of economic benefit and environmental cost frames presented in visual content of hydraulic fracturing. Results suggested an interactive relationship between visual framing and level of support, pointing to a substantial barrier to common understanding about the issue that strategic communicators should consider.

  18. Selective perceptions of hydraulic fracturing.

    PubMed

    Sarge, Melanie A; VanDyke, Matthew S; King, Andy J; White, Shawna R

    2015-01-01

    Hydraulic fracturing (HF) is a focal topic in discussions about domestic energy production, yet the American public is largely unfamiliar and undecided about the practice. This study sheds light on how individuals may come to understand hydraulic fracturing as this unconventional production technology becomes more prominent in the United States. For the study, a thorough search of HF photographs was performed, and a systematic evaluation of 40 images using an online experimental design involving N = 250 participants was conducted. Key indicators of hydraulic fracturing support and beliefs were identified. Participants showed diversity in their support for the practice, with 47 percent expressing low support, 22 percent high support, and 31 percent undecided. Support for HF was positively associated with beliefs that hydraulic fracturing is primarily an economic issue and negatively associated with beliefs that it is an environmental issue. Level of support was also investigated as a perceptual filter that facilitates biased issue perceptions and affective evaluations of economic benefit and environmental cost frames presented in visual content of hydraulic fracturing. Results suggested an interactive relationship between visual framing and level of support, pointing to a substantial barrier to common understanding about the issue that strategic communicators should consider. PMID:26399946

  19. Frontal Sinus Fractures: Current Concepts

    PubMed Central

    Strong, E. Bradley

    2009-01-01

    Frontal sinus injuries may range from isolated anterior table fractures resulting in a simple aesthetic deformity to complex fractures involving the frontal recess, orbits, skull base, and intracranial contents. The risk of long-term morbidity can be significant. Optimal treatment strategies for the management of frontal sinus fractures remain controversial. However, it is critical to have a thorough understanding of frontal sinus anatomy as well as the current treatment strategies used to manage these injuries. A thorough physical exam and thin-cut, multiplanar (axial, coronal, and sagittal) computed tomography scan should be performed in all patients suspected of having a frontal sinus fracture. The most appropriate treatment strategy can be determined by assessing five anatomic parameters including the: frontal recess, anterior table integrity, posterior table integrity, dural integrity, and presence of a cerebrospinal fluid leak. A well thought out management strategy and meticulous surgical techniques are critical to success. The primary surgical goal is to provide a safe sinus while minimizing patient morbidity. This article offers an anatomically based treatment algorithm for the management of frontal sinus fractures and highlights the key steps to surgical repair. PMID:22110810

  20. 46 CFR 64.19 - External pressure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HANDLING SYSTEMS Standards for an MPT § 64.19 External pressure. (a) A tank without a vacuum breaker must be designed to withstand an external pressure of 71/2 psig or more. (b) A tank with a vacuum...

  1. 46 CFR 64.19 - External pressure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HANDLING SYSTEMS Standards for an MPT § 64.19 External pressure. (a) A tank without a vacuum breaker must be designed to withstand an external pressure of 71/2 psig or more. (b) A tank with a vacuum...

  2. 46 CFR 64.19 - External pressure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HANDLING SYSTEMS Standards for an MPT § 64.19 External pressure. (a) A tank without a vacuum breaker must be designed to withstand an external pressure of 71/2 psig or more. (b) A tank with a vacuum...

  3. 46 CFR 64.19 - External pressure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HANDLING SYSTEMS Standards for an MPT § 64.19 External pressure. (a) A tank without a vacuum breaker must be designed to withstand an external pressure of 71/2 psig or more. (b) A tank with a vacuum...

  4. 46 CFR 64.19 - External pressure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HANDLING SYSTEMS Standards for an MPT § 64.19 External pressure. (a) A tank without a vacuum breaker must be designed to withstand an external pressure of 71/2 psig or more. (b) A tank with a vacuum...

  5. What Is an Automated External Defibrillator?

    MedlinePlus

    ANSWERS by heart Treatments + Tests What Is an Automated External Defibrillator? An automated external defibrillator (AED) is a lightweight, portable device ... AED? Non-medical personnel such as police, fire service personnel, flight attendants, security guards and other lay ...

  6. The radiation swelling effect on fracture properties and fracture mechanisms of irradiated austenitic steels. Part I. Ductility and fracture toughness

    NASA Astrophysics Data System (ADS)

    Margolin, B.; Sorokin, A.; Shvetsova, V.; Minkin, A.; Potapova, V.; Smirnov, V.

    2016-11-01

    The radiation swelling effect on the fracture properties of irradiated austenitic steels under static loading has been studied and analyzed from the mechanical and physical viewpoints. Experimental data on the stress-strain curves, fracture strain, fracture toughness and fracture mechanisms have been represented for austenitic steel of 18Cr-10Ni-Ti grade (Russian analog of AISI 321 steel) irradiated up to neutron dose of 150 dpa with various swelling. Some phenomena in mechanical behaviour of irradiated austenitic steels have been revealed and explained as follows: a sharp decrease of fracture toughness with swelling growth; untypical large increase of fracture toughness with decrease of the test temperature; some increase of fracture toughness after preliminary cyclic loading. Role of channel deformation and channel fracture has been clarified in the properties of irradiated austenitic steel and different tendencies to channel deformation have been shown and explained for the same austenitic steel irradiated at different temperatures and neutron doses.

  7. Discrete modeling of hydraulic fracturing processes in a complex pre-existing fracture network

    NASA Astrophysics Data System (ADS)

    Kim, K.; Rutqvist, J.; Nakagawa, S.; Houseworth, J. E.; Birkholzer, J. T.

    2015-12-01

    Hydraulic fracturing and stimulation of fracture networks are widely used by the energy industry (e.g., shale gas extraction, enhanced geothermal systems) to increase permeability of geological formations. Numerous analytical and numerical models have been developed to help understand and predict the behavior of hydraulically induced fractures. However, many existing models assume simple fracturing scenarios with highly idealized fracture geometries (e.g., propagation of a single fracture with assumed shapes in a homogeneous medium). Modeling hydraulic fracture propagation in the presence of natural fractures and homogeneities can be very challenging because of the complex interactions between fluid, rock matrix, and rock interfaces, as well as the interactions between propagating fractures and pre-existing natural fractures. In this study, the TOUGH-RBSN code for coupled hydro-mechanical modeling is utilized to simulate hydraulic fracture propagation and its interaction with pre-existing fracture networks. The simulation tool combines TOUGH2, a simulator of subsurface multiphase flow and mass transport based on the finite volume approach, with the implementation of a lattice modeling approach for geomechanical and fracture-damage behavior, named Rigid-Body-Spring Network (RBSN). The discrete fracture network (DFN) approach is facilitated in the Voronoi discretization via a fully automated modeling procedure. The numerical program is verified through a simple simulation for single fracture propagation, in which the resulting fracture geometry is compared to an analytical solution for given fracture length and aperture. Subsequently, predictive simulations are conducted for planned laboratory experiments using rock-analogue (soda-lime glass) samples containing a designed, pre-existing fracture network. The results of a preliminary simulation demonstrate selective fracturing and fluid infiltration along the pre-existing fractures, with additional fracturing in part

  8. Laboratory Visualization of Hydraulic Fracture Propagation and Interaction with a Network of Preexisting Fractures

    NASA Astrophysics Data System (ADS)

    Nakagawa, S.; Kneafsey, T. J.; Borglin, S. E.

    2015-12-01

    We present optical visualization experiments of hydraulic fracture propagation within transparent rock-analogue samples containing a network of preexisting fractures. Natural fractures and heterogeneities in rock have a great impact on hydraulic fracture propagation and resulting improvements in reservoir permeability. In recent years, many sophisticated numerical simulations on hydraulic fracturing have been conducted. Laboratory experiments on hydraulic fracturing are often performed with acoustic emission (Micro Earthquake) monitoring, which allows detection and location of fracturing and fracture propagation. However, the detected fractures are not necessarily hydraulically produced fractures which provide permeable pathways connected to the injection (and production) well. The primary objectives of our visualization experiments are (1) to obtain quantitative visual information of hydraulic fracture propagation affected by pre-existing fractures and (2) to distinguish fractures activated by the perturbed stress field away from the injected fluid and hydraulically produced fractures. The obtained data are also used to develop and validate a new numerical modeling technique (TOUGH-RBSN [Rigid-Body-Spring-Network] model) for hydraulic fracturing simulations, which is presented in a companion paper. The experiments are conducted using transparent soda-lime glass cubes (10 cm × 10 cm × 10 cm) containing either (1) 3D laser-engraved artificial fractures and fracture networks or (2) a random network of fractures produced by rapid thermal quenching. The strength (and also the permeability for the latter) of the fractures can be altered to examine their impact on hydraulic fracturing. The cubes are subjected to true-triaxial stress within a polyaxial loading frame, and hydraulic fractures are produced by injecting fluids with a range of viscosity into an analogue borehole drilled in the sample. The visual images of developing fractures are obtained both through a port

  9. Wnt Signaling During Fracture Repair

    PubMed Central

    Secreto, Frank J.; Hoeppner, Luke H.; Westendorf, Jennifer J.

    2010-01-01

    Bone is one of the few tissues in the body with the capacity to regenerate and repair itself. In most cases, fractures are completely repaired in a relatively short period of time; however, in a small percentage of cases, healing never occurs and non-union is the result. Fracture repair and bone regeneration require the localized re-activation of signaling cascades that are crucial for skeletal development. The Wnt/β-catenin signaling pathway is one such developmental pathway whose role in bone formation and regeneration has been recently appreciated. During the last decade, much has learned about how Wnt pathways regulate bone mass. Small molecules and biologics aimed at this pathway are now being tested as potential new anabolic agents. Here we review recent data demonstrating that Wnt pathways are active during fracture repair and that increasing the activities of Wnt pathway components accelerates bone regeneration. PMID:19631031

  10. Fracture mechanics of cellular glass

    NASA Technical Reports Server (NTRS)

    Zwissler, J. G.; Adams, M. A.

    1981-01-01

    The fracture mechanics of cellular glasses (for the structural substrate of mirrored glass for solr concentrator reflecting panels) are discussed. Commercial and developmental cellular glasses were tested and analyzed using standard testing techniques and models developed from linear fracture mechanics. Two models describing the fracture behavior of these materials were developed. Slow crack growth behavior in cellular glass was found to be more complex than that encountered in dense glasses or ceramics. The crack velocity was found to be strongly dependent upon water vapor transport to the tip of the moving crack. The existence of a static fatigue limit was not conclusively established, however, it is speculated that slow crack growth behavior in Region 1 may be slower, by orders of magnitude, than that found in dense glasses.

  11. Method for directional hydraulic fracturing

    DOEpatents

    Swanson, David E.; Daly, Daniel W.

    1994-01-01

    A method for directional hydraulic fracturing using borehole seals to confine pressurized fluid in planar permeable regions, comprising: placing a sealant in the hole of a structure selected from geologic or cemented formations to fill the space between a permeable planar component and the geologic or cemented formation in the vicinity of the permeable planar component; making a hydraulic connection between the permeable planar component and a pump; permitting the sealant to cure and thereby provide both mechanical and hydraulic confinement to the permeable planar component; and pumping a fluid from the pump into the permeable planar component to internally pressurize the permeable planar component to initiate a fracture in the formation, the fracture being disposed in the same orientation as the permeable planar component.

  12. Sudden death from pelvic hemorrhage after bilateral central fracture dislocations of the hip due to an epileptic seizure.

    PubMed

    Hughes, C A; O'Briain, D S

    2000-12-01

    Fracture and dislocation of major joints may be caused by the forceful tonic muscular contractions of seizure activity. A 77-year-old man who was found dead in bed with no sign of external trauma had bilateral central fracture dislocations of the femoral head through the acetabular floor with fatal pelvic hemorrhage and extensive pulmonary fat and bone marrow embolism. He had epilepsy, but the last seizure was 6 years earlier, and he had long discontinued medication. The fractures were attributed to a new unwitnessed seizure. This is the twentieth case of central fracture dislocation of the hip since 1970, when better anesthesia eliminated convulsive therapy-induced fractures. The authors review these 20 cases. Seizures followed inflammation, infarction or neoplasia of the brain, eclampsia, metabolic or iatrogenic causes, or epilepsy (6 cases, 2 of which had no prior seizures for 5 years). There were 11 men (mean age, 64 years) and 9 women (mean age, 47 years). Fractures were unilateral in 13 and bilateral in 7. Additional fractures (in vertebrae, shoulders, or femur) were present in eight. Only eight had prior bone disease. Local symptoms led to diagnosis in most, but two were identified incidentally on imaging. The current patient was the only one to die suddenly, but six other patients presented with shock and three died (one of whom had injuries that led to a suspicion of manslaughter). Central fracture-dislocation of the hip is a rare and little known consequence of seizures, with strong potential for misdiagnosis and lethal complications.

  13. Measuring multi-dimensional, time-dependent mechanical properties of a human tibial fracture using an automated system.

    PubMed

    Ogrodnik, P J; Moorcroft, C I; Thomas, P B

    2007-08-01

    This paper presents an element of a long-term research project determining a clinically quantifiable end point for fracture healing in humans. An automated loading and measurement device is presented. It has been developed as a research tool for the assessment of the mechanical properties of a healing human tibial fracture. The device has been specifically designed for use with patients treated with external fixation. The characteristics of the device have been presented together with an assessment of errors. A typical sample of results has been presented to demonstrate the significance of the device; subsequent papers will examine the whole data set in greater depth. The results presented here confirm the non-linear behaviour of callus and reinforce the requirement to measure the load rate when measuring the fracture stiffness. A new material property for the assessment of fracture healing, namely gamma, is examined and preliminary results are shown. Polar plots of stiffness demonstrate that, when measuring fracture stiffness, not only should the load rate be considered, but also the orientation of measurement. The results from this work support the view that the fracture stiffness should be measured in at least two planes. Currently a fracture can be considered healed when the fracture stiffness exceeds 15 N m/deg; this paper questions whether this value is now valid and suggests that it should be re-examined. PMID:17937203

  14. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  15. 46 CFR 154.452 - External pressure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false External pressure. 154.452 Section 154.452 Shipping... Independent Tank Type C and Process Pressure Vessels § 154.452 External pressure. The design external pressure...) for tanks without a vacuum relief valve. P2=0, or the pressure relief valve setting for an...

  16. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  17. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  18. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  19. 49 CFR 195.108 - External pressure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on...

  20. Your College Degree: The External Degree Way.

    ERIC Educational Resources Information Center

    Haponski, William C.; And Others

    Information on undertaking an external degree program to obtain a college education is presented. An external degree program is one that has no, or minimal requirements for residence (on-campus attendance). Most often it can be entered at any time of the year and usually grants credit for documented learning already acquired. An external degree…

  1. Teaching Externally: Lecturers' Viewpoints. Occasional Paper 6.

    ERIC Educational Resources Information Center

    Roberts, David, Ed.

    Perspectives of academic staff who have been involved in teaching externally are presented in three papers. In "Teaching Students Externally: The First Twelve Years," Frank Molloy examines three aspects of teaching by the external mode: preparing materials, making assignments, and providing educational experiences for students at the residential…

  2. Capillary fracture of soft gels.

    PubMed

    Bostwick, Joshua B; Daniels, Karen E

    2013-10-01

    A liquid droplet resting on a soft gel substrate can deform that substrate to the point of material failure, whereby fractures develop on the gel surface that propagate outwards from the contact line in a starburst pattern. In this paper, we characterize (i) the initiation process, in which the number of arms in the starburst is controlled by the ratio of the surface tension contrast to the gel's elastic modulus, and (ii) the propagation dynamics showing that once fractures are initiated they propagate with a universal power law L[proportional]t(3/4). We develop a model for crack initiation by treating the gel as a linear elastic solid and computing the deformations within the substrate from the liquid-solid wetting forces. The elastic solution shows that both the location and the magnitude of the wetting forces are critical in providing a quantitative prediction for the number of fractures and, hence, an interpretation of the initiation of capillary fractures. This solution also reveals that the depth of the gel is an important factor in the fracture process, as it can help mitigate large surface tractions; this finding is confirmed with experiments. We then develop a model for crack propagation by considering the transport of an inviscid fluid into the fracture tip of an incompressible material and find that a simple energy-conservation argument can explain the observed material-independent power law. We compare predictions for both linear elastic and neo-Hookean solids, finding that the latter better explains the observed exponent.

  3. Capillary fracture of soft gels.

    PubMed

    Bostwick, Joshua B; Daniels, Karen E

    2013-10-01

    A liquid droplet resting on a soft gel substrate can deform that substrate to the point of material failure, whereby fractures develop on the gel surface that propagate outwards from the contact line in a starburst pattern. In this paper, we characterize (i) the initiation process, in which the number of arms in the starburst is controlled by the ratio of the surface tension contrast to the gel's elastic modulus, and (ii) the propagation dynamics showing that once fractures are initiated they propagate with a universal power law L[proportional]t(3/4). We develop a model for crack initiation by treating the gel as a linear elastic solid and computing the deformations within the substrate from the liquid-solid wetting forces. The elastic solution shows that both the location and the magnitude of the wetting forces are critical in providing a quantitative prediction for the number of fractures and, hence, an interpretation of the initiation of capillary fractures. This solution also reveals that the depth of the gel is an important factor in the fracture process, as it can help mitigate large surface tractions; this finding is confirmed with experiments. We then develop a model for crack propagation by considering the transport of an inviscid fluid into the fracture tip of an incompressible material and find that a simple energy-conservation argument can explain the observed material-independent power law. We compare predictions for both linear elastic and neo-Hookean solids, finding that the latter better explains the observed exponent. PMID:24229192

  4. [Discharges for external injuries from a hospital in Ciudad Juarez, Mexico].

    PubMed

    Díaz-Apodaca, Beatriz A; De Cosio, Federico G; Moye-Elizalde, Gustavo; Fornelli-Laffon, Felipe F

    2012-05-01

    In Ciudad Juarez, Chihuahua, Mexico, morbidity and mortality from injuries have increased alarmingly since 2008. This paper aims to examine the changes in the number of hospital discharges for external injuries recorded during the 2008-2010 period in a hospital in Ciudad Juarez. A descriptive retrospective study conducted at the Ciudad Juarez General Hospital looked at the incidence of external injuries as the reason for hospital discharges during the period under analysis. The average proportion of hospital discharges attributed to external injuries was 27%, with the 25-44-year-old age group being the most affected. More than half of the discharges were for fractures. The incidence rate of hospital discharges attributed to injuries in Ciudad Juarez was almost four times greater than that reported at the national level.

  5. Stress Fracture of the Sacrum.

    PubMed

    Hearn, Darren W; Humphrey, David W

    2015-11-01

    A physical therapist evaluated a 25-year-old male military trainee, who reported 1 week of left hip pain exacerbated by running and sitting cross-legged. At follow-up, the patient reported unchanged hip pain and new left knee pain. Due to potential for multifocal stress injuries outside the visual field of a single MRI, bone scan and single-photon emission computerized tomography were chosen as imaging modalities. Imaging revealed a nondisplaced lateral left-sided sacral stress fracture and left calcaneal stress fracture. J Orthop Sports Phys Ther 2015;45(11):965. doi:10.2519/jospt.2015.0411. PMID:27136290

  6. Probabilistic Simulation for Nanocomposite Fracture

    NASA Technical Reports Server (NTRS)

    Chamis, Christos C.

    2010-01-01

    A unique probabilistic theory is described to predict the uniaxial strengths and fracture properties of nanocomposites. The simulation is based on composite micromechanics with progressive substructuring down to a nanoscale slice of a nanofiber where all the governing equations are formulated. These equations have been programmed in a computer code. That computer code is used to simulate uniaxial strengths and fracture of a nanofiber laminate. The results are presented graphically and discussed with respect to their practical significance. These results show smooth distributions from low probability to high.

  7. Modelling fracture in fibrous microstructures

    SciTech Connect

    Beyerlein, I.

    1998-04-01

    This work describes some complementary studies directed towards micromechanical modeling and simulation of the statistical fracture process in composites with fibrous microstructures. A few studies involve combining efficient computational stress analyses and piezospectroscopic measurement techniques to quantify interface deformation around a single break in model composites. It is shown how estimated interface parameters can be used to predict activity around more complex break arrangement in much larger composites. The final studies involve incorporating these experimentally refined stress analyses into large scale simulation for statistical predictions and subsequent analytical modeling of composite fracture.

  8. Fracture ventilation by surface winds

    NASA Astrophysics Data System (ADS)

    Nachshon, U.; Dragila, M. I.; Weisbrod, N.

    2011-12-01

    Gas exchange between the Earth subsurface and the atmosphere is an important mechanism, affecting hydrological, agricultural and environmental processes. From a hydrological aspect, water vapor transport is the most important process related to Earth-atmosphere gas exchange. In respect to agriculture, gas transport in the upper soil profile is important for soil aeration. From an environmental aspect, emission of volatile radionuclides, such as 3H, 14C and Rd from radioactive waste disposal facilities; volatile organic components from industrial sources and Rn from natural sources, all found in the upper vadose zone, can greatly affect public health when emissions occur in populated areas. Thus, it is vital to better understand gas exchange processes between the Earth's upper crust and atmosphere. Four major mechanisms are known to transfer gases between ground surface and atmosphere: (1) Diffusion; (2) Pressure gradients between ground pores and atmosphere due to changes in barometric pressure; (3) Density-driven gas flow in respond to thermal gradients in the ground; and (4) Winds above the ground surface. Herein, the wind ventilation mechanism is studied. Whereas the wind's impact on ground ventilation was explored in several studies, the physical mechanisms governing this process were hardly quantified or characterized. In this work the physical properties of fracture ventilation due to wind blowing along land surface were explored and quantified. Both field measurements and Hele-Shaw experiments under controlled conditions in the laboratory were used to study this process. It was found that winds in the range of 0.3 m/s result in fracture ventilation down to a depth of 0.2 m. As wind velocity increases, the depth of the ventilation inside the fracture increases respectively, in a linear manner. In addition, the fracture aperture also affects the depth of ventilation, which grows as fracture aperture increases. For the maximal examined aperture of 2 cm and wind

  9. Fracture - An Unforgiving Failure Mode

    NASA Technical Reports Server (NTRS)

    Goodin, James Ronald

    2006-01-01

    During the 2005 Conference for the Advancement for Space Safety, after a typical presentation of safety tools, a Russian in the audience simply asked, "How does that affect the hardware?" Having participated in several International System Safety Conferences, I recalled that most attention is dedicated to safety tools and little, if any, to hardware. The intent of this paper on the hazard of fracture and failure modes associated with fracture is my attempt to draw attention to the grass roots of system safety - improving hardware robustness and resilience.

  10. Hydrogen fracture toughness tester completion

    SciTech Connect

    Morgan, Michael J.

    2015-09-30

    The Hydrogen Fracture Toughness Tester (HFTT) is a mechanical testing machine designed for conducting fracture mechanics tests on materials in high-pressure hydrogen gas. The tester is needed for evaluating the effects of hydrogen on the cracking properties of tritium reservoir materials. It consists of an Instron Model 8862 Electromechanical Test Frame; an Autoclave Engineering Pressure Vessel, an Electric Potential Drop Crack Length Measurement System, associated computer control and data acquisition systems, and a high-pressure hydrogen gas manifold and handling system.

  11. Role of interactions and damage in a cohesive fracture model

    NASA Astrophysics Data System (ADS)

    Gran, Josesph; Rundle, John; Turcotte, Donald; Klein, William

    2012-02-01

    We study the influences of local and long range interactions in a numerical model of tensile fracture. Our model simulates fracture events on a 2D square lattice plane with a Metropolis algorithm. We chose a Hamiltonian that is written as a function of the crack separation (offset field) and includes contributions from an external field, interactions, as well as a cohesive energy across the crack surfaces. Included in our study is both a ferromagnetic-type (attractive) and antiferromagnetic-type (repulsive) interactions. We test both of these interactions individually as well as a hybrid interaction in which over a short range the interaction is antiferromagnetic and in the long range the interaction becomes ferromagnetic. This dual interaction approximates a Lennard-Jones potential. We also propose a characterization of damage and investigate the increase of damage in time for fractures occurring by a static-load as well as a time-dependent load. Damaged sites do not interact with neighboring sites and cannot hold any load. We compare our damage model to previous studies of fiber-bundle models.

  12. Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

    PubMed

    Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

    2015-01-01

    The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures. PMID:25534058

  13. Distal Locking Screws for Intramedullary Nailing of Tibial Fractures.

    PubMed

    Agathangelidis, Filon; Petsatodis, Georgios; Kirkos, John; Papadopoulos, Pericles; Karataglis, Dimitrios; Christodoulou, Anastasios

    2016-01-01

    Recently introduced tibial intramedullary nails allow a number of distal screws to be used to reduce the incidence of malalignment and loss of fixation of distal metaphyseal fractures. However, the number of screws and the type of screw configuration to be used remains obscure. This biomechanical study was performed to address this question. Thirty-six Expert tibial nails (Synthes, Oberdorf, Switzerland) were introduced in composite bone models. The models were divided into 4 groups with different distal locking configurations ranging from 2 to 4 screws. A 7-mm gap osteotomy was performed 72 mm from the tibial plafond to simulate a 42-C3 unstable distal tibial fracture. Each group was divided in 3 subgroups and underwent nondestructive biomechanical testing in axial compression, coronal bending, and axial torsion. The passive construct stiffness was measured and statistically analyzed with one-way analysis of variance. Although some differences were noted between the stiffness of each group, these were not statistically significant in compression (P=.105), bending (P=.801), external rotation (P=.246), and internal rotation (P=.370). This in vitro study showed that, when using the Expert tibial nail for unstable distal tibial fractures, the classic configuration of 2 parallel distal screws could provide the necessary stability under partial weight-bearing conditions. PMID:26840700

  14. The pattern of femoral diaphyseal fractures in children admitted in Sarawak General Hospital.

    PubMed

    Rasit, A H; Mohammad, A W; Pan, K L

    2006-02-01

    Trend towards changing the face of management for pediatric femoral fractures tends to advocate operative treatment. This study was undertaken to review our current practice in the wake of recent progress in the management of pediatric femoral fractures. Fifty patients with femoral diaphyseal fracture treated in Sarawak General Hospital were reviewed retrospectively after an average follow-up of 2.6 years. There were 36 boys and 14 girls, with a mean age of 6.2 years (range five months to 14 years). Children under six years of age constituted the majority of the patients. Half of the fractures were caused by road traffic accident. Nine patients had associated injuries. The most common site of fracture was at the middle third (N=31). The treatment regimens were delayed hip spica (DHS) in 16, immediate hip spica (IHS) in 24, plate osteosynthesis (PO) in five, titanium elastic nailing (TEN) in five, and external fixation (EF) in one. The minimum hospital stay was two days, and the maximum 33 days (mean, 9.7 days). Malunion was the commonest complication. Conservative treatment is the preferred option for children under six years of age. It is cost-effective with minimal complication. The other treatment options are reserved for specific indication in older children. Diaphyseal fractures of the femur in children can be adequately managed non-operatively.

  15. [Immobilization of the fractured patella by an embracing ring device].

    PubMed

    Zhou, Z; Zang, H; Li, H

    1990-06-01

    48 cases of fractured patella treated by embracing ring device from 1976-1988 were reported. Among the group, there were 31 males and 17 females, aged 20-80 years. The types of fractures were transverse 28 cases, comminuted 8 cases, fissure or stellate 12 cases; closed 43 cases, opened 5 cases. The methods were adopted, namely: (1) Simple immobilization with embracing ring device. (2) Cylinder plaster cast combined with embracing ring device. (3) Open-reduction with internal fixation combined with embracing ring device. According to the holistic concept the authors adopted both external and topical application of paste to relieve local swelling and oral administration of traditional Chinese medicine. After bone-union the embracing ring device was removed in conjunction with external lotion and active exercises. The 48 cases were followed up ranging from 5 months to 6 years. Satisfactory results were obtained in 41 cases (85.42%). Finally the authors emphasized that the preservation of patella plays an important role in maintaining the extensor mechanism of the knee from physiological and biomechanic views, if the articular surface can be perfectly restored. The nature of embracing ring device and related problems were also discussed.

  16. [Vertical fractures: apropos of 2 clinical cases].

    PubMed

    Félix Mañes Ferrer, J; Micò Muñoz, P; Sánchez Cortés, J L; Paricio Martín, J J; Miñana Laliga, R

    1991-01-01

    The aim of the study is to present a clinical review of the vertical root fractures. Two clinical cases are presented to demonstrates the criteria for obtaining a correct diagnosis of vertical root fractures.

  17. Heat Transfer in Heterogeneous Fractured Rocks

    NASA Astrophysics Data System (ADS)

    Gisladottir, V. R.; Roubinet, D.; Tartakovsky, D. M.

    2013-12-01

    Modeling heat transfer in fracture networks involves simulations of transport processes in individual fractures and ambient matrix and at fracture-matrix interfaces. In typical applications with meter-scale computational domains and millimeter-scale fracture apertures, such fracture-resolving computations can be prohibitively expensive even when nonuniform meshes are used. We develop a heat transfer particle-tracking approach that significantly reduces computational costs. Most particle-tracking methods assume infinite matrix and all of them assume one-dimensional (1D) transport in the matrix blocks. Yet our analytical solution for heat transfer in a single fracture indicates that the 1D assumption is inadequate, leading to large predictive errors. Our approach is mesh-free and takes into account both longitudinal and transversal heat conduction in the matrix. Our model is used to analyze the impact of fracture network topology and matrix block distribution on heat transport in heterogeneous fractured rocks.

  18. Multiscale Multifunctional Progressive Fracture of Composite Structures

    NASA Technical Reports Server (NTRS)

    Chamis, C. C.; Minnetyan, L.

    2012-01-01

    A new approach is described for evaluating fracture in composite structures. This approach is independent of classical fracture mechanics parameters like fracture toughness. It relies on computational simulation and is programmed in a stand-alone integrated computer code. It is multiscale, multifunctional because it includes composite mechanics for the composite behavior and finite element analysis for predicting the structural response. It contains seven modules; layered composite mechanics (micro, macro, laminate), finite element, updating scheme, local fracture, global fracture, stress based failure modes, and fracture progression. The computer code is called CODSTRAN (Composite Durability Structural ANalysis). It is used in the present paper to evaluate the global fracture of four composite shell problems and one composite built-up structure. Results show that the composite shells. Global fracture is enhanced when internal pressure is combined with shear loads. The old reference denotes that nothing has been added to this comprehensive report since then.

  19. [Vertical fractures: apropos of 2 clinical cases].

    PubMed

    Félix Mañes Ferrer, J; Micò Muñoz, P; Sánchez Cortés, J L; Paricio Martín, J J; Miñana Laliga, R

    1991-01-01

    The aim of the study is to present a clinical review of the vertical root fractures. Two clinical cases are presented to demonstrates the criteria for obtaining a correct diagnosis of vertical root fractures. PMID:1659859

  20. Closed reduction of a fractured bone - aftercare

    MedlinePlus

    Fracture reduction - closed - aftercare; Cast care ... Wood GW. General Principles of Fracture Treatment. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 53. Nettina SM. ...

  1. Creep and fracture of a model yoghurt

    NASA Astrophysics Data System (ADS)

    Manneville, Sebastien; Leocmach, Mathieu; Perge, Christophe; Divoux, Thibaut

    2014-11-01

    Biomaterials such as protein or polysaccharide gels are known to behave qualitatively as soft solids and to rupture under an external load. Combining optical and ultrasonic imaging to shear rheology we show that the failure scenario of a model yoghurt, namely a casein gel, is reminiscent of brittle solids: after a primary creep regime characterized by a macroscopically homogeneous deformation and a power-law behavior which exponent is fully accounted for by linear viscoelasticity, fractures nucleate and grow logarithmically perpendicularly to shear, up to the sudden rupture of the gel. A single equation accounting for those two successive processes nicely captures the full rheological response. The failure time follows a decreasing power-law with the applied shear stress, similar to the Basquin law of fatigue for solids. These results are in excellent agreement with recent fiber-bundle models that include damage accumulation on elastic fibers and exemplify protein gels as model, brittle-like soft solids. Work funded by the European Research Council under Grant Agreement No. 258803.

  2. Fracture of distal end clavicle: A review

    PubMed Central

    Sambandam, Balaji; Gupta, Rajat; Kumar, Santosh; Maini, Lalit

    2014-01-01

    Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-days with a relatively active lifestyle, patients want better results both cosmetically and functionally. Despite so much literature available for the management of this common fracture, there is no consensus regarding the gold standard treatment for this fracture. In this article, we reviewed the literature on various techniques of management for this fracture, both conservative as well as surgical, and their merits and demerits. PMID:25983473

  3. Fracture biology, biomechanics, and internal fixation.

    PubMed

    Trostle, S S; Markel, M D

    1996-03-01

    The success of orthopedic surgery in ruminants is directly related to the surgeon's knowledge and understanding of bone physiology and mechanics. The relationship of the macro and micro structure and function of bone as it relates to fracture physiology and repair is discussed. A basic review of the biomechanical principles of bone, bone fracture, and fracture repair are presented. The clinical and biomechanical principles of internal fixation are described for fracture repair in ruminants.

  4. Lineaments and fracture traces, Decatur County, Indiana

    USGS Publications Warehouse

    Greeman, Theodore K.

    1983-01-01

    Well placement is important in a fractured bedrock terrane, as fractures are a principal source of water to the well. Here, the most productive bedrock wells are at the mapped intersection of two or more fracture traces or lineaments and at the lowest local altitude. Use of a fracture-trace map will not guarantee a sufficient supply of ground water but will reduce the chance of drilling an inadequate well.

  5. [Treatment of hip fractures in elderly patients].

    PubMed

    Hack, Juliana; Bliemel, Christopher; Ruchholtz, Steffen; Bücking, Benjamin

    2015-04-01

    Hip fractures are among the most common fractures in elderly people. The annual number of femoral fractures is even expected to increase because of an aging society. Due to the high number of comorbidities, there are special challenges in treating geriatric hip fracture patients, which require a multidisciplinary management. This includes surgical treatment allowing full weight bearing in the immediate postoperative period, osteoporosis treatment and falls prevention as well as an early ortho-geriatric rehabilitation program.

  6. The Multi-Porosity Multi-Permeability and Electrokinetic Natures of Shales and Their Effects in Hydraulic Fracturing of Unconventional Shale Reservoirs

    NASA Astrophysics Data System (ADS)

    Liu, C.; Hoang, S. K.; Tran, M. H.; Abousleiman, Y. N.

    2013-12-01

    Imaging studies of unconventional shale reservoir rocks have recently revealed the multi-porosity multi-permeability nature of these intricate formations. In particular, the porosity spectrum of shale reservoir rocks often comprises of the nano-porosity in the organic matters, the inter-particle micro-porosity, and the macroscopic porosity of the natural fracture network. Shale is also well-known for its chemically active behaviors, especially shrinking and swelling when exposed to aqueous solutions, as the results of pore fluid exchange with external environment due to the difference in electro-chemical potentials. In this work, the effects of natural fractures and electrokinetic nature of shale on the formation responses during hydraulic fracturing are examined using the dual-poro-chemo-electro-elasticity approach which is a generalization of the classical Biot's poroelastic formulation. The analyses show that the presence of natural fractures can substantially increase the leak-off rate of fracturing fluid into the formation and create a larger region of high pore pressure near the fracture face as shown in Fig.1a. Due to the additional fluid invasion, the naturally fractured shale swells up more and the fracture aperture closes faster compared to an intrinsically low permeability non-fractured shale formation as shown in Fig.1b. Since naturally fractured zones are commonly targeted as pay zones, it is important to account for the faster fracture closing rate in fractured shales in hydraulic fracturing design. Our results also show that the presence of negative fixed charges on the surface of clay minerals creates an osmotic pressure at the interface of the shale and the external fluid as shown in Fig.1c. This additional Donnan-induced pore pressure can result in significant tensile effective stresses and tensile damage in the shale as shown in Fig.1d. The induced tensile damage can exacerbate the problem of proppant embedment resulting in more fracture closure

  7. Ceramic fracture mode-intergranular vs transgranular fracture

    SciTech Connect

    Rice, R.W.

    1996-12-31

    Available data on intergranular fracture (IGF) vs transgranular fracture (TGF) of ceramics is summarized and significantly extended. At 22 C, where there is most data, TGF is normally dominant. IGF generally increases with decreasing grain size (G, mainly at G {le} 1-10 {mu}m), increasing grain boundary phase content and the occurrence of (1) slow crack growth, (2) mist, hackle, and crack branching, and (3) (mainly finer, substantial, grain boundary) porosity, and possibly with increasing elastic anisotropy. Possible effects of grain orientation, stress rate and character, as well as microstructural stresses from thermal expansion anisotropy (TEA) are discussed. At higher temperatures, there is a general shift to more IGF, especially with more grain boundary impurities, finer G, and probably higher elastic anisotropy. This shift often starts with IGF only at the fracture origin, and may not commence until temperatures of the order of 1500 C or more in some materials. While IGF is often attributed to weaker grain boundaries (implying lower strengths), it is also often associated with fine grain size, and thus the highest strengths at lower temperatures. IGF vs TGF reflects not just grain boundary strength (as often emphasized), but a balance of this versus the fracture toughness for grain fracture (usually via cleavage, which may also entail the multiplicity of cleavage planes). Several factors may interact to shift differing balances in different materials, e.g. some increase in IGF at larger G in TiB{sub 2} with high TEA, but more IGF increase in Al{sub 2}O{sub 3}, at larger G with less TEA, and no IGF increase in BeO and all TGF in B{sub 4}C having similar TEA to Al{sub 2}O{sub 3}.

  8. An external drag measuring element

    NASA Astrophysics Data System (ADS)

    Ringel, Mordechai; Levin, Daniel; Seginer, Arnan

    The accurate measurement of the axial-force component acting on small wind-tunnel models has traditionally made use of integral string balances, which eliminated many accuracy problems, such as friction and hysteresis, but also introduced interactions between the various force and moment sensing elements due to nonlinear elastic phenomena. The reduction of these interactions usually calls for complicated designs, expensive manufacturing, hard-to-handle calibration processes, and cumbersome data reduction programs. An approach is presented that is based on an external axial-force-measuring element and avoids the ill-conditioned design problems of integral balances. Other difficulties that are encountered, such as friction, misalignment, and relative motion between metric elements are considered, and their solution is examined. Calibration and test results show that the new approach duplicates and surpasses the results of much more complicated and expensive integral balances.

  9. External Versus Endoscopic Endonasal Dacryocystorhinostomy.

    PubMed

    Grob, Seanna R; Campbell, Ashley; Lefebvre, Daniel R; Yoon, Michael K

    2015-01-01

    DCR is the treatment of choice for NLDO. External DCR has remained the standard approach since the 1890s. With advances in technique and technology, and more otolaryngologists and ophthalmologists performing endoscopic DCR, more studies have been conducted, some with equivalent success rates between the 2 approaches. Endoscopic endonasal DCR offers the advantages of avoiding a skin incision with similar success rates with experienced surgeons. However, the technique necessitates more surgical equipment, and has a steep learning curve. Both approaches have low complication rates and serious complications are very rare. The decision for the type of approach to use depends on the surgeon’s experience, the patient’s preference or concerns, and the resources available within a particular health system.

  10. A Quantitative Comparison of Fracture Attributes and Fracture Patterns: Insights From Deformation Bands and Basement-hosted Fractures

    NASA Astrophysics Data System (ADS)

    Awdal, A. H.; Healy, D.; Alsop, G.

    2012-12-01

    Fractures can act as conduits or barriers to fluid flow, and understanding the geometrical attributes of individual fractures and their patterns is a crucial step in quantifying their connectivity. The quantification of fracture attributes and fracture patterns from outcrop analogues can guide the construction of testable expressions for multidimensional scaling relationships. These relationships may offer a key to better fracture prediction in the subsurface. Deformation band and basement fracture datasets have been collected from selected outcrops with a variety of sub-horizontal and sub-vertical rock faces. Cataclastic deformation bands and their patterns have been mapped and quantified in outcrops of aeolian sandstones of the Entrada formation in SE Utah (USA) and Hopeman formation in Moray (Scotland). Basement-hosted fracture data has been collected from outcrops of Lewisian gneiss and Torridonian sandstone in Clachtoll (Scotland), and Moine gneiss and Devonian sandstone in Portskerra (Scotland). Fracture orientations and spacing have been measured from maps, sections and linear scanlines, and fracture intensity, density and mean trace lengths have all been estimated through the application of the circular scan window method. Fracture trace angles and lengths have been calculated from 2D maps and sections using custom image analysis software. In addition, we have quantified the geometrical attributes of lozenges and lenses, the area or volume of relatively undeformed rock situated between two strands of a composite deformation band. We have investigated the statistical trends among different lozenge and lens datasets (Goblin Valley, Hopeman, Bartlett Wash) and explored their potential correlation to other attributes of the fracture pattern and petrophysical properties. Quantitative statistical analysis of these natural fracture datasets from 3 approximately orthogonal planes will allow us to test multidimensional scaling relationships of fracture attributes

  11. Subtrochanteric femur fracture after removal of screws for femoral neck fracture in a child.

    PubMed

    Song, Kwang Soon; Lee, Si Wook

    2015-01-01

    Displaced femoral neck fractures are rare in children and are associated with a high rate of complications. Subtrochanteric fractures after cannulated screw fixation of femoral neck fractures in adults are well recognized, and there are several reports on the topic. However, there are no reports on complications related to hardware or subtrochanteric fractures after removal of the screws in the treatment of femoral neck fractures in children. Here we report the case of a 10-year-old boy who sustained a subtrochanteric fracture after the screw removal and healing that followed a femoral neck fracture. PMID:25566556

  12. Fractured shale reservoirs: Towards a realistic model

    SciTech Connect

    Hamilton-Smith, T.

    1996-09-01

    Fractured shale reservoirs are fundamentally unconventional, which is to say that their behavior is qualitatively different from reservoirs characterized by intergranular pore space. Attempts to analyze fractured shale reservoirs are essentially misleading. Reliance on such models can have only negative results for fractured shale oil and gas exploration and development. A realistic model of fractured shale reservoirs begins with the history of the shale as a hydrocarbon source rock. Minimum levels of both kerogen concentration and thermal maturity are required for effective hydrocarbon generation. Hydrocarbon generation results in overpressuring of the shale. At some critical level of repressuring, the shale fractures in the ambient stress field. This primary natural fracture system is fundamental to the future behavior of the fractured shale gas reservoir. The fractures facilitate primary migration of oil and gas out of the shale and into the basin. In this process, all connate water is expelled, leaving the fractured shale oil-wet and saturated with oil and gas. What fluids are eventually produced from the fractured shale depends on the consequent structural and geochemical history. As long as the shale remains hot, oil production may be obtained. (e.g. Bakken Shale, Green River Shale). If the shale is significantly cooled, mainly gas will be produced (e.g. Antrim Shale, Ohio Shale, New Albany Shale). Where secondary natural fracture systems are developed and connect the shale to aquifers or to surface recharge, the fractured shale will also produce water (e.g. Antrim Shale, Indiana New Albany Shale).

  13. Coccygeoplasty: treatment for fractures of the coccyx.

    PubMed

    Dean, L Mark; Syed, Mubin I; Jan, Solomon A; Patel, Neel A; Shaikh, Azim; Morar, Kamal; Shah, Omar

    2006-05-01

    Percutaneous vertebroplasty and sacroplasty are becoming common modalities of treatment for vertebral body compression fractures and sacral insufficiency fractures, respectively. The present report describes a case of a coccygeal fracture treated with injection of polymethylmethacrylate cement, which resulted in immediate relief of symptoms. It is suggested that this procedure be called coccygeoplasty.

  14. Teeth in the line of mandibular fractures.

    PubMed

    Spinnato, Gaetano; Alberto, Pamela L

    2009-03-01

    Many mandibular fractures occur through tooth sockets. The treatment plan for teeth in the line of fracture has evolved through the years because of the development of new antibiotics and fixation techniques. In this article we review the history and current studies and discuss treatment protocols for teeth in the line of mandibular fractures.

  15. 49 CFR 195.111 - Fracture propagation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation....

  16. DEMONSTRATION BULLETIN: HYDRAULIC FRACTURING OF CONTAMINATED SOIL

    EPA Science Inventory

    Hydraulic fracturing is a physical process that creates fractures in silty clay soil to enhance its permeability. The technology, developed by the Risk Reduction Engineering Laboratory (RREL) and the University of Cincinnati, creates sand-filled horizontal fractures up to 1 in. i...

  17. 49 CFR 195.111 - Fracture propagation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation....

  18. 49 CFR 195.111 - Fracture propagation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation....

  19. 49 CFR 195.111 - Fracture propagation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation....

  20. 49 CFR 195.111 - Fracture propagation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Fracture propagation. 195.111 Section 195.111... PIPELINE Design Requirements § 195.111 Fracture propagation. A carbon dioxide pipeline system must be designed to mitigate the effects of fracture propagation....