Meeting the Customer's Needs for Mobility and Safety During Construction and Maintenance Operations

DOT National Transportation Integrated Search

2011-01-01

This report presents the Survey, Interviews, and Workshops Test Plan for the national evaluation of the Seattle/Lake Washington Corridor (LWC) Urban Partnership Agreement (UPA) under the United States Department of Transportation (U.S. DOT) UPA Progr...

[Psychiatric residential care facilities in the Puglia region. Phase 1 results of the PROGRES project].

PubMed

Germinario, Cinzia; Semisa, Domenico; Picoco, Fulvio; Prato, Rosa; Lopalco, Pietro Luigi; Quarto, Michele

2004-01-01

One of the more important aspects of the psychiatric care reform in Italy has been the opening of a great number of psychiatric Non-Hospital Residential Facilities (NHRF). However, 22 years have elapsed since the reform and there are still very scarce data regarding such facilities, the type of patients being accomodated, and the types of treatments provided. The "PROGRES" (PROGetto RESidenze - Residential Project) project is the first national study regarding NHRFs ever carried out in Italy. The objectives of "PROGRES" are to make a survey of all NHRFs in Italy (Phase 1) and to perform a detailed assessment of 20% of the surveyed facilities and of the type of patients being treated (Phase 2). This paper reports the survey (Phase 1) results for the Puglia Region. As of March 31, 2003, 113 psychiatric residential facilities were present in Puglia, with a total of 1.479 beds. This results in an average of 13,08 beds per facility and a rate of 3,86 beds per 10.000 inhabitants. The number of NHRFs present in the territory of each Local Health Unit in Puglia is very variable. Most NHRFs (57%) opened after January 1997. Eighty-three percent have a 24-hour staff coverage while only 5,3% has a 2-hour staff coverage. Eighty five percent of the residential facilities are financed by the Italian National Healthcare System, while a small percentage is privately funded. In over half (69,93%) of the NHRFs the predominant patient age group is 40-59 years; 26,4% of the residential facilities accommodate patients below age 40 and only 3,53% accommodate patients over 60 years old.

USE OF ELECTROKINETICS FOR HAZARDOUS WASTE SITE REMEDIATION

EPA Science Inventory

The Superfund Innovative Technology Evaluation (SITE) program was authorized as part of the 1986 amendments to the Superfund legislation. It represents a joint effort between U.S. EPA`s Office of Research and Development and Office of Solid Waste and Emergency Response. The progr...

Topology-Aware Performance Optimization and Modeling of Adaptive Mesh Refinement Codes for Exascale

DOE PAGES

Chan, Cy P.; Bachan, John D.; Kenny, Joseph P.; ...

2017-01-26

Here, we introduce a topology-aware performance optimization and modeling workflow for AMR simulation that includes two new modeling tools, ProgrAMR and Mota Mapper, which interface with the BoxLib AMR framework and the SSTmacro network simulator. ProgrAMR allows us to generate and model the execution of task dependency graphs from high-level specifications of AMR-based applications, which we demonstrate by analyzing two example AMR-based multigrid solvers with varying degrees of asynchrony. Mota Mapper generates multiobjective, network topology-aware box mappings, which we apply to optimize the data layout for the example multigrid solvers. While the sensitivity of these solvers to layout and executionmore » strategy appears to be modest for balanced scenarios, the impact of better mapping algorithms can be significant when performance is highly constrained by network hop latency. Furthermore, we show that network latency in the multigrid bottom solve is the main contributing factor preventing good scaling on exascale-class machines.« less

Topology-Aware Performance Optimization and Modeling of Adaptive Mesh Refinement Codes for Exascale

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chan, Cy P.; Bachan, John D.; Kenny, Joseph P.

Here, we introduce a topology-aware performance optimization and modeling workflow for AMR simulation that includes two new modeling tools, ProgrAMR and Mota Mapper, which interface with the BoxLib AMR framework and the SSTmacro network simulator. ProgrAMR allows us to generate and model the execution of task dependency graphs from high-level specifications of AMR-based applications, which we demonstrate by analyzing two example AMR-based multigrid solvers with varying degrees of asynchrony. Mota Mapper generates multiobjective, network topology-aware box mappings, which we apply to optimize the data layout for the example multigrid solvers. While the sensitivity of these solvers to layout and executionmore » strategy appears to be modest for balanced scenarios, the impact of better mapping algorithms can be significant when performance is highly constrained by network hop latency. Furthermore, we show that network latency in the multigrid bottom solve is the main contributing factor preventing good scaling on exascale-class machines.« less

MONITORING OF A RETENTION POND BEFORE AND AFTER MAINTENANCE

EPA Science Inventory

The USEPA’s Urban Watershed Management Branch monitored a retention pond with wetland plantings in the Richmond Creek (RC) watershed. This BMP, designated RC-5, is owned and operated by the New York City Department of Environmental Protection’s (DEP) as part of the Bluebelt progr...

Feature mapping on extensive landscapes using GPS-enabled computers

USDA-ARS?s Scientific Manuscript database

Landscapes in the western United States are vast yet managers are called upon to know them intimately so they can respond to natural events such as anthropogenic disturbance, fire, insect outbreaks, and invasive species. These landscapes are not static and naturally change with season and the progr...

IMPLEMENTATION OF USEPA'S METAL FINISHING FACILITY POLLUTION PREVENTION TOOL (MFFP2T) - 2003

EPA Science Inventory

To help metal finishing facilities meet the goal of profitable pollution prevention, the USEPA is developing the Metal Finishing Facility Pollution Prevention Tool (MFFP2T), a computer program that estimates the rate of solid, liquid waste generation and air emissions. This progr...

North Dakota Metropolitan Planning Organization's peer exchange on introducing performance management into the MPO planning process : A TPCB Exchange

DOT National Transportation Integrated Search

1997-02-01

This technical memorandum was developed as part of the study, Systems Planning for Automated Commercial Vehicle Licensing and Permitting Systems. The objective of this study was to define the requirements and develop a plan for a national progr...

Effect of almond consumption on vascular function in patients with coronary artery disease: a randomized, controlled, cross-over trial

USDA-ARS?s Scientific Manuscript database

Objective: Almonds reduce cardiovascular disease risk via cholesterol reduction, anti-inflammation, glucoregulation, and antioxidation. The objective of this randomized, controlled, cross-over trial was to determine whether the addition of 85 g almonds daily to a National Cholesterol Education Progr...

Toxicity Testing in the 21st Century: Implications for Human Health Risk Assessment

EPA Science Inventory

The risk analysis perspective by Daniel Krewski and colleagues lays out the long-term vision and strategic plan developed by a National Research Council committee (1), sponsored by the U.S. Environmental Protection Agency (EPA) with support from the U.S. National Toxicology Progr...

A Complex Systems View of Sepsis: Implications for Nursing

DTIC Science & Technology

2013-02-01

resuscitation resulting from disease progres- sion and requiring vasopressor therapy.8 Ultimately, the onset of multiple organ failure is the result of loss of...Kattwinkel J, et al. Mortality reduc- tion by heart rate characteristicmonitoring in very lowbirthweight neonates : a randomized trial. J Pediatr. 2011;159(6

Comprehensive Truck Size and Weight (TS&W) Study. Phase 1-synthesis, working paper 10 : enforcement and truck size and weight regulations

DOT National Transportation Integrated Search

2012-04-01

This report presents the Content Analysis Test Plan for the national evaluation of the Los Angeles County Congestion Reduction Demonstration (CRD) under the United States Department of Transportation (U.S. DOT) Urban Partnership Agreement (UPA) Progr...

Measuring walking and cycling using the PABS (pedestrian and bicycling survey) approach : a low-cost survey method for local communities.

DOT National Transportation Integrated Search

2010-12-01

To tackle the problems of greenhouse gas emissions, traffic congestion, resident quality of life, and public health concerns, communities are using initiatives to spur more walking and cycling. As local governments face hard choices about which progr...

Benign by design: catalyst-free in-water, on-water green chemical methodologies in organic synthesis

EPA Science Inventory

The development of organic synthesis under sustainable conditions is a primary goal of practicing green chemists who want to prevent pollution and design safer pathways. Although, it is challenging to avoid the use of catalysts, or solvents in all the organic reactions but progre...

PROCEEDINGS OF THE 1991 EPA/AWMA INTERNATIONAL SYMPOSIUM: MEASUREMENT OF TOXIC AND RELATED AIR POLLUTANTS - VOLUME II

EPA Science Inventory

A joint conference of the sixth year co-sponsored by the Atmospheric Research and Exposure Assessment Laboratory (AREAL) of the U.S. Environmental Protection Agency and the Air and Waste Management Association was held in Durham, North Carolina, May 6-19, 1991. he technical progr...

PROCEEDINGS OF THE 1991 EPA/AWMA INTERNATIONAL SYMPOSIUM: MEASUREMENT OF TOXIC AND RELATED AIR POLLUTANTS - VOLUME I

EPA Science Inventory

A joint conference of the sixth year co-sponsored by the Atmospheric Research and Exposure Assessment Laboratory (AREAL) of the U.S. Environmental Protection Agency and the Air and Waste Management Association was held in Durham, North Carolina, May 6-19, 1991. he technical progr...

GENETIC DIFFERENCES IN IN VIVO/IN VITRO AIRWAY INJURY AND INFLAMMATION AFTER OIL FLY ASH EXPOSURE

EPA Science Inventory

GENETIC DIFFERENCES IN IN VIVO/ IN VITRO AIRWAY INJURY/ INFLAMMATION AFTER OIL FLY ASH EXPOSURE

Janice Dye, Debora Andrews, Judy Richards, Annette King*, Urmila Kodavanti. US EPA & *SEE Program, RTP, NC.

Oxidative stress is implicated in the pathogenesis and progres...

The surface water register: an empirically improved sample frame for monitoring the rivers and streams of Kansas

EPA Science Inventory

State-wide monitoring based on probability survey designs requires a spatially explicit representation of all streams and rivers of interest within a state, i.e., a sample frame. The sample frame should be the best available map representation of the resource. Many stream progr...

CHARACTERIZATION OF FINE PARTICLE ASSOCIATED ORGANIC COMPOUNDS: INTERLABORATORY COMPARISON AND DEVELOPMENT OF STANDARD REFERENCE MATERIALS

EPA Science Inventory

Organic chemicals adsorbed to fine particulate matter (PM) in the ambient air account for a major component of the mass and include source tracers as well as toxic compounds that may contribute to adverse human health effects. The US EPA has established a PM 2.5 research progr...

Effects of the supplementation with an high-polyphenols extra-virgin olive oil on kinetic sperm features and seminal plasma oxidative status in healthy dogs.

PubMed

Tufarelli, V; Rizzo, A; Lacalandra, G M; Guaricci, A C; Laudadio, V; Valentini, L

2018-06-01

The aim of this work was to evaluate the effects of the supplementation of two extra-virgin olive oils (EVOO) having different polyphenols content, on canine spermatozoa kinetic parameters and seminal plasma oxidative status. The study was conducted on 12 clinically healthy dogs of different breeds (2-7 years, 5-48 kg of body weight) divided into two groups: an experimental group supplemented with EVOO (Coratina cultivar) high in polyphenols (H-P) and a control group fed EVOO (Cima di Bitonto cultivar) low in polyphenols (L-P). The oil was daily administered per os (1 ml/3 kg BW) before meal. Semen collection was made twice at 15 days distance (D0 1 and D0 2 ) and then at 30 (D30), 60 (D60) and 90 (D90) days. Semen concentration and kinetic parameters were measured using computer-assisted sperm analysis (CASA) system to evaluate: sperm total count, sperm motile (MOT%), progressive motility (PROGR%) and its fractions, straight-line velocity (VSL, μm/s), curvilinear velocity (VCL, μm/s), average path velocity (VAP, μm/s), amplitude of lateral head displacement (ALH, μm), beat cross frequency (BCF, Hz), straightness (STR%) and linearity (LIN%). On seminal plasma, reactive oxygen species (ROS) and biological antioxidant potential (BAP) were tested. From findings, no differences were found for sperm MOT, VSL, VCL, VAP, ALH, BCF, STR, LIN and BAP. A gradual enhancement of PROGR% was observed in H-P group (p < .01). The ROS levels were higher in dogs H-P compared to the other group (p < .05). In conclusion, our results highlight the positive effects of EVOO polyphenols on sperm PROGR% in healthy dogs. © 2018 Blackwell Verlag GmbH.

Using P-Stat, BMDP and SPSS for a cross-products factor analysis.

PubMed

Tanner, B A; Leiman, J M

1983-06-01

The major disadvantage of the Q factor analysis with Euclidean distances described by Tanner and Koning [Comput. Progr. Biomed. 12 (1980) 201-202] is the considerable editing required. An alternative procedure with commercially distributed software, and with cross-products in place of Euclidean distances is described. This procedure does not require any editing.

Installation Restoration Program. Preliminary Assessment: 186th Tactical Reconnaissance Group, Mississippi Air National Guard, Meridian Airport, Key Field, Meridian, Mississippi

DTIC Science & Technology

1988-10-01

previous directives and meoranda. Although the DOD IRP and the USEPA Superfund pr"gr ware essentially the sase, differences in the definition of progr...Midway and Wilcox inJ Mississimp, Bulletin 102, Mississippi Geologic Research Papers, Mississippi Geological, Ecnomic and Toporapic Survey, 1964. 16

Translations from Kommunist, Number 18, December 1977.

DTIC Science & Technology

1978-01-26

reproduction of these copyrighted journal articles is prohibited without permission from the copyright agency of the Soviet Union. BIBLIOGRAPHIC DATA ...III - USSR - 5] Author (s) PUBLICATION DATA English title TRANSLATIONS FROM KOMMUNIST, No 18, Dec 1977 Russian title KOMMUNIST Editor (s) R. I...experimental research and production base and insure the extensive use of network planning methods , computers, progres- sive design methods , and so

U.S.-MEXICO BORDER PROGRAM ARIZONA BORDER STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION MANUAL OF THE MASS DATA MASSAGE PROGRAM (UA-D-44.0)

EPA Science Inventory

The purpose of this SOP is to describe the operation of the data processing program. These methods were used for every execution of the data processing program during the Arizona NHEXAS project and the Border study. Keywords: data; data processing.

The U.S.-Mexico Border Progr...

U.S. ENVIRONMENTAL PROTECTION AGENCY'S PM SUPERSITES PROGRAM - A MAJOR SUCCESSFUL COLLABORATIVE AIR QUALITY PROGRAM SUPPORTING STATES AND REGIONAL ORGANIZATIONS IN THEIR APPROACHES TO REDUCE PM LEVELS IN AIR ON URBAN AND REGIONAL SCALES

EPA Science Inventory

The U.S. Environmental Protection Agency's Particulate Matter (PM) Supersites Program (Program) is a nationwide air quality methods, measurement, modeling, and data analysis program initiated through cooperative agreements with leading universities in the United States. The Progr...

Capture-zone design in an aquifer influenced by cyclic fluctuations in hydraulic gradients

NASA Astrophysics Data System (ADS)

Zawadzki, Willy; Chorley, Don; Patrick, Guy

2002-10-01

Design of a groundwater pumping and treatment system for a wood-treatment facility adjacent to the tidally influenced Fraser River estuary required the development of methodologies to account for cyclic variations in hydraulic gradients. Design of such systems must consider the effects of these cyclic fluctuations on the capture of dissolved-phase contaminants. When the period of the cyclic fluctuation is much less than the travel time of the dissolved contaminant from the source to the discharge point, the hydraulic-gradient variations resulting from these cycles can be ignored. Capture zones are then designed based on the average hydraulic gradient determined using filter techniques on continuous groundwater-level measurements. When the period of cyclic fluctuation in hydraulic gradient is near to or greater than the contaminant travel time, the resulting hydraulic-gradient variations cannot be ignored. In these instances, procedures are developed to account for these fluctuations in the capture-zone design. These include proper characterization of the groundwater regime, assessment of the average travel time and period of the cyclic fluctuations, and numerical techniques which allow accounting for the cyclic fluctuations in the design of the capture zone. Résumé. L'étude d'un système de pompage et de traitement de l'eau souterraine d'une usine de traitement du bois proche de l'estuaire de la rivière Fraser, influencé par les marées, a nécessité la mise au point de méthodologies pour prendre en compte les variations cycliques de gradients hydrauliques. L'étude de tels systèmes doit considérer les effets de ces variations cycliques sur l'extraction des contaminants en phase dissoute. Lorsque la période des variations cycliques est très inférieure au temps de parcours du contaminant dissous entre la source et le point d'émergence, les variations du gradient hydraulique résultant de ces cycles peuvent être ignorées. Les zones d'extraction sont alors réalisées sur la base du gradient hydraulique moyen déterminé au moyen de techniques de filtrage sur des mesures continues de la piézométrie. Lorsque la période de la fluctuation cyclique dans le gradient hydraulique est proche de ou supérieure au temps de parcours du contaminant, les variations résultantes de gradient hydraulique ne peuvent plus être ignorées. Dans ces cas-là, des procédures ont été mises au point pour prendre en compte ces fluctuations dans la conception de la zone d'extraction. Celles-ci prennent en considération la caractérisation propre du régime de la nappe, l'évaluation du temps de parcours moyen et de la période des fluctuations cycliques, et des techniques numériques qui permettent de considérer les fluctuations cycliques dans la conception de la zone d'extraction. Resumen. El diseño de un sistema de bombeo y tratamiento de aguas subterráneas para una instalación de manufactura de madera que está próxima al estuario del río Fraser, sometido a la influencia de las mareas, ha requerido el desarrollo de metodologías para tener en cuenta las variaciones cíclicas de los gradientes hidráulicos. El diseño de tales sistemas debe considerar los efectos de las fluctuaciones cíclicas en la captura de contaminantes en fase disuelta. Cuando el período de la fluctuación cíclica es mucho menor que el tiempo de tránsito del contaminante disuelto entre el punto de entrada y el de descarga, se puede ignorar las variaciones del gradiente hidráulico provocadas por dichos ciclos. Las zonas de captura se diseñan entonces en función del gradiente hidráulico promedio, que se determina mediante técnicas de filtrado de medidas continuas del nivel piezométrico. Cuando el período de la fluctuación cíclica del gradiente hidráulico es comparable o mayor que el tiempo de tránsito del contaminante, no puede ignorarse las variaciones resultantes en el gradiente hidráulico. En ese caso, se tiene que desarrollar procedimientos para contar con las fluctuaciones en el diseño de las zonas de captura. Ello implica una adecuada caracterización del régimen de las aguas subterráneas, el establecimiento del tiempo de tránsito y del período de las fluctuaciones cíclicas, y el uso de técnicas numéricas que permitan incluirlas en el diseño de la zona de captura.

Phenomenological Approach to Training

DTIC Science & Technology

1977-08-01

overt responses simpler discrete steps is also like digital computer performed. It will be suggested that a highly progr.ms or flowcharts , which consist...simple proficiency performance. cue/reaction Instruction. Putting this another way, try to visualize a 2-dlnenslonal flowchart it is important to... flowchart of discrete steps, but this does not and can easily apply situational context, which is explain how the orbit is maintained. The moon built

Evaluation of Management Systems Performance at Navy Regional Data Automation Centers.

DTIC Science & Technology

1984-03-01

REPORT NUMBER 7 . AUTHN~s) S. CONTRACT OR GRANT NUM@ER(@) Gloria Jean Cummings Scott 9. PERFORMING OROANIZATION NAME AND ADDRESS 10. PROGR3AM1 ELEMENT...120 BIBLIOGRAPHY . .. .. .. .. ... . . . . .. ... 124 I INITIAl DISTRIBUTION LIST ............... 125 7 p I,, 7 7 t I...invest- ment in information resources-- people , machines, and technologies. Unit costs of hardware continue to decline [Ref. 1]. Because computer needs

Mechanical characterization of polymers and composites with a servohydraulic high-speed tensile tester

NASA Astrophysics Data System (ADS)

Béguelin, Ph.; Barbezat, M.; Kausch, H. H.

1991-12-01

This study is concerned with the measurement of the mechanical behaviour of polymers and composites at intermediate strain rates. It illustrates with two examples, the application of a high speed servohydraulic testing machine and a newly designed optical extensometer. In the first part of the study, the dynamic nature of high speed tensile testing with servohydraulic apparatus is discussed, and a damping technique is proposed. In the second part, this technique has been applied to the measurement of the tensile properties of annealed and unannealed neat PEEK at strain rates between 3 × 10^{-2} and 2,4 × 10^2 s^{-1}. Both materials show increased yield stress and drawing stress with increasing strain rate. However, annealed specimens have been shown to exhibit superior mechanical properties. In the third part, mode I delamination tests have been performed on unidirectional IM6/PEEK composites at nominal strain rates between 1 × 10^{-6} and 8 × 10^{-1} s^{-1}. At the higher velocities the analysis is performed by means of FFT filtering. A moderate reduction in interlaminar fracture toughness was found with increasing loading rate. Cette étude aborde la mesure des propriétés mécaniques des polymères et composites soumis à des vitesses de déformation moyennes. Elle illustre au travers de deux exemples l'utilisation d'une machine d'essais servo-hydraulique à grande vitesse. Elle présente également un capteur optique d'extensométrie de conception nouvelle. Dans la première partie de l'étude, la nature vibratoire des essais de traction à vitesse élevée réalisés sur une machine servo-hydraulique est discutée, et une technique d'amortissement est proposée. Dans une deuxième partie, cette technique est appliquée à l'étude des propriétés en traction du PEEK non recuit et recuit dans le domaine des vitesses de déformation de 3 × 10^{-2} à 2,4 × 10^2 s^{-1}. Les résultats montrent un accroissement systématique de la contrainte au seuil plastique ainsi que de la contrainte conventionnelle de rupture. Ces essais confirment que le traitement thermique de recuit accroît les propriétés mécaniques. La troisième partie de l'étude porte sur des essais de délaminage en mode I d'un composite unidirectionnel IM6/PEEK à des vitesses de déformations nominales comprises entre 1 × 10^{-6} et 8 × 10^{-1} s^{-1}. Aux vitesses les plus élevées on a recours au filtrage par la FFT pour l'analyse de la mesure de la force. Les résultats mettent en évidence une légère diminution des propriétés interlaminaires lorsque les vitesses de déformation augmentent.

Effective Manning of the U.S. Merchant Fleet

DTIC Science & Technology

1984-01-01

es anci progr ams of the National Research Council, appropriate balance of perspectives was committee member Cti 1 mpor"tant consi dera11 on...Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance ...vessel design and operation. Consistent with the policies and programs of the National Research Council, appropriate balance of perspectives was an

Mechanisms of Virus-Induced Neural Cell Death

DTIC Science & Technology

2005-03-01

Y, et al. Brief CMV, with isolates being resistant to acy- report: severe infectious mononucleosis -like clovir, famciclovir, and valacyclovir, and...protease depen- by 24 h post-infection. The completion of the one-step dent process. Conversion to infectious subvirion particles growth curve precedes...apoptosis increases progres- cell attachment protein o-1 (56). sively at 24-48 h post-infection (92). ISVPs are infectious and can be formed either intra

An analysis of sponge genomes.

PubMed

Costantini, Maria

2004-11-24

The genome of sponges has only been investigated so far by Bartmann-Lindholm et al. [Progr. Colloid. Polym. Sci. 107 (1997) 122-126] who reported a multimodal CsCl profile which could be resolved into five peaks for Geodia cydonium. This problem was reinvestigated here on both G. cydonium and Suberites domuncula. It was shown that DNAs from both sponges are characterized by unimodal CsCl profiles, additional peaks being due to contaminating prokaryotic and eukaryotic microorganisms.

A Cholesterol-Sensitive Regulator of the Androgen Receptor

DTIC Science & Technology

2010-07-01

Oncogene (2010) 29, 3745–3747; doi:10.1038/onc.2010.132; published online 3 May 2010 Cholesterol is a sterol that serves as a metabolic precursor to other...bioactive sterols , such as nuclear receptor ligands, and also has a major role in plasma membrane structure. Cholesterol and long- chain...cholesterol synthesis (these drugs are generically termed ‘statins’), have been reported to inhibit cancer incidence or progres- sion in some studies. Although

Progress in Military Airlift (Les Progres Realises dans le Domaine du Transport Aerien Militaire)

DTIC Science & Technology

1991-05-01

transformation of the flight deck, with both visible and concealed changes. This crew/ airplane interface modification has resulted in an evolution of ...300 ADVISORY GROUP FOR AEROSPACE RESEARCH & DEVELOPMENT 7 RUE ANCELLE 92200 NEUILLY SUR SEINE FRANCE AGARD ADVISORY REPOW 300 Technical Evaluation...Advisory Report was prepared at the request of the ’ Flight Mechanics Panel of AGARD. _ North Atlantic Treaty Organization Organisation du Trait de

Epithelial Plasticity in Castration-Resistant Prostate Cancer: Biology of the Lethal Phenotype

DTIC Science & Technology

2012-07-01

mCRPC, with metastatic progres- sion by prostate - specific antigen (PSA; 2 consecutive rises over nadir separated by more than 1 week) or radiologic...Abbreviations: CRPC, castration-resistant prostate cancer; PSA, prostate specific antigen . Armstrong et al. Mol Cancer Res; 9(8) August 2011 Molecular... antigen , which we found did correlate with PSA outcomes and high risk disease among men with localized prostate cancer who were undergoing radical

The Nature of Mental Abilities.

DTIC Science & Technology

1978-06-01

I. Rubinste in San Diego , CA 92 152 Human Resourec es Progr an Manager Naval Mat er ia l Connan~ (0 3 1111)CDR PAUL NELSON Room 101111 , Crys tal...intel— ligence that I call the unified componential theory of human reasonir~ (St ernberg , Note 1). This theory will be described in more detail later...componential theory of human reasoning, according to which performance on each of these tasks can be decomposed into a small number of basic information

Building Loads Analysis and System Thermodynamics (BLAST) Program Users Manual. Volume One. Supplement (Version 3.0).

DTIC Science & Technology

1981-03-01

AD-A B99 054 CONSTRUCTION EN INEERIN RESEARCH LAB (ARMY) CHAMPAIGN IL F/ 9/2 BUILDING LOADS ANALYSIS AND SYSTEM THERMOD NAMICS (BLAST) PROGR...continued. systems , (11) induction unit systems , (12) direct-drive chillers, and (13) purchased steam from utilities. BLAST Version 3.0 also offers the user...their BLAST input. II UNCLASSIFIED SECURITY CLASSIFICATION OF THIS PAGEftin Date Rnerod) FOREWORD This report was prepared for the Air Force Systems

A History of the U.S. Army Construction Engineering Research Laboratory (CERL) 1964-1985

DTIC Science & Technology

1987-12-01

Advlwry Cu.rctl Lqu i fWTU1l rv.lu.1 tl~ CLmn!tteo.o r t"l..kral .... m.ro . • Progr.n UJmntl t"t’ H,Hl er PI~ Camu (t~ M.I:soe.uch oInJ ~1 0fTTU...Illinois, 16 Dec. 1983, Records of Prof. William J. Hall, University of Illinois. 21. Ibid.; James J. Costello, University Counsel, to Albert E. Jenner

Human Resources Task Group. Task 4: Public School Improvement to Enhance Quality of Life around Military Bases

DTIC Science & Technology

2002-12-18

care centers, Head Start, the community hospital, and the University’s School of Education -- to share information and training. 2. Early...centers can "talk, II share childcare information , arrange field trips, get information from the health center and the School of Education . When not...the educational component for the new center, the Chelsea Public Schools expanded Project Excellence to include an afterschool progr,am at the site

A Standardized Rat Model of Volumetric Muscle Loss Injury for the Development of Tissue Engineering Therapies

DTIC Science & Technology

2012-12-01

isometric tetanic force (Po) of 28.4% and 32.5% at 2 and 4 months. Importantly, Po corrected for differences in body weight and muscle wet weights were...development, we removed progres- sively larger amounts of muscle tissue followed by a mea- surement of maximal isometric force (Po). The final model, and...indicated by increased collagen deposition (Fig. 2). The scarred area and the area immediately adjacent to it contained disorganized muscle fibers

Producible Alternative to CdTe for Epitaxy (PACE-2) of LWIR HgCdTe

DTIC Science & Technology

1984-01-01

esmv and .de~aty "p bisto momnberl isrepor cover the progre made toward the achievenientof device quality LWIR HgCdTe on an alternate substrte...initial phase of the research program en- titled, _Producible Alternative to CdTe for Epitaxyý(PACE-2) of LWIR HgCJie". Also described are alternate...objective of this program is the demonstration of the feasibility of PACE-2 technology through fabrication and evaluation of multi- plexed LWIR hybrid

Advances in Components for Active and Passive Airborne Sensors (Progres des Composants pour les Systemes des Detection Active et Passive Aeroportes)

DTIC Science & Technology

1990-09-01

simplest form the modulators are systems. 1) The inter -band absorption edges at operated as non-resonant (single-pass) which the electro-absorption...transitions in -0111- 1,’. three different wavelength bands indicated. It is the NIR inter -band transition which is of interest in this E’l Iwork. 0...quartz crystal resonator is a vector quantity. 12 random vibration at 100 Hz away from the Therefore, the frequency during acceleration carrier. Of

Domain Processes in Ferroelectric Ceramics

DTIC Science & Technology

1994-04-14

elastic strain tensor and eikl is the Levi - Civita density. Eqs (11) and (12) has three nontrivial solutions: Xr3 = 0 (13) Xr"= -1 { [ 2sj2Q 12 -Sl I...ABSTRACT (aA~iMUM 200 wardt) This report Outlines the progres achieved during a two year effort sponsored by the AFOSR on the theoretical study of domain...INTRODUCTION This is the final progress report for this two year program sponsored by the Air Force Office of Scientific Research on "Domain Processes in

Lessons Learned (Vietnam)

DTIC Science & Technology

1966-01-01

and the establishing of joint procedures whereby the above could be accom- plished." USCONARC Comment , Current Tactical Air Command policy ...i.-. . O¼* / t, O231ZGhni stnd~rz...on o ffi.eor -,as assigned. Heo cc= Cncd init~ia2 p...n... to ztais. _an Aviatioc. Ei-;adc standar-dization progr...all concerned. Parag~raphs 2 and 3 contain ma-"erz d-icussed and 6-uidance presented at the Co-ander’s Conierence held this date. 2. POLICY a. F71vin7

Exercise Desert Rock, Staff Memorandums. Army, Camp Desert Rock, Nevada.

DTIC Science & Technology

1957-01-01

I AD-AGAG 257 EXERCISE DESERT ROCK LAS VEGAS NV F/6 IS/ 3 EXERCISE DESERT ROCK, STAFF MEMORANDUMS. ARMY. CAMP DESERT ROCK-ETClUlCASIFE mm95i mm... Exercise Safety Progra - . 1. PUrose: To establish ane’ffective safety progr.Rm toreduce, and keep to a minimum, accident,1 manpower and monetary losses. at...agencies will be- followed. Supervispry personnel will: become familiar with those that Pre applicable to thei£r... operations. The Exercise Safety

Frequency-Dependent Characteristics of Regional Seismic Phases: Propagation of Pn in Western China

DTIC Science & Technology

2011-01-31

CLIMB project using instrumentation from different sources, incl uding many stations fr om the Inco rporated Research Institutions in Seismology – Progr...specific te rranes have also been id entified for later 3 processing . Four of the in-line events have epicenters less than 200 km from the Hi- CLIMB...observed and the calculated data are analyzed using the same processing steps. Figure A1. This shows an example of a data trace from the Hi-CLIMB

Fracture panfaciale: un challenge thérapeutique: à propos d'une observation et revue de la littérature

PubMed Central

Fassih, Malika; Nassik, Hicham; Abada, Mourad Nafaa Redallah; Rouadi, Sami; Mahta, Mohamed; Roubal, Mohamed; Essaadi, Mustapha; El Kadiri, Mohamed Fatmi

2015-01-01

La gestion des traumatismes de la face a subi plusieurs progrès dans la dernière décennie. Avec l'avènement de la tomodensitométrie bi- et tridimensionnelle, qui permet de dresser une cartographie précise des lésions osseuses, le développement du matériel d'ostéosynthèse, et les procédés de réduction des fractures. L'objectif est la restauration totale de la forme et la fonction de la face, seul garant pour empêcher la survenue de préjudices esthétiques et fonctionnels. Nous rapportons l'observation de Mme assal khadija, âgée de 38 ans, admise le 25 Aout 2010, au service des urgences d'ORL et maxillo-faciales, à l'hôpital 20 aout de Casablanca, victime d'un AVP, occasionnant un traumatisme facial grave, avec un important délabrement de la face, et asphyxie. Une trachéotomie a été réalisée en urgence. Le bilan lésionnel a objectivé un important fracas du massif facial intéressant l’étage supérieure, moyen et inférieur. Dans l'immédiat, un parage a été réalisé sous anesthésie générale, la réparation des parties molles délabrées a été effectuée en endobuccale (vestibules, langue et plancher buccal) et pour les téguments de la face. Une semaine après, la patiente a été reprise pour la reconstruction du massif facial, nous avons opté pour le «inside-out, de bas en haut" pour la réduction des fractures. Nous avons procédé à la fixation de la mandibule qui a précédé la reconstruction du maxillaire, de la pyramide nasale, et de l'orbite. L’évolution a été marquée par l'apparition d'un orostome, qui fera l'objet après tarissement de l'infection, d'une réparation grâce à un lambeau myocutané, et une nécrose cutanée de la région zygomatique laissée à la cicatrisation dirigée. Toutes les lésions traumatiques de la face ont des répercussions esthétiques et fonctionnelles à moyen et long termes, dont le degré dépend de la qualité de la prise en charge, qui étant la plus précoce et la plus complète possible avant la consolidation des fractures est le meilleur garant d'un résultat satisfaisant à long terme. PMID:27386025

Suicide in Recent Onset Psychosis Revisited: Significant Reduction of Suicide Rate over the Last Two Decades - A Replication Study of a Dutch Incidence Cohort.

PubMed

Castelein, Stynke; Liemburg, Edith J; de Lange, Jill S; van Es, Frank D; Visser, Ellen; Aleman, André; Bruggeman, Richard; Knegtering, Henderikus

2015-01-01

This study aims to compare the suicide risk over the past decade following recent onset psychosis to findings from the eighties and nineties in the same catchment area and to identify predictors of suicide in the context of the Psychosis Recent Onset Groningen-Survey (PROGR-S). A medical file search was carried out to determine the current status of all patients admitted between 2000 and 2009. The suicide rate was compared with a study executed in 1973-1988 in the same catchment area. Predictors of suicide were investigated using Cox regression. The status of 424 of the 614 patients was known in July 2014. Suicide occurred in 2.4% of patients with psychosis disorders (n = 10; mean follow-up 5.6 years); 6 out of 10 suicides took place within two years. Within two decades, the suicide rate dropped from 11% (follow-up 15 years, 8.5% after 5 years) to 2.4%. The Standardized Mortality Rate (SMR) of suicides compared with the general population was 41.6. A higher age was the only significant predictor for suicide. Neuroticism, living situation, disorganized and negative symptoms, and passive coping style all showed a trend for significance. A significant reduction in the suicide rate was found for people with psychosis over the past decades. Given the high SMR, suicide research should be given the highest priority. Identifying predictors may contribute to further reduction of suicide among patients with psychosis.

Differential Gene Expression in Explanted Human Retinal Pigment Epithelial Cells 24-Hours Post-Exposure to 532 nm, 3.0 ns Pulsed Laser Light and 1064 nm, 170 ps Pulsed Laser Light 12-Hours Post-Exposure: Results Compendium

DTIC Science & Technology

2004-06-01

Additionally, we offer 3 conceptual cartoons outlining our vision for the future progres of laser bioeffects research, metabonomic risk assessment...future progress of laser bioeffects research, metabonomic risk assessment modeling and knowledge building from laser bioeffects data. BACKGROUND In the...our concepts of future laser bioeffects research directions (Figure 5), a metabonomic risk assessment model of laser tissue interaction (Figure 6

Estimation and Mapping of Clouds and Rainfall Areas with an Interactive Computer.

DTIC Science & Technology

1982-12-01

test. C . TEST PROCEDURES The following lis1t is the set of procedures for this test of the SPADS Cloud Model. The steps taken were to: 1. Capture...12, 1640-1648. 121 0 APPENDIX4 SPADS CLOUD MlDEL COMPUTER PROGrRArt C CLOY) -IS DRIVER/IMAIN PROGRAIM C T41S PROC.RAM ANALYZES VIS AND IR. TOGETHEI TO...NITH AN INTERACTIVE COMPUTER(U) NAYAL POSTGRADUATE SCHOOL MONTEREY CA C A NELSON DEC 92 UNLSSIFIED F/G 9/2 NUC MENOMONE NONI smhhhhhhhhohh

Calculation of Cosmic Ray Induced Single Event Upsets: Program CRUP, Cosmic Ray Upset Program

DTIC Science & Technology

1983-09-14

1.., 0 .j ~ u M ~ t R A’- ~~ ’ .~ ; I .: ’ 1 J., ) ’- CALCULATION OF COSMIC RAY INDUCED SINGLE EVEI’o"T UPSETS: PROGRAM CRUP , COSMIC RAY UPSET...neceuety end Identity by blo..;k number) 0Thls report documents PROGR.Al\\1 CRUP , COSMIC RAY UPSET PROGRAM. The computer program calculates cosmic...34. » » •-, " 1 » V »1T"~ Calculation of Cosmic Ray Induced Single Event Upsets: PROGRAM CRUP , COSMIC RAY UPSET PROGRAM I. INTRODUCTION Since the

Entanglement renormalization, quantum error correction, and bulk causality

NASA Astrophysics Data System (ADS)

Kim, Isaac H.; Kastoryano, Michael J.

2017-04-01

Entanglement renormalization can be viewed as an encoding circuit for a family of approximate quantum error correcting codes. The logical information becomes progres-sively more well-protected against erasure errors at larger length scales. In particular, an approximate variant of holographic quantum error correcting code emerges at low energy for critical systems. This implies that two operators that are largely separated in scales behave as if they are spatially separated operators, in the sense that they obey a Lieb-Robinson type locality bound under a time evolution generated by a local Hamiltonian.

A Study of the Department of Defense Configuration Management Policies and Procedures as Applied to the FA-18 Strike/Fighter Program.

DTIC Science & Technology

1987-06-01

tempt to lower o, vera II progr am ccost.s. "t It A I Ji rt), .! the t w, air-:r att. t.hat t. he FA Id i I 1- :2,i- I e Lip I k , I F r , v i s a c:ase...Although the decision to compete the [ Alo TPS’s was made in mid CY-81, not a single production :: had been delivered to the fleet by Harris GSSD or : .j

Advances in Air-Launched Weapon Guidance and Control, Proceedings of the Guidance and Control Panel Symposium (44th) Held in Athens (Greece) on 5-8 May 1987.

DTIC Science & Technology

1987-12-01

2007 Kjeller 92320 Chitillon PORTUGAL Portuguese National Coordinator to AGARD GERMANY Gabinete de Estudos e Programas Fachinformationszentrum...OPI: DTIC-TID MAR 85~ AGARD-CP-4 31 NORTH ATLANTIC TREATY ORGANIZATION ADVISORY GROUP FOR AEROSPACE RESEARCH AND DEVELOPMENT (ORGANISATION DU TRAITE DE ...et Pilotage avait organis6 A EGLIN (Floride), une conference sur le theme des "Missiles Tactiques Air-Sol et Air-Air". Depuis lors, de nombreux progres

Progress in Military Airlift: The Flight Mechanics Panel Symposium Held in Lisbon, Portugal on 28-31 May 1990 (Les Progres Realises dans le Domaine du Transport Aerien Militaire)

DTIC Science & Technology

1990-12-01

maintenue lora des operations militaires futures. iusqu’ici, en raison des contraintes 6cononsiques, les technologies entrant dans la construction des ...transport qui sont en service & l’eure actuelie sont vicillissantes, techniquernent demodees et de momns en momns aptes a repondre aux exigences de ...combustibles, lea L . ~propulseurs et [a conception a6rodynarnique, ainai qsuun r~sumi des programmes en cours et prevu. 4 Flight Mechanics Panel

Recent Advances in Long Range and Long Endurance Operation of Aircraft (Les Progres Recents dans le Domaine des Operations Aeriennes a Longue Distance et de Longdue Duree)

DTIC Science & Technology

1993-11-01

REPORT by F. MARY 23, Rue de la Croix du Val F-92190 MEUDON FRANCE 1. SUMMARY 3. INTRODUCTION This report reviews the lectures presented at the The...the aircraft drove the design to a stiffness critical structure. INTRODUCTION : During the late eighties and early nineties a number of government...at all with any other existing means. terms of payload and endurance. 3.1.1 Earth monitoring 2. Introduction In this role HALE-UMA aircraft can be

Fracture hydraulic conductivity in the Mexico City clayey aquitard: Field piezometer rising-head tests

NASA Astrophysics Data System (ADS)

Vargas, Carlos; Ortega-Guerrero, Adrián

A regional lacustrine aquitard covers the main aquifer of the metropolitan area of Mexico City. The aquitard's hydraulic conductivity (K') is fundamental for evaluating the natural protection of the aquifer against a variety of contaminants present on the surface and its hydraulic response. This study analyzes the distribution and variation of K' in the plains of Chalco, Texcoco and Mexico City (three of the six former lakes that existed in the Basin of Mexico), on the basis of 225 field-permeability tests, in nests of existing piezometers located at depths of 2-85 m. Tests were interpreted using the Hvorslev method and some by the Bouwer-Rice method. Results indicate that the distribution of K' fits log-Gaussian regression models. Dominant frequencies for K' in the Chalco and Texcoco plains range between 1E-09 and 1E-08 m/s, with similar population means of 1.19E-09 and 1.7E-09 m/s, respectively, which are one to two orders of magnitude higher than the matrix conductivity. In the Mexico City Plain the population mean is near by one order of magnitude lower; K'=2.6E-10 m/s. The contrast between the measured K' and that of the matrix is attributed to the presence of fractures in the upper 25-40 m, which is consistent with the findings of previous studies on solute migration in the aquitard. Un imperméable régional d'origine lacustre recouvre le principal aquifère de la zone urbaine de la ville de Mexico. La conductivité hydraulique K' de cet imperméable est fondamentale pour évaluer la protection naturelle de l'aquifère, contre les différents contaminants présents en surface, et sa réponse hydraulique. Cette étude analyse et les variations de K' dans les plaines de Chalco, Texcoco et Mexico (trois des six anciens lacs qui existaient dans le Bassin de Mexico), sur la base de 225 essais de perméabilité sur le terrain, réalisés en grappes dans des piézomètres existants entre 2 et 85 m de profondeur. Les essais ont été interprétés avec la méthode de Hvorslev et certains avec la méthode de Bouwer-Rice. Les résultats indiquent que la distribution de K' s'ajuste à des modèles de régression log-gaussiens. Les valeurs de K' les plus fréquentes dans les plaines de Chalco et de Texcoco sont entre 1E-09 et 1E-08 m/s, avec des moyennes similaires de 1.19E-09 et 1.7E-09 m/s respectivement, qui sont d'un ou deux ordres de grandeurs supérieures à la conductivité de la matrice. Dans la plaine de Mexico, la moyenne est proche d'un ordre de grandeur en moins, avec 2.6E-10 m/s. Ce contraste entre le K' mesuré et celui de la matrice est attribué à la présence de fractures dans les 25-40 m supérieurs, ce qui est en accord avec les études précédentes sur la migration de solutés au travers de l'imperméable. El acuífero principal del Área Metropolitana de la Ciudad de México está recubierto por un acuitardo regional lacustre, cuya conductividad hidráulica es fundamental para evaluar la protección natural de las aguas subterráneas contra los contaminantes presentes en superficie y su respuesta hidráulica. Este estudio analiza la distribución y variación de dicha conductividad en las llanuras de Chalco, Texcoco y Ciudad de México (tres de los seis lagos que existían al principio en la Cuenca de México) a partir de 225 ensayos de campo en piezómetros múltiples existentes, ubicados entre 2 y 85 m de profundidad. La interpretación de los ensayos se ha realizado mediante el método de Hvorslev y-algunos-el de Bouwer-Rice. Los resultados indican que la distribución de la conductividad se ajusta a modelos de regresión lognormales. Las frecuencias dominantes en las Llanuras de Chalco y Texoco están comprendidas entre 1-9 y 10-8 m/s, con medias de población similares de 1.19×10-9 y 1.70×10-9 m/s, respectivamente, que son dos órdenes de magnitud mayores que el valor de la matriz. En el Llano de México, la media es casi un orden de magnitud inferior (2.60×10-10 m/s). Se atribuye este contraste entre la conductividad hidráulica medida y la de la matriz a la presencia de fracturas en el tramo superior situado entre 25 y 40 m, cosa que es coherente con estudios previos de migración de solutos en el acuitardo.

Un cosmologiste oublié: Jean Henri Lambert

NASA Astrophysics Data System (ADS)

Débarbat, Suzanne; Lévy, Jacques

Si les travaux de Kepler ont eu une large influence sure les progrès réalisés en astronomie au cours du 17e siècle, le Siècle de lumières a vu apparaître de nouvelles conceptions. La court vie de J.H. lambert s'inscrit dans le 18e siècle. Il s'agit d'un nom bien connu dans différents domaines (photométrie, projections cartographiques, mathématiques appliquées, etc.); mais il n'est guàre mentionné en cosmologie, alors que Lambert y a fourni une contribution originale offrant quelques suprenantes anticipations...

Explosive Forming of Butt Welded Pipe Reducers.

DTIC Science & Technology

1979-04-01

Ao—A 072 I3Q NAVAL ORDNANCE STATION LOUISVILLE KY F~ G 13/it EXPLOSIVE FORMING OF BIJTT WELDED PIPE REDUCERS. (U) APR 79 M W JO$*4SON UNCLASSIFIED...NOSL MT OS2 _ Eli _ _El [LII] DliB I I —~~~~~~~~~~ I 4 1 V S -. RB’ORT NO. M1052 AP~t 1919v-fl o~toswE FORMING (j~~c BUTI WELDED PIPE RE~~~ A PQWECT...MING BUTT WELDED PIPE REDUCERS A PROJECT OP THE MANUFACTURING TECHNOLOGY PROGR AM NAVAL SEA SYST~~(S COMMA ND fiNAL REPORT NAVAL ORDNANCE STATION L

Aircraft Avionics and Missile System Installation Cost Study. Volume 2. Appendices F and G.

DTIC Science & Technology

1988-02-12

C WING STRUCTUAL FAITIGU LIFI ENBANCEMEINT 3 25 983 81018 F-4 AFPSOOSBR Al A F-4S A/C STRUCTUAL NOD 3 26 200 81019 F-4 AFPS00674 Al A A1N-7N SPARROW...INTERFACE CONPATIBILITY 3 25 18 81019 YCA542523 A1 B AIAING-1OA TECHICAI L OBSOLESCEICE PROGR AM 3 200000 39 1336 34 328 811 C522 2Bh/W-10A TECHNICAL...OBSOLESENCE PROGRAM 3 196000 00 0 328* 81019 YCA542523 B1 B AN/AWG-IOA TECHNICAL OBSOLESENCE PROGRAN 3 2210 2 82 41 29 81019 YCA542523 B2 B ANANG

Fractional vector calculus and fluid mechanics

NASA Astrophysics Data System (ADS)

Lazopoulos, Konstantinos A.; Lazopoulos, Anastasios K.

2017-04-01

Basic fluid mechanics equations are studied and revised under the prism of fractional continuum mechanics (FCM), a very promising research field that satisfies both experimental and theoretical demands. The geometry of the fractional differential has been clarified corrected and the geometry of the fractional tangent spaces of a manifold has been studied in Lazopoulos and Lazopoulos (Lazopoulos KA, Lazopoulos AK. Progr. Fract. Differ. Appl. 2016, 2, 85-104), providing the bases of the missing fractional differential geometry. Therefore, a lot can be contributed to fractional hydrodynamics: the basic fractional fluid equations (Navier Stokes, Euler and Bernoulli) are derived and fractional Darcy's flow in porous media is studied.

The Nuclear Cryogenic Propulsion Stage

NASA Technical Reports Server (NTRS)

Houts, Michael G.; Kim, Tony; Emrich, William J.; Hickman, Robert R.; Broadway, Jeramie W.; Gerrish, Harold P.; Doughty, Glen; Belvin, Anthony; Borowski, Stanley K.; Scott, John

2014-01-01

The fundamental capability of Nuclear Thermal Propulsion (NTP) is game changing for space exploration. A first generation Nuclear Cryogenic Propulsion Stage (NCPS) based on NTP could provide high thrust at a specific impulse above 900 s, roughly double that of state of the art chemical engines. Characteristics of fission and NTP indicate that useful first generation systems will provide a foundation for future systems with extremely high performance. The role of the NCPS in the development of advanced nuclear propulsion systems could be analogous to the role of the DC-3 in the development of advanced aviation. Progres made under the NCPS project could help enable both advanced NTP and advanced Nuclear Electric Propulsion (NEP).

Atelier d'astronomie X

NASA Astrophysics Data System (ADS)

Ballet, J.; Barret, D.

2001-01-01

L'astronomie X connait aujourd'hui une de ses périodes les plus actives et les plus fastes, après le lancement de Chandra et XMM-Newton, et alors que Beppo SAX et Rossi XTE sont toujours en orbite. L'extraordinaire complémentarité de ces satellites est telle que leur domaine d'utilisation est extrêmement vaste, couvrant des étoiles jeunes aux toujours énigmatiques sursauts γ, en passant bien entendu par les trous noirs accrétants dans les binaires X ou dans les noyaux actifs de galaxies. L'atelier fut organisé selon quatre thèmes les étoiles, les phénomènes explosifs, les binaires X et les noyaux actifs de galaxies. Les résultats qui y furent présentés, pour chacun de ces thèmes témoignent de la superbe qualité des données obtenues. En particulier l'accès à la haute résolution spectrale (réseaux) en rayons X marque un pas important. Les présentations plus théoriques ont montré que parallèlement des progrès significatifs sont réalisés dans la physique de l'accrétion autour des objets compacts. Les actes de l'atelier donnent un panorama représentatif des progrès réalisés récemment par l'astronomie X, aussi bien du point de vue observationnel que théorique. Ces actes de colloque sont aussi l'occasion de rappeler l'historique et ce que furent les activités scientifiques de notre GdR au moment ou il doit s'intègrer au GdR PCHE et au PNPS. Enfin, pour toutes informations complémentaires concernant l'atelier: http://www.cesr.fr/~barret/adj/vg.html Ce site donne accès en particulier à la plupart des présentations (transparents).

Satellite (SWOT) and Airborne (AirSWOT) Wide-Swath Altimeters to Study the Garonne River

NASA Astrophysics Data System (ADS)

Biancamaria, S.; Rodriguez, E.; Goutal, N.; Ricci, S.; Mognard, N.; Rogel, P.; Le Pape, E.

2013-09-01

The future NASA/CNES Surface Water and Ocean Topography (SWOT) satellite mission will provide global 2D maps of water elevations, water surface volume change and river discharge at an unprecedented resolution. To prepare this mission, airborne campaigns, called AirSWOT, will fly over the Garonne River (and other targets of interest) in 2014. To plan AirSWOT flights over the Garonne, 1D and 2D hydrodynamic models of the 50 km Garonne River reach between Tonneins and La Reole towns developed by the Laboratoire National d'Hydraulique et Environnement (LNHE) will be used. Models outputs will help to validate airborne measurements. After validation, AirSWOT measurements will be assimilated in the models to reduce model errors. Finally, potential algorithms to estimate discharge from AirSWOT and SWOT observations will be tested over this river reach. This paper presents the study domain, the hydrodynamic models and their use in the context of AirSWOT campaigns in France.

Investigation experimentale de l'ecoulement et des performances thermiques du nanofluide eau-oxyde de cuivre dans un Micro-Canal Chauffe

NASA Astrophysics Data System (ADS)

Rimbault, Benjamin

Cette these de maitrise presentee par articles visait a etudier le comportement hydraulique et thermique d'un ecoulement de nanofluides en micro-canal chauffe. Nous avons etudie premierement de l'eau distillee, ensuite des melanges de particules d'oxyde de cuivre (taille 29nm) avec de l'eau distillee en concentrations particulaires volumiques 4.5%, 1.03%, et 0.24% (CuO-H2O). L'ecoulement force des differents fluides a ete realise au moyen de pompes a engrenages au sein d'un circuit ferme, comprenant un micro-canal a section rectangulaire (e=1.116mm,1=25.229mm) chauffe sur deux faces paralleles via des cartouches electriques, deux echangeurs de chaleurs en serie, ainsi qu'un debitmetre magnetique. A notre connaissance peu d'etudes sur l'ecoulement de nanofluides d'oxyde de cuivre-eau en micro-canal rectangulaire chauffe sont disponibles dans la litterature, cette recherche sert de contribution. Premierement, une validation avec la litterature a ete effectuee pour le cas d'un ecoulement d'eau entre plaques planes paralleles chauffees. Des essais hydrauliques ont ete realises pour une gamme du nombre de Reynolds allant jusqu'a Re=5000 a temperature constante. Par la suite des essais thermiques jusqu'a Re=2500 ont consiste en une elevation de temperature fixe (20.5°C a 30.5°C) a travers la longueur du micro-canal sous un regime stationnaire. Les resultats ont demontre une augmentation de la perte de pression et du coefficient de frottement des nanofluides sur l'eau pour un meme debit. Une telle augmentation de perte de pression etait de +70%, +25%, et +0 a 30% respectivement pour les concentrations 4.50%, 1.03%, et 0.24%. Concernant la transition laminaire a turbulent les comportements semblaient indiquer une valeur critique semblable entre l'eau et les differentes concentrations avec et sans chauffage a un nombre de Reynolds critique Rem 1000. Nous avons observe une legere augmentation du coefficient de convection thermique avec le debit massique pour les faibles concentrations (1.03% et 0.24%), alors que la concentration 4.5% demontre une nette diminution. En general la performance energetique globale definie par la chaleur transferee sur la puissance de pompage, reste inferieure compare a l'eau pour un meme Reynolds et un meme debit massique egalement. L'eau semble etre la meilleure solution en termes de performance energetique globale.

The political ecology of health: perceptions of environment, economy, health and well-being among 'Namgis First Nation.

PubMed

Richmond, C; Elliott, S J; Matthews, R; Elliott, B

2005-12-01

Informed by Mayer's (Progr. Hum. Geogr 20 (1996) 441) political ecology of disease framework, this paper investigates First Nation's perceptions of the links between environment, economy and health and well-being. A case study of 'Namgis First Nation (Alert Bay, British Columbia, Canada) is used to explore the risks and benefits of salmon aquaculture for British Columbia's First Nations. Analysis of interview data (n = 23) indicates strong links between reduced access to environmental resources, marginal participation in the economy, and declining community health and well being. Results suggest that aquaculture development has further decreased the community's access to environmental resources, thereby restricting those economic, social, and cultural activities that determine good health and well-being for this community.

Characterisation of the hydrogeology of the Augustus River catchment, Western Australia

NASA Astrophysics Data System (ADS)

Wilkes, Shane M.; Clement, T. Prabhakar; Otto, Claus J.

Understanding the hydrogeology of weathered rock catchments is integral for the management of various problems related to increased salinity within the many towns of Western Australia. This paper presents the results of site characterisation investigations aimed at improving the overall understanding of the hydrogeology of the southern portion of the Augustus River catchment, an example of a weathered rock catchment. Site data have highlighted the presence of both porous media aquifers within the weathered profile and fractured rock aquifers within the basement rocks. Geophysical airborne surveys and other drilling data have identified a large number of dolerite dykes which crosscut the site. Fractured quartz veins have been found along the margins of these dolerite dykes. Detailed groundwater-level measurements and barometric efficiency estimates indicate that these dolerite dykes and fractured quartz veins are affecting groundwater flow directions, promoting a strong hydraulic connection between all aquifers, and also influencing recharge mechanisms. The hydrogeological significance of the dolerite dykes and fractured quartz veins has been assessed using a combination of high-frequency groundwater-level measurements (30-min sampling interval), rainfall measurements (5-min sampling interval) and barometric pressure fluctuations (30-min sampling interval). A conceptual model was developed for describing various hydrogeological features of the study area. The model indicates that fractured quartz veins along the margins of dolerite dykes are an important component of the hydrogeology of the weathered rock catchments. Comprendre l'hydrogéologie des bassins en roches altérées est essentiel pour la gestion de différents problèmes liés à l'augmentation de la salinité dans de nombreuses villes d'Australie occidentale. Cet article présente les résultats d'études de caractérisation de sites conduites pour améliorer la compréhension de l'hydrogéologie de la partie sud du bassin de la rivière Augustus, exemple de bassin en roches altérées. Les données concernant le site ont mis en évidence la présence simultanée d'aquifères poreux dans le profil d'altération et d'aquifères de roches fracturées dans le socle. Des campagnes de géophysique aéroportée et d'autres données de forages ont identifié de très nombreux dykes de dolérite traversant le site. Des veines de quartz fracturées ont été trouvées aux marges de ces dykes de dolérite. Des mesures détaillées de niveau des nappes et des estimations des effets barométriques indiquent que ces dykes de dolérite et les veines de quartz fracturées affectent les directions d'écoulement souterrain, favorisant une forte connexion hydraulique entre tous ces aquifères, et influençant également les mécanismes de recharge. La signification hydrogéologique des dykes de dolérite et des veines de quartz fracturées a été analysée en combinant des mesures à haute fréquence du niveau des nappes (toutes les 30 min), de la pluie (toutes les 5 min) et des variations de la pression barométrique (toutes les 30 min). Un modèle conceptuel a été établi pour décrire les différents phénomènes hydrogéologiques de la région étudiée. Ce modèle indique que les veines de quartz aux marges des dykes de dolérite sont une importante composante de l'hydrogéologie des bassins en roches altérées. Entender la hidrogeología de cuencas con rocas meteorizadas es esencial para gestionar diversos problemas relacionados con el incremento de salinidad en muchas ciudades de Australia Occidental. Este artículo presenta los resultados obtenidos en la caracterización de varios emplazamientos con el fin de mejorar el conocimiento general de la hidrogeología en la zona sur de la cuenca del Río Augustus, que sirve como ejemplo de cuenca en rocas meteorizadas. Los datos de campo resaltan la presencia tanto de medios acuíferos porosos dentro del perfil meteorizado como de acuíferos en rocas fracturadas dentro de la roca fresca. Los registros geofísicos aéreos y datos de las perforaciones han identificado un gran número de diques de dolerita que intersectan el emplazamiento. Se ha hallado venas de cuarzo fracturado a lo largo de los márgenes de los diques de dolerita. Medidas detalladas del nivel piezométrico y estimaciones de la eficiencia barométrica indican que los diques de dolerita y las venas de cuarzo fracturado afectan las direcciones del flujo de las aguas subterráneas, originando una fuerte conexión hidráulica entre todos los acuíferos e influenciando también a los mecanismos de recarga. Se ha establecido la importancia hidrogeológica de los diques de dolerita y de las venas de cuarzo fracturado mediante una combinación de medidas muy frecuentes del nivel piezométrico (cada 30 min), de la precipitación (cada 5 min) y de las fluctuaciones de la presión barométrica (cada 30 min). Se ha desarrollado un modelo conceptual para describir varias características hidrogeológicas del área de estudio. El modelo indica que las venas de cuarzo fracturado en los márgenes de los diques de dolerita constituyen un componente importante de la hidrogeología de cuencas con rocas meteorizadas.

Chemical response to groundwater extraction southeast of Mexico City

NASA Astrophysics Data System (ADS)

Huizar-Alvarez, R.; Carrillo-Rivera, J. J.; Ángeles-Serrano, G.; Hergt, T.; Cardona, A.

An alternative procedure of pumping test data interpretation is used through a joint analysis of the standard time-drawdown curve and simultaneous field measurements of total dissolved solids (TDS); additional support is also provided by the temperature of extracted groundwater and the chemical composition of extracted water. The overall information was applied to characterise the groundwater flow system and its sources, the hydraulic conditions of the aquifer and hydraulic response of extraction boreholes. The analysis of this information suggests the presence of: (i) a local flow system that circulates at shallow depth through basalt units interstratified with fine grained sediments and pyroclastics; these materials contain water with TDS of 127-600 mg/L and Na of 24-178 mg/L, and temperature of 18-19.5 °C (ii) intermediate flow in granular material under reducing conditions by the oxidation of organic matter in aquitard sediments; this water has TDS and Na values of 203-940 and 30-370 mg/L, respectively, and temperatures of about 20-22 °C (iii) regional flow through volcanic rocks and limestone, with TDS content of 300-700 mg/L, Na of 80-230 mg/L and temperature of 23.0-24.8 °C. The hydraulic response and the chemical composition of the water produced by some boreholes are affected by the seepage inflow from sewage effluents, the input from an overlying aquitard unit and the inducement of regional flow. The conception of the flow regime thus obtained allowed the recognition of hydraulic conditions which were more consistent with the hydrogeological setting, than if only a time vs. drawdown test analysis would have been carried out. L'interprétation simultanée de pompages d'essais, des données de température et résidu sec (RS) de L'eau souterraine pompée, mesurées simultanément sur le terrain et la composition chimique de L'eau pompée comme un aide additionnelle, est utilisée comme une différent procédure pour interpréter les pompages d'essais. La procédure a été appliquée pour caractériser le système d'écoulement souterraine et sa source, les conditions hydrauliques de l'aquifère et la réponse hydraulique des puits considéré. L'analyse de cette information suggérer la présence des systèmes d'écoulement suivantes. (i) local avec18 et 19.5 °C de température, RS de 127-600 mg/L, et Na de 24-178 mg/L, (ii) intermédiaire avec une température de 20 á 22 °C, le RS de 203-940 mg/L et Na 30-370 mg/L, (iii) régional avec 300 à 700 mg/L de RS et 80 à 230 mg/L de Na, une température de 23 à 24.8 °C. Dans le premier cas, l'eau traverse des roches basaltiques, dans le deuxième, des sédiments clastiques avec matière organique de l'aquitard, dans le troisième, des roches volcaniques et calcaires. La chimie de l'eau des quelques puits et sa réponse hydraulique met en évidence l'influence de l'eau de L'aquitard, des effluents de surface et écoulement régional. La conception du régime d'écoulement obtenu, a permis reconnaître les conditions hydrauliques des puits plus correspondantes au contexte hydrogéologique, que si uniquement les données rabattement vs temps auraient été analysé La interpretación conjunta de la gráfica de prueba de bombeo, valores de temperatura y sólidos totales disueltos (STD) del agua subterránea extraída, medidos simultáneamente en campo y la composición química del agua extraída como apoyo adicional; se utilizó como un procedimiento alternativo para interpretar los datos de pruebas de bombeo. Toda esa información fue aplicada para caracterizar el sistema de flujo subterráneo y el origen de éste, las condiciones hidráulicas del acuífero y la respuesta hidráulica de los pozos de extracción. El análisis de la información indica la presencia de: (i) flujo local con temperatura de 18-19.5 °C, STD de 127-600, y Na de 24-178 mg/L (ii) flujo intermedio con temperatura de 20-22 °C, los STD y Na son de (203-940 y 30-370 mg/L), respectivamente; (iii) regional con STD de 300-700 y Na de 80-230 mg/L, y temperatura de 23-24.8 °C. En el primer caso el agua circula a través de rocas basálticas, en el segundo viaja por material granular y materia orgánica en sedimentos del acuitado. El flujo regional circula por material volcánico y rocas calizas. La respuesta hidráulica y la composición química del agua extraída por algunos pozos, es afectada por infiltración de efluentes de agua residual, entrada de agua del acuitardo sobreyacente y la inducción de flujo regional. La concepción del régimen de flujo obtenida, permitió reconocer a las condiciones hidráulicas de los pozos, más correspondientes con el contexto hidrogeológico, que sí únicamente se hubieran analizado los datos de abatimiento vs tiempo.

Etude thermo-hydraulique de l'ecoulement du moderateur dans le reacteur CANDU-6

NASA Astrophysics Data System (ADS)

Mehdi Zadeh, Foad

Etant donne la taille (6,0 m x 7,6 m) ainsi que le domaine multiplement connexe qui caracterisent la cuve des reacteurs CANDU-6 (380 canaux dans la cuve), la physique qui gouverne le comportement du fluide moderateur est encore mal connue de nos jours. L'echantillonnage de donnees dans un reacteur en fonction necessite d'apporter des changements a la configuration de la cuve du reacteur afin d'y inserer des sondes. De plus, la presence d'une zone intense de radiations empeche l'utilisation des capteurs courants d'echantillonnage. En consequence, l'ecoulement du moderateur doit necessairement etre etudie a l'aide d'un modele experimental ou d'un modele numerique. Pour ce qui est du modele experimental, la fabrication et la mise en fonction de telles installations coutent tres cher. De plus, les parametres de la mise a l'echelle du systeme pour fabriquer un modele experimental a l'echelle reduite sont en contradiction. En consequence, la modelisation numerique reste une alternative importante. Actuellement, l'industrie nucleaire utilise une approche numerique, dite de milieu poreux, qui approxime le domaine par un milieu continu ou le reseau des tubes est remplace par des resistances hydrauliques distribuees. Ce modele est capable de decrire les phenomenes macroscopiques de l'ecoulement, mais ne tient pas compte des effets locaux ayant un impact sur l'ecoulement global, tel que les distributions de temperatures et de vitesses a proximite des tubes ainsi que des instabilites hydrodynamiques. Dans le contexte de la surete nucleaire, on s'interesse aux effets locaux autour des tubes de calandre. En effet, des simulations faites par cette approche predisent que l'ecoulement peut prendre plusieurs configurations hydrodynamiques dont, pour certaines, l'ecoulement montre un comportement asymetrique au sein de la cuve. Ceci peut provoquer une ebullition du moderateur sur la paroi des canaux. Dans de telles conditions, le coefficient de reactivite peut varier de maniere importante, se traduisant par l'accroissement de la puissance du reacteur. Ceci peut avoir des consequences majeures pour la surete nucleaire. Une modelisation CFD (Computational Fluid Dynamics) detaillee tenant compte des effets locaux s'avere donc necessaire. Le but de ce travail de recherche est de modeliser le comportement complexe de l'ecoulement du moderateur au sein de la cuve d'un reacteur nucleaire CANDU-6, notamment a proximite des tubes de calandre. Ces simulations servent a identifier les configurations possibles de l'ecoulement dans la calandre. Cette etude consiste ainsi a formuler des bases theoriques a l'origine des instabilites macroscopiques du moderateur, c.-a-d. des mouvements asymetriques qui peuvent provoquer l'ebullition du moderateur. Le defi du projet est de determiner l'impact de ces configurations de l'ecoulement sur la reactivite du reacteur CANDU-6.

Investigation of Intravenous Hydroxocobalamin Compared to Hextend for Resuscitation in a Swine Model of Uncontrolled Hemorrhagic Shock: A Preliminary Report

DTIC Science & Technology

2017-06-16

Iy Dlrec~ b. Is not ~j’lnll I’cr ~pport. res, ~ es or otollr~phs for pu -.. 2. Pilnt your ~me, r~nk;;. l ~Ge. sllln dll~ tt. ’brm In tt.e ~utho(s block...or e eledronl: slgnal1Jre. :> ..••• 1t21 a COP)’of the S9 [e.O.=e report, QA’ DWIR:E> IAC\\JC sl1JGY,progr ev~1 ~ the r8~arch ~ l ". ed l .1udy. If this...a ~chnl~1 U! l caU:,"!IJ~SCI’l~3I1on,~e the ~pe rn~DtlTllI.llon report. eft< , etc.) In the "P~co Tltee" t: x. 4 ..•••1tll a copy of your b’WIlc1

La tachycardie supraventriculaire chez l’enfant

PubMed Central

Bellavance, Marc

2001-01-01

La tachycardie supraventriculaire est l’arythmie symptomatique la plus fréquente chez l’enfant. Ainsi, le pédiatre a avantage à se familiariser avec ce problème. De nombreux progrès ont été réalisés récemment. Les mécanismes physiopathologiques sont mieux connus, et les options pharmacologiques plus variées. De plus, il est possible d’offrir un traitement curatif avec l’ablation par cathéter. Le présent article résume ce trouble du rythme cardiaque sous différents aspects, soit la définition, l’épidémiologie, les différentes catégories (principalement le syndrome de Wolff-Parkinson-White et la tachycardie de réentrée par le nœud auriculoventriculaire), les manifestations cliniques, le diagnostic différentiel, les options thérapeutiques et le pronostic. PMID:20084129

[Recent advances in analysis of petroleum geological samples by comprehensive two-dimensional gas chromatography].

PubMed

Gao, Xuanbo; Chang, Zhenyang; Dai, Wei; Tong, Ting; Zhang, Wanfeng; He, Sheng; Zhu, Shukui

2014-10-01

Abundant geochemical information can be acquired by analyzing the chemical compositions of petroleum geological samples. The information obtained from the analysis provides scientifical evidences for petroleum exploration. However, these samples are complicated and can be easily influenced by physical (e. g. evaporation, emulsification, natural dispersion, dissolution and sorption), chemical (photodegradation) and biological (mainly microbial degradation) weathering processes. Therefore, it is very difficult to analyze the petroleum geological samples and they cannot be effectively separated by traditional gas chromatography/mass spectrometry. A newly developed separation technique, comprehensive two-dimensional gas chromatography (GC x GC), has unique advantages in complex sample analysis, and recently it has been applied to petroleum geological samples. This article mainly reviews the research progres- ses in the last five years, the main problems and the future research about GC x GC applied in the area of petroleum geology.

Evaluation of probabilistic flow in two unsaturated soils

NASA Astrophysics Data System (ADS)

Boateng, Samuel

2001-11-01

A variably saturated flow model is coupled to a first-order reliability algorithm to simulate unsaturated flow in two soils. The unsaturated soil properties are considered as uncertain variables with means, standard deviations, and marginal probability distributions. Thus, each simulation constitutes an unsaturated probability flow event. Sensitivities of the uncertain variables are estimated for each event. The unsaturated hydraulic properties of a fine-textured soil and a coarse-textured soil are used. The properties are based on the van Genuchten model. The flow domain has a recharge surface, a seepage boundary along the bottom, and a no-flow boundary along the sides. The uncertain variables are saturated water content, residual water content, van Genuchten model parameters alpha (α) and n, and saturated hydraulic conductivity. The objective is to evaluate the significance of each uncertain variable to the probabilistic flow. Under wet conditions, saturated water content and residual water content are the most significant uncertain variables in the sand. For dry conditions in the sand, however, the van Genuchten model parameters α and n are the most significant. Model parameter n and saturated hydraulic conductivity are the most significant for the wet clay loam. Saturated water content is most significant for the dry clay loam. Résumé. Un modèle d'écoulement variable en milieu saturé est couplé à un algorithme d'exactitude de premier ordre pour simuler les écoulements en milieu non saturé dans deux sols. Les propriétés des sols non saturés sont considérés comme des variables incertaines avec des moyennes, des écarts-types et des distributions de probabilité marginale. Ainsi chaque simulation constitue un événement d'écoulement non saturé probable. La sensibilité des variables incertaines est estimée pour chaque événement. Les propriétés hydrauliques non saturées d'un sol à texture fine et d'un sol à texture grossière sont utilisées. Les propriétés sont basées sur le modèle de van Genuchten. Le domaine d'écoulement possède une surface de recharge, une limite de fuite à sa base et des limites sans écoulement sur les côtés. Les variables incertaines sont la teneur en eau à saturation, la teneur en eau résiduelle, les paramètres alpha (α) et n du modèle de van Genuchten et la conductivité hydraulique à saturation. L'objectif est d'évaluer la signification de chacune des variables incertaines dans l'écoulement probabiliste. Dans des conditions humides, la teneur en eau à saturation et la teneur en eau résiduelle sont les variables incertaines les plus significatives dans le sable. Toutefois, dans des conditions sèches dans le sable, les paramètres α et n du modèle de van Genuchten sont les plus significatifs. Le paramètre n du modèle et la conductivité hydraulique à saturation sont les plus significatifs pour un sol argileux humide. La teneur en eau à saturation est très significative pour le sol argileux sec. Resumen. Se ha acoplado un modelo de flujo de saturación variable con un algoritmo de fiabilidad de primer orden con el fin de simular el flujo no saturado en dos tipos de suelos. Se ha tratado las propiedades del suelo no saturado como variables inciertas, a las que se asigna las medias, desviaciones estándar y distribuciones de probabilidad marginal correspondientes. Así, cada simulación constituye un evento probabilístico de flujo no saturado y la sensibilidad de las variables inciertas es estimada para cada evento. Se ha utilizado las propiedades de la conductividad hidráulica no saturada de dos suelos con dos tipos de textura - fina y gruesa - mediante el modelo de van Genuchten. El dominio de flujo está delimitado por una superficie de recarga, base de goteo y contornos laterales de flujo nulo. Las variables inciertas son el contenido de agua residual, el de saturación, los parámetros del modelo de van Genuchten (α y n) y la conductividad hidráulica saturada. El objetivo era evaluar la contribución de cada variable incierta al flujo probabilístico. Para arenas, las variables inciertas más importantes, en condiciones de humedad, son el contenido de agua residual y el de saturación en ausencia de humedad, lo son ambos parámetros del modelo de van Genuchten. Para margas arcillosas, las variables más significativas en condiciones húmedas son el parámetro n y la conductividad hidráulica saturada; en condiciones secas, el contenido de agua en saturación.

Numerical analysis of the hydrogeologic controls in a layered coastal aquifer system, Oahu, Hawaii, USA

NASA Astrophysics Data System (ADS)

Oki, Delwyn S.; Souza, William R.; Bolke, Edward L.; Bauer, Glenn R.

The coastal aquifer system of southern Oahu, Hawaii, USA, consists of highly permeable volcanic aquifers overlain by weathered volcanic rocks and interbedded marine and terrestrial sediments of both high and low permeability. The weathered volcanic rocks and sediments are collectively known as caprock, because they impede the free discharge of groundwater from the underlying volcanic aquifers. A cross-sectional groundwater flow and transport model was used to evaluate the hydrogeologic controls on the regional flow system in southwestern Oahu. Controls considered were: (a) overall caprock hydraulic conductivity; and (b) stratigraphic variations of hydraulic conductivity in the caprock. Within the caprock, variations in hydraulic conductivity, caused by stratigraphy or discontinuities of the stratigraphic units, are a major control on the direction of groundwater flow and the distribution of water levels and salinity. Results of cross-sectional modeling confirm the general groundwater flow pattern that would be expected in a layered coastal system. Groundwater flow is: (a) predominantly upward in the low-permeability sedimentary units; and (b) predominantly horizontal in the high-permeability sedimentary units. Résumé Le système aquifère littoral du sud d'Oahu (Hawaii, États-Unis) est constitué par des aquifères de terrains volcaniques très perméables, recouverts par des roches volcaniques altérées, et interstratifiés avec des sédiments marins et continentaux de perméabilité aussi bien forte que faible. Les roches volcaniques altérées et les sédiments sont globalement considérés comme une couverture, parce qu'ils s'opposent à l'écoulement de l'eau souterraine provenant des aquifères volcaniques sous-jacents. Les contrôles hydrogéologiques sur le système aquifère régional du sud-ouest d'Oahu ont étéévaluées au moyen d'un modèle d'écoulement et de transport sur une section transversale. Ces contrôles prennent en compte la conductivité hydraulique de la couverture dans son ensemble et les variations de la conductivité hydraulique liées à la stratigraphie de la couverture. A l'intérieur de la couverture, les variations de la conductivité hydraulique, dues à la stratigraphie ou à des discontinuités entre les unités stratigraphiques, sont le contrôle principal de la direction d'écoulement et de la répartition des niveaux et de la salinité de l'eau. La modélisation sur une section transversale a donné des résultats qui confirment l'organisation générale des directions d'écoulement, telle qu'elle pouvait être envisagée dans un aquifère littoral multicouche. L'écoulement souterrain est essentiellement vertical vers le haut dans les unités sédimentaires à faible perméabilité, et essentiellement horizontal dans les unités sédimentaires à forte perméabilité. Resumen El sistema acuífero costero de la zona sur de Oahu, en Hawaii, está formado por acuíferos volcánicos de alta permeabilidad, subyacentes a rocas volcánicas alteradas, con inclusiones de sedimentos marinos y terrestres, tanto de alta como de baja permeabilidad. Al conjunto de rocas volcánicas alteradas y sedimentos se le conoce por "tapón de roca", ya que impide la descarga libre de las aguas subterráneas del acuífero volcánico subyacente. Se usó un modelo de flujo de agua subterránea y transporte de solutos en sección vertical para evaluar los aspectos hidrogeológicos que controlan el flujo regional en la zona sudoeste de Oahu. Se consideraron: (a) la conductividad hidráulica global del tapón y (b) las variaciones estratigráficas de la conductividad hidráulica. En el tapón de roca, las variaciones de la conductividad hidráulica, causadas por la estratigrafía o por discontinuidades en las unidades estratigráficas, son las que controlan la dirección del flujo subterráneo y la distribución de niveles piezométricos y salinidad. Los resultados del modelo en sección transversal confirman la distribución del flujo subterráneo que cabría esperar en un sistema costero estratificado. El flujo de aguas subterráneas es: (a) predominantemente vertical hacia arriba en las unidades sedimentarias de baja permeabilidad; y (b) predominantemente horizontal en las unidades sedimentarias de alta permeabilidad.

Préface

NASA Astrophysics Data System (ADS)

Jörgen Stevefelt, Henri Bachau Et

2003-06-01

UVX 2002, sixième édition du “Colloque sur les Sources Cohérentes et Incohérentes UV, VUV, et X : Applications et Développements Récents" s'est tenu du 11 au 14 juin 2002 au Centre CAES du CNRS “La Vieille, Perrotine", à Saint-Pierre d'Oléron. Le colloque a réunni une centaine de chercheurs et d'industriels et a permis de faire le point sur la production, la caractérisation et l'utilisation de rayonnement dans un domaine spectral s'étendant de l'ultraviolet aux rayons X. Les participants ont pu assister a trente conférences et une table ronde autour des problèmes locaux de pollution, une cinquantaine d'affiches ont été présentées au travers de deux sessions. Une douzaine d'industriels ont exposé leurs produits durant les séances d'affiches.Conformément aux éditions précédentes, les domaines couverts par le colloque UVX 2002 sont très variés et il est impossible de les résumer en quelques lignes. Parmi les activités en développement rapide on notera les lasers femtosecondes dont les applications se multiplient dans les laboratoires (propriétés des molécules, agrégats et solides), dans l'industrie (usinage, ablation...) et en médecine. L'absence de thermalisation ou de diffusion thermique ouvre aussi des perspectives pour la réalisation de films minces par ablation laser, un domaine où les lasers excimères sont traditionnellement utilisés, avec des applications importantes dans le secteur des télécommunications. Dans le domaine de l'extrème UV, des progrès significatifs ont été réalisés par plusieurs groupes dans la gamme de longueur d'onde de 5 à 20 nm, ouvrant ainsi la voie au développement industriel de la lithographie EUV. On note les progrès dans la réalisation des sources UV et X (laser X, génération d'harmoniques, laser a électrons libres) et la nécessité de développer des optiques adaptées. Une perspective intéressante, ouverte par la génération d'harmoniques, est la production d'impulsions attosecondes qui permettra d'explorer la matière à l'echelle de temps atomique. En même temps la caractérisation de ces impulsions nécessite la conception de techniques nouvelles d'analyse du signal aux temps ultra brefs.L'intéret particulier du colloque UVX est de réunir les communautés de scientifiques qui vont des chercheurs s'intéressant aux processus fondamentaux à ceux travaillant dans les domaines les plus appliqués, voire industriels. Une caractéristique marquante de notre discipline est la rapidité avec laquelle les progrès réalisés dans les laboratoires de recherche sont diffusés vers les applications industrielles. Il est donc important de maintenir un bon équilibre entre les recherches a caractères fondamental et appliqué dans les laboratoires.Nous tenons remercier les membres du comité d'organisation, le comité scientifique et les différents partenaires, institutionnels et industriels, qui par leur soutien ont permis que le colloque UVX puisse se dérouler. Ce colloque a été parrainé par les départements des Sciences Physiques et Mathématiques (SPM) et des Sciences pour l'Ingénieur (SPI) du CNRS, la Délégation Générale de l'Armement (DGA), le CEA DRECAM, le CEA DAM, le Conseil Géneral de Charente Maritime, l'Université de Bordeaux I, la Société Française d'optique, le Groupement de Recherche “SAXO" du CNRS et la société Air Liquide.

Analytic and computational modelling of super-radiant pulse compression in plasma and comparisons with experiment

NASA Astrophysics Data System (ADS)

Shvets, Gennady; Kalmykov, Serguei; Dreher, Matthias; Meyer-Ter-Vehn, Juergen

2003-10-01

The strongly non-linear regime of Raman backscattering [1,2] holds the promise of compressing long low-intensity laser beams into ultra-short high intensity pulses. As the short pulse is amplified by the long counter-propagating pump via backscattering the pump off the nonlinear plasma wave, its duration shrinks and intensity grows. The increase of the bandwidth of the amplified pulse only occurs in the nonlinear amplification regime, and is its most telling signature. Recent experiments at MPQ carried out in the strongly nonlinear regime reveal two previously unobserved features: (i) bandwidth expansion, and (ii) breakdown of the initially smooth amplified pulse into several spikes. Using semi-analytic model and particle-in-cell simulations, we explain the multiple pulse formation by the synchrotron motion of plasma electrons in the ponderomotive potential. Self-similar solutions consisting of multiple spikes are derived, and their nonlinear frequency shifts evaluated. The nonlinear focusing of the pulse by the pump is predicted and compared with experimental observations. [1] G. Shvets et. al., Phys. Rev. Lett. 81, 4879 (1998). [2] A. Pukhov, Rep. Progr. Phys. 66, 47 (1998).

Linfoma Nasal de Células T/Natural Killer Extranodal Refractario Mal Diagnosticado, Tratado de Manera Exitosa: Informe de Caso.

PubMed

Saavedra Ramírez, José Domingo

2017-01-01

El linfoma de células T/natural killer extranodal ("extranodal natural killer/T-cell lymphoma", ENKL) nasal es un linfoma no Hodgkin (LNH) agresivo y poco común para el cual no se ha establecido un tratamiento de referencia claro, especialmente en el escenario de la enfermedad recidivante/refractaria. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Presentamos el informe de caso de un paciente con ENKL nasal (previamente mal diagnosticado como una sinusitis crónica recidivante) en quien la enfermedad progresó durante la quimioterapia con múltiples agentes pero respondió al tratamiento de segunda línea con pralatrexato como agente único. Analizamos opciones de tratamiento para el ENKL nasal recidivante/refractario y sugerimos que el pralatrexato se evalúe más a fondo en este escenario clínico.

Changing the Food Environment: The French Experience12

PubMed Central

Chauliac, Michel; Hercberg, Serge

2012-01-01

The French National Nutrition and Health Program was launched in 2001. To achieve its objectives, 2 main preventive strategies were identified: 1) provide information and education to help individuals make healthy food and physical activity choices; and 2) improve the food and physical environment so that making healthy choices is easier. School regulations have been established to improve the nutritional quality of meals served to children and adolescents, and vending machines have been banned. Since 2007, companies in France’s food industry have had the option of signing the national government’s “Charte d'engagement volontaire de progrès nutritionnel” (charter of commitments to nutritional improvements) which aims to benefit all consumers. A standard reference document, developed by public authorities as the basis for decisions made by a committee of experts in the food industry, aims to validate the voluntary commitments made by companies to improve the nutrient content of the foods they produce. There is strict follow-up. A Food Quality Observatory was created in 2009 to monitor the nutrient quality of the food supply in France. Various results show the positive impact of these actions. PMID:22798000

Les supraconducteurs en courant alternatif

NASA Astrophysics Data System (ADS)

Lacaze, A.; Laumond, Y.

1991-02-01

Since 1983, when the very first AC wire became available, the comprehension of electromagnetic phenomenas ruling over stability and losses of multifilamentary superconductors in AC use, has much improved. Improvements of manufacturing process has opened up the possibility of industrial scale manufacturing of up to one million, 140 nm in diameter, filaments. The AC loss performances and stability remains at the best level up to date. Les premiers brins supraconducteurs utilisables en courants alternatifs sont apparus en 1983. Depuis, des progrès importants ont été réalisés sur le plan de la compréhension des phénomènes électromagnétiques commandant les pertes et la stabilité dans des brins multifilamentaires à filaments ultrafins. L'amélioration des performances et des procédés de fabrication nous permet aujourd'hui de présenter des brins, fabriqués à l'échelle industrielle, comprenant jusqu'à près d'un million de filaments de 140 nm de diamètre, avec des niveaux de pertes et de stabilité inégalés à ce jour.

Changing the food environment: the French experience.

PubMed

Chauliac, Michel; Hercberg, Serge

2012-07-01

The French National Nutrition and Health Program was launched in 2001. To achieve its objectives, 2 main preventive strategies were identified: 1) provide information and education to help individuals make healthy food and physical activity choices; and 2) improve the food and physical environment so that making healthy choices is easier. School regulations have been established to improve the nutritional quality of meals served to children and adolescents, and vending machines have been banned. Since 2007, companies in France's food industry have had the option of signing the national government's "Charte d'engagement volontaire de progrès nutritionnel" (charter of commitments to nutritional improvements) which aims to benefit all consumers. A standard reference document, developed by public authorities as the basis for decisions made by a committee of experts in the food industry, aims to validate the voluntary commitments made by companies to improve the nutrient content of the foods they produce. There is strict follow-up. A Food Quality Observatory was created in 2009 to monitor the nutrient quality of the food supply in France. Various results show the positive impact of these actions.

La planification préalable des soins pour les patients en pédiatrie

PubMed Central

2008-01-01

RÉSUMÉ Les progrès médicaux et technologiques ont permis d’ac-croître les taux de survie et d’améliorer la qualité de vie des nourrissons, des enfants et des adolescents ayant des maladies chroniques mettant la vie en danger. La planifi-cation préalable des soins inclut le processus relié aux discussions sur les traitements essentiels au maintien de la survie et la détermination des objectifs des soins de longue durée. Les dispensateurs de soins pédiatriques ont l’obligation éthique d’assimiler cet aspect des soins médicaux. Le présent document de principes vise à aider les dispensateurs de soins à discuter de la planification préalable des soins des patients pédiatriques dans diverses situations. La planification préalable des soins exige des communications efficaces afin de clarifier les objectifs des soins et de s’entendre sur les traitements pertinents ou non pour réaliser ces objectifs, y compris les mesures de réanimation et les mesures palliatives.

Linfoma Nasal de Células T/Natural Killer Extranodal Refractario Mal Diagnosticado, Tratado de Manera Exitosa: Informe de Caso

PubMed Central

Saavedra Ramírez, José Domingo

2017-01-01

El linfoma de células T/natural killer extranodal (“extranodal natural killer/T-cell lymphoma”, ENKL) nasal es un linfoma no Hodgkin (LNH) agresivo y poco común para el cual no se ha establecido un tratamiento de referencia claro, especialmente en el escenario de la enfermedad recidivante/refractaria. Debido a su rareza, no se han llevado a cabo ensayos aleatorizados específicamente en ENKL nasal; sin embargo, los informes de caso y las series de caso pequeñas ofrecen un conocimiento importante sobre nuevos tratamientos potenciales. Presentamos el informe de caso de un paciente con ENKL nasal (previamente mal diagnosticado como una sinusitis crónica recidivante) en quien la enfermedad progresó durante la quimioterapia con múltiples agentes pero respondió al tratamiento de segunda línea con pralatrexato como agente único. Analizamos opciones de tratamiento para el ENKL nasal recidivante/refractario y sugerimos que el pralatrexato se evalúe más a fondo en este escenario clínico. PMID:29430232

In situ and laboratory investigations of fluid flow through an argillaceous formation at different scales of space and time, Tournemire tunnel, southern France

NASA Astrophysics Data System (ADS)

Boisson, Jean-Yves; Bertrand, Lucien; Heitz, Jean-François; Golvan, Yann Moreau-Le

2001-01-01

In the context of a research and development program on waste disposal, an experimental site (Tournemire tunnel, Aveyron, France) was selected by the French Institute for Nuclear Protection and Safety (IPSN) in order to undertake studies on potential fluid flow at different scales of space and time within a 250-m-thick argillaceous formation. The argillite has a low natural water content ( 3-5%) and very low radii access porosity. Diffusion (tritiated water) coefficients (1×10-12 to 2×10-11 m2/s) and hydraulic conductivities derived from different types of laboratory tests (10-14 to 10-13 m/s) are characteristics of a very low-permeable rock. In situ hydraulic tests (including long-term hydraulic-head measurements) were used to obtain values for hydraulic head and hydraulic conductivity at a scale of 1-10 m (10-13 to 10-11 m/s). Despite uncertainties on these data (due to a scale factor, presence of fissures, and possible artefacts due to hydro-chemo-mechanical coupling), it is expected that fluid flow is essentially governed by diffusion processes. Identification of possible natural flows at larger scales of time and space was investigated using natural isotopic tracers from interstitial fluids. Modelling, based on the deuterium profile along the clay formation and assuming pure diffusion processes, provides estimations of possible flow times. However, lack of knowledge concerning the past geological evolution of the site and the possible role of a fracture network do not permit reduction of uncertainties on these estimations at this stage. Résumé. Dans le cadre de son programme de recherche et développement sur les stockages de déchets, un site expérimental (tunnel de Tournemire, Aveyron, France) a été sélectionné par l'Institut de Protection et Sûreté Nucléaire (IPSN) pour conduire des études sur les possibilités de transferts de fluides à différentes échelles de temps et d'espace au sein d'une formation argileuse de 250 m d'épaisseur. L'argilite est caractérisée par de faibles teneurs en eau ( 3-5%) et de très petits rayons d'accès de pores. Les coefficients de diffusion à l'eau tritiée (1×10-12 à 2×10-11 m2/s) et les conductivités hydrauliques déduites de différents types d'essais au laboratoire (10-13 à 10-14 m/s) sont caractéristiques d'une roche très imperméable. Des tests hydrauliques in situ (y compris une mesure de charge à long terme) ont fourni des valeurs approchées des charges et un ordre de grandeur des perméabilités à l'échelle de 1-10 m (10-11 à 10-13 m/s). En dépit des incertitudes sur ces données (facteur d'échelle, présence de fissures, et artéfacts possibles dus aux couplages hydro-chimique et mécanique) on suppose que les transferts sont essentiellement gouvernés par des processus diffusifs. La reconnaissance de transferts naturels possible à une plus grande échelle de temps et d'espace a été étudiée à partir des traceurs isotopiques naturels des fluides interstitiels. Une modélisation, basée sur un profil en deutérium le long de la colonne argileuse et postulant un processus diffusif a permis de proposer une estimation de temps de transfert possible, mais le manque de connaissances précises au stade actuel de l'étude concernant l'évolution géologique passée du site et le rôle possible de la fracturation ne permet pas de réduire les incertitudes constatées sur ces estimations. Resumen. Dentro del contexto de un programa de investigación y desarrollo para la eliminación de residuos, el Instituto Francés de Protección Nuclear y Seguridad seleccionó un emplazamiento experimental en el túnel de Tournemire (Aveyron, Francia) para llevar a cabo estudios sobre el flujo potencial de fluídos a diferentes escalas temporales y espaciales, en una formación arcillosa de 250 m de espesor. La argilita tiene un contenido natural bajo de agua ( 3-5%) y una porosidad accesible muy pequeña. Los coeficientes de difusión de agua con tritio (entre 10-12 y 2×10-11 m2/s) y las conductividades hidráulicas calculadas a partir de diferentes ensayos de laboratorio (entre 10-13 y 10-14 m/s) son característicos de rocas de muy baja permeabilidad. Se hicieron ensayos hidráulicos in-situ (incluyendo medidas de nivel piezométrico de larga duración) para obtener valores del nivel piezométrico y de la conductividad hidráulica a una escala de 1-10 m (con valores entre 10-11 y 10-13 m/s). A pesar de las incertidumbres sobre estos datos (debido a factores de escala, a la presencia de fisuras y a posibles artificios ocasionados por el acoplamiento hidro-quimiomecánico), se espera que el flujo de fluídos esté esencialmente controlado por procesos de difusión. La identificación de posibles flujos naturales a escalas temporales y espaciales mayores fue investigada mediante trazadores isotópicos naturales del fluído intersticial. La modelación, basada en el perfil de deuterio a lo largo de la formación de arcilla y en la hipótesis de procesos puramente difusivos, proporciona estimaciones de posibles tiempos de tránsito. Sin embargo, la falta de conocimiento sobre la evolución geológica del lugar y sobre el rol potencial de una red de fracturas no permite reducir las incertidumbres asociadas, en el momento actual, a dichas estimaciones.

Effect of Random Natural Fractures on Hydraulic Fracture Propagation Geometry in Fractured Carbonate Rocks

NASA Astrophysics Data System (ADS)

Liu, Zhiyuan; Wang, Shijie; Zhao, Haiyang; Wang, Lei; Li, Wei; Geng, Yudi; Tao, Shan; Zhang, Guangqing; Chen, Mian

2018-02-01

Natural fractures have a significant influence on the propagation geometry of hydraulic fractures in fractured reservoirs. True triaxial volumetric fracturing experiments, in which random natural fractures are created by placing cement blocks of different dimensions in a cuboid mold and filling the mold with additional cement to create the final test specimen, were used to study the factors that influence the hydraulic fracture propagation geometry. These factors include the presence of natural fractures around the wellbore, the dimension and volumetric density of random natural fractures and the horizontal differential stress. The results show that volumetric fractures preferentially formed when natural fractures occurred around the wellbore, the natural fractures are medium to long and have a volumetric density of 6-9%, and the stress difference is less than 11 MPa. The volumetric fracture geometries are mainly major multi-branch fractures with fracture networks or major multi-branch fractures (2-4 fractures). The angles between the major fractures and the maximum horizontal in situ stress are 30°-45°, and fracture networks are located at the intersections of major multi-branch fractures. Short natural fractures rarely led to the formation of fracture networks. Thus, the interaction between hydraulic fractures and short natural fractures has little engineering significance. The conclusions are important for field applications and for gaining a deeper understanding of the formation process of volumetric fractures.

Direct medical costs attributable to peripheral fractures in Canadian post-menopausal women.

PubMed

Bessette, L; Jean, S; Lapointe-Garant, M-P; Belzile, E L; Davison, K S; Ste-Marie, L G; Brown, J P

2012-06-01

This study determined the cost of treating fractures at osteoporotic sites (except spine fractures) for the year following fracture. While the average cost of treating a hip fracture was the highest of all fractures ($46,664 CAD per fracture), treating other fractures also accounted for significant expenditures ($5,253 to $10,410 CAD per fracture). This study aims to determine the mean direct medical cost of treating fractures at peripheral osteoporotic sites in the year post-fracture (through 2 years post-hip fracture). Health administrative databases from the province of Quebec, Canada were used to estimate the cost of treating peripheral fractures at osteoporotic sites for the year following fracture (through 2 years for hip fractures). Included in costs analyses were physician claims, emergency and outpatient clinic costs, hospitalization costs, and subsequent costs for treatment of complications. A total of 15,827 patients (mean age 72 years) who suffered one fracture at an osteoporotic site had data for analyses. Hip/femur fractures had the highest rate of hospital stays related to fracture (91%) and the highest rate of hospital stays associated with a post-fracture complication (8%). In the year following fracture, the mean (SD) costs (2009 Canadian dollars) of treating acute fractures and post-fracture complications were: hip/femur fracture $46,664 ($43,198), wrist fracture $5,253 ($18,982), and fractures at other peripheral sites $10,410 ($27,641). The average (SD) cost of treating post-fracture complications at the hip/femur in the second year post-fracture was $1,698 ($12,462). Hospitalizations associated with the fracture accounted for 88% of the total cost of fracture treatment. The treatment of hip fractures accounts for a significant proportion of the costs associated with the treatment of peripheral osteoporotic fractures. Interventions to reduce the incidence of fractures, particularly hip fractures, would result in significant cost savings to the health care system and would preserve quality of life in many patients.

Basic principles of fracture treatment in children.

PubMed

Ömeroğlu, Hakan

2018-04-01

This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods. Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment and in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. Most of the fractures in children can successfully be treated by non-surgical methods.

Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study.

PubMed

Barrett-Connor, Elizabeth; Nielson, Carrie M; Orwoll, Eric; Bauer, Douglas C; Cauley, Jane A

2010-03-15

To study the causes and consequences of radiologically confirmed rib fractures (seldom considered in the context of osteoporosis) in community dwelling older men. Prospective cohort study (Osteoporotic Fractures in Men (MrOS) Study). 5995 men aged 65 or over recruited in 2000-2 from six US sites; 99% answered mailed questionnaires about falls and fractures every four months for a mean 6.2 (SD 1.3) year follow-up. New fractures validated by radiology reports; multivariate Cox proportional hazard ratios were used to evaluate factors independently associated with time to incident rib fracture; associations between baseline rib fracture and incident hip and wrist fracture were also evaluated. The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. Nearly half of new rib fractures (48%; n=61) followed falling from standing height or lower. Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. Men with a history of rib/chest fracture had at least a twofold increased risk of an incident rib fracture (adjusted hazard ratio 2.71, 95% confidence interval 1.86 to 3.95), hip fracture (2.05, 1.33 to 3.15), and wrist fracture (2.06, 1.14 to 3.70). Only 14/82 of men reported being treated with bone specific drugs after their incident rib fracture. Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. Rib fractures should be considered to be osteoporotic fractures in the evaluation of older men for treatment to prevent future fracture.

Discrete Fracture Network Characterization of Fractured Shale Reservoirs with Implications to Hydraulic Fracturing Optimization

NASA Astrophysics Data System (ADS)

Jin, G.

2016-12-01

Shales are important petroleum source rocks and reservoir seals. Recent developments in hydraulic fracturing technology have facilitated high gas production rates from shale and have had a strong impact on the U.S. gas supply and markets. Modeling of effective permeability for fractured shale reservoirs has been challenging because the presence of a fracture network significantly alters the reservoir hydrologic properties. Due to the frequent occurrence of fracture networks, it is of vital importance to characterize fracture networks and to investigate how these networks can be used to optimize the hydraulic fracturing. We have conducted basic research on 3-D fracture permeability characterization and compartmentization analyses for fractured shale formations, which takes the advantages of the discrete fracture networks (DFN). The DFN modeling is a stochastic modeling approach using the probabilistic density functions of fractures. Three common scenarios of DFN models have been studied for fracture permeability mapping using our previously proposed techniques. In DFN models with moderately to highly concentrated fractures, there exists a representative element volume (REV) for fracture permeability characterization, which indicates that the fractured reservoirs can be treated as anisotropic homogeneous media. Hydraulic fracturing will be most effective if the orientation of the hydraulic fracture is perpendicular to the mean direction of the fractures. A DFN model with randomized fracture orientations, on the other hand, lacks an REV for fracture characterization. Therefore, a fracture permeability tensor has to be computed from each element. Modeling of fracture interconnectivity indicates that there exists no preferred direction for hydraulic fracturing to be most effective oweing to the interconnected pathways of the fracture network. 3-D fracture permeability mapping has been applied to the Devonian Chattanooga Shale in Alabama and the results suggest that an REV exist for fluid flow and transport modeling at element sizes larger than 200 m. Fracture pathway analysis indicates that hydraulic fracturing can be equally effective for hydrocarbon fluid/gas exploration as long as its orientation is not aligned with that of the regional system fractures.

Fractures of the Tibial Plateau Involve Similar Energies as the Tibial Pilon but Greater Articular Surface Involvement

PubMed Central

Dibbern, Kevin; Kempton, Laurence B.; Higgins, Thomas F.; Morshed, Saam; McKinley, Todd O.; Marsh, J. Lawrence; Anderson, Donald D.

2016-01-01

Patients with tibial pilon fractures have a higher incidence of post-traumatic osteoarthritis than those with fractures of the tibial plateau. This may indicate that pilon fractures present a greater mechanical insult to the joint than do plateau fractures. We tested the hypothesis that fracture energy and articular fracture edge length, two independent indicators of severity, are higher in pilon than plateau fractures. We also evaluated if clinical fracture classification systems accurately reflect severity. Seventy-five tibial plateau fractures and fifty-two tibial pilon fractures from a multi-institutional study were selected to span the spectrum of severity. Fracture severity measures were calculated using objective CT-based image analysis methods. The ranges of fracture energies measured for tibial plateau and pilon fractures were 3.2 to 33.2 Joules (J) and 3.6 to 32.2 J, respectively, and articular fracture edge lengths were 68.0 to 493.0 mm and 56.1 to 288.6 mm, respectively. There were no differences in the fracture energies between the two fracture types, but plateau fractures had greater articular fracture edge lengths (p<0.001). The clinical fracture classifications generally reflected severity, but there was substantial overlap of fracture severity measures between different classes. Clinical Significance Similar fracture energies with different degrees of articular surface involvement suggest a possible explanation for dissimilar rates of post-traumatic osteoarthritis for fractures of the tibial plateau compared to the tibial pilon. The substantial overlap of severity measures between different fracture classes may well have confounded prior clinical studies relying on fracture classification as a surrogate for severity. PMID:27381653

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

PubMed

Joeris, Alexander; Lutz, Nicolas; Blumenthal, Andrea; Slongo, Theddy; Audigé, Laurent

2017-04-01

Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the upper extremities of a representative population of children classified according to the PCCF. Patients and methods - We included children and adolescents (0-17 years old) diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at the university hospitals in Bern and Lausanne (Switzerland). Patient charts were retrospectively reviewed and fractures were classified from standard radiographs. Results - Of 2,292 upper extremity fractures in 2,203 children and adolescents, 26% involved the humerus and 74% involved the forearm. In the humerus, 61%, and in the forearm, 80% of single distal fractures involved the metaphysis. In adolescents, single humerus fractures were more often epiphyseal and diaphyseal fractures, and among adolescents radius fractures were more often epiphyseal fractures than in other age groups. 47% of combined forearm fractures were distal metaphyseal fractures. Only 0.7% of fractures could not be classified within 1 of the child-specific fracture patterns. Of the single epiphyseal fractures, 49% were Salter-Harris type-II (SH II) fractures; of these, 94% occurred in schoolchildren and adolescents. Of the metaphyseal fractures, 58% showed an incomplete fracture pattern. 89% of incomplete fractures affected the distal radius. Of the diaphyseal fractures, 32% were greenstick fractures. 24 Monteggia fractures occurred in pre-school children and schoolchildren, and 2 occurred in adolescents. Interpretation - The pattern of pediatric fractures in the upper extremity can be comprehensively described according to the PCCF. Prospective clinical studies are needed to determine its clinical relevance for treatment decisions and prognostication of outcome.

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 solution-precipitation creep in the hostrock can independently affect fracture opening displacement and thus fracture aperture profiles and aperture distribution.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF)

PubMed Central

Joeris, Alexander; Lutz, Nicolas; Blumenthal, Andrea; Slongo, Theddy; Audigé, Laurent

2017-01-01

Background and purpose To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the upper extremities of a representative population of children classified according to the PCCF. Patients and methods We included children and adolescents (0–17 years old) diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at the university hospitals in Bern and Lausanne (Switzerland). Patient charts were retrospectively reviewed and fractures were classified from standard radiographs. Results Of 2,292 upper extremity fractures in 2,203 children and adolescents, 26% involved the humerus and 74% involved the forearm. In the humerus, 61%, and in the forearm, 80% of single distal fractures involved the metaphysis. In adolescents, single humerus fractures were more often epiphyseal and diaphyseal fractures, and among adolescents radius fractures were more often epiphyseal fractures than in other age groups. 47% of combined forearm fractures were distal metaphyseal fractures. Only 0.7% of fractures could not be classified within 1 of the child-specific fracture patterns. Of the single epiphyseal fractures, 49% were Salter-Harris type-II (SH II) fractures; of these, 94% occurred in schoolchildren and adolescents. Of the metaphyseal fractures, 58% showed an incomplete fracture pattern. 89% of incomplete fractures affected the distal radius. Of the diaphyseal fractures, 32% were greenstick fractures. 24 Monteggia fractures occurred in pre-school children and schoolchildren, and 2 occurred in adolescents. Interpretation The pattern of pediatric fractures in the upper extremity can be comprehensively described according to the PCCF. Prospective clinical studies are needed to determine its clinical relevance for treatment decisions and prognostication of outcome. PMID:27882802

Mechanics in the Production of Mandibular Fractures: A Clinical, Retrospective Case-Control Study

PubMed Central

Yang, Rongtao; Li, Zhi; Li, Zubing

2016-01-01

As the mandible is susceptible to fracture, the aim of this study was to use multivariate logistic regression analysis to identify and distinguish various internal factors that may influence the location of mandibular fractures. The study included 1131 patients with maxillofacial fractures during the period from January 2000 to December 2009 to evaluate the association of mandibular fracture location (unilateral symphysis, body, angle, condylar, or bilateral condylar fractures) with various internal factors. Among the 1131 patients, 869 had mandibular fractures. Data on age, sex, soft tissue injuries, dental trauma, and maxillofacial fracture type were collected and analyzed using multivariate logistic regression. In total, 387, 210, 139, 319, and 172 patients were diagnosed with unilateral symphysis, body, angle, unilateral, or bilateral condylar fractures, respectively. The dental trauma in patients with bilateral condylar fractures differed from that in patients with unilateral condylar fractures. Patients with mandibular fracture (unilateral symphysis, body, unilateral or bilateral condylar) possessed an approximately equal risk of soft tissue injuries in the mandible. Patients with either unilateral or bilateral condylar fractures were associated with a low risk of mandibular angle fracture (OR < 1). Similarly, patients with mandibular angle fracture were associated with a low risk of unilateral or bilateral condylar fractures (OR < 1). Moreover, patients with symphysis fracture were associated with a low risk of bilateral condylar fractures (90 of 387 [23.3%], OR 0.899). By contrast, patients with bilateral condylar fractures were associated with a high risk of symphysis fracture (90 of 172 [52.3%], OR 17.38). Patients with condylar fractures, particularly those with bilateral condylar fractures, were infrequently associated with secondary mandibular fractures. Mandibular fractures tended to have less of an association with midfacial fractures. The occurrence of mandibular fractures is strongly correlated with age, sex, soft tissue injuries, dental trauma, and the pattern and position of the maxillofacial fractures in patients. PMID:26900699

Previous Fractures at Multiple Sites Increase the Risk for Subsequent Fractures: The Global Longitudinal Study of Osteoporosis in Women

PubMed Central

Gehlbach, Stephen; Saag, Kenneth G.; Adachi, Jonathan D.; Hooven, Fred H.; Flahive, Julie; Boonen, Steven; Chapurlat, Roland D.; Compston, Juliet E.; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L.; LaCroix, Andrea Z.; Netelenbos, J. Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Sambrook, Philip N.; Silverman, Stuart; Siris, Ethel S.; Watts, Nelson B.; Lindsay, Robert

2016-01-01

Previous fractures of the hip, spine, or wrist are well-recognized predictors of future fracture, but the role of other fracture sites is less clear. We sought to assess the relationship between prior fracture at 10 skeletal locations and incident fracture. The Global Longitudinal Study of Osteoporosis in Women (GLOW) is an observational cohort study being conducted in 17 physician practices in 10 countries. Women ≥ 55 years answered questionnaires at baseline and at 1 and/or 2 years (fractures in previous year). Of 60,393 women enrolled, follow-up data were available for 51,762. Of these, 17.6%, 4.0%, and 1.6% had suffered 1, 2, or ≥3 fractures since age 45. During the first 2 years of follow-up, 3149 women suffered 3683 incident fractures. Compared with women with no prior fractures, women with 1, 2, or ≥ 3 prior fractures were 1.8-, 3.0-, and 4.8-fold more likely to have any incident fracture; those with ≥3 prior fractures were 9.1-fold more likely to sustain a new vertebral fracture. Nine of 10 prior fracture locations were associated with an incident fracture. The strongest predictors of incident spine and hip fractures were prior spine fracture (hazard ratio 7.3) and hip (hazard ratio 3.5). Prior rib fractures were associated with a 2.3-fold risk of subsequent vertebral fracture, previous upper leg fracture predicted a 2.2-fold increased risk of hip fracture; women with a history of ankle fracture were at 1.8-fold risk of future fracture of a weight-bearing bone. Our findings suggest that a broad range of prior fracture sites are associated with an increased risk of incident fractures, with important implications for clinical assessments and risk model development. PMID:22113888

Expected lifetime numbers, risks, and burden of osteoporotic fractures for 50-year old Chinese women: a discrete event simulation incorporating FRAX.

PubMed

Jiang, Yawen; Ni, Weiyi

2016-11-01

This work was undertaken to provide an estimation of expected lifetime numbers, risks, and burden of fractures for 50-year-old Chinese women. A discrete event simulation model was developed to simulate the lifetime fractures of 50-year-old Chinese women at average risk of osteoporotic fracture. Main events in the model included hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture. Fracture risks were calculated using the FRAX ® tool. Simulations of 50-year-old Chinese women without fracture risks were also carried out as a comparison to determine the burden of fractures. A 50-year-old Chinese woman at average risk of fracture is expected to experience 0.135 (95 % CI: 0.134-0.137) hip fractures, 0.120 (95 % CI: 0.119-0.122) clinical vertebral fractures, 0.095 (95 % CI: 0.094-0.096) wrist fractures, 0.079 (95 % CI: 0.078-0.080) humerus fractures, and 0.407 (95 % CI: 0.404-0.410) other fractures over the remainder of her life. The residual lifetime risk of any fracture, hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture for a 50-year-old Chinese woman is 37.36, 11.77, 10.47, 8.61, 7.30, and 27.80 %, respectively. The fracture-attributable excess quality-adjusted life year (QALY) loss and lifetime costs are estimated at 0.11 QALYs (95 % CI: 0.00-0.22 QALYs) and US $714.61 (95 % CI: US $709.20-720.02), totaling a net monetary benefit loss of US $1,104.43 (95 % CI: US $904.09-1,304.78). Chinese women 50 years of age are at high risk of osteoporotic fracture, and the expected economic and quality-of-life burden attributable to osteoporotic fractures among Chinese women is substantial.

Characteristics of bone fractures and usefulness of micro-computed tomography for fracture detection in rabbits: 210 cases (2007-2013).

PubMed

Sasai, Hiroshi; Fujita, Daisuke; Tagami, Yukari; Seto, Eiko; Denda, Yuki; Hamakita, Hideaki; Ichihashi, Tomonori; Okamura, Kensaku; Furuya, Masaru; Tani, Hiroyuki; Sasai, Kazumi; Yamate, Jyoji

2015-06-15

To characterize bone fractures and the usefulness of micro-CT for imaging fractures in pet rabbits. Retrospective case series. 210 client-owned rabbits with bone fractures. Medical records of rabbits evaluated for bone fractures from 2007 through 2013 were examined. Information was collected on signalment and nature of fractures, and radiographic and micro-CT images of fractures were reviewed. Almost half (n = 95 [47.7%]) of fractures were in rabbits < 3 years old. Accidental fall was the most common cause. Vertebral fracture was the most common type of fracture with a nonneoplastic cause (n = 46 [23.2%]) and was most common in the L4-L7 region. The tibia was the most common site for limb fracture among all fractures with a nonneoplastic cause (45 [22.7%]). Twelve (5.7%) fractures had a neoplastic cause, and 7 of these were associated with metastatic uterine adenocarcinoma. Females were significantly more likely to have a fracture caused by neoplasia than were males. Compared with radiography, micro-CT provided more detailed fracture information, particularly for complicated fractures or structures (eg, skull, pelvic, vertebral, and comminuted limb fractures). Findings were useful for understanding the nature of fractures in pet rabbits and supported the use of micro-CT versus radiography for fracture detection and evaluation.

Investigation of the Effect of Cemented Fractures on Fracturing Network Propagation in Model Block with Discrete Orthogonal Fractures

NASA Astrophysics Data System (ADS)

Wang, Y.; Li, C. H.

2017-07-01

Researchers have recently realized that the natural fractures in shale reservoirs are often cemented or sealed with various minerals. However, the influence of cement characteristics of natural fracture on fracturing network propagation is still not well understood. In this work, laboratory-scaled experiments are proposed to prepare model blocks with discrete orthogonal fractures network with different strength of natural fracture, in order to reveal the influence of cemented natural fractures on the interactions between hydraulic fractures and natural fractures. A series of true triaxial hydraulic fracturing experiments were conducted to investigate the mechanism of hydraulic fracture initiation and propagation in model blocks with natural fractures of different cement strength. The results present different responses of interactions between hydraulic and natural fractures, which can be reflected on the pump pressure profiles and block failure morphology. For model blocks with fluctuated pump pressure curves, the communication degree of hydraulic and natural fractures is good, which is confirmed by a proposed new index of "P-SRV." The most significant finding is that too high and too low strength properties of cemented natural fracture are adverse to generate complex fracturing network. This work can help us better understand how cemented natural fractures affect the fracturing network propagation subsurface and give us reference to develop more accurate hydraulic fracturing models.

Outcome of limb fracture repair in rabbits: 139 cases (2007-2015).

PubMed

Sasai, Hiroshi; Fujita, Daisuke; Seto, Eiko; Denda, Yuki; Imai, Yutaro; Okamoto, Kanako; Okamura, Kensaku; Furuya, Masaru; Tani, Hiroyuki; Sasai, Kazumi

2018-02-15

OBJECTIVE To evaluate outcome of limb fracture repair in rabbits. DESIGN Retrospective case series. ANIMALS 139 client-owned rabbits with limb fractures treated between 2007 and 2015. PROCEDURES Medical records were reviewed for information on fracture location, fracture treatment, and time to fracture healing. RESULTS 25 rabbits had fractures involving the distal aspects of the limbs (ie, metacarpal or metatarsal bones, phalanges, and calcaneus or talus). Fractures were treated in 23 of these 25 rabbits (external coaptation, n = 17; external skeletal fixation, 4; and intramedullary pinning, 2) and healed in all 23, with a median healing time of 28 days (range, 20 to 45 days). One hundred ten rabbits had long bone fractures, and fractures were treated in 100 of the 110 (external skeletal fixation, n = 89; bone plating, 1; intramedullary pinning, 3; and external coaptation, 7). The percentage of fractures that healed was significantly lower for open (14/18) than for closed (26/26) tibial fractures and was significantly lower for femoral (19/26) and treated humeral (4/6) fractures than for radial (23/24) or closed tibial (26/26) fractures. Micro-CT was used to assess fracture realignment during external skeletal fixator application and to evaluate fracture healing. CONCLUSIONS AND CLINICAL RELEVANCE The prognosis for rabbits with limb fractures was good, with fractures healing in most rabbits following fracture repair (109/123). Micro-CT was useful in assessing fracture realignment and evaluating fracture healing.

Rib fracture as a predictor of future fractures in young and older postmenopausal women: National Osteoporosis Risk Assessment (NORA)

PubMed Central

Sajjan, S. G.; Barrett-Connor, E.; McHorney, C. A.; Miller, P. D.; Sen, S. S.; Siris, E.

2013-01-01

Summary A rib fracture history after age 45 was associated with a 5.4-fold increase in new rib fracture risk and a 2.4-fold increase in risk of any new clinical fracture in 155,031 postmenopausal women. A rib fracture history suggests osteoporosis and should be considered when evaluating patients for interventions to prevent fractures. Introduction Until recently, little attention was paid to rib fracture as an osteoporosis marker. Emerging evidence suggests rib fracture may be an osteoporotic fracture in men and women. We report the 5-year independent association between baseline rib fracture histories and self-reported future fractures by age (decade) in the NORA cohort (155,031 postmenopausal women, 50–99 years). Methods Participants reported fracture history and responded to follow-up surveys at years 1, 3, or 6. Women with a baseline rib fracture history without other fractures were compared with women with no fracture. Results At baseline, 4,758 (3.07%) women reported a rib fracture history without other fractures; 6,300 women reported 6,830 new clinical fractures, including wrist (2,271), rib (1,891), spine (1,136), hip (941), and forearm (591). Adjusted relative risk (ARR) values (95% confidence interval [CI]) for future fractures in women with rib fracture history versus women with no fracture history were 5.4 (4.8–6.1) at the rib, 2.1 (1.7–2.6) at the spine, and 1.4 (1.1–1.7) at the wrist, and not significant for forearm or hip fractures. Future fracture risk was at least doubled in women with a rib fracture history in all ages: ARR (95% CI) 3.4 (2.8–4.0) for ages 50–59, 2.5 (2.1–3.0) for ages 60–69, 2.0 (1.7–2.3) for ages 70–79, and 2.0 (1.6–2.6) for ages >80. Conclusions Rib fracture, the second most common clinical fracture in women (after wrist fracture), predicted future fractures of the rib, wrist, and spine at all ages. Women presenting with rib fractures should be evaluated for appropriate management to prevent future fractures. PMID:21904951

High fracture probability predicts fractures in a 4-year follow-up in women from the RAC-OST-POL study.

PubMed

Pluskiewicz, W; Adamczyk, P; Czekajło, A; Grzeszczak, W; Drozdzowska, B

2015-12-01

In 770 postmenopausal women, the fracture incidence during a 4-year follow-up was analyzed in relation to the fracture probability (FRAX risk assessment tool) and risk (Garvan risk calculator) predicted at baseline. Incident fractures occurred in 62 subjects with a higher prevalence in high-risk subgroups. Prior fracture, rheumatoid arthritis, femoral neck T-score and falls increased independent of fracture incidence. The aim of the study was to analyze the incidence of fractures during a 4-year follow-up in relation to the baseline fracture probability and risk. Enrolled in the study were 770 postmenopausal women with a mean age of 65.7 ± 7.3 years. Bone mineral density (BMD) at the proximal femur, clinical data, and fracture probability using the FRAX tool and risk using the Garvan calculator were determined. Each subject was asked yearly by phone call about the incidence of fracture during the follow-up period. Of the 770 women, 62 had a fracture during follow-up, and 46 had a major fracture. At baseline, BMD was significantly lower, and fracture probability and fracture risk were significantly higher in women who had a fracture. Among women with a major fracture, the percentage with a high baseline fracture probability (>10 %) was significantly higher than among those without a fracture (p < 0.01). Fracture incidence during follow-up was significantly higher among women with a high baseline fracture probability (12.7 % vs. 5.2 %) and a high fracture risk (9.2 vs. 5.3 %) so that the "fracture-free survival" curves were significantly different (p < 0.05). The number of clinical risk factors noted at baseline was significantly associated with fracture incidence (chi-squared = 20.82, p < 0.01). Prior fracture, rheumatoid arthritis, and femoral neck T-score were identified as significant risk factors for major fractures (for any fractures, the influence of falls was also significant). During follow-up, fracture incidence was predicted by baseline fracture probability (FRAX risk assessment tool) and risk (Garvan risk calculator). A number of clinical risk factors and a prior fracture, rheumatoid arthritis, femoral neck T-score, and falls were independently associated with an increased incidence of fractures. [Corrected

Measurements of radiated elastic wave energy from dynamic tensile cracks

NASA Technical Reports Server (NTRS)

Boler, Frances M.

1990-01-01

The role of fracture-velocity, microstructure, and fracture-energy barriers in elastic wave radiation during a dynamic fracture was investigated in experiments in which dynamic tensile cracks of two fracture cofigurations of double cantilever beam geometry were propagating in glass samples. The first, referred to as primary fracture, consisted of fractures of intact glass specimens; the second configuration, referred to as secondary fracture, consisted of a refracture of primary fracture specimens which were rebonded with an intermittent pattern of adhesive to produce variations in fracture surface energy along the crack path. For primary fracture cases, measurable elastic waves were generated in 31 percent of the 16 fracture events observed; the condition for radiation of measurable waves appears to be a local abrupt change in the fracture path direction, such as occurs when the fracture intersects a surface flaw. For secondary fractures, 100 percent of events showed measurable elastic waves; in these fractures, the ratio of radiated elastic wave energy in the measured component to fracture surface energy was 10 times greater than for primary fracture.

Periprosthetic fractures of the humerus.

PubMed

McDonough, Edward B; Crosby, Lynn A

2005-12-01

Periprosthetic humeral fractures present a treatment challenge for the orthopedic surgeon. The overall incidence of fracture is between 0.5% and 3%, with the majority of fractures occurring intraoperatively and involving the humeral diaphysis. Excess torque produced during surgery is usually responsible for intraoperative fractures. Improper canal preparation or prosthetic placement may also increase the chance of sustaining a fracture. Postoperative fractures are most commonly caused by minor trauma, such as a fall. Poor bone quality, female sex, advanced age, and history of rheumatoid arthritis are the risk factors most commonly associated with periprosthetic fractures. All 4 systems used to describe periprosthetic humeral shaft fractures classify fracture patterns according to the anatomic relation of the fracture to the prosthetic stem. Treatment decisions should be made with respect to obtaining fracture stability, initiating early gleno-humeral motion, and restoring shoulder function. Intraoperative fractures and any postoperative fracture resulting in prosthetic instability should be treated with a long-stem prosthesis extending at least 2 to 3 cortical diameters past the fracture site with consideration for rigid plate fixation. Short oblique or transverse postoperative fractures should be managed with early stable fixation. There has been some support for conservative treatment of long oblique or spiral postoperative fractures. Postoperative diaphyseal fractures distal to the stem generally are well maintained with standard fracture management.

Clavicle fractures: epidemiology, classification and treatment of 2 422 fractures in the Swedish Fracture Register; an observational study.

PubMed

Kihlström, Caroline; Möller, Michael; Lönn, Katarina; Wolf, Olof

2017-02-15

Large multi-centre studies of clavicle fractures have so far been missing. The aim of this observational study was to describe the epidemiology, classification and treatment of clavicle fractures in the The Swedish Fracture Register (SFR) that collects national prospective data from large fracture populations. Data were retrieved from the SFR on all clavicle fractures sustained by patients ≥ 15 years of age in 2013-2014 (n = 2 422) with regards to date of injury, cause of injury, fracture classification and treatment. Sixty-eight per cent of the clavicle fractures occurred in males. The largest subgroup was males aged 15-24 years, representing 21% of clavicle fractures. At the ages of 65 years and above, females sustained more clavicle fractures than males. Same-level falls and bicycle accidents were the most common injury mechanisms. Displaced midshaft fractures constituted 43% of all fractures and were the most frequently operated fractures. Seventeen per cent of the patients underwent operative treatment within 30 days of the injury, where plate fixation was the choice of treatment in 94% of fractures. The largest patient group was young males. Displaced midshaft fractures were the most common type of clavicle fracture as well as the most frequently operated type of fracture.

Prevalence of Temporal Bone Fractures in Patients with Mandibular Fractures Using Multidetector-Row CT.

PubMed

Ogura, I; Kaneda, T; Sasaki, Y; Buch, K; Sakai, O

2015-06-01

Temporal bone fracture after mandibular trauma is thought to be rare, and its prevalence has not been reported in the literature. The purpose of this study was to investigate the prevalence of temporal bone fractures in patients with mandibular fractures and the relationship between temporal bone fractures and the mandibular fracture location using multidetector-row computed tomography (MDCT). A prospective study was performed in 201 patients with mandibular fractures who underwent 64-MDCT scans. The mandibular fracture locations were classified as median, paramedian, angle, and condylar types. Statistical analysis for the relationship between prevalence of temporal bone fractures and mandibular fracture locations was performed using χ(2) test with Fisher's exact test. A P-value < 0.05 was considered statistically significant. The percentage of cases with temporal bone fracture was 3.0 % of all patients with mandibular fractures and 19.0 % of those with multiple mandibular fractures of paramedian and condylar type. There was a significant relationship between the incidence of temporal bone fracture and the paramedian- and condylar-type mandibular fracture (P = 0.001). Multiple mandibular fractures of paramedian and condylar type may be a stronger indicator for temporal bone fractures. This study suggests that patients with mandibular fracture, especially the paramedian and condylar type, should be examined for coexisting temporal bone fracture using MDCT.

Treatment of Pediatric Condylar Fractures: A 20-Year Experience.

PubMed

Ghasemzadeh, Ali; Mundinger, Gerhard S; Swanson, Edward W; Utria, Alan F; Dorafshar, Amir H

2015-12-01

The purpose of this study was to define patterns of injury and treatment for condylar and subcondylar fractures and evaluate short-term outcomes in the pediatric population. A retrospective chart review was performed on pediatric patients with mandibular condylar fractures who presented between 1990 and 2010. Computed tomographic imaging was reviewed for all patients to assess fracture characteristics. Mandibular fractures were codified using the Strasbourg Osteosynthesis Research Group and Lindahl classification methods. Sixty-four patients with 92 condylar fractures were identified. Of these patients, 29 had isolated condylar fracture and 35 had a condylar fracture associated with an additional mandibular arch fracture. The most common fracture patterns were diacapitular fracture in the Strasbourg Osteosynthesis Research Group system (n = 46) and vertical condylar head fracture in the Lindahl system (n = 14). Condylar fracture with additional mandibular arch fractures were treated with maxillomandibular fixation more often than patients with condylar fracture [n = 40 (74.1 percent) versus n = 14 (25.9 percent); p = 0.004]. No condylar fracture was treated in an open fashion. Forty-three patients returned for follow-up. The median follow-up period was 81 days (interquartile range, 35 to 294 days). Ten patients had complications (23.3 percent). The most common complication was malocclusion (n = 5). Nine of 10 patients with complications had condylar fracture with an additional mandibular arch fracture. Closed treatment of condylar fractures yields satisfactory results in pediatric patients. Pediatric patients with condylar fractures combined with additional arch fractures experience a higher rate of unfavorable outcomes.

Mandibular fracture patterns consistent with posterior maxillary fractures involving the posterior maxillary sinus, pterygoid plate or both: CT characteristics.

PubMed

Imai, T; Sukegawa, S; Kanno, T; Fujita, G; Yamamoto, N; Furuki, Y; Michizawa, M

2014-01-01

The aim of this study was to determine the incidence of posterior maxillary fractures involving the posterior maxillary sinus wall, pterygoid plate or both, unrelated to major midface fractures in patients with mandibular fractures, and to characterize associated fractures. A CT study was performed in patients with mandibular fractures to identify posterior maxillary fractures. Patients aged under 16 years, those with mandibular fractures involving only dentoalveolar components and those with concurrent major midfacial fractures were excluded. 13 (6.7%) of 194 patients with mandibular fractures also had posterior maxillary fractures (case group). The injury pattern correlated with the external force directed to the lateral side of the mandible (p < 0.001), alcohol consumption (p = 0.049), the presence of multifocal fractures (p = 0.002) and the fracture regions in the symphysis/parasymphysis (p = 0.001) and the angle/ramus (p = 0.001). No significant difference between the case and non-case groups was seen for age, sex or cause of trauma. Non-displaced fractures in the ipsilateral posterior mandible occurred with significant frequency (p = 0.001) when the posterior maxillary fractures involved only the sinus. Mandibular fractures accompanied by posterior maxillary fractures are not rare. The finding of a unilateral posterior maxillary fracture on CT may aid the efficient radiological examination of the mandible based on possible patterns of associated fractures, as follows: in the ipsilateral posterior region as a direct fracture when the impact is a medially directed force, and in the symphysis/parasymphysis or contralateral condylar neck as an indirect fracture.

Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

PubMed

Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

2015-02-01

The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.

PubMed

Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael

2017-04-01

To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either <100% displacement or >100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from <100% to >100% displacement of the fracture compared with only 54% of the CnIR group (P < 0.05). The odds ratio for progression of the clavicle fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Progressively increasing fracture risk with advancing age after initial incident fragility fracture: the Tromsø study.

PubMed

Ahmed, Luai Awad; Center, Jacqueline R; Bjørnerem, Ashild; Bluic, Dana; Joakimsen, Ragnar M; Jørgensen, Lone; Meyer, Haakon E; Nguyen, Nguyen D; Nguyen, Tuan V; Omsland, Tone K; Størmer, Jan; Tell, Grethe S; van Geel, Tineke Acm; Eisman, John A; Emaus, Nina

2013-10-01

The risk of subsequent fracture is increased after initial fractures; however, proper understanding of its magnitude is lacking. This population-based study examines the subsequent fracture risk in women and men by age and type of initial incident fracture. All incident nonvertebral fractures between 1994 and 2009 were registered in 27,158 participants in the Tromsø Study, Norway. The analysis included 3108 subjects with an initial incident fracture after the age of 49 years. Subsequent fracture (n = 664) risk was expressed as rate ratios (RR) and absolute proportions irrespective of death. The rates of both initial and subsequent fractures increased with age, the latter with the steepest curve. Compared with initial incident fracture rate of 30.8 per 1000 in women and 12.9 per 1000 in men, the overall age-adjusted RR of subsequent fracture was 1.3 (95% CI, 1.2-1.5) in women, and 2.0 (95% CI, 1.6-2.4) in men. Although the RRs decreased with age, the absolute proportions of those with initial fracture who suffered a subsequent fracture increased with age; from 9% to 30% in women and from 10% to 26% in men, between the age groups 50-59 to 80+ years. The type of subsequent fracture varied by age from mostly minor fractures in the youngest to hip or other major fractures in the oldest age groups, irrespective of type and severity of initial fracture. In women and men, 45% and 38% of the subsequent hip or other major fractures, respectively, were preceded by initial minor fractures. The risk of subsequent fracture is high in all age groups. At older age, severe subsequent fracture types follow both clinically severe and minor initial incident fractures. Any fragility fracture in the elderly reflects the need for specific osteoporosis management to reduce further fracture risk. © 2013 American Society for Bone and Mineral Research.

Fracture Reactivation in Chemically Reactive Rock Systems

NASA Astrophysics Data System (ADS)

Eichhubl, P.; Hooker, J. N.

2013-12-01

Reactivation of existing fractures is a fundamental process of brittle failure that controls the nucleation of earthquake ruptures, propagation and linkage of hydraulic fractures in oil and gas production, and the evolution of fault and fracture networks and thus of fluid and heat transport in the upper crust. At depths below 2-3 km, and frequently shallower, brittle processes of fracture growth, linkage, and reactivation compete with chemical processes of fracture sealing by mineral precipitation, with precipitation rates similar to fracture opening rates. We recently found rates of fracture opening in tectonically quiescent settings of 10-20 μm/m.y., rates similar to euhedral quartz precipitation under these conditions. The tendency of existing partially or completely cemented fractures to reactivate will vary depending on strain rate, mineral precipitation kinetics, strength contrast between host rock and fracture cement, stress conditions, degree of fracture infill, and fracture network geometry. Natural fractures in quartzite of the Cambrian Eriboll Formation, NW Scotland, exhibit a complex history of fracture formation and reactivation, with reactivation involving both repeated crack-seal opening-mode failure and shear failure of fractures that formed in opening mode. Fractures are partially to completely sealed with crack-seal or euhedral quartz cement or quartz cement fragmented by shear reactivation. Degree of cementation controls the tendency of fractures for later shear reactivation, to interact elastically with adjacent open fractures, and their intersection behavior. Using kinematic, dynamic, and diagenetic criteria, we determine the sequence of opening-mode fracture formation and later shear reactivation. We find that sheared fracture systems of similar orientation display spatially varying sense of slip We attribute these inconsistent directions of shear reactivation to 1) a heterogeneous stress field in this highly fractured rock unit and 2) variations in the degree of fracture cement infill in fractures of same orientation, allowing fractures to reactivate at times when adjacent, more cemented fractures remain dormant. The observed interaction of chemical and mechanical fracture growth and sealing processes in this chemically reactive and heavily deformed rock unit results in a complex fracture network geometry not generally observed in less chemically reactive, shallower crustal environments.

Rigid fixation of facial fractures in children.

PubMed

Koltai, P J; Rabkin, D; Hoehn, J

1995-01-01

This article presents a retrospective analysis of a selective use of rigid fixation among 62 children with facial fractures, treated at a Level I trauma center over a 5-year period (1986-1991). There were 21 mandible fractures, 11 orbital fractures, 11 zygomaticomalar complex fractures, 7 nasal fractures, 5 maxillary fractures, 3 pan-facial fractures, 2 nasal-orbital-ethmoidal complex fractures, and 2 frontal sinus fractures. Only 18 children had rigid fixation of their injuries. Complications of Le Fort upper facial fractures repaired with rigid fixation involved perioperative sinusitis; one case required oral antibiotics, the other ethmoidectomy and maxillary antrostomy. One child with a Le Fort fracture had delayed exposure of a zygomaticomalar buttress plate, which required surgical removal. Permanent enophthalmos occurred in two children with Le Fort fractures. The authors conclude that traditional conservative management is appropriate in most cases. However, in children aged 13 and older with mandible fractures and children with complex mid- and upper facial fractures, a judicious use of rigid fixation has advantages over the traditional techniques.

A new classification and treatment protocol for combined fractures of the femoral shaft with the proximal or distal femur with closed locked intramedullary nailing: clinical experience of 63 fractures.

PubMed

Lambiris, Elias; Giannikas, Dimitrios; Galanopoulos, George; Tyllianakis, Minos; Megas, Panagiotis

2003-03-01

The medical records and radiographs of 63 patients, who were admitted between 1989-1997, with a combined femur fracture, were reviewed. Associated injuries were present in 38 (60%) patients. The combined fractures were classified into four major types depending on their anatomical position: type I, femoral shaft fracture combined with hip neck fracture; type II, femoral shaft fracture combined with a trochanteric fracture; type III, femoral shaft fracture combined with a distal femur fracture; and type IV, femoral shaft fracture combined with a proximal or distal femur fracture. The fractures were treated with locked intramedullary nailing and additional free cancellous 6.5-mm screws as needed. Fifty-six fractures healed without further operations. Of the remaining 6 fractures, 2 were material failures, 1 malunion with 3-cm shortening and external rotation of the femoral diaphysis, 2 early infections of the surgical wound, and 1 pseudarthrosis of the femoral shaft. All fractures were healed between 16 and 32 weeks (average: 20 weeks).

The Shear Mechanisms of Natural Fractures during the Hydraulic Stimulation of Shale Gas Reservoirs.

PubMed

Zhang, Zhaobin; Li, Xiao

2016-08-23

The shearing of natural fractures is important in the permeability enhancement of shale gas reservoirs during hydraulic fracturing treatment. In this work, the shearing mechanisms of natural fractures are analyzed using a newly proposed numerical model based on the displacement discontinuities method. The fluid-rock coupling system of the model is carefully designed to calculate the shearing of fractures. Both a single fracture and a complex fracture network are used to investigate the shear mechanisms. The investigation based on a single fracture shows that the non-ignorable shearing length of a natural fracture could be formed before the natural fracture is filled by pressurized fluid. Therefore, for the hydraulic fracturing treatment of the naturally fractured shale gas reservoirs, the shear strength of shale is generally more important than the tensile strength. The fluid-rock coupling propagation processes of a complex fracture network are simulated under different crustal stress conditions and the results agree well with those of the single fracture. The propagation processes of complex fracture network show that a smaller crustal stress difference is unfavorable to the shearing of natural fractures, but is favorable to the formation of complex fracture network.

The Shear Mechanisms of Natural Fractures during the Hydraulic Stimulation of Shale Gas Reservoirs

PubMed Central

Zhang, Zhaobin; Li, Xiao

2016-01-01

The shearing of natural fractures is important in the permeability enhancement of shale gas reservoirs during hydraulic fracturing treatment. In this work, the shearing mechanisms of natural fractures are analyzed using a newly proposed numerical model based on the displacement discontinuities method. The fluid-rock coupling system of the model is carefully designed to calculate the shearing of fractures. Both a single fracture and a complex fracture network are used to investigate the shear mechanisms. The investigation based on a single fracture shows that the non-ignorable shearing length of a natural fracture could be formed before the natural fracture is filled by pressurized fluid. Therefore, for the hydraulic fracturing treatment of the naturally fractured shale gas reservoirs, the shear strength of shale is generally more important than the tensile strength. The fluid-rock coupling propagation processes of a complex fracture network are simulated under different crustal stress conditions and the results agree well with those of the single fracture. The propagation processes of complex fracture network show that a smaller crustal stress difference is unfavorable to the shearing of natural fractures, but is favorable to the formation of complex fracture network. PMID:28773834

Physical simulation study on the hydraulic fracture propagation of coalbed methane well

NASA Astrophysics Data System (ADS)

Wu, Caifang; Zhang, Xiaoyang; Wang, Meng; Zhou, Longgang; Jiang, Wei

2018-03-01

As the most widely used technique to modify reservoirs in the exploitation of unconventional natural gas, hydraulic fracturing could effectively raise the production of CBM wells. To study the propagation rules of hydraulic fractures, analyze the fracture morphology, and obtain the controlling factors, a physical simulation experiment was conducted with a tri-axial hydraulic fracturing test system. In this experiment, the fracturing sample - including the roof, the floor, and the surrounding rock - was prepared from coal and similar materials, and the whole fracturing process was monitored by an acoustic emission instrument. The results demonstrated that the number of hydraulic fractures in coal is considerably higher than that observed in other parts, and the fracture morphology was complex. Vertical fractures were interwoven with horizontal fractures, forming a connected network. With the injection of fracturing fluid, a new hydraulic fracture was produced and it extended along the preexisting fractures. The fracture propagation was a discontinuous, dynamic process. Furthermore, in-situ stress plays a key role in fracture propagation, causing the fractures to extend in a direction perpendicular to the minimum principal stress. To a certain extent, the different mechanical properties of the coal and the other components inhibited the vertical propagation of hydraulic fractures. Nonetheless, the vertical stress and the interfacial property are the major factors to influence the formation of the "T" shaped and "工" shaped fractures.

High prevalence of simultaneous rib and vertebral fractures in patients with hip fracture.

PubMed

Lee, Bong-Gun; Sung, Yoon-Kyoung; Kim, Dam; Choi, Yun Young; Kim, Hunchul; Kim, Yeesuk

2017-02-01

The purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture. One hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4±4.1days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors. Simultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p=0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01-0.57). The prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture. Copyright © 2016 Elsevier Ltd. All rights reserved.

Treatment of Pediatric Condylar Fractures: A 20-Year Experience

PubMed Central

Ghasemzadeh, Ali; Mundinger, Gerhard S.; Swanson, Edward W.; Utria, Alan F.; Dorafshar, Amir H.

2016-01-01

Background The purpose of this study was to define patterns of injury and treatment for condylar and subcondylar fractures and evaluate short-term outcomes in the pediatric population. Methods A retrospective chart review was performed on pediatric patients with mandibular condylar fractures who presented between 1990 and 2010. Computed tomographic imaging was reviewed for all patients to assess fracture characteristics. Mandibular fractures were codified using the Strasbourg Osteosynthesis Research Group and Lindahl classification methods. Results Sixty-four patients with 92 condylar fractures were identified. Of these patients, 29 had isolated condylar fracture and 35 had a condylar fracture associated with an additional mandibular arch fracture. The most common fracture patterns were diacapitular fracture in the Strasbourg Osteosynthesis Research Group system (n = 46) and vertical condylar head fracture in the Lindahl system (n = 14). Condylar fracture with additional mandibular arch fractures were treated with maxillomandibular fixation more often than patients with condylar fracture [n = 40 (74.1 percent) versus n = 14 (25.9 percent); p = 0.004]. No condylar fracture was treated in an open fashion. Forty-three patients returned for follow-up. The median follow-up period was 81 days (interquartile range, 35 to 294 days). Ten patients had complications (23.3 percent). The most common complication was malocclusion (n = 5). Nine of 10 patients with complications had condylar fracture with an additional mandibular arch fracture. Conclusions Closed treatment of condylar fractures yields satisfactory results in pediatric patients. Pediatric patients with condylar fractures combined with additional arch fractures experience a higher rate of unfavorable outcomes. PMID:26595021

Mandibular fracture patterns consistent with posterior maxillary fractures involving the posterior maxillary sinus, pterygoid plate or both: CT characteristics

PubMed Central

Sukegawa, S; Kanno, T; Fujita, G; Yamamoto, N; Furuki, Y; Michizawa, M

2014-01-01

Objectives: The aim of this study was to determine the incidence of posterior maxillary fractures involving the posterior maxillary sinus wall, pterygoid plate or both, unrelated to major midface fractures in patients with mandibular fractures, and to characterize associated fractures. Methods: A CT study was performed in patients with mandibular fractures to identify posterior maxillary fractures. Patients aged under 16 years, those with mandibular fractures involving only dentoalveolar components and those with concurrent major midfacial fractures were excluded. Results: 13 (6.7%) of 194 patients with mandibular fractures also had posterior maxillary fractures (case group). The injury pattern correlated with the external force directed to the lateral side of the mandible (p < 0.001), alcohol consumption (p = 0.049), the presence of multifocal fractures (p = 0.002) and the fracture regions in the symphysis/parasymphysis (p = 0.001) and the angle/ramus (p = 0.001). No significant difference between the case and non-case groups was seen for age, sex or cause of trauma. Non-displaced fractures in the ipsilateral posterior mandible occurred with significant frequency (p = 0.001) when the posterior maxillary fractures involved only the sinus. Conclusions: Mandibular fractures accompanied by posterior maxillary fractures are not rare. The finding of a unilateral posterior maxillary fracture on CT may aid the efficient radiological examination of the mandible based on possible patterns of associated fractures, as follows: in the ipsilateral posterior region as a direct fracture when the impact is a medially directed force, and in the symphysis/parasymphysis or contralateral condylar neck as an indirect fracture. PMID:24336313

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 suspensory complex. PMID:19857183

Lower limb fracture presentations at a regional hospital.

PubMed

Holloway, K L; Yousif, D; Bucki-Smith, G; Hosking, S; Betson, A G; Williams, L J; Brennan-Olsen, S L; Kotowicz, M A; Sepetavc, A; Pasco, J A

2017-08-28

We found that lower limb fractures, which were largely the result of minimal trauma, had high levels of hospitalisation, length of stay and surgery. It is therefore important to prevent fractures at all sites to avoid the associated morbidity and mortality. Hip fractures are a major cause of morbidity and mortality, particularly in older women. In comparison, less is known about the epidemiology and burden of other lower limb fractures. The study aimed to investigate the epidemiology and burden of these fractures. Incident fractures of the hip, femur, tibia/fibula, ankle and foot in women (≥ 20 years) managed through the University Hospital Geelong, Australia, were ascertained from 1 Jan. 2014 to 31 Dec. 2014 from radiology reports. Age, cause of fracture, post-fracture hospitalisation, surgery, length of stay and discharge location were ascertained from medical records. We identified 585 fractures of the lower limb (209 hip, 42 femur, 41 tibia/fibula, 162 ankle, 131 foot). Most fractures were sustained by women aged ≥ 50 years. Fractures were largely a result of minimal trauma. Most women with hip or femur fractures were hospitalised; fewer were hospitalised for fractures at other sites. Surgery for fracture followed the same pattern as hospitalisations. Length of stay was the highest for hip and femur fractures and the lowest for foot fractures. Women with hip or femur fractures were discharged to rehabilitation more often than home. Fractures at other sites were most commonly discharged home. Fractures of the lower limb occurred frequently in older women. Hospitalisation and subsequent surgery were common in cases of hip and femur fractures. It is important for prevention strategies to target fractures at a range of skeletal sites to reduce costs, hospitalisations, loss of independence and reduced quality of life.

Sites, frequencies, and causes of self-reported fractures in 9,720 rheumatoid arthritis patients: a large prospective observational cohort study in Japan.

PubMed

Ochi, Kensuke; Furuya, Takefumi; Ikari, Katsunori; Taniguchi, Atsuo; Yamanaka, Hisashi; Momohara, Shigeki

2013-01-01

Sites, frequencies, and causes of self-reported fractures in Japanese patients with rheumatoid arthritis (RA) were evaluated in a prospective, observational cohort study. The incidence and cause of fracture differ by anatomical site, sex, and age. These differences may be considered in establishing custom strategies for preventing fractures in RA patients in the future. The literature contains limited data describing the details of fractures at different skeletal sites in patients with RA. We evaluated the details of fractures in Japanese RA patients on the basis of our Institute of Rheumatology Rheumatoid Arthritis cohort study in 9,720 RA patients (82 % women; mean age, 56 years) who were enrolled from 2000 to 2010. The details of fractures were obtained through biannual patient self-report questionnaires. Over a mean duration of 5.2 years, 1,317 patients (13.5 %) reported 2,323 incident fractures comprising 563 (24.2 %) clinical vertebral fractures and 1,760 (75.8 %) nonvertebral fractures. Rib fractures were the most common fractures in men, followed by clinical vertebral and hip fractures; the most common fractures in women were clinical vertebral fractures, followed by rib, foot, and hip fractures. There was a significant difference between sexes in the rates of rib, clavicle, shoulder, and ankle fractures. Spontaneous event was the primary cause of clinical vertebral fracture (65.4 %), whereas falls were the primary cause of upper extremity (76.5 %) and lower extremity (57.8 %) fractures. Rates of clinical vertebral and hip fractures increased, while those of rib and foot fractures decreased with increasing age. Incidence of falls, as causes of nonvertebral fractures, also increased in older age groups. Our results suggest that the causes of fractures may differ depending on anatomical site and that prevention of falls may be the most effective way to reduce upper and lower extremity fractures, especially in older patients with RA.

Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar-a retrospective study.

PubMed

Rajan, Ritesh; Verma, Dinesh Kumar; Borle, R M; Yadav, Abhilasha

2016-06-01

The purpose of the present study was to find, if there exists, a co-relation between presence of unerupted mandibular third molar and fracture of mandibular condyle. A retrospective, multicenter study was done collecting the data of all mandibular condyle fractures treated from November 2006 till August 2015. Data was collected from the patient's records and radiographs for the following information: age, sex, etiology of fracture, presence and state of lower third molars, and associated fracture. The results were subjected to statistical analysis. Out of 180 patients of condylar fracture, unerupted third molars were present in 35 (19.44 %) cases compared to 145 (80.55 %) cases of condylar fracture where the unerupted third molars were not present. The difference was statistically significant (p < 0.05). In the unerupted third molar present group, isolated bilateral condylar fracture was seen in 4 (11.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 9 (25.7 %) cases, isolated unilateral condylar fracture in 0 (0.0 %) cases, and unilateral condylar fracture associated with other mandibular fractures in 17 (48.5 %) cases and condylar fracture associated with mid face fractures in 5 (14.2 %) cases. In the unerupted third molar absent group, isolated bilateral condylar fracture was seen in 5 (3.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 30 (20.6 %) cases, isolated unilateral condylar fracture in 24 (16.5 %) cases, unilateral condylar fracture associated with other mandibular fractures in 73 (50.34 %) cases, and condylar fracture associated with mid face fractures in 13(8.96 %) cases. The difference between the groups was statistically significant (p = 0.032). This study suggests that the fractures of mandibular condylar region have a significantly higher incidence in patients without an unerupted mandibular third molar.

Causes and treatment of mandibular and condylar fractures in children and adolescents: a review of 104 cases.

PubMed

Shi, Jun; Chen, Zhibiao; Xu, Bing

2014-03-01

There are no uniform treatments, standards, and specifications for conservative and surgical management of mandibular fractures in children and adolescents. To review the management of mandibular fractures in children and adolescents at our institution. The medical records of 104 children and adolescents (60 male and 44 female) treated for mandibular fractures from 2005 to 2012 at the Ninth People's Hospital, Shanghai, China, were retrospectively reviewed. The participants were classified as having deciduous dentition (age ≤6 years), mixed dentition (age >6 but <12 years), and permanent dentition (age ≥12 but ≤16 years). Conservative treatment and surgical management. Helkimo clinical dysfunction and anamnestic indices. Condylar process fractures accounted for 55.7% of the fractures (112 fractures of 201 total fracture sites), and symphysis fractures, parasymphysis fractures, fractures of the body, and fractures of the angle accounted for 20.9%, 11.9%, 7.0%, and 3.5% of the fractures, respectively. A total of 83 cases with 159 fracture sites with complete follow-up data were included in the treatment analysis. In these 83 patients, 77 fractures were dentigerous bone fractures, 46 were intracapsular fractures, and 36 were extracapsular fractures. Dentigerous bone fractures of the mandible were managed by closed or open reduction in children younger than 12 years and were managed more often by open reduction and fixation in those between ages 12 and 16 years. Closed treatment was performed for 22 condylar process fractures (28.6%), and open reduction was carried out for 55 condylar process fractures (71.4%). In patients with intracapsular fractures, there was no significant relationship between dentation age and treatment method (P = .06). Most patients with extracapsular fractures with permanent dentition underwent surgical fixation (73.3%), whereas most with deciduous dentition received conservative treatment (87.5%). In patients with condylar process fractures, there was no significant difference in Ai and Di based on treatment method (P = .49 and P = .76, respectively). The treatment of mandibular fractures in children and adolescents should be determined by clinical factors including age, location, and type of fracture.

Hydraulic Fracturing and Production Optimization in Eagle Ford Shale Using Coupled Geomechanics and Fluid Flow Model

NASA Astrophysics Data System (ADS)

Suppachoknirun, Theerapat; Tutuncu, Azra N.

2017-12-01

With increasing production from shale gas and tight oil reservoirs, horizontal drilling and multistage hydraulic fracturing processes have become a routine procedure in unconventional field development efforts. Natural fractures play a critical role in hydraulic fracture growth, subsequently affecting stimulated reservoir volume and the production efficiency. Moreover, the existing fractures can also contribute to the pressure-dependent fluid leak-off during the operations. Hence, a reliable identification of the discrete fracture network covering the zone of interest prior to the hydraulic fracturing design needs to be incorporated into the hydraulic fracturing and reservoir simulations for realistic representation of the in situ reservoir conditions. In this research study, an integrated 3-D fracture and fluid flow model have been developed using a new approach to simulate the fluid flow and deliver reliable production forecasting in naturally fractured and hydraulically stimulated tight reservoirs. The model was created with three key modules. A complex 3-D discrete fracture network model introduces realistic natural fracture geometry with the associated fractured reservoir characteristics. A hydraulic fracturing model is created utilizing the discrete fracture network for simulation of the hydraulic fracture and flow in the complex discrete fracture network. Finally, a reservoir model with the production grid system is used allowing the user to efficiently perform the fluid flow simulation in tight formations with complex fracture networks. The complex discrete natural fracture model, the integrated discrete fracture model for the hydraulic fracturing, the fluid flow model, and the input dataset have been validated against microseismic fracture mapping and commingled production data obtained from a well pad with three horizontal production wells located in the Eagle Ford oil window in south Texas. Two other fracturing geometries were also evaluated to optimize the cumulative production and for the three wells individually. Significant reduction in the production rate in early production times is anticipated in tight reservoirs regardless of the fracturing techniques implemented. The simulations conducted using the alternating fracturing technique led to more oil production than when zipper fracturing was used for a 20-year production period. Yet, due to the decline experienced, the differences in cumulative production get smaller, and the alternating fracturing is not practically implementable while field application of zipper fracturing technique is more practical and widely used.

Survival times of patients with a first hip fracture with and without subsequent major long-bone fractures.

PubMed

Angthong, Chayanin; Angthong, Wirana; Harnroongroj, Thos; Naito, Masatoshi; Harnroongroj, Thossart

2013-01-01

Survival rates are poorer after a second hip fracture than after a first hip fracture. Previous survival studies have included in-hospital mortality. Excluding in-hospital deaths from the analysis allows survival times to be evaluated in community-based patients. There is still a lack of data regarding the effects of subsequent fractures on survival times after hospital discharge following an initial hip fracture. This study compared the survival times of community-dwelling patients with hip fracture who had or did not have a subsequent major long-bone fracture. Hazard ratios and risk factors for subsequent fractures and mortality rates with and without subsequent fractures were calculated. Of 844 patients with hip fracture from 2000 through 2008, 71 had a subsequent major long-bone fracture and 773 did not. Patients who died of other causes, such as perioperative complications, during hospitalization were excluded. Such exclusion allowed us to determine the effect of subsequent fracture on the survival of community-dwelling individuals after hospital discharge or after the time of the fracture if they did not need hospitalization. Demographic data, causes of death, and mortality rates were recorded. Differences in mortality rates between the patient groups and hazard ratios were calculated. Mortality rates during the first year and from 1 to 5 years after the most recent fracture were 5.6% and 1.4%, respectively, in patients with subsequent fractures, and 4.7% and 1.4%, respectively, in patients without subsequent fractures. These rates did not differ significantly between the groups. Cox regression analysis and calculation of hazard ratios did not show significant differences between patients with subsequent fractures and those without. On univariate and multivariate analyses, age <75 years and male sex were risk factors for subsequent fracture. This study found that survival times did not differ significantly between patients with and without subsequent major long-bone fractures after hip fracture. Therefore, all patients with hip fracture, with or without subsequent fractures, need the same robust holistic care. The risks of subsequent fractures should be addressed in patients with hip fracture and should be reduced where possible by education regarding fracture prevention and regular rehabilitation programs. Efforts should be made to decrease the rates of major long-bone fractures and their burdens, even though such fractures have only a minor effect on survival in community-dwelling individuals.

Fracture mechanism maps in unirradiated and irradiated metals and alloys

NASA Astrophysics Data System (ADS)

Li, Meimei; Zinkle, S. J.

2007-04-01

This paper presents a methodology for computing a fracture mechanism map in two-dimensional space of tensile stress and temperature using physically-based constitutive equations. Four principal fracture mechanisms were considered: cleavage fracture, low temperature ductile fracture, transgranular creep fracture, and intergranular creep fracture. The methodology was applied to calculate fracture mechanism maps for several selected reactor materials, CuCrZr, 316 type stainless steel, F82H ferritic-martensitic steel, V4Cr4Ti and Mo. The calculated fracture maps are in good agreement with empirical maps obtained from experimental observations. The fracture mechanism maps of unirradiated metals and alloys were modified to include radiation hardening effects on cleavage fracture and high temperature helium embrittlement. Future refinement of fracture mechanism maps is discussed.

Fully Coupled 3D Finite Element Model of Hydraulic Fracturing in a Permeable Rock Formation

NASA Astrophysics Data System (ADS)

Salimzadeh, S.; Paluszny, A.; Zimmerman, R. W.

2015-12-01

Hydraulic fracturing in permeable rock formations is a complex three-dimensional multi-physics phenomenon. Numerous analytical models of hydraulic fracturing processes have been proposed that typically simplify the physical processes, or somehow reduce the problem from three dimensions to two dimensions. Moreover, although such simplified models are able to model the growth of a single hydraulic fracture into an initially intact, homogeneous rock mass, they are generally not able to model fracturing of heterogeneous rock formations, or to account for interactions between multiple induced fractures, or between an induced fracture and pre-existing natural fractures. We have developed a numerical finite-element model for hydraulic fracturing that does not suffer from any of the limitations mentioned above. The model accounts for fluid flow within a fracture, the propagation of the fracture, and the leak-off of fluid from the fracture into the host rock. Fluid flow through the permeable rock matrix is modelled using Darcy's law, and is coupled with the laminar flow within the fracture. Fractures are discretely modelled in the three-dimensional mesh. Growth of a fracture is modelled using the concepts of linear elastic fracture mechanics (LEFM), with the onset and direction of growth based on stress intensity factors that are computed for arbitrary tetrahedral meshes. The model has been verified against several analytical solutions available in the literature for plane-strain (2D) and penny-shaped (3D) fractures, for various regimes of domination: viscosity, toughness, storage and leak-off. The interaction of the hydraulically driven fracture with pre-existing fractures and other fluid-driven fractures in terms of fluid leak-off, stress interaction and fracture arrest is investigated and the results are presented. Finally, some preliminary results are presented regarding the interaction of a hydraulically-induced fracture with a set of pre-existing natural fractures.

An Embedded 3D Fracture Modeling Approach for Simulating Fracture-Dominated Fluid Flow and Heat Transfer in Geothermal Reservoirs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnston, Henry; Wang, Cong; Winterfeld, Philip

An efficient modeling approach is described for incorporating arbitrary 3D, discrete fractures, such as hydraulic fractures or faults, into modeling fracture-dominated fluid flow and heat transfer in fractured geothermal reservoirs. This technique allows 3D discrete fractures to be discretized independently from surrounding rock volume and inserted explicitly into a primary fracture/matrix grid, generated without including 3D discrete fractures in prior. An effective computational algorithm is developed to discretize these 3D discrete fractures and construct local connections between 3D fractures and fracture/matrix grid blocks of representing the surrounding rock volume. The constructed gridding information on 3D fractures is then added tomore » the primary grid. This embedded fracture modeling approach can be directly implemented into a developed geothermal reservoir simulator via the integral finite difference (IFD) method or with TOUGH2 technology This embedded fracture modeling approach is very promising and computationally efficient to handle realistic 3D discrete fractures with complicated geometries, connections, and spatial distributions. Compared with other fracture modeling approaches, it avoids cumbersome 3D unstructured, local refining procedures, and increases computational efficiency by simplifying Jacobian matrix size and sparsity, while keeps sufficient accuracy. Several numeral simulations are present to demonstrate the utility and robustness of the proposed technique. Our numerical experiments show that this approach captures all the key patterns about fluid flow and heat transfer dominated by fractures in these cases. Thus, this approach is readily available to simulation of fractured geothermal reservoirs with both artificial and natural fractures.« less

Long-bone fractures in persons with spinal cord injury.

PubMed

Frotzler, A; Cheikh-Sarraf, B; Pourtehrani, M; Krebs, J; Lippuner, K

2015-09-01

Retrospective data analysis. To document fracture characteristics, management and related complications in individuals with traumatic spinal cord injury (SCI). Rehabilitation centre for SCI individuals. Patients' records were reviewed. Patients with traumatic SCI and extremity fractures that had occurred after SCI were included. Patient characteristics, fractured bone, fracture localisation, severity and management (operative/conservative), and fracture-related complications were extracted. A total of 156 long-bone fractures in 107 SCI patients (34 women and 73 men) were identified. The majority of patients were paraplegics (77.6%) and classified as American Spinal Injury Association Impairment Scale A (86.0%). Only the lower extremities were affected, whereby the femur (60.9% of all fractures) was fractured more frequently than the lower leg (39.1%). A total of 70 patients (65.4%) had one fracture, whereas 37 patients (34.6%) had two or more fractures. Simple or extraarticular fractures were most common (75.0%). Overall, 130 (83.3%) fractures were managed operatively. Approximately half of the femur fractures (48.2%) were treated with locking compression plates. In the lower leg, fractures were mainly managed with external fixation (48.8%). Conservative fracture management was applied in 16.7% of the cases and consisted of braces or a well-padded soft cast. Fracture-associated complications were present in 13.5% of the cases but did not differ significantly between operative (13.1%) and conservative (15.4%) fracture management. SCI was associated with simple or extraarticular fractures of the distal femur and the lower leg. Fractures were mainly managed operatively with a low complication rate.

A new approach to the treatment of nasal bone fracture: radiologic classification of nasal bone fractures and its clinical application.

PubMed

Han, Daniel Seung Youl; Han, Yea Sik; Park, Jin Hyung

2011-11-01

A radiologic examination is required in the treatment of nasal bone fracture to determine the fracture condition. Thus, there is an increasing need for radiologic classification of nasal bone fractures that can be applied to clinical practice. Computed tomography was performed in 125 patients with nasal bone fractures to determine which axial view best showed the entire nasal view. The obtained axial view was then used as a reference for classification. The length from the top to the base of the nasal bone was divided into upper, middle, and lower levels, after which the fracture location was determined. If the fracture spanned the boundaries of these levels, it was classified as the total level. Subsequently, the fracture was subclassified based on the fracture direction and pattern and the concurrent fracture. Radiologic examination of patients with nasal bone fracture showed that nasal bone fracture was frequently found at the total, middle, upper, and lower levels, in that order. Nasal bone fractures at the upper level showed lower frequencies of complication and reoperation than the fractures at the other levels, whereas nasal bone fractures at the total level showed the highest frequencies of complication and reoperation. Radiologic classification can be useful for preoperative and postoperative evaluations of nasal bone fractures and can be helpful in understanding such fractures because it can efficiently predict the prognosis of a fracture. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.

PubMed

Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

2015-01-01

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

PubMed Central

Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

2015-01-01

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity. PMID:26175916

Laboratory investigation of shale rock to identify fracture propagation in vertical direction to bedding

NASA Astrophysics Data System (ADS)

Peng, Tan; Yan, Jin; Bing, Hou; Yingcao, Zhou; Ruxin, Zhang; Zhi, Chang; Meng, Fan

2018-06-01

Affected by beddings and natural fractures, fracture geometry in the vertical plane is complex in shale formation, which differs from a simple fracture in homogeneous sandstone reservoirs. However, the propagation mechanism of a hydraulic fracture in the vertical plane has not been well understood. In this paper, a true tri-axial pressure machine was deployed for shale horizontal well fracturing simulation experiments of shale outcrops. The effects of multiple factors on hydraulic fracture vertical propagation were studied. The results revealed that hydraulic fracture initiation and propagation displayed four basic patterns in the vertical plane of laminated shale formation. A hydraulic fracture would cross the beddings under the high vertical stress difference between a vertical stress and horizontal minimum stress of 12 MPa, while a hydraulic fracture propagates along the beddings under a low vertical stress difference of 3 MPa. Four kinds of fracture geometry, including a single main fracture, a nonplanar fracture, a complex fracture, and a complex fracture network, were observed due to the combined effects of flow rate and viscosity. Due to the influence of binding strength (or cementing strength) on the fracture communication effects between a hydraulic fracture and the beddings, the opening region of the beddings takes the shape of an ellipse.

Comparison of Surface Properties in Natural and Artificially Generated Fractures in a Crystalline Rock

NASA Astrophysics Data System (ADS)

Vogler, Daniel; Walsh, Stuart D. C.; Bayer, Peter; Amann, Florian

2017-11-01

This work studies the roughness characteristics of fracture surfaces from a crystalline rock by analyzing differences in surface roughness between fractures of various types and sizes. We compare the surface properties of natural fractures sampled in situ and artificial (i.e., man-made) fractures created in the same source rock under laboratory conditions. The topography of the various fracture types is compared and characterized using a range of different measures of surface roughness. Both natural and artificial, and tensile and shear fractures are considered, along with the effects of specimen size on both the geometry of the fracture and its surface characterization. The analysis shows that fracture characteristics are substantially different between natural shear and artificial tensile fractures, while natural tensile fracture often spans the whole result domain of the two other fracture types. Specimen size effects are also evident, not only as scale sensitivity in the roughness metrics, but also as a by-product of the physical processes used to generate the fractures. Results from fractures generated with Brazilian tests show that fracture roughness at small scales differentiates fractures from different specimen sizes and stresses at failure.

Influence of fracture extension on in-situ stress in tight reservoir

NASA Astrophysics Data System (ADS)

Zhang, Yongping; Wei, Xu; Zhang, Ye; Xing, Libo; Xu, Jianjun

2018-01-01

Currently, hydraulic fracturing is an important way to develop low permeability reservoirs. The fractures produced during the fracturing process are the main influencing factors of changing in-situ stress. In this paper, the influence of fracture extension on in-situ stress is studied by establishing a mathematical model to describe the relationship between fracture length and in-situ stress. The results show that the growth rate gradually decreases after the fracture reaches a certain length with the increase of fracturing time; the continuous extension of the fracture is the main factor to change the in-situ stress. In order to reduce the impact on the subsequent fracture extension due to the changing of in-situ stress, controlling fracturing time and fracture length without affecting the stimulated reservoir effect is an important way. The results presented in this study can effectively reduce the impact of changing of in-situ stress on subsequent fracturing construction.

Novel classification system of rib fractures observed in infants.

PubMed

Love, Jennifer C; Derrick, Sharon M; Wiersema, Jason M; Pinto, Deborrah C; Greeley, Christopher; Donaruma-Kwoh, Marcella; Bista, Bibek

2013-03-01

Rib fractures are considered highly suspicious for nonaccidental injury in the pediatric clinical literature; however, a rib fracture classification system has not been developed. As an aid and impetus for rib fracture research, we developed a concise schema for classifying rib fracture types and fracture location that is applicable to infants. The system defined four fracture types (sternal end, buckle, transverse, and oblique) and four regions of the rib (posterior, posterolateral, anterolateral, and anterior). It was applied to all rib fractures observed during 85 consecutive infant autopsies. Rib fractures were found in 24 (28%) of the cases. A total of 158 rib fractures were identified. The proposed schema was adequate to classify 153 (97%) of the observed fractures. The results indicate that the classification system is sufficiently robust to classify rib fractures typically observed in infants and should be used by researchers investigating infant rib fractures. © 2013 American Academy of Forensic Sciences.

Characteristics of fractures in crystalline bedrock determined by surface and borehole geophysical surveys, eastern surplus superfund site, Meddybemps, Maine

USGS Publications Warehouse

Hansen, Bruce P.; Stone, Janet Radway; Lane, John W.

1999-01-01

Surface and borehole geophysical methods were used to determine fracture orientation in crystalline bedrock at the Eastern Surplus Superfund Site in Meddybemps, Maine. Fracture-orientation information is needed to address concerns about the fate of contaminants in ground water at the site. Azimuthal square-array resistivity surveys were conducted at 3 locations at the site, borehole-acoustic televiewer and borehole-video logs were collected in 10 wells, and single-hole directional radar surveys were conducted in 9 wells. Borehole-video logs were used to supplement the results of other geophysical techniques and are not described in this report. Analysis of azimuthal square-array resistivity data indicated that high-angle fracturing generally strikes northeast-southwest at the three locations. Borehole-acoustic televiewer logs detected one prominent low-angle and two prominent high-angle fracture sets. The low-angle fractures strike generally north-northeast and dip about 20 degrees west-northwest. One high-angle fracture set strikes north-northeast and dips east-southeast; the other high-angle set strikes east-northeast and dips south-southeast. Single-hole directional radar surveys identified two prominent fracture sets: a low-angle set striking north-northeast, dipping west-northwest; and a high-angle fracture set striking north-northeast, dipping east-southeast. Two additional high-angle fracture sets are defined weakly, one striking east-west, dipping north; and a second striking east-west, dipping south. Integrated results from all of the geophysical surveys indicate the presence of three primary fracture sets. A low-angle set strikes north-northeast and dips west-northwest. Two high-angle sets strike north-northeast and east-northeast and dip east-southeast and south-southeast. Statistical correction of the fracture data for orientation bias indicates that high-angle fractures are more numerous than observed in the data but are still less numerous than the low-angle fractures. The orientation and distribution of water-yielding fractures sets were determined by correlating the fracture data from this study with previously collected borehole-flowmeter data. The water-yielding fractures are generally within the three prominent fracture sets observed for the total fracture population. The low-angle water-yielding fractures primarily strike north-northeast to west-northwest and dip west-northwest to south-southwest. Most of the high-angle water-yielding fractures strike either north-northeast or east-west and dip east-southeast or south. The spacing between water-yielding fractures varies but the probable average spacing is estimated to be 30 feet for low-angle fractures; 27 feet for the east-southeast dipping, high-angle fractures; and 43 feet for the south-southeast dipping, high-angle fractures. The median estimated apparent transmissivity of individual water-yielding fractures or fracture zones was 0.3 feet squared per day and ranged from 0.01 to 382 feet squared per day. Ninety-five percent of the water-yielding fractures or fracture zones had an estimated apparent transmissivity of 19.5 feet squared per day or less. The orientation, spacing, and hydraulic properties of water-yielding fractures identified during this study can be used to help estimate recharge, flow, and discharge of ground water contaminants. High-angle fractures provide vertical pathways for ground water to enter the bedrock, interconnections between low-angle fractures, and, subsequently, pathways for water flow within the bedrock along fracture planes. Low-angle fractures may allow horizontal ground-water flow in all directions. The orientation of fracturing and the hydraulic properties of each fracture set strongly affect changes in ground-water flow under stress (pumping) conditions.

Innovations in the management of hip fractures.

PubMed

Teasdall, Robert D; Webb, Lawrence X

2003-08-01

Hip fractures include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region that is exposed to large compressive stresses. Implants used to address these fractures must accommodate significant loads while the fractures consolidate. Complications secondary to hip fractures produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

Characteristic Fracture Spacing in Primary and Secondary Recovery from Naturally Fractured Reservoirs

NASA Astrophysics Data System (ADS)

Gong, J.; Rossen, W.

2015-12-01

We showed previously (Gong and Rossen, 2014a,b) that, if the fracture aperture distribution is broad enough in a naturally fractured reservoir, even one where the fracture network is well-connected, most fractures can be eliminated without significantly affecting the flow through the fracture network. During a waterflood or enhanced-oil-recovery (EOR) process, the production of oil depends on the supply of injected water or EOR agent. This suggests that the characteristic fracture spacing for the dual-porosity/dual-permeability simulation of waterflood or EOR in a naturally fractured reservoir should account not for all fractures but only the relatively small portion of the fracture network carrying almost all the injected water or EOR agent. In contrast, in primary production even a relatively small fracture represents an effective path for oil to flow to a production well. Thus in primary production the effective fracture spacing should include all the fractures. This distinction means that the "shape factor" in dual-porosity/dual-permeability reservoir simulators and the repeating unit in homogenization should depend on the process involved: specifically, it should be different for primary and secondary or tertiary recovery. We test this hypothesis in a simple representation of a fractured reservoir with a non-uniform distribution of fracture flow conductivities. We compare oil production, flow patterns in matrix, and the pattern of oil recovery around fractures with and without the "unimportant" fractures present. In primary production, all fractures which are much more permeable than matrix play a significant role in production. The shape factor or repeating-unit size should reflect the entire fracture distribution. In secondary or tertiary production, the role of fractures that carry relatively little flow depends on injection rate, the ratio of flow carried by the different fractures, and the permeability of matrix. In some cases, the appropriate shape factor or repeating-unit size for waterflood or EOR should reflect only those fractures that carry most of the flow. References:Gong, and Rossen, 14th ECMOR Conf., Catania, Sicily, 2014(a). Gong, and Rossen, Intl. Discrete Fracture Network Eng. Conf., Vancouver, Canada, 2014(b).

The relationship of fall-related fractures to social deprivation.

PubMed

Court-Brown, C M; Aitken, S A; Ralston, S H; McQueen, M M

2011-04-01

The relationship between fall-related fractures and social deprivation was studied in 3,843 patients. The incidence of fractures correlated with deprivation in all age groups although the spectrum of fractures was not affected by deprivation. The average age and the prevalence of hip fractures decreased with increasing deprivation. This study examines the relationship between social deprivation and fall-related fractures. Social deprivation has been shown to be a predisposing factor in a number of diseases. There is evidence that it is implicated in fractures in children and young adults, but the evidence that it is associated with fragility fractures in older adults is weak. As fragility fractures are becoming progressively more common and increasingly expensive to treat, the association between social deprivation and fractures is important to define. All out-patient and in-patient fractures presenting to the Royal Infirmary of Edinburgh over a 1-year period were prospectively recorded. The fractures caused by falls from a standing height were analysed in all patients of at least 15 years of age. Social deprivation was assessed using the Carstairs score and social deprivation deciles, and the 2001 census was used to calculate fracture incidence. The data were used to analyse the relationship between social deprivation and fall-related fractures in all age groups. The incidence of fall-related fractures correlated with social deprivation in all age groups including fragility fractures in the elderly. The overall spectrum of fractures was not affected by social deprivation although the prevalence of proximal femoral fractures decreased with increasing deprivation. The average age of patients with fall-related fractures also decreased with increasing social deprivation as did the requirement for in-patient treatment. This is the first study to show the relationship between fall-related fractures and social deprivation in older patients. We believe that the decreased incidence of proximal femoral fractures, and the lower average age of patients with fall-related fractures, in the socially deprived relates to the relative life expectancies in the different deprivation deciles.

Non-catastrophic and catastrophic fractures in racing Thoroughbreds at the Hong Kong Jockey Club.

PubMed

Sun, T C; Riggs, C M; Cogger, N; Wright, J; Al-Alawneh, J I

2018-04-19

Reports of fractures in racehorses have predominantly focused on catastrophic injuries, and there is limited data identifying the location and incidence of fractures that did not result in a fatal outcome. To describe the nature and the incidence of non-catastrophic and catastrophic fractures in Thoroughbreds racing at the Hong Kong Jockey Club (HKJC) over seven racing seasons. Retrospective cohort study. Data of fractures sustained in horses while racing and of race characteristics were extracted from the HKJC Veterinary Management Information System (VMIS) and Racing Information System (RIS) respectively. The fracture event was determined from the first clinical entry for each specific injury. The incidence rates of non-catastrophic and catastrophic fractures were calculated per 1000 racing starts for racetrack, age, racing season, sex and trainer. 179 first fracture events occurred in 64,807 racing starts. The incidence rate of non-catastrophic fractures was 2.2 per 1000 racing starts and of catastrophic fractures was 0.6 per 1000 racing starts. Fractures of the proximal sesamoid bones represented 55% of all catastrophic fractures while the most common non-catastrophic fractures involved the carpus and the first phalanx. Significant associations were detected between the incidence of non-catastrophic fractures and sex, trainer and racing season. The first fracture event was used to calculate the incidence rate in this study and may have resulted in underestimation of the true incidence rate of fractures in this population. However, given the low number of recorded fracture events compared to the size of the study population, this underestimation is likely to be small. There were 3.6 times as many non-catastrophic fractures as catastrophic fractures in Thoroughbreds racing in Hong Kong between 2004 and 2011. Non-catastrophic fractures interfere with race training schedules and may predispose to catastrophic fracture. Future analytical studies on non-catastrophic racing fractures should be a priority for the racing industry. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Experimental analysis of multiple factors on hydraulic fracturing in coalbed methane reservoirs

PubMed Central

Ma, Geng; Liu, Xiao; Tao, Yunqi; Feng, Dan; Li, Rui

2018-01-01

Hydraulic fracturing can improve the permeability of coalbed methane (CBM) reservoirs effectively, which is of great significance to the commercial production of CBM. However, the efficiency of hydraulic fracturing is affected by multiple factors. The mechanism of fracture initiation, morphology and propagation in CBM reservoirs is not clear and need to be further explored. Hydraulic fracturing experiment is an accurate tool to explore these mechanisms. The quantity of experimental coal rock is large and processing method is complex, so specimen made of similar materials was applied to replace coal rock. The true triaxial hydraulic fracturing experimental apparatus, 3D scanning device for coal rock section were applied to carry out hydraulic fracturing experiment. The results show that the initiation pressure is inversely proportional to the horizontal stress difference (Δσ) and positively related to fracturing fluid injection rate. When vertical stress (σv) is constant, the initiation pressure and fracture width decrease with the increasing of Δσ. Natural fractures can be connected by main fracture when propagates perpendicular to the direction of minimum horizontal stress (σh), then secondary fractures and fracture network form in CBM reservoirs. When two stresses of crustal stress are close and far different from the third one, the fracture morphology and propagation become complex. Influenced by perforations and filtration of fracturing fluid in specimen, fracturing fluid flows to downward easily after comparing horizontal well fracturing with vertical well fracturing. Fracture width increases with the decreasing of elastic modulus, the intensity of fracture is positively related with the elastic modulus of coal rock. The research results can provide theoretical basis and technical support for the efficient development of CBM. PMID:29621295

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

The second fracture of the same clavicle: prevalence and fracture configurations.

PubMed

Asavamongkolkul, Apichat; Harnroongroj, Thos; Suteeraporn, Wuttipon; Sudjai, Narumol; Harnroongroj, Thossart

2012-12-01

To study second fracture at the same clavicle including prevalence, fracture configurations related to malunion types of the first fracture, and healing. Between 2008 and 2011, the authors reviewed medical records and radiographs of the clavicles of patients who sustained acute clavicular fractures from motorcycle accident. Second fracture at the same clavicle and prevalence were studied. Malunion of the first fracture of the same clavicle were typed and configurations of the second fracture at the same clavicles were described related to type of the malunion. There were 552 clavicular fractures. Four cases of which sustained a second fracture at the same clavicles. Malunion of the first clavicular fracture of the four cases were typed: type I, extension, type II, flexion, and type III, bayonet. There were one, two, and one case of second clavicular fractures of the type I, II, and III clavicular malunion. The configuration of second clavicular fracture of the type I malunion clavicle is located at lateral fragment, inferior displacement, and dorsal angulation with dorsal cortex conminution. The type II malunion clavicle is located at lateral fragment with minimal displacement. For the type III malunion clavicle, the second fracture is located at medial fragment with mild inferior displacement and inferior angulation. The four cases of the second fractures of the same clavicles healed within two months without complication. The prevalence of second fracture at the same clacicles was 7.2:1000. The three types of the first fracture malunion were extension, flexion, and bayonet. The configuration of the second fracture at the same clavicles depends on malunion types of the first clavicular fracture. They healed without complication.

Experimental analysis of multiple factors on hydraulic fracturing in coalbed methane reservoirs.

PubMed

Zhang, Fan; Ma, Geng; Liu, Xiao; Tao, Yunqi; Feng, Dan; Li, Rui

2018-01-01

Hydraulic fracturing can improve the permeability of coalbed methane (CBM) reservoirs effectively, which is of great significance to the commercial production of CBM. However, the efficiency of hydraulic fracturing is affected by multiple factors. The mechanism of fracture initiation, morphology and propagation in CBM reservoirs is not clear and need to be further explored. Hydraulic fracturing experiment is an accurate tool to explore these mechanisms. The quantity of experimental coal rock is large and processing method is complex, so specimen made of similar materials was applied to replace coal rock. The true triaxial hydraulic fracturing experimental apparatus, 3D scanning device for coal rock section were applied to carry out hydraulic fracturing experiment. The results show that the initiation pressure is inversely proportional to the horizontal stress difference (Δσ) and positively related to fracturing fluid injection rate. When vertical stress (σv) is constant, the initiation pressure and fracture width decrease with the increasing of Δσ. Natural fractures can be connected by main fracture when propagates perpendicular to the direction of minimum horizontal stress (σh), then secondary fractures and fracture network form in CBM reservoirs. When two stresses of crustal stress are close and far different from the third one, the fracture morphology and propagation become complex. Influenced by perforations and filtration of fracturing fluid in specimen, fracturing fluid flows to downward easily after comparing horizontal well fracturing with vertical well fracturing. Fracture width increases with the decreasing of elastic modulus, the intensity of fracture is positively related with the elastic modulus of coal rock. The research results can provide theoretical basis and technical support for the efficient development of CBM.

Risk factors for distal radius fracture in postmenopausal women.

PubMed

Xu, Wenting; Ni, Cheng; Yu, Ren; Gu, Guoqing; Wang, Zheren; Zheng, Guoqing

2017-05-01

The aim of this work was to explore the risk factors for distal radius fracture in postmenopausal women. A total of 611 postmenopausal women with distal radius fractures were included. In all, 173 patients with unstable distal radius fractures were included (unstable fracture group), while there were 438 patients with stable distal radius fractures (stable fracture group). The control group comprised 800 postmenopausal women with no fracture. A questionnaire survey was conducted. Compared with the control group, the 611 postmenopausal women with distal radius fractures had a higher body mass index (BMI). Advanced age and higher BMI were more common in the unstable fracture group than in the stable fracture group (P <0.05). A higher proportion of the 611 postmenopausal women with a distal radius fracture had fallen in the last 12 months than in the control group. Comorbidities and the frequency of falls in the last 12 months were higher in the unstable fracture group than in the stable fracture group (P < 0.05). A higher proportion of the control group was taking calcium supplements, while the proportion taking calcium supplementation in the unstable fracture group was lower than that in the stable fracture group (P < 0.05). Osteoporosis in the two fracture groups (P < 0.05) was significantly higher than in the control group and was the highest in the unstable fracture group (P < 0.05). In postmenopausal women, obesity, falls, unknown osteoporosis status, and osteoporosis are associated with high risk of distal radius fracture. If comorbidities and advanced age are also present, this group of persons may be at higher risk for unstable distal radius fractures.

Evaluating the effect of internal aperture variability on transport in kilometer scale discrete fracture networks

DOE PAGES

Makedonska, Nataliia; Hyman, Jeffrey D.; Karra, Satish; ...

2016-08-01

The apertures of natural fractures in fractured rock are highly heterogeneous. However, in-fracture aperture variability is often neglected in flow and transport modeling and individual fractures are assumed to have uniform aperture distribution. The relative importance of in-fracture variability in flow and transport modeling within kilometer-scale fracture networks has been under debate for a long time, since the flow in each single fracture is controlled not only by in-fracture variability but also by boundary conditions. Computational limitations have previously prohibited researchers from investigating the relative importance of in-fracture variability in flow and transport modeling within large-scale fracture networks. We addressmore » this question by incorporating internal heterogeneity of individual fractures into flow simulations within kilometer scale three-dimensional fracture networks, where fracture intensity, P 32 (ratio between total fracture area and domain volume) is between 0.027 and 0.031 [1/m]. The recently developed discrete fracture network (DFN) simulation capability, dfnWorks, is used to generate kilometer scale DFNs that include in-fracture aperture variability represented by a stationary log-normal stochastic field with various correlation lengths and variances. The Lagrangian transport parameters, non-reacting travel time, , and cumulative retention, , are calculated along particles streamlines. As a result, it is observed that due to local flow channeling early particle travel times are more sensitive to in-fracture aperture variability than the tails of travel time distributions, where no significant effect of the in-fracture aperture variations and spatial correlation length is observed.« less

Evaluating the effect of internal aperture variability on transport in kilometer scale discrete fracture networks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Makedonska, Nataliia; Hyman, Jeffrey D.; Karra, Satish

The apertures of natural fractures in fractured rock are highly heterogeneous. However, in-fracture aperture variability is often neglected in flow and transport modeling and individual fractures are assumed to have uniform aperture distribution. The relative importance of in-fracture variability in flow and transport modeling within kilometer-scale fracture networks has been under debate for a long time, since the flow in each single fracture is controlled not only by in-fracture variability but also by boundary conditions. Computational limitations have previously prohibited researchers from investigating the relative importance of in-fracture variability in flow and transport modeling within large-scale fracture networks. We addressmore » this question by incorporating internal heterogeneity of individual fractures into flow simulations within kilometer scale three-dimensional fracture networks, where fracture intensity, P 32 (ratio between total fracture area and domain volume) is between 0.027 and 0.031 [1/m]. The recently developed discrete fracture network (DFN) simulation capability, dfnWorks, is used to generate kilometer scale DFNs that include in-fracture aperture variability represented by a stationary log-normal stochastic field with various correlation lengths and variances. The Lagrangian transport parameters, non-reacting travel time, , and cumulative retention, , are calculated along particles streamlines. As a result, it is observed that due to local flow channeling early particle travel times are more sensitive to in-fracture aperture variability than the tails of travel time distributions, where no significant effect of the in-fracture aperture variations and spatial correlation length is observed.« less

The epidemiology of fractures in infants--Which accidents are preventable?

PubMed

Wegmann, Helmut; Orendi, Ingrid; Singer, Georg; Eberl, Robert; Castellani, Christoph; Schalamon, Johannes; Till, Holger

2016-01-01

In children, fractures have a huge impact on the health care system. In order to develop effective prevention strategies exact knowledge about the epidemiology of fractures is mandatory. This study aims to describe clinical and epidemiological data of fractures diagnosed in infants. A retrospective analysis of all infants (children<1 year of age) presenting with fractures in an 11 years period (2001-2011) was performed. Information was obtained regarding the location of the fractures, sites of the accident, circumstances and mechanisms of injury and post-injury care. 248 infants (54% male, 46% female) with a mean age of 7 months presented with 253 fractures. In more than half of the cases skull fractures were diagnosed (n=151, 61%). Most frequently the accidents causing fractures happened at home (67%). Falls from the changing table, from the arm of the care-giver and out of bed were most commonly encountered (n=92, 37%). While the majority of skull fractures was caused from falls out of different heights, external impacts tended to lead to fractures of the extremities. 6 patients (2%) were victims of maltreatment and sustained 10 fractures (2 skull fractures, 4 proximal humeral fractures, 2 rib fractures, and 2 tibial fractures). Falls from the changing table, the arms of the caregivers and out of bed caused the majority of fractures (especially skull fracture) in infants. Therefore, awareness campaigns and prevention strategies should focus on these mechanisms of accident in order to decrease the rate of fractures in infants. Copyright © 2015 Elsevier Ltd. All rights reserved.

Fluid driven fracture mechanics in highly anisotropic shale: a laboratory study with application to hydraulic fracturing

NASA Astrophysics Data System (ADS)

Gehne, Stephan; Benson, Philip; Koor, Nick; Enfield, Mark

2017-04-01

The finding of considerable volumes of hydrocarbon resources within tight sedimentary rock formations in the UK led to focused attention on the fundamental fracture properties of low permeability rock types and hydraulic fracturing. Despite much research in these fields, there remains a scarcity of available experimental data concerning the fracture mechanics of fluid driven fracturing and the fracture properties of anisotropic, low permeability rock types. In this study, hydraulic fracturing is simulated in a controlled laboratory environment to track fracture nucleation (location) and propagation (velocity) in space and time and assess how environmental factors and rock properties influence the fracture process and the developing fracture network. Here we report data on employing fluid overpressure to generate a permeable network of micro tensile fractures in a highly anisotropic shale ( 50% P-wave velocity anisotropy). Experiments are carried out in a triaxial deformation apparatus using cylindrical samples. The bedding planes are orientated either parallel or normal to the major principal stress direction (σ1). A newly developed technique, using a steel guide arrangement to direct pressurised fluid into a sealed section of an axially drilled conduit, allows the pore fluid to contact the rock directly and to initiate tensile fractures from the pre-defined zone inside the sample. Acoustic Emission location is used to record and map the nucleation and development of the micro-fracture network. Indirect tensile strength measurements at atmospheric pressure show a high tensile strength anisotropy ( 60%) of the shale. Depending on the relative bedding orientation within the stress field, we find that fluid induced fractures in the sample propagate in two of the three principal fracture orientations: Divider and Short-Transverse. The fracture progresses parallel to the bedding plane (Short-Transverse orientation) if the bedding plane is aligned (parallel) with the direction of σ1. Conversely, the crack plane develops perpendicular to the bedding plane, if the bedding plane is orientated normal to σ1. Fracture initiation pressures are higher in the Divider orientation ( 24MPa) than in the Short-Transverse orientation ( 14MPa) showing a tensile strength anisotropy ( 42%) comparable to ambient tensile strength results. We then use X-Ray Computed Tomography (CT) 3D-images to evaluate the evolved fracture network in terms of fracture pattern, aperture and post-test water permeability. For both fracture orientations, very fine, axial fractures evolve over the entire length of the sample. For the fracturing in the Divider orientation, it has been observed, that in some cases, secondary fractures are branching of the main fracture. Test data from fluid driven fracturing experiments suggest that fracture pattern, fracture propagation trajectories and fracturing fluid pressure (initiation and propagation pressure) are predominantly controlled by the interaction between the anisotropic mechanical properties of the shale and the anisotropic stress environment. The orientation of inherent rock anisotropy relative to the principal stress directions seems to be the main control on fracture orientation and required fracturing pressure.

Genetic research of fractures in carbonate reservoir: a case study of NT carbonate reservoir in the pre-Caspian basin

NASA Astrophysics Data System (ADS)

Fan, Zifei; Wang, Shuqin; Li, Jianxin; Zhao, Wenqi; Sun, Meng; Li, Weiqiang; Li, Changhai

2018-02-01

The degree of development and characteristics of fractures are key factors for the appraisal of carbonate reservoirs. In this paper, core data and well logging data from the NT oilfield in the Pre-Caspian Basin are used to study the formation mechanism and distribution characteristics of different genetic fractures, and analyze their influence on reservoir properties. Fractures in carbonate reservoirs can be divided into three categories according to their formation mechanism; these are tectonic fracture, dissolved fracture, and diagenetic fracture,which is further divided into interlayer fracture and stylolite. Fractures of different formation mechanism influence fluid seepage in different degree, tectonic fractures possessing strong connecting ability to pores, and dissolved fractures also improving reservoir properties effectively, however, diagenetic fractures contributing relatively little to fluid seepage.

Fracture line morphology of complex proximal humeral fractures.

PubMed

Hasan, Afsana P; Phadnis, Joideep; Jaarsma, Ruurd L; Bain, Gregory I

2017-10-01

The aim of this study was to assess proximal humeral fracture patterns using 3-dimensional computed tomography images and relate them to the normal osseous landmarks and soft-tissue attachments. Forty-eight 3-dimensional computed tomography scans of proximal humeral fractures were retrospectively collected, and the fractures were transcribed onto proximal humeral templates. We analyzed the common location and orientation of the fracture lines, with a focus on fractures of the articular surface, tuberosities, metaphysis, and proximal diaphysis. These fractures were compared with the attachments of the rotator cuff and glenohumeral capsule. Fifty-two percent of the fractures involved the articular surface. No fractures passed through the bicipital groove, and fractures were more commonly found on the posterior lesser tuberosity and on the anterior greater tuberosity, coinciding with the intervals between the rotator cuff tendon insertions. Intracapsular fractures of the calcar were more common (68%) than extracapsular fractures (32%). On the anterolateral aspect of the proximal humerus, fractures radiated from the articular margin, vertically down through the tuberosity zone between the rotator cuff footprints, meeting horizontally oriented fractures in the metaphyseal zone. On the posterior aspect, vertical fractures from the tuberosity zone continued downward to the metaphyseal zone adjacent to the infraspinatus and teres minor footprints. Fractures of the proximal humerus follow characteristic patterns. Fractures frequently split the greater tuberosity and are closely related to the intervals of the rotator cuff attachments. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Implications of heterogeneous fracture distribution on reservoir quality; an analogue from the Torridon Group sandstone, Moine Thrust Belt, NW Scotland

NASA Astrophysics Data System (ADS)

Watkins, Hannah; Healy, David; Bond, Clare E.; Butler, Robert W. H.

2018-03-01

Understanding fracture network variation is fundamental in characterising fractured reservoirs. Simple relationships between fractures, stress and strain are commonly assumed in fold-thrust structures, inferring relatively homogeneous fracture patterns. In reality fractures are more complex, commonly appearing as heterogeneous networks at outcrop. We use the Achnashellach Culmination (NW Scotland) as an outcrop analogue to a folded tight sandstone reservoir in a thrust belt. We present fracture data is collected from four fold-thrust structures to determine how fracture connectivity, orientation, permeability anisotropy and fill vary at different structural positions. We use a 3D model of the field area, constructed using field observations and bedding data, and geomechanically restored using Move software, to determine how factors such as fold curvature and strain influence fracture variation. Fracture patterns in the Torridon Group are consistent and predictable in high strain forelimbs, however in low strain backlimbs fracture patterns are inconsistent. Heterogeneities in fracture connectivity and orientation in low strain regions do not correspond to fluctuations in strain or fold curvature. We infer that where strain is low, other factors such as lithology have a greater control on fracture formation. Despite unpredictable fracture attributes in low strain regions, fractured reservoir quality would be highest here because fractures in high strain forelimbs are infilled with quartz. Heterogeneities in fracture attribute data on fold backlimbs mean that fractured reservoir quality and reservoir potential is difficult to predict.

Stress fracture of the pelvis and lower limbs including atypical femoral fractures-a review.

PubMed

Tins, Bernhard J; Garton, Mark; Cassar-Pullicino, Victor N; Tyrrell, Prudencia N M; Lalam, Radhesh; Singh, Jaspreet

2015-02-01

Stress fractures, that is fatigue and insufficiency fractures, of the pelvis and lower limb come in many guises. Most doctors are familiar with typical sacral, tibial or metatarsal stress fractures. However, even common and typical presentations can pose diagnostic difficulties especially early after the onset of clinical symptoms. This article reviews the aetiology and pathophysiology of stress fractures and their reflection in the imaging appearances. The role of varying imaging modalities is laid out and typical findings are demonstrated. Emphasis is given to sometimes less well-appreciated fractures, which might be missed and can have devastating consequences for longer term patient outcomes. In particular, atypical femoral shaft fractures and their relationship to bisphosphonates are discussed. Migrating bone marrow oedema syndrome, transient osteoporosis and spontaneous osteonecrosis are reviewed as manifestations of stress fractures. Radiotherapy-related stress fractures are examined in more detail. An overview of typical sites of stress fractures in the pelvis and lower limbs and their particular clinical relevance concludes this review. Teaching Points • Stress fractures indicate bone fatigue or insufficiency or a combination of these. • Radiographic visibility of stress fractures is delayed by 2 to 3 weeks. • MRI is the most sensitive and specific modality for stress fractures. • Stress fractures are often multiple; the underlying cause should be evaluated. • Infratrochanteric lateral femoral fractures suggest an atypical femoral fracture (AFF); endocrinologist referral is advisable.

Percolation Laws of a Fractal Fracture-Pore Double Medium

NASA Astrophysics Data System (ADS)

Zhao, Yangsheng; Feng, Zengchao; Lv, Zhaoxing; Zhao, Dong; Liang, Weiguo

2016-12-01

The fracture-pore double porosity medium is one of the most common media in nature, for example, rock mass in strata. Fracture has a more significant effect on fluid flow than a pore in a fracture-pore double porosity medium. Hence, the fracture effect on percolation should be considered when studying the percolation phenomenon in porous media. In this paper, based on the fractal distribution law, three-dimensional (3D) fracture surfaces, and two-dimensional (2D) fracture traces in rock mass, the locations of fracture surfaces or traces are determined using a random function of uniform distribution. Pores are superimposed to build a fractal fracture-pore double medium. Numerical experiments were performed to show percolation phenomena in the fracture-pore double medium. The percolation threshold can be determined from three independent variables (porosity n, fracture fractal dimension D, and initial value of fracture number N0). Once any two are determined, the percolation probability exists at a critical point with the remaining parameter changing. When the initial value of the fracture number is greater than zero, the percolation threshold in the fracture-pore medium is much smaller than that in a pore medium. When the fracture number equals zero, the fracture-pore medium degenerates to a pore medium, and both percolation thresholds are the same.

Concurrent rib and pelvic fractures as an indicator of solid abdominal organ injury.

PubMed

Al-Hassani, Ammar; Afifi, Ibrahim; Abdelrahman, Husham; El-Menyar, Ayman; Almadani, Ammar; Recicar, Jan; Al-Thani, Hassan; Maull, Kimball; Latifi, Rifat

2013-01-01

To study the association of solid organ injuries (SOIs) in patients with concurrent rib and pelvic fractures. Retrospective analysis of prospectively collected data from November 2007 to May 2010. Patients' demographics, mechanism of injury, Injury severity scoring, pelvic fracture, and SOIs were analyzed. Patients with SOIs were compared in rib fractures with and without pelvic fracture. The study included 829 patients (460 with rib fractures ± pelvic fracture and 369 with pelvic fracture alone) with mean age of 35 ± 12.7 years. Motor vehicle crashes (45%) and falls from height (30%) were the most common mechanism of injury. The overall incidence of SOIs in this study was 22% (185/829). Further, 15% of patient with rib fractures had associated pelvic fracture. SOI was predominant in patients with concurrent rib fracture and pelvic fracture compared to ribs or pelvic fractures alone (42% vs. 26% vs. 15%, respectively, p = 0.02). Concurrent multiple rib fractures and pelvic fracture increases the risk of SOI compared to either group alone. Lower RFs and pelvic fracture had higher association for SOI and could be used as an early indicator of the presence of SOIs. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Influence of natural fractures on hydraulic fracture propagation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teufel, L.W.; Warpinski, N.R.

Hydraulic fracturing has become a valuable technique for the stimulation of oil, gas, and geothermal reservoirs in a variety of reservoir rocks. In many applications, only short fractures are needed for economic production. In low-permeability reservoirs, however, long penetrating fractures are generally needed, and in this case, natural fractures can be the cause of many adverse effects during a fracture treatment. Natural fractures can influence the overall geometry and effectiveness of the hydraulic fracture by: (1) arresting the vertical or lateral growth, (2) reducing total fracture length via fluid leakoff, (3) limiting proppant transport and placement, and (4) enhancing themore » creation of multiple or secondary fractures rather than a single planar hydraulic fracture. The result may range from negligible to catastrophic depending on the values of the ancillary treatment and reservoir parameters, such as the treating pressure, in-situ stresses, pore pressure, orientations of the natural fractures relative to principal in-situ stresses, spacing and distribution of the natural fractures, permeability, etc. Field observations from mineback experiments at DOE's Nevada Test Site and the multiwell experiment in Colorado, laboratory tests, and analyses of these data are integrated to describe the complex fracture behavior found and to provide guidelines for predicting when this complex fracturing will occur.« less

Influence of natural fractures on hydraulic fracture propagation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teufel, L.W.; Warpinski, N.R.

Hydraulic fracturing has become a valuable technique for the stimulation of oil, gas, and geothermal reservoirs in a variety of reservoir rocks. In many applications, only short fractures are needed for economic production. In low-permeability reservoirs, however, long penetrating fractures are generally needed, and in this case, natural fractures can be the cause of many adverse effects during a fracture treatment. Natural fractures can influence the overall geometry and effectiveness of the hydraulic fracture by: (1) arresting the vertical or lateral growth, (2) reducing total fracture length via fluid leakoff, (3) limiting proppant transport and placement, and (4) enhancing themore » creation of multiple or secondary fractures rather than a single planar hydraulic fracture. The result may range from negligible to catastrophic depending on the values of the ancillary treatment and reservoir parameters, such as the treating pressure, in-situ stresses, pore pressure, orientations of the natural fractures relative to principle in-situ stresses, spacing and distribution of the natural fractures, permeability, etc. Field observations from mineback experiments at DOE's Nevada Test Site and the multiwell experiment in Colorado, laboratory tests, and analyses of these data are integrated to describe the complex fracture behavior found to an provide guidelines for predicting when this complex fracturing occurs.« less

Borehole sampling of fracture populations - compensating for borehole sampling bias in crystalline bedrock aquifers, Mirror Lake, Grafton County, New Hampshire

USGS Publications Warehouse

McDonald, G.D.; Paillet, Frederick L.; Barton, C.C.; Johnson, C.D.

1997-01-01

The clustering of orientations of hydraulically conductive fractures in bedrock at the Mirror Lake, New Hampshire fractured rock study site was investigated by comparing the orientations of fracture populations in two subvertical borehole arrays with those mapped on four adjacent subvertical roadcuts. In the boreholes and the roadcuts, the orientation of fracture populations appears very similar after borehole data are compensated for undersampling of steeply dipping fractures. Compensated borehole and pavement fracture data indicate a northeast-striking population of fractures with varying dips concentrated near that of the local foliation in the adjacent rock. The data show no correlation between fracture density (fractures/linear meter) and distance from lithologic contacts in both the boreholes and the roadcuts. The population of water-producing borehole fractures is too small (28 out of 610 fractures) to yield meaningful orientation comparisons. However, the orientation of large aperture fractures (which contains all the producing fractures) contains two or three subsidiary clusters in orientation frequency that are not evident in stereographic projections of the entire population containing all aperture sizes. Further, these subsidiary orientation clusters do not coincide with the dominant (subhorizontal and subvertical) regional fracture orientations.

Major factors controlling fracture development in the Middle Permian Lucaogou Formation tight oil reservoir, Junggar Basin, NW China

NASA Astrophysics Data System (ADS)

Zhang, Chen; Zhu, Deyu; Luo, Qun; Liu, Luofu; Liu, Dongdong; Yan, Lin; Zhang, Yunzhao

2017-09-01

Natural fractures in seven wells from the Middle Permian Lucaogou Formation in the Junggar Basin were evaluated in light of regional structural evolution, tight reservoir geochemistry (including TOC and mineral composition), carbon and oxygen isotopes of calcite-filled fractures, and acoustic emission (AE). Factors controlling the development of natural fractures were analyzed using qualitative and/or semi-quantitative techniques, with results showing that tectonic factors are the primary control on fracture development in the Middle Permian Lucaogou Formation of the Junggar Basin. Analyses of calcite, dolomite, and TOC show positive correlations with the number of fractures, while deltaic lithofacies appear to be the most favorable for fracture development. Mineral content was found to be a major control on tectonic fracture development, while TOC content and sedimentary facies mainly control bedding fractures. Carbon and oxygen isotopes vary greatly in calcite-filled fractures (δ13C ranges from 0.87‰ to 7.98‰, while δ18O ranges from -12.63‰ to -5.65‰), indicating that fracture development increases with intensified tectonic activity or enhanced diagenetic alteration. By analyzing the cross-cutting relationships of fractures in core, as well as four Kaiser Effect points in the acoustic emission curve, we observed four stages of tectonic fracture development. First-stage fractures are extensional, and were generated in the late Triassic, with calcite fracture fills formed between 36.51 °C and 56.89 °C. Second-stage fractures are shear fractures caused by extrusion stress from the southwest to the northeast, generated by the rapid uplift of the Tianshan in the Middle and Late Jurassic; calcite fracture fills formed between 62.91 °C and 69.88 °C. Third-stage fractures are NNW-trending shear fractures that resulted from north-south extrusion and thrusting in a foreland depression along the front of the Early Cretaceous Bogda Mountains. Calcite fracture fills formed between 81.74 °C and 85.43 °C. Fourth-stage fractures inherited the tectonic framework of the third stage, resulting in fractures with the same orientation, but without calcite filling. By differentiating the various stages of fracture development, we were able to better understand the origin of fractures in tight oil reservoirs and their significance for exploration and development.

Acetabular fractures: anatomic and clinical considerations.

PubMed

Lawrence, David A; Menn, Kirsten; Baumgaertner, Michael; Haims, Andrew H

2013-09-01

Classifying acetabular fractures can be an intimidating topic. However, it is helpful to remember that there are only three basic types of acetabular fractures: column fractures, transverse fractures, and wall fractures. Within this framework, acetabular fractures are classified into two broad categories: elementary or associated fractures. We will review the osseous anatomy of the pelvis and provide systematic approaches for reviewing both radiographs and CT scans to effectively evaluate the acetabulum. Although acetabular fracture classification may seem intimidating, the descriptions and distinctions discussed and shown in this article hopefully make the topic simpler to understand. Approach the task by recalling that there are only three basic types of acetabular fractures: column fractures (coronally oriented on CT images), transverse fractures (sagittally oriented on CT images), and wall fractures (obliquely oriented on CT images). We have provided systematic approaches for reviewing both conventional radiographs and CT scans to effectively assess the acetabulum. The clinical implications of the different fracture patterns have also been reviewed because it is critically important to include pertinent information for our clinical colleagues to provide the most efficient and timely clinical care.

TOUGH-RBSN simulator for hydraulic fracture propagation within fractured media: Model validations against laboratory experiments

NASA Astrophysics Data System (ADS)

Kim, Kunhwi; Rutqvist, Jonny; Nakagawa, Seiji; Birkholzer, Jens

2017-11-01

This paper presents coupled hydro-mechanical modeling of hydraulic fracturing processes in complex fractured media using a discrete fracture network (DFN) approach. The individual physical processes in the fracture propagation are represented by separate program modules: the TOUGH2 code for multiphase flow and mass transport based on the finite volume approach; and the rigid-body-spring network (RBSN) model for mechanical and fracture-damage behavior, which are coupled with each other. Fractures are modeled as discrete features, of which the hydrological properties are evaluated from the fracture deformation and aperture change. The verification of the TOUGH-RBSN code is performed against a 2D analytical model for single hydraulic fracture propagation. Subsequently, modeling capabilities for hydraulic fracturing are demonstrated through simulations of laboratory experiments conducted on rock-analogue (soda-lime glass) samples containing a designed network of pre-existing fractures. Sensitivity analyses are also conducted by changing the modeling parameters, such as viscosity of injected fluid, strength of pre-existing fractures, and confining stress conditions. The hydraulic fracturing characteristics attributed to the modeling parameters are investigated through comparisons of the simulation results.

Functional outcomes of conservatively treated clavicle fractures

PubMed Central

Bajuri, Mohd Yazid; Maidin, S; Rauf, A; Baharuddin, M; Harjeet, S

2011-01-01

OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique. RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution), the fracture displacement (21 mm or more), shortening (15 mm or more) and the fracture union (malunion). CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes. PMID:21655759

La problématique du coût des nouvelles thérapeutiques en oncologie: qu'en-est-il du Maroc?

PubMed Central

Brahmi, Sami Aziz; Zahra, Ziani Fatima; Seddik, Youssef; Afqir, Said

2016-01-01

Le cancer est un problème majeur de santé public en Afrique. Les progrès réalisé dans le traitement des cancers ces dix dernières années est indéniable. L’émergence des thérapies ciblés en oncologie a permit de modifier l'histoire naturelle de certains cancers réputés de mauvais pronostic. En dépit de leurs efficacité, ces thérapeutiques pose un problème majeur de coût qui les rend inaccessible à la majorité des patients dans les pays en voie développement. Au Maroc, le cancer est reconnu comme a une affection de longue durée et les patients bénéficient de ce fait d'une couverture médicale totale. L'implication de la société civile a permis aussi d'améliorer la prise en charge ainsi qu'un accès plus élargi aux médicaments innovants pour les patients les plus démunis. PMID:27642392

Performance on physical function tests and the risk of fractures and admissions: Findings from a national health screening of 557,648 community-dwelling older adults.

PubMed

Chun, So Hyun; Cho, Belong; Yang, Hyung-Kook; Ahn, Eunmi; Han, Min Kyu; Oh, Bumjo; Shin, Dong Wook; Son, Ki Young

Falls and fractures in older adults are often preventable, yet remain major health concerns as comprehensive physical function assessment may not be readily available. This study investigated whether simple timed up and go test (TUG) and unipedal stance test (UST) are effective in identifying people with an increased risk of fractures, femoral fractures, or admissions due to femoral fractures. Community-dwelling Korean older adults aged 66 years participated in the Korean National Screening Program for the Transitional Ages (n=557,648) between 2007 and 2010. Overall fractures, femoral fractures, and admissions due to femoral fracture during this period were outcome measures. The outcome measures were overall fractures, femoral fractures, and admissions due to femoral fracture after the health screening. The associations between inferior physical function test results and outcome measures were evaluated. A total of 523,502 subjects were followed-up for a mean period of 1.42 years, which resulted in 12,965 subjects with any fractures. Fracture data were retrieved from medical claims record. Subjects who performed poorly on one or both of the two physical function tests experienced higher number of overall fractures (aHR 1.21, 95% CI: 1.16-1.26), femoral fractures (aHR 1.80, 95% CI: 1.59-2.17), and admissions due to femoral fractures (aHR 1.85, 95% CI: 1.55-2.22) as compared to subjects with normal results on both tests. Combining TUG and UST was not superior to performing UST alone in predicting the increased risk of overall fractures (p=0.347), femoral fractures (p=0.402) or admissions due to femoral fractures (p=0.774). Poor performance on physical performance tests is associated with a higher risk of overall fractures, femoral fractures and admissions due to femoral fractures. The TUG and UST can be used to identify community-dwelling older individuals who are more vulnerable to fractures. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Population-Wide Impact of Non-Hip Non-Vertebral Fractures on Mortality.

PubMed

Tran, Thach; Bliuc, Dana; van Geel, Tineke; Adachi, Jonathan D; Berger, Claudie; van den Bergh, Joop; Eisman, John A; Geusens, Piet; Goltzman, David; Hanley, David A; Josse, Robert G; Kaiser, Stephanie M; Kovacs, Christopher S; Langsetmo, Lisa; Prior, Jerilynn C; Nguyen, Tuan V; Center, Jacqueline R

2017-09-01

Data on long-term consequences of non-hip non-vertebral (NHNV) fractures, accounting for approximately two-thirds of all fragility fractures, are scanty. Our study aimed to quantify the population-wide impact of NHNV fractures on mortality. The national population-based prospective cohort study (Canadian Multicentre Osteoporosis Study) included 5526 community dwelling women and 2163 men aged 50 years or older followed from July 1995 to September 2013. Population impact number was used to quantify the average number of people for whom one death would be attributable to fracture and case impact number to quantify the number of deaths out of which one would be attributable to a fracture. There were 1370 fragility fractures followed by 296 deaths in women (mortality rate: 3.49; 95% CI, 3.11 to 3.91), and 302 fractures with 92 deaths in men (5.05; 95% CI, 4.12 to 6.20). NHNV fractures accounted for three-quarters of fractures. In women, the population-wide impact of NHNV fractures on mortality was greater than that of hip and vertebral fractures because of the greater number of NHNV fractures. Out of 800 women, one death was estimated to be attributable to a NHNV fracture, compared with one death in 2000 women attributable to hip or vertebral fracture. Similarly, out of 15 deaths in women, one was estimated to be attributable to a NHNV fracture, compared with one in over 40 deaths for hip or vertebral fracture. The impact of forearm fractures (ie, one death in 2400 women and one out of 42 deaths in women attributable to forearm fracture) was similar to that of hip, vertebral, or rib fractures. Similar, albeit not significant, results were noted for men. The study highlights the important contribution of NHNV fractures on mortality because many NHNV fracture types, except for the most distal fractures, have serious adverse consequences that affect a significant proportion of the population. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

Epidemiology of fractures in people with severe and profound developmental disabilities

USGS Publications Warehouse

Glick, N.R.; Fischer, M.H.; Heisey, D.M.; Leverson, G.E.; Mann, D.C.

2005-01-01

Fractures are more prevalent among people with severe and profound developmental disabilities than in the general population. In order to characterize the tendency of these people to fracture, and to identify features that may guide the development of preventive strategies, we analyzed fracture epidemiology in people with severe and profound developmental disabilities who lived in a stable environment. Data from a 23-year longitudinal cohort registry of 1434 people with severe and profound developmental disabilities were analyzed to determine the effects of age, gender, mobility, bone fractured, month of fracture, and fracture history upon fracture rates. Eighty-five percent of all fractures involved the extremities. The overall fracture rate increased as mobility increased. In contrast, femoral shaft fracture risk was substantially higher in the least mobile [relative risk (RR), 10.36; 95% confidence interval (CI), 3.29-32.66] compared with the most mobile group. Although the overall fracture rate was not associated with age, the femoral shaft fractures decreased but hand/foot fractures increased with age. Overall fracture risk declined in August and September (RR, 0.70; 95% CI, 0.55-0.89), being especially prominent for tibial/fibular fractures (RR, 0.31; 95% CI, 0.13-0.70). Gender was not a factor in fracture risk. Two primary fracture mechanisms are apparent: one, largely associated with lack of weight-bearing in people with the least mobility, is exemplified by femoral fractures during non-traumatic events as simple as diapering or transfers; the other, probably due to movement- or fall-related trauma, is exemplified by hand/foot fractures in people who ambulate. The fracture experience of people with severe and profound developmental disabilities is unique and, because it differs qualitatively from postmenopausal osteoporosis, may require population-specific methods for assessing risk, for improving bone integrity, and for reduction of falls and accidents. ?? International Osteoporosis Foundation and National Osteoporosis Foundation 2004.

Hydro-fracture in the laboratory: matching diagnostic seismic signals to fracture networks

NASA Astrophysics Data System (ADS)

Gehne, S.; Benson, P. M.; Koor, N.; Dobson, K. J.; Enfield, M.; Barber, A.

2017-12-01

Hydraulic fracturing is a key process in both natural (e.g. dyke intrusion) and engineered environments (e.g. shale gas). To better understand this process, we present new data from simulated hydraulic fracturing in a controlled laboratory environment in order to track fracture nucleation (location) and propagation (velocity) in space and time to assess the fracture mechanics and developing fracture network. Fluid overpressure is used to generate a permeable network of micro tensile fractures in an anisotropic sandstone and a highly anisotropic shale. A newly developed technique, using a steel guide arrangement to direct pressurised fluid into a sealed section of an axially drilled conduit, allows the pore fluid to contact the rock directly and to initiate tensile fractures from a pre-defined zone inside the sample. Acoustic emission location is used to record and map the nucleation and development of the micro-fracture network. For both rock types, fractures progresses parallel to the bedding plane (short-transverse) if the bedding plane is aligned with the direction of σ1 requiring breakdown pressures of approximately 7 and 13MPa respectively at a confining pressure of 8MPa. The data also indicates a more ductile behaviour of the shale than expected. We use X-Ray Computed Tomography (CT) to evaluate the evolved fracture network in terms of fracture pattern and aperture. Hydraulic fracturing produces very planar fractures in the shale, with axial fractures over the entire length of the sample broadly following the bedding. In contrast, fractures in the sandstone are more diffuse, linking pore spaces as they propagate. However, secondary micro cracking, branching of the main fracture, are also observed. These new experiments suggest that fracture pattern, fracture propagation trajectories, and fracturing fluid pressures are predominantly controlled by the interaction between the anisotropic mechanical properties of the rock and the anisotropic stress environment.

Altered-stress fracturing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warpinski, N.R.; Branagan, P.T.

Altered-stress fracturing is a concept whereby a hydraulic fracture in one well is reoriented by another hydraulic fracture in a nearby location. The application is in tight, naturally fractured, anisotropic reservoirs in which conventional hydraulic fractures parallel the highly permeable natural fractures and little production enhancement is achieved by conventional hydraulic fracturing. Altered-stress fracturing can modify the stress field so that hydraulic fractures propagate across the permeable natural fractures. A field test was conducted in which stress changes of 250 to 300 psi (1.7 to 2.1 MPa) were measured in an offset well 120 ft (37 m) away during relativelymore » small minifracs in a production well. These results show that stress-altered fracturing is possible at this site and others. Analytic and finite element calculations quantify the effects of layers, stresses, and crack size. Reservoir calculations show significant enhancement compared to conventional treatments. 21 refs., 12 figs., 3 tabs.« less

Isolated tympanic plate fracture frequency and its relationship to mandibular trauma.

PubMed

Altay, Canan; Erdoğan, Nezahat; Batkı, Ozan; Eren, Erdem; Altay, Sedat; Karasu, Sebnem; Mete, Berna; Uluç, Engin

2014-11-01

This study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT). We retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists. The maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side (P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found (P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined (P > .05). Sex had no impact on the presence of tympanic plate fracture (P > .05). The frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Pediatric fractures during skateboarding, roller skating, and scooter riding.

PubMed

Zalavras, Charalampos; Nikolopoulou, Georgia; Essin, Daniel; Manjra, Nahid; Zionts, Lewis E

2005-04-01

Skateboarding, roller skating, and scooter riding are popular recreational and sporting activities for children and adolescents but can be associated with skeletal injury. The purpose of this study is to describe the frequency and characteristics of fractures resulting from these activities. Fractures from skateboarding, roller skating, and scooter riding compose a considerable proportion of pediatric musculoskeletal injuries. Case series; Level of evidence, 4. Demographic data and injury characteristics were analyzed for all patients who presented to the pediatric fracture clinic of the level I trauma center from January 2001 to May 2002 after sustaining fractures due to skateboarding, roller skating, and scooter riding. Among a total of 2371 fractures, the authors identified 325 fractures (13.7%) that occurred during one of these activities. There were 187 patients (mean age, 13 years; 95% male) who sustained 191 skateboard-related fractures, 64 patients (mean age, 10.8 years; 54% male) who sustained 65 fractures while roller skating, and 66 patients (mean age, 9.7 years; 64% male) who sustained 69 fractures while riding a scooter. The forearm was fractured most often, composing 48.2% of skate-boarding fractures, 63.1% of roller-skating fractures, and 50.7% of fractures due to scooter riding. Of the forearm fractures, 94% were located in the distal third. In the skateboarding group, 10 of 191 (5.2%) fractures were open injuries of the forearm, compared to 6 of 2046 (0.3%) fractures caused by other mechanisms of injury (significant odds ratio, 18.8). Skateboarding, roller-skating, and scooter-riding accidents result in a large proportion of pediatric fractures. An open fracture, especially of the forearm, was more likely to be caused by skateboarding than by other mechanisms of injury. Use of wrist and forearm protective equipment should be considered in all children who ride a skateboard.

Nano-scale zero valent iron transport in a variable aperture dolomite fracture and a glass fracture

NASA Astrophysics Data System (ADS)

Mondal, P.; Sleep, B. E.; Cui, Z.; Zhou, Z.

2014-12-01

Experiments and numerical simulations are being performed to understand the transport behavior of carboxymethyl cellulose polymer stabilized nano-scale zero valent iron (nZVI) in a variable aperture dolomite rock fracture and a variable aperture glass replica of a fractured slate. The rock fracture was prepared by artificially inducing a fracture in a dolomite block along a stylolite, and the glass fracture was prepared by creating molds with melted glass on two opposing sides of a fractured slate rock block. Both of the fractures were 0.28 m in length and 0.21 m in width. Equivalent hydraulic apertures are about 110 microns for the rock fracture and 250 microns for the glass replica fracture. Sodium bromide and lissamine green B (LGB) serve as conservative tracers in the rock fracture and glass replica fracture, respectively. A dark box set-up with a light source and digital camera is being used to visualize the LGB and CMC-nZVI movement in the glass fracture. Experiments are being performed to determine the effects of water specific discharge and CMC concentration on nZVI transport in the fractures. Transmission electron microscopy, dynamic light scattering, and UV-visual spectrophotometry were performed to determine the stability and characteristics of the CMC-nZVI mixture. The transport of bromide, LGB, CMC, and CMC-nZVI in both fractures is being evaluated through analysis of the effluent concentrations. Time-lapse images are also being captured for the glass fracture. Bromide, LGB, and CMC recoveries have exceeded 95% in both fractures. Significant channeling has been observed in the fractures for CMC transport due to viscous effects.

A novel classification of frontal bone fractures: The prognostic significance of vertical fracture trajectory and skull base extension.

PubMed

Garg, Ravi K; Afifi, Ahmed M; Gassner, Jennifer; Hartman, Michael J; Leverson, Glen; King, Timothy W; Bentz, Michael L; Gentry, Lindell R

2015-05-01

The broad spectrum of frontal bone fractures, including those with orbital and skull base extension, is poorly understood. We propose a novel classification scheme for frontal bone fractures. Maxillofacial CT scans of trauma patients were reviewed over a five year period, and frontal bone fractures were classified: Type 1: Frontal sinus fracture without vertical extension. Type 2: Vertical fracture through the orbit without frontal sinus involvement. Type 3: Vertical fracture through the frontal sinus without orbit involvement. Type 4: Vertical fracture through the frontal sinus and ipsilateral orbit. Type 5: Vertical fracture through the frontal sinus and contralateral or bilateral orbits. We also identified the depth of skull base extension, and performed a chart review to identify associated complications. 149 frontal bone fractures, including 51 non-vertical frontal sinus (Type 1, 34.2%) and 98 vertical (Types 2-5, 65.8%) fractures were identified. Vertical fractures penetrated the middle or posterior cranial fossa significantly more often than non-vertical fractures (62.2 v. 15.7%, p = 0.0001) and had a significantly higher mortality rate (18.4 v. 0%, p < 0.05). Vertical fractures with frontal sinus and orbital extension, and fractures that penetrated the middle or posterior cranial fossa had the strongest association with intracranial injuries, optic neuropathy, disability, and death (p < 0.05). Vertical frontal bone fractures carry a worse prognosis than frontal bone fractures without a vertical pattern. In addition, vertical fractures with extension into the frontal sinus and orbit, or with extension into the middle or posterior cranial fossa have the highest complication rate and mortality. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

PubMed

Joeris, Alexander; Lutz, Nicolas; Blumenthal, Andrea; Slongo, Theddy; Audigé, Laurent

2017-04-01

Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods - We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland. Patient charts were retrospectively reviewed. Results - More lower extremity fractures occurred in boys (62%, n = 341). Of 548 fractured long bones in the lower extremity, 25% involved the femur and 75% the lower leg. The older the patients, the more combined fractures of the tibia and fibula were sustained (adolescents: 50%, 61 of 123). Salter-Harris (SH) fracture patterns represented 66% of single epiphyseal fractures (83 of 126). Overall, 74 of the 83 SH patterns occurred in the distal epiphysis. Of all the metaphyseal fractures, 74 of 79 were classified as incomplete or complete. Complete oblique spiral fractures accounted for 57% of diaphyseal fractures (120 of 211). Of all fractures, 7% (40 of 548) were classified in the category "other", including 29 fractures that were identified as toddler's fractures. 5 combined lower leg fractures were reported in the proximal metaphysis, 40 in the diaphysis, 26 in the distal metaphysis, and 8 in the distal epiphysis. Interpretation - The PCCF allows classification of lower extremity fracture patterns in the clinical setting. Re-introduction of a specific code for toddler's fractures in the PCCF should be considered.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF)

PubMed Central

Joeris, Alexander; Lutz, Nicolas; Blumenthal, Andrea; Slongo, Theddy; Audigé, Laurent

2017-01-01

Background and purpose To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland. Patient charts were retrospectively reviewed. Results More lower extremity fractures occurred in boys (62%, n = 341). Of 548 fractured long bones in the lower extremity, 25% involved the femur and 75% the lower leg. The older the patients, the more combined fractures of the tibia and fibula were sustained (adolescents: 50%, 61 of 123). Salter-Harris (SH) fracture patterns represented 66% of single epiphyseal fractures (83 of 126). Overall, 74 of the 83 SH patterns occurred in the distal epiphysis. Of all the metaphyseal fractures, 74 of 79 were classified as incomplete or complete. Complete oblique spiral fractures accounted for 57% of diaphyseal fractures (120 of 211). Of all fractures, 7% (40 of 548) were classified in the category "other", including 29 fractures that were identified as toddler’s fractures. 5 combined lower leg fractures were reported in the proximal metaphysis, 40 in the diaphysis, 26 in the distal metaphysis, and 8 in the distal epiphysis. Interpretation The PCCF allows classification of lower extremity fracture patterns in the clinical setting. Re-introduction of a specific code for toddler’s fractures in the PCCF should be considered. PMID:27882811

Fracture patterns at lava-ice contacts on Kokostick Butte, OR, and Mazama Ridge, Mount Rainier, WA: Implications for flow emplacement and cooling histories

NASA Astrophysics Data System (ADS)

Lodge, Robert W. D.; Lescinsky, David T.

2009-09-01

Cooling lava commonly develop polygonal joints that form equant hexagonal columns. Such fractures are formed by thermal contraction resulting in an isotropic tensional stress regime. However, certain linear cooling fracture patterns observed at some lava-ice contacts do not appear to fit the model for formation of cooling fractures and columns because of their preferred orientations. These fracture types include sheet-like (ladder-like rectangular fracture pattern), intermediate (pseudo-aligned individual column-bounding fractures), and pseudopillow (straight to arcuate fractures with perpendicular secondary fractures caused by water infiltration) fractures that form the edges of multiple columns along a single linear fracture. Despite the relatively common occurrence of these types of fractures at lava-ice contacts, their significance and mode of formation have not been fully explored. This study investigates the stress regimes responsible for producing these unique fractures and their significance for interpreting cooling histories at lava-ice contacts. Data was collected at Kokostick Butte dacite flow at South Sister, OR, and Mazama Ridge andesite flow at Mount Rainier, WA. Both of these lava flows have been interpreted as being emplaced into contact with ice and linear fracture types have been observed on their ice-contacted margins. Two different mechanisms are proposed for the formation of linear fracture networks. One possible mechanism for the formation of linear fracture patterns is marginal bulging. Melting of confining ice walls will create voids into which flowing lava can deform resulting in margin-parallel tension causing margin-perpendicular fractures. If viewed from the ice-wall, these fractures would be steeply dipping, linear fractures. Another possible mechanism for the formation of linear fracture types is gravitational settling. Pure shear during compression and settling can result in a tensional environment with similar consequences as marginal inflation. In addition to this, horizontally propagating cooling fractures will be directly influenced by viscous strain caused by the settling of the flow. This would cause preferential opening of fractures horizontally, resulting in vertically oriented fractures. It is important to note that the proposed model for the formation of linear fractures is dependent on contact with and confinement by glacial ice. The influence of flow or movement on cooling fracture patterns has not been extensively discussed in previous modeling of cooling fractures. Rapid cooling of lava by the interaction with water and ice will increase the ability to the capture and preserve perturbations in the stress regime.

Characterizing Fractures Across the Astronaut Corps: Preliminary Findings from Population-Level Analysis

NASA Technical Reports Server (NTRS)

Rossi, Meredith M.; Charvat, Jacqueline; Sibonga, Jean; Sieker, Jeremy

2017-01-01

Despite evidence of bone loss during spaceflight and operational countermeasures to mitigate this loss, the subsequent risk of fracture among astronauts is not known. The physiologic process of diminished bone density and bone recovery during or following spaceflight is multifactorial. Such factors as age, sex, fracture history, and others may combine to increase fracture risk among astronauts. As part of the 2016 Bone Research and Clinical Advisory Panel (RCAP), the authors analyzed data collected on 338 NASA astronauts to describe the demographics, bone-relevant characteristics, and fracture history of the astronaut population. The majority of the population are male (n=286, 84.6%), have flown at least one mission (n=306, 90.5%), and were between the ages of 30 and 49 at first mission (n=296, 96.7% of those with at least one mission). Of the 338 astronauts, 241 (71.3%) experienced a fracture over the course of their lifetime. One hundred and five (43.5%) of these 241 astronauts only experienced a fracture prior to being selected into the Astronaut Corps, whereas 53 (22.0%) only experienced a fracture after selection as an astronaut. An additional 80 astronauts (33.2%) had both pre- and post-selection fractures. The remaining 3 astronauts had a fracture of unknown date, which could not be categorized as pre- or post-selection. Among the 133 astronauts with at least one post-selection fracture, males comprised 90.2% (n=120) compared to 84.5% of the entire Corps, and females accounted for 9.8% (n=13) compared to 15.4% of the Corps. Ninety-seven of the 133 astronauts with post-selection fractures (72.9%) had one fracture event, 22 (16.5%) had two fractures, and 14 (10.5%) had three or more fractures. Some astronauts with multiple fractures suffered these in a single event, such as an automobile accident. The 133 astronauts with a post-selection fracture accounted for a total of 188 fracture events. One hundred and four (78.2%) of astronauts with post-selection fractures experienced those fractures following their first mission (mean 12.7 +/- 11.1 years following first mission; range 14.0 days - 50.6 years). Additional analyses are ongoing and include examination of fracture history, skeletal site, mechanism, and type of fracture, age at time of fracture, time from spaceflight to fracture, as well as multivariable analysis comparing fracture events to non-events. The results of such analyses may reveal trends in risk factors for fracture among the astronaut corps that have yet to be systematically described through a corps-wide approach.

Hydraulic Fracture Extending into Network in Shale: Reviewing Influence Factors and Their Mechanism

PubMed Central

Ren, Lan; Zhao, Jinzhou; Hu, Yongquan

2014-01-01

Hydraulic fracture in shale reservoir presents complex network propagation, which has essential difference with traditional plane biwing fracture at forming mechanism. Based on the research results of experiments, field fracturing practice, theory analysis, and numerical simulation, the influence factors and their mechanism of hydraulic fracture extending into network in shale have been systematically analyzed and discussed. Research results show that the fracture propagation in shale reservoir is influenced by the geological and the engineering factors, which includes rock mineral composition, rock mechanical properties, horizontal stress field, natural fractures, treating net pressure, fracturing fluid viscosity, and fracturing scale. This study has important theoretical value and practical significance to understand fracture network propagation mechanism in shale reservoir and contributes to improving the science and efficiency of shale reservoir fracturing design. PMID:25032240

Prevalence and Cost of Subsequent Fractures Among U.S. Patients with an Incident Fracture.

PubMed

Weaver, Jessica; Sajjan, Shiva; Lewiecki, E Michael; Harris, Steven T; Marvos, Panagiotis

2017-04-01

The prevalence and cost of subsequent fractures among patients with an incident fracture are not well defined. To assess the prevalence of, and costs associated with, subsequent fractures in the year after an incident fracture. This was a retrospective claims database analysis using data from Humana Medicare Advantage claims (Medicare group) and Optum Insight Clinformatics Data Mart commercial claims (commercial group). Patients included in the study had a claim for a qualifying fracture occurring between January 2008 and December 2013 (index fracture), were continuously enrolled in the health plan for ≥ 1 year before and after the index fracture, and were aged ≥ 65 years in the Medicare group or ≥ 50 years in the commercial group at the time of the index fracture. Subsequent fractures were identified by ICD-9-CM codes and were defined as the second fracture occurring ≥ 3 to ≤ 12 months after the index fracture (≥ 6 to ≤ 12 months for fractures at the same site as the index fracture). Rates of subsequent fractures were calculated as the number of patients who had a subsequent fracture divided by the total sample size. After propensity matching of demographic and clinical variables, we determined the total medical and pharmacy costs accrued within 1 year of the index fracture by patients with and without a subsequent fracture. Health care costs were compared between patients with and without a subsequent fracture using McNemar's test. A total of 45,603 patients were included in the Medicare group, and 54,145 patients were included in the commercial group. In the Medicare group, 7,604 (16.7%) patients experienced a subsequent fracture. The proportion of patients with a subsequent fracture was highest among patients with multiple index fractures (26.2%, n = 905), followed by those with hip (25.5%, n = 1,280) and vertebral (20.2%, n = 1,908) index fractures. In the commercial group, 6,256 (11.6%) patients experienced a subsequent fracture. The proportion of patients with a subsequent fracture paralleled those observed in the Medicare group: 24.5% (n = 808) in patients with multiple index fractures, 22.0% (n = 525) in those with hip fracture, and 14.5% (n = 841) in those with vertebral fracture. For vertebral, hip, and nonhip nonvertebral fractures, subsequent fractures were most frequently of the same type as the index fracture. The mean total health care cost (sum of medical and pharmacy costs) in the year following the incident fracture for the Medicare group was $27,844 and differed significantly between patients with and without a subsequent fracture ($34,897 vs. $20,790; P < 0.001). The mean total health care cost in the year following the incident fracture for the commercial group was $29,316 and also differed significantly between patients with and without a subsequent fracture ($39,501 vs. $19,131; P < 0.001). Among patients with an incident fracture, those who experienced a subsequent fracture in the following year had significantly higher health care costs than those who did not. A subsequent fracture is most likely to be of the same type as the initial fracture. This study was funded by Merck & Co. Other than through the employer relationships disclosed here, Merck & Co did not have a role in the study design, data collection, interpretation of the data, in writing of the manuscript, or in the decision to submit the manuscript for publication. Weaver and Marvos are employees of Merck & Co. Sajjan was an employee of Merck & Co. and owned stock in the company at the time of the study. Lewiecki has received consulting and/or speaker honoraria from Merck, AbbVie, AgNovos Healthcare, Alexion Pharmaceuticals, Amgen, Eli Lilly and Company, Radius Health, Shire, and TheraNova. Lewiecki has received research grant support from Merck, Amgen, and Eli Lilly and Company and serves as a board member for the National Osteoporosis Foundation, the International Society for Clinical Densitometry, and the Osteoporosis Foundation of New Mexico. Harris has received consulting honoraria from Merck, Alexion Pharmaceuticals, Amgen, Eli Lilly and Company, Gilead Sciences, Primus Pharmaceuticals, and Radius Health. Study concept and design were contributed by Weave and Sajjan. Lewiecki collected the data, and data interpretation was performed by all the authors. The manuscript was written and revised by Weaver, Lewiecki, and Harris.

Microscopic Characterization of Tensile and Shear Fracturing in Progressive Failure in Marble

NASA Astrophysics Data System (ADS)

Cheng, Yi; Wong, Louis Ngai Yuen

2018-01-01

Compression-induced tensile and shear fractures were reported to be the two fundamental fracture types in rock fracturing tests. This study investigates such tensile and shear fracturing process in marble specimens containing two different flaw configurations. Observations first reveal that the development of a tensile fracture is distinct from shear fracture with respect to their nucleation, propagation, and eventual formation in macroscale. Second, transgranular cracks and grain-scale spallings become increasingly abundant in shear fractures as loading increases, which is almost not observed in tensile fractures. Third, one or some dominant extensional microcracks are commonly observed in the center of tensile fractures, while such development of microcracks is almost absent in shear fractures. Microcracks are generally of a length comparable to grain size and distribute uniformly within the damage zone of the shear fracture. Fourth, the width of densely damaged zone in the shear fracture is nearly 10 times of that in the tensile fracture. Quantitative measurement on microcrack density suggests that (1) microcrack density in tensile and shear fractures display distinct characteristics with increasing loading, (2) transgranular crack density in the shear fracture decreases logarithmically with the distance away from the shear fracture center, and (3) whatever the fracture type, the anisotropy can only be observed for transgranular cracks with a large density, which partially explains why microcrack anisotropy usually tends to be unobvious until approaching peak stress in specimens undergoing brittle failure. Microcracking characteristics observed in this work likely shed light to some phenomena and conclusions generalized in seismological studies.

An integrated structural and geochemical study of fracture aperture growth in the Campito Formation of eastern California

NASA Astrophysics Data System (ADS)

Doungkaew, N.; Eichhubl, P.

2015-12-01

Processes of fracture formation control flow of fluid in the subsurface and the mechanical properties of the brittle crust. Understanding of fundamental fracture growth mechanisms is essential for understanding fracture formation and cementation in chemically reactive systems with implications for seismic and aseismic fault and fracture processes, migration of hydrocarbons, long-term CO2 storage, and geothermal energy production. A recent study on crack-seal veins in deeply buried sandstone of east Texas provided evidence for non-linear fracture growth, which is indicated by non-elliptical kinematic fracture aperture profiles. We hypothesize that similar non-linear fracture growth also occurs in other geologic settings, including under higher temperature where solution-precipitation reactions are kinetically favored. To test this hypothesis, we investigate processes of fracture growth in quartzitic sandstone of the Campito Formation, eastern California, by combining field structural observations, thin section petrography, and fluid inclusion microthermometry. Fracture aperture profile measurements of cemented opening-mode fractures show both elliptical and non-elliptical kinematic aperture profiles. In general, fractures that contain fibrous crack-seal cement have elliptical aperture profiles. Fractures filled with blocky cement have linear aperture profiles. Elliptical fracture aperture profiles are consistent with linear-elastic or plastic fracture mechanics. Linear aperture profiles may reflect aperture growth controlled by solution-precipitation creep, with the aperture distribution controlled by solution-precipitation kinetics. We hypothesize that synkinematic crack-seal cement preserves the elliptical aperture profiles of elastic fracture opening increments. Blocky cement, on the other hand, may form postkinematically relative to fracture opening, with fracture opening accommodated by continuous solution-precipitation creep.

Rib fractures predict incident limb fractures: results from the European prospective osteoporosis study.

PubMed

Ismail, A A; Silman, A J; Reeve, J; Kaptoge, S; O'Neill, T W

2006-01-01

Population studies suggest that rib fractures are associated with a reduction in bone mass. While much is known about the predictive risk of hip, spine and distal forearm fracture on the risk of future fracture, little is known about the impact of rib fracture. The aim of this study was to determine whether a recalled history of rib fracture was associated with an increased risk of future limb fracture. Men and women aged 50 years and over were recruited from population registers in 31 European centres for participation in a screening survey of osteoporosis (European Prospective Osteoporosis Study). Subjects were invited to complete an interviewer-administered questionnaire that included questions about previous fractures including rib fracture, the age of their first fracture and also the level of trauma. Lateral spine radiographs were performed and the presence of vertebral deformity was determined morphometrically. Following the baseline survey, subjects were followed prospectively by annual postal questionnaire to determine the occurrence of clinical fractures. The subjects included 6,344 men, with a mean age of 64.2 years, and 6,788 women, with a mean age of 63.6 years, who were followed for a median of 3 years (range 0.4-5.9 years), of whom 135 men (2.3%) and 101 women (1.6%) reported a previous low trauma rib fracture. In total, 138 men and 391 women sustained a limb fracture during follow-up. In women, after age adjustment, those with a recalled history of low trauma rib fracture had an increased risk of sustaining 'any' limb fracture [relative hazard (RH)=2.3; 95% CI 1.3, 4.0]. When stratified by fracture type the predictive risk was more marked for hip (RH=7.7; 95% CI 2.3, 25.9) and humerus fracture (RH=4.5; 95% CI 1.4, 14.6) than other sites (RH=1.6; 95% CI 0.6, 4.3). Additional adjustment for prevalent vertebral deformity and previous (non-rib) low trauma fractures at other sites slightly reduced the strength of the association between rib fracture and subsequent limb fracture. In men, after age adjustment, there was a small though non-significant association between recalled history of rib fracture and future limb fracture. Our data highlight the importance of rib fracture as a marker of bone fragility in women.

Consequences of Fluid Lag in Three-Dimensional Hydraulic Fractures

NASA Astrophysics Data System (ADS)

Advani (Deceased), S. H.; Lee, T. S.; Dean, R. H.; Pak, C. K.; Avasthi, J. M.

1997-04-01

Research investigations on three-dimensional (3-D) rectangular hydraulic fracture configurations with varying degrees of fluid lag are reported. This paper demonstrates that a 3-D fracture model coupled with fluid lag (a small region of reduced pressure) at the fracture tip can predict very large excess pressure measurements for hydraulic fracture processes. Predictions of fracture propagation based on critical stress intensity factors are extremely sensitive to the pressure profile at the tip of a propagating fracture. This strong sensitivity to the pressure profile at the tip of a hydraulic fracture is more strongly pronounced in 3-D models versus 2-D models because 3-D fractures are clamped at the top and bottom, and pressures in the 3-D fractures that are far removed from the fracture tip have little effect on the stress intensity factor at the fracture tip. This rationale for the excess pressure mechanism is in marked contrast to the crack tip process damage zone assumptions and attendant high rock fracture toughness value hypotheses advanced in the literature. A comparison with field data is presented to illustrate the proposed fracture fluid pressure sensitivity phenomenon. This paper does not attempt to calculate the length of the fluid lag region in a propagating fracture but instead attempts to show that the pressure profile at the tip of the propagating fracture plays a major role in fracture propagation, and this role is magnified in 3-D models. Int. J. Numer. Anal. Meth. Geomech., vol. 21, 229-240 (1997).

[Study of incidence of osteoporotic fractures in a cohort of individuals older than 50 years from Asturias, Spain, after a 6 year follow-up period].

PubMed

Naves Díaz, M; Díaz López, J B; Gómez Alonso, C; Altadill Arregui, A; Rodríguez Rebollar, A; Cannata Andía, J B

2000-11-18

The present work, performed as follow-up of the prevalence study of vertebral fractures (EVOS Study), evaluates in a 6 year period the incidence of vertebral fractures and other osteoporotic fractures in Oviedo (Asturias, Spain) in people older than 50 years. The study was performed in a cohort from the Oviedo's local registry in 1986. 624 men and women were followed by 3 postal questionnaires. The first questionnaire referred to the history of falls and fractures that happened during the follow-up period performed. Between the 2nd and 3rd follow-up subjects were invited to repeat the X-rays previously performed in the initial study. The incidence of osteoporotic fractures was higher in women than in men. In both sexes, vertebral fracture was the one which reached the highest incidence. Compared with men, Colles' fracture in women occurred earlier, with 5 times higher incidence. The incidence of hip fracture was twice higher in women than in men. A prevalent vertebral fractures increased until 5 times the incidence of vertebral and hip fracture. Among the osteoporotic fractures, vertebral fracture had a highest incidence values in both sexes. Although vertebral and hip fractures were twice incident in women compared with men, the incidence of Colles fracture was five times higher in women. A pre-existing vertebral fracture is an important risk factor to develop a new vertebral or hip fracture.

Integration of fracturing dynamics and pressure transient analysis for hydraulic fracture evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arihara, N.; Abbaszadeh, M.; Wright, C.A.

This paper presents pre- and post-fracture pressure transient analysis, combined with net fracture pressure interpretation, for a well in a naturally fractured geothermal reservoir. Integrated analysis was performed to achieve a consistent interpretation of the created fracture geometry, propagation, conductivity, shrinkage, reservoir flow behavior, and formation permeability characteristics. The interpreted data includes two-rate pre-frac injection tests, step-rate injection tests, a series of pressure falloff tests, and the net fracturing pressure from a massive fracture treatment. Pressure transient analyses were performed utilizing advanced well test interpretation techniques and a thermal reservoir simulator with fracture propagation option. Hydraulic fracture propagation analysis wasmore » also performed Milt a generalized 3-D dynamic fracture growth model simulator. Three major conclusions resulted from the combined analysis: (1) that an increasing number of hydraulic fractures were being simultaneously propagated during the fracture treatment. (2) that the reservoir behaved as a composite reservoir Keith the outer region permeability being greater than the permeability of the region immediately surrounding the wellbore, and (3) that the created fractures extended into the outer region during the fracture treatment but retreated to the inner region several days after stimulation had ceased. These conclusions were apparent from independent pressure transient analysis and from independent hydraulic fracture propagation analysis. Integrated interpretation, however, increased the confidence in these conclusions and greatly aided the quantification of the created hydraulic fracture geometry and characterization of the reservoir permeability.« less

Second hip fractures at Chiang Mai University Hospital.

PubMed

Wongtriratanachai, Prasit; Chiewchantanakit, Siripong; Vaseenon, Tanawat; Rojanasthien, Sattaya; Leerapun, Taninnit

2015-02-01

Hip fractures are a major public health problem. Patients who have suffered a hip fracture have an increased risk of a subsequent hip fracture. This study examines the incidence ofsecondhip fractures and attempts to identify underlying risk factors. To examine the incidence ofsecond hip fractures in osteoporotic patients at Chiang Mai University Hospital and to identify risk factors related to second hip fractures. A retrospective review was conducted of all low-energy mechanism hip fracture patients admitted during 2008 and 2009. Analysis of second hip fractures was conducted using survival analysis and logistic regression analysis. A total of 191 patients were observed for 391.68 person-years (mean 2.05 person-years per patient). Among that group, nine second hip fractures were identified, an overall incidence rate of 0.023 second fractures per person-year. Second hip fractures tended to occur within the first year following an initial hip fracture. There were no significant differences related to either gender or comorbid medical conditions. Logistic regression analysis revealed that increased risk of a second hip fracture was associated with age (highest between 80 to 89 years) and patients who were not treated for osteoporosis following their initial fracture. The incidence of second hip fractures at Chiang Mai University Hospital was 0.023 per person-year Careful follow-up of older patients, especially those over 80, and treatment ofosteoporosis with bisphosphonate plus vitamin D and calcium supplements was correlated with a reduction in the incidence of second hip fractures.

Geographic and ethnic disparities in osteoporotic fractures.

PubMed

Cauley, Jane A; Chalhoub, Didier; Kassem, Ahmed M; Fuleihan, Ghada El-Hajj

2014-06-01

Osteoporotic fractures are a major worldwide epidemic. Here, we review global variability, ethnic differences and secular changes in osteoporotic fractures. Worldwide, age-standardized incidence rates of hip fracture vary >200-fold in women and >140-fold in men when comparing the country in which incidence rates are the highest with that in which they are the lowest. Median age-standardized rates are highest in North America and Europe, followed by Asia, Middle East, Oceania, Latin America and Africa. Globally, rates of hip fracture are greater in women than in men, with an average ratio of ∼2:1. The incidence of radiographic vertebral fractures is much higher than that of hip fractures, whereas the incidence rates of clinical vertebral fractures mirror hip fracture rates in most countries. Methodological challenges of defining and ascertaining vertebral fractures limit the interpretation of these data. Secular declines in hip fracture rates have been reported in populations from North America, Europe and Oceania. These declines are especially notable in women, suggesting that reproductive factors might contribute to this reduction. By contrast, hip fracture rates are increasing in parts of Asia and Latin America. Global indicators of health, education and socioeconomic status are positively correlated with fracture rates suggesting that lifestyles in developed countries might contribute to hip fracture. Improvements in fracture assessment, in particular for nonhip fractures, and identification of factors that contribute to this variability might substantially influence our understanding of osteoporotic fracture aetiology and provide new avenues for prevention.

Prior nonhip limb fracture predicts subsequent hip fracture in institutionalized elderly people.

PubMed

Nakamura, K; Takahashi, S; Oyama, M; Oshiki, R; Kobayashi, R; Saito, T; Yoshizawa, Y; Tsuchiya, Y

2010-08-01

This 1-year cohort study of nursing home residents revealed that historical fractures of upper limbs or nonhip lower limbs were associated with hip fracture (hazard ratio = 2.14), independent of activities of daily living (ADL), mobility, dementia, weight, and type of nursing home. Prior nonhip fractures are useful for predicting of hip fracture in institutional settings. The aim of this study was to evaluate the utility of fracture history for the prediction of hip fracture in nursing home residents. This was a cohort study with a 1-year follow-up. Subjects were 8,905 residents of nursing homes in Niigata, Japan (mean age, 84.3 years). Fracture histories were obtained from nursing home medical records. ADL levels were assessed by caregivers. Hip fracture diagnosis was based on hospital medical records. Subjects had fracture histories of upper limbs (5.0%), hip (14.0%), and nonhip lower limbs (4.6%). Among historical single fractures, only prior nonhip lower limbs significantly predicted subsequent fracture (adjusted hazard ratio, 2.43; 95% confidence interval (CI), 1.30-4.57). The stepwise method selected the best model, in which a combined historical fracture at upper limbs or nonhip lower limbs (adjusted hazard ratio, 2.14; 95% CI, 1.30-3.52), dependence, ADL levels, mobility, dementia, weight, and type of nursing home independently predicted subsequent hip fracture. A fracture history at upper or nonhip lower limbs, in combination with other known risk factors, is useful for the prediction of future hip fracture in institutional settings.

Fluid Production Induced Stress Analysis Surrounding an Elliptic Fracture

NASA Astrophysics Data System (ADS)

Pandit, Harshad Rajendra

Hydraulic fracturing is an effective technique used in well stimulation to increase petroleum well production. A combination of multi-stage hydraulic fracturing and horizontal drilling has led to the recent boom in shale gas production which has changed the energy landscape of North America. During the fracking process, highly pressurized mixture of water and proppants (sand and chemicals) is injected into to a crack, which fractures the surrounding rock structure and proppants help in keeping the fracture open. Over a longer period, however, these fractures tend to close due to the difference between the compressive stress exerted by the reservoir on the fracture and the fluid pressure inside the fracture. During production, fluid pressure inside the fracture is reduced further which can accelerate the closure of a fracture. In this thesis, we study the stress distribution around a hydraulic fracture caused by fluid production. It is shown that fluid flow can induce a very high hoop stress near the fracture tip. As the pressure gradient increases stress concentration increases. If a fracture is very thin, the flow induced stress along the fracture decreases, but the stress concentration at the fracture tip increases and become unbounded for an infinitely thin fracture. The result from the present study can be used for studying the fracture closure problem, and ultimately this in turn can lead to the development of better proppants so that prolific well production can be sustained for a long period of time.

Microfracture spacing distributions and the evolution of fracture patterns in sandstones

NASA Astrophysics Data System (ADS)

Hooker, J. N.; Laubach, S. E.; Marrett, R.

2018-03-01

Natural fracture patterns in sandstone were sampled using scanning electron microscope-based cathodoluminescence (SEM-CL) imaging. All fractures are opening-mode and are fully or partially sealed by quartz cement. Most sampled fractures are too small to be height-restricted by sedimentary layers. At very low strains (<∼0.001), fracture spatial distributions are indistinguishable from random, whereas at higher strains, fractures are generally statistically clustered. All 12 large (N > 100) datasets show spacings that are best fit by log-normal size distributions, compared to exponential, power law, or normal distributions. The clustering of fractures suggests that the locations of natural factures are not determined by a random process. To investigate natural fracture localization, we reconstructed the opening history of a cluster of fractures within the Huizachal Group in northeastern Mexico, using fluid inclusions from synkinematic cements and thermal-history constraints. The largest fracture, which is the only fracture in the cluster visible to the naked eye, among 101 present, opened relatively late in the sequence. This result suggests that the growth of sets of fractures is a self-organized process, in which small, initially isolated fractures grow and progressively interact, with preferential growth of a subset of fractures developing at the expense of growth of the rest. Size-dependent sealing of fractures within sets suggests that synkinematic cementation may contribute to fracture clustering.

Anatomical and Functional Recovery of Intracapsular Fractures of the Mandibular Condyle: Analysis of 124 Cases after Closed Treatment

PubMed Central

Lee, Jong-Sung; Jeon, Eun-Gyu; Seol, Guk-Jin; Choi, So-Young; Kim, Jin-Wook; Kwon, Tae-Geon; Paeng, Jun-Young

2014-01-01

Purpose: The purpose of this study is to evaluate the influence of intracapsular fracture lines of the mandibular condyle on the anatomical and functional recovery after non-surgical closed treatment. Methods: Clinical and radiological follow-up of 124 patients with intracapsular fractures of the mandibular condyle was performed after closed treatment between 2005 and 2012. The intracapsular fractures were classified into three categories: type A (medial condylar pole fracture), type B (lateral condylar pole fracture with loss of vertical height) and type M (multiple fragments or comminuted fracture). Results: By radiological finding, fracture types B and M lost up to 24% vertical height of the mandibular condyle compared to the height on the opposite side. In Type M, moderate to severe dysfunction was observed in 33% of the cases. Bilateral fractures were significantly associated with the risk of temporomandibular joint (TMJ) dysfunction in fracture types A and B. Bilateral fracture and TMJ dysfunction were not statistically significantly associated in type M fractures. Conclusion: Most of the mandibular intracapsular condylar fractures recovered acceptably after conservative non-surgical treatment with functional rehabilitation, even with some anatomical shortening of the condylar height. The poor functional recovery encountered in type M fractures, especially in cases with additional fracture sites and bilateral fractures, points up the limitation of closed treatment in such cases. PMID:27489844

Prior ankle fractures in postmenopausal women are associated with low areal bone mineral density and bone microstructure alterations.

PubMed

Biver, E; Durosier, C; Chevalley, T; Herrmann, F R; Ferrari, S; Rizzoli, R

2015-08-01

In a cross-sectional analysis in postmenopausal women, prior ankle fractures were associated with lower areal bone mineral density (BMD) and trabecular bone alterations compared to no fracture history. Compared to women with forearm fractures, microstructure alterations were of lower magnitude. These data suggest that ankle fractures are another manifestation of bone fragility. Whether ankle fractures represent fragility fractures associated with low areal bone mineral density (aBMD) and volumetric bone mineral density (vBMD) and/or bone microstructure alterations remains unclear, in contrast to the well-recognised association between forearm fractures and osteoporosis. The objective of this study was to investigate aBMD, vBMD and bone microstructure in postmenopausal women with prior ankle fracture in adulthood, compared with women without prior fracture or with women with prior forearm fractures, considered as typically of osteoporotic origin. In a cross-sectional analysis in the Geneva Retirees Cohort study, 63 women with ankle fracture and 59 with forearm fracture were compared to 433 women without fracture (mean age, 65 ± 1 years). aBMD was measured by dual-energy X-ray absorptiometry; distal radius and tibia vBMD and bone microstructure were measured by high-resolution peripheral quantitative computed tomography. Compared with women without fracture, those with ankle fractures had lower aBMD, radius vBMD (-7.9%), trabecular density (-10.7%), number (-7.3%) and thickness (-4.6%) and higher trabecular spacing (+14.5%) (P < 0.05 for all). Tibia trabecular variables were also altered. For 1 standard deviation decrease in total hip aBMD or radius trabecular density, odds ratios for ankle fractures were 2.2 and 1.6, respectively, vs 2.2 and 2.7 for forearm fracture, respectively (P ≤ 0.001 for all). Compared to women with forearm fractures, those with ankle fractures had similar spine and hip aBMD, but microstructure alterations of lower magnitude. Women with ankle fractures have lower aBMD and vBMD and trabecular bone alterations, suggesting that ankle fractures are another manifestation of bone fragility.

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial.

PubMed

Katzman, W B; Vittinghoff, E; Kado, D M; Lane, N E; Ensrud, K E; Shipp, K

2016-03-01

Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. We used data from the Fracture Intervention Trial among 3038 women 55-81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Mean baseline kyphosis was 48° (SD = 12) (range 7-83). At baseline, 962 (32%) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95% CI 2.8-4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22% increase (95% CI 8-38%, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8% per 10° kyphosis (95% CI -4 to 22%, p = 0.18). While greater kyphosis increased the rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture.

Thoracic kyphosis and rate of incident vertebral fractures: the Fracture Intervention Trial

PubMed Central

Vittinghoff, E.; Kado, D. M.; Lane, N. E.; Ensrud, K. E.; Shipp, K.

2016-01-01

Summary Biomechanical analyses support the theory that thoracic spine hyperkyphosis may increase risk of new vertebral fractures. While greater kyphosis was associated with an increased rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. Introduction Biomechanical analyses suggest hyperkyphosis may increase risk of incident vertebral fracture by increasing the load on vertebral bodies during daily activities. We propose to assess the association of kyphosis with incident radiographic vertebral fracture. Methods We used data from the Fracture Intervention Trial among 3038 women 55–81 years of age with low bone mineral density (BMD). Baseline kyphosis angle was measured using a Debrunner kyphometer. Vertebral fractures were assessed at baseline and follow-up from lateral radiographs of the thoracic and lumbar spine. We used Poisson models to estimate the independent association of kyphosis with incident fracture, controlling for age and femoral neck BMD. Results Mean baseline kyphosis was 48° (SD = 12) (range 7–83). At baseline, 962 (32 %) participants had a prevalent fracture. There were 221 incident fractures over a median of 4 years. At baseline, prevalent fracture was associated with 3.7° greater average kyphosis (95 % CI 2.8–4.6, p < 0.0005), adjusting for age and femoral neck BMD. Before adjusting for prevalent fracture, each 10° greater kyphosis was associated with 22 % increase (95 % CI 8–38 %, p = 0.001) in annualized rate of new radiographic vertebral fracture, adjusting for age and femoral neck BMD. After additional adjustment for prevalent fracture, estimated increased annualized rate was attenuated and no longer significant, 8 % per 10° kyphosis (95 % CI −4 to 22 %, p = 0.18). Conclusions While greater kyphosis increased the rate of incident vertebral fractures, our analysis does not show an independent association of kyphosis on incident fracture, after adjustment for prevalent vertebral fracture. Excessive kyphosis may still be a clinical marker for prevalent vertebral fracture. PMID:26782685

A Generic analytical solution for modelling pumping tests in wells intersecting fractures

NASA Astrophysics Data System (ADS)

Dewandel, Benoît; Lanini, Sandra; Lachassagne, Patrick; Maréchal, Jean-Christophe

2018-04-01

The behaviour of transient flow due to pumping in fractured rocks has been studied for at least the past 80 years. Analytical solutions were proposed for solving the issue of a well intersecting and pumping from one vertical, horizontal or inclined fracture in homogeneous aquifers, but their domain of application-even if covering various fracture geometries-was restricted to isotropic or anisotropic aquifers, whose potential boundaries had to be parallel or orthogonal to the fracture direction. The issue thus remains unsolved for many field cases. For example, a well intersecting and pumping a fracture in a multilayer or a dual-porosity aquifer, where intersected fractures are not necessarily parallel or orthogonal to aquifer boundaries, where several fractures with various orientations intersect the well, or the effect of pumping not only in fractures, but also in the aquifer through the screened interval of the well. Using a mathematical demonstration, we show that integrating the well-known Theis analytical solution (Theis, 1935) along the fracture axis is identical to the equally well-known analytical solution of Gringarten et al. (1974) for a uniform-flux fracture fully penetrating a homogeneous aquifer. This result implies that any existing line- or point-source solution can be used for implementing one or more discrete fractures that are intersected by the well. Several theoretical examples are presented and discussed: a single vertical fracture in a dual-porosity aquifer or in a multi-layer system (with a partially intersecting fracture); one and two inclined fractures in a leaky-aquifer system with pumping either only from the fracture(s), or also from the aquifer between fracture(s) in the screened interval of the well. For the cases with several pumping sources, analytical solutions of flowrate contribution from each individual source (fractures and well) are presented, and the drawdown behaviour according to the length of the pumped screened interval of the well is discussed. Other advantages of this proposed generic analytical solution are also given. The application of this solution to field data should provide additional field information on fracture geometry, as well as identifying the connectivity between the pumped fractures and other aquifers.

Developing a Fracture Model of the Granite Rocks Around the Research Tunnel at the Mizunami Underground Research Laboratory in Central Japan

NASA Astrophysics Data System (ADS)

Kalinina, E.; Hadgu, T.; Wang, Y.

2017-12-01

The Mizunami Underground Research Laboratory (MIU) is located in Tono area in Central Japan. It is operated by the Japan Atomic Energy Agency (JAEA) with the main purpose of providing scientific basis for the research and development of technologies needed for deep geological disposal of radioactive waste in fractured crystalline rocks. The current work is focused on the research and experiments in the tunnel located at 500 m depth. The data collected in the tunnel and exploratory boreholes were shared with the participants of the DEvelopment of COupled models and their VALidation against EXperiments (DECOVALEX), an international research and model comparison collaboration. This study describes the development of the fracture model representing granite rocks around the research tunnel. The model domain is 100x150x100m with the main experimental part of the tunnel, Closure Test Drift, located approximately in the center. The major input data were the fracture traces measured on the tunnel walls (total of 2,023 fractures), fractures observed in the horizontal borehole parallel to the tunnel, and the packer tests conducted in this borehole and one vertical borehole located within the modeling domain. 78 fractures (the ones with the inflow) in the tunnel were incorporated in the development of the fracture model. Fracture size was derived from the fracture trace analysis. It was shown that the fracture radius followed lognormal distributions. Fracture transmissivity was estimated from an analytical solution of inflow into the tunnel through an individual fracture and the total measured inflow into the tunnel. 16 fractures were incorporated in the model along the horizontal borehole. The packer test data in the different well intervals were used to estimate the range in fracture transmissivity. A relationship between the fracture transmissivity and fracture radius was developed. The fractures in the tunnel and borehole were used to derive fracture orientation and fracture intensity distributions. These distributions were used to generate stochastic fractures outside the tunnel and horizontal borehole. The fracture model was upscaled to an orthogonal continuum mesh with 1x1x1 m3 cell size using Oda's method.

The Effect of fluid buoyancy and fracture orientation on CaCO3 Formation in a Fracture

NASA Astrophysics Data System (ADS)

Xu, Z.; Li, Q.; Sheets, J.; Kneafsey, T. J.; Jun, Y. S.; Cole, D. R.; Pyrak-Nolte, L. J.

2016-12-01

Sealing fractures through mineral precipitation is a potential way for improving caprock integrity in subsurface reservoirs. We investigated the effect of buoyancy and fracture orientation on the amount and spatial distribution of calcium carbonate (CaCO3) precipitates in a fracture. To monitor mineral precipitation during reactive flow, transparent acrylic casts of an induced fracture in Austin chalk were used. To trigger CaCO3 precipitates, 1M CaCl2 with either 0.6M NaHCO3 solution (for surface adhering precipitation), or 0.3M Na2CO3 solution (for pore filling precipitation) were injected simultaneously into a saturated fracture. Experiments were performed with the fracture plane oriented either parallel or perpendicular to gravity. Acoustic wave transmission (compressional wave, 1 MHz) and optical imaging were used to monitor the sample prior to, during and after fluid injection. Complementary X-ray computed tomography was performed throughout the experiments on vertical fractures and post injection for the horizontal fractures. For the vertical fractures, the denser CaCl2 almost completely displaced the carbonate solution in the fracture and caused strong localization of the precipitates. The width of the precipitated region grew slowly over time. The horizontal fracture caused the less dense carbonate to flow over the CaCl2 solution thus resulting in more mixing and a more even distribution of precipitates throughout the fracture. The acoustic signatures depended on the type of precipitation that occurred. For pore filling experiments, the compressional wave amplitude increased by 5-20% and the velocity increased for both the vertical and horizontal fractures. However, the acoustic responses differed between the vertical and horizontal fractures for surface adhering experiments. Based on the acoustic response, surface adhering precipitation increased fracture specific stiffness more in the horizontal fracture than in the vertical fracture. The horizontal fracture enabled more mixing of the two solutions within the fracture than the vertical fracture. This work was supported by the Center for Nanoscale Controls on Geologic CO (NCGC), an Energy Frontier Research Center funded by the U.S. Department of Energy, Office of Science, Basic Energy Sciences under Award # DE-AC02-05CH11231

Proximal femoral fractures.

PubMed

Webb, Lawrence X

2002-01-01

Fractures of the proximal femur include fractures of the head, neck, intertrochanteric, and subtrochanteric regions. Head fractures commonly accompany dislocations. Neck fractures and intertrochanteric fractures occur with greatest frequency in elderly patients with a low bone mineral density and are produced by low-energy mechanisms. Subtrochanteric fractures occur in a predominantly strong cortical osseous region which is exposed to large compressive stresses. Implants used to address these fractures must be able to accommodate significant loads while the fractures consolidate. Complications secondary to these injuries produce significant morbidity and include infection, nonunion, malunion, decubitus ulcers, fat emboli, deep venous thrombosis, pulmonary embolus, pneumonia, myocardial infarction, stroke, and death.

Theoretical Analysis of the Mechanism of Fracture Network Propagation with Stimulated Reservoir Volume (SRV) Fracturing in Tight Oil Reservoirs.

PubMed

Su, Yuliang; Ren, Long; Meng, Fankun; Xu, Chen; Wang, Wendong

2015-01-01

Stimulated reservoir volume (SRV) fracturing in tight oil reservoirs often induces complex fracture-network growth, which has a fundamentally different formation mechanism from traditional planar bi-winged fracturing. To reveal the mechanism of fracture network propagation, this paper employs a modified displacement discontinuity method (DDM), mechanical mechanism analysis and initiation and propagation criteria for the theoretical model of fracture network propagation and its derivation. A reasonable solution of the theoretical model for a tight oil reservoir is obtained and verified by a numerical discrete method. Through theoretical calculation and computer programming, the variation rules of formation stress fields, hydraulic fracture propagation patterns (FPP) and branch fracture propagation angles and pressures are analyzed. The results show that during the process of fracture propagation, the initial orientation of the principal stress deflects, and the stress fields at the fracture tips change dramatically in the region surrounding the fracture. Whether the ideal fracture network can be produced depends on the geological conditions and on the engineering treatments. This study has both theoretical significance and practical application value by contributing to a better understanding of fracture network propagation mechanisms in unconventional oil/gas reservoirs and to the improvement of the science and design efficiency of reservoir fracturing.

Antebrachial fractures in four captive polar bears (Ursus maritimus).

PubMed

Lin, Rebecca C; Engeli, Emmanuel; Prowten, Allan W; Erb, Hollis N; Ducharme, Norm G; Goodrich, Laurie R

2005-01-01

To identify common risk factors for antebrachial fractures of captive polar bears and to evaluate outcome after fracture repair. Retrospective study. Four captive polar bears. United States zoological collections were surveyed to determine the prevalence of fractures in captive polar bears. Medical records of captive polar bears that had antebrachial fractures were reviewed for signalment, history, physical and radiographic findings, fracture management, postoperative care, and outcome. Serum samples from healthy bears and bears with antebrachial fractures were assayed for 25-hydroxyvitamin D (25-OHD) concentrations. Nineteen fractures (12 polar bears) occurred from 1974 to 2002; 12 fractures involved the antebrachium. Management of 4 antebrachial fractures was reviewed; 3 were repaired by internal fixation and 1 by external coaptation. Fractures healed and bears were returned to exhibit on average 3 months postfracture. Of 11 serum samples assayed for 25-OHD concentrations, 6 were below normal, 1 was low normal and 4 were within normal reference intervals. The 7 bears with subnormal or low normal values were housed in 2 zoos. Subnormal vitamin D concentrations were identified in 2 of 3 bears with fractures. Fracture disease is not uncommon in captive polar bears. Additional research is necessary to explore the role of nutrition in polar bear fracture disease. Internal fixation of antebrachial fractures is feasible and reasonably well tolerated in captive polar bears.

Simulating Fragmentation and Fluid-Induced Fracture in Disordered Media Using Random Finite-Element Meshes

DOE PAGES

Bishop, Joseph E.; Martinez, Mario J.; Newell, Pania

2016-11-08

Fracture and fragmentation are extremely nonlinear multiscale processes in which microscale damage mechanisms emerge at the macroscale as new fracture surfaces. Numerous numerical methods have been developed for simulating fracture initiation, propagation, and coalescence. In this paper, we present a computational approach for modeling pervasive fracture in quasi-brittle materials based on random close-packed Voronoi tessellations. Each Voronoi cell is formulated as a polyhedral finite element containing an arbitrary number of vertices and faces. Fracture surfaces are allowed to nucleate only at the intercell faces. Cohesive softening tractions are applied to new fracture surfaces in order to model the energy dissipatedmore » during fracture growth. The randomly seeded Voronoi cells provide a regularized discrete random network for representing fracture surfaces. The potential crack paths within the random network are viewed as instances of realizable crack paths within the continuum material. Mesh convergence of fracture simulations is viewed in a weak, or distributional, sense. The explicit facet representation of fractures within this approach is advantageous for modeling contact on new fracture surfaces and fluid flow within the evolving fracture network. Finally, applications of interest include fracture and fragmentation in quasi-brittle materials and geomechanical applications such as hydraulic fracturing, engineered geothermal systems, compressed-air energy storage, and carbon sequestration.« less

Simulating Fragmentation and Fluid-Induced Fracture in Disordered Media Using Random Finite-Element Meshes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bishop, Joseph E.; Martinez, Mario J.; Newell, Pania

Fracture and fragmentation are extremely nonlinear multiscale processes in which microscale damage mechanisms emerge at the macroscale as new fracture surfaces. Numerous numerical methods have been developed for simulating fracture initiation, propagation, and coalescence. In this paper, we present a computational approach for modeling pervasive fracture in quasi-brittle materials based on random close-packed Voronoi tessellations. Each Voronoi cell is formulated as a polyhedral finite element containing an arbitrary number of vertices and faces. Fracture surfaces are allowed to nucleate only at the intercell faces. Cohesive softening tractions are applied to new fracture surfaces in order to model the energy dissipatedmore » during fracture growth. The randomly seeded Voronoi cells provide a regularized discrete random network for representing fracture surfaces. The potential crack paths within the random network are viewed as instances of realizable crack paths within the continuum material. Mesh convergence of fracture simulations is viewed in a weak, or distributional, sense. The explicit facet representation of fractures within this approach is advantageous for modeling contact on new fracture surfaces and fluid flow within the evolving fracture network. Finally, applications of interest include fracture and fragmentation in quasi-brittle materials and geomechanical applications such as hydraulic fracturing, engineered geothermal systems, compressed-air energy storage, and carbon sequestration.« less

Theoretical Analysis of the Mechanism of Fracture Network Propagation with Stimulated Reservoir Volume (SRV) Fracturing in Tight Oil Reservoirs

PubMed Central

Su, Yuliang; Ren, Long; Meng, Fankun; Xu, Chen; Wang, Wendong

2015-01-01

Stimulated reservoir volume (SRV) fracturing in tight oil reservoirs often induces complex fracture-network growth, which has a fundamentally different formation mechanism from traditional planar bi-winged fracturing. To reveal the mechanism of fracture network propagation, this paper employs a modified displacement discontinuity method (DDM), mechanical mechanism analysis and initiation and propagation criteria for the theoretical model of fracture network propagation and its derivation. A reasonable solution of the theoretical model for a tight oil reservoir is obtained and verified by a numerical discrete method. Through theoretical calculation and computer programming, the variation rules of formation stress fields, hydraulic fracture propagation patterns (FPP) and branch fracture propagation angles and pressures are analyzed. The results show that during the process of fracture propagation, the initial orientation of the principal stress deflects, and the stress fields at the fracture tips change dramatically in the region surrounding the fracture. Whether the ideal fracture network can be produced depends on the geological conditions and on the engineering treatments. This study has both theoretical significance and practical application value by contributing to a better understanding of fracture network propagation mechanisms in unconventional oil/gas reservoirs and to the improvement of the science and design efficiency of reservoir fracturing. PMID:25966285

Sacral Fractures and Associated Injuries

PubMed Central

Kurd, Mark F.; Schroeder, Gregory D.; Kepler, Christopher K.; Krieg, James C.; Holstein, Jörg H.; Bellabarba, Carlo; Firoozabadi, Reza; Oner, F. Cumhur; Kandziora, Frank; Dvorak, Marcel F.; Kleweno, Conor P.; Vialle, Luiz R.; Rajasekaran, S.; Schnake, Klause J.; Vaccaro, Alexander R.

2017-01-01

Study Design: Literature review. Objective: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome. Methods: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures. Results: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated. Only 5% of sacral fractures occur in isolation. Injuries most often associated with sacral fractures include neurologic injuries (present in up to 50% of sacral fractures), pelvic ring disruptions, hip and lumbar spine fractures, active pelvic/ abdominal bleeding and the presence of an open fracture or significant soft tissue injury. Diagnosis of pelvic ring fractures and fractures extending to the lumbar spine are key factors for the appropriate management of sacral fractures. Importantly, associated systemic (cranial, thoracic, and abdominopelvic) or musculoskeletal injuries should be promptly assessed and addressed. These associated injuries often dictate the management and eventual outcome of sacral fractures and, therefore, any treatment algorithm should take them into consideration. Conclusions: Sacral fractures are complex in nature and often associated with other often-missed injuries. This review summarizes the most relevant associated injuries in sacral fractures and discusses on their appropriate management. PMID:28989838

Toughness-Dominated Regime of Hydraulic Fracturing in Cohesionless Materials

NASA Astrophysics Data System (ADS)

Germanovich, L. N.; Hurt, R. S.; Ayoub, J.; Norman, W. D.

2011-12-01

This work examines the mechanisms of hydraulic fracturing in cohesionless particulate materials with geotechnical, geological, and petroleum applications. For this purpose, experimental techniques have been developed, and used to quantify the initiation and propagation of hydraulic fractures in saturated particulate materials. The fracturing liquid is injected into particulate materials, which are practically cohesionless. The liquid flow is localized in thin self-propagating crack-like conduits. By analogy we call them 'cracks' or 'hydraulic fractures.' When a fracture propagates in a solid, new surfaces are created by breaking material bonds. Consequently, the material is in tension at the fracture tip. Because the particulate material is already 'fractured,' no new surface is created and no fracturing process per se is involved. Therefore, the conventional fracture mechanics principles cannot be directly applied. Based on the laboratory observations, performed on three particulate materials (Georgia Red Clay, silica flour, and fine sand, and their mixtures), this work offers physical concepts to explain the observed phenomena. The goal is to determine the controlling parameters of fracture behavior and to quantify their effects. An important conclusion of our work is that all parts of the cohesionless particulate material (including the tip zone of hydraulic fracture) are likely to be in compression. The compressive stress state is an important characteristic of hydraulic fracturing in particulate materials with low, or no, cohesion (such as were used in our experiments). At present, two kinematic mechanisms of fracture propagation, consistent with the compressive stress regime, can be offered. The first mechanism is based on shear bands propagating ahead of the tip of an open fracture. The second is based on the tensile strain ahead of the fracture tip and reduction of the effective stresses to zero within the leak-off zone. Scaling indicates that in our experiments, there is a high pressure gradient in the leak-off zone in the direction normal to the fracture. Fluid pressure does not decrease considerably along the fracture, however, due to the relatively wide fracture aperture. This suggests that hydraulically induced fractures in unconsolidated materials may be considered to be within the toughness-dominated regime of hydraulic fracturing. Our results indicate that the primary influence on peak or initiation pressure comes from the remote stresses. However, fracture morphology changes significantly with other chosen parameters (stress, flow rate, rheology and permeability). Additionally, an important characteristic feature of fractures in our experiments is the frequent bluntness of the fracture tip, which suggests that plastic deformation at the fracture tip is important. Modeling shows that large openings at the fracture tip correspond to relatively large 'effective' fracture (surface) energy, which can be orders of magnitude greater than for typical (solid) rocks.

Structural-Diagenetic Controls on Fracture Opening in Tight Gas Sandstone Reservoirs, Alberta Foothills

NASA Astrophysics Data System (ADS)

Ukar, Estibalitz; Eichhubl, Peter; Fall, Andras; Hooker, John

2013-04-01

In tight gas reservoirs, understanding the characteristics, orientation and distribution of natural open fractures, and how these relate to the structural and stratigraphic setting are important for exploration and production. Outcrops provide the opportunity to sample fracture characteristics that would otherwise be unknown due to the limitations of sampling by cores and well logs. However, fractures in exhumed outcrops may not be representative of fractures in the reservoir because of differences in burial and exhumation history. Appropriate outcrop analogs of producing reservoirs with comparable geologic history, structural setting, fracture networks, and diagenetic attributes are desirable but rare. The Jurassic to Lower Cretaceous Nikanassin Formation from the Alberta Foothills produces gas at commercial rates where it contains a network of open fractures. Fractures from outcrops have the same diagenetic attributes as those observed in cores <100 km away, thus offering an ideal opportunity to 1) evaluate the distribution and characteristics of opening mode fractures relative to fold cores, hinges and limbs, 2) compare the distribution and attributes of fractures in outcrop vs. core samples, 3) estimate the timing of fracture formation relative to the evolution of the fold-and-thrust belt, and 4) estimate the degradation of fracture porosity due to postkinematic cementation. Cathodoluminescence images of cemented fractures in both outcrop and core samples reveal several generations of quartz and ankerite cement that is synkinematic and postkinematic relative to fracture opening. Crack-seal textures in synkinematic quartz are ubiquitous, and well-developed cement bridges abundant. Fracture porosity may be preserved in fractures wider than ~100 microns. 1-D scanlines in outcrop and core samples indicate fractures are most abundant within small parasitic folds within larger, tight, mesoscopic folds. Fracture intensity is lower away from parasitic folds; intensity progressively decreases from the faulted cores of mesoscopic folds to their forelimbs, with lowest intensities within relatively undeformed backlimb strata. Fracture apertures locally increase adjacent to reverse faults without an overall increase in fracture frequency. Fluid inclusion analyses of crack-seal quartz cement indicate both aqueous and methane-rich inclusions are present. Homogenization temperatures of two-phase inclusions indicate synkinematic fracture cement precipitation and fracture opening under conditions at or near maximum burial of 190-210°C in core samples, and 120-160°C in outcrop samples. In comparison with the fracture evolution in other, less deformed tight-gas sandstone reservoirs such as the Piceance and East Texas basins where fracture opening is primarily controlled by gas generation, gas charge, and pore fluid pressure, these results suggest a strong control of regional tectonic processes on fracture generation. In conjunction with timing and rate of gas charge, rates of fracture cement growth, and stratigraphic-lithological controls, these processes determine the overall distribution of open fractures in these reservoirs.

Structural-Diagenetic Controls on Fracture Opening in Tight Gas Sandstone Reservoirs, Alberta Foothills

NASA Astrophysics Data System (ADS)

Ukar, E.; Eichhubl, P.; Fall, A.; Hooker, J. N.

2012-12-01

In tight gas reservoirs, understanding the characteristics, orientation and distribution of natural open fractures, and how these relate to the structural and stratigraphic setting are important for exploration and production. Outcrops provide the opportunity to sample fracture characteristics that would otherwise be unknown due to the limitations of sampling by cores and well logs. However, fractures in exhumed outcrops may not be representative of fractures in the reservoir because of differences in burial and exhumation history. Appropriate outcrop analogs of producing reservoirs with comparable geologic history, structural setting, fracture networks, and diagenetic attributes are desirable but rare. The Jurassic to Lower Cretaceous Nikanassin Formation from the Alberta Foothills produces gas at commercial rates where it contains a network of open fractures. Fractures from outcrops have the same diagenetic attributes as those observed in cores <100 km away, thus offering an ideal opportunity to 1) evaluate the distribution and characteristics of opening mode fractures relative to fold cores, hinges and limbs, 2) compare the distribution and attributes of fractures in outcrop vs. core samples, 3) estimate the timing of fracture formation relative to the evolution of the fold-and-thrust belt, and 4) estimate the degradation of fracture porosity due to postkinematic cementation. Cathodoluminescence images of cemented fractures in both outcrop and core samples reveal several generations of quartz and ankerite cement that is synkinematic and postkinematic relative to fracture opening. Crack-seal textures in synkinematic quartz are ubiquitous, and well-developed cement bridges abundant. Fracture porosity may be preserved in fractures wider than ~100 microns. 1-D scanlines in outcrop and core samples indicate fractures are most abundant within small parasitic folds within larger, tight, mesoscopic folds. Fracture intensity is lower away from parasitic folds; intensity progressively decreases from the faulted cores of mesoscopic folds to their forelimbs, with lowest intensities within relatively undeformed backlimb strata. Fracture apertures locally increase adjacent to reverse faults without an overall increase in fracture frequency. Fluid inclusion analyses of crack-seal quartz cement indicate both aqueous and methane-rich inclusions are present. Homogenization temperatures of two-phase inclusions indicate synkinematic fracture cement precipitation and fracture opening under conditions at or near maximum burial of 190-210°C in core samples, and 120-160°C in outcrop samples. In comparison with the fracture evolution in other, less deformed tight-gas sandstone reservoirs such as the Piceance and East Texas basins where fracture opening is primarily controlled by gas generation, gas charge, and pore fluid pressure, these results suggest a strong control of regional tectonic processes on fracture generation. In conjunction with timing and rate of gas charge, rates of fracture cement growth, and stratigraphic-lithological controls, these processes determine the overall distribution of open fractures in these reservoirs.

Skull fracture

MedlinePlus

Basilar skull fracture; Depressed skull fracture; Linear skull fracture ... Skull fractures may occur with head injuries . The skull provides good protection for the brain. However, a severe impact ...

Coupling Hydraulic Fracturing Propagation and Gas Well Performance for Simulation of Production in Unconventional Shale Gas Reservoirs

NASA Astrophysics Data System (ADS)

Wang, C.; Winterfeld, P. H.; Wu, Y. S.; Wang, Y.; Chen, D.; Yin, C.; Pan, Z.

2014-12-01

Hydraulic fracturing combined with horizontal drilling has made it possible to economically produce natural gas from unconventional shale gas reservoirs. An efficient methodology for evaluating hydraulic fracturing operation parameters, such as fluid and proppant properties, injection rates, and wellhead pressure, is essential for the evaluation and efficient design of these processes. Traditional numerical evaluation and optimization approaches are usually based on simulated fracture properties such as the fracture area. In our opinion, a methodology based on simulated production data is better, because production is the goal of hydraulic fracturing and we can calibrate this approach with production data that is already known. This numerical methodology requires a fully-coupled hydraulic fracture propagation and multi-phase flow model. In this paper, we present a general fully-coupled numerical framework to simulate hydraulic fracturing and post-fracture gas well performance. This three-dimensional, multi-phase simulator focuses on: (1) fracture width increase and fracture propagation that occurs as slurry is injected into the fracture, (2) erosion caused by fracture fluids and leakoff, (3) proppant subsidence and flowback, and (4) multi-phase fluid flow through various-scaled anisotropic natural and man-made fractures. Mathematical and numerical details on how to fully couple the fracture propagation and fluid flow parts are discussed. Hydraulic fracturing and production operation parameters, and properties of the reservoir, fluids, and proppants, are taken into account. The well may be horizontal, vertical, or deviated, as well as open-hole or cemented. The simulator is verified based on benchmarks from the literature and we show its application by simulating fracture network (hydraulic and natural fractures) propagation and production data history matching of a field in China. We also conduct a series of real-data modeling studies with different combinations of hydraulic fracturing parameters and present the methodology to design these operations with feedback of simulated production data. The unified model aids in the optimization of hydraulic fracturing design, operations, and production.

A comparison of bone density and bone morphology between patients presenting with hip fractures, spinal fractures or a combination of the two

PubMed Central

2013-01-01

Background Currently it is uncertain how to define osteoporosis and who to treat after a hip fracture. There is little to support the universal treatment of all such patients but how to select those most in need of treatment is not clear. In this study we have compared cortical and trabecular bone status between patients with spinal fractures and those with hip fracture with or without spinal fracture with the aim to begin to identify, by a simple clinical method (spine x-ray), a group of hip fracture patients likely to be more responsive to treatment with current antiresorptive agents. Methods Comparison of convenience samples of three groups of 50 patients, one with spinal fractures, one with a hip fracture, and one with both. Measurements consist of bone mineral density at the lumbar spine, at the four standard hip sites, number, distribution and severity of spinal fractures by the method of Genant, cortical bone thickness at the infero-medial femoral neck site, femoral neck and axis length and femoral neck width. Results Patients with spinal fractures alone have the most deficient bones at both trabecular and cortical sites: those with hip fracture and no spinal fractures the best at trabecular bone and most cortical bone sites: and those with both hip and spinal fractures intermediate in most measurements. Hip axis length and neck width did not differ between groups. Conclusion The presence of the spinal fracture indicates poor trabecular bone status in hip fracture patients. Hip fracture patients without spinal fractures have a bone mass similar to the reference range for their age and gender. Poor trabecular bone in hip fracture patients may point to a category of patient more likely to benefit from therapy and may be indicated by the presence of spinal fractures. PMID:23432767

Discrete fracture modeling of multiphase flow and hydrocarbon production in fractured shale or low permeability reservoirs

NASA Astrophysics Data System (ADS)

Hao, Y.; Settgast, R. R.; Fu, P.; Tompson, A. F. B.; Morris, J.; Ryerson, F. J.

2016-12-01

It has long been recognized that multiphase flow and transport in fractured porous media is very important for various subsurface applications. Hydrocarbon fluid flow and production from hydraulically fractured shale reservoirs is an important and complicated example of multiphase flow in fractured formations. The combination of horizontal drilling and hydraulic fracturing is able to create extensive fracture networks in low permeability shale rocks, leading to increased formation permeability and enhanced hydrocarbon production. However, unconventional wells experience a much faster production decline than conventional hydrocarbon recovery. Maintaining sustainable and economically viable shale gas/oil production requires additional wells and re-fracturing. Excessive fracturing fluid loss during hydraulic fracturing operations may also drive up operation costs and raise potential environmental concerns. Understanding and modeling processes that contribute to decreasing productivity and fracturing fluid loss represent a critical component for unconventional hydrocarbon recovery analysis. Towards this effort we develop a discrete fracture model (DFM) in GEOS (LLNL multi-physics computational code) to simulate multiphase flow and transfer in hydraulically fractured reservoirs. The DFM model is able to explicitly account for both individual fractures and their surrounding rocks, therefore allowing for an accurate prediction of impacts of fracture-matrix interactions on hydrocarbon production. We apply the DFM model to simulate three-phase (water, oil, and gas) flow behaviors in fractured shale rocks as a result of different hydraulic stimulation scenarios. Numerical results show that multiphase flow behaviors at the fracture-matrix interface play a major role in controlling both hydrocarbon production and fracturing fluid recovery rates. The DFM model developed in this study will be coupled with the existing hydro-fracture model to provide a fully integrated geomechanical and reservoir simulation capability for an accurate prediction and assessment of hydrocarbon production and hydraulic fracturing performance. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

Mechanical stratigraphic controls on natural fracture spacing and penetration

NASA Astrophysics Data System (ADS)

McGinnis, Ronald N.; Ferrill, David A.; Morris, Alan P.; Smart, Kevin J.; Lehrmann, Daniel

2017-02-01

Fine-grained low permeability sedimentary rocks, such as shale and mudrock, have drawn attention as unconventional hydrocarbon reservoirs. Fracturing - both natural and induced - is extremely important for increasing permeability in otherwise low-permeability rock. We analyze natural extension fracture networks within a complete measured outcrop section of the Ernst Member of the Boquillas Formation in Big Bend National Park, west Texas. Results of bed-center, dip-parallel scanline surveys demonstrate nearly identical fracture strikes and slight variation in dip between mudrock, chalk, and limestone beds. Fracture spacing tends to increase proportional to bed thickness in limestone and chalk beds; however, dramatic differences in fracture spacing are observed in mudrock. A direct relationship is observed between fracture spacing/thickness ratio and rock competence. Vertical fracture penetrations measured from the middle of chalk and limestone beds generally extend to and often beyond bed boundaries into the vertically adjacent mudrock beds. In contrast, fractures in the mudrock beds rarely penetrate beyond the bed boundaries into the adjacent carbonate beds. Consequently, natural bed-perpendicular fracture connectivity through the mechanically layered sequence generally is poor. Fracture connectivity strongly influences permeability architecture, and fracture prediction should consider thin bed-scale control on fracture heights and the strong lithologic control on fracture spacing.

Is there a specific fracture ‘cascade'?

PubMed Central

Melton, L Joseph; Amin, Shreyasee

2013-01-01

Different kinds of epidemiologic data provide varying views of the relationships among the main osteoporotic fractures. Descriptive incidence data indicate that distal forearm fractures typically occur earlier than vertebral fractures that, in turn, precede hip fractures late in life. In addition, relative risk estimates document the fact that one osteoporotic fracture increases the risk of subsequent ones. These two observations support the notion of a ‘fracture cascade' and justify the recent emphasis on secondary prevention, that is, more aggressive treatment of patients presenting with a fracture in order to prevent recurrences. However, the absolute risk of a subsequent fracture given an initial one is modest, and the degree to which the second fracture can be attributed to the first one is unclear. Moreover, the osteoporotic fractures encountered in the majority of patients are the first one experienced, and even these initial fractures lead to substantial morbidity and cost. These latter points reemphasize the importance of primary prevention, that is, the management of bone loss and other risk factors to prevent the first fracture. Continued efforts are needed to refine risk assessment algorithms so that candidates for such fracture prophylaxis can be identified more accurately and efficiently. PMID:24575296

Modeling of Propagation of Interacting Cracks Under Hydraulic Pressure Gradient

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Hai; Mattson, Earl Douglas; Podgorney, Robert Karl

A robust and reliable numerical model for fracture initiation and propagation, which includes the interactions among propagating fractures and the coupling between deformation, fracturing and fluid flow in fracture apertures and in the permeable rock matrix, would be an important tool for developing a better understanding of fracturing behaviors of crystalline brittle rocks driven by thermal and (or) hydraulic pressure gradients. In this paper, we present a physics-based hydraulic fracturing simulator based on coupling a quasi-static discrete element model (DEM) for deformation and fracturing with conjugate lattice network flow model for fluid flow in both fractures and porous matrix. Fracturingmore » is represented explicitly by removing broken bonds from the network to represent microcracks. Initiation of new microfractures and growth and coalescence of the microcracks leads to the formation of macroscopic fractures when external and/or internal loads are applied. The coupled DEM-network flow model reproduces realistic growth pattern of hydraulic fractures. In particular, simulation results of perforated horizontal wellbore clearly demonstrate that elastic interactions among multiple propagating fractures, fluid viscosity, strong coupling between fluid pressure fluctuations within fractures and fracturing, and lower length scale heterogeneities, collectively lead to complicated fracturing patterns.« less

Numerical simulation and fracture identification of dual laterolog in organic shale

NASA Astrophysics Data System (ADS)

Maojin, Tan; Peng, Wang; Qiong, Liu

2012-09-01

Fracture is one of important spaces in shale oil and shale gas reservoirs, and fractures identification and evaluation are an important part in organic shale interpretation. According to the fractured shale gas reservoir, a physical model is set up to study the dual laterolog logging responses. First, based on the principle of dual laterolog, three-dimensional finite element method (FEM) is used to simulate the dual laterolog responses in various formation models with different fractures widths, different fracture numbers, different fractures inclination angle. All the results are extremely important for the fracture identification and evaluation in shale reservoirs. Appointing to different base rock resistivity models, the fracture models are constructed respectively through a number of numerical simulation, and the fracture porosity can be calculated by solving the corresponding formulas. A case study about organic shale formation is analyst and discussed, and the fracture porosity is calculated from dual laterolog. The fracture evaluation results are also be validated right by Full borehole Micro-resistivity Imaging (FMI). So, in case of the absence of borehole resistivity imaging log, the dual laterolog resistivity can be used to estimate the fracture development.

Relationships between fractures

NASA Astrophysics Data System (ADS)

Peacock, D. C. P.; Sanderson, D. J.; Rotevatn, A.

2018-01-01

Fracture systems comprise many fractures that may be grouped into sets based on their orientation, type and relative age. The fractures are often arranged in a network that involves fracture branches that interact with one another. Interacting fractures are termed geometrically coupled when they share an intersection line and/or kinematically coupled when the displacements, stresses and strains of one fracture influences those of the other. Fracture interactions are characterised in terms of the following. 1) Fracture type: for example, whether they have opening (e.g., joints, veins, dykes), closing (stylolites, compaction bands), shearing (e.g., faults, deformation bands) or mixed-mode displacements. 2) Geometry (e.g., relative orientations) and topology (the arrangement of the fractures, including their connectivity). 3) Chronology: the relative ages of the fractures. 4) Kinematics: the displacement distributions of the interacting fractures. It is also suggested that interaction can be characterised in terms of mechanics, e.g., the effects of the interaction on the stress field. It is insufficient to describe only the components of a fracture network, with fuller understanding coming from determining the interactions between the different components of the network.

An Equivalent Fracture Modeling Method

NASA Astrophysics Data System (ADS)

Li, Shaohua; Zhang, Shujuan; Yu, Gaoming; Xu, Aiyun

2017-12-01

3D fracture network model is built based on discrete fracture surfaces, which are simulated based on fracture length, dip, aperture, height and so on. The interesting area of Wumishan Formation of Renqiu buried hill reservoir is about 57 square kilometer and the thickness of target strata is more than 2000 meters. In addition with great fracture density, the fracture simulation and upscaling of discrete fracture network model of Wumishan Formation are very intense computing. In order to solve this problem, a method of equivalent fracture modeling is proposed. First of all, taking the fracture interpretation data obtained from imaging logging and conventional logging as the basic data, establish the reservoir level model, and then under the constraint of reservoir level model, take fault distance analysis model as the second variable, establish fracture density model by Sequential Gaussian Simulation method. Increasing the width, height and length of fracture, at the same time decreasing its density in order to keep the similar porosity and permeability after upscaling discrete fracture network model. In this way, the fracture model of whole interesting area can be built within an accepted time.

Description and analysis of cored hydraulic fractures -- Lost Hills field, Kern County, California

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fast, R.E.; Murer, A.S.; Timmer, R.S.

1994-05-01

An inclined observation well was drilled in shallow (2,000 ft) Opal-A diatomite. Seven sand-propped hydraulic fractures were cored and recovered. The hydraulic fractures were found within 5[degree] of the azimuth measured with tilt meters and were tilted 15[degree] from vertical, oriented perpendicular to the formation bedding dip. Hydraulic fractures widths ranged from less than one sand grain (40/60 mesh) to 0.4 in. Scanning electron microscopy (SEM) examination of fracture faces showed no damage to the matrix from proppant embedment or compaction, and no evidence of guard residue was detected in the proppant pack or on the formation face. Fractures appearmore » to be considerably longer than modeled. Three closely spaced fractures are interpreted to be branches of a single hydraulic fracture treatment. This paper presents a description of the fractures recovered during coring in Well OO2. Findings related to fracture dimensions and orientations, fracture sources, fracture permeability measurements, and fracture characteristics (proppant embedment, presence of gel residue) are presented. Implications related to field development are discussed.« less

Fractography and fracture toughness of human dentin.

PubMed

Yan, J; Taskonak, B; Mecholsky, J J

2009-10-01

Dentin, the mineralized tissue forming the bulk of the tooth, serves as an energy-absorbing cushion for the hard, wear-resistant enamel and protects the inner soft tissues. Several studies used fracture mechanics methods to study the fracture toughness of dentin. However, all of them utilized precracks and cannot be used to estimate the intrinsic critical flaw size of dentin. We applied quantitative fractography to study the fracture pattern and fracture toughness of human dentin. Sixteen specimens were prepared from the coronal dentin and fractured in three-point flexure. Fracture surfaces were examined using a scanning electron microscope and the fracture toughness was calculated using a fracture mechanics equation. It was found that human dentin has a fracture surface similar to those of brittle materials. Twist hackle markings were observed and were used to identify the fracture origins. Average fracture toughness of all specimens was found to be 2.3 MPa m(1/2) and the average critical flaw size was estimated to 120 mum. It is suggested that fractography is a promising technique in analyzing the fracture of dentin under catastrophic failure.

Biomechanical Concepts for Fracture Fixation

PubMed Central

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

2015-01-01

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, “standard” iliosacral screw fixation is not sufficient for fractures with vertical or multiplanar instabilities. 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 in order 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. PMID:26584263

Sphenoid Sinus and Sphenoid Bone Fractures in Patients with Craniomaxillofacial Trauma

PubMed Central

Cantini Ardila, Jorge Ernesto; Mendoza, Miguel Ángel Rivera; Ortega, Viviana Gómez

2013-01-01

Background and Purpose Sphenoid bone fractures and sphenoid sinus fractures have a high morbidity due to its association with high-energy trauma. The purpose of this study is to describe individuals with traumatic injuries from different mechanisms and attempt to determine if there is any relationship between various isolated or combined fractures of facial skeleton and sphenoid bone and sphenoid sinus fractures. Methods We retrospectively studied hospital charts of all patients who reported to the trauma center at Hospital de San José with facial fractures from December 2009 to August 2011. All patients were evaluated by computed tomography scan and classified into low-, medium-, and high-energy trauma fractures, according to the classification described by Manson. Design This is a retrospective descriptive study. Results The study data were collected as part of retrospective analysis. A total of 250 patients reported to the trauma center of the study hospital with facial trauma. Thirty-eight patients were excluded. A total of 212 patients had facial fractures; 33 had a combination of sphenoid sinus and sphenoid bone fractures, and facial fractures were identified within this group (15.5%). Gender predilection was seen to favor males (77.3%) more than females (22.7%). The mean age of the patients was 37 years. Orbital fractures (78.8%) and maxillary fractures (57.5%) were found more commonly associated with sphenoid sinus and sphenoid bone fractures. Conclusions High-energy trauma is more frequently associated with sphenoid fractures when compared with medium- and low-energy trauma. There is a correlation between facial fractures and sphenoid sinus and sphenoid bone fractures. A more exhaustive multicentric case-control study with a larger sample and additional parameters will be essential to reach definite conclusions regarding the spectrum of fractures of the sphenoid bone associated with facial fractures. PMID:24436756

Spatial arrangement of faults and opening-mode fractures

NASA Astrophysics Data System (ADS)

Laubach, S. E.; Lamarche, J.; Gauthier, B. D. M.; Dunne, W. M.; Sanderson, David J.

2018-03-01

Spatial arrangement is a fundamental characteristic of fracture arrays. The pattern of fault and opening-mode fracture positions in space defines structural heterogeneity and anisotropy in a rock volume, governs how faults and fractures affect fluid flow, and impacts our understanding of the initiation, propagation and interactions during the formation of fracture patterns. This special issue highlights recent progress with respect to characterizing and understanding the spatial arrangements of fault and fracture patterns, providing examples over a wide range of scales and structural settings. Five papers describe new methods and improvements of existing techniques to quantify spatial arrangement. One study unravels the time evolution of opening-mode fracture spatial arrangement, which are data needed to compare natural patterns with progressive fracture growth in kinematic and mechanical models. Three papers investigate the role of evolving diagenesis in localizing fractures by mechanical stratigraphy and nine discuss opening-mode fracture spatial arrangement. Two papers show the relevance of complex cluster patterns to unconventional reservoirs through examples of fractures in tight gas sandstone horizontal wells, and a study of fracture arrangement in shale. Four papers demonstrate the roles of folds in fracture localization and the development spatial patterns. One paper models along-fault friction and fluid pressure and their effects on fault-related fracture arrangement. Contributions address deformation band patterns in carbonate rocks and fault size and arrangement above a detachment fault. Three papers describe fault and fracture arrangements in basement terrains, and three document fracture patterns in shale. This collection of papers points toward improvement in field methods, continuing improvements in computer-based data analysis and creation of synthetic fracture patterns, and opportunities for further understanding fault and fracture attributes in the subsurface through coupled spatial, size, and pattern analysis.

Defining hip fracture with claims data: outpatient and provider claims matter.

PubMed

Berry, S D; Zullo, A R; McConeghy, K; Lee, Y; Daiello, L; Kiel, D P

2017-07-01

Medicare claims are commonly used to identify hip fractures, but there is no universally accepted definition. We found that a definition using inpatient claims identified fewer fractures than a definition including outpatient and provider claims. Few additional fractures were identified by including inconsistent diagnostic and procedural codes at contiguous sites. Medicare claims data is commonly used in research studies to identify hip fractures, but there is no universally accepted definition of fracture. Our purpose was to describe potential misclassification when hip fractures are defined using Medicare Part A (inpatient) claims without considering Part B (outpatient and provider) claims and when inconsistent diagnostic and procedural codes occur at contiguous fracture sites (e.g., femoral shaft or pelvic). Participants included all long-stay nursing home residents enrolled in Medicare Parts A and B fee-for-service between 1/1/2008 and 12/31/2009 with follow-up through 12/31/2011. We compared the number of hip fractures identified using only Part A claims to (1) Part A plus Part B claims and (2) Part A and Part B claims plus discordant codes at contiguous fracture sites. Among 1,257,279 long-stay residents, 40,932 (3.2%) met the definition of hip fracture using Part A claims, and 41,687 residents (3.3%) met the definition using Part B claims. 4566 hip fractures identified using Part B claims would not have been captured using Part A claims. An additional 227 hip fractures were identified after considering contiguous fracture sites. When ascertaining hip fractures, a definition using outpatient and provider claims identified 11% more fractures than a definition with only inpatient claims. Future studies should publish their definition of fracture and specify if diagnostic codes from contiguous fracture sites were used.

Contaminant transport in fractured rocks with significant matrix permeability, using natural fracture geometries

NASA Astrophysics Data System (ADS)

Odling, Noelle E.; Roden, Julie E.

1997-09-01

Some results from numerical models of flow and contaminant transport in fractured permeable rocks, where fractures are more conductive than rock matrix, are described. The 2D flow field in the fractured and permeable rock matrix is calculated using a finite difference, 'conductance mesh' method, and the contaminant transport is simulated by particle tracking methods using an advection-biased, random walk technique. The model is applied to simulated and naturally occurring fracture patterns. The simulated pattern is an en echelon array of unconnected fractures, as an example of a common, naturally occurring fracture geometry. Two natural fracture patterns are used: one of unconnected, sub-parallel fractures and one with oblique fracture sets which is well connected. Commonly occurring matrix permeability and fracture aperture values are chosen. The simulations show that the presence of fractures creates complex and heterogeneous flow fields and contaminant distribution in the permeable rock matrix. The modelling results have shown that some effects are non-intuitive and therefore difficult to foresee without the help of a model. With respect to contaminant transport rates and plume heterogeneity, it was found that fracture connectivity (crucial when the matrix is impermeable) can play a secondary role to fracture orientation and density. Connected fracture systems can produce smooth break-through curves of contaminants summed over, for example, a bore-hole length, whereas in detail the contaminant plume is spatially highly heterogeneous. Close to a constant-pressure boundary (e.g. an extraction bore-hole), flow and contaminants can be channelled by fractures. Thus observations at a bore-hole may suggest that contaminants are largely confined to the fracture system, when, in fact, significant contamination resides in the matrix.

Simple X-ray versus ultrasonography examination in blunt chest trauma: effective tools of accurate diagnosis and considerations for rib fractures.

PubMed

Hwang, Eun Gu; Lee, Yunjung

2016-12-01

Simple radiography is the best diagnostic tool for rib fractures caused by chest trauma, but it has some limitations. Thus, other tools are also being used. The aims of this study were to investigate the effectiveness of ultrasonography (US) for identifying rib fractures and to identify influencing factors of its effectiveness. Between October 2003 and August 2007, 201 patients with blunt chest trauma were available to undergo chest radiographic and US examinations for diagnosis of rib fractures. The two modalities were compared in terms of effectiveness based on simple radiographic readings and US examination results. We also investigated the factors that influenced the effectiveness of US examination. Rib fractures were detected on radiography in 69 patients (34.3%) but not in 132 patients. Rib fractures were diagnosed by using US examination in 160 patients (84.6%). Of the 132 patients who showed no rib fractures on radiography, 92 showed rib fractures on US. Among the 69 patients of rib fracture detected on radiography, 33 had additional rib fractures detected on US. Of the patients, 76 (37.8%) had identical radiographic and US results, and 125 (62.2%) had fractures detected on US that were previously undetected on radiography or additional fractures detected on US. Age, duration until US examination, and fracture location were not significant influencing factors. However, in the group without detected fractures on radiography, US showed a more significant effectiveness than in the group with detected fractures on radiography ( P =0.003). US examination could detect unnoticed rib fractures on simple radiography. US examination is especially more effective in the group without detected fractures on radiography. More attention should be paid to patients with chest trauma who have no detected fractures on radiography.

The utility of dual-energy X-ray absorptiometry, calcaneal quantitative ultrasound, and fracture risk indices (FRAX® and Osteoporosis Risk Assessment Instrument) for the identification of women with distal forearm or hip fractures: A pilot study.

PubMed

Esmaeilzadeh, Sina; Cesme, Fatih; Oral, Aydan; Yaliman, Ayse; Sindel, Dilsad

2016-08-01

Dual-energy X-ray absorptiometry (DXA) is considered the "gold standard" in predicting osteoporotic fractures. Calcaneal quantitative ultrasound (QUS) variables are also known to predict fractures. Fracture risk assessment tools may also guide us for the detection of individuals at high risk for fractures. The aim of this case-control study was to evaluate the utility of DXA bone mineral density (BMD), calcaneal QUS parameters, FRAX® (Fracture Risk Assessment Tool), and Osteoporosis Risk Assessment Instrument (ORAI) for the discrimination of women with distal forearm or hip fractures. This case-control study included 20 women with a distal forearm fracture and 18 women with a hip fracture as cases and 76 age-matched women served as controls. BMD at the spine, proximal femur, and radius was measured using DXA and acoustic parameters of bone were obtained using a calcaneal QUS device. FRAX® 10-year probability of fracture and ORAI scores were also calculated in all participants. Receiver operating characteristic (ROC) analysis was used to assess fracture discriminatory power of all the tools. While all DXA BMD, and QUS variables and FRAX® fracture probabilities demonstrated significant areas under the ROC curves for the discrimination of hip-fractured women and those without, only 33% radius BMD, broadband ultrasound attenuation (BUA), and FRAX® major osteoporotic fracture probability calculated without BMD showed significant discriminatory power for distal forearm fractures. It can be concluded that QUS variables, particularly BUA, and FRAX® major osteoporotic fracture probability without BMD are good candidates for the identification of both hip and distal forearm fractures.

The influence of local bone quality on fracture pattern in proximal humerus fractures.

PubMed

Mazzucchelli, Ruben A; Jenny, Katharina; Zdravkovic, Vilijam; Erhardt, Johannes B; Jost, Bernhard; Spross, Christian

2018-02-01

Bone mineral density and fracture morphology are widely discussed and relevant factors when considering the different treatment options for proximal humerus fractures. It was the aim of this study to investigate the influence of local bone quality on fracture patterns of the Neer classification as well as on fracture impaction angle in these injuries. All acute, isolated and non-pathological proximal humerus fractures admitted to our emergency department were included. The fractures were classified according to Neer and the humeral head impaction angle was measured. Local bone quality was assessed using the Deltoid Tuberosity Index (DTI). The distribution between DTI and fracture pattern was analysed. 191 proximal humerus fractures were included (61 men, mean age 59 years; 130 women, mean age 69.5). 77 fractures (40%) were classified as one-part, 72 (38%) were two-part, 24 (13%) were three- and four-part and 18 (9%) were fracture dislocations. 30 fractures (16%) were varus impacted, whereas 45 fractures (24%) were classified as valgus impacted. The mean DTI was 1.48. Valgus impaction significantly correlated with good bone quality (DTI ≥ 1.4; p = 0.047) whereas no such statistical significance was found for the Neer fracture types. We found that valgus impaction significantly depended on good bone quality. However, neither varus impaction nor any of the Neer fracture types correlated with bone quality. We conclude that the better bone quality of valgus impacted fractures may be a reason for their historically benign amenability to ORIF. On the other hand, good local bone quality does not prevent fracture comminution. Copyright © 2017 Elsevier Ltd. All rights reserved.

Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW)

PubMed Central

Roux, C.; Wyman, A.; Hooven, F. H.; Gehlbach, S. H.; Adachi, J. D.; Chapurlat, R. D.; Compston, J. E.; Cooper, C.; Díez-Pérez, A.; Greenspan, S. L.; LaCroix, A. Z.; Netelenbos, J. C.; Pfeilschifter, J.; Rossini, M.; Saag, K. G.; Sambrook, P. N.; Silverman, S.; Siris, E. S.; Watts, N. B.; Boonen, S.

2016-01-01

Purpose Most fracture studies have focused on hip and vertebral fractures, but there is growing evidence that non-hip, non-vertebral (NHNV) fractures also result in substantial morbidity and healthcare costs. We sought to assess the effect of NHNV fractures on quality of life. Methods We analyzed 1-year incidences of hip, spine, major NHNV (pelvis/leg, shoulder/arm) and minor NHNV (wrist/hand, ankle/foot, rib/clavicle) fractures among women from the GLOW registry, a prospective, multinational, observational cohort study. Health-related quality of life (HRQL) was analyzed using EuroQol EQ-5D and the SF-36 health survey. Results Among 50,461 women analyzed, there were 1,822 fractures (57% minor NHNV, 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D summary scores, followed by major NHNV and hip fractures. The amount of women with mobility problems increased most for those with major NHNV and spine fractures (both +8%); spine fractures were associated with the largest increases in problems with self care (+11%), activities (+14%), and pain/discomfort (+12%). Decreases in physical function and health status were greatest for women with spine or hip fractures. Multivariable modeling found that EQ-5D reduction was greatest for spine fractures, followed by hip and major/minor NHNV. Significant reductions in SF-36 physical function were found only for spine and major NHNV fractures. Conclusion This prospective study shows that NHNV fractures have a detrimental effect on HRQL. As NHNV fractures account for >80% of incident fractures, efforts to optimize osteoporosis care should include prevention of NHNV fractures. PMID:22398855

Validation of fragility fractures in primary care electronic medical records: A population-based study.

PubMed

Martinez-Laguna, Daniel; Soria-Castro, Alberto; Carbonell-Abella, Cristina; Orozco-López, Pilar; Estrada-Laza, Pilar; Nogues, Xavier; Díez-Perez, Adolfo; Prieto-Alhambra, Daniel

2017-11-28

Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP. Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected. Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis. More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Radial and tibial fracture repair with external skeletal fixation. Effects of fracture type, reduction, and complications on healing.

PubMed

Johnson, A L; Kneller, S K; Weigel, R M

1989-01-01

Twenty-eight consecutive fractures of the canine radius and tibia were treated with external skeletal fixation as the primary method of stabilization. The time of fixation removal (T1) and the time to unsupported weight-bearing (T2) were correlated with: (1) bone involved; (2) communication of the fracture with the external environment; (3) severity of the fracture; (4) proximity of the fracture to the nutrient artery; (5) method of reduction; (6) diaphyseal displacement after reduction; and (7) gap between cortical fragments after reduction. The Kruskal-Wallis one-way analysis of variance was used to test the correlation with p less than .05 set as the criterion for significance. The median T1 was 10 weeks and the median T2 was 11 weeks. None of the variables correlated significantly with either of the healing times; however, there was a strong trend toward longer healing times associated with open fractures and shorter healing times associated with closed reduction. Periosteal and endosteal callus uniting the fragments were observed radiographically in comminuted fractures, with primary bone union observed in six fractures in which anatomic reduction was achieved. Complications observed in the treatment of these fractures included: bone lysis around pins (27 fractures), pin track drainage (27 fractures), pin track hemorrhage (1 fracture), periosteal reaction around pins (27 fractures), radiographic signs consistent with osteomyelitis (12 fractures), degenerative joint disease (2 dogs), and nonunion (1 fracture). Valgus or rotational malalignment resulted in 16 malunions of fractures. One external fixation device was replaced and four loose pins were removed before the fractures healed. One dog was treated with antibiotics during the postoperative period because clinical signs of osteomyelitis appeared.(ABSTRACT TRUNCATED AT 250 WORDS)

Mathematical modeling and simulation analysis of hydraulic fracture propagation in three-layered poro-elastic media

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moon, H.Y.; Advani, S.H.; Lee, T.S.

1992-11-01

Hydraulic fracturing plays a pivotal role in the enhancement of oil and gas production recovery from low permeability reservoirs. The process of hydraulic fracturing entails the generation of a fracture by pumping fluids blended with special chemicals and proppants into the payzone at high injection rates and pressures to extend and wedge fractures. The mathematical modeling of hydraulically induced fractures generally incorporates coupling between the formation elasticity, fracture fluid flow, and fracture mechanics equations governing the formation structural responses, fluid pressure profile, and fracture growth. Two allied unsymmetric elliptic fracture models are developed for fracture configuration evolutions in three-layered rockmore » formations. The first approach is based on a Lagrangian formulation incorporating pertinent energy components associated with the formation structural responses and fracture fluid flow. The second model is based on a generalized variational principle, introducing an energy rate related functional. These models initially simulate a penny-shaped fracture, which becomes elliptic if the crack tips encounters (upper and/or lower) barriers with differential reservoir properties (in situ stresses, 16 elastic moduli, and fracture toughness-contrasts and fluid leak-off characteristics). The energy rate component magnitudes are determined to interpret the governing hydraulic fracture mechanisms during fracture evolution. The variational principle is extended to study the phenomenon and consequences of fluid lag in fractures. Finally, parametric sensitivity and energy rate investigations to evaluate the roles of controllable hydraulic treatment variables and uncontrollable reservoir property characterization parameters are performed. The presented field applications demonstrate the overall capabilities of the developed models. These studies provide stimulation treatment guidelines for fracture configuration design, control, and optimization.« less

Differences in childhood adiposity influence upper limb fracture site

PubMed Central

Moon, Rebecca J; Lim, Adelynn; Farmer, Megan; Segaran, Avinash; Clarke, Nicholas MP; Dennison, Elaine M; Harvey, Nicholas C; Cooper, Cyrus; Davies, Justin H

2015-01-01

Introduction Although it has been suggested that overweight and obese children have an increased risk of fracture, recent studies in post-menopausal women have shown that the relationship between obesity and fracture risk varies by fracture site. We therefore assessed whether adiposity and overweight/obesity prevalence differed by upper limb fracture site in children. Methods Height, weight, BMI, triceps and subscapular skinfold thickness (SFT) were measured in children aged 3-18 years with an acute upper limb fracture. Data was compared across three fracture sites (hand, forearm and upper arm/shoulder [UA]), and to published reference data. Results 401 children (67.1% male, median age 11.71 years (range 3.54-17.27 years) participated. 34.2%, 50.6% and 15.2% had fractures of the hand, forearm and UA, respectively. Children with forearm fractures had higher weight, BMI and SFT z-scores than those with UA fractures (p<0.05 for all). SFT z-scores were also higher in children with forearm fractures compared to hand fractures, but children withor hand and UA fractures did not differ. Overweight and obesity prevalence was higher in children with forearm fractures (37.6%) than those with UA fractures (19.0%, p=0.009). This prevalence was also higher than the published United Kingdom population prevalence (27.9%, p=0.003), whereas that of children with either UA (p=0.13) or hand fractures (29.1%, p=0.76) did not differ. The differences in anthropometry and overweight/obesity were similar for boys, but not present in girls. Conclusion Measurements of adiposity and the prevalence of overweight/obesity differ by fracture site in children, and in particular boys, with upper limb fractures. PMID:26027507

Characterising rock fracture aperture-spacing relationships using power-law relationships: some considerations

NASA Astrophysics Data System (ADS)

Brook, Martin; Hebblewhite, Bruce; Mitra, Rudrajit

2016-04-01

The size-scaling of rock fractures is a well-studied problem in geology, especially for permeability quantification. The intensity of fractures may control the economic exploitation of fractured reservoirs because fracture intensity describes the abundance of fractures potentially available for fluid flow. Moreover, in geotechnical engineering, fractures are important for parameterisation of stress models and excavation design. As fracture data is often collected from widely-spaced boreholes where core recovery is often incomplete, accurate interpretation and representation of fracture aperture-frequency relationships from sparse datasets is important. Fracture intensity is the number of fractures encountered per unit length along a sample scanline oriented perpendicular to the fractures in a set. Cumulative frequency of fractures (F) is commonly related to fracture aperture (A) in the form of a power-law (F = aA-b), with variations in the size of the a coefficient between sites interpreted to equate to fracture frequency for a given aperture (A). However, a common flaw in this approach is that even a small change in b can have a large effect on the response of the fracture frequency (F) parameter. We compare fracture data from the Late Permian Rangal Coal Measures from Australia's Bowen Basin, with fracture data from Jurassic carbonates from the Sierra Madre Oriental, northeastern Mexico. Both power-law coefficient a and exponent b control the fracture aperture-frequency relationship in conjunction with each other; that is, power-laws with relatively low a coefficients have relatively high b exponents and vice versa. Hence, any comparison of different power-laws must take both a and b into consideration. The corollary is that different sedimentary beds in the Sierra Madre carbonates do not show ˜8× the fracture frequency for a given fracture aperture, as based solely on the comparison of coefficient a. Rather, power-law "sensitivity factors" developed from both Sierra Madre and the Bowen Basin span similar ranges, indicating that the factor of increase in frequency (F) for a doubling of aperture size (A) shows similar relationships and variability from both sites. Despite their limitations, we conclude that fracture aperture-frequency power-law relationships are valid and, when interpreted carefully, provide a useful basis for comparing rock fracture distributions across different sites.

3D Numerical Modeling of the Propagation of Hydraulic Fracture at Its Intersection with Natural (Pre-existing) Fracture

NASA Astrophysics Data System (ADS)

Dehghan, Ali Naghi; Goshtasbi, Kamran; Ahangari, Kaveh; Jin, Yan; Bahmani, Aram

2017-02-01

A variety of 3D numerical models were developed based on hydraulic fracture experiments to simulate the propagation of hydraulic fracture at its intersection with natural (pre-existing) fracture. Since the interaction between hydraulic and pre-existing fractures is a key condition that causes complex fracture patterns, the extended finite element method was employed in ABAQUS software to simulate the problem. The propagation of hydraulic fracture in a fractured medium was modeled in two horizontal differential stresses (Δ σ) of 5e6 and 10e6 Pa considering different strike and dip angles of pre-existing fracture. The rate of energy release was calculated in the directions of hydraulic and pre-existing fractures (G_{{frac}} /G_{{rock}}) at their intersection point to determine the fracture behavior. Opening and crossing were two dominant fracture behaviors during the hydraulic and pre-existing fracture interaction at low and high differential stress conditions, respectively. The results of numerical studies were compared with those of experimental models, showing a good agreement between the two to validate the accuracy of the models. Besides the horizontal differential stress, strike and dip angles of the natural (pre-existing) fracture, the key finding of this research was the significant effect of the energy release rate on the propagation behavior of the hydraulic fracture. This effect was more prominent under the influence of strike and dip angles, as well as differential stress. The obtained results can be used to predict and interpret the generation of complex hydraulic fracture patterns in field conditions.

A Year of Fractures: a snapshot analysis of the logistics, problems and outcomes of a hospital-based fracture liaison service.

PubMed

Vaile, J H; Sullivan, L; Connor, D; Bleasel, J F

2013-10-01

Our fracture liaison service identifies patients with low trauma fractures, determines the need for osteoporosis therapy and instigates therapy if necessary. We describe the tracking and outcome of 768 patients attending our emergency department over 1 year and discuss the problems we encountered and potential solutions. Osteoporotic fractures result in substantial morbidity, mortality and economic cost, and patients sustaining a first fracture are known to be at higher risk of sustaining future fracture. Treatment of at-risk patients has been shown to assist in prevention of future fracture including hip fracture. We established a "First Fracture Project" to identify and treat these patients in 2003. We assessed "A Year of Fractures": the logistics, outcome and problems in tracking patients presenting to our emergency department with a low trauma fracture by our fracture liaison service, over 1 year from July 2008 to June 2009. Patients were tracked by our osteoporosis nurse and offered assessment, and treatment where necessary. In 1 year, 768 patients aged 50 or over were identified from emergency department records as attending with a low trauma fracture. About 84 % of patients eventually received assessment. Of the162 patients progressing through the entire process, 74 % had osteoporosis treatment planned and/or commenced. Our fracture liaison service was effective at identifying most low trauma fracture patients at risk of further fracture and providing access to osteoporosis assessment. There were many difficulties: we outline logistic and practical issues in delivering our service and suggest potential improvements.

The impact of different aperture distribution models and critical stress criteria on equivalent permeability in fractured rocks

NASA Astrophysics Data System (ADS)

Bisdom, Kevin; Bertotti, Giovanni; Nick, Hamidreza M.

2016-05-01

Predicting equivalent permeability in fractured reservoirs requires an understanding of the fracture network geometry and apertures. There are different methods for defining aperture, based on outcrop observations (power law scaling), fundamental mechanics (sublinear length-aperture scaling), and experiments (Barton-Bandis conductive shearing). Each method predicts heterogeneous apertures, even along single fractures (i.e., intrafracture variations), but most fractured reservoir models imply constant apertures for single fractures. We compare the relative differences in aperture and permeability predicted by three aperture methods, where permeability is modeled in explicit fracture networks with coupled fracture-matrix flow. Aperture varies along single fractures, and geomechanical relations are used to identify which fractures are critically stressed. The aperture models are applied to real-world large-scale fracture networks. (Sub)linear length scaling predicts the largest average aperture and equivalent permeability. Barton-Bandis aperture is smaller, predicting on average a sixfold increase compared to matrix permeability. Application of critical stress criteria results in a decrease in the fraction of open fractures. For the applied stress conditions, Coulomb predicts that 50% of the network is critically stressed, compared to 80% for Barton-Bandis peak shear. The impact of the fracture network on equivalent permeability depends on the matrix hydraulic properties, as in a low-permeable matrix, intrafracture connectivity, i.e., the opening along a single fracture, controls equivalent permeability, whereas for a more permeable matrix, absolute apertures have a larger impact. Quantification of fracture flow regimes using only the ratio of fracture versus matrix permeability is insufficient, as these regimes also depend on aperture variations within fractures.

Fracturesis Jointitis: Causes, Symptoms, and Treatment in Groundwater Communities.

PubMed

Manda, Alex K; Horsman, Eric

2015-01-01

Fracturesis Jointitis is a grammatical disorder characterized by failure or inability to understand the difference between overarching and specific terms of brittle deformation features. The disorder leads to the use of the word "fracture" as a specific type of discontinuity rather than as an overarching term for mechanical breaks in rocks. This condition appears to be prevalent among groundwater practitioners working with fractured rocks. Common signs and symptoms of Fracturesis Jointitis include the use of terms such as "joints and fractures" and "joints, faults and fractures" when describing fractures in rocks. At best, such terms imply that a "fracture" is one of many kinds of features like joints and faults, and at worst that joints and faults are not fractures but something else. Using proper terms to identify specific fracture types is critical because fractures may act as either barriers to groundwater flow (e.g., faults or deformation bands) or conduits for flow (e.g., faults and joints), The treatment for Fracturesis Jointitis involves an education campaign highlighting to the groundwater community the different fracture types that exist, the modes by which fractures propagate and the role that these fractures play in facilitating or hindering groundwater flow. Those afflicted by Fracturesis Jointitis can be cured of the condition by avoiding the word "fractures" in phrases such as "joints and fractures" or by adding descriptive words before the word "fractures" to specify fracture types (e.g., "foliation-parallel" fractures). Only with a concerted education campaign can we rid our community of Fracturesis Jointitis. © 2014, National Ground Water Association.

Real frequency of ordinary and atypical sub-trochanteric and diaphyseal fractures in France based on X-rays and medical file analysis.

PubMed

Beaudouin-Bazire, Constance; Dalmas, Noémie; Bourgeois, Julie; Babinet, Antoine; Anract, Philippe; Chantelot, Christophe; Farizon, Frédéric; Chopin, Florence; Briot, Karine; Roux, Christian; Cortet, Bernard; Thomas, Thierry

2013-03-01

Atypical sub-trochanteric and femoral shaft fractures have been reported in patients treated with bisphosphonates. Their incidence has been determined from registered data analysis using international codes. Therefore, the aim of our study was to estimate the real frequency of typical and atypical sub-trochanteric or diaphyseal fractures, based on radiological and clinical data compared to registered data. In the registers of three large French University Hospitals, patients identified with International Classification of Diseases, 10th Revision diagnosis codes for sub-trochanteric or diaphyseal fracture were selected. Frequencies of ordinary and atypical fractures were calculated after both registered data, radiological and clinical files analysis. Among the 4592 patients hospitalized for a femoral fracture over 5 years, 574 were identified to have had a sub-trochanteric or femoral shaft fracture. 47.7% of the sub-trochanteric and femoral shaft fractures were misclassified, predominantly in the sub-trochanteric fractures subset. 12 patients had an atypical fracture (4% of the sub-trochanteric and femoral shaft fractures) and 11 fractures presented radiological features of atypical fractures, whereas clinical files analysis revealed they were pathological or traumatic fractures. Atypical fractures frequency is very low. Because of their low frequency and the unreliability of registered databases, the risk of atypical fractures is very difficult to estimate retrospectively. A prospective study is needed to clarify the risk factors associated with these fractures. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Medial joint space widening of the ankle in displaced Tillaux and Triplane fractures in children.

PubMed

Gourineni, Prasad; Gupta, Asheesh

2011-10-01

Tillaux and Triplane fractures occur in children predominantly from external rotation mechanism. We hypothesized that in displaced fractures, the talus would shift laterally along with the distal fibula and the distal tibial epiphyseal fragment increasing the medial joint space. Consecutive cases evaluated retrospectively. Level I and Level II centers. Twenty-two skeletally immature patients with 14 displaced Triplane fractures and eight displaced Tillaux fractures were evaluated for medial joint space widening. Measurement of fracture displacement and medial joint space widening before and after intervention. Thirteen Triplane and six Tillaux fractures (86%) showed medial space widening of 1 to 9 mm and equal to the amount of fracture displacement. Reduction of the fracture reduced the medial space to normal. There were no known complications. Medial space widening of the ankle may be a sign of ankle fracture displacement. Anatomic reduction of the fracture reduces the medial space and may improve the results in Tillaux and Triplane fractures.

Parameter Prediction of Hydraulic Fracture for Tight Reservoir Based on Micro-Seismic and History Matching

NASA Astrophysics Data System (ADS)

Zhang, Kai; Ma, Xiaopeng; Li, Yanlai; Wu, Haiyang; Cui, Chenyu; Zhang, Xiaoming; Zhang, Hao; Yao, Jun

Hydraulic fracturing is an important measure for the development of tight reservoirs. In order to describe the distribution of hydraulic fractures, micro-seismic diagnostic was introduced into petroleum fields. Micro-seismic events may reveal important information about static characteristics of hydraulic fracturing. However, this method is limited to reflect the distribution area of the hydraulic fractures and fails to provide specific parameters. Therefore, micro-seismic technology is integrated with history matching to predict the hydraulic fracture parameters in this paper. Micro-seismic source location is used to describe the basic shape of hydraulic fractures. After that, secondary modeling is considered to calibrate the parameters information of hydraulic fractures by using DFM (discrete fracture model) and history matching method. In consideration of fractal feature of hydraulic fracture, fractal fracture network model is established to evaluate this method in numerical experiment. The results clearly show the effectiveness of the proposed approach to estimate the parameters of hydraulic fractures.

Simulation of Hydraulic and Natural Fracture Interaction Using a Coupled DFN-DEM Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, J.; Huang, H.; Deo, M.

2016-03-01

The presence of natural fractures will usually result in a complex fracture network due to the interactions between hydraulic and natural fracture. The reactivation of natural fractures can generally provide additional flow paths from formation to wellbore which play a crucial role in improving the hydrocarbon recovery in these ultra-low permeability reservoir. Thus, accurate description of the geometry of discrete fractures and bedding is highly desired for accurate flow and production predictions. Compared to conventional continuum models that implicitly represent the discrete feature, Discrete Fracture Network (DFN) models could realistically model the connectivity of discontinuities at both reservoir scale andmore » well scale. In this work, a new hybrid numerical model that couples Discrete Fracture Network (DFN) and Dual-Lattice Discrete Element Method (DL-DEM) is proposed to investigate the interaction between hydraulic fracture and natural fractures. Based on the proposed model, the effects of natural fracture orientation, density and injection properties on hydraulic-natural fractures interaction are investigated.« less

Simulation of Hydraulic and Natural Fracture Interaction Using a Coupled DFN-DEM Model

DOE Office of Scientific and Technical Information (OSTI.GOV)

J. Zhou; H. Huang; M. Deo

The presence of natural fractures will usually result in a complex fracture network due to the interactions between hydraulic and natural fracture. The reactivation of natural fractures can generally provide additional flow paths from formation to wellbore which play a crucial role in improving the hydrocarbon recovery in these ultra-low permeability reservoir. Thus, accurate description of the geometry of discrete fractures and bedding is highly desired for accurate flow and production predictions. Compared to conventional continuum models that implicitly represent the discrete feature, Discrete Fracture Network (DFN) models could realistically model the connectivity of discontinuities at both reservoir scale andmore » well scale. In this work, a new hybrid numerical model that couples Discrete Fracture Network (DFN) and Dual-Lattice Discrete Element Method (DL-DEM) is proposed to investigate the interaction between hydraulic fracture and natural fractures. Based on the proposed model, the effects of natural fracture orientation, density and injection properties on hydraulic-natural fractures interaction are investigated.« less

Patterns of Pediatric Mandible Fractures in the United States.

PubMed

Owusu, James A; Bellile, Emily; Moyer, Jeffrey S; Sidman, James D

2016-01-01

The mandible is arguably the most frequently fractured facial bone in children. However, facial fractures are rare in children compared with adults, resulting in few large studies on patterns of pediatric facial fractures. To report the patterns, demographics, and cause of pediatric mandible fractures across the United States. A retrospective analysis was conducted of the Healthcare Cost and Utilization Project's National Emergency Department Sample from January 1 to December 31, 2012, using the International Classification of Disease, Ninth Revision, codes for mandible fractures (802.20-802.39) among patients 18 years and younger who presented to emergency departments. Demographics, fracture site, and fracture mechanism were analyzed to identify factors associated with fractures. Analysis was conducted from July 9 to July 28, 2015. There were 1984 records, representing a weighted estimate of 8848 cases of pediatric mandible fracture. The mean patient age was 14.0 years (95% CI, 13.6-14.3). The male to female ratio was 4:1 and females were comparatively younger, with a mean age of 12.5 years (95% CI, 11.8-13.1; P < .001). The most frequently fractured sites were the condyle, in 1288 patients (14.6% [95% CI, 12.6%-16.5%]), and the angle, in 1252 patients (14.1% [12.4%-15.9%]). Associated intracranial injuries occurred in 756 patients (8.5% [7.1%-10.0%]), and cervical spine fractures occurred in 393 (4.4% [3.5%-5.4%]). The fracture site and mechanism of injury varied with age and sex. For patients 12 years and younger, the most frequent fracture site was the condyle, accounting for 636 fractures (27.9% [24.2%-31.6%]), and the most frequent cause was falls, accounting for 692 fractures (30.3% [25.9%-34.8%]). In teenaged patients (13-18 years), the angle was the most frequent fracture site, accounting for 1157 fractures (17.6% [15.6%-19.6%]), and the most frequent cause was assault, accounting for 2619 fractures (39.9% [36.4%-43.3%]). For male patients, the angle was the predominant site, accounting for 1053 fractures (15.0% [13.1%-16.8%]), and the leading cause was assault, accounting for 2360 fractures (33.5% [30.2%-36.9%]). For female patients, the condyle was the most frequent site, accounting for 369 fractures (20.3% [16.0%-24.6%]), and the leading cause was falls, accounting for 422 fractures (23.2% [18.6%-28.0%]). In this study, age and sex disparities among pediatric mandible fractures were identified. Younger patients and female patients tend to have condyle fractures caused more commonly by falls while older patients and male patients tend to have angle fractures caused by assault. NA.

Origin of Permeability and Structure of Flows in Fractured Media

NASA Astrophysics Data System (ADS)

De Dreuzy, J.; Darcel, C.; Davy, P.; Erhel, J.; Le Goc, R.; Maillot, J.; Meheust, Y.; Pichot, G.; Poirriez, B.

2013-12-01

After more than three decades of research, flows in fractured media have been shown to result from multi-scale geological structures. Flows result non-exclusively from the damage zone of the large faults, from the percolation within denser networks of smaller fractures, from the aperture heterogeneity within the fracture planes and from some remaining permeability within the matrix. While the effect of each of these causes has been studied independently, global assessments of the main determinisms is still needed. We propose a general approach to determine the geological structures responsible for flows, their permeability and their organization based on field data and numerical modeling [de Dreuzy et al., 2012b]. Multi-scale synthetic networks are reconstructed from field data and simplified mechanical modeling [Davy et al., 2010]. High-performance numerical methods are developed to comply with the specificities of the geometry and physical properties of the fractured media [Pichot et al., 2010; Pichot et al., 2012]. And, based on a large Monte-Carlo sampling, we determine the key determinisms of fractured permeability and flows (Figure). We illustrate our approach on the respective influence of fracture apertures and fracture correlation patterns at large scale. We show the potential role of fracture intersections, so far overlooked between the fracture and the network scales. We also demonstrate how fracture correlations reduce the bulk fracture permeability. Using this analysis, we highlight the need for more specific in-situ characterization of fracture flow structures. Fracture modeling and characterization are necessary to meet the new requirements of a growing number of applications where fractures appear both as potential advantages to enhance permeability and drawbacks for safety, e.g. in energy storage, stimulated geothermal energy and non-conventional gas productions. References Davy, P., et al. (2010), A likely universal model of fracture scaling and its consequence for crustal hydromechanics, Journal of Geophysical Research-Solid Earth, 115, 13. de Dreuzy, J.-R., et al. (2012a), Influence of fracture scale heterogeneity on the flow properties of three-dimensional Discrete Fracture Networks (DFN), J. Geophys. Res.-Earth Surf., 117(B11207), 21 PP. de Dreuzy, J.-R., et al. (2012b), Synthetic benchmark for modeling flow in 3D fractured media, Computers and Geosciences(0). Pichot, G., et al. (2010), A Mixed Hybrid Mortar Method for solving flow in Discrete Fracture Networks, Applicable Analysis, 89(10), 1729-1643. Pichot, G., et al. (2012), Flow simulation in 3D multi-scale fractured networks using non-matching meshes, SIAM Journal on Scientific Computing (SISC), 34(1). Figure: (a) Fracture network with a broad-range of fracture lengths. (b) Flows (log-scale) with homogeneous fractures. (c) Flows (log-scale) with heterogeneous fractures [de Dreuzy et al., 2012a]. The impact of the fracture apertures (c) is illustrated on the organization of flows.

Extending Topological Approaches to Microseismic-Derived 3D Fracture Networks

NASA Astrophysics Data System (ADS)

Urbancic, T.; Bosman, K.; Baig, A.; Ardakani, E. P.

2017-12-01

Fracture topology is important for determining the fluid-flow characteristics of a fracture network. In most unconventional petroleum applications, flow through subsurface fracture networks is the primary source of production, as matrix permeability is often in the nanodarcy range. Typical models of reservoir discrete fracture networks (DFNs) are constructed using fracture orientation and average spacing, without consideration of how the connectivity of the fracture network aids the percolation of hydrocarbons back to the wellbore. Topological approaches to DFN characterization have been developed and extensively used in analysis of outcrop data and aerial photography. Such study of the surface expression of fracture networks is straight-forward, and the physical form of the observed fractures is directly reflected in the parameters used to describe the topology. However, this analysis largely ignores the three-dimensional nature of natural fracture networks, which is difficult to define accurately in geological studies. SMTI analysis of microseismic event distributions can produce DFNs, where each event is represented by a penny-shaped crack with radius and orientation determined from the frequency content of the waveforms and assessment of the slip instability of the potential fracture planes, respectively. Analysis of the geometric relationships between a set of fractures can provide details of intersections between fractures, and thus the topological characteristics of the fracture network. Extension of existing 2D topology approaches to 3D fracture networks is non-trivial. In the 2D case, a fracture intersection is a single point (node), and branches connect adjacent nodes along fractures. For the 3D case, intersection "nodes" become lines, and connecting nodes to find branches becomes more complicated. There are several parameters defined in 2D topology to quantify the connectivity of the fracture network. Equivalent quantities must be defined and calibrated for the 3D case to provide a meaningful measurement of fracture network connectivity. We have developed an approach to analyze the topology of 3D fracture networks derived from microseismic moment tensors. We illustrate the utility of the approach with applications to example datasets from hydraulic fracturing completions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmad Ghassemi

Geothermal energy is recovered by circulating water through heat exchange areas within a hot rock mass. Geothermal reservoir rock masses generally consist of igneous and metamorphic rocks that have low matrix permeability. Therefore, cracks and fractures play a significant role in extraction of geothermal energy by providing the major pathways for fluid flow and heat exchange. Therefore, knowledge of the conditions leading to formation of fractures and fracture networks is of paramount importance. Furthermore, in the absence of natural fractures or adequate connectivity, artificial fractures are created in the reservoir using hydraulic fracturing. Multiple fractures are preferred because of themore » large size necessary when using only a single fracture. Although the basic idea is rather simple, hydraulic fracturing is a complex process involving interactions of high pressure fluid injections with a stressed hot rock mass, mechanical interaction of induced fractures with existing natural fractures, and the spatial and temporal variations of in-situ stress. As a result, it is necessary to develop tools that can be used to study these interactions as an integral part of a comprehensive approach to geothermal reservoir development, particularly enhanced geothermal systems. In response to this need we have developed advanced poro-thermo-chemo-mechanical fracture models for rock fracture research in support of EGS design. The fracture propagation models are based on a regular displacement discontinuity formulation. The fracture propagation studies include modeling interaction of induced fractures. In addition to the fracture propagation studies, two-dimensional solution algorithms have been developed and used to estimate the impact of pro-thermo-chemical processes on fracture permeability and reservoir pressure. Fracture permeability variation is studied using a coupled thermo-chemical model with quartz reaction kinetics. The model is applied to study quartz precipitation/dissolution, as well as the variation in fracture aperture and pressure. Also, a three-dimensional model of injection/extraction has been developed to consider the impact poro- and thermoelastic stresses on fracture slip and injection pressure. These investigations shed light on the processes involved in the observed phenomenon of injection pressure variation (e.g., in Coso), and allow the assessment of the potential of thermal and chemical stimulation strategies.« less

[Anatomy of fractures of the inferior scapular angle].

PubMed

Bartoníček, J; Tuček, M; Malík, J

2018-01-01

The aim of this study is to describe the anatomy of fractures of the inferior angle and the adjacent part of the scapular body, based on 3D CT reconstructions. In a series of 375 scapular fractures, we identified a total of 20 fractures of the inferior angle of the scapular body (13 men, 7 women), with a mean patient age of 50 years (range 3373). In all fractures, 3D CT reconstructions were obtained, allowing an objective evaluation of the fracture pattern with a focus on the size and shape of the inferior angle fragment, propagation of the fracture line to the lateral and medial borders of the infraspinous part of the scapular body, fragment displacement and any additional fracture of the ipsilateral scapula and the shoulder girdle. We identified a total of 5 types of fracture involving the distal half of the infraspinous part of the scapular body. The first type, recorded in 5 cases, affected only the apex of the inferior angle, with a small part of the adjacent medial border. The second type, occurring in 4 cases, involved fractures separating the entire inferior angle. The third type, represented by 4 cases, was characterized by a fracture line starting medially close above the inferior angle and passing proximolaterally. The separated fragment had a shape of a big drop, carrying also the distal half of the lateral pillar in addition to the inferior angle. In the fourth type identified in 5 fractures, the separated fragment was formed both by the inferior angle and a variable part of the medial border. The fifth type, being by its nature a transition to the fracture of the infraspinous part of the body, was recorded in 2 cases, with the same V-shaped fragment. Fractures of the inferior angle and the adjacent part of the scapular body are groups of fractures differing from other infraspinous fractures of the scapular body. Although these fractures are highly variable in terms of shape, they have the same course of fracture line and the manner of displacement.Key words: scapula scapula fractures scapular body fractures inferior angle classification of scapular body fractures.

Identification and characterisation of individual Fractures in 3D fracture-network of shale reservoir rocks from microtomography

NASA Astrophysics Data System (ADS)

Qi, C.; Liu, J.

2017-12-01

Fractures are essential for unconventional hydrocarbon production. However, the observation of fractures in three-dimensional (3D) space is very difficult except using microtomography to obtain 3D fracture structures at micro-scales. Twelve shale samples taken from a specimen are analyzed in this study: six of them were isobarically and five were isothermally processed in experiments of simulating hydrocarbon generation and expulsion and one is unprocessed. The resolutions of microtomographic images are in the range from 5.83 to 9.12 μm. Fractures developed in different complexities: some samples have mostly parallel fractures, some have major parallel fractures plus irregular fractures forming crack-network and some samples have fully intersected fractures of various directions. To identify individual fractures in 3D network is crucial for the characterization of fractures and it needs to separate each fractures or disconnect intersections of fractures. For those samples with fewer intersections, it is not difficult to disconnect intersections manually slice by slice using Avizo®. For those samples with complex intersections, it is impractical to process manually. A patented method and corresponding programs are used to separate, identify and characterize individual fractures. By procedures of filtering, smoothing, thinning, separating and combining, intersected cracks are separated, the segments of a broken elongated cracks are identified as one crack, and the thinned thickness is restored, finally the shape, orientation and dimensions of individual fractures are characterized. Our results show that: 1) relatively large fractures are very thin, showing typical fracture morphology, while small fractures may have various shapes; 2) isothermal processed samples have stronger anisotropy, which implies that the fractures in isothermal series are thinner or flatter than in isobaric series; 3) the fractal dimension exists in the samples and there is good correlation between the fractal dimension and temperature/pressure. This study is a first trial of the characterization of individual cracks in 3D network. It lays a foundation for future research on the prediction of large-scale fractures in tight reservoirs.

The causes and prognoses of different types of fractures in wild koalas submitted to wildlife hospitals.

PubMed

Henning, Joerg; Hannon, Christabel; McKinnon, Allan; Larkin, Rebecca; Allavena, Rachel

2015-12-01

Fractures are a major problem in wild koalas of great veterinary and conservation importance as their occurrence in different locations of the body might result in varying healing success. The aim of this study was to determine the fracture types (defined by location of the fracture) occurring in wild koalas, temporal patterns, possible causes and risk factors of fracture types, and the prognosis for successfully releasing kolas with healed fracture types into the wild. Data from a total of 2031 wild koalas submitted to wildlife hospitals in South-East Queensland, Australia, over a period of 13 years were analysed. Approximately 56.7% of koalas experienced head fractures, 13.4% had torso fractures, 14.9% had limb fractures and 15% had combination fractures. A total of 84.1% of fractures were caused by vehicle collisions, 9.1% by dog attacks, 3.3% by falls from trees, 1.3% by train collisions, 0.2% by livestock trampling and 1.8% due to unknown causes. Multinominal logistic regression was used to identify risk factors (cause of fracture, age category, sex, year, three-year admission period and season of fracture event) by fracture type. The type of fracture was associated with both the cause of the fracture and the season when it occurred: for example torso fractures (compared to combination fractures) were associated with dog attacks (OR=10.98; 95% CI6.03, 20.01) and falls from trees (OR=4.79; 95% CI2.26, 10.19) relative to vehicle collisions. More submissions of koalas with head fractures due to vehicle collisions occurred in spring compared to autumn and winter, coinciding with the breeding season of koalas and increased animal movement. Prognosis for koalas with fractures was poor, with approximately 63.8% of koalas admitted dead on arrival, 34.2% euthanised, and only 2.0% of koalas able to be released. Given this data, further research into mitigation strategies to decrease the risk of fractures and to increase the observed low recovery rate should be considered. Copyright © 2015 Elsevier B.V. All rights reserved.

A Distal Forearm Fracture in Childhood Is Associated With an Increased Risk for Future Fragility Fractures in Adult Men, but Not Women

PubMed Central

Amin, Shreyasee; Melton, L Joseph; Achenbach, Sara J; Atkinson, Elizabeth J; Dekutoski, Mark B; Kirmani, Salman; Fischer, Philip R; Khosla, Sundeep

2014-01-01

Distal forearm fractures are among the most common fractures during childhood, but it remains unclear whether they predict an increased fracture risk later in life. We studied a population-based cohort of 1776 children ≤18 years of age, from Olmsted County, MN, USA, who had a distal forearm fracture in 1935–1992. Incident fractures occurring at age ≥35 years were identified through review of complete medical records using the linkage system of the Rochester Epidemiology Project. Observed nonpathologic fractures resulting from no more than moderate trauma (fragility fractures) were compared with expected numbers estimated from fracture site–specific incidence rates, based on age, sex, and calendar year, for Olmsted County (standardized incidence ratios [SIR]). In 1086 boys (mean ± SD age; 11 ± 4 years) and 690 girls (10 ± 4 years) followed for 27,292 person-years after the age of 35 years, subsequent fragility fractures were observed in 144 (13%) men and 74 (11%) women. There was an increased risk for future fragility fractures in boys who had a distal forearm fracture (SIR, 1.9; 95% CI, 1.6–2.3) but not girls (SIR, 1.0; 95% CI, 0.8–1.2). Fragility fractures at both major osteoporotic (hip, spine, wrist, and shoulder) sites (SIR, 2.6; 95% CI, 2.1–3.3) and remaining sites (SIR, 1.7; 95% CI, 1.3–2.0) were increased in men, irrespective of age at distal forearm fracture as boys. A distal forearm fracture in boys, but not girls, is associated with an increased risk for fragility fractures as older adults. It is necessary to determine whether the increased fractures observed in men is due to persistent deficits of bone strength, continued high fracture risk activity, or both. Until then, men should be asked about a childhood distal forearm fracture and, if so, warrant further screening and counseling on measures to optimize bone health and prevent fractures. PMID:23456800

Influence of Natural Fractures Cohesive Properties on Geometry of Hydraulic Fracture Networks

NASA Astrophysics Data System (ADS)

Gonzalez-Chavez, M. A.; Dahi Taleghani, A.; Puyang, P.

2014-12-01

An integrated modeling methodology is proposed to analyze hydraulic fracturing jobs in the presence of the natural fracture network in the formation. A propagating hydraulic fracture may arrest, cross, or diverts into a preexisting natural crack depending on fracture properties of rock and magnitude and direction of principal rock stresses. Opening of natural fractures during fracturing treatment could define the effectiveness of the stimulation technique. Here, we present an integrated methodology initiated with lab scale fracturing properties using Double Cantilever Beam tests (DCB) to determine cohesive properties of rock and natural fractures. We used cohesive finite element models to reproduce laboratory results to verify the numerical model for the interaction of the hydraulic fracture and individual cemented natural fractures. Based on the initial investigations, we found out that distribution of pre-existing natural fractures could play a significant role in the final geometry of the induced fracture network; however in practice, there is not much information about the distribution of natural fractures in the subsurface due to the limited access. Hence, we propose a special optimization scheme to generate natural fracture geometry from the location of microseismic events. Accordingly, the criteria of evaluating the fitness of natural fracture realizations is defined as the total minimum distance squares of all microseismic events, which is the sum of minimum square distance for all microseismic events. Moreover, an additional constraint in this problem is that we need to set a minimum distance between fracture grids. Using generated natural fracture realizations, forward field-scale simulations are implemented using cohesive finite element analysis to find the best match with the recorded bottomhole pressure. To show the robustness of the proposed workflow for real field problem, we implemented this technique on available data from several well Chicontepec basin to forecast post-treatment production rate. Our results show a constructive approach to integrate microseismic maps with lab mechanical measurements and bottomhole pressure to estimate the geometry of induced fracture network in the subsurface which does not suffer from any limiting assumption about fracture geometries.

High revision rate but good healing capacity of atypical femoral fractures. A comparison with common shaft fractures.

PubMed

Schilcher, Jörg

2015-12-01

Healing of complete, atypical femoral fractures is thought to be impaired, but the evidence is weak and appears to be based on the delayed healing observed in patients with incomplete atypical fractures. Time until fracture healing is difficult to assess, therefore we compared the reoperation rates between women with complete atypical femoral fractures and common femoral shaft fractures. We searched the orthopaedic surgical registry in Östergötland County for patients with subtrochanteric and femoral shaft fractures (ICD-10 diagnosis codes S72.2, S72.3 and M84.3F) between January 1st 2007 and December 31st 2013. Out of 895 patients with surgically treated femoral shaft fractures, 511 were women 50 years of age or older. Among these we identified 24 women with atypical femoral shaft fractures, and 71 with common shaft fractures. Reoperations were performed in 6 and 5 patients, respectively, odds ratio 4.4 (95% CI 1.2 to 16.1). However, 5 reoperations in the atypical fracture group could not be ascribed to poor healing. In 3 patients the reoperation was due to a new fracture proximal to a standard intramedullary nail. In 2 patients the distal locking screws were removed due to callus formation that was deemed incomplete 5 months post-operatively. The one patient with poor healing showed faint callus formation at 5 months when the fracture was dynamised and callus remained sparse at 11 months. Among patients with common shaft fractures, 2 reoperations were performed to remove loose screws, 2 because of peri-implant fractures and 1 reoperation due to infection. Reoperation rates in patients with complete atypical femoral fractures are higher than in patients with common shaft fractures. The main reason for failure was peri-implant fragility fractures which might be prevented with the use of cephalomedullary nails at the index surgery. Fracture healing however, seems generally good. A watchful waiting approach is advocated in patients with fractures that appear to heal slowly. Copyright © 2015 Elsevier Ltd. All rights reserved.

Distal Fibula Fractures in National Football League Athletes.

PubMed

Werner, Brian C; Mack, Christina; Franke, Kristina; Barnes, Ronnie P; Warren, Russell F; Rodeo, Scott A

2017-09-01

Despite the frequency of distal fibula fractures in elite athletes and the significant potential impact on the athletes' season and future careers, little data exist characterizing the epidemiology of these injuries or, more importantly, return to competition. To (1) evaluate the incidence of acute distal fibula fractures in National Football League (NFL) athletes, including isolated distal fibula and combined ankle fracture patterns; (2) analyze distal fibula fracture rates in NFL athletes by position, type of play, and contact type; (3) determine the rates of distal fibula fracture surgery in NFL athletes; and (4) report the days missed due to distal fibula fractures in NFL athletes. Descriptive epidemiology study. A retrospective review of distal fibula fractures reported to the NFL from 2000 to 2014 was performed using the NFL Injury Surveillance System. All distal fibula fractures were included, along with isolated and combined fracture patterns. Stress fractures and proximal fibula fractures were excluded. Epidemiological data and rates of surgery were determined. Return to sport was calculated and stratified by injury pattern and management. Overall, 237 distal fibula fractures in NFL athletes from 2000 to 2014 were included; 197 (83%) were isolated distal fibula fractures. A mean of 16 distal fibula fractures occurred each year (median, 16 per year). Fractures occurred most frequently on running (38%) and passing (24%) plays, but the frequency was next highest on kickoffs (16%), despite the relative infrequency of kickoffs during the average game compared with other play types. Surgery was reported for more than half of all distal fibula fractures (n = 128, 54%). Overall, patients who underwent surgery missed significantly more days (mean, 123.8 days) than players who did not undergo surgery (mean, 75.3 days) ( P < .001). Players with isolated distal fibula fractures had significantly fewer days missed (mean, 93.6 days) compared with those with combined patterns (mean, 132.3 days) ( P = .0004). Fibula fractures affect a number of NFL athletes and result in significant time missed from competition. Further research is required to determine the optimal management of fibula fractures in NFL athletes. In this study, time to return to play depended on both the fracture pattern and whether surgery was required and ranged from 72 to 145 days.

The subsurface impact of hydraulic fracturing in shales- Perspectives from the well and reservoir

NASA Astrophysics Data System (ADS)

ter Heege, Jan; Coles, Rhys

2017-04-01

It has been identified that the main risks of subsurface shale gas operations in the U.S.A. and Canada are associated with (1) drilling and well integrity, (2) hydraulic fracturing, and (3) induced seismicity. Although it is unlikely that hydraulic fracturing operations result in direct pathways of enhanced migration between stimulated fracture disturbed rock volume and shallow aquifers, operations may jeopardize well integrity or induce seismicity. From the well perspective, it is often assumed that fluid injection leads to the initiation of tensile (mode I) fractures at different perforation intervals along the horizontal sections of shale gas wells if pore pressure exceeds the minimum principal stress. From the reservoir perspective, rise in pore pressure resulting from fluid injection may lead to initiation of tensile fractures, reactivation of shear (mode II) fractures if the criterion for failure in shear is exceeded, or combinations of different fracturing modes. In this study, we compare tensile fracturing simulations using conventional well-based models with shear fracturing simulations using a fractured shale model with characteristic fault populations. In the fractured shale model, stimulated permeability is described by an analytical model that incorporates populations of reactivated faults and that combines 3D permeability tensors for layered shale matrix, damage zone and fault core. Well-based models applied to wells crosscutting the Posidonia Shale Formation are compared to generic fractured shale models, and fractured shale models are compared to micro-seismic data from the Marcellus Shale. Focus is on comparing the spatial distribution of permeability, stimulated reservoir volume and seismicity, and on differences in fracture initiation pressure and fracture orientation for tensile and shear fracturing end-members. It is shown that incorporation of fault populations (for example resulting from analysis of 3D seismics or outcrops) in hydraulic fracturing models provides better constraints on well pressures, stimulated fracture disturbed volume and induced seismicity. Thereby, it helps assessing the subsurface impact of hydraulic fracturing in shales and mitigating risks associated with loss of loss of well integrity, loss of fracture containment, and induced seismicity.

Finite element modeling of the influence of hand position and bone properties on the Colles' fracture load during a fall.

PubMed

Buchanan, Drew; Ural, Ani

2010-08-01

Distal forearm fracture is one of the most frequently observed osteoporotic fractures, which may occur as a result of low energy falls such as falls from a standing height and may be linked to the osteoporotic nature of the bone, especially in the elderly. In order to prevent the occurrence of radius fractures and their adverse outcomes, understanding the effect of both extrinsic and intrinsic contributors to fracture risk is essential. In this study, a nonlinear fracture mechanics-based finite element model is applied to human radius to assess the influence of extrinsic factors (load orientation and load distribution between scaphoid and lunate) and intrinsic bone properties (age-related changes in fracture properties and bone geometry) on the Colles' fracture load. Seven three-dimensional finite element models of radius were created, and the fracture loads were determined by using cohesive finite element modeling, which explicitly represented the crack and the fracture process zone behavior. The simulation results showed that the load direction with respect to the longitudinal and dorsal axes of the radius influenced the fracture load. The fracture load increased with larger angles between the resultant load and the dorsal axis, and with smaller angles between the resultant load and longitudinal axis. The fracture load also varied as a function of the load ratio between the lunate and scaphoid, however, not as drastically as with the load orientation. The fracture load decreased as the load ratio (lunate/scaphoid) increased. Multiple regression analysis showed that the bone geometry and the load orientation are the most important variables that contribute to the prediction of the fracture load. The findings in this study establish a robust computational fracture risk assessment method that combines the effects of intrinsic properties of bone with extrinsic factors associated with a fall, and may be elemental in the identification of high fracture risk individuals as well as in the development of fracture prevention methods including protective falling techniques. The additional information that this study brings to fracture identification and prevention highlights the promise of fracture mechanics-based finite element modeling in fracture risk assessment.

Multifocal humeral fractures.

PubMed

Maresca, A; Pascarella, R; Bettuzzi, C; Amendola, L; Politano, R; Fantasia, R; Del Torto, M

2014-02-01

Multifocal humeral fractures are extremely rare. These may affect the neck and the shaft, the shaft alone, or the diaphysis and the distal humerus. There is no classification of these fractures in the literature. From 2004 to 2010, 717 patients with humeral fracture were treated surgically at our department. Thirty-five patients presented with an associated fracture of the proximal and diaphyseal humerus: synthesis was performed with plate and screws in 34 patients, and the remaining patient had an open fracture that was treated with an external fixator. Mean follow-up was 3 years and 3 months. A classification is proposed in which type A fractures are those affecting the proximal and the humeral shaft, type B the diaphysis alone, and type C the diaphysis in association with the distal humerus. Type A fractures are then divided into three subgroups: A-I, undisplaced fracture of the proximal humerus and displaced shaft fracture; A-II: displaced fracture of the proximal and humeral shaft; and A-III: multifragmentary fracture affecting the proximal humerus and extending to the diaphysis. Multifocal humeral fractures are very rare and little described in the literature, both for classification and treatment. The AO classification describes bifocal fracture of the humeral diaphysis, type B and C. The classification suggested in this article mainly concerns fractures involving the proximal and humeral shaft. A simple classification of multifocal fractures is suggested to help the surgeon choose the most suitable type of synthesis for surgical treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

A discrete fracture model for two-phase flow in fractured porous media

NASA Astrophysics Data System (ADS)

Gläser, Dennis; Helmig, Rainer; Flemisch, Bernd; Class, Holger

2017-12-01

A discrete fracture model on the basis of a cell-centered finite volume scheme with multi-point flux approximation (MPFA) is presented. The fractures are included in a d-dimensional computational domain as (d - 1)-dimensional entities living on the element facets, which requires the grid to have the element facets aligned with the fracture geometries. However, the approach overcomes the problem of small cells inside the fractures when compared to equi-dimensional models. The system of equations considered is solved on both the matrix and the fracture domain, where on the prior the fractures are treated as interior boundaries and on the latter the exchange term between fracture and matrix appears as an additional source/sink. This exchange term is represented by the matrix-fracture fluxes, computed as functions of the unknowns in both domains by applying adequate modifications to the MPFA scheme. The method is applicable to both low-permeable as well as highly conductive fractures. The quality of the results obtained by the discrete fracture model is studied by comparison to an equi-dimensional discretization on a simple geometry for both single- and two-phase flow. For the case of two-phase flow in a highly conductive fracture, good agreement in the solution and in the matrix-fracture transfer fluxes could be observed, while for a low-permeable fracture the discrepancies were more pronounced. The method is then applied two-phase flow through a realistic fracture network in two and three dimensions.

Dimensional threshold for fracture linkage and hooking

NASA Astrophysics Data System (ADS)

Lamarche, Juliette; Chabani, Arezki; Gauthier, Bertrand D. M.

2018-03-01

Fracture connectivity in rocks depends on spatial properties of the pattern including length, abundance and orientation. When fractures form a single-strike set, they hardly cross-cut each other and the connectivity is limited. Linkage probability increases with increasing fracture abundance and length as small fractures connect to each other to form longer ones. A process for parallel fracture linkage is the "hooking", where two converging fracture tips mutually deviate and then converge to connect due to the interaction of their crack-tip stresses. Quantifying the processes and conditions for fracture linkage in single-strike fracture sets is crucial to better predicting fluid flow in Naturally Fractured Reservoirs. For 1734 fractures in Permian shales of the Lodève Basin, SE France, we measured geometrical parameters in 2D, characterizing three stages of the hooking process: underlapping, overlapping and linkage. We deciphered the threshold values, shape ratios and limiting conditions to switch from one stage to another one. The hook set up depends on the spacing (S) and fracture length (Lh) with the relation S ≈ 0.15 Lh. Once the hooking is initiated, with the fracture deviation length (L) L ≈ 0.4 Lh, the fractures reaches the linkage stage only when the spacing is reduced to S ≈ 0.02 Lh and the convergence (C) is < 0.1 L. These conditions apply to multi-scale fractures with a shape ratio L/S = 10 and for fracture curvature of 10°-20°.

Risk of fractures in an intermediate care facility for persons with mental retardation.

PubMed

Tannenbaum, T N; Lipworth, L; Baker, S

1989-01-01

The epidemiology of fractures among 553 residents of an intermediate care facility for persons with mental retardation was examined. In a 10-month period, 61 fractures occurred among 55 residents; application of fracture rates in the United States revealed an expected number of 15 fractures among the 553 residents, p less than .001. Although 52% of fractures involved small bones of the hands and feet, elderly residents were more likely to fracture major bones and to suffer their fractures from a fall than were younger residents. The relationship between potential risk factors and fracture risk were examined and implications for preventive and rehabilitative measures discussed.

Fracture mechanics; Proceedings of the 22nd National Symposium, Atlanta, GA, June 26-28, 1990. Vols. 1 & 2

NASA Technical Reports Server (NTRS)

Ernst, Hugo A. (Editor); Saxena, Ashok (Editor); Mcdowell, David L. (Editor); Atluri, Satya N. (Editor); Newman, James C., Jr. (Editor); Raju, Ivatury S. (Editor); Epstein, Jonathan S. (Editor)

1992-01-01

Current research on fracture mechanics is reviewed, focusing on ductile fracture; high-temperature and time-dependent fracture; 3D problems; interface fracture; microstructural aspects of fatigue and fracture; and fracture predictions and applications. Particular attention is given to the determination and comparison of crack resistance curves from wide plates and fracture mechanics specimens; a relationship between R-curves in contained and uncontained yield; the creep crack growth behavior of titanium alloy Ti-6242; a crack growth response in three heat resistant materials at elevated temperature; a crack-surface-contact model for determining effective-stress-intensity factors; interfacial dislocations in anisotropic bimaterials; an effect of intergranular crack branching on fracture toughness evaluation; the fracture toughness behavior of exservice chromium-molybdenum steels; the application of fracture mechanics to assess the significance of proof loading; and a load ratio method for estimating crack extension.

Onset of density-driven instabilities in fractured aquifers

NASA Astrophysics Data System (ADS)

Jafari Raad, Seyed Mostafa; Hassanzadeh, Hassan

2018-04-01

Linear stability analysis is conducted to study the onset of density-driven convection involved in solubility trapping of C O2 in fractured aquifers. The effect of physical properties of a fracture network on the stability of a diffusive boundary layer in a saturated fractured porous media is investigated using the dual porosity concept. Linear stability analysis results show that both fracture interporosity flow and fracture storativity play an important role in the stability behavior of the system. It is shown that a diffusive boundary layer under the gravity field in fractured porous media with lower fracture storativity and/or higher fracture interporosity flow coefficient is more stable. We present scaling relations for the onset of convective instability in fractured aquifers with single and variable matrix block size distribution. These findings improve our understanding of density-driven flow in fractured aquifers and are important in the estimation of potential storage capacity, risk assessment, and storage site characterization and screening.

[Fractures of the proximal interphalangeal joint: Diagnostic and operative therapy options].

PubMed

Unglaub, F; Langer, M F; Hahn, P; Müller, L P; Ahrens, C; Spies, C K

2016-02-01

Joint fractures of the fingers often entail operative interventions in contrast to extra-articular fractures. These types of fracture are inclined to dislocate in addition to the actual fracture. The proximal interphalangeal (PIP) joint in particular often shows comminuted fractures due to the long leverage of the finger and a relatively small diameter of the joint. The clinical examination, X-ray diagnostics and if necessary computed tomography allow the classification into stable and unstable fractures. Unstable fractures must be treated by surgical reduction and fixation. A multitude of operative techniques are available for these mostly complicated fractures. The foremost goal is a stable osteosynthesis of the fracture with repositioning of the dislocation, which enables early physiotherapy in order to prevent tendon adhesion and contracture. This article presents the different types of PIP joint fractures, their specific surgical treatment and postoperative treatment regimens.

Self-Organizing Fluid Convection Patterns in an en Echelon Fault Array

NASA Astrophysics Data System (ADS)

Patterson, James W.; Driesner, Thomas; Matthai, Stephan K.

2018-05-01

We present three-dimensional numerical simulations of natural convection in buried, vertical en echelon faults in impermeable host rock. Despite the fractures being hydraulically disconnected, convection within each fracture alters the temperature field in the surrounding host rock, altering convection in neighboring fractures. This leads to self-organization of coherent patterns of upward/downward flow and heating/cooling of the host rock spanning the entire fault array. This "synchronization" effect occurs when fracture spacing is less than the width of convection cells within the fractures, which is controlled by fracture transmissivity (permeability times thickness) and heterogeneity. Narrow fracture spacing and synchronization enhance convective fluid flow within fractures and cause convection to initiate earlier, even lowering the critical transmissivity necessary for convection initiation. Heat flow through the en echelon region, however, is enhanced only in low-transmissivity fractures, while heat flow in high-permeability fractures is reduced due to thermal interference between fractures.

a Fractal Network Model for Fractured Porous Media

NASA Astrophysics Data System (ADS)

Xu, Peng; Li, Cuihong; Qiu, Shuxia; Sasmito, Agus Pulung

2016-04-01

The transport properties and mechanisms of fractured porous media are very important for oil and gas reservoir engineering, hydraulics, environmental science, chemical engineering, etc. In this paper, a fractal dual-porosity model is developed to estimate the equivalent hydraulic properties of fractured porous media, where a fractal tree-like network model is used to characterize the fracture system according to its fractal scaling laws and topological structures. The analytical expressions for the effective permeability of fracture system and fractured porous media, tortuosity, fracture density and fraction are derived. The proposed fractal model has been validated by comparisons with available experimental data and numerical simulation. It has been shown that fractal dimensions for fracture length and aperture have significant effect on the equivalent hydraulic properties of fractured porous media. The effective permeability of fracture system can be increased with the increase of fractal dimensions for fracture length and aperture, while it can be remarkably lowered by introducing tortuosity at large branching angle. Also, a scaling law between the fracture density and fractal dimension for fracture length has been found, where the scaling exponent depends on the fracture number. The present fractal dual-porosity model may shed light on the transport physics of fractured porous media and provide theoretical basis for oil and gas exploitation, underground water, nuclear waste disposal and geothermal energy extraction as well as chemical engineering, etc.

Application of fracture mechanics to failure in manatee rib bone.

PubMed

Yan, Jiahau; Clifton, Kari B; Reep, Roger L; Mecholsky, John J

2006-06-01

The Florida manatee (Trichechus manatus latirostris) is listed as endangered by the U.S. Department of the Interior. Manatee ribs have different microstructure from the compact bone of other mammals. Biomechanical properties of the manatee ribs need to be better understood. Fracture toughness (K(C)) has been shown to be a good index to assess the mechanical performance of bone. Quantitative fractography can be used in concert with fracture mechanics equations to identify fracture initiating defects/cracks and to calculate the fracture toughness of bone materials. Fractography is a standard technique for analyzing fracture behavior of brittle and quasi-brittle materials. Manatee ribs are highly mineralized and fracture in a manner similar to quasi-brittle materials. Therefore, quantitative fractography was applied to determine the fracture toughness of manatee ribs. Average fracture toughness values of small flexure specimens from six different sizes of manatees ranged from 1.3 to 2.6 MPa(m)(12). Scanning electron microscope (SEM) images show most of the fracture origins were at openings for blood vessels and interlayer spaces. Quantitative fractography and fracture mechanics can be combined to estimate the fracture toughness of the material in manatee rib bone. Fracture toughness of subadult and calf manatees appears to increase as the size of the manatee increases. Average fracture toughness of the manatee rib bone materials is less than the transverse fracture toughness of human and bovine tibia and femur.

Insights from the Global Longitudinal Study of Osteoporosis in Women (GLOW).

PubMed

Watts, Nelson B

2014-07-01

GLOW is an observational, longitudinal, practice-based cohort study of osteoporosis in 60,393 women aged ≥55 years in 10 countries on three continents. In this Review, we present insights from the first 3 years of the study. Despite cost analyses being frequently based on spine and hip fractures, we found that nonvertebral, nonhip fractures were around five times more common and doubled the use of health-care resources compared with hip and spine fractures combined. Fractures not at the four so-called major sites in FRAX(®) (upper arm, forearm, hip and clinical vertebral fractures) account for >40% of all fractures. The risk of fracture is increased by various comorbidities, such as Parkinson disease, multiple sclerosis and lung and heart disease. Obesity, although thought to be protective against all fractures, substantially increased the risk of fractures in the ankle or lower leg. Simple assessment by age plus fracture history has good predictive value for all fractures, but risk profiles differ for first and subsequent fractures. Fractures diminish quality of life as much or more than diabetes mellitus, arthritis and lung disease, yet women substantially underestimate their own fracture risk. Treatment rates in patients at high risk of fracture are below those recommended but might be too frequent in women at low risk. Comorbidities and the limits of current therapeutic regimens jeopardize the efficacy of drugs; new regimens should be explored for severe cases.

Open natural fractures in sandstone at 18,300 ft: Do they help or hinder production of gas?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lorenz, J.C.; Billingsley, R.L.; Evans, L.W.

1996-06-01

Vertical core, from relatively undeformed Cretaceous (Frontier FM) sandstones at a depth of 18,300 ft in the Green River Basin, contains three sets of mineralized natural fractures. The earliest fractures opened in extension as the strata passed through the hydrocarbon window. Continued subsidence and the maturation of organic material created overpressured conditions, causing oil to be injected into the fractures. Only a carbon residue of the original oil remains in these fractures, suggesting continued burial and maturation. The residue seriously inhibits permeability along and across fractures. Oil residue is also present in oblique, unmineralized mare`s-tails at the ends of fractures,more » suggesting that the in situ stress orientations had changed slightly. Quartz crystals mineralized the fracture walls, growing over the oil residue or pushing it aside. A second set of extension fractures strikes 20-30 degrees oblique to the first set. These fractures are mineralized with calcite, which was also deposited over the quartz in the first fracture set. Continued tectonism reoriented the horizontal stresses by nearly 90 degrees, forming a third set of extension fractures and further degrading permeability by narrowing apertures along earlier fractures. Significant porosity remains along many of the fractures at this depth, yet the in situ stresses and oil residue have combined to degrade fracture permeability to uneconomic matrix values.« less

Open natural fractures in sandstone at 18,300 ft: Do they help or hinder production of gas?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lorenz, J.C.; Billingsley, R.L.; Evans, L.W.

1995-06-01

Vertical core, from relatively undeformed Cretaceous (Frontier Fm) sandstones at a depth of 18,300 ft in the Green River Basin, contains three sets of mineralized natural fractures. The earliest fractures opened in extension as the strata passed through the hydrocarbon window. Continued subsidence and the maturation of organic material created overpressured conditions, causing oil to be injected into the fractures. Only a carbon residue of the original oil remains in these fractures, suggesting continued burial and maturation. The residue seriously inhibits permeability along and across fractures. Oil residue is also present in oblique, unmineralized mare`s-tails at the ends of fractures,more » suggesting that the in-situ stress orientations had changed slightly. Quartz crystals mineralized the fracture walls, growing over the oil residue or pushing it aside. A second set of extension fractures strikes 20-30 degrees oblique to the first set. These fractures are mineralized with calcite, which was also deposited over the quartz in the first fracture set. Continued tectonism reoriented the horizontal stresses by nearly 90 degrees, forming a third set of extension fractures and further degrading permeability by narrowing apertures along earlier fractures. Significant porosity remains along many of the fractures at this depth, yet the in situ stresses and oil residue have combined to degrade fracture permeability to uneconomic matrix values.« less

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 compound fractures, most cases had to undergo surgical repairs. PMID:25729514

Paratrooper's ankle fracture: posterior malleolar fracture.

PubMed

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

2015-03-01

We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. 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. 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. Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to undergo surgical repairs.

Fracture predictive ability of physical performance tests and history of falls in elderly women: a 10-year prospective study.

PubMed

Wihlborg, A; Englund, M; Åkesson, K; Gerdhem, P

2015-08-01

In a large cohort of elderly women followed for 10 years, we found that balance, gait speed, and self-reported history of fall independently predicted fracture. These clinical risk factors are easily evaluated and therefore advantageous in a clinical setting. They would improve fracture risk assessment and thereby also fracture prevention. The aim of this study was to identify additional risk factors for osteoporosis-related fracture by investigating the fracture predictive ability of physical performance tests and self-reported history of falls. In the population-based Osteoporosis Prospective Risk Assessment study (OPRA), 1044 women were recruited at the age of 75 and followed for 10 years. At inclusion, knee extension force, standing balance, gait speed, and bone mineral density (BMD) were examined. Falls the year before investigation was assessed by questionnaire. Cox proportional hazards regression analysis was used to determine fracture hazard ratios (HR) with BMD, history of fracture, BMI, smoking habits, bisphosphonate, vitamin D, glucocorticoid, and alcohol use as covariates. Continuous variables were standardized and HR shown for each standard deviation change. Of all women, 427 (41%) sustained at least one fracture during the 10-year follow-up. Failing the balance test had an HR of 1.98 (1.18-3.32) for hip fracture. Each standard deviation decrease in gait speed was associated with an HR of 1.37 (1.14-1.64) for hip fracture. Previous fall had an HR of 1.30 (1.03-1.65) for any fracture; 1.39 (1.08-1.79) for any osteoporosis-related fracture; and 1.60 (1.03-2.48) for distal forearm fracture. Knee extension force did not show fracture predictability. The balance test, gait speed test, and self-reported history of fall all hold independent fracture predictability. Consideration of these clinical risk factors for fracture would improve the fracture risk assessment and subsequently also fracture prevention.

The use of hybrid fractures in paleostress determinations: test case with the the Palygorskite-bearing fractures in the Kinshasa area, DR Congo

NASA Astrophysics Data System (ADS)

Delvaux, Damien; Gloire, Ganza; Mees, Florias; Lahogue, Pascale

2014-05-01

Hybrid fractures represent the transition from extension fracture to shear fracture (Ramsey and Chester, 2004, Nature 428, 63-66). Although hybrid fractures have long been hypothesized to represent brittle fracture types between the extension and shear fractures end-members, it was only in 2004 that these authors succeeded to demonstrate their existence experimentally. As a consequence, observation of hybrid fractures in naturally deformed rocks remained ambiguous for a long time and only few studies reported their natural existence. Hybrid fractures have also not been considered so far as brittle element in paleostress reconstructions as their kinematic understanding was unclear. The Paleozoic Inkisi red sandstones of the West-Congo Supergroup in the region of Kinshasa and Brazzaville (Congo) are affected by prominent fracture sets, the most prominent of which are filled by palygorskite veins. They were formed in a strike-slip setting related to intraplate stress field generated by the mid Atlantic ridge push since that became efficient in late Cretaceous. We found an almost continuous range of fracture types, from plume joints to open fractures filled with calcite-palygorskite but without slip striae, and slickensided fractures with only thin films of redeposited palygorskite. The structural data have been analyzed with the Win-Tensor program (version 5.0.1) which has been adapted to consider hybrid fractures. Those are characterized by extension and shear, as opposed to tension fractures, on which no shear movement occurs, and to shear fractures, on which contraction occurs instead of extension. The results obtained suggest that the fractures have been initiated locally as plume joint and developed laterally under hybrid conditions. Later, some of them have been reactivated as strike-slip shear fractures and a new conjugated set appeared. Overall, this illustrates the progressive development with time of the stress state corresponding to an increase in the sigma 1 - sigma 3 stress difference.

External validation of the Garvan nomograms for predicting absolute fracture risk: the Tromsø study.

PubMed

Ahmed, Luai A; Nguyen, Nguyen D; Bjørnerem, Åshild; Joakimsen, Ragnar M; Jørgensen, Lone; Størmer, Jan; Bliuc, Dana; Center, Jacqueline R; Eisman, John A; Nguyen, Tuan V; Emaus, Nina

2014-01-01

Absolute risk estimation is a preferred approach for assessing fracture risk and treatment decision making. This study aimed to evaluate and validate the predictive performance of the Garvan Fracture Risk Calculator in a Norwegian cohort. The analysis included 1637 women and 1355 aged 60+ years from the Tromsø study. All incident fragility fractures between 2001 and 2009 were registered. The predicted probabilities of non-vertebral osteoporotic and hip fractures were determined using models with and without BMD. The discrimination and calibration of the models were assessed. Reclassification analysis was used to compare the models performance. The incidence of osteoporotic and hip fracture was 31.5 and 8.6 per 1000 population in women, respectively; in men the corresponding incidence was 12.2 and 5.1. The predicted 5-year and 10-year probability of fractures was consistently higher in the fracture group than the non-fracture group for all models. The 10-year predicted probabilities of hip fracture in those with fracture was 2.8 (women) to 3.1 times (men) higher than those without fracture. There was a close agreement between predicted and observed risk in both sexes and up to the fifth quintile. Among those in the highest quintile of risk, the models over-estimated the risk of fracture. Models with BMD performed better than models with body weight in correct classification of risk in individuals with and without fracture. The overall net decrease in reclassification of the model with weight compared to the model with BMD was 10.6% (p = 0.008) in women and 17.2% (p = 0.001) in men for osteoporotic fractures, and 13.3% (p = 0.07) in women and 17.5% (p = 0.09) in men for hip fracture. The Garvan Fracture Risk Calculator is valid and clinically useful in identifying individuals at high risk of fracture. The models with BMD performed better than those with body weight in fracture risk prediction.

Growth Kinematics of Opening-Mode Fractures

NASA Astrophysics Data System (ADS)

Eichhubl, P.; Alzayer, Y.; Laubach, S.; Fall, A.

2014-12-01

Fracture aperture is a primary control on flow in fractured reservoirs of low matrix permeability including unconventional oil and gas reservoirs and most geothermal systems. Guided by principles of linear elastic fracture mechanics, fracture aperture is generally assumed to be a linear function of fracture length and elastic material properties. Natural opening-mode fractures with significant preserved aperture are observed in core and outcrop indicative of fracture opening strain accommodated by permanent solution-precipitation creep. Fracture opening may thus be decoupled from length growth if the material effectively weakens after initial elastic fracture growth by either non-elastic deformation processes or changes in elastic properties. To investigate the kinematics of fracture length and aperture growth, we reconstructed the opening history of three opening-mode fractures that are bridged by crack-seal quartz cement in Travis Peak Sandstone of the SFOT-1 well, East Texas. Similar crack-seal cement bridges had been interpreted to form by repeated incremental fracture opening and subsequent precipitation of quartz cement. We imaged crack-seal cement textures for bridges sampled at varying distance from the tips using scanning electron microscope cathodoluminescence, and determined the number and thickness of crack-seal cement increments as a function of position along the fracture length and height. Observed trends in increment number and thickness are consistent with an initial stage of fast fracture propagation relative to aperture growth, followed by a stage of slow propagation and pronounced aperture growth. Consistent with fluid inclusion observations indicative of fracture opening and propagation occurring over 30-40 m.y., we interpret the second phase of pronounced aperture growth to result from fracture opening strain accommodated by solution-precipitation creep and concurrent slow, possibly subcritical, fracture propagation. Similar deformation mechanisms are envisioned to govern fracture growth over shorter timescales in reactive chemical subsurface environments including CO2 reservoirs, organic-rich shales, and geothermal systems.

Application of Reservoir Flow Simulation Integrated with Geomechanics in Unconventional Tight Play

NASA Astrophysics Data System (ADS)

Lin, Menglu; Chen, Shengnan; Mbia, Ernest; Chen, Zhangxing

2018-01-01

Multistage hydraulic fracturing techniques, combined with horizontal drilling, have enabled commercial production from the vast reserves of unconventional tight formations. During hydraulic fracturing, fracturing fluid and proppants are pumped into the reservoir matrix to create the hydraulic fractures. Understanding the propagation mechanism of hydraulic fractures is essential to estimate their properties, such as half-length. In addition, natural fractures are often present in tight formations, which might be activated during the fracturing process and contribute to the post-stimulation well production rates. In this study, reservoir simulation is integrated with rock geomechanics to predict the well post-stimulation productivities. Firstly, a reservoir geological model is built based on the field data collected from the Montney formation in the Western Canadian Sedimentary Basin. The hydraulic fracturing process is then simulated through an integrated approach of fracturing fluid injection, rock geomechanics, and tensile failure criteria. In such a process, the reservoir pore pressure increases with a continuous injection of the fracturing fluid and proppants, decreasing the effective stress exerted on the rock matrix accordingly as the overburden pressure remains constant. Once the effective stress drops to a threshold value, tensile failure of the reservoir rock occurs, creating hydraulic fractures in the formation. The early production history of the stimulated well is history-matched to validate the predicted fracture geometries (e.g., half-length) generated from the fracturing simulation process. The effects of the natural fracture properties and well bottom-hole pressures on well productivity are also studied. It has been found that nearly 40% of hydraulic fractures propagate in the beginning stage (the pad step) of the fracturing schedule. In addition, well post-stimulation productivity will increase significantly if the natural fractures are propped or partially propped by the proppants. This paper provides insights on fracture propagation and can be a reference for fracturing treatments in unconventional tight reservoirs.

Prevalence of carpal fracture in Singapore.

PubMed

Hey, Hwee Weng Dennis; Dennis, Hey Hwee Weng; Chong, Alphonsus Khin Sze; Sze, Alphonsus Chong Khin; Murphy, Diarmuid

2011-02-01

To determine the prevalence of carpal fracture in Singapore, to compare demographic differences between isolated scaphoid and other carpal fractures, and to identify parameters associated with multiple carpal fractures. A total of 149 patients with 162 carpal fractures seen at the National University Hospital in 2009 were enrolled into the study. We retrospectively reviewed their case records and radiographic studies. Pertinent demographic data including patient age, gender, occupation, injured wrist, dominant hand, mechanism of injury, and type of carpal fracture were then recorded and statistically analyzed. We also performed a separate analysis of isolated scaphoid versus other carpal fractures and single versus multiple carpal fractures. Patients with carpal fracture were predominantly male (132), below 40 years of age (116), and usually right hand dominant (136). The more common occupations were students (30), full-time military national servicemen (24), and construction workers (14). Most presented after a fall on an outstretched hand from standing height (81). The scaphoid was the most common single carpal fracture (99). This was followed by triquetrum (27), hamate (5), pisiform (4), lunate (2), capitate (1), and trapezium (1). No fracture of the trapezoid was encountered. Ten patients had multiple carpal fractures, of which 4 were perilunate fracture dislocations. The mean age and male/female ratio for isolated scaphoid and other carpal fractures was 26 years versus 41 years (p<.001) and 13:1 versus 4:1 (p=.036), respectively. A high-energy mechanism of injury was the only parameter associated with multiple carpal fractures (p=.009). The prevalence of carpal fracture in our population was consistent with studies performed in other countries. Military conscription was identified as an at-risk activity predisposing to carpal fracture. Isolated scaphoid and other carpal fractures exhibit different demographics in terms of age and gender, which may be related to differences in the mechanism of injury. A high-energy mechanism of injury was associated with multiple carpal fractures. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Epidemiology and recent trends of geriatric fractures presenting to the emergency department for United States population from year 2004-2014.

PubMed

Baidwan, N K; Naranje, S M

2017-01-01

Fractures in geriatric age group (over 65 years of age) are an important public health issue and frequent causes of emergency room visits. The purpose of this descriptive epidemiological study was to present the epidemiology of geriatric fractures and their trends in the USA using National Electronic Injury Surveillance System (NEISS) database from year 2004-2014. National Electronic Injury Surveillance System (NEISS) Database was queried for all fracture injuries from 2004 to 2014 for ages 65 years and above. The proportions of fractures based on NEISS national estimates were calculated and their trends using linear regression over last 11 years were studied. Lower trunk (pelvis, hip and lower spine) fractures were the most common (34% for year 2014) type of fractures in this age group. Upper trunk (upper spine, clavicle and ribs) fractures were the second most common type of fractures (13% for year 2014). Other body parts commonly fractured involved the upper arm and wrist with an average of 7% fractures in both during the study period. About 5% of geriatric fractures pertained to shoulder and upper leg. Although less common, there was also about 2% increase in fractures to face and neck in 2014 as compared to about 3.2% and 1% respectively in 2004. Fractures to other body parts were less common with no major variations during the study period. Overall, lower trunk (hip, pelvic and lower spine) fractures were the most common geriatric fractures followed by upper trunk (upper spine, clavicle and rib) fractures. We suggest that there were decreasing trends for incidence of lower trunk, wrist and upper body fractures over the last 11 years (2004-2014). Approximately half of the geriatric fractures presenting to Emergency Department needed hospitalizations. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Clinical effects of internal fixation for ulnar styloid fractures associated with distal radius fractures: A matched case-control study.

PubMed

Sawada, Hideyoshi; Shinohara, Takaaki; Natsume, Tadahiro; Hirata, Hitoshi

2016-11-01

Ulnar styloid fractures are often associated with distal radius fractures. However, controversy exists regarding whether to treat ulnar styloid fractures. This study aimed to evaluate clinical effects of internal fixation for ulnar styloid fractures after distal radius fractures were treated with the volar locking plate system. We used prospectively collected data of distal radius fractures. 111 patients were enrolled in this study. A matched case-control study design was used. We selected patients who underwent fixation for ulnar styloid fractures (case group). Three control patients for each patient of the case group were matched on the basis of age, sex, and fracture type of distal radius fractures from among patients who did not undergo fixation for ulnar styloid fractures (control group). The case group included 16 patients (7 men, 9 women; mean age: 52.6 years; classification of ulnar styloid fractures: center, 3; base, 11; and proximal, 2). The control group included 48 patients (15 men, 33 women; mean age: 61.1 years; classification of ulnar styloid fractures: center, 10; base, 31; and proximal, 7). For radiographic examination, the volar tilt angle, radial inclination angle, and ulnar variance length were measured, and the union of ulnar styloid fractures was judged. For clinical examination, the range of motions, grip strength, Hand20 score, and Numeric Rating Scale score were evaluated. There was little correction loss for each radiological parameter of fracture reduction, and these parameters were not significantly different between the groups. The bone-healing rate of ulnar styloid fractures was significantly higher in the case group than in the control group, but the clinical results were not significantly different. We revealed that there was no need to fix ulnar styloid fractures when distal radius fractures were treated via open reduction and internal fixation with a volar locking plate system. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Linear Elastic and Cohesive Fracture Analysis to Model Hydraulic Fracture in Brittle and Ductile Rocks

NASA Astrophysics Data System (ADS)

Yao, Yao

2012-05-01

Hydraulic fracturing technology is being widely used within the oil and gas industry for both waste injection and unconventional gas production wells. It is essential to predict the behavior of hydraulic fractures accurately based on understanding the fundamental mechanism(s). The prevailing approach for hydraulic fracture modeling continues to rely on computational methods based on Linear Elastic Fracture Mechanics (LEFM). Generally, these methods give reasonable predictions for hard rock hydraulic fracture processes, but still have inherent limitations, especially when fluid injection is performed in soft rock/sand or other non-conventional formations. These methods typically give very conservative predictions on fracture geometry and inaccurate estimation of required fracture pressure. One of the reasons the LEFM-based methods fail to give accurate predictions for these materials is that the fracture process zone ahead of the crack tip and softening effect should not be neglected in ductile rock fracture analysis. A 3D pore pressure cohesive zone model has been developed and applied to predict hydraulic fracturing under fluid injection. The cohesive zone method is a numerical tool developed to model crack initiation and growth in quasi-brittle materials considering the material softening effect. The pore pressure cohesive zone model has been applied to investigate the hydraulic fracture with different rock properties. The hydraulic fracture predictions of a three-layer water injection case have been compared using the pore pressure cohesive zone model with revised parameters, LEFM-based pseudo 3D model, a Perkins-Kern-Nordgren (PKN) model, and an analytical solution. Based on the size of the fracture process zone and its effect on crack extension in ductile rock, the fundamental mechanical difference of LEFM and cohesive fracture mechanics-based methods is discussed. An effective fracture toughness method has been proposed to consider the fracture process zone effect on the ductile rock fracture.

The ameloblastin extracellular matrix molecule enhances bone fracture resistance and promotes rapid bone fracture healing.

PubMed

Lu, Xuanyu; Li, Wenjin; Fukumoto, Satoshi; Yamada, Yoshihiko; Evans, Carla A; Diekwisch, Tom; Luan, Xianghong

2016-01-01

The extracellular matrix (ECM) provides structural support, cell migration anchorage, cell differentiation cues, and fine-tuned cell proliferation signals during all stages of bone fracture healing, including cartilaginous callus formation, callus remodeling, and bony bridging of the fracture gap. In the present study we have defined the role of the extracellular matrix protein ameloblastin (AMBN) in fracture resistance and fracture healing of mouse long bones. To this end, long bones from WT and AMBN(Δ5-6) truncation model mice were subjected to biomechanical analysis, fracture healing assays, and stem cell colony formation comparisons. The effect of exogenous AMBN addition to fracture sites was also determined. Our data indicate that lack of a functional AMBN in the bone matrix resulted in 31% decreased femur bone mass and 40% reduced energy to failure. On a cellular level, AMBN function inhibition diminished the proliferative capacity of fracture repair callus cells, as evidenced by a 58% reduction in PCNA and a 40% reduction in Cyclin D1 gene expression, as well as PCNA immunohistochemistry. In terms of fracture healing, AMBN truncation was associated with an enhanced and prolonged chondrogenic phase, resulting in delayed mineralized tissue gene expression and delayed ossification of the fracture repair callus. Underscoring a role of AMBN in fracture healing, there was a 6.9-fold increase in AMBN expression at the fracture site one week after fracture, and distinct AMBN immunolabeling in the fracture gap. Finally, application of exogenous AMBN protein to bone fracture sites accelerated callus formation and bone fracture healing (33% increase in bone volume and 19% increase in bone mineral density), validating the findings of our AMBN loss of function studies. Together, these data demonstrate the functional importance of the AMBN extracellular matrix protein in bone fracture prevention and rapid fracture healing. Copyright © 2016 International Society of Matrix Biology. Published by Elsevier B.V. All rights reserved.

The Ameloblastin extracellular matrix molecule enhances bone fracture resistance and promotes rapid bone fracture healing

PubMed Central

Lu, Xuanyu; Li, Wenjin; Fukumoto, Satoshi; Yamada, Yoshihiko; Evans, Carla; Diekwisch, Thomas G.H.; Luan, Xianghong

2016-01-01

The extracellular matrix (ECM) provides structural support, cell migration anchorage, cell differentiation cues, and fine-tuned cell proliferation signals during all stages of bone fracture healing, including cartilaginous callus formation, callus remodeling, and bony bridging of the fracture gap. In the present study we have defined the role of the extracellular matrix protein ameloblastin (AMBN) in fracture resistance and fracture healing of mouse long bones. To this end, long bones from WT and AMBNΔ5-6 truncation model mice were subjected to biomechanical analysis, fracture healing assays, and stem cell colony formation comparisons. The effect of exogenous AMBN addition to fracture sites was also determined. Our data indicate that lack of a functional AMBN in the bone matrix resulted in 31% decreased femur bone mass and 40% reduced energy to failure. On a cellular level, AMBN function inhibition diminished the proliferative capacity of fracture repair callus cells, as evidenced by a 58% reduction in PCNA and a 40% reduction in Cyclin D1 gene expression, as well as PCNA immunohistochemistry. In terms of fracture healing, AMBN truncation was associated with an enhanced and prolonged chondrogenic phase, resulting in delayed mineralized tissue gene expression and delayed ossification of the fracture repair callus. Underscoring a role of AMBN in fracture healing, there was a 6.9-fold increase in AMBN expression at the fracture site one week after fracture, and distinct AMBN immunolabeling in the fracture gap. Finally, application of exogenous AMBN protein to bone fracture sites accelerated callus formation and bone fracture healing (33% increase in bone volume and 19% increase in bone mineral density), validating the findings of our AMBN loss of function studies. Together, these data demonstrate the functional importance of the AMBN extracellular matrix protein in bone fracture prevention and rapid fracture healing. PMID:26899203

Burden of non-hip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW).

PubMed

Roux, C; Wyman, A; Hooven, F H; Gehlbach, S H; Adachi, J D; Chapurlat, R D; Compston, J E; Cooper, C; Díez-Pérez, A; Greenspan, S L; Lacroix, A Z; Netelenbos, J C; Pfeilschifter, J; Rossini, M; Saag, K G; Sambrook, P N; Silverman, S; Siris, E S; Watts, N B; Boonen, S

2012-12-01

Among 50,461 postmenopausal women, 1,822 fractures occurred (57% minor non-hip, non-vertebral [NHNV], 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D, followed by major NHNV and hip fractures. Decreases in physical function and health status were greatest for spine or hip fractures. There is growing evidence that NHNV fractures result in substantial morbidity and healthcare costs. The aim of this prospective study was to assess the effect of these NHNV fractures on quality of life. We analyzed the 1-year incidences of hip, spine, major NHNV (pelvis/leg, shoulder/arm) and minor NHNV (wrist/hand, ankle/foot, rib/clavicle) fractures among women from the Global Longitudinal study of Osteoporosis in Women (GLOW). Health-related quality of life (HRQL) was analyzed using the EuroQol EQ-5D tool and the SF-36 health survey. Among 50,461 women analyzed, there were 1,822 fractures (57% minor NHNV, 26% major NHNV, 10% spine, 7% hip) over 1 year. Spine fractures had the greatest detrimental effect on EQ-5D summary scores, followed by major NHNV and hip fractures. The number of women with mobility problems increased most for those with major NHNV and spine fractures (both +8%); spine fractures were associated with the largest increases in problems with self care (+11%), activities (+14%), and pain/discomfort (+12%). Decreases in physical function and health status were greatest for those with spine or hip fractures. Multivariable modeling found that EQ-5D reduction was greatest for spine fractures, followed by hip and major/minor NHNV. Statistically significant reductions in SF-36 physical function were found for spine fractures, and were borderline significant for major NHNV fractures. This prospective study shows that NHNV fractures have a detrimental effect on HRQL. Efforts to optimize the care of osteoporosis patients should include the prevention of NHNV fractures.

Forecasting the burden of future postmenopausal hip fractures.

PubMed

Omsland, T K; Magnus, J H

2014-10-01

A growing elderly population is expected worldwide, and the rate of hip fractures is decisive for the future fracture burden. Significant declines in hip fracture rates in Norway, the USA, France, Germany, and the UK are required to counteract the impact of the ageing effects. This study aims to evaluate the consequences of the expected growth of the elderly population worldwide on the hip fracture burden using Norway as an example. Furthermore, we wanted to estimate the decline in hip fracture rates required to counteract the anticipated increase in the burden of hip fracture for Norway, the USA, France, Germany, and the UK. The burden of future postmenopausal hip fractures in Norway were estimated given (1) constant age-specific rates, (2) continued decline, and (3) different cohort scenarios. Based on population projection estimates and population age-specific hip fracture rates in women 65 years and older, we calculated the required declines in hip fracture rates needed to counteract the growing elderly populations in Norway, the USA, France, Germany, and the UK. The level of age-specific hip fracture rates had a huge impact on the future hip fracture burden in Norway. Even if the hip fracture rates decline at the same speed, a 22 % increase in the burden of hip fractures can be expected by 2040. An annual decline in hip fracture rates of 1.1-2.2 % until 2040 is required to counteract the effects of the growing elderly population on the future burden of hip fractures in Norway, the USA, France, Germany, and the UK. Hip fracture rates have a great impact on the burden of hip fractures. The rates will have to decline significantly to counteract the impact of a growing elderly population. A change in preventive strategies and further studies are warranted to identify the complex causes associated to hip fractures.

Fractures of the manubrium sterni: treatment options and a possible classification of different types of fractures

PubMed Central

Krinner, Sebastian; Oppel, Pascal; Grupp, Sina; Schulz-Drost, Melanie; Hennig, Friedrich F.; Langenbach, Andreas

2018-01-01

Background Sternum fractures are mostly located on the sternal corpus, seldom on the manubrium. Fractures of the sternal manubrium are, however, more frequently associated with severe concomitant injuries of thoracic organs, and therefore deserve special attention. In addition, in its function as a capstone in between the anterior chest wall and the shoulder girdle, it is exposed to a multiplicity of forces. Therefore the questions arise what types of fractures are observed in today’s clinical practice, how to classify them and which treatment options are available. This study reports on different types of fractures which involve the manubrium sterni. Methods Between January 2012 and October 2014, data was collected from all severely injured patients (ISS ≥16), which received a CT scan of the thorax in our Level-I-Trauma Center and retrospectively analyzed concerning sternal fractures. Fracture type, collateral injuries, age, and information about the circumstances of the accident were noted. Results Of 890 evaluable patients, 154 (17.3%) had a fracture of the sternum and 23 (2.6%) of the manubrium. Fractures of the manubrium appeared in following types: A-type—transverse fracture (n=11) in 1st intercostal space by direct blunt trauma or flexion of the torso with sagittal instability; B-type—oblique fracture (n=9) by seat belt injury with rotatory instability; C-type—combined, more fragmentary fracture (n=3) by direct blunt trauma with simultaneous flexion of the torso and multi directional instability. Fractures only little dislocation were treated conservatively, and unstable fractures were surgically stabilized (n=10). Conclusions In summary, three main types of fractures could be found. A-type fractures were stabilized with a longitudinal plate osteosynthesis and B-type fractures with transverse positioned plates. To treat complex C-type fractures, plates with a T- or H-form could be a good solution. Level of evidence: Level III retrospective prognostic cohort study PMID:29707289

Fracture of Fully-coated Femoral Stem after Primary Total Hip Arthroplasty for Nonunion of Intertrochanteric Fracture: A Case Report.

PubMed

Chun, Young Soo; Juh, Hyung Suk; Cho, Yoon Je; Rhyu, Kee Hyung

2015-09-01

Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture.

Fracture of Fully-coated Femoral Stem after Primary Total Hip Arthroplasty for Nonunion of Intertrochanteric Fracture: A Case Report

PubMed Central

Chun, Young Soo; Juh, Hyung Suk; Cho, Yoon Je

2015-01-01

Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture. PMID:27536622

Trends in the volume of operative treatment of midshaft clavicle fractures in children and adolescents: a retrospective, 12-year, single-institution analysis.

PubMed

Suppan, Catherine A; Bae, Donald S; Donohue, Kyna S; Miller, Patricia E; Kocher, Mininder S; Heyworth, Benton E

2016-07-01

The purpose of this study was to examine institutional trends in the volume of clavicle fractures in children and adolescents. Medical records were retrospectively reviewed to identify patients aged 10-18 years treated for a clavicle fracture between 1999 and 2011 at a single tertiary-care pediatric hospital. There were significant increases in the number of clavicle fractures seen annually, of midshaft clavicle fractures, and of midshaft clavicle fractures treated operatively. The percentage of midshaft clavicle fractures treated with fixation also increased significantly. The volumes of clavicle fractures and midshaft clavicle fractures treated operatively appear to be increasing. Despite a lack of evidence-based support, the frequency of fixation of midshaft clavicle fractures appear to be increasing in the pediatric population.

Complementary hydro-mechanical coupled finite/discrete element and microseismic modelling to predict hydraulic fracture propagation in tight shale reservoirs

NASA Astrophysics Data System (ADS)

Profit, Matthew; Dutko, Martin; Yu, Jianguo; Cole, Sarah; Angus, Doug; Baird, Alan

2016-04-01

This paper presents a novel approach to predict the propagation of hydraulic fractures in tight shale reservoirs. Many hydraulic fracture modelling schemes assume that the fracture direction is pre-seeded in the problem domain discretisation. This is a severe limitation as the reservoir often contains large numbers of pre-existing fractures that strongly influence the direction of the propagating fracture. To circumvent these shortcomings, a new fracture modelling treatment is proposed where the introduction of discrete fracture surfaces is based on new and dynamically updated geometrical entities rather than the topology of the underlying spatial discretisation. Hydraulic fracturing is an inherently coupled engineering problem with interactions between fluid flow and fracturing when the stress state of the reservoir rock attains a failure criterion. This work follows a staggered hydro-mechanical coupled finite/discrete element approach to capture the key interplay between fluid pressure and fracture growth. In field practice, the fracture growth is hidden from the design engineer and microseismicity is often used to infer hydraulic fracture lengths and directions. Microseismic output can also be computed from changes of the effective stress in the geomechanical model and compared against field microseismicity. A number of hydraulic fracture numerical examples are presented to illustrate the new technology.

Corrective Septorhinoplasty in Acute Nasal Bone Fractures.

PubMed

Kim, Jisung; Jung, Hahn Jin; Shim, Woo Sub

2018-03-01

Closed reduction is generally recommended for acute nasal bone fractures, and rhinoplasty is considered in cases with an unsatisfactory outcome. However, concomitant rhinoplasty with fracture reduction might achieve better surgical outcomes. This study investigated the surgical techniques and outcomes in patients who underwent rhinoplasty and fracture reduction concomitantly, during the acute stage of nasal bone fracture. Forty-five patients who underwent concomitant rhinoplasty and fracture reduction were enrolled. Nasal bone fractures were classified into three major types (type I, simple fracture; type II, fracture line that mimics nasal osteotomy; and type III, comminuted fracture) based on computed tomography images and preoperative facial images. Two independent otolaryngology-head and neck surgeons evaluated the surgical outcomes and telephone based survey were made to evaluate patients satisfaction. Among 45 patients, there were 39 males and 6 females. Type I was the commonest type of fracture with 18 patients (40%), while the most frequently used surgical technique for corrective surgery was dorsal augmentation with 44 patients (97.8%). The mean visual analogue scale satisfaction score of the surgeons and patients were 7.62 and 8, respectively, with no significant differences between fracture types. Concomitant rhinoplasty with fracture reduction can be performed for acute nasal bone fracture patients, and it might lead to better aesthetic outcomes.

Thermal convection in three-dimensional fractured porous media

NASA Astrophysics Data System (ADS)

Mezon, C.; Mourzenko, V. V.; Thovert, J.-F.; Antoine, R.; Fontaine, F.; Finizola, A.; Adler, P. M.

2018-01-01

Thermal convection is numerically computed in three-dimensional (3D) fluid saturated isotropically fractured porous media. Fractures are randomly inserted as two-dimensional (2D) convex polygons. Flow is governed by Darcy's 2D and 3D laws in the fractures and in the porous medium, respectively; exchanges take place between these two structures. Results for unfractured porous media are in agreement with known theoretical predictions. The influence of parameters such as the fracture aperture (or fracture transmissivity) and the fracture density on the heat released by the whole system is studied for Rayleigh numbers up to 150 in cubic boxes with closed-top conditions. Then, fractured media are compared to homogeneous porous media with the same macroscopic properties. Three major results could be derived from this study. The behavior of the system, in terms of heat release, is determined as a function of fracture density and fracture transmissivity. First, the increase in the output flux with fracture density is linear over the range of fracture density tested. Second, the increase in output flux as a function of fracture transmissivity shows the importance of percolation. Third, results show that the effective approach is not always valid, and that the mismatch between the full calculations and the effective medium approach depends on the fracture density in a crucial way.

Influence of Fracture Width on Sealability in High-Strength and Ultra-Low-Permeability Concrete in Seawater.

PubMed

Fukuda, Daisuke; Nara, Yoshitaka; Hayashi, Daisuke; Ogawa, Hideo; Kaneko, Katsuhiko

2013-06-25

For cementitious composites and materials, the sealing of fractures can occur in water by the precipitation of calcium compounds. In this study, the sealing behavior in a macro-fractured high-strength and ultra-low-permeability concrete (HSULPC) specimen was investigated in simulated seawater using micro-focus X-ray computed tomography (CT). In particular, the influence of fracture width (0.10 and 0.25 mm) on fracture sealing was investigated. Precipitation occurred mainly at the outermost parts of the fractured surface of the specimen for both fracture widths. While significant sealing was observed for the fracture width of 0.10 mm, sealing was not attained for the fracture width of 0.25 mm within the observation period (49 days). Examination of the sealed regions on the macro-fracture was performed using a three-dimensional image registration technique and applying image subtraction between the CT images of the HSULPC specimen before and after maintaining the specimen in simulated seawater. The temporal change of the sealing deposits for the fracture width of 0.10 mm was much larger than that for the fracture width of 0.25 mm. Therefore, it is concluded that the sealability of the fracture in the HSULPC is affected by the fracture width.

Laboratory testing on infiltration in single synthetic fractures

NASA Astrophysics Data System (ADS)

Cherubini, Claudia; Pastore, Nicola; Li, Jiawei; Giasi, Concetta I.; Li, Ling

2017-04-01

An understanding of infiltration phenomena in unsaturated rock fractures is extremely important in many branches of engineering for numerous reasons. Sectors such as the oil, gas and water industries are regularly interacting with water seepage through rock fractures, yet the understanding of the mechanics and behaviour associated with this sort of flow is still incomplete. An apparatus has been set up to test infiltration in single synthetic fractures in both dry and wet conditions. To simulate the two fracture planes, concrete fractures have been moulded from 3D printed fractures with varying geometrical configurations, in order to analyse the influence of aperture and roughness on infiltration. Water flows through the single fractures by means of a hydraulic system composed by an upstream and a downstream reservoir, the latter being subdivided into five equal sections in order to measure the flow rate in each part to detect zones of preferential flow. The fractures have been set at various angles of inclination to investigate the effect of this parameter on infiltration dynamics. The results obtained identified that altering certain fracture parameters and conditions produces relevant effects on the infiltration process through the fractures. The main variables influencing the formation of preferential flow are: the inclination angle of the fracture, the saturation level of the fracture and the mismatch wavelength of the fracture.

The influence of renal dialysis and hip fracture sites on the 10-year mortality of elderly hip fracture patients

PubMed Central

Hung, Li-Wei; Hwang, Yi-Ting; Huang, Guey-Shiun; Liang, Cheng-Chih; Lin, Jinn

2017-01-01

Abstract Hip fractures in older people requiring dialysis are associated with high mortality. Our study primarily aimed to evaluate the specific burden of dialysis on the mortality rate following hip fracture. The secondary aim was to clarify the effect of the fracture site on mortality. A retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database to analyze nationwide health data regarding dialysis and non-dialysis patients ≥65 years who sustained a first fragility-related hip fracture during the period from 2001 to 2005. Each dialysis hip fracture patient was age- and sex-matched to 5 non-dialysis hip fracture patients to construct the matched cohort. Survival status of patients was followed-up until death or the end of 2011. Survival analyses using multivariate Cox proportional hazards models and the Kaplan-Meier estimator were performed to compare between-group survival and impact of hip fracture sites on mortality. A total of 61,346 hip fracture patients were included nationwide. Among them, 997 dialysis hip fracture patients were identified and matched to 4985 non-dialysis hip fracture patients. Mortality events were 155, 188, 464, and 103 in the dialysis group, and 314, 382, 1505, and 284 in the non-dialysis group, with adjusted hazard ratios (associated 95% confidence intervals) of 2.58 (2.13–3.13), 2.95 (2.48–3.51), 2.84 (2.55–3.15), and 2.39 (1.94–2.93) at 0 to 3 months, 3 months to 1 year, 1 to 6 years, and 6 to 10 years after the fracture, respectively. In the non-dialysis group, survival was consistently better for patients who sustained femoral neck fractures compared to trochanteric fractures (0–10 years’ log-rank test, P < .001). In the dialysis group, survival of patients with femoral neck fractures was better than that of patients with trochanteric fractures only within the first 6 years post-fracture (0–6 years’ log-rank, P < .001). Dialysis was a significant risk factor of mortality in geriatric hip fracture patients. Survival outcome was better for non-dialysis patients with femoral neck fractures compared to those with trochanteric fractures throughout 10 years. However, the survival advantage of femoral neck fractures was limited to the first 6 years postinjury among dialysis patients. PMID:28906354

Morphology of the posteromedial fragment in pertrochanteric fractures: A three-dimensional computed tomography analysis.

PubMed

Sharma, Gaurav; Gn, Kiran Kumar; Khatri, Kavin; Singh, Ravijot; Gamanagatti, Shivanand; Sharma, Vijay

2017-02-01

In this study we describe the morphology of the posteromedial fragment in pertrochanteric fractures using 3D CT scans and answer two questions 1) Do differences exist between the 3D CT appearances of posteromedial fragments and the depictions made in the AO classification 2) Does the posteromedial fragment affect stability in pertrochanteric fractures, in terms of fracture collapse? Preoperative CT scans of eight 31-A1 and fifty 31-A2 fractures were analysed. The presence of PM fragment, its fragmentation, greater trochanter (GT) involvement, lesser trochanter (LT) fragment size (in terms of its posterior and medial extent as well as LT length), LT fragment displacement (in terms of medial displacement and rotation) were determined. All fractures were treated with a DHS. Fracture collapse was determined on postoperative radiographs. The relationship between fracture collapse and patient factors including age, gender, fracture type (A1 versus A2), characteristics of the posteromedial fragment, and the presence of a lateral wall fracture were determined. Three out of eight 31-A1 fractures demonstrated a separate GT fragment (three part fracture). Out of the 50 31-A2 fractures, 12 had a single PM fragment, which included the LT and GT in continuity. The more common four part fractures seem to form by further fragmentation of this basic form. In A2 fractures, the GT was almost always broken and the broken fragment comprised a mean 56% of normal GT. The LT fragment involved an average of 74% of the posterior wall, and an average of 36% of the medial wall of the proximal femur. Larger LT fragments were less displaced as compared to smaller fragments. Univariate regression analyses revealed that fracture collapse was significantly correlated with fracture type (A1 versus A2, p 0.036), GT size (p 0.002) and the presence of a lateral wall fracture (p<0.001). This study revealed some important differences between the 3D CT appearances and AO classification of pertrochanteric fractures. Further, neither fragmentation of the posteromedial fragment, nor the size of the lesser trochanter fragment was found to predict stability in pertrochanteric fractures. A perioperative lateral wall fracture is the main determinant of stability in these fractures. Copyright © 2016 Elsevier Ltd. All rights reserved.

Regional characterisation of hydraulic properties of rock using air-lift data

NASA Astrophysics Data System (ADS)

Wladis, David; Gustafson, Gunnar

Hydrogeologic studies are commonly data-intense. In particular, estimations of hydraulic properties of hard rock often require large amounts of data. In many countries, large quantities of hydrogeologic data have been collected and archived over the years. Therefore, the use of existing data may provide a cost-efficient alternative to collecting new data in early stages of hydrogeologic studies, although the available data may be considered imprecise. Initially, however, the potential usefulness, i.e., the expected accuracy, of the available data in each specific case must be carefully examined. This study investigates the possibilities of obtaining estimates of transmissivity from hard-rock air-lift data in Sweden within an order of magnitude of results obtained from high-quality injection-test data. The expected accuracy of the results was examined analytically and by means of statistical methods. The results were also evaluated by comparison with injection-test data. The results indicate that air-lift data produce estimates of transmissivity within an order of magnitude compared to injection-test data in the studied examples. The study also shows that partial penetration and hydrofracturing may only affect the estimations approximately half an order of magnitude. Thus, existing data may provide a cost-efficient alternative to collection of new data in early stages of hydrogeologic studies. Résumé Les études hydrogéologiques reposent en général sur un nombre important de données. En particulier, l'estimation des propriétés hydrauliques des roches indurées exige souvent un grand nombre de données. Dans de nombreuses régions, des données hydrogéologiques très nombreuses ont été recueillies et archivées depuis longtemps. C'est pourquoi le recours à des données existantes peut être une alternative intéressante en termes de coût par rapport à l'obtention de nouvelles données dans les premières étapes des études hydrogéologiques, même si les données disponibles présentent une certaine imprécision. Au départ, il faut cependant examiner l'utilité potentielle, c'est-à-dire la précision attendue, de données imprécises dans chaque cas spécifique. Cette étude analyse les possibilités d'obtenir des estimations de transmissivitéà partir de données d'air-lift dans des roches de socle en Suède, au mieux à un facteur 10 près par rapport aux données d'excellente qualité fournies par des essais d'injection. La précision attendue des résultats a été examinée analytiquement et grâce à des méthodes statistiques. Les résultats ont aussi été comparés aux données d'essais d'injection. Les résultats indiquent que les données obtenues par air-lift fournissent des estimations de transmissivitéà un facteur 10 près par comparaison avec celles des essais d'injection des exemples étudiés. L'étude montre aussi que la pénétration partielle et la fracturation hydraulique peuvent affecter les estimations seulement d'environ un facteur 5. Ainsi, le recours à des données existantes peut être économiquement plus intéressant que le recueil de nouvelles données dans les premières étapes des études hydrogéologiques. Resumen Los estudios hidrogeológicos, en general, y las estimaciones de propiedades hidráulicas en rocas, en particular, requieren gran cantidad de datos. En muchos países se han creado grandes bases de datos hidrogeológicos, recogidos y almacenados a lo largo de los años. Por tanto, el uso de los datos ya existentes, aunque imprecisos, puede suponer una alternativa barata a la recopilación de nuevos datos, particularmente en las primeras fases de un estudio hidrogeológico. Sin embargo la precisión y utilidad del método deben analizarse para cada caso específico. En este estudio se contempla la posibilidad de, a partir de datos de ensayos de inyección de aire realizados en Suecia, obtener valores estimativos de transmisividad dentro del orden de magnitud de los resultados obtenidos de ensayos de inyección de alta calidad. La precisión del método se examinó de manera analítica y mediante métodos estadísticos, así como mediante la comparación con los datos de ensayos de inyección tradicionales. Del trabajo se observa que los datos procedentes de ensayos de inyección de aire dan lugar a unas estimaciones de transmisividad dentro del mismo orden de magnitud que los datos obtenidos en ensayos de inyección para los ejemplos que se han estudiado. También se concluye que la penetración parcial y la hidrofractura afectan las estimaciones de transmisividad en medio orden de magnitud, como mucho. Por tanto, el uso de los datos ya existentes es una alternativa eficiente y barata a la recopilación de nuevos datos en una primera fase de un estudio hidrogeológico.

Early Weightbearing After Operatively Treated Ankle Fractures: A Biomechanical Analysis.

PubMed

Tan, Eric W; Sirisreetreerux, Norachart; Paez, Adrian G; Parks, Brent G; Schon, Lew C; Hasenboehler, Erik A

2016-06-01

No consensus exists regarding the timing of weightbearing after surgical fixation of unstable traumatic ankle fractures. We evaluated fracture displacement and timing of displacement with simulated early weightbearing in a cadaveric model. Twenty-four fresh-frozen lower extremities were assigned to Group 1, bimalleolar ankle fracture (n=6); Group 2, trimalleolar ankle fracture with unfixed small posterior malleolar fracture (n=9); or Group 3, trimalleolar ankle fracture with fixed large posterior malleolar fracture (n=9) and tested with axial compressive load at 3 Hz from 0 to 1000 N for 250 000 cycles to simulate 5 weeks of full weightbearing. Displacement was measured by differential variable reluctance transducer. The average motion at all fracture sites in all groups was significantly less than 1 mm (P < .05). Group 1 displacement of the lateral and medial malleolus fracture was 0.1±0.1 mm and 0.4±0.4 mm, respectively. Group 2 displacement of the lateral, medial, and posterior malleolar fracture was 0.6±0.4 mm, 0.5±0.4 mm, and 0.5±0.6 mm, respectively. Group 3 displacement of the lateral, medial, and posterior malleolar fracture was 0.1±0.1 mm, 0.5±0.7 mm, and 0.5±0.4 mm, respectively. The majority of displacement (64.0% to 92.3%) occurred in the first 50 000 cycles. There was no correlation between fracture displacement and bone mineral density. No significant fracture displacement, no hardware failure, and no new fractures occurred in a cadaveric model of early weightbearing in unstable ankle fracture after open reduction and internal fixation. This study supports further investigation of early weightbearing postoperative protocols after fixation of unstable ankle fractures. © The Author(s) 2016.

Trajectory of social isolation following hip fracture: an analysis of the English Longitudinal Study of Ageing (ELSA) cohort.

PubMed

Smith, Toby O; Dainty, Jack R; MacGregor, Alex

2018-01-01

social isolation is defined as a lack of meaningful and sustained communication or interactions with social networks. There is limited understanding on the prevalence of social isolation and loneliness in people following hip fracture and no previous understanding of how this changes over time. to determine the prevalence and trajectory of social isolation and loneliness before a hip fracture, during the recovery phase and a minimum of 2 years post-hip fracture in an English population. data were from the English Longitudinal Study of Ageing (ELSA) cohort (2004/5-2014/15). The sample comprised of 215 participants who had sustained a hip fracture. Measures of social isolation and loneliness were analysed through multilevel modelling to determine their trajectories during three-time intervals (pre-fracture; interval at hip fracture and recovery; minimum 2 years post-fracture). The prevalence of social isolation and loneliness were determined pre- and post-fracture. prevalence of social isolation was 19% post-hip fracture and loneliness 13% post-hip fracture. There was no statistically significant change in social isolation pre-fracture compared to a minimum of 2 years post-fracture (P = 0.78). Similarly, there was no statistically significant change in loneliness pre-fracture compared to a minimum of 2 years post-fracture (P = 0.12). this analysis has determined that whilst social isolation and loneliness do not change over time following hip fracture, these remain a significant problem for this population. Interventions are required to address these physical and psychological health needs. This is important as they may have short and longer term health benefits for people post-hip fracture. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

In Situ Fracture of Stents Implanted for Relief of Pulmonary Arterial Stenosis in Patients with Congenitally Malformed Hearts

PubMed Central

McElhinney, Doff B.; Bergersen, Lisa; Marshall, Audrey C.

2014-01-01

Background One of the most common uses of stents in patients with congenitally malformed hearts is treatment of pulmonary arterial stenosis. Although there are reports of fractured pulmonary arterial stents, little is known about the risk factors for, and implications of, such fractures. Methods We reviewed angiograms to identify fractures in stents previously inserted to relieve stenoses in pulmonary arteries from 1990 through 2001 in patients who also underwent follow-up catheterization at least 3 years after placement of the stent. We undertook matched cohort analysis, matching a ratio of 2 fractured to 1 unfractured stent. Results Overall, 166 stents meeting the criterions of our study had been placed in 120 patients. We identified fractures in 35 stents (21%) in 29 patients. All fractured stents were in the central pulmonary arteries, 24 (69%) in the central part of the right pulmonary artery, and all were complete axial fractures, or complex fractures along at least 2 planes. Stent-related factors associated with increased risk of fracture identified by multivariable logistic regression included placement in close apposition to the ascending aorta (p = 0.001), and a larger expanded diameter (p = 0.002). There was obstruction across 28 of 35 fractured stents, which was severe in 11. We re-stented 21 of the fractured stents, and recurrent fracture was later diagnosed in 3 of these. A fragment of the fractured stent embolized distally in 2 patients, without clinically important effects. Conclusions In situ fracture of pulmonary arterial stents is relatively common, and in most cases is related to compression by the aorta. There is usually recurrent obstruction across the fractured stent, but fractured stents rarely embolize, and are not associated with other significant complications. PMID:18559137

Optimizing for Large Planar Fractures in Multistage Horizontal Wells in Enhanced Geothermal Systems Using a Coupled Fluid and Geomechanics Simulator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hu, Xiexiaomen; Tutuncu, Azra; Eustes, Alfred

Enhanced Geothermal Systems (EGS) could potentially use technological advancements in coupled implementation of horizontal drilling and multistage hydraulic fracturing techniques in tight oil and shale gas reservoirs along with improvements in reservoir simulation techniques to design and create EGS reservoirs. In this study, a commercial hydraulic fracture simulation package, Mangrove by Schlumberger, was used in an EGS model with largely distributed pre-existing natural fractures to model fracture propagation during the creation of a complex fracture network. The main goal of this study is to investigate optimum treatment parameters in creating multiple large, planar fractures to hydraulically connect a horizontal injectionmore » well and a horizontal production well that are 10,000 ft. deep and spaced 500 ft. apart from each other. A matrix of simulations for this study was carried out to determine the influence of reservoir and treatment parameters on preventing (or aiding) the creation of large planar fractures. The reservoir parameters investigated during the matrix simulations include the in-situ stress state and properties of the natural fracture set such as the primary and secondary fracture orientation, average fracture length, and average fracture spacing. The treatment parameters investigated during the simulations were fluid viscosity, proppant concentration, pump rate, and pump volume. A final simulation with optimized design parameters was performed. The optimized design simulation indicated that high fluid viscosity, high proppant concentration, large pump volume and pump rate tend to minimize the complexity of the created fracture network. Additionally, a reservoir with 'friendly' formation characteristics such as large stress anisotropy, natural fractures set parallel to the maximum horizontal principal stress (SHmax), and large natural fracture spacing also promote the creation of large planar fractures while minimizing fracture complexity.« less

"Buckle" rib fracture: an artifact following cardio-pulmonary resuscitation detected on postmortem CT.

PubMed

Yang, Kyung-Moo; Lynch, Matthew; O'Donnell, Chris

2011-09-01

Buckle rib fractures are incomplete fractures involving the inner cortex alone, and are rarely detected on routine chest X-ray or at autopsy. The characteristics of these fractures have not been well evaluated in situ although they are commonly observed on postmortem CT images especially following CPR. The postmortem CT findings in 42 cases showing buckle rib fractures caused by CPR were reviewed. The cause of death in all cases was non-traumatic. The shape, number, location, and distribution of these buckle rib fractures and their relationship to other types of rib fractures were evaluated using a novel oblique axial multiplanar reconstruction technique. Almost all incomplete rib fractures associated with CPR are buckle rib fractures (90.5%). All rib fractures were distributed from the second to ninth ribs with over 95% being within the second to seventh ribs. Buckle rib fractures are dominant in the seventh to ninth ribs and the proportion of buckle rib fractures located in the vicinity of the costochondral junctions increases with the lower ribs. Over 97% of all CPR associated rib fractures are located in the anterior one third of the ribs based on a new measurement method utilizing oblique axial multiplanar reconstruction of the CT data. When recognition of incomplete or buckle rib fractures on postmortem CT is taken into account, detection of symmetry and continuity of rib fractures typically associated with CPR is improved compared with the detection of complete fractures alone. Recognition of buckle rib fractures and their characteristics on postmortem CT is of benefit to the forensic pathologist in evaluating the possibility of CPR and the differentiation of resuscitative artifact from forensically significant visceral injury observed at autopsy. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Empirically Based Composite Fracture Prediction Model From the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW)

PubMed Central

Compston, Juliet E.; Chapurlat, Roland D.; Pfeilschifter, Johannes; Cooper, Cyrus; Hosmer, David W.; Adachi, Jonathan D.; Anderson, Frederick A.; Díez-Pérez, Adolfo; Greenspan, Susan L.; Netelenbos, J. Coen; Nieves, Jeri W.; Rossini, Maurizio; Watts, Nelson B.; Hooven, Frederick H.; LaCroix, Andrea Z.; March, Lyn; Roux, Christian; Saag, Kenneth G.; Siris, Ethel S.; Silverman, Stuart; Gehlbach, Stephen H.

2014-01-01

Context: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. Objective: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. Design: This was a prospective, observational cohort study. Setting: The study was conducted at primary care practices in 10 countries. Patients: Women aged 55 years or older participated in the study. Intervention: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. Main Outcome Measure: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. Results: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The unadjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. Conclusions: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model. PMID:24423345

Increasing number of fractured ribs is not predictive of the severity of splenic injury following blunt trauma: an analysis of a National Trauma Registry database.

PubMed

Boris, Kessel; Forat, Swaid; Itamar, Ashkenazi; Oded, Olsha; Kobi, Peleg; Adi, Givon; Igor, Jeroukhimov; Ricardo, Alfici

2014-05-01

Association between rib fractures and incidence of abdominal solid organs injury is well described. However, the correlation between the number of fractured ribs and severity of splenic injury is not clear. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of splenic injury in blunt trauma patients. A retrospective cohort study involving blunt trauma patients with concomitant splenic injuries and rib fractures, between the years 1998 and 2012, registered in the Israeli National Trauma Registry. Of 321,618 patients with blunt mechanism of trauma, 57,130 had torso injuries, and of these 14,651 patients sustained rib fractures, and 3691 patients suffered from splenic injury. Concomitant splenic injury occurred in 1326 of the patients with rib fractures (9.1%), as compared to 2365 patients sustaining splenic injury without rib fractures (5.6%). The incidence of splenic injury among patients sustaining 5 or more rib fractures was significantly higher compared to patients suffering from 1 to 4 rib fractures. Among patients with splenic injury, the tendency to sustain associated rib fractures increased steadily with age. Patients with concomitant rib fractures had higher Injury Severity Score (ISS), but similar mortality rates, compared to patients with splenic injury without rib fractures. Among patients with concomitant rib fractures and splenic injury, there was no relation between the number of fractured ribs and the severity of splenic injury, neither as a whole group, nor after stratification according to the mechanism of injury. Although the presence of rib fractures increases the probability of splenic injury in blunt torso trauma, there is no relation between the number of fractured ribs and splenic injury severity. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effect of isolated fractures on accelerated flow in unsaturated porous rock

USGS Publications Warehouse

Su, Grace W.; Nimmo, John R.; Dragila, Maria I.

2003-01-01

Fractures that begin and end in the unsaturated zone, or isolated fractures, have been ignored in previous studies because they were generally assumed to behave as capillary barriers and remain nonconductive. We conducted a series of experiments using Berea sandstone samples to examine the physical mechanisms controlling flow in a rock containing a single isolated fracture. The input fluxes and fracture orientation were varied in these experiments. Visualization experiments using dyed water in a thin vertical slab of rock were conducted to identify flow mechanisms occurring due to the presence of the isolated fracture. Two mechanisms occurred: (1) localized flow through the rock matrix in the vicinity of the isolated fracture and (2) pooling of water at the bottom of the fracture, indicating the occurrence of film flow along the isolated fracture wall. These mechanisms were observed at fracture angles of 20 and 60 degrees from the horizontal, but not at 90 degrees. Pooling along the bottom of the fracture was observed over a wider range of input fluxes for low‐angled isolated fractures compared to high‐angled ones. Measurements of matrix water pressures in the samples with the 20 and 60 degree fractures also demonstrated that preferential flow occurred through the matrix in the fracture vicinity, where higher pressures occurred in the regions where faster flow was observed in the visualization experiments. The pooling length at the terminus of a 20 degree isolated fracture was measured as a function of input flux. Calculations of the film flow rate along the fracture were made using these measurements and indicated that up to 22% of the flow occurred as film flow. These experiments, apparently the first to consider isolated fractures, demonstrate that such features can accelerate flow through the unsaturated zone and should be considered when developing conceptual models.

FracPaQ: a MATLAB™ Toolbox for the Quantification of Fracture Patterns

NASA Astrophysics Data System (ADS)

Healy, D.; Rizzo, R. E.; Cornwell, D. G.; Timms, N.; Farrell, N. J.; Watkins, H.; Gomez-Rivas, E.; Smith, M.

2016-12-01

The patterns of fractures in deformed rocks are rarely uniform or random. Fracture orientations, sizes, shapes and spatial distributions often exhibit some kind of order. In detail, there may be relationships among the different fracture attributes e.g. small fractures dominated by one orientation, larger fractures by another. These relationships are important because the mechanical (e.g. strength, anisotropy) and transport (e.g. fluids, heat) properties of rock depend on these fracture patterns and fracture attributes. This presentation describes an open source toolbox to quantify fracture patterns, including distributions in fracture attributes and their spatial variation. Software has been developed to quantify fracture patterns from 2-D digital images, such as thin section micrographs, geological maps, outcrop or aerial photographs or satellite images. The toolbox comprises a suite of MATLAB™ scripts based on published quantitative methods for the analysis of fracture attributes: orientations, lengths, intensity, density and connectivity. An estimate of permeability in 2-D is made using a parallel plate model. The software provides an objective and consistent methodology for quantifying fracture patterns and their variations in 2-D across a wide range of length scales. Our current focus for the application of the software is on quantifying the fracture patterns in and around fault zones. There is a large body of published work on the quantification of relatively simple joint patterns, but fault zones present a bigger, and arguably more important, challenge. The method presented is inherently scale independent, and a key task will be to analyse and integrate quantitative fracture pattern data from micro- to macro-scales. Planned future releases will incorporate multi-scale analyses based on a wavelet method to look for scale transitions, and combining fracture traces from multiple 2-D images to derive the statistically equivalent 3-D fracture pattern.

Fragility non-hip fracture patients are at risk.

PubMed

Gosch, M; Druml, T; Nicholas, J A; Hoffmann-Weltin, Y; Roth, T; Zegg, M; Blauth, M; Kammerlander, C

2015-01-01

Fragility fractures are a growing worldwide health care problem. Hip fractures have been clearly associated with poor outcomes. Fragility fractures of other bones are common reasons for hospital admission and short-term disability, but specific long-term outcome studies of non-hip fragility fractures are rare. The aim of our trial was to evaluate the 1-year outcomes of non-hip fragility fracture patients. This study is a retrospective cohort review of 307 consecutive older inpatient non-hip fracture patients. Patient data for analysis included fracture location, comorbidity prevalence, pre-fracture functional status, osteoporosis treatments and sociodemographic characteristics. The main outcomes evaluated were 1-year mortality and post-fracture functional status. As compared to the expected mortality, the observed 1-year mortality was increased in the study group (17.6 vs. 12.2 %, P = 0.005). After logistic regression, three variables remained as independent risk factors for 1-year mortality among non-hip fracture patients: malnutrition (OR 3.3, CI 1.5-7.1), Charlson comorbidity index (CCI) (OR 1.3, CI 1.1-1.5) and the Parker Mobility Score (PMS) (OR 0.85, CI 0.74-0.98). CCI and PMS were independent risk factors for a high grade of dependency after 1 year. Management of osteoporosis did not significantly improve after hospitalization due to a non-hip fragility fracture. The outcomes of older non-hip fracture patients are comparable to the poor outcomes of older hip fracture patients, and appear to be primarily related to comorbidities, pre-fracture function and nutritional status. The low rate of patients on osteoporosis medications likely reflects the insufficient recognition of the importance of osteoporosis assessment and treatment in non-hip fracture patients. Increased clinical and academic attention to non-hip fracture patients is needed.

The evolution of fracture surface roughness and its dependence on slip

NASA Astrophysics Data System (ADS)

Wells, Olivia L.

Under effective compression, impingement of opposing rough surfaces of a fracture can force the walls of the fracture apart during slip. Therefore, a fracture's surface roughness exerts a primary control on the amount of dilation that can be sustained on a fracture since the opposing surfaces need to remain in contact. Previous work has attempted to characterize fracture surface roughness through topographic profiles and power spectral density analysis, but these metrics describing the geometry of a fracture's surface are often non-unique when used independently. However, when combined these metrics are affective at characterizing fracture surface roughness, as well as the mechanisms affecting changes in roughness with increasing slip, and therefore changes in dilation. These mechanisms include the influence of primary grains and pores on initial fracture roughness, the effect of linkage on locally increasing roughness, and asperity destruction that limits the heights of asperities and forms gouge. This analysis reveals four essential stages of dilation during the lifecycle of a natural fracture, whereas previous slip-dilation models do not adequately address the evolution of fracture surface roughness: (1) initial slip companied by small dilation is mediated by roughness controlled by the primary grain and pore dimensions; (2) rapid dilation during and immediately following fracture growth by linkage of formerly isolated fractures; (3) wear of the fracture surface and gouge formation that minimizes dilation; and (4) between slip events cementation that modifies the mineral constituents in the fracture. By identifying these fundamental mechanisms that influence fracture surface roughness, this new conceptual model relating dilation to slip has specific applications to Enhanced Geothermal Systems (EGS), which attempt to produce long-lived dilation in natural fractures by inducing slip.

Evidence for tectonic, lithologic, and thermal controls on fracture system geometries in an andesitic high-temperature geothermal field

NASA Astrophysics Data System (ADS)

Massiot, Cécile; Nicol, Andrew; McNamara, David D.; Townend, John

2017-08-01

Analysis of fracture orientation, spacing, and thickness from acoustic borehole televiewer (BHTV) logs and cores in the andesite-hosted Rotokawa geothermal reservoir (New Zealand) highlights potential controls on the geometry of the fracture system. Cluster analysis of fracture orientations indicates four fracture sets. Probability distributions of fracture spacing and thickness measured on BHTV logs are estimated for each fracture set, using maximum likelihood estimations applied to truncated size distributions to account for sampling bias. Fracture spacing is dominantly lognormal, though two subordinate fracture sets have a power law spacing. This difference in spacing distributions may reflect the influence of the andesitic sequence stratification (lognormal) and tectonic faults (power law). Fracture thicknesses of 9-30 mm observed in BHTV logs, and 1-3 mm in cores, are interpreted to follow a power law. Fractures in thin sections (˜5 μm thick) do not fit this power law distribution, which, together with their orientation, reflect a change of controls on fracture thickness from uniform (such as thermal) controls at thin section scale to anisotropic (tectonic) at core and BHTV scales of observation. However, the ˜5% volumetric percentage of fractures within the rock at all three scales suggests a self-similar behavior in 3-D. Power law thickness distributions potentially associated with power law fluid flow rates, and increased connectivity where fracture sets intersect, may cause the large permeability variations that occur at hundred meter scales in the reservoir. The described fracture geometries can be incorporated into fracture and flow models to explore the roles of fracture connectivity, stress, and mineral precipitation/dissolution on permeability in such andesite-hosted geothermal systems.

Incorporating Scale-Dependent Fracture Stiffness for Improved Reservoir Performance Prediction

NASA Astrophysics Data System (ADS)

Crawford, B. R.; Tsenn, M. C.; Homburg, J. M.; Stehle, R. C.; Freysteinson, J. A.; Reese, W. C.

2017-12-01

We present a novel technique for predicting dynamic fracture network response to production-driven changes in effective stress, with the potential for optimizing depletion planning and improving recovery prediction in stress-sensitive naturally fractured reservoirs. A key component of the method involves laboratory geomechanics testing of single fractures in order to develop a unique scaling relationship between fracture normal stiffness and initial mechanical aperture. Details of the workflow are as follows: tensile, opening mode fractures are created in a variety of low matrix permeability rocks with initial, unstressed apertures in the micrometer to millimeter range, as determined from image analyses of X-ray CT scans; subsequent hydrostatic compression of these fractured samples with synchronous radial strain and flow measurement indicates that both mechanical and hydraulic aperture reduction varies linearly with the natural logarithm of effective normal stress; these stress-sensitive single-fracture laboratory observations are then upscaled to networks with fracture populations displaying frequency-length and length-aperture scaling laws commonly exhibited by natural fracture arrays; functional relationships between reservoir pressure reduction and fracture network porosity, compressibility and directional permeabilities as generated by such discrete fracture network modeling are then exported to the reservoir simulator for improved naturally fractured reservoir performance prediction.

Clinical, retrospective case-control study on the mechanics of obstacle in mouth opening and malocclusion in patients with maxillofacial fractures.

PubMed

Zhou, Hai-Hua; Lv, Kun; Yang, Rong-Tao; Li, Zhi; Yang, Xue-Wen; Li, Zu-Bing

2018-05-16

This study aims to identify and distinguish various factors that may influence the clinical symptoms (limited mouth opening and malocclusion) in patients with maxillofacial fractures. From January 2000 to December 2009, 963 patients with maxillofacial fractures were enrolled in this statistical study to aid in evaluating the association between various risk factors and clinical symptoms. Patients with fractured posterior mandibles tended to experience serious limitation in mouth opening. Patients who sustained coronoid fractures have the highest risk of serious limitation in mouth opening (OR = 9.849), followed by arch fractures, maxilla fractures, condylar fractures, zygomatic complex fractures and symphysis fractures. Meanwhile, the combined fracture of zygomatic arch and condylar process results in normal or mild mouth opening. High risks of sustaining malocclusion are preceded by the fracture of nasal bone (OR = 3.067), mandible, condylar neck/base, combined fracture of zygomatic arch and condylar process, mandibular body, bilateral condylar, dental trauma, mandibular ramus, symphysis, mandibular angle and mid-facial. Patients who experienced serious limitation in mouth opening are treated with surgery more frequently (OR = 2.118). No relationship exists between the treatment options and the patients with malocclusion.

CT scanning and flow measurements of shale fractures after multiple shearing events

DOE PAGES

Crandall, Dustin; Moore, Johnathan; Gill, Magdalena; ...

2017-11-05

A shearing apparatus was used in conjunction with a Hassler-style core holder to incrementally shear fractured shale cores while maintaining various confining pressures. Computed tomography scans were performed after each shearing event, and were used to obtain information on evolving fracture geometry. Fracture transmissivity was measured after each shearing event to understand the hydrodynamic response to the evolving fracture structure. The digital fracture volumes were used to perform laminar single phase flow simulations (local cubic law with a tapered plate correction model) to qualitatively examine small scale flow path variations within the altered fractures. Fractures were found to generally increasemore » in aperture after several shear slip events, with corresponding transmissivity increases. Lower confining pressure resulted in a fracture more prone to episodic mechanical failure and sudden changes in transmissivity. Conversely, higher confining pressures resulted in a system where, after an initial setting of the fracture surfaces, changes to the fracture geometry and transmissivity occurred gradually. Flow paths within the fractures are largely controlled by the location and evolution of zero aperture locations. Lastly, a reduction in the number of primary flow pathways through the fracture, and an increase in their width, was observed during all shearing tests.« less

Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.

PubMed

Rostas, Jack W; Lively, Timothy B; Brevard, Sidney B; Simmons, Jon D; Frotan, Mohammad A; Gonzalez, Richard P

2017-04-01

The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P < .001); 151 patients had spleen injuries with 119 (79%) associated left rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P < .003). Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Initiation and propagation of mixed mode fractures in granite and sandstone

NASA Astrophysics Data System (ADS)

Rück, Marc; Rahner, Roman; Sone, Hiroki; Dresen, Georg

2017-10-01

We investigate mixed mode fracture initiation and propagation in experimentally deformed granite and sandstone. We performed a series of asymmetric loading tests to induce fractures in cylindrical specimens at confining pressures up to 20 MPa. Loading was controlled using acoustic emission (AE) feedback control, which allows studying quasi-static fracture propagation for several hours. Location of acoustic emissions reveals distinct differences in spatial-temporal fracture evolution between granite and sandstone samples. Before reaching peak stress in experiments performed on granite, axial fractures initiate first at the edge of the indenter and then propagate through the entire sample. Secondary inclined fractures develop during softening of the sample. In sandstone, inclined shear fractures nucleate at peak stress and propagate through the specimen. AE source type analysis shows complex fracturing in both materials with pore collapse contributing significantly to fracture growth in sandstone samples. We compare the experimental results with numerical models to analyze stress distribution and energy release rate per unit crack surface area in the samples at different stages during fracture growth. We thereby show that for both rock types the energy release rate increases approximately linearly during fracture propagation. The study illuminates how different material properties modify fracture initiation direction under similar loading conditions.

Unexpected timely fracture union in matrix metalloproteinase 9 deficient mice.

PubMed

Yuasa, Masato; Saito, Masanori; Molina, Cesar; Moore-Lotridge, Stephanie N; Benvenuti, Michael A; Mignemi, Nicholas A; Okawa, Atsushi; Yoshii, Toshitaka; Schwartz, Herbert S; Nyman, Jeffry S; Schoenecker, Jonathan G

2018-01-01

Immediately following a fracture, a fibrin laden hematoma is formed to prevent bleeding and infection. Subsequently, the organized removal of fibrin, via the protease plasmin, is essential to permit fracture repair through angiogenesis and ossification. Yet, when plasmin activity is lost, the depletion of fibrin alone is insufficient to fully restore fracture repair, suggesting the existence of additional plasmin targets important for fracture repair. Previously, activated matrix metalloproteinase 9 (MMP-9) was demonstrated to function in fracture repair by promoting angiogenesis. Given that MMP-9 is a defined plasmin target, it was hypothesized that pro-MMP-9, following plasmin activation, promotes fracture repair. This hypothesis was tested in a fixed murine femur fracture model with serial assessment of fracture healing. Contrary to previous findings, a complete loss of MMP-9 failed to affect fracture healing and union through 28 days post injury. Therefore, these results demonstrated that MMP-9 is dispensable for timely fracture union and cartilage transition to bone in fixed femur fractures. Pro-MMP-9 is therefore not a significant target of plasmin in fracture repair and future studies assessing additional plasmin targets associated with angiogenesis are warranted.

Detection of Natural Fractures from Observed Surface Seismic Data Based on a Linear-Slip Model

NASA Astrophysics Data System (ADS)

Chen, Huaizhen; Zhang, Guangzhi

2018-03-01

Natural fractures play an important role in migration of hydrocarbon fluids. Based on a rock physics effective model, the linear-slip model, which defines fracture parameters (fracture compliances) for quantitatively characterizing the effects of fractures on rock total compliance, we propose a method to detect natural fractures from observed seismic data via inversion for the fracture compliances. We first derive an approximate PP-wave reflection coefficient in terms of fracture compliances. Using the approximate reflection coefficient, we derive azimuthal elastic impedance as a function of fracture compliances. An inversion method to estimate fracture compliances from seismic data is presented based on a Bayesian framework and azimuthal elastic impedance, which is implemented in a two-step procedure: a least-squares inversion for azimuthal elastic impedance and an iterative inversion for fracture compliances. We apply the inversion method to synthetic and real data to verify its stability and reasonability. Synthetic tests confirm that the method can make a stable estimation of fracture compliances in the case of seismic data containing a moderate signal-to-noise ratio for Gaussian noise, and the test on real data reveals that reasonable fracture compliances are obtained using the proposed method.

CT scanning and flow measurements of shale fractures after multiple shearing events

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crandall, Dustin; Moore, Johnathan; Gill, Magdalena

A shearing apparatus was used in conjunction with a Hassler-style core holder to incrementally shear fractured shale cores while maintaining various confining pressures. Computed tomography scans were performed after each shearing event, and were used to obtain information on evolving fracture geometry. Fracture transmissivity was measured after each shearing event to understand the hydrodynamic response to the evolving fracture structure. The digital fracture volumes were used to perform laminar single phase flow simulations (local cubic law with a tapered plate correction model) to qualitatively examine small scale flow path variations within the altered fractures. Fractures were found to generally increasemore » in aperture after several shear slip events, with corresponding transmissivity increases. Lower confining pressure resulted in a fracture more prone to episodic mechanical failure and sudden changes in transmissivity. Conversely, higher confining pressures resulted in a system where, after an initial setting of the fracture surfaces, changes to the fracture geometry and transmissivity occurred gradually. Flow paths within the fractures are largely controlled by the location and evolution of zero aperture locations. Lastly, a reduction in the number of primary flow pathways through the fracture, and an increase in their width, was observed during all shearing tests.« less

Surgical repair of femoral fractures in New World camelids: five cases (1996-2003).

PubMed

Shoemaker, R W; Wilson, D G

2007-04-01

Five New World camelids were admitted to the Western College of Veterinary Medicine between 1996 and 2003 for evaluation of femoral fractures. There were three alpacas and two llamas. Four of the animals were female and three were less than 3 months of age. Fracture configurations consisted of distal physeal fractures (three), a comminuted diaphyseal/metaphyseal fracture, and a transverse diaphyseal fracture. Fractures were diagnosed with a combination of physical examination and radiographs in all cases. All five fractures were repaired with internal fixation and three animals were discharged from the hospital with fractures that healed. One cria underwent successful internal fixation but died from pulmonary oedema during recovery from anaesthesia. Postoperative complications were rare and limited to inadequate fracture stability in one alpaca and prolonged recovery to weight bearing in another. One llama with a comminuted metaphyseal fracture, repaired with a 4.5 mm dynamic compression plate, subsequently had catastrophic failure of the bone 17 days after surgery. Overall the clients were pleased with the outcome of discharged animals. Although femoral fractures are considered rare, they pose a unique opportunity for the large animal veterinarian to successfully achieve fracture union with the aid of internal fixation.

Prevalence of overweight in children with bone fractures: a case control study.

PubMed

Valerio, Giuliana; Gallè, Francesca; Mancusi, Caterina; Di Onofrio, Valeria; Guida, Pasquale; Tramontano, Antonino; Ruotolo, Edoardo; Liguori, Giorgio

2012-10-22

Children's fractures have been enlisted among orthopaedics complaints of childhood obesity. Unhealthy lifestyle behaviours may contribute to increased risk. This study described the prevalence of overweight/obesity in children and adolescents reporting a recent fracture in relation to gender, dynamic of trauma, and site of fracture. Four-hundred-forty-nine children and adolescents with fracture and 130 fracture-free controls were recruited from a large children's hospital. The interaction between overweight and gender, dynamic of trauma, site of fracture was explored. Sports participation, television viewing, and calcium intake were also investigated. Overweight/obesity rate was increased in girls with fracture either at the upper or the lower limb (p= 0.004), while it was increased only in boys with fracture at the lower limb (p <0.02). Overweight/obesity rate did not differ between groups with low or moderate trauma. TV viewing ≥ 2 hrs was more frequent in children with fractures than controls (61.5% vs 34.5%, p =0.015) in the overweight/obese group. The increased prevalence of overweight/obesity in children with fractures is related to gender and site of fracture. Higher levels of sedentary behaviours characterize overweight children reporting fractures.

Prevalence of overweight in children with bone fractures: a case control study

PubMed Central

2012-01-01

Background Children's fractures have been enlisted among orthopaedics complaints of childhood obesity. Unhealthy lifestyle behaviours may contribute to increased risk. This study described the prevalence of overweight/obesity in children and adolescents reporting a recent fracture in relation to gender, dynamic of trauma, and site of fracture. Methods Four-hundred-forty-nine children and adolescents with fracture and 130 fracture-free controls were recruited from a large children’s hospital. The interaction between overweight and gender, dynamic of trauma, site of fracture was explored. Sports participation, television viewing, and calcium intake were also investigated. Results Overweight/obesity rate was increased in girls with fracture either at the upper or the lower limb (p= 0.004), while it was increased only in boys with fracture at the lower limb (p <0.02). Overweight/obesity rate did not differ between groups with low or moderate trauma. TV viewing ≥ 2 hrs was more frequent in children with fractures than controls (61.5% vs 34.5%, p =0.015) in the overweight/obese group. Conclusions The increased prevalence of overweight/obesity in children with fractures is related to gender and site of fracture. Higher levels of sedentary behaviours characterize overweight children reporting fractures. PMID:23088687

Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women.

PubMed

Si, Lei; Winzenberg, Tania M; Chen, Mingsheng; Jiang, Qicheng; Palmer, Andrew J

2015-06-01

To determine the residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. A validated state-transition microsimulation model was used. Microsimulation and probabilistic sensitivity analyses were performed to address the uncertainties in the model. All parameters including fracture incidence rates and mortality rates were retrieved from published literature. Simulated subjects were run through the model until they died to estimate the residual lifetime fracture risks. A 10 year time horizon was used to determine the 10 year fracture risks. We estimated the risk of only the first osteoporotic fracture during the simulation time horizon. The residual lifetime and 10 year risks of having the first osteoporotic (hip, clinical vertebral or wrist) fracture for Chinese women aged 50 years were 40.9% (95% CI: 38.3-44.0%) and 8.2% (95% CI: 6.8-9.3%) respectively. For men, the residual lifetime and 10 year fracture risks were 8.7% (95% CI: 7.5-9.8%) and 1.2% (95% CI: 0.8-1.7%) respectively. The residual lifetime fracture risks declined with age, whilst the 10 year fracture risks increased with age until the short-term mortality risks outstripped the fracture risks. Residual lifetime and 10 year clinical vertebral fracture risks were higher than those of hip and wrist fractures in both sexes. More than one third of the Chinese women and approximately one tenth of the Chinese men aged 50 years are expected to sustain a major osteoporotic fracture in their remaining lifetimes. Due to increased fracture risks and a rapidly ageing population, osteoporosis will present a great challenge to the Chinese healthcare system. While national data was used wherever possible, regional Chinese hip and clinical vertebral fracture incidence rates were used, wrist fracture rates were taken from a Norwegian study and calibrated to the Chinese population. Other fracture sites like tibia, humerus, ribs and pelvis were not included in the analysis, thus these risks are likely to be underestimates. Fracture risk factors other than age and sex were not included in the model. Point estimates were used for fracture incidence rates, osteoporosis prevalence and mortality rates for the general population.

Foal Fractures: Osteochondral Fragmentation, Proximal Sesamoid Bone Fractures/Sesamoiditis, and Distal Phalanx Fractures.

PubMed

Reesink, Heidi L

2017-08-01

Foals are susceptible to many of the same types of fractures as adult horses, often secondary to external sources of trauma. In addition, some types of fractures are specific to foals and occur routinely in horses under 1 year of age. These foal-specific fractures may be due to the unique musculoskeletal properties of the developing animal and may present with distinct clinical signs. Treatment plans and prognoses are tailored specifically to young animals. Common fractures not affecting the long bones in foals are discussed in this article, including osteochondral fragmentation, proximal sesamoid bone fractures/sesamoiditis, and distal phalanx fractures. Copyright © 2017 Elsevier Inc. All rights reserved.

Pattern of Cortical Fracture following Corticotomy for Distraction Osteogenesis.

PubMed

Luvan, M; Kanthan, S R; Roshan, G; Saw, A

2015-11-01

Corticotomy is an essential procedure for deformity correction and there are many techniques described. However there is no proper classification of the fracture pattern resulting from corticotomies to enable any studies to be conducted. We performed a retrospective study of corticotomy fracture patterns in 44 patients (34 tibias and 10 femurs) performed for various indications. We identified four distinct fracture patterns, Type I through IV classification based on the fracture propagation following percutaneous corticotomy. Type I transverse fracture, Type II transverse fracture with a winglet, Type III presence of butterfly fragment and Type IV fracture propagation to a fixation point. No significant correlation was noted between the fracture pattern and the underlying pathology or region of corticotomy.

Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries.

PubMed

Wood, C P; Hunt, C H; Bergen, D C; Carlson, M L; Diehn, F E; Schwartz, K M; McKenzie, G A; Morreale, R F; Lane, J I

2014-01-01

The prevalence of tympanic plate fractures, which are associated with an increased risk of external auditory canal stenosis following temporal bone trauma, is unknown. A review of posttraumatic high-resolution CT temporal bone examinations was performed to determine the prevalence of tympanic plate fractures and to identify any associated temporal bone injuries. A retrospective review was performed to evaluate patients with head trauma who underwent emergent high-resolution CT examinations of the temporal bone from July 2006 to March 2012. Fractures were identified and assessed for orientation; involvement of the tympanic plate, scutum, bony labyrinth, facial nerve canal, and temporomandibular joint; and ossicular chain disruption. Thirty-nine patients (41.3 ± 17.2 years of age) had a total of 46 temporal bone fractures (7 bilateral). Tympanic plate fractures were identified in 27 (58.7%) of these 46 fractures. Ossicular disruption occurred in 17 (37.0%). Fractures involving the scutum occurred in 25 (54.4%). None of the 46 fractured temporal bones had a mandibular condyle dislocation or fracture. Of the 27 cases of tympanic plate fractures, 14 (51.8%) had ossicular disruption (P = .016) and 18 (66.6%) had a fracture of the scutum (P = .044). Temporomandibular joint gas was seen in 15 (33%) but was not statistically associated with tympanic plate fracture (P = .21). Tympanic plate fractures are commonly seen on high-resolution CT performed for evaluation of temporal bone trauma. It is important to recognize these fractures to avoid the preventable complication of external auditory canal stenosis and the potential for conductive hearing loss due to a fracture involving the scutum or ossicular chain.

An analytical model for hydraulic fracturing in shallow bedrock formations.

PubMed

dos Santos, José Sérgio; Ballestero, Thomas Paul; Pitombeira, Ernesto da Silva

2011-01-01

A theoretical method is proposed to estimate post-fracturing fracture size and transmissivity, and as a test of the methodology, data collected from two wells were used for verification. This method can be employed before hydrofracturing in order to obtain estimates of the potential hydraulic benefits of hydraulic fracturing. Five different pumping test analysis methods were used to evaluate the well hydraulic data. The most effective methods were the Papadopulos-Cooper model (1967), which includes wellbore storage effects, and the Gringarten-Ramey model (1974), known as the single horizontal fracture model. The hydraulic parameters resulting from fitting these models to the field data revealed that as a result of hydraulic fracturing, the transmissivity increased more than 46 times in one well and increased 285 times in the other well. The model developed by dos Santos (2008), which considers horizontal radial fracture propagation from the hydraulically fractured well, was used to estimate potential fracture geometry after hydrofracturing. For the two studied wells, their fractures could have propagated to distances of almost 175 m or more and developed maximum apertures of about 2.20 mm and hydraulic apertures close to 0.30 mm. Fracturing at this site appears to have expanded and propagated existing fractures and not created new fractures. Hydraulic apertures calculated from pumping test analyses closely matched the results obtained from the hydraulic fracturing model. As a result of this model, post-fracturing geometry and resulting post-fracturing well yield can be estimated before the actual hydrofracturing. Copyright © 2010 The Author(s). Journal compilation © 2010 National Ground Water Association.

Deferoxamine restores callus size, mineralization, and mechanical strength in fracture healing after radiotherapy.

PubMed

Donneys, Alexis; Ahsan, Salman; Perosky, Joseph E; Deshpande, Sagar S; Tchanque-Fossuo, Catherine N; Levi, Benjamin; Kozloff, Ken M; Buchman, Steven R

2013-05-01

Therapeutic augmentation of fracture-site angiogenesis with deferoxamine has proven to increase vascularity, callus size, and mineralization in long-bone fracture models. The authors posit that the addition of deferoxamine would enhance pathologic fracture healing in the setting of radiotherapy in a model where nonunions are the most common outcome. Thirty-five Sprague-Dawley rats were divided into three groups. Fracture, irradiated fracture, and irradiated fracture plus deferoxamine. The irradiated fracture and irradiated fracture plus deferoxamine groups received a human equivalent dose of radiotherapy [7 Gy/day for 5 days, (35 Gy)] 2 weeks before mandibular osteotomy and external fixation. The irradiated fracture plus deferoxamine group received injections of deferoxamine into the fracture callus after surgery. After a 40-day healing period, mandibles were dissected, clinically assessed for bony union, imaged with micro-computed tomography, and tension tested to failure. Compared with irradiated fractures, metrics of callus size, mineralization, and strength in deferoxamine-treated mandibles were significantly increased. These metrics were restored to a level demonstrating no statistical difference from control fractures. In addition, the authors observed an increased rate of achieving bony unions in the irradiated fracture plus deferoxamine-treated group when compared with irradiated fracture (67 percent and 20 percent, respectively). The authors' data demonstrate nearly total restoration of callus size, mineralization, and biomechanical strength, and a threefold increase in the rate of union with the use of deferoxamine. The authors' results suggest that the administration of deferoxamine may have the potential for clinical translation as a new treatment paradigm for radiation-induced pathologic fractures.

Association between findings on palmarodorsal radiographic images and detection of a fracture in the proximal sesamoid bones of forelimbs obtained from cadavers of racing Thoroughbreds.

PubMed

Anthenill, Lucy A; Stover, Susan M; Gardner, Ian A; Hill, Ashley E; Lee, Christina M; Anderson, Mark L; Barr, Bradd C; Read, Deryck H; Johnson, Bill J; Woods, Leslie W; Daft, Barbara M; Kinde, Hailu; Moore, Janet D; Farman, Cynthia A; Odani, Jenee S; Pesavento, Patricia A; Uzal, Francisco A; Case, James T; Ardans, Alex A

2006-05-01

To determine the distribution for limbs and bones in horses with fractures of the proximal sesamoid bones and relationships with findings on palmarodorsal radiographic images. Proximal sesamoid bones obtained from both forelimbs of cadavers of 328 racing Thoroughbreds. Osteophytes; large vascular channels; and fracture location, orientation, configuration, and margin distinctness were categorized by use of high-detail contact palmarodorsal radiographs. Distributions of findings were determined. Relationships between radiographic findings and fracture characteristics were examined by use of chi2 and logistic regression techniques. Fractures were detected in 136 (41.5%) horses. Biaxial fractures were evident in 109 (80%) horses with a fracture. Osteophytes and large vascular channels were evident in 266 (81%) and 325 (99%) horses, respectively. Medial bones typically had complete transverse or split transverse simple fractures, indistinct fracture margins, > 1 vascular channel that was > 1 mm in width, and osteophytes in abaxial wing and basilar middle or basilar abaxial locations. Lateral bones typically had an oblique fracture and distinct fracture margins. Odds of proximal sesamoid bone fracture were approximately 2 to 5 times higher in bones without radiographic evidence of osteophytes or large vascular channels, respectively. Biaxial fractures of proximal sesamoid bones were common in cadavers of racing Thoroughbreds. Differences between medial and lateral bones for characteristics associated with fracture may relate to differences in fracture pathogeneses for these bones. Osteophytes and vascular channels were common findings; however, fractures were less likely to occur in bones with these features.

Predicting bulk permeability using outcrop fracture attributes: The benefits of a Maximum Likelihood Estimator

NASA Astrophysics Data System (ADS)

Rizzo, R. E.; Healy, D.; De Siena, L.

2015-12-01

The success of any model prediction is largely dependent on the accuracy with which its parameters are known. In characterising fracture networks in naturally fractured rocks, the main issues are related with the difficulties in accurately up- and down-scaling the parameters governing the distribution of fracture attributes. Optimal characterisation and analysis of fracture attributes (fracture lengths, apertures, orientations and densities) represents a fundamental step which can aid the estimation of permeability and fluid flow, which are of primary importance in a number of contexts ranging from hydrocarbon production in fractured reservoirs and reservoir stimulation by hydrofracturing, to geothermal energy extraction and deeper Earth systems, such as earthquakes and ocean floor hydrothermal venting. This work focuses on linking fracture data collected directly from outcrops to permeability estimation and fracture network modelling. Outcrop studies can supplement the limited data inherent to natural fractured systems in the subsurface. The study area is a highly fractured upper Miocene biosiliceous mudstone formation cropping out along the coastline north of Santa Cruz (California, USA). These unique outcrops exposes a recently active bitumen-bearing formation representing a geological analogue of a fractured top seal. In order to validate field observations as useful analogues of subsurface reservoirs, we describe a methodology of statistical analysis for more accurate probability distribution of fracture attributes, using Maximum Likelihood Estimators. These procedures aim to understand whether the average permeability of a fracture network can be predicted reducing its uncertainties, and if outcrop measurements of fracture attributes can be used directly to generate statistically identical fracture network models.

Post-fracture management of patients with hip fracture: a perspective.

PubMed

Bruyere, O; Brandi, M-L; Burlet, N; Harvey, N; Lyritis, G; Minne, H; Boonen, S; Reginster, J-Y; Rizzoli, R; Akesson, K

2008-10-01

Hip fracture creates a worldwide morbidity, mortality and economic burden. After surgery, many patients experience long-term disability or die as a consequence of the fracture. A fracture is a major risk factor for a subsequent fracture, which may occur within a short interval. A literature search on post-fracture management of patients with hip fracture was performed on the Medline database. Key experts convened to develop a consensus document. Management of hip-fracture patients to optimize outcome after hospital discharge requires several stages of care co-ordinated by a multidisciplinary team from before admission through to discharge. Further studies that specifically assess prevention and post-fracture management of hip fracture are needed, as only one study to date has assessed an osteoporosis medication in patients with a recent hip fracture. Proper nutrition is vital to assist bone repair and prevent further falls, particularly in malnourished patients. Vitamin D, calcium and protein supplementation is associated with an increase in hip BMD and reduction in falls. Rehabilitation is essential to improve functional disabilities and survival rates. Fall prevention and functional recovery strategies should include patient education and training to improve balance and increase muscle strength and mobility. Appropriate management can prevent further fractures and it is critical that high-risk patients are identified and treated. To foster this process, clinical pathways have been established to support orthopaedic surgeons. Although hip fracture is generally associated with poor outcomes, appropriate management can ensure optimal recovery and survival, and should be prioritized after a hip fracture to avoid deterioration of health and prevent subsequent fracture.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

PubMed

Audigé, Laurent; Slongo, Theddy; Lutz, Nicolas; Blumenthal, Andrea; Joeris, Alexander

2017-04-01

Background and purpose - The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) describes the localization and morphology of fractures, and considers severity in 2 categories: (1) simple, and (2) multifragmentary. We evaluated simple and multifragmentary fractures in a large consecutive cohort of children diagnosed with long bone fractures in Switzerland. Patients and methods - Children and adolescents treated for fractures between 2009 and 2011 at 2 tertiary pediatric surgery hospitals were retrospectively included. Fractures were classified according to the AO PCCF. Severity classes were described according to fracture location, patient age and sex, BMI, and cause of trauma. Results - Of all trauma events, 3% (84 of 2,730) were diagnosed with a multifragmentary fracture. This proportion was age-related: 2% of multifragmentary fractures occurred in school-children and 7% occurred in adolescents. In patients diagnosed with a single fracture only, the highest percentage of multifragmentation occurred in the femur (12%, 15 of 123). In fractured paired radius/ulna bones, multifragmentation occurred in 2% (11 of 687); in fractured paired tibia/fibula bones, it occurred in 21% (24 of 115), particularly in schoolchildren (5 of 18) and adolescents (16 of 40). In a multivariable regression model, age, cause of injury, and bone were found to be relevant prognostic factors of multifragmentation (odds ratio (OR) > 2). Interpretation - Overall, multifragmentation in long bone fractures in children was rare and was mostly observed in adolescents. The femur was mostly affected in single fractures and the lower leg was mostly affected in paired-bone fractures. The clinical relevance of multifragmentation regarding growth and long-term functional recovery remains to be determined.

Incidence and epidemiology of tibial shaft fractures.

PubMed

Larsen, Peter; Elsoe, Rasmus; Hansen, Sandra Hope; Graven-Nielsen, Thomas; Laessoe, Uffe; Rasmussen, Sten

2015-04-01

The literature lacks recent population-based epidemiology studies of the incidence, trauma mechanism and fracture classification of tibial shaft fractures. The purpose of this study was to provide up-to-date information on the incidence of tibial shaft fractures in a large and complete population and report the distribution of fracture classification, trauma mechanism and patient baseline demographics. Retrospective reviews of clinical and radiological records. A total of 196 patients were treated for 198 tibial shaft fractures in the years 2009 and 2010. The mean age at time of fracture was 38.5 (21.2SD) years. The incidence of tibial shaft fracture was 16.9/100,000/year. Males have the highest incidence of 21.5/100,000/year and present with the highest frequency between the age of 10 and 20, whereas women have a frequency of 12.3/100,000/year and have the highest frequency between the age of 30 and 40. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures. The majority of tibial shaft fractures occur during walking, indoor activity and sports. The distribution among genders shows that males present a higher frequency of fractures while participating in sports activities and walking. Women present the highest frequency of fractures while walking and during indoor activities. This study shows an incidence of 16.9/100,000/year for tibial shaft fractures. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pneumothorax complicating isolated clavicle fracture

PubMed Central

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. PMID:26421097

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.

Computational simulation of progressive fracture in fiber composites

NASA Technical Reports Server (NTRS)

Chamis, C. C.

1986-01-01

Computational methods for simulating and predicting progressive fracture in fiber composite structures are presented. These methods are integrated into a computer code of modular form. The modules include composite mechanics, finite element analysis, and fracture criteria. The code is used to computationally simulate progressive fracture in composite laminates with and without defects. The simulation tracks the fracture progression in terms of modes initiating fracture, damage growth, and imminent global (catastrophic) laminate fracture.

Pore-level influence of micro-fracture parameters on visco-capillary behavior of two-phase displacements in porous media

NASA Astrophysics Data System (ADS)

Rokhforouz, M. R.; Akhlaghi Amiri, H. A.

2018-03-01

In this work, coupled Cahn-Hilliard phase field and Navier-Stokes equations were solved using finite element method to address the effects of micro-fracture and its characterizations on water-oil displacements in a heterogeneous porous medium. Sensitivity studies at a wide range of viscosity ratios (M) and capillary numbers (Ca), and the resultant log Ca-log M stability phase diagram, revealed that in both media, with/without fracture, the three regimes of viscous fingering, capillary fingering and stable displacement similarly occur. However, presence of the fracture caused water channeling phenomenon which resulted in reduction of the number of active fingers and hence the final oil recovery factor. At high Ca (especially in the stable regime, with log Ca ≥ -2.5 and log M ≥ 0), recovery factor for the fractured medium was relatively identical with the non-fractured one. At log M ≥ 0, the fracture was fully swept, but flow instabilities were observed inside the fracture at lower M values, especially for log Ca > -4.6. In the case of the fractured medium at log Ca = -4.6 and log M = 0 (capillary dominant flow), it is observed that the primary breakthrough took place by a finger progressed through the matrix, not those channeled through the fracture. Geometrical properties of the fracture, including length, aperture and orientation, highly affected both displacement profile and efficiency. The fracture length inversely influenced the oil recovery factor. It was observed that there is a critical fracture width (almost half of the medium average pore diameter) at which the recovery factor of the medium during displacement is minimum, compared to the media having thinner and thicker fractures. Minor channeling effect in the media with thinner fracture and larger fracture swept volume as well as high fracture/matrix cross flow in the media with thicker fracture were detected as the main cause of this non-monotonic behavior. In the models with thick fractures (with the thickness higher than the average pore diameter), considerable trapped oil volumes were observed inside the fracture at low M values. The fracture orientation had the most impressive effect on oil recovery compared to the other studied parameters; where the oil recovery factor incremented more than 20% as the fracture rotated 90° from flow direction. Due to the dominant effect of the channeling phenomenon, the change in the medium wettability from slightly oil-wet to slightly water-wet, did not considerably affect the displacement profile in the fractured medium. However, oil recovery factor increased as the medium became more water-wet. The fracture area was fully swept by the injected water in the oil-wet and neutral-wet media. However, flow instabilities were observed inside the fracture of the water-wet medium due to counter-current imbibition between fracture/matrix. Micro-scale mechanisms of pore doublet effect, interface coalesce, snap-off and reverse movements were captured during the studied unstable displacements.

NOTCH signaling in skeletal progenitors is critical for fracture repair

PubMed Central

Wang, Cuicui; Inzana, Jason A.; Mirando, Anthony J.; Liu, Zhaoyang; Shen, Jie; O’Keefe, Regis J.; Awad, Hani A.; Hilton, Matthew J.

2016-01-01

Fracture nonunions develop in 10%–20% of patients with fractures, resulting in prolonged disability. Current data suggest that bone union during fracture repair is achieved via proliferation and differentiation of skeletal progenitors within periosteal and soft tissues surrounding bone, while bone marrow stromal/stem cells (BMSCs) and other skeletal progenitors may also contribute. The NOTCH signaling pathway is a critical maintenance factor for BMSCs during skeletal development, although the precise role for NOTCH and the requisite nature of BMSCs following fracture is unknown. Here, we evaluated whether NOTCH and/or BMSCs are required for fracture repair by performing nonstabilized and stabilized fractures on NOTCH-deficient mice with targeted deletion of RBPjk in skeletal progenitors, maturing osteoblasts, and committed chondrocytes. We determined that removal of NOTCH signaling in BMSCs and subsequent depletion of this population result in fracture nonunion, as the fracture repair process was normal in animals harboring either osteoblast- or chondrocyte-specific deletion of RBPjk. Together, this work provides a genetic model of a fracture nonunion and demonstrates the requirement for NOTCH and BMSCs in fracture repair, irrespective of fracture stability and vascularity. PMID:26950423

Conjugate fracture pairs in the Molina Member of the Wasatch Formation, Piceance basin, Colorado: Implications for fracture origins and hydrocarbon production/exploration

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lorenz, J.C.

1997-05-01

The sandstones of the Molina Member of the Wasatch Formation in the Piceance basin of northwestern Colorado contain a suite of fractures that have a conjugate-pair geometry. The fractures are vertical and intersect at an acute angle of between 20 and 40 degrees. Although direct evidence of shear is rare, the fracture surfaces commonly display small steps. The fracture geometries suggest that the maximum compressive stress during fracturing was in the plane of the acute angle of the conjugate fractures: the steps are interpreted as broken-face manifestations of very low angle en echelon fractures, formed within exceptionally narrow zones ofmore » incipient shear. In contrast to the highly anisotropic permeability enhancement created by subparallel vertical extension fractures in the underlying Mesaverde Formation, the conjugate pairs in the Molina sandstones should create a well connected and relatively isotropic mesh of fracture conductivity. Increases in stress magnitudes and anisotropy during production drawdown of reservoir pressures should cause shear offsets along the fractures, initially enhancing permeability.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rybicki, E.F.; Luiskutty, C.T.; Sutrick, J.S.

This User's Manual contains information for four fracture/proppant models. TUPROP1 contains a Geertsma and de Klerk type fracture model. The section of the program utilizing the proppant fracture geometry data from the pseudo three-dimensional highly elongated fracture model is called TUPROPC. The analogous proppant section of the program that was modified to accept fracture shape data from SA3DFRAC is called TUPROPS. TUPROPS also includes fracture closure. Finally there is the penny fracture and its proppant model, PENNPROP. In the first three chapters, the proppant sections are based on the same theory for determining the proppant distribution but have modifications tomore » support variable height fractures and modifications to accept fracture geometry from three different fracture models. Thus, information about each proppant model in the User's Manual builds on information supplied in the previous chapter. The exception to the development of combined treatment models is the penny fracture and its proppant model. In this case, a completely new proppant model was developed. A description of how to use the combined treatment model for the penny fracture is contained in Chapter 4. 2 refs.« less

A further study on seismic response of a set of parallel rock fractures filled with viscoelastic materials

NASA Astrophysics Data System (ADS)

Wu, W.; Zhu, J. B.; Zhao, J.

2013-02-01

The purpose of this study is to further investigate the seismic response of a set of parallel rock fractures filled with viscoelastic materials, following the work by Zhu et al. Dry quartz sands are used to represent the viscoelastic materials. The split Hopkinson rock bar (SHRB) technique is modified to simulate 1-D P-wave propagation across the sand-filled parallel fractures. At first, the displacement and stress discontinuity model (DSDM) describes the seismic response of a sand-filled single fracture. The modified recursive method (MRM) then predicts the seismic response of the sand-filled parallel fractures. The SHRB tests verify the theoretical predictions by DSDM for the sand-filled single fracture and by MRM for the sand-filled parallel fractures. The filling sands cause stress discontinuity across the fractures and promote displacement discontinuity. The wave transmission coefficient for the sand-filled parallel fractures depends on wave superposition between the fractures, which is similar to the effect of fracture spacing on the wave transmission coefficient for the non-filled parallel fractures.

Bilateral mandibular angle fractures: clinical considerations.

PubMed

Boffano, Paolo; Roccia, Fabio

2010-03-01

The mandibular angle is a frequent site of fracture. It is a weak zone that is more exposed to fractures than other areas of the mandibular bone. The presence of incompletely erupted third molars is associated with a further increased risk of angle fractures. Our objective was to evaluate and discuss the surgical outcomes of a group of patients with bilateral mandibular angle fractures.In our study, patients with bilateral mandibular angle fractures surgically treated from January 1, 2001, to June 30, 2009, at the Division of Maxillofacial Surgery of the University of Turin were retrospectively analyzed. A combined transbuccal and intraoral approach or an intraoral approach only was adopted.Eight patients (7 men and 1 woman) underwent surgery for bilateral mandibular angle fractures. Good to satisfactory reduction of the fractures was obtained with both surgical techniques. Good to fair restored occlusion was observed postoperatively in all patients.Successful treatment of bilateral mandibular angle fractures may be achieved via different techniques. Superficially impacted third molars seem to be associated with an increased risk of angle fractures. Bilateral angle fractures are an ideal model to study the biomechanical pathogenesis of angle fractures.

Fracture behaviors under pure shear loading in bulk metallic glasses

NASA Astrophysics Data System (ADS)

Chen, Cen; Gao, Meng; Wang, Chao; Wang, Wei-Hua; Wang, Tzu-Chiang

2016-12-01

Pure shear fracture test, as a special mechanical means, had been carried out extensively to obtain the critical information for traditional metallic crystalline materials and rocks, such as the intrinsic deformation behavior and fracture mechanism. However, for bulk metallic glasses (BMGs), the pure shear fracture behaviors have not been investigated systematically due to the lack of a suitable test method. Here, we specially introduce a unique antisymmetrical four-point bend shear test method to realize a uniform pure shear stress field and study the pure shear fracture behaviors of two kinds of BMGs, Zr-based and La-based BMGs. All kinds of fracture behaviors, the pure shear fracture strength, fracture angle and fracture surface morphology, are systematically analyzed and compared with those of the conventional compressive and tensile fracture. Our results indicate that both the Zr-based and La-based BMGs follow the same fracture mechanism under pure shear loading, which is significantly different from the situation of some previous research results. Our results might offer new enlightenment on the intrinsic deformation and fracture mechanism of BMGs and other amorphous materials.

Fracture behaviors under pure shear loading in bulk metallic glasses.

PubMed

Chen, Cen; Gao, Meng; Wang, Chao; Wang, Wei-Hua; Wang, Tzu-Chiang

2016-12-23

Pure shear fracture test, as a special mechanical means, had been carried out extensively to obtain the critical information for traditional metallic crystalline materials and rocks, such as the intrinsic deformation behavior and fracture mechanism. However, for bulk metallic glasses (BMGs), the pure shear fracture behaviors have not been investigated systematically due to the lack of a suitable test method. Here, we specially introduce a unique antisymmetrical four-point bend shear test method to realize a uniform pure shear stress field and study the pure shear fracture behaviors of two kinds of BMGs, Zr-based and La-based BMGs. All kinds of fracture behaviors, the pure shear fracture strength, fracture angle and fracture surface morphology, are systematically analyzed and compared with those of the conventional compressive and tensile fracture. Our results indicate that both the Zr-based and La-based BMGs follow the same fracture mechanism under pure shear loading, which is significantly different from the situation of some previous research results. Our results might offer new enlightenment on the intrinsic deformation and fracture mechanism of BMGs and other amorphous materials.

Hybrid external fixation in the treatment of tibial pilon fractures: A retrospective analysis of 162 fractures.

PubMed

Galante, Vito N; Vicenti, Giovanni; Corina, Gianfranco; Mori, Claudio; Abate, Antonella; Picca, Girolamo; Conserva, Vito; Speciale, Domenico; Scialpi, Lorenzo; Tartaglia, Nicola; Caiaffa, Vincenzo; Moretti, Biagio

2016-10-01

To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. Retrospective, multicentre study. Adult patients with tibial pilon fractures treated with hybrid external fixation. Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. Fracture union, complications, functional outcome (Mazur Ankle Score). Union was obtained in 159 fractures at an average of 125days; there were three delayed unions and three non-unions. The most frequent complication was superficial pin-track infections (48), all of which responded to local wound care and antibiotics. There were no deep infections and no DVT. Only one fracture had loss of reduction that required frame revision. The overall functional scores were 91 (excellent) for AO/OTA type A fractures, 89 (good) for type B fractures, and 75 (satisfactory) for type C fractures. Hybrid external fixation is an effective method of stabilising tibial pilon fractures, particularly those with marked comminution. The minimally-invasive technique and stable fixation enable early mobilisation, with good functional results and minimal complications. Level IV Case series. Copyright © 2016 Elsevier Ltd. All rights reserved.

Return to sport following clavicle fractures: a systematic review.

PubMed

Robertson, G A J; Wood, A M

2016-09-01

This review aims to provide information on the return rates and return times to sport following clavicle fractures. A systematic search of Medline, EMBASE, CINAHAL, Cochrane, Web of Science, PEDro, SPORTDiscus, Scopus and Google Scholar was performed using the keywords 'clavicle', 'clavicular', 'fractures', 'athletes', 'sports', 'non-operative', 'conservative', 'operative', 'return to sport'. Twenty-three studies were included: 10 reported on mid-shaft fractures, 14 on lateral fractures. The management principles for athletic patients were to attempt non-operative management for undisplaced fractures to undertake operative intervention for displaced lateral fractures and to recommend operative intervention for displaced mid-shaft fractures. The optimal surgical modality for mid-shaft and lateral clavicle fractures. Operative management of displaced mid-shaft fractures offers improved return rates and times to sport compared to non-operative management. Suture fixation and non-acromio-clavicular joint (ACJ)-spanning plate fixation of displaced lateral fractures show promising results. Future prospective studies should aim to establish the optimal treatment modalities for clavicle fractures. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Influence of fracture network physical properties on stability criteria of density-driven flow in a dual-porosity system

NASA Astrophysics Data System (ADS)

Hassanzadeh, H.; Jafari Raad, S. M.

2017-12-01

Linear stability analysis is conducted to study the onset of buoyancy-driven convection involved in solubility trapping of CO2 into deep fractured aquifers. In this study, the effect of fracture network physical properties on the stability criteria in a brine-rich fractured porous layer is investigated using dual porosity concept for both single and variable matrix block size distributions. Linear stability analysis results show that both fracture interporosity flow and fracture storativity factors play an important role in the stability behavior of the system. It is shown that a diffusive boundary layer under the gravity field in a fractured rock with lower fracture storativity and/or higher fracture interporosity flow coefficient is more stable. We present scaling relations that relate the onset of convective instability in fractured aquifers. These findings improve our understanding of buoyancy driven flow in fractured aquifers and are particularly important in estimation of potential storage capacity, risk assessment, and storage sites characterization and screening.Keywords: CO2 sequestration; fractured rock; buoyancy-driven convection; stability analysis

Fractures of the Fifth Metatarsal

MedlinePlus

... overlooked when they occur with an ankle sprain. Jones fracture. Jones fractures occur in a small area of the ... therefore more prone to difficulties in healing. A Jones fracture can be either a stress fracture (a ...

Fractures (Broken Bones): First Aid

MedlinePlus

First aid Fractures (broken bones) Fractures (broken bones): First aid By Mayo Clinic Staff A fracture is a ... 10, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-fractures/basics/ART-20056641 . Mayo Clinic ...

Mechanical behavior and fracture characteristics of off-axis fiber composites. 1: Experimental investigation. [at the Lewis Research Center

NASA Technical Reports Server (NTRS)

Sinclair, J. H.; Chamis, C. C.

1977-01-01

The mechanical behavior, fracture surfaces, and fracture modes of unidirectional high-modulus graphite-fiber/epoxy composites subjected to off-axis tensile loads were investigated experimentally. The investigation included the generation of stress-strain-to-fracture data and scanning electron microscope studies of the fractured surfaces. The results led to the identification of fracture modes and distinct fracture surface characteristics for off-axis tensile loading. The results also led to the formulation of critical for identifying and characterizing these fracture modes and their associated fracture surfaces. The results presented and discussed herein were used in the theoretical investigation and comparisons described in Part 2. These results should also provide a good foundation for identifying, characterizing, and quantifying fracture modes in both off-axis and angle-plied laminates.

Teeth in the Line of Fracture: To Retain or Remove?

PubMed Central

Samson, Jimson; John, Reena; Jayakumar, Shalini

2010-01-01

The purpose of this study was to analyze mandibular fracture site, relationship of the fracture line to the periodontium, vitality of teeth, displacement of the fracture segments and their implications, and determine whether to retain or remove the teeth in the fracture line. Fifty patients with 62 fractures were involved in this study. An electric pulp tester was used to measure the pulpal response. The degree of fracture displacement and the relationship of the fracture line to the periodontium were evaluated using panoramic radiographs. Fractures of the parasymphysis region constituted a majority of 60.87% in the gross displacement category. Four of 50 patients showed no response presurgically and minimal response postoperatively on pulp vitality testing. Patients with teeth in the fracture line showing no response on pulp vitality testing should be advised extraction to avoid further complications. PMID:22132255

Repair of long-bone fractures in cats and small dogs with the Unilock mandible locking plate system.

PubMed

Voss, K; Kull, M; Hässig, M; Montavon, P

2009-01-01

To retrospectively evaluate stabilisation of long-bone fractures in cats and small dogs using the Unilock system. Medical histories and radiographs of consecutive patients with long-bone fractures stabilised with the Unilock system were reviewed. Cases with follow-up radiographs taken at least four weeks postoperatively were included. Signalment of the patient, fracture localisation and type, primary fracture repair or revision surgery, single or double plating, and complications for each patient were noted. Additionally, implant size, number of screws, number of cortices engaged with screws, and number of empty holes across the fracture were evaluated in fractures where a single plate had been applied. Eighteen humeral, 18 radial, 20 femoral, and 10 tibial fractures were treated. The Unilock system was used for primary repair in 44 fractures and for revision surgery in 22 fractures. Two plates were applied in 17 fractures, and a single plate was applied in 49 fractures. Follow-up radiographs were taken four to 109 weeks postoperatively. Complications were seen in 12 animals and 13 fractures (19.7%). Fixation failure occurred in seven fractures (10.6%). Cases with a single plate that suffered fixation failure had thinner screws in relation to bone diameter than cases with double plates, and more screws in a main fragment than those without fixation failure. The Unilock system is a suitable implant for fracture fixation of long bones in cats and small dogs.

Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options.

PubMed

Matcuk, George R; Mahanty, Scott R; Skalski, Matthew R; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J

2016-08-01

Stress fracture, in its most inclusive description, includes both fatigue and insufficiency fracture. Fatigue fractures, sometimes equated with the term "stress fractures," are most common in runners and other athletes and typically occur in the lower extremities. These fractures are the result of abnormal, cyclical loading on normal bone leading to local cortical resorption and fracture. Insufficiency fractures are common in elderly populations, secondary to osteoporosis, and are typically located in and around the pelvis. They are a result of normal or traumatic loading on abnormal bone. Subchondral insufficiency fractures of the hip or knee may cause acute pain that may present in the emergency setting. Medial tibial stress syndrome is a type of stress injury of the tibia related to activity and is a clinical syndrome encompassing a range of injuries from stress edema to frank-displaced fracture. Atypical subtrochanteric femoral fracture associated with long-term bisphosphonate therapy is also a recently discovered entity that needs early recognition to prevent progression to a complete fracture. Imaging recommendations for evaluation of stress fractures include initial plain radiographs followed, if necessary, by magnetic resonance imaging (MRI), which is preferred over computed tomography (CT) and bone scintigraphy. Radiographs are the first-line modality and may reveal linear sclerosis and periosteal reaction prior to the development of a frank fracture. MRI is highly sensitive with findings ranging from periosteal edema to bone marrow and intracortical signal abnormality. Additionally, a brief description of relevant clinical management of stress fractures is included.

Steeply-dipping extension fractures in the Newark basin, New Jersey

USGS Publications Warehouse

Herman, G.C.

2009-01-01

Late Triassic and Early Jurassic bedrock in the Newark basin is pervasively fractured as a result of Mesozoic rifting of the east-central North American continental margin. Tectonic rifting imparted systematic sets of steeply-dipping, en ??chelon, Mode I, extension fractures in basin strata including ordinary joints and veins. These fractures are arranged in transitional-tensional arrays resembling normal dip-slip shear zones. They contributed to crustal stretching, sagging, and eventual faulting of basin rift deposits. Extension fractures display progressive linkage and spatial clustering that probably controlled incipient fault growth. They cluster into three prominent strike groups correlated to early, intermediate, and late-stage tectonic events reflecting about 50- 60?? of counterclockwise rotation of incremental stretching directions. Finite strain analyses show that extension fractures allowed the stretching of basin strata by a few percent, and these fractures impart stratigraphic dips up to a few degrees in directions opposing fracture dips. Fracture groups display three-dimensional spatial variability but consistent geometric relations. Younger fractures locally cut across and terminate against older fractures having more complex vein-cement morphologies and bed-normal folds from stratigraphic compaction. A fourth, youngest group of extension fractures occur sporadically and strike about E-W in obliquely inverted crustal blocks. A geometric analysis of overlapping fracture sets shows how fracture groups result from incremental rotation of an extending tectonic plate, and that old fractures can reactivate with oblique slip components in the contemporary, compressive stress regime. ?? 2008 Elsevier Ltd. All rights reserved.

[Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].

PubMed

Schwabe, P; Märdian, S; Perka, C; Schaser, K-D

2016-04-01

Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup. Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation. Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening. Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition. Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups. Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.

The burden of previous fractures in hip fracture patients. The Break Study.

PubMed

Maggi, Stefania; Siviero, Paola; Gonnelli, Stefano; Caffarelli, Carla; Gandolini, Giorgio; Cisari, Carlo; Rossini, Maurizio; Iolascon, Giovanni; Mauro, Giulia Letizia; Nuti, Ranuccio; Crepaldi, Gaetano

2011-06-01

A positive history of fractures in older patients with hip fracture is common. We determined the risk factors associated with a positive history of fractures and the profile of care in hip fracture patients. In the Break Study, we enrolled 1249 women aged ≥60 years, seeking care for a hip fracture. Baseline information included age, body mass index, lifestyle (smoking habit, alcohol consumption), patient's history of fracture after the age of 50 years, family history of fragility fracture and health status (presence of comorbidity, use of specific drugs, pre-fracture walking ability, type of fracture, time to surgery, type of surgery, osteoporosis treatment). In the multivariable model age, smoking, family history, treatment with antiplatelet, anticoagulants and anticonvulsants, were significant predictors of a positive history of fracture. More than 70% of patients underwent surgery more than 48 hours after admission. About 50% were discharged with a treatment for osteoporosis, but more than 30% only with calcium and vitamin D. In conclusion, factors associated with a positive history of fracture are the traditional risk factors, suggesting that they continue to have a negative impact on health even at older ages. Selected drugs, such as antiplatelet and anticoagulants, deserve further consideration as significant factors associated with fractures. Given that delay in surgery is a major cause of mortality and disability, while treatment for osteoporosis decreases significantly the risk of recurrent fractures and disability, interventions to modify these patterns of care are urgently needed.

Bioinformatics and Microarray Analysis of miRNAs in Aged Female Mice Model Implied New Molecular Mechanisms for Impaired Fracture Healing

PubMed Central

He, Bing; Zhang, Zong-Kang; Liu, Jin; He, Yi-Xin; Tang, Tao; Li, Jie; Guo, Bao-Sheng; Lu, Ai-Ping; Zhang, Bao-Ting; Zhang, Ge

2016-01-01

Impaired fracture healing in aged females is still a challenge in clinics. MicroRNAs (miRNAs) play important roles in fracture healing. This study aims to identify the miRNAs that potentially contribute to the impaired fracture healing in aged females. Transverse femoral shaft fractures were created in adult and aged female mice. At post-fracture 0-, 2- and 4-week, the fracture sites were scanned by micro computed tomography to confirm that the fracture healing was impaired in aged female mice and the fracture calluses were collected for miRNA microarray analysis. A total of 53 significantly differentially expressed miRNAs and 5438 miRNA-target gene interactions involved in bone fracture healing were identified. A novel scoring system was designed to analyze the miRNA contribution to impaired fracture healing (RCIFH). Using this method, 11 novel miRNAs were identified to impair fracture healing at 2- or 4-week post-fracture. Thereafter, function analysis of target genes was performed for miRNAs with high RCIFH values. The results showed that high RCIFH miRNAs in aged female mice might impair fracture healing not only by down-regulating angiogenesis-, chondrogenesis-, and osteogenesis-related pathways, but also by up-regulating osteoclastogenesis-related pathway, which implied the essential roles of these high RCIFH miRNAs in impaired fracture healing in aged females, and might promote the discovery of novel therapeutic strategies. PMID:27527150

Fracture rate in children with cerebral palsy.

PubMed

Stevenson, Richard D; Conaway, Mark; Barrington, John W; Cuthill, Sara L; Worley, Gordon; Henderson, Richard C

2006-01-01

To determine the prevalence of previous fracture, the rate of fracture over time and associated risk factors for fracture in children with moderate or severe cerebral palsy (CP). Three hundred and sixty-four children with moderate-to-severe motor impairment (Gross Motor Function Classification System III, IV and V) enrolled in a multi-centre, region-based longitudinal study of growth, nutrition and health. Of these, 297 had baseline fracture information and 261 children had at least one follow-up assessment. Median duration of follow-up was 1.6 years, for over 600 person-years of follow-up. Forty-six (15.5%) children reported 62 previous fractures at baseline assessment. Children with a history of fractures at baseline were older (mean age 11.9 vs. 8.9 years, p<0.0001) and had greater body fat (triceps z-score -0.01 vs. -0.68, p=0.0003) than children with no previous fracture. Twenty children (6.7%) reported 24 fractures during the follow-up period. Factors associated with risk of fracture during the follow-up period were higher body fat (p=0.03), gastrostomy use (p=0.05) and previous fracture (p=0.10). Based on 24 fractures in 604.5 person-years of follow-up, the rate of fracture was 4.0 per hundred children (4.0%) per year. For children with a history of fracture at baseline, the fracture rate was 7.0% per year; for children with gastrostomy, 6.8% per year; and for children with high triceps skinfold, 9.7% per year. Children with moderate or severe CP are at high risk for fracture. Children with greater body fat, feeding gastrostomy and prior history of fracture are at highest risk and may benefit most from intervention. Further longitudinal study and clinical trials in children with CP are needed to better understand the factors contributing to fracture risk in this population and the best methods of prevention and treatment.

Pathomorphism of spiral tibial fractures in computed tomography imaging.

PubMed

Guzik, Grzegorz

2011-01-01

Spiral fractures of the tibia are virtually homogeneous with regard to their pathomorphism. The differences that are seen concern the level of fracture of the fibula, and, to a lesser extent, the level of fracture of the tibia, the length of fracture cleft, and limb shortening following the trauma. While conventional radiographs provide sufficient information about the pathomorphism of fractures, computed tomography can be useful in demonstrating the spatial arrangement of bone fragments and topography of soft tissues surrounding the fracture site. Multiple cross-sectional computed tomography views of spiral fractures of the tibia show the details of the alignment of bone chips at the fracture site, axis of the tibial fracture cleft, and topography of soft tissues that are not visible on standard radiographs. A model of a spiral tibial fracture reveals periosteal stretching with increasing spiral and longitudinal displacement. The cleft in tibial fractures has a spiral shape and its line is invariable. Every spiral fracture of both crural bones results in extensive damage to the periosteum and may damage bellies of the long flexor muscle of toes, flexor hallucis longus as well as the posterior tibial muscle. Computed tomography images of spiral fractures of the tibia show details of damage that are otherwise invisible on standard radiographs. Moreover, CT images provide useful information about the spatial location of the bone chips as well as possible threats to soft tissues that surround the fracture site. Every spiral fracture of the tibia is associated with disruption of the periosteum. 1. Computed tomography images of spiral fractures of the tibia show details of damage otherwise invisible on standard radiographs, 2. The sharp end of the distal tibial chip can damage the tibialis posterior muscle, long flexor muscles of the toes and the flexor hallucis longus, 3. Every spiral fracture of the tibia is associated with disruption of the periosteum.

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density.

PubMed

Ripamonti, C; Lisi, L; Avella, M

2014-05-01

To investigate the specificity of the neck shaft angle (NSA) to predict hip fracture in males. We consecutively studied 228 males without fracture and 38 with hip fracture. A further 49 males with spine fracture were studied to evaluate the specificity of NSA for hip-fracture prediction. Femoral neck (FN) bone mineral density (FN-BMD), NSA, hip axis length and FN diameter (FND) were measured in each subject by dual X-ray absorptiometry. Between-mean differences in the studied variables were tested by the unpaired t-test. The ability of NSA to predict hip fracture was tested by logistic regression. Compared with controls, FN-BMD (p < 0.01) was significantly lower in both groups of males with fractures, whereas FND (p < 0.01) and NSA (p = 0.05) were higher only in the hip-fracture group. A significant inverse correlation (p < 0.01) was found between NSA and FN-BMD. By age-, height- and weight-corrected logistic regression, none of the tested geometric parameters, separately considered from FN-BMD, entered the best model to predict spine fracture, whereas NSA (p < 0.03) predicted hip fracture together with age (p < 0.001). When forced into the regression, FN-BMD (p < 0.001) became the only fracture predictor to enter the best model to predict both fracture types. NSA is associated with hip-fracture risk in males but is not independent of FN-BMD. The lack of ability of NSA to predict hip fracture in males independent of FN-BMD should depend on its inverse correlation with FN-BMD by capturing, as the strongest fracture predictor, some of the effects of NSA on the hip fracture. Conversely, NSA in females does not correlate with FN-BMD but independently predicts hip fractures.

Femoral neck shaft angle width is associated with hip-fracture risk in males but not independently of femoral neck bone density

PubMed Central

Lisi, L; Avella, M

2014-01-01

Objective: To investigate the specificity of the neck shaft angle (NSA) to predict hip fracture in males. Methods: We consecutively studied 228 males without fracture and 38 with hip fracture. A further 49 males with spine fracture were studied to evaluate the specificity of NSA for hip-fracture prediction. Femoral neck (FN) bone mineral density (FN-BMD), NSA, hip axis length and FN diameter (FND) were measured in each subject by dual X-ray absorptiometry. Between-mean differences in the studied variables were tested by the unpaired t-test. The ability of NSA to predict hip fracture was tested by logistic regression. Results: Compared with controls, FN-BMD (p < 0.01) was significantly lower in both groups of males with fractures, whereas FND (p < 0.01) and NSA (p = 0.05) were higher only in the hip-fracture group. A significant inverse correlation (p < 0.01) was found between NSA and FN-BMD. By age-, height- and weight-corrected logistic regression, none of the tested geometric parameters, separately considered from FN-BMD, entered the best model to predict spine fracture, whereas NSA (p < 0.03) predicted hip fracture together with age (p < 0.001). When forced into the regression, FN-BMD (p < 0.001) became the only fracture predictor to enter the best model to predict both fracture types. Conclusion: NSA is associated with hip-fracture risk in males but is not independent of FN-BMD. Advances in knowledge: The lack of ability of NSA to predict hip fracture in males independent of FN-BMD should depend on its inverse correlation with FN-BMD by capturing, as the strongest fracture predictor, some of the effects of NSA on the hip fracture. Conversely, NSA in females does not correlate with FN-BMD but independently predicts hip fractures. PMID:24678889

Reduced bone mineral density in postmenopausal women self-reporting premenopausal wrist fractures.

PubMed

Fiorano-Charlier, C; Ostertag, A; Aquino, J P; de Vernejoul, M-C; Baudoin, C

2002-07-01

Postmenopausal fractures are associated with low bone mass; however, the role of low peak bone mass in young adults in determining subsequent osteoporosis suggests that premenopausal fractures may also be relevant. We therefore sought to determine whether a self-reported previous history of premenopausal wrist and nonwrist fractures could also be associated with bone density and therefore be used to predict osteoporosis. We recruited 453 volunteer women with a median age of 64 years (range 50-83 years), with no metabolic bone disease, previous femoral neck fracture, or prevalent vertebral fracture. Bone density at the femoral neck (FN) and lumbar spine (LS) was measured using a Lunar DPX-L. As expected, the 319 women who did not report any fracture had a higher T score at LS (-0.93 +/- 1.44) than the 134 women who reported a previous fracture at any site and at any age (T score -1.60 +/- 1.21, p < 0.001). The findings for the FN were similar. Compared with fracture-free women, the women who reported a first wrist fracture before menopause now had a lower LS T score (-1.77 +/- 1.20, n = 15, p < 0.05), whereas those who reported a nonwrist fracture showed no significant decrease in their LS T score (-1.26 +/- 1.00, n = 36). When both wrist and nonwrist fractures had occurred after menopause, the T score was significantly lower. Twenty percent of the fracture-free women were osteoporosis patients. After adjusting for body weight, age, hormonal replacement therapy (HRT), and hip fracture in the family, the relative risk (RR) of osteoporosis for premenopausal wrist fractures was 2.7 (95% confidence interval 1.4-4.3) vs. 1.2 (0.7-2.4) for women with premenopausal nonwrist fractures. We conclude that self-reported premenopausal wrist fractures, but no other fractures occurring before menopause, are likely to be associated with osteoporosis at 65 years of age, and therefore constitute strong grounds for screening.

Depression following fracture in women: a study of age-matched cohorts

PubMed Central

Williams, Lana J; Berk, Michael; Henry, Margaret J; Stuart, Amanda L; Brennan, Sharon L; Jacka, Felice N; Pasco, Julie A

2014-01-01

Objectives High levels of disability, functional impairment and mortality are independently associated with fracture and depression, however the relationship between fracture and depression is uncertain. The aim of this study was to investigate whether fracture is associated with subsequent depressive symptoms in a population-based sample of women. Design A study of age-matched fracture versus non-fracture cohorts of women. Setting Barwon Statistical Division, southeastern Australia. Participants Two samples of women aged ≥35 years were drawn from the Geelong Osteoporosis Study (GOS). The fracture cohort included women with incident fracture identified from radiology reports and the non-fracture cohort were randomly selected from the electoral roll during 1994–1996. Outcome measure Symptoms of depression for women with and without fracture during the 12-month period 2000–2001 were identified by self-report questionnaire based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Results A total of 296 women with fracture (12 hip, 48 vertebral, 91 wrist/forearm, 17 upper arm, 7 pelvis, 11 rib, 62 lower leg and 48 other fractures) and 590 women without fracture were included. Associations between fracture and depression differed between younger (≤65 years) and older (>65 years) women. Age and weight-adjusted odds ratio for depression following fracture among younger women was 0.62 (0.35 to 1.11, p=0.12) and 3.33 (1.24 to 8.98, p=0.02) for older women. Further adjustment for lifestyle factors did not affect the results. Conclusions This study demonstrated that differences in mood status exist between older and younger women following fracture and that fracture is associated with increased depression in older women. Assessment of mood status in both the short and long term following fracture in the elderly seems justified, with early detection and treatment likely to result in improved outcomes. PMID:24561497

Tea and flavonoid intake predict osteoporotic fracture risk in elderly Australian women: a prospective study.

PubMed

Myers, Gael; Prince, Richard L; Kerr, Deborah A; Devine, Amanda; Woodman, Richard J; Lewis, Joshua R; Hodgson, Jonathan M

2015-10-01

Observational studies have linked tea drinking, a major source of dietary flavonoids, with higher bone density. However, there is a paucity of prospective studies examining the association of tea drinking and flavonoid intake with fracture risk. The objective of this study was to examine the associations of black tea drinking and flavonoid intake with fracture risk in a prospective cohort of women aged >75 y. A total of 1188 women were assessed for habitual dietary intake with a food-frequency and beverage questionnaire. Incidence of osteoporotic fracture requiring hospitalization was determined through the Western Australian Hospital Morbidity Data system. Multivariable adjusted Cox regression was used to examine the HRs for incident fracture. Over 10 y of follow-up, osteoporotic fractures were identified in 288 (24.2%) women; 212 (17.8%) were identified as a major osteoporotic fracture, and of these, 129 (10.9%) were a hip fracture. In comparison with the lowest tea intake category (≤1 cup/wk), consumption of ≥3 cups/d was associated with a 30% decrease in the risk of any osteoporotic fracture (HR: 0.70; 95% CI: 0.50, 0.96). Compared with women in the lowest tertile of total flavonoid intake (from tea and diet), women in the highest tertile had a lower risk of any osteoporotic fracture (HR: 0.65; 95% CI: 0.47, 0.88), major osteoporotic fracture (HR: 0.66; 95% CI: 0.45, 0.95), and hip fracture (HR: 0.58; 95% CI: 0.36, 0.95). For specific classes of flavonoids, statistically significant reductions in fracture risk were observed for higher intake of flavonols for any osteoporotic fracture and major osteoporotic fracture, as well as flavones for hip fracture (P < 0.05). Higher intake of black tea and particular classes of flavonoids were associated with lower risk of fracture-related hospitalizations in elderly women at high risk of fracture. © 2015 American Society for Nutrition.

FracPaQ: a MATLAB™ toolbox for the quantification of fracture patterns

NASA Astrophysics Data System (ADS)

Healy, David; Rizzo, Roberto; Farrell, Natalie; Watkins, Hannah; Cornwell, David; Gomez-Rivas, Enrique; Timms, Nick

2017-04-01

The patterns of fractures in deformed rocks are rarely uniform or random. Fracture orientations, sizes, shapes and spatial distributions often exhibit some kind of order. In detail, there may be relationships among the different fracture attributes e.g. small fractures dominated by one orientation, larger fractures by another. These relationships are important because the mechanical (e.g. strength, anisotropy) and transport (e.g. fluids, heat) properties of rock depend on these fracture patterns and fracture attributes. This presentation describes an open source toolbox to quantify fracture patterns, including distributions in fracture attributes and their spatial variation. Software has been developed to quantify fracture patterns from 2-D digital images, such as thin section micrographs, geological maps, outcrop or aerial photographs or satellite images. The toolbox comprises a suite of MATLAB™ scripts based on published quantitative methods for the analysis of fracture attributes: orientations, lengths, intensity, density and connectivity. An estimate of permeability in 2-D is made using a parallel plate model. The software provides an objective and consistent methodology for quantifying fracture patterns and their variations in 2-D across a wide range of length scales. Our current focus for the application of the software is on quantifying crack and fracture patterns in and around fault zones. There is a large body of published work on the quantification of relatively simple joint patterns, but fault zones present a bigger, and arguably more important, challenge. The methods presented are inherently scale independent, and a key task will be to analyse and integrate quantitative fracture pattern data from micro- to macro-scales. New features in this release include multi-scale analyses based on a wavelet method to look for scale transitions, support for multi-colour traces in the input file processed as separate fracture sets, and combining fracture traces from multiple 2-D images to derive the statistically equivalent 3-D fracture pattern expressed as a 2nd rank crack tensor.

Epidemiology of metatarsal stress fractures versus tibial and femoral stress fractures during elite training.

PubMed

Finestone, Aharon; Milgrom, Charles; Wolf, Omer; Petrov, Kaloyan; Evans, Rachel; Moran, Daniel

2011-01-01

The training of elite infantry recruits takes a year or more. Stress fractures are known to be endemic in their basic training and the clinical presentation of tibial, femoral, and metatarsal stress fractures are different. Stress fracture incidence during the subsequent progressively more demanding training is not known. The study hypothesis was that after an adaptation period, the incidence of stress fractures during the course of 1 year of elite infantry training would fall in spite of the increasingly demanding training. Seventy-six male elite infantry recruits were followed for the development of stress fractures during a progressively more difficult training program composed of basic training (1 to 14 weeks), advanced training (14 to 26 weeks), and unit training (26 to 52 weeks). Subjects were reviewed regularly and those with clinical suspicion of stress fracture were assessed using bone scan and X-rays. The incidence of stress fractures was 20% during basic training, 14% during advanced training and 23% during unit training. There was a statistically significant difference in the incidence of tibial and femoral stress fractures versus metatarsal stress fractures before and after the completion of phase II training at week 26 (p=0.0001). Seventy-eight percent of the stress fractures during phases I and II training were either tibial or femoral, while 91% of the stress fractures in phase III training were metatarsal. Prior participation in ball sports (p=0.02) and greater tibial length (p=0.05) were protective factors for stress fracture. The study hypothesis that after a period of soldier adaptation, the incidence of stress fractures would decrease in spite of the increasingly demanding elite infantry training was found to be true for tibial and femoral fractures after 6 months of training but not for metatarsal stress fractures. Further studies are required to understand the mechanism of this difference but physicians and others treating stress fractures should be aware of this pattern.

Patients with prior vertebral or hip fractures treated with teriparatide in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study.

PubMed

Beall, D P; Feldman, R G; Gordon, M L; Gruber, B L; Lane, J M; Valenzuela, G; Yim, D; Alam, J; Krege, J H; Krohn, K

2016-03-01

In patients in the Direct Assessment of Nonvertebral Fractures in Community Experience (DANCE) observational study with and without a prior vertebral or hip fracture, the incidence of nonvertebral fractures was lower with >6 months of teriparatide treatment than during the first 6 months. Clinical evidence on the effect of teriparatide in patients with prior fracture is limited. In the DANCE observational study, the incidence of nonvertebral fragility fractures (NVFX) decreased significantly in patients receiving teriparatide for >6 months (6-24 months) versus >0 to ≤6 months (reference period). We performed a post hoc analysis to assess the effect of teriparatide 20 μg/day in patients who entered DANCE with prior vertebral or hip fractures. The incidence of patients experiencing a NVFX for four 6-month intervals during and after treatment was compared with the reference period. Overall, 4085 patients received ≥1 dose of teriparatide. Of 3720 with sufficient data for efficacy analysis, 692 had prior vertebral fracture, including 179 with previous kyphoplasty/vertebroplasty; 290 had prior hip fracture. These patients were older, and those with prior vertebral fractures had more comorbid conditions at baseline than those without prior vertebral fractures. The incidence of patients experiencing NVFX declined over time in all patient groups. The fracture incidence rate declined 49 and 46%, respectively, in patients with and without prior vertebral fracture and was 63 and 46% lower in patients with previous kyphoplasty/vertebroplasty and without prior vertebral fracture. NVFX declined 43 and 48% in patients with and without prior hip fracture. The reduced incidence over time was consistent in the subgroups (all interaction p values >0.05). Patients with prior fracture were more likely to experience serious adverse events. The incidence of NVFX decreased over time in patients receiving teriparatide in DANCE regardless of prior fracture status.

Temporomandibular joint dysfunction after mandibular fracture in children: a 10-year review.

PubMed

Leuin, Shelby C; Frydendall, Emily; Gao, Dexiang; Chan, Kenny H

2011-01-01

To collect demographic and clinical data on pediatric mandibular fractures and to assess temporomandibular joint (TMJ) dysfunction in patients with condylar and subcondylar (C/SC) fractures. Retrospective case series of pediatric mandibular fractures (1999-2009) with follow-up telephone questionnaire of patients with C/SC fractures. Collected data included age, gender, unilateral vs bilateral C/SC fracture, presence of concomitant fracture, velocity of injury, and treatment modality. Tertiary care children's hospital. Of 164 patients with mandibular fractures, 83 (50.6%) had C/SC fractures, of which 45 (54.2%) completed the questionnaire. Helkimo Anamnestic Dysfunction Index (A(i)) quantification of TMJ dysfunction after C/SC fracture and treatment modality of C/SC fractures. Of the 164 patients, 122 (74.4%) were male (median age, 10.4 years; age range, 0.6-19.0 years). Of the 83 patients with C/SC fractures, 61 (73.5%) were male (median age, 9.1 years; age range, 1.1-18.7 years); 66 (79.5%) had unilateral fractures and 17 (20.5%) had bilateral fractures. The A(i) distribution of the 45 patients who completed the questionnaire was as follows: 15 (33.3%) none, 6 (13.3%) mild, and 24 (53.3%) severe. Females have more severe dysfunction than do males (95% confidence interval, 1.6-140.0; P = .02). No other significant predictors of treatment modality or TMJ dysfunction were identified. Patients with bilateral fracture are 8.1 times (95% confidence interval, 1.0-66.1 times; P = .05) more likely to have closed reduction than are those with unilateral fracture. This is one of the largest series of pediatric C/SC fractures reported in the recent literature. Findings are significant for increased severity of TMJ dysfunction in females and higher incidence of closed reduction in patients with bilateral C/SC fracture.

Discontinuities in effective permeability due to fracture percolation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hyman, Jeffrey De'Haven; Karra, Satish; Carey, James William

Motivated by a triaxial coreflood experiment with a sample of Utica shale where an abrupt jump in permeability was observed, possibly due to the creation of a percolating fracture network through the sample, we perform numerical simulations based on the experiment to characterize how the effective permeability of otherwise low-permeability porous media depends on fracture formation, connectivity, and the contrast between the fracture and matrix permeabilities. While a change in effective permeability due to fracture formation is expected, the dependence of its magnitude upon the contrast between the matrix permeability and fracture permeability and the fracture network structure is poorlymore » characterized. We use two different high-fidelity fracture network models to characterize how effective permeability changes as percolation occurs. The first is a dynamic two-dimensional fracture propagation model designed to mimic the laboratory settings of the experiment. The second is a static three-dimensional discrete fracture network (DFN) model, whose fracture and network statistics are based on the fractured sample of Utica shale. Once the network connects the inflow and outflow boundaries, the effective permeability increases non-linearly with network density. In most networks considered, a jump in the effective permeability was observed when the embedded fracture network percolated. We characterize how the magnitude of the jump, should it occur, depends on the contrast between the fracture and matrix permeabilities. For small contrasts between the matrix and fracture permeabilities the change is insignificant. However, for larger contrasts, there is a substantial jump whose magnitude depends non-linearly on the difference between matrix and fracture permeabilities. A power-law relationship between the size of the jump and the difference between the matrix and fracture permeabilities is observed. In conclusion, the presented results underscore the importance of fracture network topology on the upscaled properties of the porous medium in which it is embedded.« less

Strontium ranelate reduces the risk of vertebral fractures in patients with osteopenia.

PubMed

Seeman, Ego; Devogelaer, Jean-Pierre; Lorenc, Roman; Spector, Timothy; Brixen, Kim; Balogh, Adam; Stucki, Gerold; Reginster, Jean-Yves

2008-03-01

Many fractures occur in women with moderate fracture risk caused by osteopenia. Strontium ranelate was studied in 1431 postmenopausal women with osteopenia. Vertebral fracture risk reduction of 41-59% was shown depending on the site and fracture status at baseline. This is the first report of antivertebral fracture efficacy in women with vertebral osteopenia. Women with osteoporosis are at high risk for fracture. However, more than one half of all fractures in the community originate from the larger population at more moderate risk of fracture caused by osteopenia. Despite this, evidence for antifracture efficacy in these persons is limited. The aim of this study was to determine whether strontium ranelate, a new drug that reduces fracture risk in women with osteoporosis, is also effective in women with osteopenia. Data from the Spinal Osteoporosis Therapeutic Intervention study (SOTI; n = 1649) and the TReatment Of Peripheral OSteoporosis (TROPOS; n = 5091) were pooled to evaluate the antivertebral fracture efficacy of strontium ranelate in women with lumbar spine (LS) osteopenia with any BMD value at the femoral neck (FN; N = 1166) and in 265 women with osteopenia at both sites (intention-to-treat analysis). The women were randomized to strontium ranelate 2 g/d orally or placebo for 3 yr. No group differences were present in baseline characteristics that may influence fracture outcome independent of therapy. In women with LS osteopenia, treatment reduced the risk of vertebral fracture by 41% (RR = 0.59; 95% CI, 0.43-0.82), by 59% (RR = 0.41; 95% CI, 0.17-0.99) in the 447 patients with no prevalent fractures, and by 38% (RR = 0.62; 95% CI, 0.44-0.88) in the 719 patients with prevalent fractures. In women with osteopenia at both sites, treatment reduced the risk of fracture by 52% (RR = 0.48; 95% CI, 0.24-0.96). Strontium ranelate safely reduces the risk of vertebral fractures in women with osteopenia with or without a prevalent fracture.

A New Physics-Based Modeling of Multiple Non-Planar Hydraulic Fractures Propagation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhou, Jing; Huang, Hai; Deo, Milind

Because of the low permeability in shale plays, closely spaced hydraulic fractures and multilateral horizontal wells are generally required to improve production. Therefore, understanding the potential fracture interaction and stress evolution is critical in optimizing fracture/well design and completion strategy in multi-stage horizontal wells. In this paper, a novel fully coupled reservoir flow and geomechanics model based on the dual-lattice system is developed to simulate multiple non-planar fractures propagation. The numerical model from Discrete Element Method (DEM) is used to simulate the mechanics of fracture propagations and interactions, while a conjugate irregular lattice network is generated to represent fluid flowmore » in both fractures and formation. The fluid flow in the formation is controlled by Darcy’s law, but within fractures it is simulated by using cubic law for laminar flow through parallel plates. 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. We investigate the fracture propagation path in both homogeneous and heterogeneous reservoirs using the simulator developed. Stress shadow caused by the transverse fracture will change the orientation of principal stress in the fracture neighborhood, which may inhibit or alter the growth direction of nearby fracture clusters. However, the initial in-situ stress anisotropy often helps overcome this phenomenon. Under large in-situ stress anisotropy, the hydraulic fractures are more likely to propagate in a direction that is perpendicular to the minimum horizontal stress. Under small in-situ stress anisotropy, there is a greater chance for fractures from nearby clusters to merge with each other. Then, we examine the differences in fracture geometry caused by fracturing in cemented or uncemented wellbore. Moreover, the impact of intrinsic reservoir heterogeneity caused by the rock fabric and mineralogy on fracture nucleation and propagation paths is examined through a three-layered reservoir. Finally, we apply the method to a realistic heterogeneous dataset.« less

Mortality and Readmissions After Cervical Fractures From Falls In Older Adults: A Comparison To Hip Fractures Using National Medicare Data

PubMed Central

Cooper, Zara; Mitchell, Susan L.; Lipsitz, Stuart; Ayanian, John Z.; Bernacki, Rachelle E.; Harris, Mitchel B.; Jha, Ashish K.

2015-01-01

Background Cervical fractures from falls are a potentially lethal injury in older patients. Little is known about their epidemiology and outcomes. Objectives To examine the prevalence of cervical spine fractures after falls among older Americans and show changes in recent years. Further, to compare 12-month outcomes in patients with cervical and hip fracture after falls. Design, Setting, and Participants A retrospective study of Medicare data from 2007–2011 including patients ≥65 with cervical fracture and hip fracture after falls treated at acute care hospitals. Measurements Rates of cervical fracture, 12-month mortality and readmission rates after injury. Results Rates of cervical fracture increased from 4.6/10,000 in 2007 to 5.3/10,000 in 2011, whereas rates of hip fracture decreased from 77.3/10,000 in 2007 to 63.5/10,000 in 2011. Patients with cervical fracture without and with spinal cord injury (SCI) were more likely than patients with hip fracture, respectively, to receive treatment at large hospitals (54.1%, 59.4% vs. 28.1%, p< 0.001), teaching hospitals (40.0%, 49.3% vs. 13.4%, p< 0.001), and regional trauma centers (38.5%, 46.3% vs. 13.0%, p< 0.001). Patients with cervical fracture, particularly those with SCI, had higher risk-adjusted mortality rates at one year than those with hip fracture (24.5%, 41.7% vs. 22.7%, p<0.001). By one year, more than half of patients with cervical and hip fracture died or were readmitted to the hospital (59.5%, 73.4% vs. 59.3%, p<0.001). Conclusion Cervical spine fractures occur in one of every 2,000 Medicare beneficiaries annually and appear to be increasing over time. Patients with cervical fractures had higher mortality than those with hip fractures. Given the increasing prevalence and the poor outcomes of this population, hospitals need to develop processes to improve care for these vulnerable patients. PMID:26456855

Official Positions for FRAX® clinical regarding prior fractures from Joint Official Positions Development Conference of the International Society for Clinical Densitometry and International Osteoporosis Foundation on FRAX®.

PubMed

Blank, Robert D

2011-01-01

The 2010 Position Development Conference addressed four questions related to the impact of previous fractures on 10-year fracture risk as calculated by FRAX(®). To address these questions, PubMed was searched on the keywords "fracture, epidemiology, osteoporosis." Titles of retrieved articles were reviewed for an indication that risk for future fracture was discussed. Abstracts of these articles were reviewed for an indication that one or more of the questions listed above was discussed. For those that did, the articles were reviewed in greater detail to extract the findings and to find additional past work and citing works that also bore on the questions. The official positions and the supporting literature review are presented here. FRAX(®) underestimates fracture probability in persons with a history of multiple fractures (good, A, W). FRAX(®) may underestimate fracture probability in individuals with prevalent severe vertebral fractures (good, A, W). While there is evidence that hip, vertebral, and humeral fractures appear to confer greater risk of subsequent fracture than fractures at other sites, quantification of this incremental risk in FRAX(®) is not possible (fair, B, W). FRAX(®) may underestimate fracture probability in individuals with a parental history of non-hip fragility fracture (fair, B, W). Limitations of the methodology include performance by a single reviewer, preliminary review of the literature being confined to titles, and secondary review being limited to abstracts. Limitations of the evidence base include publication bias, overrepresentation of persons of European descent in the published studies, and technical differences in the methods used to identify prevalent and incident fractures. Emerging topics for future research include fracture epidemiology in non-European populations and men, the impact of fractures in family members other than parents, and the genetic contribution to fracture risk. Copyright © 2011 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Hip fractures: incidence, risk factors, energy absorption, and prevention.

PubMed

Lauritzen, J B

1996-01-01

The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled clinical studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially with aging, but the time trend in increasing age-specific incidence may finally reach a plateau. Postmenopausal women suffering earlier non-hip fractures have an increased risk of later hip fracture. The relative risk is highest within the first years following the fracture. Nursing home residents have a high risk of hip fracture (annual rate of 5-6%), and their incidence of falls is about 1.5 falls/person per year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 0.29 falls/person per year and about 20% of these traumas lead to hip fracture. Women with hip fractures have a lower body weight compared with controls, and they may also have less soft tissue covering the hip, even when adjusted for body mass index, indicating a more android body habitus. Experimental studies show that the passive energy absorption in soft tissue covering the hip may influence the risk of hip fracture and be an important determinant for the development of hip fracture, perhaps even more important than bone strength. External hip protectors were developed and tested in an open randomized nursing home study. The rate of hip fracture was reduced by 50%, corresponding to 9 of 247 residents saved from sustaining a hip fracture. This review points to the essentials in the development of hip fracture: risk of fall; type of fall; type of impact; energy absorption; and last, bone strength, which is the final permissive factor leading to hip fracture. Risk estimation and prevention of hip fracture may prove realistic when these issues are taken into consideration.

Why do nickel-titanium archwires fracture intraorally? Fractographic analysis and failure mechanism of in-vivo fractured wires.

PubMed

Zinelis, Spiros; Eliades, Theodore; Pandis, Nikolaos; Eliades, George; Bourauel, Christoph

2007-07-01

The aim of this study was to characterize intraorally fractured nickel-titanium (Ni-Ti) archwires, determine the type of fracture, assess changes in the alloy's hardness and structure, and propose a mechanism of failure. Eleven Ni-Ti SE 200 and 19 copper-Ni-Ti (both, Ormco, Glendora, Calif) intraorally fractured archwires were collected. The location of fracture (anterior or posterior), wire type, cross section, and period of service before fracture were recorded. The retrieved wires and brand-, type-, and size-matched specimens of unused wires were subjected to scanning electron microscopy to assess the fracture type and morphological variation of fracture site of retrieved specimens, and to Vickers hardness (HV200) testing to investigate the hardness of as-received and in-vivo fractured specimens. Fracture site distribution was statistically analyzed with the chi-square test (alpha = 0.05), whereas the results of the hardness testing were analyzed with 2-way ANOVA with state (control vs in-vivo fractured) and composition (Ni-Ti SE vs copper-Ni-Ti) serving as discriminating variables and the Student-Newman-Keuls test at the 95% confidence level. The fracture site distribution showed a preferential location at the midspan between the premolar and the molar, suggesting that masticatory forces and complex loading during engagement of the wire to the bracket slot and potential intraoral aging might account for fracture incidence. All retrieved wires had the distinct features of brittle fracture without plastic deformation or crack propagation, whereas no increase in hardness was observed for the retrieved specimens. Most fractures sites were in the posterior region of the arch, probably because of the high-magnitude masticatory forces. Brittle fracture without plastic deformation was observed in most Ni-Ti wires regardless of archwire composition. There was no increase in the hardness of the intraorally exposed specimens regardless of wire type. This contradicts previous in-vitro studies and rules out hydrogen embrittlement as the cause of fracture.

Discontinuities in effective permeability due to fracture percolation

DOE PAGES

Hyman, Jeffrey De'Haven; Karra, Satish; Carey, James William; ...

2018-01-31

Motivated by a triaxial coreflood experiment with a sample of Utica shale where an abrupt jump in permeability was observed, possibly due to the creation of a percolating fracture network through the sample, we perform numerical simulations based on the experiment to characterize how the effective permeability of otherwise low-permeability porous media depends on fracture formation, connectivity, and the contrast between the fracture and matrix permeabilities. While a change in effective permeability due to fracture formation is expected, the dependence of its magnitude upon the contrast between the matrix permeability and fracture permeability and the fracture network structure is poorlymore » characterized. We use two different high-fidelity fracture network models to characterize how effective permeability changes as percolation occurs. The first is a dynamic two-dimensional fracture propagation model designed to mimic the laboratory settings of the experiment. The second is a static three-dimensional discrete fracture network (DFN) model, whose fracture and network statistics are based on the fractured sample of Utica shale. Once the network connects the inflow and outflow boundaries, the effective permeability increases non-linearly with network density. In most networks considered, a jump in the effective permeability was observed when the embedded fracture network percolated. We characterize how the magnitude of the jump, should it occur, depends on the contrast between the fracture and matrix permeabilities. For small contrasts between the matrix and fracture permeabilities the change is insignificant. However, for larger contrasts, there is a substantial jump whose magnitude depends non-linearly on the difference between matrix and fracture permeabilities. A power-law relationship between the size of the jump and the difference between the matrix and fracture permeabilities is observed. In conclusion, the presented results underscore the importance of fracture network topology on the upscaled properties of the porous medium in which it is embedded.« less

[Cannulated lag screw combined with lateral supporting plate for treatment of Hoffa fracture of Letenneur type I and type III].

PubMed

Lin, Tao; Yang, Shuhua; Xiao, Baojun; Fu, Dehao

2013-09-01

To investigate the effectiveness of cannulated lag screws combined with lateral supporting plates in the treatment of Hoffa fracture of Letenneur type I and type III. Between May 2004 and April 2011, 11 patients with Hoffa fracture of Letenneur type I and type III were treated, including 6 males and 5 females with an average age of 36 years (range, 25-47 years). Factures were caused by traffic accident in 8 cases, by falling in 2 cases, and by the other in 1 case. Fracture involved the left knee in 7 patients and the right knee in 4 patients. According Letenneur's classification criteria, there were 7 type I fractures (6 lateral condyle fractures and 1 medial condyle fracture) and 4 type III fractures (3 lateral condyle fractures and 1 medial condyle fracture). Of 11 fractures, 9 were fresh fractures and 2 were old fractures. Two 6.5 mm cannulated lag screws combined with lateral supporting plates were used to fix fractures by anterolateral or anteromedial incision. All incisions achieved primary healing with no early complication. All patients were followed up 12-26 months (mean, 15 months). X-ray films showed bone healing with an average healing time of 15 weeks (range, 10-18 weeks). No loosening or breaking of internal fixator was observed; the removal time of internal fixation was 9-15 months (mean, 12 months). Accoding to Letenneur's functional assessment system, the results were excellent in 7 cases, good in 3 cases, and poor in 1 case at last follow-up. Cannulated lag screws combined with lateral supporting plates fixation is effective in treatment of Hoffa fracture of Letenneur type I and type III with a high union rate; anterolateral or anteromedial approach is the first choice for Hoffa fracture of type I and type III, especially for complicating by tibial plateau fracture or patella fracture.

Scaling of the flow-stiffness relationship in weakly correlated single fractures

NASA Astrophysics Data System (ADS)

Petrovitch, Christopher L.

The remote characterization of the hydraulic properties of fractures in rocks is important in many subsurface projects. Fractures create uncertainty in the hydraulic properties of the subsurface in that their topology controls the amount of flow that can occur in addition to that from the matrix. In turn, the fracture topology is also affected by stress which alters the topology as the stress changes directly. This alteration of fracture topology with stress is captured by fracture specific stiffness. The specific stiffness of a single fracture can be remotely probed from the attenuation and velocity of seismic waves. The hydromechanical coupling of single fractures, i.e. the relationship between flow and stiffness, holds the key to finding a method to remotely characterize a fractures hydraulic properties. This thesis is separated into two parts: (1) a description of the hydromechanical coupling of fractures based on numerical models used to generate synthetic fractures, compute the flow through a fracture, and deform fracture topologies to unravel the scaling function that is fundamental to the hydromechanical coupling of single fractures; (2) a Discontinuous Galerkin (DG) method was developed to accurately simulate the scattered seismic waves from realistic fracture topologies. The scaling regimes of fluid flow and specific stiffness in weakly correlated fractures are identified by using techniques from Percolation Theory and initially treating the two processes separately. The fixed points associated with fluid flow were found to display critical scaling while the fixed points for specific stiffness were trivial. The two processes could be indirectly related because the trivial scaling of the mechanical properties allowed the specific stiffness to be used as surrogate to the void area fraction. The dynamic transport exponent was extracted at threshold by deforming fracture geometries within the effective medium regime (near the ``cubic law'' regime) to the critical regime. From this, a scaling function was defined for the hydromechanical coupling. This scaling function provides the link between fluid flow and fracture specific stiffness so that seismic waves may be used to remotely probe the hydraulic properties of fractures. Then, the DG method is shown to be capable of measuring such fracture specific stiffnesses by numerically measuring the velocity of interface waves when propagated across laboratory measured fracture geometries of Austin Chalk.

Characterization of Sheet Fracture Patterns in Polygonal-Jointed Lavas at Kokostick Butte, OR, and Mazama Ridge, WA: Investigation and Interpretation of Their Formation and Significance

NASA Astrophysics Data System (ADS)

Lodge, R. W.; Lescinsky, D. T.

2006-12-01

Polygonal joints in lava flows ("columns") are commonly equant leading to a model of formation associated with cooling in an isotropic stress field. This model, however, does not explain rectangular columns, sheet-like fractures, fractures with crosscutting relationships, and fractures with orientations other than perpendicular to the cooling surface. These fracture patterns are often observed at glaciated volcanoes. The presence of preferential fracture orientations suggests an applied stress component likely due to environmental conditions such as the presence of glaciers or flow dynamics such as down-slope settling or flow margin inflation. During this study we investigated the formation and significance of these non-equant fracture patterns to propose a model for their formation. These `abnormal' fracture patterns have not been discussed in the literature and may be important to better understanding the cooling conditions of such lava flows. To test these possibilities we studied Kokostick Butte dacite flow, OR (near South Sister), and Mazama Ridge andesite flow at Mount Rainier, WA. Both of these flows have well developed sheet-like fractures and display evidence of ice-contact during eruption and emplacement. Sheet fractures are long and continuous fractures that have perpendicular connecting fractures forming rectangular columns. The sheet-like fractures are largely parallel to each other on the exposure surface and the connecting fractures vary locally from primary fractures (associated with cooling toward flow interior) to secondary fractures (associated with cooling by water infiltration). Detailed measurements of fracture orientations and spacing were collected at Kokostick Butte and Mazama Ridge to examine the relationship between the sheet fractures and flow geometry. Preliminary results support this relationship and suggest these patterns likely form due to shear associated with small amounts of flow advance by the rapidly cooling lava. Laboratory studies have been undertaken to complement the field observations and measurements. Starch- water experiments have been proven a useful analogue for lava column formation. Various experimental setups involving different mixture thicknesses and compression of the mixture were utilized to simulate the stresses acting during ponding of lava against glacial ice and to produce different fracture morphologies and patterns. Initial results show that compression of the starch slurry results in non-equant fracture patterns with some sheet-like fracturing present.

Rush Fracture Liaison Service for capturing "missed opportunities" to treat osteoporosis in patients with fragility fractures.

PubMed

Gupta, M J; Shah, S; Peterson, S; Baim, S

2018-06-04

In spite of being a public health problem of pandemic proportions, osteoporosis continues to be underdiagnosed and undertreated especially in older adults with fragility fractures. Confirmation of this hypothesis resulted in the development of a novel Fracture Liaison Service (Rush FLS). Results of the first 12 months of operation revealed that patients with confirmed fragility fracture do not have a timely diagnosis at fracture occurrence or treatment of their disease. The Rush FLS is an effective fracture liaison model. Determining the prevalence of undiagnosed and untreated osteoporosis in fragility fracture patients, either admitted to an academic tertiary care center or treated and discharged from the center's emergency department to be followed in the endocrinology bone clinic, using an innovative, educational, low-cost, physician-run Fracture Liaison Service (FLS). An automated alert was integrated into the electronic medical record at Rush University Medical Center (RUMC), triggered by historical and/or acute fracture(s) in patients 50 years or older, in patients that were either admitted to the hospital or in patients evaluated in the emergency department and discharged to be followed in the endocrinology bone clinic. We report the results of the first 12 months of operation in patients admitted to the hospital. First acute fragility fracture(s) were identified in 36% (80/223), only historical fragility fracture(s) in 28% (63/223) and both acute and historical fragility fracture(s) in 36% (80/223). The cumulative subgroup with historical fragility fractures with/without new fractures included 67% (96/143) without a previous diagnosis of osteoporosis. First acute fragility fracture group included 83.8% (67/80) without a previous diagnosis of osteoporosis. Rush FLS "captured missed opportunities" in 73.1% (163/223) of previously undiagnosed and 77.1% (172/223) of previously untreated osteoporosis patients. Dual-energy x-ray absorptiometry (DXA) prior to FLS consult was confirmed in 30% (67/223). Vitamin D deficiency (25-hydroxy vitamin D < 20 ng/ml) in 41.9% (78/186) including undetectable levels in 16.6% (31/186) and secondary hyperparathyroidism in 43.3% (78/180) were the most common laboratory confirmed secondary etiologies for bone loss. This study reported undiagnosed, uninvestigated, and untreated osteoporosis in the majority of fragility fracture patients seen by the Rush FLS in the first 12 months of operation.

An efficient hydro-mechanical model for coupled multi-porosity and discrete fracture porous media

NASA Astrophysics Data System (ADS)

Yan, Xia; Huang, Zhaoqin; Yao, Jun; Li, Yang; Fan, Dongyan; Zhang, Kai

2018-02-01

In this paper, a numerical model is developed for coupled analysis of deforming fractured porous media with multiscale fractures. In this model, the macro-fractures are modeled explicitly by the embedded discrete fracture model, and the supporting effects of fluid and fillings in these fractures are represented explicitly in the geomechanics model. On the other hand, matrix and micro-fractures are modeled by a multi-porosity model, which aims to accurately describe the transient matrix-fracture fluid exchange process. A stabilized extended finite element method scheme is developed based on the polynomial pressure projection technique to address the displacement oscillation along macro-fracture boundaries. After that, the mixed space discretization and modified fixed stress sequential implicit methods based on non-matching grids are applied to solve the coupling model. Finally, we demonstrate the accuracy and application of the proposed method to capture the coupled hydro-mechanical impacts of multiscale fractures on fractured porous media.

Fracture identification based on remote detection acoustic reflection logging

NASA Astrophysics Data System (ADS)

Zhang, Gong; Li, Ning; Guo, Hong-Wei; Wu, Hong-Liang; Luo, Chao

2015-12-01

Fracture identification is important for the evaluation of carbonate reservoirs. However, conventional logging equipment has small depth of investigation and cannot detect rock fractures more than three meters away from the borehole. Remote acoustic logging uses phase-controlled array-transmitting and long sound probes that increase the depth of investigation. The interpretation of logging data with respect to fractures is typically guided by practical experience rather than theory and is often ambiguous. We use remote acoustic reflection logging data and high-order finite-difference approximations in the forward modeling and prestack reverse-time migration to image fractures. First, we perform forward modeling of the fracture responses as a function of the fracture-borehole wall distance, aperture, and dip angle. Second, we extract the energy intensity within the imaging area to determine whether the fracture can be identified as the formation velocity is varied. Finally, we evaluate the effect of the fracture-borehole distance, fracture aperture, and dip angle on fracture identification.

Preferential pathways in complex fracture systems and their influence on large scale transport

NASA Astrophysics Data System (ADS)

Willmann, M.; Mañé, R.; Tyukhova, A.

2017-12-01

Many subsurface applications in complex fracture systems require large-scale predictions. Precise predictions are difficult because of the existence of preferential pathways at different scales. The intrinsic complexity of fracture systems increases within fractured sedimentary formations, because also the coupling of fractures and matrix has to be taken into account. This interplay of fracture system and the sedimentary matrix is strongly controlled by the actual fracture aperture of an individual fracture. And an effective aperture cannot be easily be determined because of the preferential pathways along the fracture plane. We investigate the influence of these preferential pathways on large scale solute transport and upscale the aperture. By explicitly modeling flow and particle tracking in individual fractures, we develop a new effective transport aperture, which is weighted by the aperture along the preferential paths, a Lagrangian aperture. We show that this new aperture is consistently larger than existing definitions of effective flow and transport apertures. Finally, we apply our results to a fractured sedimentary formation in Northern Switzerland.

Mathematical algorithm development and parametric studies with the GEOFRAC three-dimensional stochastic model of natural rock fracture systems

NASA Astrophysics Data System (ADS)

Ivanova, Violeta M.; Sousa, Rita; Murrihy, Brian; Einstein, Herbert H.

2014-06-01

This paper presents results from research conducted at MIT during 2010-2012 on modeling of natural rock fracture systems with the GEOFRAC three-dimensional stochastic model. Following a background summary of discrete fracture network models and a brief introduction of GEOFRAC, the paper provides a thorough description of the newly developed mathematical and computer algorithms for fracture intensity, aperture, and intersection representation, which have been implemented in MATLAB. The new methods optimize, in particular, the representation of fracture intensity in terms of cumulative fracture area per unit volume, P32, via the Poisson-Voronoi Tessellation of planes into polygonal fracture shapes. In addition, fracture apertures now can be represented probabilistically or deterministically whereas the newly implemented intersection algorithms allow for computing discrete pathways of interconnected fractures. In conclusion, results from a statistical parametric study, which was conducted with the enhanced GEOFRAC model and the new MATLAB-based Monte Carlo simulation program FRACSIM, demonstrate how fracture intensity, size, and orientations influence fracture connectivity.

Lunate fractures and associated radiocarpal and midcarpal instabilities: a systematic review.

PubMed

Shunmugam, Meenalochani; Phadnis, Joideep; Watts, Amy; Bain, Gregory I

2018-01-01

The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated. Associated fractures of the scaphoid and the radial and ulnar styloid processes were common. Lunate fractures without subluxation or dislocation had good outcomes with cast immobilization or fixation of associated fractures. Lunate fracture-subluxations are unstable injuries that are best managed with fixation of the carpal fractures. Lunate fracture-dislocations are complex injuries, requiring stabilization of the lunate, associated fractures and ligament injuries; complications are common and acute or delayed salvage procedures may be required.

Rock fracture skeleton tracing by image processing and quantitative analysis by geometry features

NASA Astrophysics Data System (ADS)

Liang, Yanjie

2016-06-01

In rock engineering, fracture measurement is important for many applications. This paper proposes a novel method for rock fracture skeleton tracing and analyzing. As for skeleton localizing, the curvilinear fractures are multiscale enhanced based on a Hessian matrix, after image binarization, and clutters are post-processed by image analysis; subsequently, the fracture skeleton is extracted via ridge detection combined with a distance transform and thinning algorithm, after which gap sewing and burrs removal repair the skeleton. In regard to skeleton analyzing, the roughness and distribution of a fracture network are respectively described by the fractal dimensions D s and D b; the intersection and fragmentation of a fracture network are respectively characterized by the average number of ends and junctions per fracture N average and the average length per fracture L average. Three rock fracture surfaces are analyzed for experiments and the results verify that both the fracture tracing accuracy and the analysis feasibility are satisfactory using the new method.

Assessing Impact Direction in 3-point Bending of Human Femora: Incomplete Butterfly Fractures and Fracture Surfaces,.

PubMed

Isa, Mariyam I; Fenton, Todd W; Deland, Trevor; Haut, Roger C

2018-01-01

Current literature associates bending failure with butterfly fracture, in which fracture initiates transversely at the tensile surface of a bent bone and branches as it propagates toward the impact surface. The orientation of the resulting wedge fragment is often considered diagnostic of impact direction. However, experimental studies indicate bending does not always produce complete butterfly fractures or produces wedge fragments variably in tension or compression, precluding their use in interpreting directionality. This study reports results of experimental 3-point bending tests on thirteen unembalmed human femora. Complete fracture patterns varied following bending failure, but incomplete fractures and fracture surface characteristics were observed in all impacted specimens. A flat, billowy fracture surface was observed in tension, while jagged, angular peaks were observed in compression. Impact direction was accurately reconstructed using incomplete tension wedge butterfly fractures and tension and compression fracture surface criteria in all thirteen specimens. © 2017 American Academy of Forensic Sciences.

The Role of Interface Shape on the Impact Characteristics and Cranial Fracture Patterns Using the Immature Porcine Head Model,.

PubMed

Vaughan, Patrick E; Vogelsberg, Caitlin C M; Vollner, Jennifer M; Fenton, Todd W; Haut, Roger C

2016-09-01

The forensic literature suggests that when adolescents fall onto edged and pointed surfaces, depressed fractures can occur at low energy levels. This study documents impact biomechanics and fracture characteristics of infant porcine skulls dropped onto flat, curved, edged, and focal surfaces. Results showed that the energy needed for fracture initiation was nearly four times higher against a flat surface than against the other surfaces. While characteristic measures of fracture such as number and length of fractures did not vary with impact surface shape, the fracture patterns did depend on impact surface shape. While experimental impacts against the flat surface produced linear fractures initiating at sutural boundaries peripheral to the point of impact (POI), more focal impacts produced depressed fractures initiating at the POI. The study supported case-based forensic literature suggesting cranial fracture patterns depend on impact surface shape and that fracture initiation energy is lower for more focal impacts. © 2016 American Academy of Forensic Sciences.

Prescribing by general practitioners after an osteoporotic fracture.

PubMed

Torgerson, D J; Dolan, P

1998-06-01

Osteoporosis is a major cause of morbidity and cost. Patients sustaining one osteoporotic fracture are at increased risk of having another fracture. The objective of this study was to examine the use of "bone drugs" for the prevention of further osteoporotic fractures among patients who have had a "typical" osteoporotic fracture. This study took a random sample of 300 women aged 50 and over who had sustained either a vertebral, hip or Colles fracture in 1995 from the General Practice Research Database (GPRD) and compared their use of bone drugs with 300 age and practice matched controls. Compared with age and practice matched control patients only vertebral fracture patients showed a statistically significant increase in the use of bone drugs in the year after fracture (39% and 2% for cases and controls respectively; 95% CI of difference 27% to 47%). Etidronate was the most commonly used compound. The majority of patients sustaining an osteoporotic fracture are not prescribed any pharmaceutical agents for the secondary prevention of fracture one year after a primary fracture.

Experimental investigation of heat transport through single synthetic fractures

NASA Astrophysics Data System (ADS)

Pastore, Nicola; Cherubini, Claudia; Giasi, Concetta I.; Redondo, Jose M.

2017-04-01

In fractured geothermal reservoirs, heat transport is highly influenced by the presence of the fractures, so appropriate knowledge of heat behaviour in fractured porous media is essential for accurate prediction of the energy extraction in geothermal reservoirs. The present study focuses on the study of heat transport within single synthetic fractures. In particular manner several tests have been carried out in order to explore the role of fracture roughness, aperture variability and the fracture-matrix ratio on the heat transport dynamics. The Synfrac program together with a 3d printer have been used to build several fracture planes having different geometrical characteristics that have been moulded to generate concrete porous fractured blocks. The tests regard the observation of the thermal breakthrough curves obtained through a continuous flow injection in correspondence of eight thermocouples located uniformly on the fractured blocks. The physical model developed permits to reproduce and understand adequately some features of heat transport dynamics in fractured media. The results give emphasis on the errors of the assumptions commonly used in heat transport modelling.

Upscaling permeability for three-dimensional fractured porous rocks with the multiple boundary method

NASA Astrophysics Data System (ADS)

Chen, Tao; Clauser, Christoph; Marquart, Gabriele; Willbrand, Karen; Hiller, Thomas

2018-02-01

Upscaling permeability of grid blocks is crucial for groundwater models. A novel upscaling method for three-dimensional fractured porous rocks is presented. The objective of the study was to compare this method with the commonly used Oda upscaling method and the volume averaging method. First, the multiple boundary method and its computational framework were defined for three-dimensional stochastic fracture networks. Then, the different upscaling methods were compared for a set of rotated fractures, for tortuous fractures, and for two discrete fracture networks. The results computed by the multiple boundary method are comparable with those of the other two methods and fit best the analytical solution for a set of rotated fractures. The errors in flow rate of the equivalent fracture model decrease when using the multiple boundary method. Furthermore, the errors of the equivalent fracture models increase from well-connected fracture networks to poorly connected ones. Finally, the diagonal components of the equivalent permeability tensors tend to follow a normal or log-normal distribution for the well-connected fracture network model with infinite fracture size. By contrast, they exhibit a power-law distribution for the poorly connected fracture network with multiple scale fractures. The study demonstrates the accuracy and the flexibility of the multiple boundary upscaling concept. This makes it attractive for being incorporated into any existing flow-based upscaling procedures, which helps in reducing the uncertainty of groundwater models.

Comparison of implant component fractures in external and internal type: A 12-year retrospective study.

PubMed

Yi, Yuseung; Koak, Jai-Young; Kim, Seong-Kyun; Lee, Shin-Jae; Heo, Seong-Joo

2018-04-01

The aim of this study was to compare the fracture of implant component behavior of external and internal type of implants to suggest directions for successful implant treatment. Data were collected from the clinical records of all patients who received WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Total number of implants was 1,289 and an average of 3.2 implants was installed per patient. Information about abutment connection type, implant locations, platform sizes was collected with presence of implant component fractures and their managements. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region and screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.

Fractures in outcrops in the vicinity of drill hole USW G-4. Yucca Mountain, Nevada; data analysis and compilation

USGS Publications Warehouse

Barton, Christopher C.; Page, William R.; Morgan, Terrance L.

1989-01-01

Fractures on outcrops in the vicinity of drill hole USW G-4, Yucca Mountain, Nevada, were studied in order to contribute to characterization of fractures for hydrologjc, geomechanical, and tectonic modeling of the Yucca Mountain block and to characterize fractures prior to the excavation of a proposed exploratory shaft located near USW G-4. Yucca Mountain is a prospective site for the construction of an underground repository for high-level nuclear waste.Measurements were taken and recorded on 5,000 fractures at 50 outcrop stations primarily in the upper lithophysal unit of the Tiva Canyon Member of the Miocene Paintbrush Tuff. Fracture orientation and surface roughness were recorded for each fracture. Additionally, notes were taken on fracture abutting, crossing, and offsetting relations, swarming, curvature, brecciation, slickensides, and fracture fillings. Frequency distributions of orientation and roughness were plotted and analyzed. Fractures with low roughness coefficients (0-4) group tightly into two sets based on orientation. We conclude that such fractures are cooling joints and that all other fractures are tectonic. The development of small-scale fractures adjacent, subparallel, and possibly related to the Ghost Dance fault has been addressed in a preliminary way based on data collected in this study. Such sympathetic fractures are abundant in the upper cliff unit but not in the upper lithophysal unit.

Modeling CO2 Storage in Fractured Reservoirs: Fracture-Matrix Interactions of Free-Phase and Dissolved CO2

NASA Astrophysics Data System (ADS)

Oldenburg, C. M.; Zhou, Q.; Birkholzer, J. T.

2017-12-01

The injection of supercritical CO2 (scCO2) in fractured reservoirs has been conducted at several storage sites. However, no site-specific dual-continuum modeling for fractured reservoirs has been reported and modeling studies have generally underestimated the fracture-matrix interactions. We developed a conceptual model for enhanced CO2 storage to take into account global scCO2 migration in the fracture continuum, local storage of scCO2 and dissolved CO2 (dsCO2) in the matrix continuum, and driving forces for scCO2 invasion and dsCO2 diffusion from fractures. High-resolution discrete fracture-matrix models were developed for a column of idealized matrix blocks bounded by vertical and horizontal fractures and for a km-scale fractured reservoir. The column-scale simulation results show that equilibrium storage efficiency strongly depends on matrix entry capillary pressure and matrix-matrix connectivity while the time scale to reach equilibrium is sensitive to fracture spacing and matrix flow properties. The reservoir-scale modeling results shows that the preferential migration of scCO2 through fractures is coupled with bulk storage in the rock matrix that in turn retards the fracture scCO2 plume. We also developed unified-form diffusive flux equations to account for dsCO2 storage in brine-filled matrix blocks and found solubility trapping is significant in fractured reservoirs with low-permeability matrix.

Prevalence of fractures among Thais with thalassaemia syndromes.

PubMed

Sutipornpalangkul, W; Janechetsadatham, Y; Siritanaratkul, N; Harnroongroj, T

2010-10-01

The association of fractures with thalassaemia syndromes is well established. The aim of this study was to determine the prevalence and risk factors for fracture in Thai people with thalassaemia syndromes. A retrospective study and a patient interview were conducted in 201 Thai thalassaemia patients who attended the Division of Haematology, Department of Medicine Siriraj Hospital, Thailand. The patient interview questionnaire included sections on demographics, medical, orthopaedic and surgical history, usage of tobacco and alcohol, as well as questions that pertained to fracture. The risk factors for fracture were determined by odds ratio. The prevalence of fracture in Thai people with thalassaemia syndromes was 35.3 percent. Fracture occurred more often in beta thalassaemia patients (44.1 percent) than in alpha thalassaemia patients (16.9 percent). Upper extremity was the most common site of fracture, while falls and motor vehicle accidents were the most common causes of fracture, and cast/splint was the most common choice of treatment. 28 percent of the patients sustained multiple fractures. Among alpha thalassaemia patients, adults sustained fractures more frequently than children and adolescents. In contrast, beta thalassaemia children had a greater rate of fracture than the adults and adolescents. The risk factors for fracture in thalassaemia patients included male gender, beta thalassaemia, splenectomy, transfusion and a low body mass index. A high prevalence of fracture is observed among Thais with thalassaemia. The aetiology was found to be multifactorial.

Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

PubMed

Hong, Wei; Cheng, Qun; Zhu, Xiaoying; Zhu, Hanmin; Li, Huilin; Zhang, Xuemei; Zheng, Songbai; Du, Yanping; Tang, Wenjing; Xue, Sihong; Ye, Zhibin

2015-01-01

Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients. Patients (322 men and 435 women) aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263) and women (n = 1057) aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI), fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group. Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group). Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men. Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.

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.

Effect of hydro mechanical coupling on natural fracture network formation in sedimentary basins

NASA Astrophysics Data System (ADS)

Ouraga, Zady; Guy, Nicolas; Pouya, Amade

2018-05-01

In sedimentary basin context, numerous phenomena, depending on the geological time span, can result in natural fracture network formation. In this paper, fracture network and dynamic fracture spacing triggered by significant sedimentation rate are studied considering mode I fracture propagation using a coupled hydro-mechanical numerical methods. The focus is put on synthetic geological structure under a constant sedimentation rate on its top. This model contains vertical fracture network initially closed and homogeneously distributed. The fractures are modelled with cohesive zone model undergoing damage and the flow is described by Poiseuille's law. The effect of the behaviour of the rock is studied and the analysis leads to a pattern of fracture network and fracture spacing in the geological layer.

Role of MRI in hip fractures, including stress fractures, occult fractures, avulsion fractures.

PubMed

Nachtrab, O; Cassar-Pullicino, V N; Lalam, R; Tins, B; Tyrrell, P N M; Singh, J

2012-12-01

MR imaging plays a vital role in the diagnosis and management of hip fractures in all age groups, in a large spectrum of patient groups spanning the elderly and sporting population. It allows a confident exclusion of fracture, differentiation of bony from soft tissue injury and an early confident detection of fractures. There is a spectrum of MR findings which in part is dictated by the type and cause of the fracture which the radiologist needs to be familiar with. Judicious but prompt utilisation of MR in patients with suspected hip fractures has a positive therapeutic impact with healthcare cost benefits as well as social care benefits. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Pattern of Cortical Fracture following Corticotomy for Distraction Osteogenesis

PubMed Central

Luvan, M; Roshan, G; Saw, A

2015-01-01

Corticotomy is an essential procedure for deformity correction and there are many techniques described. However there is no proper classification of the fracture pattern resulting from corticotomies to enable any studies to be conducted. We performed a retrospective study of corticotomy fracture patterns in 44 patients (34 tibias and 10 femurs) performed for various indications. We identified four distinct fracture patterns, Type I through IV classification based on the fracture propagation following percutaneous corticotomy. Type I transverse fracture, Type II transverse fracture with a winglet, Type III presence of butterfly fragment and Type IV fracture propagation to a fixation point. No significant correlation was noted between the fracture pattern and the underlying pathology or region of corticotomy. PMID:28611907

Evaluation and management of pediatric proximal humerus fractures.

PubMed

Popkin, Charles A; Levine, William N; Ahmad, Christopher S

2015-02-01

In the pediatric population, sports participation, falls, and motor vehicle accidents can result in proximal humerus fractures. Because the proximal humeral growth plate is responsible for up to 80% of the growth of the humerus, the remodeling of these fractures in children is tremendous. Most of these injuries can be treated with a sling or hanging arm cast, although older children with decreased remodeling capacity may require surgery. Special considerations should be taken for management of proximal humerus fractures that occur in the context of Little League shoulder, lesser tuerosity avulsion fractures, fracture-dislocations, birth fractures, and fractures associated with cysts. Most pediatric patients with proximal humerus fractures have favorable results, and complications are infrequent. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Subclinical Thyroid Dysfunction and Fracture Risk

PubMed Central

Blum, Manuel R.; Bauer, Douglas C.; Collet, Tinh-Hai; Fink, Howard A.; Cappola, Anne R.; da Costa, Bruno R.; Wirth, Christina D.; Peeters, Robin P.; Åsvold, Bjørn O.; den Elzen, Wendy P. J.; Luben, Robert N.; Imaizumi, Misa; Bremner, Alexandra P.; Gogakos, Apostolos; Eastell, Richard; Kearney, Patricia M.; Strotmeyer, Elsa S.; Wallace, Erin R.; Hoff, Mari; Ceresini, Graziano; Rivadeneira, Fernando; Uitterlinden, André G.; Stott, David J.; Westendorp, Rudi G. J.; Khaw, Kay-Tee; Langhammer, Arnuf; Ferrucci, Luigi; Gussekloo, Jacobijn; Williams, Graham R.; Walsh, John P.; Jüni, Peter; Aujesky, Drahomir; Rodondi, Nicolas

2015-01-01

IMPORTANCE Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. OBJECTIVE To assess the association of subclinical thyroid dysfunction with hip, nonspine, spine, or any fractures. DATA SOURCES AND STUDY SELECTION The databases of MEDLINE and EMBASE (inception to March 26, 2015) were searched without language restrictions for prospective cohort studies with thyroid function data and subsequent fractures. DATA EXTRACTION Individual participant data were obtained from 13 prospective cohorts in the United States, Europe, Australia, and Japan. Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45–4.49 mIU/L), subclinical hyperthyroidism (TSH <0.45 mIU/L), and subclinical hypothyroidism (TSH ≥4.50–19.99 mIU/L) with normal thyroxine concentrations. MAIN OUTCOME AND MEASURES The primary outcome was hip fracture. Any fractures, nonspine fractures, and clinical spine fractures were secondary outcomes. RESULTS Among 70 298 participants, 4092 (5.8%) had subclinical hypothyroidism and 2219 (3.2%) had subclinical hyperthyroidism. During 762 401 person-years of follow-up, hip fracture occurred in 2975 participants (4.6%; 12 studies), any fracture in 2528 participants (9.0%; 8 studies), nonspine fracture in 2018 participants (8.4%; 8 studies), and spine fracture in 296 participants (1.3%; 6 studies). In age- and sex-adjusted analyses, the hazard ratio (HR) for subclinical hyperthyroidism vs euthyroidism was 1.36 for hip fracture (95% CI, 1.13–1.64; 146 events in 2082 participants vs 2534 in 56 471); for any fracture, HR was 1.28 (95% CI, 1.06–1.53; 121 events in 888 participants vs 2203 in 25 901); for nonspine fracture, HR was 1.16 (95% CI, 0.95–1.41; 107 events in 946 participants vs 1745 in 21 722); and for spine fracture, HR was 1.51 (95% CI, 0.93–2.45; 17 events in 732 participants vs 255 in 20 328). Lower TSH was associated with higher fracture rates: for TSH of less than 0.10 mIU/L, HR was 1.61 for hip fracture (95% CI, 1.21–2.15; 47 events in 510 participants); for any fracture, HR was 1.98 (95% CI, 1.41–2.78; 44 events in 212 participants); for nonspine fracture, HR was 1.61 (95% CI, 0.96–2.71; 32 events in 185 participants); and for spine fracture, HR was 3.57 (95% CI, 1.88–6.78; 8 events in 162 participants). Risks were similar after adjustment for other fracture risk factors. Endogenous subclinical hyperthyroidism (excluding thyroid medication users) was associated with HRs of 1.52 (95% CI, 1.19–1.93) for hip fracture, 1.42 (95% CI, 1.16–1.74) for any fracture, and 1.74 (95% CI, 1.01–2.99) for spine fracture. No association was found between subclinical hypothyroidism and fracture risk. CONCLUSIONS AND RELEVANCE Subclinical hyperthyroidism was associated with an increased risk of hip and other fractures, particularly among those with TSH levels of less than 0.10 mIU/L and those with endogenous subclinical hyperthyroidism. Further study is needed to determine whether treating subclinical hyperthyroidism can prevent fractures. PMID:26010634

MINERAL METABOLISM OF FRACTURES OF THE TIBIA IN MAN STUDIED WITH EXTERNAL COUNTING OF Sr$sup 8$$sup 5$

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wendberg, B.

1961-01-01

A study was made of 51 adult patients with tibial fractures by external counting with scintillation detectors over the thighs, knees, and tibias during a 14-day period after intravenous injection of 25 to 50 mu c Sr/sup 85/. The pattern of activity curves recorded over the fractured leg compared to those recorded over the control leg varied significantly with the age of the fracture (2 days to 9 yr). Increased uptake of Sr/sup 85/ was observed in all cases. The activity ratio fracture/control tibia obtained 14 days after injection rose during the 1st months after fracture to reach a peakmore » value 6 to 8 months after fracture. The mean 14-day fracture/ control ratios obtained 5 to 10 months after fracture was 15.5 plus or minus 7.2; then it dropped. Even 6 to 9 yr after fracture the counting rate over the fracture was higher than that over the intact tibia. No differences in activity uptake were observed between normally healing fractures and fractures showing delayed or nonunion. Activity curves obtained over the thigh, knee, and tibia of the fractured and intact legs 1 to l4 days after injection of Sr/sup 85/ could be simulated on the basis of a 2-compartment model for the kinetics of Sr in the body. Based on this kinetic analysis the externally recorded Sr/sup 85/ activity values may be interpreted as follows: The activity ratios fractured/intact leg obtained during early intervals after injection are mainly related to differences in the size of the exchangeable mineral spaces under the detector. The 14-day activity ratio of 2 anatomically comparable locations may be used as a relative index of the difference in the accretion rate (rate of irreversible deposition of bone mineral) in these locations, but is somewhat lower than the absolute dfference in the accretion rate. The bone salt laid down in the fracture callus is derived from the body fluids. The accretion rate in the fracture region is increased within a week of the fracture. It rapidly increases during the first months after fracture to reach a peak value at 6 to 8 months after fracture. The accretion rate in the entire fractured leg is increased some months after fracture. The traumatic osteopenia is caused by increased resorption and not by decreased accretion. (H.H.D.)« less

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

PubMed

Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible deviation was observed in 3 patients of 2 groups, respectively when gaping. The X-ray films showed healing of fracture and condylar remodeling at 3-6 months. Mandibular ramus were symmetric in cephalometry. Good effectiveness can be obtained by surgical or non-surgical treatment in pediatric mandibular condylar fractures. Considering the pediatric mandibular condyle having powerful healing and reconstructing potency and avoiding secondary injury on the temporomandibular joint from surgery, non-surgical treatment should be first selected for the pediatric mandibular condylar fractures in patients under 7 years.

Altered disc pressure profile after an osteoporotic vertebral fracture is a risk factor for adjacent vertebral body fracture

PubMed Central

Tzermiadianos, Michael N.; Renner, Susan M.; Phillips, Frank M.; Hadjipavlou, Alexander G.; Zindrick, Michael R.; Havey, Robert M.; Voronov, Michael

2008-01-01

This study investigated the effect of endplate deformity after an osteoporotic vertebral fracture in increasing the risk for adjacent vertebral fractures. Eight human lower thoracic or thoracolumbar specimens, each consisting of five vertebrae were used. To selectively fracture one of the endplates of the middle VB of each specimen a void was created under the target endplate and the specimen was flexed and compressed until failure. The fractured vertebra was subjected to spinal extension under 150 N preload that restored the anterior wall height and vertebral kyphosis, while the fractured endplate remained significantly depressed. The VB was filled with cement to stabilize the fracture, after complete evacuation of its trabecular content to ensure similar cement distribution under both the endplates. Specimens were tested in flexion-extension under 400 N preload while pressure in the discs and strain at the anterior wall of the adjacent vertebrae were recorded. Disc pressure in the intact specimens increased during flexion by 26 ± 14%. After cementation, disc pressure increased during flexion by 15 ± 11% in the discs with un-fractured endplates, while decreased by 19 ± 26.7% in the discs with the fractured endplates. During flexion, the compressive strain at the anterior wall of the vertebra next to the fractured endplate increased by 94 ± 23% compared to intact status (p < 0.05), while it did not significantly change at the vertebra next to the un-fractured endplate (18.2 ± 7.1%, p > 0.05). Subsequent flexion with compression to failure resulted in adjacent fracture close to the fractured endplate in six specimens and in a non-adjacent fracture in one specimen, while one specimen had no adjacent fractures. Depression of the fractured endplate alters the pressure profile of the damaged disc resulting in increased compressive loading of the anterior wall of adjacent vertebra that predisposes it to wedge fracture. This data suggests that correction of endplate deformity may play a role in reducing the risk of adjacent fractures. PMID:18795344

External Validation of the Garvan Nomograms for Predicting Absolute Fracture Risk: The Tromsø Study

PubMed Central

Ahmed, Luai A.; Nguyen, Nguyen D.; Bjørnerem, Åshild; Joakimsen, Ragnar M.; Jørgensen, Lone; Størmer, Jan; Bliuc, Dana; Center, Jacqueline R.; Eisman, John A.; Nguyen, Tuan V.; Emaus, Nina

2014-01-01

Background Absolute risk estimation is a preferred approach for assessing fracture risk and treatment decision making. This study aimed to evaluate and validate the predictive performance of the Garvan Fracture Risk Calculator in a Norwegian cohort. Methods The analysis included 1637 women and 1355 aged 60+ years from the Tromsø study. All incident fragility fractures between 2001 and 2009 were registered. The predicted probabilities of non-vertebral osteoporotic and hip fractures were determined using models with and without BMD. The discrimination and calibration of the models were assessed. Reclassification analysis was used to compare the models performance. Results The incidence of osteoporotic and hip fracture was 31.5 and 8.6 per 1000 population in women, respectively; in men the corresponding incidence was 12.2 and 5.1. The predicted 5-year and 10-year probability of fractures was consistently higher in the fracture group than the non-fracture group for all models. The 10-year predicted probabilities of hip fracture in those with fracture was 2.8 (women) to 3.1 times (men) higher than those without fracture. There was a close agreement between predicted and observed risk in both sexes and up to the fifth quintile. Among those in the highest quintile of risk, the models over-estimated the risk of fracture. Models with BMD performed better than models with body weight in correct classification of risk in individuals with and without fracture. The overall net decrease in reclassification of the model with weight compared to the model with BMD was 10.6% (p = 0.008) in women and 17.2% (p = 0.001) in men for osteoporotic fractures, and 13.3% (p = 0.07) in women and 17.5% (p = 0.09) in men for hip fracture. Conclusions The Garvan Fracture Risk Calculator is valid and clinically useful in identifying individuals at high risk of fracture. The models with BMD performed better than those with body weight in fracture risk prediction. PMID:25255221

Discrete Dual Porosity Modeling of Electrical Current Flow in Fractured Media

NASA Astrophysics Data System (ADS)

Roubinet, D.; Irving, J.

2013-12-01

The study of fractured rocks is highly important in a variety of research fields and applications such as hydrogeology, geothermal energy, hydrocarbon extraction, and the long-term storage of toxic waste. Fractured media are characterized by a large contrast in permeability between the fractures and the rock matrix. For hydrocarbon extraction, the presence of highly conductive fractures is an advantage as they allow for quick and easy access to the resource. For toxic waste storage, however, the fractures represent a significant drawback as there is an increased risk of leakage and migration of pollutants deep into the subsurface. In both cases, the identification of fracture network characteristics is a critical, challenging, and required step. A number of previous studies have indicated that the presence of fractures in geological materials can have a significant impact on geophysical electrical resistivity measurements. It thus appears that, in some cases, geoelectrical surveys might be used to obtain useful information regarding fracture network characteristics. However, existing geoelectrical modeling tools and inversion methods are not properly adapted to deal with the specific challenges of fractured media. This prevents us from fully exploring the potential of the method to characterize fracture network properties. We thus require, as a first step, the development of accurate and efficient numerical modeling tools specifically designed for fractured domains. Building on the discrete fracture network (DFN) approach that has been widely used for modeling groundwater flow in fractured rocks, we have developed a discrete dual-porosity model for electrical current flow in fractured media. Our novel approach combines an explicit representation of the fractures with fracture-matrix electrical flow exchange at the block-scale. Tests in two dimensions show the ability of our method to deal with highly heterogeneous fracture networks in a highly computationally efficient manner, which permits us to study the impact of fractures and their properties on the electrical response of the domain. With additional development, the method will be extended to three dimensions and used in the context of geoelectrical field investigations.

Dynamic osteosynthesis by modified Kuntscher nail for the treatment of tibial diaphyseal fractures.

PubMed

Gadegone, Wasudeo M; Salphale, Yogesh S

2009-04-01

We evaluated a series of diaphyseal fractures of the tibia using low-cost, Indian-made modified Kuntscher nail (Daga nail) with the provision of distal locking screw for the management of the tibial diaphyseal fractures. One hundred and fifty one consecutive patients with diaphyseal fractures of tibia with 151 fractures who were treated by Daga nail were enrolled. One of the patients who had died because of cancer, and the two patients who were lost to follow-up at 3 months were excluded from the study.Therefore data of 148 patients with one hundred and fortyeight fractures is described. One hundred twenty closed fractures, 20 open Grade I fractures, and eight open Grade II fractures as per Gustilo and Anderson classification were included in this study. One hundred fourteen men and 34 women, with a mean age of 38.4 years, were studied. The result were analysed for Surgical time, duration of hospitalisation, union time, union rate, complication rate, functional recovery and crutch walking time. The fractures were followed at least until the time of solid union. The follow-up period averaged 15 months (range, 6-26 months). Union occurred in 140 cases (94.6%). The mean time to union was 13 weeks for closed fractures,17.8 weeks for Grade I open fractures, and 21.6 weeks for Grade II open fractures. Compartment syndrome occurred in two patients. Superficial infection occurred in five cases of Grade I and II compound fractures. Three closed fractures and one case of Grade I compound fracture required bone grafting for delayed union. Two cases of Grade II compound fracture with nonunion required revision surgery and bone grafting. Twelve cases resulted in acceptable malalignment due to operative technical error. In four cases, the distal screw breakage was seen, but none of these complications interfered with fracture healing. Recovery of joint motion was essentially normal in those patients without knee or ankle injury. Unreamed distally locked dynamic tibial nailing (modified Kuntscher nail/Daga nail) can produce excellent clinical results for diaphyseal tibial fractures. It has the advantages of technical simplicity, minimal cost, user-friendly instrumentation, and a short learning curve.

Roughness-Dominated Hydraulic Fracture Propagation

NASA Astrophysics Data System (ADS)

Garagash, D.

2015-12-01

Current understanding suggests that the energy to propagate a hydraulic fracture is defined by the viscous fluid pressure drop along the fracture channel, while the energy dissipation in the immediate vicinity of the fracture front (i.e. fracture toughness) is negligible. This status quo relies on the assumption of Poiseuille flow in the fracture, which transmissivity varies as cube of the aperture. We re-evaluate this assumption in the vicinity of the fracture tip, where the aperture roughness and/or branching of the fracture path may lead to very significant deviations from the cubic law. Existing relationships suggest rough fracture transmissivity power laws ~ wr with 4.5 ≤ r ≤ 6, when aperture w is smaller than the roughness. Solving for the tip region of a steadily propagating hydraulic fracture with the "rough fracture" transmissivity, we are able to show (a) larger energy dissipation than predicted by the Poiseuille flow model; (b) localization of the fluid pressure drop into the low-transmissivity, rough tip region; and (c) emergence of potentially preeminent "toughness-dominated" fracture propagation regime where most of the energy is dissipated at the tip and can be described in the context of classical fracture mechanics by invoking the effective fracture toughness dependent upon the details of the pressure drop in the rough tip. We establish that the ratio of the roughness scale wc to the viscous aperture scale wμ = μVE / σ02, controls the pressure drop localization. (Here V - propagation speed, μ - fluid viscosity, E - rock modulus, and σ0 - in-situ stress). For a range of industrial fracturing fluids (from slick-water to linear gels) and treatment conditions, wc/wμ is large, suggesting a fully-localized pressure drop and energy dissipation. The latter is adequately described by the effective toughness - a function of the propagation velocity, confining stress and material parameters, which estimated values are much larger than the "dry" rock fracture toughness measured in the lab. Using the effective, velocity-dependent fracture toughness to predict the evolution of a penny-shape fracture, we are able to show how/when the classical viscosity-dominated and toughness-dominated solutions based upon the Poiseuille law and the "dry", laboratory fracture toughness values, respectively, may become inadequate.

Ipsilateral intact fibula as a predictor of tibial plafond fracture pattern and severity.

PubMed

Luk, Pamela C; Charlton, Timothy P; Lee, Jackson; Thordarson, David B

2013-10-01

The objective of this study was to determine whether there is a difference in fracture pattern and severity of comminution between tibial plafond fractures with and without associated fibular fractures using computed tomography (CT). We hypothesized that the presence of an intact fibula was predictive of increased tibial plafond fracture severity. This was a case control, radiographic review performed at a single level I university trauma center. Between November 2007 and July 2011, 104 patients with 107 operatively treated tibial pilon fractures and preoperative CT scans were identified: 70 patients with 71 tibial plafond fractures had associated fibular fractures, and 34 patients with 36 tibial plafond fractures had intact fibulas. Four criteria were compared between the 2 groups: AO/OTA classification of distal tibia fractures, Topliss coronal and sagittal fracture pattern classification, plafond region of greatest comminution, and degree of proximal extension of fracture line. The intact fibula group had greater percentages of AO/OTA classification B2 type (5.5 vs 0, P = .046) and B3 type (52.8 vs 28.2, P = .013). Conversely, the percentage of AO/OTA classification C3 type was greater in the fractured fibula group (53.5 vs 30.6, P = .025). Evaluation using the Topliss sagittal and coronal classifications revealed no difference between the 2 groups (P = .226). Central and lateral regions of the plafond were the most common areas of comminution in fractured fibula pilons (32% and 31%, respectively). The lateral region of the plafond was the most common area of comminution in intact fibula pilon fractures (42%). There was no statistically significant difference (P = .71) in degree of proximal extension of fracture line between the 2 groups. Tibial plafond fractures with intact fibulas were more commonly associated with AO/OTA classification B-type patterns, whereas those with fractured fibulas were more commonly associated with C-type patterns. An intact fibula may be predictive of less comminution of the plafond. The lateral and central regions of the plafond were the most common areas of comminution in tibial plafond fractures, regardless of fibular status. Level III, case control study.

FRACOR-software toolbox for deterministic mapping of fracture corridors in oil fields on AutoCAD platform

NASA Astrophysics Data System (ADS)

Ozkaya, Sait I.

2018-03-01

Fracture corridors are interconnected large fractures in a narrow sub vertical tabular array, which usually traverse entire reservoir vertically and extended for several hundreds of meters laterally. Fracture corridors with their huge conductivities constitute an important element of many fractured reservoirs. Unlike small diffuse fractures, actual fracture corridors must be mapped deterministically for simulation or field development purposes. Fracture corridors can be identified and quantified definitely with borehole image logs and well testing. However, there are rarely sufficient image logs or well tests, and it is necessary to utilize various fracture corridor indicators with varying degrees of reliability. Integration of data from many different sources, in turn, requires a platform with powerful editing and layering capability. Available commercial reservoir characterization software packages, with layering and editing capabilities, can be cost intensive. CAD packages are far more affordable and may easily acquire the versatility and power of commercial software packages with addition of a small software toolbox. The objective of this communication is to present FRACOR, a software toolbox which enables deterministic 2D fracture corridor mapping and modeling on AutoCAD platform. The FRACOR toolbox is written in AutoLISPand contains several independent routines to import and integrate available fracture corridor data from an oil field, and export results as text files. The resulting fracture corridor maps consists mainly of fracture corridors with different confidence levels from combination of static and dynamic data and exclusion zones where no fracture corridor can exist. The exported text file of fracture corridors from FRACOR can be imported into an upscaling programs to generate fracture grid for dual porosity simulation or used for field development and well planning.

Epidemiology of Surgically Managed Mandibular Condylar Fractures at a Tertiary Referral Hospital in Urban Southwest China.

PubMed

Thapa, Swosti; Wang, Jun; Hu, Hong-Tao; Zhang, Fu-Gui; Ji, Ping

2017-01-01

Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.

Application of Fractal Geometry in Evaluation of Effective Stimulated Reservoir Volume in Shale Gas Reservoirs

NASA Astrophysics Data System (ADS)

Sheng, Guanglong; Su, Yuliang; Wang, Wendong; Javadpour, Farzam; Tang, Meirong

According to hydraulic-fracturing practices conducted in shale reservoirs, effective stimulated reservoir volume (ESRV) significantly affects the production of hydraulic fractured well. Therefore, estimating ESRV is an important prerequisite for confirming the success of hydraulic fracturing and predicting the production of hydraulic fracturing wells in shale reservoirs. However, ESRV calculation remains a longstanding challenge in hydraulic-fracturing operation. In considering fractal characteristics of the fracture network in stimulated reservoir volume (SRV), this paper introduces a fractal random-fracture-network algorithm for converting the microseismic data into fractal geometry. Five key parameters, including bifurcation direction, generating length (d), deviation angle (α), iteration times (N) and generating rules, are proposed to quantitatively characterize fracture geometry. Furthermore, we introduce an orthogonal-fractures coupled dual-porosity-media representation elementary volume (REV) flow model to predict the volumetric flux of gas in shale reservoirs. On the basis of the migration of adsorbed gas in porous kerogen of REV with different fracture spaces, an ESRV criterion for shale reservoirs with SRV is proposed. Eventually, combining the ESRV criterion and fractal characteristic of a fracture network, we propose a new approach for evaluating ESRV in shale reservoirs. The approach has been used in the Eagle Ford shale gas reservoir, and results show that the fracture space has a measurable influence on migration of adsorbed gas. The fracture network can contribute to enhancement of the absorbed gas recovery ratio when the fracture space is less than 0.2 m. ESRV is evaluated in this paper, and results indicate that the ESRV accounts for 27.87% of the total SRV in shale gas reservoirs. This work is important and timely for evaluating fracturing effect and predicting production of hydraulic fracturing wells in shale reservoirs.

Reduced Bone Material Strength is Associated with Increased Risk and Severity of Osteoporotic Fractures. An Impact Microindentation Study.

PubMed

Sosa, Daysi Duarte; Eriksen, Erik Fink

2017-07-01

The aim of the study was to test, whether bone material strength differs between different subtypes of osteoporotic fracture and assess whether it relates to vertebral fracture severity. Cortical bone material strength index (BMSi) was measured by impact microindentation in 66 women with osteoporotic fracture and 66 age- and sex-matched controls without fracture. Bone mineral density (BMD) and bone turnover markers were also assessed. Vertebral fracture severity was graded by semiquantitative (SQ) grading. Receiver operator characteristic (ROC) curves were used to examine the ability of BMSi to discriminate fractures. Subjects with osteoporotic fractures exhibited lower BMSi than controls (71.5 ± 7.3 vs. 76.4 ± 6.2, p < 0.001). After adjusting for age and hip BMD, a significant negative correlation was seen between BMSi and vertebral fracture severity (r 2  = 0.19, p = 0.007). A decrease of one standard deviation (SD) in BMSi was associated with increased risk of fracture (OR 2.62; 95% CI 1.35, 5.10, p = 0.004). ROC curve areas under the curve (AUC) for BMSi in subjects with vertebral fracture (VF), hip fracture (HF), and non-vertebral non-hip fracture (NVNHFx), (mean; 95% CI) were 0.711 (0.608; 0.813), 0.712 (0.576; 0.843), 0.689 (0.576; 0.775), respectively. Combining BMSi and BMD provided further improvement in the discrimination of fractures with AUC values of 0.777 (0.695; 0.858), 0.789 (0.697; 0.882), and 0.821 (0.727; 0.914) for VFx, HFx, and NVNHFx, respectively. Low BMSi of the tibial cortex is associated with increased risk of all osteoporotic fractures and severity of vertebral fractures.

Multiscale fracture network characterization and impact on flow: A case study on the Latemar carbonate platform

NASA Astrophysics Data System (ADS)

Hardebol, N. J.; Maier, C.; Nick, H.; Geiger, S.; Bertotti, G.; Boro, H.

2015-12-01

A fracture network arrangement is quantified across an isolated carbonate platform from outcrop and aerial imagery to address its impact on fluid flow. The network is described in terms of fracture density, orientation, and length distribution parameters. Of particular interest is the role of fracture cross connections and abutments on the effective permeability. Hence, the flow simulations explicitly account for network topology by adopting Discrete-Fracture-and-Matrix description. The interior of the Latemar carbonate platform (Dolomites, Italy) is taken as outcrop analogue for subsurface reservoirs of isolated carbonate build-ups that exhibit a fracture-dominated permeability. New is our dual strategy to describe the fracture network both as deterministic- and stochastic-based inputs for flow simulations. The fracture geometries are captured explicitly and form a multiscale data set by integration of interpretations from outcrops, airborne imagery, and lidar. The deterministic network descriptions form the basis for descriptive rules that are diagnostic of the complex natural fracture arrangement. The fracture networks exhibit a variable degree of multitier hierarchies with smaller-sized fractures abutting against larger fractures under both right and oblique angles. The influence of network topology on connectivity is quantified using Discrete-Fracture-Single phase fluid flow simulations. The simulation results show that the effective permeability for the fracture and matrix ensemble can be 50 to 400 times higher than the matrix permeability of 1.0 · 10-14 m2. The permeability enhancement is strongly controlled by the connectivity of the fracture network. Therefore, the degree of intersecting and abutting fractures should be captured from outcrops with accuracy to be of value as analogue.

Cough-induced rib fractures.

PubMed

Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H

2005-07-01

To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.

Rib fractures after percutaneous radiofrequency and microwave ablation of lung tumors: incidence and relevance.

PubMed

Alexander, Erica S; Hankins, Carol A; Machan, Jason T; Healey, Terrance T; Dupuy, Damian E

2013-03-01

To retrospectively identify the incidence and probable risk factors for rib fractures after percutaneous radiofrequency ablation (RFA) and microwave ablation (MWA) of neoplasms in the lung and to identify complications related to these fractures. Institutional review board approval was obtained for this HIPAA-compliant retrospective study. Study population was 163 patients treated with MWA and/or RFA for 195 lung neoplasms between February 2004 and April 2010. Follow-up computed tomographic images of at least 3 months were retrospectively reviewed by board-certified radiologists to determine the presence of rib fractures. Generalized estimating equations were performed to assess the effect that patient demographics, tumor characteristics, treatment parameters, and ablation zone characteristics had on development of rib fractures. Kaplan-Meier curve was used to estimate patients' probability of rib fracture after ablation as a function of time. Clinical parameters (ie, pain in ribs or chest, organ damage caused by fractured rib) were evaluated for patients with confirmed fracture. Rib fractures in proximity to the ablation zone were found in 13.5% (22 of 163) of patients. Estimated probability of fracture was 9% at 1 year and 22% at 3 years. Women were more likely than were men to develop fracture after ablation (P = .041). Patients with tumors closer to the chest wall were more likely to develop fracture (P = .0009), as were patients with ablation zones that involved visceral pleura (P = .039). No patients with rib fractures that were apparently induced by RFA and MWA had organ injury or damage related to fracture, and 9.1% (2 of 22) of patients reported mild pain. Rib fractures were present in 13.5% of patients after percutaneous RFA and MWA of lung neoplasms. Patients who had ablations performed close to the chest wall should be monitored for rib fractures.

Effects of fracture surface roughness and shear displacement on geometrical and hydraulic properties of three-dimensional crossed rock fracture models

NASA Astrophysics Data System (ADS)

Huang, Na; Liu, Richeng; Jiang, Yujing; Li, Bo; Yu, Liyuan

2018-03-01

While shear-flow behavior through fractured media has been so far studied at single fracture scale, a numerical analysis of the shear effect on the hydraulic response of 3D crossed fracture model is presented. The analysis was based on a series of crossed fracture models, in which the effects of fracture surface roughness and shear displacement were considered. The rough fracture surfaces were generated using the modified successive random additions (SRA) algorithm. The shear displacement was applied on one fracture, and at the same time another fracture shifted along with the upper and lower surfaces of the sheared fracture. The simulation results reveal the development and variation of preferential flow paths through the model during the shear, accompanied by the change of the flow rate ratios between two flow planes at the outlet boundary. The average contact area accounts for approximately 5-27% of the fracture planes during shear, but the actual calculated flow area is about 38-55% of the fracture planes, which is much smaller than the noncontact area. The equivalent permeability will either increase or decrease as shear displacement increases from 0 to 4 mm, depending on the aperture distribution of intersection part between two fractures. When the shear displacement continuously increases by up to 20 mm, the equivalent permeability increases sharply first, and then keeps increasing with a lower gradient. The equivalent permeability of rough fractured model is about 26-80% of that calculated from the parallel plate model, and the equivalent permeability in the direction perpendicular to shear direction is approximately 1.31-3.67 times larger than that in the direction parallel to shear direction. These results can provide a fundamental understanding of fluid flow through crossed fracture model under shear.

Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan.

PubMed

Moriwaki, K; Noto, S

2017-02-01

A model-based cost-effectiveness analysis was performed to evaluate the cost-effectiveness of secondary fracture prevention by osteoporosis liaison service (OLS) relative to no therapy in patients with osteoporosis and a history of hip fracture. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture. The purpose of this study was to estimate, from the perspective of Japan's healthcare system, the cost-effectiveness of secondary fracture prevention by OLS relative to no therapy in patients with osteoporosis and a history of hip fracture. A patient-level state transition model was developed to predict lifetime costs and quality-adjusted life years (QALYs) in patients with or without secondary fracture prevention by OLS. The incremental cost-effectiveness ratio (ICER) of secondary fracture prevention compared with no therapy was estimated. Sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results. Compared with no therapy, secondary fracture prevention in patients aged 65 with T-score of -2.5 resulted in an additional lifetime cost of $3396 per person and conferred an additional 0.118 QALY, resulting in an ICER of $28,880 per QALY gained. Deterministic sensitivity analyses showed that treatment duration and offset time strongly affect the cost-effectiveness of OLS. According to the results of scenario analyses, secondary fracture prevention by OLS was cost-saving compared with no therapy in patients with a family history of hip fracture and high alcohol intake. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture. In addition, secondary fracture prevention is less expensive than no therapy in high-risk patients with multiple risk factors.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF)

PubMed Central

Audigé, Laurent; Slongo, Theddy; Lutz, Nicolas; Blumenthal, Andrea; Joeris, Alexander

2017-01-01

Background and purpose The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) describes the localization and morphology of fractures, and considers severity in 2 categories: (1) simple, and (2) multifragmentary. We evaluated simple and multifragmentary fractures in a large consecutive cohort of children diagnosed with long bone fractures in Switzerland. Patients and methods Children and adolescents treated for fractures between 2009 and 2011 at 2 tertiary pediatric surgery hospitals were retrospectively included. Fractures were classified according to the AO PCCF. Severity classes were described according to fracture location, patient age and sex, BMI, and cause of trauma. Results Of all trauma events, 3% (84 of 2,730) were diagnosed with a multifragmentary fracture. This proportion was age-related: 2% of multifragmentary fractures occurred in school­children and 7% occurred in adolescents. In patients diagnosed with a single fracture only, the highest percentage of multifragmentation occurred in the femur (12%, 15 of 123). In fractured paired radius/ulna bones, multifragmentation occurred in 2% (11 of 687); in fractured paired tibia/fibula bones, it occurred in 21% (24 of 115), particularly in schoolchildren (5 of 18) and adolescents (16 of 40). In a multivariable regression model, age, cause of injury, and bone were found to be relevant prognostic factors of multifragmentation (odds ratio (OR) > 2). Interpretation Overall, multifragmentation in long bone fractures in children was rare and was mostly observed in adolescents. The femur was mostly affected in single fractures and the lower leg was mostly affected in paired-bone fractures. The clinical relevance of multifragmentation regarding growth and long-term functional recovery remains to be determined. PMID:27882814

Effects of foot posture on fifth metatarsal fracture healing: a finite element study.

PubMed

Brilakis, Emmanuel; Kaselouris, Evaggelos; Xypnitos, Frank; Provatidis, Christopher G; Efstathopoulos, Nicolas

2012-01-01

The goal of this study was to evaluate the effects of maintaining different foot postures during healing of proximal fifth metatarsal fractures for each of 3 common fracture types. A 3-dimensional (3D) finite element model of a human foot was developed and 3 loading situations were evaluated, including the following: (1) normal weightbearing, (2) standing with the affected foot in dorsiflexion at the ankle, and (3) standing with the affected foot in eversion. Three different stages of the fracture-healing process were studied, including: stage 1, wherein the material interposed between the fractured edges was the initial connective tissue; stage 2, wherein connective tissue had been replaced by soft callus; and stage 3, wherein soft callus was replaced by mature bone. Thus, 30 3D finite element models were analyzed that took into account fracture type, foot posture, and healing stage. Different foot postures did not statistically significantly affect the peak-developed strains on the fracture site. When the fractured foot was everted or dorsiflexed, it developed a slightly higher strain within the fracture than when it was in the normal weightbearing position. In Jones fractures, eversion of the foot caused further torsional strain and we believe that this position should be avoided during foot immobilization during the treatment of fifth metatarsal base fractures. Tuberosity avulsion fractures and Jones fractures seem to be biomechanically stable fractures, as compared with shaft fractures. Our understanding of the literature and experience indicate that current clinical observations and standard therapeutic options are in accordance with the results that we observed in this investigation, with the exception of Jones fractures. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Seismic Attenuation and Stiffness Modulus Dispersion in Porous Rocks Containing Stochastic Fracture Networks

NASA Astrophysics Data System (ADS)

Hunziker, Jürg; Favino, Marco; Caspari, Eva; Quintal, Beatriz; Rubino, J. Germán.; Krause, Rolf; Holliger, Klaus

2018-01-01

Understanding seismic attenuation and modulus dispersion mechanisms in fractured rocks can result in significant advances for the indirect characterization of such environments. In this paper, we study attenuation and modulus dispersion of seismic waves caused by fluid pressure diffusion (FPD) in stochastic 2-D fracture networks, allowing for a state-of-the-art representation of natural fracture networks by a power law length distribution. To this end, we apply numerical upscaling experiments consisting of compression and shear tests to our samples of fractured rocks. The resulting P and S wave attenuation and modulus dispersion behavior is analyzed with respect to the density, the length distribution, and the connectivity of the fractures. We focus our analysis on two manifestations of FPD arising in fractured rocks, namely, fracture-to-background FPD at lower frequencies and fracture-to-fracture FPD at higher frequencies. Our results indicate that FPD is sensitive not only to the fracture density but also to the geometrical characteristics of the fracture length distributions. In particular, our study suggests that information about the local connectivity of a fracture network could be retrieved from seismic data. Conversely, information about the global connectivity, which is directly linked to the effective hydraulic conductivity of the probed volume, remains rather difficult to infer.

Role of geomechanically grown fractures on dispersive transport in heterogeneous geological formations.

PubMed

Nick, H M; Paluszny, A; Blunt, M J; Matthai, S K

2011-11-01

A second order in space accurate implicit scheme for time-dependent advection-dispersion equations and a discrete fracture propagation model are employed to model solute transport in porous media. We study the impact of the fractures on mass transport and dispersion. To model flow and transport, pressure and transport equations are integrated using a finite-element, node-centered finite-volume approach. Fracture geometries are incrementally developed from a random distributions of material flaws using an adoptive geomechanical finite-element model that also produces fracture aperture distributions. This quasistatic propagation assumes a linear elastic rock matrix, and crack propagation is governed by a subcritical crack growth failure criterion. Fracture propagation, intersection, and closure are handled geometrically. The flow and transport simulations are separately conducted for a range of fracture densities that are generated by the geomechanical finite-element model. These computations show that the most influential parameters for solute transport in fractured porous media are as follows: fracture density and fracture-matrix flux ratio that is influenced by matrix permeability. Using an equivalent fracture aperture size, computed on the basis of equivalent permeability of the system, we also obtain an acceptable prediction of the macrodispersion of poorly interconnected fracture networks. The results hold for fractures at relatively low density.

Stress Fractures of the Pelvis and Legs in Athletes

PubMed Central

Behrens, Steve B.; Deren, Matthew E.; Matson, Andrew; Fadale, Paul D.; Monchik, Keith O.

2013-01-01

Context: Stress fractures are common injuries in athletes, often difficult to diagnose. A stress fracture is a fatigue-induced fracture of bone caused by repeated applications of stress over time. Evidence Acquisition: PubMed articles published from 1974 to January 2012. Results: Intrinsic and extrinsic factors may predict the risk of stress fractures in athletes, including bone health, training, nutrition, and biomechanical factors. Based on their location, stress fractures may be categorized as low- or high-risk, depending on the likelihood of the injury developing into a complete fracture. Treatment for these injuries varies substantially and must account for the risk level of the fractured bone, the stage of fracture development, and the needs of the patient. High-risk fractures include the anterior tibia, lateral femoral neck, patella, medial malleolus, and femoral head. Low-risk fractures include the posteromedial tibia, fibula, medial femoral shaft, and pelvis. Magnetic resonance is the imaging test of choice for diagnosis. Conclusions: These injuries can lead to substantial lost time from participation. Treatment will vary by fracture location, but most stress fractures will heal with rest and modified weightbearing. Some may require more aggressive intervention, such as prolonged nonweightbearing movement or surgery. Contributing factors should also be addressed prior to return to sports. PMID:24427386

Stress-Induced Fracturing of Reservoir Rocks: Acoustic Monitoring and μCT Image Analysis

NASA Astrophysics Data System (ADS)

Pradhan, Srutarshi; Stroisz, Anna M.; Fjær, Erling; Stenebråten, Jørn F.; Lund, Hans K.; Sønstebø, Eyvind F.

2015-11-01

Stress-induced fracturing in reservoir rocks is an important issue for the petroleum industry. While productivity can be enhanced by a controlled fracturing operation, it can trigger borehole instability problems by reactivating existing fractures/faults in a reservoir. However, safe fracturing can improve the quality of operations during CO2 storage, geothermal installation and gas production at and from the reservoir rocks. Therefore, understanding the fracturing behavior of different types of reservoir rocks is a basic need for planning field operations toward these activities. In our study, stress-induced fracturing of rock samples has been monitored by acoustic emission (AE) and post-experiment computer tomography (CT) scans. We have used hollow cylinder cores of sandstones and chalks, which are representatives of reservoir rocks. The fracture-triggering stress has been measured for different rocks and compared with theoretical estimates. The population of AE events shows the location of main fracture arms which is in a good agreement with post-test CT image analysis, and the fracture patterns inside the samples are visualized through 3D image reconstructions. The amplitudes and energies of acoustic events clearly indicate initiation and propagation of the main fractures. Time evolution of the radial strain measured in the fracturing tests will later be compared to model predictions of fracture size.

Orbital blowout fracture location in Japanese and Chinese patients.

PubMed

Sun, Michelle T; Wu, Wencan; Watanabe, Akihide; Kakizaki, Hirohiko; Chen, Ben; Ueda, Kosuke; Katori, Nobutada; Takahashi, Yasuhiro; Selva, Dinesh

2015-01-01

To characterize the location of orbital blowout fractures in Asian individuals. This was a retrospective review of 470 consecutive Asian patients with orbital blowout fractures who presented to four tertiary care hospitals in Japan and China. Computed tomography (CT) characterized the location and severity of fractures involving the medial wall, the orbital floor, and/or the maxilloethmoidal strut. A total of 475 orbital blowout fractures were identified. More than one fracture location was involved in 19% of all cases. The medial orbital wall was the most commonly involved location, presenting in 29 cases (61%), of which 204 (43%) were isolated medial blowout fractures. The orbital floor was the second most common location involved, present in 226 cases (48%) with 150 isolated orbital floor fractures (32%), while the maxilloethmoidal strut was involved in 45 cases (9%) with 30 of those being isolated strut fractures (6%). The majority of fractures (62%) were classified as moderately severe, whilst 14% were mild, and 24% were severe. Associated nasal fractures were present in 16% of the cases. Orbital blowout fractures in Japanese and Chinese individuals occur most commonly in the medial wall. This is in contrast to previous reports on white individuals, who tend to sustain fractures involving the orbital floor rather than the medial wall.

A Comprehensive Model for Real Gas Transport in Shale Formations with Complex Non-planar Fracture Networks

PubMed Central

Yang, Ruiyue; Huang, Zhongwei; Yu, Wei; Li, Gensheng; Ren, Wenxi; Zuo, Lihua; Tan, Xiaosi; Sepehrnoori, Kamy; Tian, Shouceng; Sheng, Mao

2016-01-01

A complex fracture network is generally generated during the hydraulic fracturing treatment in shale gas reservoirs. Numerous efforts have been made to model the flow behavior of such fracture networks. However, it is still challenging to predict the impacts of various gas transport mechanisms on well performance with arbitrary fracture geometry in a computationally efficient manner. We develop a robust and comprehensive model for real gas transport in shales with complex non-planar fracture network. Contributions of gas transport mechanisms and fracture complexity to well productivity and rate transient behavior are systematically analyzed. The major findings are: simple planar fracture can overestimate gas production than non-planar fracture due to less fracture interference. A “hump” that occurs in the transition period and formation linear flow with a slope less than 1/2 can infer the appearance of natural fractures. The sharpness of the “hump” can indicate the complexity and irregularity of the fracture networks. Gas flow mechanisms can extend the transition flow period. The gas desorption could make the “hump” more profound. The Knudsen diffusion and slippage effect play a dominant role in the later production time. Maximizing the fracture complexity through generating large connected networks is an effective way to increase shale gas production. PMID:27819349

A Comprehensive Model for Real Gas Transport in Shale Formations with Complex Non-planar Fracture Networks.

PubMed

Yang, Ruiyue; Huang, Zhongwei; Yu, Wei; Li, Gensheng; Ren, Wenxi; Zuo, Lihua; Tan, Xiaosi; Sepehrnoori, Kamy; Tian, Shouceng; Sheng, Mao

2016-11-07

A complex fracture network is generally generated during the hydraulic fracturing treatment in shale gas reservoirs. Numerous efforts have been made to model the flow behavior of such fracture networks. However, it is still challenging to predict the impacts of various gas transport mechanisms on well performance with arbitrary fracture geometry in a computationally efficient manner. We develop a robust and comprehensive model for real gas transport in shales with complex non-planar fracture network. Contributions of gas transport mechanisms and fracture complexity to well productivity and rate transient behavior are systematically analyzed. The major findings are: simple planar fracture can overestimate gas production than non-planar fracture due to less fracture interference. A "hump" that occurs in the transition period and formation linear flow with a slope less than 1/2 can infer the appearance of natural fractures. The sharpness of the "hump" can indicate the complexity and irregularity of the fracture networks. Gas flow mechanisms can extend the transition flow period. The gas desorption could make the "hump" more profound. The Knudsen diffusion and slippage effect play a dominant role in the later production time. Maximizing the fracture complexity through generating large connected networks is an effective way to increase shale gas production.

In situ measurements of hydraulic fracture behavior, PTE-3. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warpinski, N.R.

Measurements of width and pressure in a propagating hydraulic fracture have been made in tests conducted at DOE`s Nevada Test Site. This was accomplished by creating an "instrumented fracture" at a tunnel complex (at a depth of 1400 ft) where realistic in situ conditions prevail, particularly with respect to stress and geologic features such as natural fractures and material anisotropy. Analyses of these data show that the pressure drop along the fracture length is much larger than predicted by viscous theory currently in use in models today. This is apparently due to the tortuosity of the fracture path, multiple fracturemore » strands, roughness, and sharp turns (corners) in the flow path due to natural fractures and rock property variations. It suggests that fracture design models need to be updated to include a more realistic friction factor so that fracture lengths are not overestimated. The width and pressure profiles near the crack tip have been investigated in some detail, including the length of the unwetted region and the tapering of the crack tip. The overall fracture behavior has been compared with published fracture models. Mineback of the fracture provided evidence of the geometry of the fracture and details of surface features. 35 refs., 89 figs., 30 tabs.« less

Characterization of a remotely intersected set of hydraulic fractures: Results of intersection well no. 1-B, GRI/DOE multi-site project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Branagan, P.T.; Peterson, R.E.; Warpinski, N.R.

A deviated observation or {open_quotes}intersection{close_quotes} well (IW 1-B) was drilled, cored, logged and tested through an area in a fluvial sandstone reservoir that had previously been hydraulically fractured. The point of intersection with the fractured interval was located 126 ft from the fracture well along one wing of the fracture(s) at a measured depth of 4,675 ft. Direct observations from core and borehole imagery logs in IW 1-B indicate that a total of 11 far-field vertical fractures were created. Clustered in a narrow 2.6-ft-wide interval, these 11 fractures are the direct result of 6 experimental fracture treatments executed in themore » distant frac well over a 4-month period. Diagnostic data acquired through IW I-B included direct core observations and measurements, borehole log imagery, gamma ray (GR) tracer identification, well-to-well pressure transient and fracture conductivity tests, and production logging surveys. The explicit intent in the emplacement of IW 1-B was to provide direct observations and information to characterize the hydraulic fracture(s) in support of a remote-sensing fracture diagnostic program that included microseismic monitoring and inclinometer measurements.« less

Ductile fracture theories for pressurised pipes and containers

NASA Technical Reports Server (NTRS)

Erdogan, F.

1976-01-01

Two mechanisms of fracture are distinguished. Plane strain fractures occur in materials which do not undergo large-scale plastic deformations prior to and during a possible fracture deformation. Plane stress or high energy fractures are generally accompanied by large inelastic deformations. Theories for analyzing plane stress are based on the concepts of critical crack opening stretch, K(R) characterization, J-integral, and plastic instability. This last is considered in some detail. The ductile fracture process involves fracture initiation followed by a stable crack growth and the onset of unstable fracture propagation. The ductile fracture propagation process may be characterized by either a multiparameter (discrete) model, or some type of a resistance curve which may be considered as a continuous model expressed graphically. These models are studied and an alternative model is also proposed for ductile fractures which cannot be modeled as progressive crack growth phenomena.

Fracture behavior of the Space Shuttle thermal protection system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Komine, A.; Kobayashi, A.S.

1983-09-01

Stable crack-growth and fracture-toughness experiments were conducted using precracked specimens machined from LI-900 reusable surface insulation (RSI) tiles of the Space Shuttle thermal protection system (TPS) at room temperature. Similar fracture experiments were conducted on fracture specimens with preexisting cracks at the interface of the tile and the strain isolation pad (SIP). Stable crack growth was not observed in the LI-900 tile fracture specimens which had a fracture toughness of 12.0 kPa sq rt of m. The intermittent subcritical crack growth at the tile-pad interface of the fracture specimens was attributed to successive local pull-outs due to tensile overload inmore » the LI-900 tile and cannot be characterized by linear elastic fracture mechanics. No subcritical interfacial crack growth was observed in the fracture specimens with densified LI-900 tiles where brittle fracture initiated at an interior point away from the densification. 11 references.« less

Arthroscopic fixation of the clavicle shaft fracture.

PubMed

Kim, Yang-Soo; Lee, Hyo-Jin; Kim, Jong-Ick; Yang, Hyo; Jin, Hong-Ki; Patel, Hiren Kirtibhai; Kim, Jong-Ho; Park, In

2017-01-01

This article describes an arthroscopic technique for the fixation of clavicle shaft fractures. A viewing portal is made 2 cm anterior to the fracture site, and a working portal is made 2 cm lateral to the fracture site. The guide wire for a 4.0-mm cannulated screw is inserted through the fracture site to the medial fracture fragment under arthroscopic guidance. Through the medial fragment, the guide wire is delivered through the skin anteriorly. The fracture is reduced, and then, the guide wire is drilled back across the fracture site to the lateral fracture fragment. After confirming the reduction under arthroscopy, the appropriately sized cannulated screw is inserted after reaming. This arthroscopic technique would be useful for the precise reduction and minimal invasive fixation of clavicle shaft fractures. Preliminary results are encouraging, and further studies with long-term follow-up are needed to determine the precise indications and limitations of the procedure.

PREVALENCE OF HEALED LONG-BONE FRACTURES IN WILD CARNIVORES FROM THE NORTHEASTERN UNITED STATES.

PubMed

Argyros, George C; Roth, Aaron J

2016-09-01

Museum specimens representing 12 species of terrestrial carnivores from the northeastern United States were inspected for evidence of healed long-bone fractures. Of 413 individuals, 18 (4.4%) exhibited healed fractures. Thirteen (72.2%) occurred in hind limbs; five (27.8%) occurred in forelimbs. Mustelids had the highest prevalence of healed long-bone fractures (38.8%) of all observed fractures. Within family, 5.6% of Canidae and 2.8% of Mustelidae exhibited healed fractures. Bobcats had the highest taxon prevalence of fractures, 18%. Observational data to assess use of and behavior near roads could provide insight to causes of fracture. Capture in combination with noninvasive examination techniques could be employed to determine incidence of healed fractures in wild populations. Individuals with healed fractures could then be tracked via radio telemetry to determine if these animals behave differently than uninjured conspecifics, and assess long-term survivability and fitness.

Comparison of temporal bone fractures in children and adults.

PubMed

Kang, Ho Min; Kim, Myung Gu; Hong, Seok Min; Lee, Ho Yun; Kim, Tae Hyun; Yeo, Seung Geun

2013-05-01

Contrary to our expectation, that the clinical characteristics of temporal bone fracture would differ in children and adults, we found that the two groups were similar. Most studies of temporal bone fractures have been performed in adults. To our knowledge, no study has investigated differences in temporal bone fractures in children and adults. We therefore investigated differences in temporal bone fractures in adults and children by examining the manifestations and clinical symptoms of temporal bone fractures in pediatric patients. The demographic and clinical characteristics were assessed in 32 children and 186 adults with temporal bone fractures. All patients underwent computed tomography of the temporal bone. Causes of fracture, gender distribution, manifestations of temporal bone fracture, and clinical symptoms were similar in adults and children (p > 0.05 each). Petrous fracture, ear fullness, dizziness, and tinnitus were significantly more frequent in adults than in children (p < 0.05 each).

Obesity and fractures in postmenopausal women.

PubMed

Compston, Juliet

2015-07-01

Although obesity was previously believed to be protective against fracture, there is now evidence that a significant proportion of fractures in postmenopausal women occur in those who are obese. In this article the epidemiology, pathophysiology and clinical management of fractures in obese postmenopausal women are discussed with particular focus on the site specificity of the effect of BMI on fracture, interactions between fat and bone and risk assessment and prevention of fractures. There is similarity in many respects between risk factors for fracture in obese and nonobese women, although falls may play a particularly important role in the obese. Treatment rates in obese postmenopausal women with fracture are currently low, and further studies are required to establish effective preventive strategies. Fractures in obese postmenopausal women contribute significantly to the overall fracture burden in this population. Further work is required to establish their pathophysiology and to develop effective preventive strategies.

[Multiple long bone fractures in a child with pycnodysostosis. A case report].

PubMed

Rojas, Paula I; Niklitschek, Nathia E; Sepúlveda, Matías F

2016-06-01

Fractures are an important entity to consider in pediatric patients. There are certain diseases in which bones fracture with a minimal trauma. Pycnodysostosis is an autosomal recessive unusual type of cráneo metaphyseal dysplasia, that presents frequently as fracture in a pathological bone. A 9 year old caucasian female, diagnosed with pycnodysostosis, was admitted with a right femur fracture as a result of a low energy trauma. Radiographic studies showed bilateral femur fractures, proximal fracture and non-union in antecurvatum of the left tibia. Pycnodysostosis is a rare disease, generally diagnosed at an early age by growth restriction, frequent fractures or fractures with low energy trauma. Therapy alternatives are limited, and no permanent cure has been developed. If a patient has dysmorphic facial features and fractures in a pathological bone, it is important to suspect bone dysplasia, such as pycnodysostosis and its differential diagnoses. Sociedad Argentina de Pediatría.

[Treatment of periprosthetic and peri-implant fractures : modern plate osteosynthesis procedures].

PubMed

Raschke, M J; Stange, R; Kösters, C

2012-11-01

Periprosthetic fractures are increasing not only due to the demographic development with high life expectancy, the increase in osteoporosis and increased prosthesis implantation but also due to increased activity of the elderly population. The therapeutic algorithms are manifold but general valid rules for severe fractures are not available. The most commonly occurring periprosthetic fractures are proximal and distal femoral fractures but in the clinical routine fractures of the tibial head, ankle, shoulder, elbow and on the borders to other implants (peri-implant fractures) and complex interprosthetic fractures are being seen increasingly more. It is to be expected that in the mid-term further options, such as cement augmentation of cannulated polyaxial locking screws will extend the portfolio of implants for treatment of periprosthetic fractures. The aim of this review article is to present the new procedures for osteosynthesis of periprosthetic fractures.

[Treatment of periprosthetic and peri-implant fractures : modern plate osteosynthesis procedures].

PubMed

Raschke, M J; Stange, R; Kösters, C

2012-08-01

Periprosthetic fractures are increasing not only due to the demographic development with high life expectancy, the increase in osteoporosis and increased prosthesis implantation but also due to increased activity of the elderly population. The therapeutic algorithms are manifold but general valid rules for severe fractures are not available. The most commonly occurring periprosthetic fractures are proximal and distal femoral fractures but in the clinical routine fractures of the tibial head, ankle, shoulder, elbow and on the borders to other implants (peri-implant fractures) and complex interprosthetic fractures are being seen increasingly more. It is to be expected that in the mid-term further options, such as cement augmentation of cannulated polyaxial locking screws will extend the portfolio of implants for treatment of periprosthetic fractures. The aim of this review article is to present the new procedures for osteosynthesis of periprosthetic fractures.

Mineback Stimulation Research Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warpinski, N.R.

The Mineback Stimulation Research Program is a systematic study of hydraulic fracturing and the parameters which influence or control fracture geometry or behavior. Fractures are created near a tunnel complex at DOE's Nevada Test Site and are monitored, instrumented, and mined back to observe the effect of treatment, rock and reservoir properties on the fractures. An initial experiment to measure width and pressure in a hydraulic fracture was completed in FY 1983. The test showed that pressure drops along fractures are much larger than predicted, with the result that fractures are shorter, higher, and wider than present models estimate. Themore » cause of this is the complex morphology of hydraulic fractures, including a hierarchy of roughnesses, multiple stranding, and corners, such as the offsets which occur when natural fractures are intersected. A test to study flow behavior in hydraulic fractures with proppant is proposed for FY 1984. 7 figures.« less

Measurement of width and pressure in a propagating hydraulic fracture

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warpinski, N.R.

Measurements of width and pressure in a propagating hydraulic fracture have been made in tests conducted at DOE's Nevada Test Site. This was accomplished by creating an instrumented fracture at a tunnel complex (at a depth of 1400 ft) where realistic in situ conditions prevail, particularly with respect to stress and geologic features such as natural fractures and material anisotropy. Analyses of these data show that the pressure drop along the fracture length is much larger than predicted by viscous theory and currently in use in models today. This is apparently due to the tortuosity of the fracture path, multiplemore » fracture strands, roughness and sharp turns (corners) in the flow path due to natural fractures and rock property variations. It suggests that fracture design models need to be updated to include a more realistic friction factor so that fracture lengths are not overestimated.« less

Multiwell fracturing experiments. [Nitrogen foam fracture treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warpinski, N.

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) determiningmore » 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.« less

Computerized method for detection of vertebral fractures on lateral chest radiographs based on morphometric data

NASA Astrophysics Data System (ADS)

Kasai, Satoshi; Li, Feng; Shiraishi, Junji; Li, Qiang; Straus, Christopher; Vokes, Tamara; MacMahon, Heber; Doi, Kunio

2007-03-01

Vertebral fractures are the most common osteoporosis-related fractures. It is important to detect vertebral fractures, because they are associated with increased risk of subsequent fractures, and because pharmacologic therapy can reduce the risk of subsequent fractures. Although vertebral fractures are often not clinically recognized, they can be visualized on lateral chest radiographs taken for other purposes. However, only 15-60% of vertebral fractures found on lateral chest radiographs are mentioned in radiology reports. The purpose of this study was to develop a computerized method for detection of vertebral fractures on lateral chest radiographs in order to assist radiologists' image interpretation. Our computerized method is based on the automated identification of upper and lower vertebral edges. In order to develop the scheme, radiologists provided morphometric data for each identifiable vertebra, which consisted of six points for each vertebra, for 25 normals and 20 cases with severe fractures. Anatomical information was obtained from morphometric data of normal cases in terms of vertebral heights, heights of vertebral disk spaces, and vertebral centerline. Computerized detection of vertebral fractures was based on the reduction in the heights of fractured vertebrae compared to adjacent vertebrae and normal reference data. Vertebral heights from morphometric data on normal cases were used as reference. On 138 chest radiographs (20 with fractures) the sensitivity of our method for detection of fracture cases was 95% (19/20) with 0.93 (110/118) false-positives per image. In conclusion, the computerized method would be useful for detection of potentially overlooked vertebral fractures on lateral chest radiographs.

Facial nerve injuries associated with the retromandibular transparotid approach for reduction and fixation of mandibular condyle fractures.

PubMed

Shi, Dan; Patil, Pavan Manohar; Gupta, Ritika

2015-04-01

To document facial nerve (FN) injuries after surgical treatment of mandibular condylar fractures using the retromandibular transparotid approach and to identify risk factors associated with these injuries. A retrospective study of patients surgically treated for mandibular condylar fractures using the retromandibular transparotid approach over seven years was conducted. The primary study variable was the postoperative change in FN function after fracture fixation. Risk factors were categorized as demographic, anatomic, experience of the operator, fracture displacement/dislocation and number of miniplates placed at the fracture site. Appropriate statistics were computed. Ninety patients with 102 fractures were analysed. Thirty two fractures (31%) were located in the condylar neck and 70 fractures (69%) were subcondylar (located below the sigmoid notch). The condylar segment was undisplaced in twelve cases (12%), displaced medially in thirty five (34%), laterally displaced in thirty (29%) and dislocated in 25 (24.5%). In 18 fractures (18%), postoperative examination revealed various degrees of damage to the FN. All nerve injuries recovered completely in 8-24 weeks. In a multivariate model, condylar neck fractures, fracture dislocation and operator inexperience were associated with a statistically significant risk of postoperative deterioration of FN function (P ≤ 0.05). The majority of facial nerve injuries after surgical treatment of condylar fractures by the retromandibular transparotid approach are transient in nature. Condylar neck fractures, fracture dislocation and operator inexperience were associated with an increased risk for FN injury. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Fractured rock stress-permeability relationships from in situ data and effects of temperature and chemical-mechanical couplings

DOE PAGES

Rutqvist, J.

2014-09-19

The purpose of this paper is to (i) review field data on stress-induced permeability changes in fractured rock; (ii) describe estimation of fractured rock stress-permeability relationships through model calibration against such field data; and (iii) discuss observations of temperature and chemically mediated fracture closure and its effect on fractured rock permeability. The field data that are reviewed include in situ block experiments, excavation-induced changes in permeability around tunnels, borehole injection experiments, depth (and stress) dependent permeability, and permeability changes associated with a large-scale rock-mass heating experiment. Data show how the stress-permeability relationship of fractured rock very much depends on localmore » in situ conditions, such as fracture shear offset and fracture infilling by mineral precipitation. Field and laboratory experiments involving temperature have shown significant temperature-driven fracture closure even under constant stress. Such temperature-driven fracture closure has been described as thermal overclosure and relates to better fitting of opposing fracture surfaces at high temperatures, or is attributed to chemically mediated fracture closure related to pressure solution (and compaction) of stressed fracture surface asperities. Back-calculated stress-permeability relationships from field data may implicitly account for such effects, but the relative contribution of purely thermal-mechanical and chemically mediated changes is difficult to isolate. Therefore, it is concluded that further laboratory and in situ experiments are needed to increase the knowledge of the true mechanisms behind thermally driven fracture closure, and to further assess the importance of chemical-mechanical coupling for the long-term evolution of fractured rock permeability.« less

Correlation analysis of fracture arrangement in space

NASA Astrophysics Data System (ADS)

Marrett, Randall; Gale, Julia F. W.; Gómez, Leonel A.; Laubach, Stephen E.

2018-03-01

We present new techniques that overcome limitations of standard approaches to documenting spatial arrangement. The new techniques directly quantify spatial arrangement by normalizing to expected values for randomly arranged fractures. The techniques differ in terms of computational intensity, robustness of results, ability to detect anti-correlation, and use of fracture size data. Variation of spatial arrangement across a broad range of length scales facilitates distinguishing clustered and periodic arrangements-opposite forms of organization-from random arrangements. Moreover, self-organized arrangements can be distinguished from arrangements due to extrinsic organization. Traditional techniques for analysis of fracture spacing are hamstrung because they account neither for the sequence of fracture spacings nor for possible coordination between fracture size and position, attributes accounted for by our methods. All of the new techniques reveal fractal clustering in a test case of veins, or cement-filled opening-mode fractures, in Pennsylvanian Marble Falls Limestone. The observed arrangement is readily distinguishable from random and periodic arrangements. Comparison of results that account for fracture size with results that ignore fracture size demonstrates that spatial arrangement is dominated by the sequence of fracture spacings, rather than coordination of fracture size with position. Fracture size and position are not completely independent in this example, however, because large fractures are more clustered than small fractures. Both spatial and size organization of veins here probably emerged from fracture interaction during growth. The new approaches described here, along with freely available software to implement the techniques, can be applied with effect to a wide range of structures, or indeed many other phenomena such as drilling response, where spatial heterogeneity is an issue.

The impact of in-situ stress and outcrop-based fracture geometry on hydraulic aperture and upscaled permeability in fractured reservoirs

NASA Astrophysics Data System (ADS)

Bisdom, Kevin; Bertotti, Giovanni; Nick, Hamidreza M.

2016-10-01

Aperture has a controlling impact on porosity and permeability and is a source of uncertainty in modeling of naturally fractured reservoirs. This uncertainty results from difficulties in accurately quantifying aperture in the subsurface and from a limited fundamental understanding of the mechanical and diagenetic processes that control aperture. In the absence of cement bridges and high pore pressure, fractures in the subsurface are generally considered to be closed. However, experimental work, outcrop analyses and subsurface data show that some fractures remain open, and that aperture varies even along a single fracture. However, most fracture flow models consider constant apertures for fractures. We create a stress-dependent heterogeneous aperture by combining Finite Element modeling of discrete fracture networks with an empirical aperture model. Using a modeling approach that considers fractures explicitly, we quantify equivalent permeability, i.e. combined matrix and stress-dependent fracture flow. Fracture networks extracted from a large outcropping pavement form the basis of these models. The results show that the angle between fracture strike and σ1 has a controlling impact on aperture and permeability, where hydraulic opening is maximum for an angle of 15°. At this angle, the fracture experiences a minor amount of shear displacement that allows the fracture to remain open even when fluid pressure is lower than the local normal stress. Averaging the heterogeneous aperture to scale up permeability probably results in an underestimation of flow, indicating the need to incorporate full aperture distributions rather than simplified aperture models in reservoir-scale flow models.

Comparison of the fracture resistances of glass fiber mesh- and metal mesh-reinforced maxillary complete denture under dynamic fatigue loading.

PubMed

Im, So-Min; Huh, Yoon-Hyuk; Cho, Lee-Ra; Park, Chan-Jin

2017-02-01

The aim of this study was to investigate the effect of reinforcing materials on the fracture resistances of glass fiber mesh- and Cr-Co metal mesh-reinforced maxillary complete dentures under fatigue loading. Glass fiber mesh- and Cr-Co mesh-reinforced maxillary complete dentures were fabricated using silicone molds and acrylic resin. A control group was prepared with no reinforcement (n = 15 per group). After fatigue loading was applied using a chewing simulator, fracture resistance was measured by a universal testing machine. The fracture patterns were analyzed and the fractured surfaces were observed by scanning electron microscopy. After cyclic loading, none of the dentures showed cracks or fractures. During fracture resistance testing, all unreinforced dentures experienced complete fracture. The mesh-reinforced dentures primarily showed posterior framework fracture. Deformation of the all-metal framework caused the metal mesh-reinforced denture to exhibit the highest fracture resistance, followed by the glass fiber mesh-reinforced denture ( P <.05) and the control group ( P <.05). The glass fiber mesh-reinforced denture primarily maintained its original shape with unbroken fibers. River line pattern of the control group, dimples and interdendritic fractures of the metal mesh group, and radial fracture lines of the glass fiber group were observed on the fractured surfaces. The glass fiber mesh-reinforced denture exhibits a fracture resistance higher than that of the unreinforced denture, but lower than that of the metal mesh-reinforced denture because of the deformation of the metal mesh. The glass fiber mesh-reinforced denture maintains its shape even after fracture, indicating the possibility of easier repair.

Fractured rock stress-permeability relationships from in situ data and effects of temperature and chemical-mechanical couplings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rutqvist, J.

The purpose of this paper is to (i) review field data on stress-induced permeability changes in fractured rock; (ii) describe estimation of fractured rock stress-permeability relationships through model calibration against such field data; and (iii) discuss observations of temperature and chemically mediated fracture closure and its effect on fractured rock permeability. The field data that are reviewed include in situ block experiments, excavation-induced changes in permeability around tunnels, borehole injection experiments, depth (and stress) dependent permeability, and permeability changes associated with a large-scale rock-mass heating experiment. Data show how the stress-permeability relationship of fractured rock very much depends on localmore » in situ conditions, such as fracture shear offset and fracture infilling by mineral precipitation. Field and laboratory experiments involving temperature have shown significant temperature-driven fracture closure even under constant stress. Such temperature-driven fracture closure has been described as thermal overclosure and relates to better fitting of opposing fracture surfaces at high temperatures, or is attributed to chemically mediated fracture closure related to pressure solution (and compaction) of stressed fracture surface asperities. Back-calculated stress-permeability relationships from field data may implicitly account for such effects, but the relative contribution of purely thermal-mechanical and chemically mediated changes is difficult to isolate. Therefore, it is concluded that further laboratory and in situ experiments are needed to increase the knowledge of the true mechanisms behind thermally driven fracture closure, and to further assess the importance of chemical-mechanical coupling for the long-term evolution of fractured rock permeability.« less

Exercise prescription after fragility fracture in older adults: a scoping review

PubMed Central

Feehan, Lynne M.; Beck, Charlotte A.; Harris, Susan R.; MacIntyre, Donna L.; Li, Linda C.

2017-01-01

Purpose To identify and chart research literature on safety, efficacy or effectiveness of exercise prescription following fracture in older adults. Methods We conducted a systematic, research-user-informed, scoping review. The population of interest was adults aged ≥ 45 years with any fracture. ‘Exercise prescription’ included post-fracture therapeutic exercise, physical activity or rehabilitation interventions. Eligible designs included knowledge synthesis studies, primary interventional studies and observational studies. Trained reviewers independently evaluated citations for inclusion. Results A total of 9415 citations were reviewed with 134 citations (119 unique studies) identified: 13 knowledge syntheses, 95 randomized or controlled clinical trials, and 11 ‘other’ designs, representing 74 articles on lower extremity fractures, 34 on upper extremity, eight on vertebral, and three on mixed body region fractures. Exercise prescription characteristics were often missing or poorly described. Six general categories emerged describing exercise prescription characteristics: timing post-fracture, person prescribing, program design, functional focus, exercise script parameters and co-interventions. Upper extremity and ankle fracture studies focused on fracture healing or structural impairment outcomes, whereas hip fracture studies focused more on activity limitation outcomes. The variety of different outcome measures used made pooling or comparison of outcomes difficult. Conclusions There was insufficient information to identify evidence-informed parameters for safe and effective exercise prescription for older adults following fracture. Key gaps in the literature include limited numbers of studies on exercise prescription following vertebral fracture, poor delineation of effectiveness of different strategies for early post-fracture mobilization following upper extremity fracture, and inconsistent details of exercise prescription characteristics after lower extremity fracture. PMID:20967425

High rates of death and hospitalization follow bone fracture among hemodialysis patients

PubMed Central

Tentori, Francesca; McCullough, Keith; Kilpatrick, Ryan D.; Bradbury, Brian D.; Robinson, Bruce M.; Kerr, Peter G.; Pisoni, Ronald L.

2013-01-01

Altered bone structure and function contribute to the high rates of fractures in dialysis patients compared to the general population. Fracture events may increase the risk of subsequent adverse clinical outcomes. Here we assessed incidence of post-fracture morbidity and mortality in an international cohort of 34, 579 in-center hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS). We estimated country-specific rates of fractures requiring a hospital admission and associated length of stay in the hospital. Incidence rates of death and of a composite event of death/re-hospitalization were estimated for the 1-year post-fracture. Overall, 3% of participants experienced a fracture. Fracture incidence varied across countries, from 12 events/1000 patient year (p-y) in Japan to 45/1000 p-y in Belgium. In all countries, fracture rates were higher in the hemodialysis group compared to those reported for the general population. Median length of stay ranged from 7 to 37 days in the United States and Japan, respectively. In most countries, post-fracture mortality rates exceeded 500/1000 p-y and death/re-hospitalization rates exceeded 1500/1000 p-y. Fracture patients had higher unadjusted rates of death (3.7- fold) and death/re-hospitalization (4.0-fold) compared to the overall DOPPS population. Mortality and hospitalization rates were highest in the first month after the fracture and declined thereafter. Thus, the high frequency of fractures and increased adverse outcomes following a fracture pose a significant health burden for dialysis patients. Fracture prevention strategies should be identified and applied broadly in nephrology practices. PMID:23903367

An animal model of co-existing sarcopenia and osteoporotic fracture in senescence accelerated mouse prone 8 (SAMP8).

PubMed

Zhang, Ning; Chow, Simon Kwoon Ho; Leung, Kwok Sui; Lee, Ho Hin; Cheung, Wing Hoi

2017-10-15

Sarcopenia and osteoporotic fracture are common aging-related musculoskeletal problems. Recent evidences report that osteoporotic fracture patients showed high prevalence of sarcopenia; however, current clinical practice basically does not consider sarcopenia in the treatment or rehabilitation of osteoporotic fracture. There is almost no report studying the relationship of the co-existing of sarcopenia and osteoporotic fracture healing. In this study, we validated aged senescence accelerated mouse prone 8 (SAMP8) and senescence accelerated mouse resistant 1 (SAMR1) as animal models of senile osteoporosis with/without sarcopenia. Bone mineral density (BMD) at the 5th lumbar and muscle testing of the two animal strains were measured to confirm the status of osteoporosis and sarcopenia, respectively. Closed fracture was created on the right femur of 8-month-old animals. Radiographs were taken weekly post-fracture. MicroCT and histology of the fractured femur were performed at week 2, 4 and 6 post-fracture, while mechanical test of both femora at week 4 and 6 post-fracture. Results showed that the callus of SAMR1 was significantly larger at week 2 but smaller at week 6 post-fracture than SAMP8. Mechanical properties were significantly better at week 4 post-fracture in SAMR1 than SAMP8, indicating osteoporotic fracture healing was delayed in sarcopenic SAMP8. This study validated an animal model of co-existing sarcopenia and osteoporotic fracture, where a delayed fracture healing might be resulted in the presence of sarcopenia. Copyright © 2017 Elsevier Inc. All rights reserved.

The use of circular external fixators in the management of lower limb trauma in Dublin: a single surgeon's 20-year experience.

PubMed

O'Neill, B J; Fox, C M; Molloy, A P; O'hEireamhoin, S; Moore, D P

2016-02-01

It has been estimated that approximately 520,000 injury presentations are made to Irish accident and emergency departments each year. Fractures account for 20 % of these injuries. Circular external fixators (frames) have been shown to be a safe and effective method of treatment for long bone fractures where internal fixation is impossible or in-advisable. We present the outcomes of all frames applied at our institution for stabilisation of acute fractures over a 20-year period. We retrospectively reviewed a prospectively compiled database of all frames applied in our institution and identified all frames which were applied for acute lower limb trauma. We identified 68 fractures in 63 patients. There were 11 femoral fractures and 57 tibial fractures. All fractures were classified using the AO Classification system, and most fractures were Type C fractures. We used an Ilizarov frame for 53 fractures and a Taylor Spatial Frame for 15 fractures. The mean time in frame was 365 days for a femoral fracture and 230 days for a tibial fracture. There were five tibial non-unions giving an overall union rate of 93 %. Factors associated with non-union included high-energy trauma and cigarette smoking. The vast majority of lower limb fractures can be treated using 'conventional' methods. Complex fractures which are not amenable to open reduction and internal fixation or cast immobilisation can be treated in a frame with excellent results. The paucity of published reports regarding the use of frames for complex trauma reflects the under-utilisation of the technique.

Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study.

PubMed

Wang, Hongwei; Yu, Hailong; Zhou, Yue; Li, Changqing; Liu, Jun; Ou, Lan; Zhao, Yiwen; Song, Guoli; Han, Jianda; Chen, Yu; Xiang, Liangbi

2017-09-01

The aim of this study is to investigate the incidence and pattern of traumatic fractures (TFs) as a result of falls in a population of children and adolescents (≤18 years old) in China.This was a cross-sectional study. We retrospectively reviewed 1412 patients who were children and adolescents with TFs as a result of falls admitted to our university-affiliated hospitals in China from 2001 to 2010. Etiologies included high fall (height ≥2) and low fall (height <2 m). The incidence and pattern were summarized with respect to different age groups, year of admission, etiologies, genders, and the neurological function.This study enrolled 1054 males (74.6%) and 358 females (25.4%) aged 10.8 ± 4.7 years. The etiologies were low fall (1059, 75.0%) and high fall (353, 25.0%). There were 2073 fractures in total and 92 patients (6.5%) presented with multiple fractures. The most common fracture sites were upper extremity fractures in 814 patients (57.6%) and lower extremity fractures in 383 patients (27.1%), followed by craniofacial fractures in 233 patients (16.5%). A total of 231 (16.4%) patients suffered a nerve injury. The frequencies of early and late complications/associated injuries were 19.5% (n = 275) and 9.2% (n = 130). The frequencies of emergency admission, nerve injury, spinal fracture, lower extremity fractures, craniofacial fracture, sternum and rib fracture, and early complications/ASOIs were significantly larger in high fall than low fall (all P <.001, respectively). The frequencies of medical insurance rate (P = .042) and upper extremity fractures (P <.001) were significantly larger in low fall than high fall. The frequencies of spinal fracture (P = .039), lower extremity fractures (P = .048), and craniofacial fracture (P = .041) were significantly larger in female than the male patients. The frequency of upper extremity fractures (P <.001) and the mean age (P <.001) was significantly larger in male than female patients. The frequencies of emergency admission, high fall, spinal fracture, and craniofacial fracture were significantly larger in patients with nerve injury than other patients without nerve injury (all P <.001, respectively).Low falls and upper extremity fractures were the most common etiologies and sites, respectively. High fall, spinal fracture and craniofacial fracture were risk factors for nerve injury. Therefore, we should focus on patients who were caused by high fall and presented with spinal and craniofacial fracture to determine the presence of a nerve injury so that we can provide early, timely diagnosis and targeted treatment to children.

Surgical treatment and a unique management of rostral mandibular fracture with cerclage wire in a horse.

PubMed

Naddaf, Hadi; Sabiza, Soroush; Kavosi, Narges

2015-01-01

A 3-year-old Arabian colt was presented for a major gingiva wound at the right rostral part of mandible. After clinical assessments, rostral mandibular fracture was determined. Stabilization of fractured region was achieved via cerclage wire application under general anesthesia. Fixation wires were left in place for 6 weeks. A 3 -month follow up revealed complete fracture healing. The purpose of this case report was to give clinical information about rostral mandibular fractures and treatment of these fractures and nutrition protocol in a horse, as this fracture is of the most common type of jaw fracture sustained by young horses.

Pediatric nasoorbitoethmoid fractures.

PubMed

Liau, James Y; Woodlief, Justin; van Aalst, John A

2011-09-01

The pediatric craniofacial trauma literature largely focuses on the management of mandible fractures, with very little information focusing on pediatric midface fractures, specifically nasoorbitethmoid (NOE) fractures. Because the diagnosis and surgical treatment plan for adult NOE fractures is well established in the literature, the treatment algorithms for NOE are essentially a transfer of adult practices to pediatric patients. This article reviews the differences between the pediatric and adult facial skeleton and the pathology and presentation of NOE fractures in the pediatric craniomaxillofacial skeleton. It also presents the effects of NOE fractures on the growth and development of the pediatric facial skeleton and describes the current surgical management for NOE fractures.

Natural fracture systems on planetary surfaces: Genetic classification and pattern randomness

NASA Technical Reports Server (NTRS)

Rossbacher, Lisa A.

1987-01-01

One method for classifying natural fracture systems is by fracture genesis. This approach involves the physics of the formation process, and it has been used most frequently in attempts to predict subsurface fractures and petroleum reservoir productivity. This classification system can also be applied to larger fracture systems on any planetary surface. One problem in applying this classification system to planetary surfaces is that it was developed for ralatively small-scale fractures that would influence porosity, particularly as observed in a core sample. Planetary studies also require consideration of large-scale fractures. Nevertheless, this system offers some valuable perspectives on fracture systems of any size.

Mechanics of Hydraulic Fractures

NASA Astrophysics Data System (ADS)

Detournay, Emmanuel

2016-01-01

Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.

[Is ultrasound equal to X-ray in pediatric fracture diagnosis?].

PubMed

Moritz, J D; Hoffmann, B; Meuser, S H; Sehr, D H; Caliebe, A; Heller, M

2010-08-01

Ultrasound is currently not established for the diagnosis of fractures. The aim of this study was to compare ultrasound and X-ray beyond their use solely for the identification of fractures, i. e., for the detection of fracture type and dislocation for pediatric fracture diagnosis. Limb bones of dead young pigs served as a model for pediatric bones. The fractured bones were examined with ultrasound, X-ray, and CT, which served as the gold standard. 162 of 248 bones were fractured. 130 fractures were identified using ultrasound, and 148 using X-ray. There were some advantages of X-ray over ultrasound in the detection of fracture type (80 correct results using X-ray, 66 correct results using ultrasound). Ultrasound, however, was superior to X-ray for dislocation identification (41 correct results using X-ray, 51 correct results using ultrasound). Both findings were not statistically significant after adjustment for multiple testing. Ultrasound not only has comparable sensitivity to that of X-ray for the identification of limb fractures but is also equally effective for the diagnosis of fracture type and dislocation. Thus, ultrasound can be used as an adequate alternative method to X-ray for pediatric fracture diagnosis. Georg Thieme Verlag KG Stuttgart, New York.

Incidence and Risk Factors of Subsequent Hip Fractures in Korea: Multicenter Study

PubMed Central

2014-01-01

This study analyzes the incidence of subsequent hip fractures and its risk factors in the northwestern region of Korea. We analyzed hip fracture patients who visited any of the 5 teaching hospitals in the Bucheon and Incheon area from January 2000 to December 2010. Medical records were reviewed and presence of subsequent hip fractures, alcohol history, marital status, live in solitude, dementia, dizziness, American society of anesthesiologists score, osteoporosis treatment after fracture, body mass index (BMI) and initial bone mineral density were analyzed. The average follow-up period was 12 months (range 1-130 months). A total of 2,546 patients (women 1,770, men 776) who had experienced hip fractures were included. Of these, subsequent hip fractures were found in 233 patients (9.2%) (women 187, men 46). Mean age at the time of the first fracture was 79.2 yr old (range 50-100 yr). The average interval between the first fracture and the subsequent hip fractures was 30.2 months (range 4 days-154 months). In this large-scale, retrospective, multicenter study, overall incidence of subsequent hip fractures is 9.2%. Independent risk factors of subsequent fracture are women, BMI<22 kg/m2, and being unmarried. PMID:25045233

Laboratory hydraulic fracturing experiments in intact and pre-fractured rock

USGS Publications Warehouse

Zoback, M.D.; Rummel, F.; Jung, R.; Raleigh, C.B.

1977-01-01

Laboratory hydraulic fracturing experiments were conducted to investigate two factors which could influence the use of the hydrofrac technique for in-situ stress determinations; the possible dependence of the breakdown pressure upon the rate of borehole pressurization, and the influence of pre-existing cracks on the orientation of generated fractures. The experiments have shown that while the rate of borehole pressurization has a marked effect on breakdown pressures, the pressure at which hydraulic fractures initiate (and thus tensile strength) is independent of the rate of borehole pressurization when the effect of fluid penetration is negligible. Thus, the experiments indicate that use of breakdown pressures rather than fracture initiation pressures may lead to an erroneous estimate of tectonic stresses. A conceptual model is proposed to explain anomalously high breakdown pressures observed when fracturing with high viscosity fluids. In this model, initial fracture propagation is presumed to be stable due to large differences between the borehole pressure and that within the fracture. In samples which contained pre-existing fractures which were 'leaky' to water, we found it possible to generate hydraulic fractures oriented parallel to the direction of maximum compression if high viscosity drilling mud was used as the fracturing fluid. ?? 1977.

Approach for computing 1D fracture density: application to fracture corridor characterization

NASA Astrophysics Data System (ADS)

Viseur, Sophie; Chatelée, Sebastien; Akriche, Clement; Lamarche, Juliette

2016-04-01

Fracture density is an important parameter for characterizing fractured reservoirs. Many stochastic simulation algorithms that generate fracture networks indeed rely on the determination of a fracture density on volumes (P30) to populate the reservoir zones with individual fracture surfaces. However, only 1D fracture density (P10) are available from subsurface data and it is then important to be able to accurately estimate this entity. In this paper, a novel approach is proposed to estimate fracture density from scan-line or well data. This method relies on regression, hypothesis testing and clustering techniques. The objective of the proposed approach is to highlight zones where fracture density are statistically very different or similar. This technique has been applied on both synthetic and real case studies. These studies concern fracture corridors, which are particular tectonic features that are generally difficult to characterize from subsurface data. These tectonic features are still not well known and studies must be conducted to better understand their internal spatial organization and variability. The presented synthetic cases aim at showing the ability of the approach to extract known features. The real case study illustrates how this approach allows the internal spatial organization of fracture corridors to be characterized.

A multi-scale experimental and simulation approach for fractured subsurface systems

NASA Astrophysics Data System (ADS)

Viswanathan, H. S.; Carey, J. W.; Frash, L.; Karra, S.; Hyman, J.; Kang, Q.; Rougier, E.; Srinivasan, G.

2017-12-01

Fractured systems play an important role in numerous subsurface applications including hydraulic fracturing, carbon sequestration, geothermal energy and underground nuclear test detection. Fractures that range in scale from microns to meters and their structure control the behavior of these systems which provide over 85% of our energy and 50% of US drinking water. Determining the key mechanisms in subsurface fractured systems has been impeded due to the lack of sophisticated experimental methods to measure fracture aperture and connectivity, multiphase permeability, and chemical exchange capacities at the high temperature, pressure, and stresses present in the subsurface. In this study, we developed and use microfluidic and triaxial core flood experiments required to reveal the fundamental dynamics of fracture-fluid interactions. In addition we have developed high fidelity fracture propagation and discrete fracture network flow models to simulate these fractured systems. We also have developed reduced order models of these fracture simulators in order to conduct uncertainty quantification for these systems. We demonstrate an integrated experimental/modeling approach that allows for a comprehensive characterization of fractured systems and develop models that can be used to optimize the reservoir operating conditions over a range of subsurface conditions.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ball, J.B. Jr.

Direct oblique sagittal CT was used to evaluate trauma to 77 orbits. Sixty-seven orbital wall fractures with intact orbital rims (36 floor, 22 medial wall, nine roof) were identified in 47 orbits. Since persistent diplopia and/or enophthalmos may warrant surgical repair of orbital floor fractures, optimal imaging should include an evaluation of extraocular muscle status, the nature and amount of displaced orbital contents, and an accurate definition of fracture margins. For orbital floor fractures, a combination of the direct oblique sagittal and direct coronal projections optimally displayed all fracture margins, the fracture's relationship to the inferior orbital rim and medialmore » orbital wall, and the amount of displacement into the maxillary sinus. Inferior rectus muscle status with 36 floor fractures was best seen on the direct oblique sagittal projection in 30 fractures (83.3%) and was equally well seen on sagittal and coronal projections in two fractures (5.5%). Floor fractures were missed on 100% of axial, 5.5% of sagittal, and 0% of coronal projections. Since the direct oblique sagittal projection complements the direct coronal projection in evaluating orbital floor fractures, it should not be performed alone. A technical approach to the CT evaluation or orbital wall fractures is presented.« less

Scapular Fractures in Blunt Chest Trauma – Self-Experience Study

PubMed Central

Al-Sadek, Tabet A.; Niklev, Desislav; Al-Sadek, Ahmed; Al-Sadek, Lina

2016-01-01

AIM: The aim of this retrospective study was to report the scapular fractures in patients with blunt chest trauma and to present the type and the frequency of associated thoracic injuries. MATERIAL AND METHODS: Nine patients with fractures of the scapula were included in the study. The mechanisms of the injury, the type of scapular fractures and associated thoracic injuries were analysed. RESULTS: Scapular fractures were caused by high-energy blunt chest trauma. The body of the scapula was fractured in all scapular fractures. In all cases, scapular fractures were associated with other thoracic injuries (average 3.25/per case). Rib fractures were present in eight patients, fractured clavicula - in four cases, the affection of pleural cavity - in eight of the patients and pulmonary contusion in all nine cases. Eight patients were discharged from the hospital up to the 15th day. One patient had died on the 3rd day because of postconcussional lung oedema. CONCLUSIONS: The study confirms the role of scapular fractures as a marker for the severity of the chest trauma (based on the number of associated thoracic injuries), but doesn’t present scapular fractures as an indicator for high mortality in blunt chest trauma patients. PMID:28028415

Fracture-permeability behavior of shale

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carey, J. William; Lei, Zhou; Rougier, Esteban

The fracture-permeability behavior of Utica shale, an important play for shale gas and oil, was investigated using a triaxial coreflood device and X-ray tomography in combination with finite-discrete element modeling (FDEM). Fractures generated in both compression and in a direct-shear configuration allowed permeability to be measured across the faces of cylindrical core. Shale with bedding planes perpendicular to direct-shear loading developed complex fracture networks and peak permeability of 30 mD that fell to 5 mD under hydrostatic conditions. Shale with bedding planes parallel to shear loading developed simple fractures with peak permeability as high as 900 mD. In addition tomore » the large anisotropy in fracture permeability, the amount of deformation required to initiate fractures was greater for perpendicular layering (about 1% versus 0.4%), and in both cases activation of existing fractures are more likely sources of permeability in shale gas plays or damaged caprock in CO₂ sequestration because of the significant deformation required to form new fracture networks. FDEM numerical simulations were able to replicate the main features of the fracturing processes while showing the importance of fluid penetration into fractures as well as layering in determining fracture patterns.« less

Water saturation effects on P-wave anisotropy in synthetic sandstone with aligned fractures

NASA Astrophysics Data System (ADS)

Amalokwu, Kelvin; Chapman, Mark; Best, Angus I.; Minshull, Timothy A.; Li, Xiang-Yang

2015-08-01

The seismic properties of rocks are known to be sensitive to partial liquid or gas saturation, and to aligned fractures. P-wave anisotropy is widely used for fracture characterization and is known to be sensitive to the saturating fluid. However, studies combining the effect of multiphase saturation and aligned fractures are limited even though such conditions are common in the subsurface. An understanding of the effects of partial liquid or gas saturation on P-wave anisotropy could help improve seismic characterization of fractured, gas bearing reservoirs. Using octagonal-shaped synthetic sandstone samples, one containing aligned penny-shaped fractures and the other without fractures, we examined the influence of water saturation on P-wave anisotropy in fractured rocks. In the fractured rock, the saturation related stiffening effect at higher water saturation values is larger in the direction across the fractures than along the fractures. Consequently, the anisotropy parameter `ε' decreases as a result of this fluid stiffening effect. These effects are frequency dependent as a result of wave-induced fluid flow mechanisms. Our observations can be explained by combining a frequency-dependent fractured rock model and a frequency-dependent partial saturation model.

Fracture-permeability behavior of shale

DOE PAGES

Carey, J. William; Lei, Zhou; Rougier, Esteban; ...

2015-05-08

The fracture-permeability behavior of Utica shale, an important play for shale gas and oil, was investigated using a triaxial coreflood device and X-ray tomography in combination with finite-discrete element modeling (FDEM). Fractures generated in both compression and in a direct-shear configuration allowed permeability to be measured across the faces of cylindrical core. Shale with bedding planes perpendicular to direct-shear loading developed complex fracture networks and peak permeability of 30 mD that fell to 5 mD under hydrostatic conditions. Shale with bedding planes parallel to shear loading developed simple fractures with peak permeability as high as 900 mD. In addition tomore » the large anisotropy in fracture permeability, the amount of deformation required to initiate fractures was greater for perpendicular layering (about 1% versus 0.4%), and in both cases activation of existing fractures are more likely sources of permeability in shale gas plays or damaged caprock in CO₂ sequestration because of the significant deformation required to form new fracture networks. FDEM numerical simulations were able to replicate the main features of the fracturing processes while showing the importance of fluid penetration into fractures as well as layering in determining fracture patterns.« less

Interpretation of hip fracture patterns using areal bone mineral density in the proximal femur.

PubMed

Hey, Hwee Weng Dennis; Sng, Weizhong Jonathan; Lim, Joel Louis Zongwei; Tan, Chuen Seng; Gan, Alfred Tau Liang; Ng, Jun Han Charles; Kagda, Fareed H Y

2015-12-01

Bone mineral density scans are currently interpreted based on an average score of the entire proximal femur. Improvements in technology now allow us to measure bone density in specific regions of the proximal femur. The study attempts to explain the pathophysiology of neck of femur (NOF) and intertrochanteric/basi-cervical (IT) fractures by correlating areal BMD (aBMD) scores with fracture patterns, and explore possible predictors for these fracture patterns. This is a single institution retrospective study on all patients who underwent hip surgeries from June 2010 to August 2012. A total of 106 patients (44 IT/basi-cervical, 62 NOF fractures) were studied. The data retrieved include patient characteristics and aBMD scores measured at different regions of the contralateral hip within 1 month of the injury. Demographic and clinical characteristic differences between IT and NOF fractures were analyzed using Fisher's Exact test and two-sample t test. Relationship between aBMD scores and fracture patterns was assessed using multivariable regression modeling. After adjusted multivariable analysis, T-Troc and T-inter scores were significantly lower in intertrochanteric/basi-cervical fractures compared to neck of femur fractures (P = 0.022 and P = 0.026, respectively). Both intertrochanteric/basi-cervical fractures (mean T.Tot -1.99) and neck of femur fractures (mean T.Tot -1.64) were not found to be associated with a mean T.tot less than -2.5. However, the mean aBMD scores were consistently less than -2.5 for both intertrochanteric/basi-cervical fractures and neck of femur fractures. Gender and calcium intake at the time of injury were associated with specific hip fracture patterns (P = 0.002 and P = 0.011, respectively). Hip fracture patterns following low energy trauma may be influenced by the pattern of reduced bone density in different areas of the hip. Intertrochanteric/basi-cervical fractures were associated with significantly lower T-Troc and T-Inter scores compared to neck of femur fractures, suggesting that the fracture traversed through the areas with the lowest bone density in the proximal femur. In the absence of reduced T.Troc and T.Inter, neck of femur fractures occurred more commonly. T-Total scores may underestimate the severity of osteoporosis/osteopenia and measuring T-score at the neck of femur may better reflect the severity of osteoporosis and likelihood of a fragility fracture.

Proximal third humeral shaft fractures -- a fracture entity not fully characterized by conventional AO classification.

PubMed

Stedtfeld, H W; Biber, R

2014-01-01

The retrospective study was made to evaluate the fracture patterns at the proximal humeral shaft for which the long version of a standard proximal humeral nail (PHNLV) has been used. The indication has been decided by the individual surgeons. Over a five year period 72 consecutive PHNLV cases of an acute fracture were identified and were included in the study. Mean patient age was 68.9 years. Gender ratio was m/f=22/50. 86.1% of the patients fractured their humerus by a fall, the rest by a high velocity accident. We analysed patient comorbidity, ASA score, osteoporosis, social status before accident, additional injuries affecting local soft tissues or other anatomic regions. We analysed the expansion of the fractures, dividing the humerus into five zones. Fracture morphology was categorized according to the standard AO/ASIF classification (if applicable). Comorbidities were found in 76.4% of the patients. Almost all patients (93.1%) had been living independently at home before the accident. 47.2% of patients had osteoporosis in their medical history. Five patients (6.9%) had a primary palsy of the radial nerve. Six fractures chosen for PHNLV fixation were clearly restricted to the humeral head. The remaining 66 fractures were located in the humeral shaft (AO region 12). There were 5 segmental fractures. Of the remaining 67 fractures affecting the proximal third of the humeral shaft 49.3 percent extended into the humeral head. 98 percent of these fractures displayed spiral morphology. Proximal humeral shaft fractures are amazingly similar to subtrochanteric and distal tibial shaft fractures: Spiral fracture types with different grades of comminution are absolutely dominant; a great proportion of the fractures extend into the humeral head with growing tendency of displacement if located closer to the humeral head. Diverging traction of deltoid and pectoralis muscle causes typical displacement if the fracture line runs in between their attachments substantiating the term 'intermuscular fracture'. A distinct classification system for proximal humeral shaft fractures seems meaningful and is proposed. There is clear evidence of specific characteristics which differentiate proximal third humeral shaft fractures from those of midshaft and distal third. They explain the specific problems of reduction and fixation. If disrespected they will lead to higher rates of therapeutic failure. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002-2012.

PubMed

Papaioannou, A; Kennedy, C C; Ioannidis, G; Cameron, C; Croxford, R; Adachi, J D; Mursleen, S; Jaglal, S

2016-03-01

In this population-based study, we compared incident fracture rates in long-term care (LTC) versus community seniors between 2002 and 2012. Hip fracture rates declined more rapidly in LTC than in the community. An excess burden of fractures occurred in LTC for hip, pelvis, and humerus fractures in men and hip fractures only in women. This study compares trends in incident fracture rates between long-term care (LTC) and community-dwelling seniors ≥65 years, 2002-2012. This is a population-based cohort study using administrative data. Measurements were age/sex-adjusted incident fracture rates and rate ratios (RR) and annual percent change (APC). Over 11 years, hip fracture rates had a marked decline occurring more rapidly in LTC (APC, -3.49 (95% confidence interval (CI), -3.97, -3.01)) compared with the community (APC, -2.93 (95% CI, -3.28, -2.57); p < 0.05 for difference in slopes). Humerus and wrist fracture rates decreased; however, an opposite trend occurred for pelvis and spine fractures with rates increasing over time in both cohorts (all APCs, p < 0.05). In 2012, incident hip fracture rates were higher in LTC than the community (RRs: women, 1.55 (95% CI, 1.45, 1.67); men, 2.18 (95% CI, 1.93, 2.47)). Higher rates of pelvis (RR, 1.48 (95% CI, 1.22, 1.80)) and humerus (RR, 1.40 (95% CI, 1.07, 1.84)) fractures were observed in LTC men, not women. In women, wrist (RR, 0.76 (95% CI, 0.71, 0.81)) and spine (RR, 0.52 (95% CI, 0.45, 0.61)) fracture rates were lower in LTC than the community; in men, spine (RR, 0.75 (95% CI, 0.57, 0.98) but not wrist fracture (RR, 0.91 (95% CI, 0.67, 1.23)) rates were significantly lower in LTC than the community. Previous studies in the community have shown declining hip fracture rates over time, also demonstrated in our study but at a more rapid rate in LTC. Rates of humerus and wrist fractures also declined. An excess burden of fractures in LTC occurred for hip fractures in women and for hip, pelvis, and humerus fractures in men.

Different effects of age, adiposity and physical activity on the risk of ankle, wrist and hip fractures in postmenopausal women

PubMed Central

Armstrong, Miranda E.G.; Cairns, Benjamin J.; Banks, Emily; Green, Jane; Reeves, Gillian K.; Beral, Valerie

2012-01-01

While increasing age, decreasing body mass index (BMI), and physical inactivity are known to increase hip fracture risk, whether these factors have similar effects on other common fractures is not well established. We used prospectively-collected data from a large cohort to examine the role of these factors on the risk of incident ankle, wrist and hip fractures in postmenopausal women. 1,155,304 postmenopausal participants in the Million Women Study with a mean age of 56.0 (SD 4.8) years, provided information about lifestyle, anthropometric, and reproductive factors at recruitment in 1996–2001. All participants were linked to National Health Service cause-specific hospital records for day-case or overnight admissions. During follow-up for an average of 8.3 years per woman, 6807 women had an incident ankle fracture, 9733 an incident wrist fracture, and 5267 an incident hip fracture. Adjusted absolute and relative risks (RRs) for incident ankle, wrist, and hip fractures were calculated using Cox regression models. Age-specific rates for wrist and hip fractures increased sharply with age, whereas rates for ankle fracture did not. Cumulative absolute risks from ages 50 to 84 years per 100 women were 2.5 (95%CI 2.2–2.8) for ankle fracture, 5.0 (95%CI 4.4–5.5) for wrist fracture, and 6.2 (95%CI 5.5–7.0) for hip fracture. Compared with lean women (BMI < 20 kg/m2), obese women (BMI ≥ 30 kg/m2) had a three-fold increased risk of ankle fracture (RR = 3.07; 95%CI 2.53–3.74), but a substantially reduced risk of wrist fracture and especially of hip fracture (RR = 0.57; 0.51–0.64 and 0.23; 0.21–0.27, respectively). Physical activity was associated with a reduced risk of hip fracture but was not associated with ankle or wrist fracture risk. Ankle, wrist and hip fractures are extremely common in postmenopausal women, but the associations with age, adiposity, and physical activity differ substantially between the three fracture sites. PMID:22465850

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 parameters used in the reservoir flow simulator have large uncertainty. Those biased and uncertain parameters will result in misleading oil and gas recovery predictions. The Ensemble Kalman Filter is used to estimate and update both the state variables (pressure and saturations) and uncertain reservoir parameters (permeability). In order to directly incorporate spatial information such as fracture location and formation heterogeneity into the algorithm, a new covariance matrix method is proposed. This new method has been applied to a simplified single-phase reservoir and a complex black oil reservoir with complex structures to prove its capability in calibrating the reservoir parameters.

Hyperkyphosis, Kyphosis Progression, and Risk of Non-Spine Fractures in Older Community Dwelling Women: The Study of Osteoporotic Fractures (SOF)

PubMed Central

Kado, Deborah M.; Miller-Martinez, Dana; Lui, Li-Yung; Cawthon, Peggy; Katzman, Wendy B.; Hillier, Teresa A.; Fink, Howard A.; Ensrud, Kristine E.

2014-01-01

While accentuated kyphosis is associated with osteoporosis, it is unknown whether it increases risk of future fractures, independent of bone mineral density (BMD) and vertebral fractures. We examined the associations of baseline Cobb angle kyphosis and 15 year change in kyphosis with incident non-spine fractures using data from the Study of Osteoporotic Fractures. A total of 994 predominantly white women, aged 65 or older, were randomly sampled from 9,704 original participants to have repeated Cobb angle measurements of kyphosis measured from lateral spine radiographs at baseline and an average of 15 years later. Non-spine fractures, confirmed by radiographic report, were assessed every four months for up to 21.3 years. Compared with women in the lower three quartiles of kyphosis, women with kyphosis greater than 53 degrees (top quartile) had a 50% increased risk of non-spine fracture (95% CI, 1.10 –2.06 after adjusting for BMD, prevalent vertebral fractures, prior history of fractures, and other fracture risk factors. Cobb angle kyphosis progressed an average of 7 degrees (SD = 6.8) over 15 years. Per 1 SD increase in kyphosis change, there was a multivariable adjusted 28% increased risk of fracture (95% CI, 1.06 – 1.55) that was attenuated by further adjustment for baseline BMD (HR per SD increase in kyphosis change, 1.19; 95% CI 0.99 –1.44). Greater kyphosis is associated with an elevated non-spine fracture risk independent of traditional fracture risk factors in older women. Furthermore, worsening kyphosis is also associated with increased fracture risk that is partially mediated by low baseline BMD that itself is a risk factor for kyphosis progression. These results suggest that randomized controlled fracture intervention trials should consider implementing kyphosis measures to: 1) further study kyphosis and kyphosis change as an additional fracture risk factor; and 2) test whether therapies may improve or delay its progression. PMID:24715607

Hyperkyphosis, kyphosis progression, and risk of non-spine fractures in older community dwelling women: the study of osteoporotic fractures (SOF).

PubMed

Kado, Deborah M; Miller-Martinez, Dana; Lui, Li-Yung; Cawthon, Peggy; Katzman, Wendy B; Hillier, Teresa A; Fink, Howard A; Ensrud, Kristine E

2014-10-01

While accentuated kyphosis is associated with osteoporosis, it is unknown whether it increases risk of future fractures, independent of bone mineral density (BMD) and vertebral fractures. We examined the associations of baseline Cobb angle kyphosis and 15 year change in kyphosis with incident non-spine fractures using data from the Study of Osteoporotic Fractures. A total of 994 predominantly white women, aged 65 or older, were randomly sampled from 9704 original participants to have repeated Cobb angle measurements of kyphosis measured from lateral spine radiographs at baseline and an average of 15 years later. Non-spine fractures, confirmed by radiographic report, were assessed every 4 months for up to 21.3 years. Compared with women in the lower three quartiles of kyphosis, women with kyphosis greater than 53° (top quartile) had a 50% increased risk of non-spine fracture (95% CI, 1.10-2.06 after adjusting for BMD, prevalent vertebral fractures, prior history of fractures, and other fracture risk factors. Cobb angle kyphosis progressed an average of 7° (SD = 6.8) over 15 years. Per 1 SD increase in kyphosis change, there was a multivariable adjusted 28% increased risk of fracture (95% CI, 1.06-1.55) that was attenuated by further adjustment for baseline BMD (HR per SD increase in kyphosis change, 1.19; 95% CI 0.99-1.44). Greater kyphosis is associated with an elevated non-spine fracture risk independent of traditional fracture risk factors in older women. Furthermore, worsening kyphosis is also associated with increased fracture risk that is partially mediated by low baseline BMD that itself is a risk factor for kyphosis progression. These results suggest that randomized controlled fracture intervention trials should consider implementing kyphosis measures to the following: (1) further study kyphosis and kyphosis change as an additional fracture risk factor; and (2) test whether therapies may improve or delay its progression. © 2014 American Society for Bone and Mineral Research.

Severity of aortic calcification is positively associated with vertebral fracture in older men—a densitometry study in the STRAMBO cohort

PubMed Central

Samelson, E. J.; Sornay-Rendu, E.; Chapurlat, R.; Kiel, D. P.

2013-01-01

Summary In older men, severe abdominal aortic calcification and vertebral fracture (both assessed using dual-energy X-ray absorptiometry) were positively associated after adjustment for confounders including bone mineral density. Introduction Abdominal aortic calcification (AAC) is associated with higher fracture risk, independently of low bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) can be used to assess both vertebral fracture and AAC and requires less time, cost, and radiation exposure. Methods We conducted a cross-sectional study of the association between AAC and prevalent vertebral fractures in 901 men ≥50 years old. We used DXA (vertebral fracture assessment) to evaluate BMD, vertebral fracture, and AAC. Results Prevalence of vertebral fracture was 11 %. Median AAC score was 1 and 12 % of men had AAC score >6. After adjustment for age, weight, femoral neck BMD, smoking, ischemic heart disease, diabetes, and hypertension, AAC score >6 (vs ≤6) was associated with 2.5 (95 % CI, 1.4–4.5) higher odds of vertebral fracture. Odds of vertebral fracture for AAC score >6 increased with vertebral fracture severity (grade 1, OR=1.8; grade 2, OR=2.4; grade 3, OR=4.4; trend p<0.01) and with the number of vertebral fractures (1 fracture, OR=2.0, >1 fracture, OR=3.5). Prevalence of vertebral fracture was twice as high in men having both a T-score<−2.0 and an AAC score>6 compared with men having only one of these characteristics. Conclusions Men with greater severity AAC had greater severity and greater number of vertebral fractures, independently of BMD and co-morbidities. DXA can be used to assess vertebral fracture and AAC. It can provide a rapid, safe, and less expensive alternative to radiography. DXA may be an important clinical tool to identify men at high risk of adverse outcomes from osteoporosis and cardiovascular disease. PMID:22872071

In vitro simulation of pathological bone conditions to predict clinical outcome of bone tissue engineered materials

NASA Astrophysics Data System (ADS)

Nguyen, Duong Thuy Thi

According to the Centers for Disease Control, the geriatric population of ≥65 years of age will increase to 51.5 million in 2020; 40% of white women and 13% of white men will be at risk for fragility fractures or fractures sustained under normal stress and loading conditions due to bone disease, leading to hospitalization and surgical treatment. Fracture management strategies can be divided into pharmaceutical therapy, surgical intervention, and tissue regeneration for fracture prevention, fracture stabilization, and fracture site regeneration, respectively. However, these strategies fail to accommodate the pathological nature of fragility fractures, leading to unwanted side effects, implant failures, and non-unions. Compromised innate bone healing reactions of patients with bone diseases are exacerbated with protective bone therapy. Once these patients sustain a fracture, bone healing is a challenge, especially when fracture stabilization is unsuccessful. Traditional stabilizing screw and plate systems were designed with emphasis on bone mechanics rather than biology. Bone grafts are often used with fixation devices to provide skeletal continuity at the fracture gap. Current bone grafts include autologous bone tissue and donor bone tissue; however, the quality and quantity demanded by fragility fractures sustained by high-risk geriatric patients and patients with bone diseases are not met. Consequently, bone tissue engineering strategies are advancing towards functionalized bone substitutes to provide fracture reconstruction while effectively mediating bone healing in normal and diseased fracture environments. In order to target fragility fractures, fracture management strategies should be tailored to allow bone regeneration and fracture stabilization with bioactive bone substitutes designed for the pathological environment. The clinical outcome of these materials must be predictable within various disease environments. Initial development of a targeted treatment strategy should focus on simulating, in vitro, a physiological bone environment to predict clinical effectiveness of engineered bone and understand cellular responses due to the proposed agents and bioactive scaffolds. An in vitro test system can be the necessary catalyst to reduce implant failures and non-unions in fragility fractures.

The direct and indirect costs of long bone fractures in a working age US population.

PubMed

Bonafede, Machaon; Espindle, Derek; Bower, Anthony G

2013-01-01

Information regarding the burden of fractures is limited, especially among working age patients. The objective of this study was to evaluate the direct and indirect costs associated with long bone fractures in a working age population using real-world claims data. This was a claims-based retrospective analysis, comparing adult patients in the 6 months before and 6 months after a long bone fracture between 1/1/2001 and 12/31/2008 using the MarketScan Research Databases. Outcomes included direct medical costs and utilization, as well as work absenteeism and short term disability, which was available for a sub-set of the patients. Observed and adjusted incremental costs (i.e., the difference in costs before and after a fracture) were evaluated and reported in 2008 US$. A total of 208,094 patients with at least one fracture were included in the study. Six, mutually exclusive fracture cohorts were evaluated: tibia shaft (n = 49,839), radius (n = 97,585), hip (n = 11,585), femur (n = 6788), humerus (n = 29,884), and those with multiple long bone fractures (n = 12,413). Average unadjusted direct costs in the 6-months before a long bone fracture ranged from $3291 (radius) to $12,923 (hip). The average incremental direct cost increase in the 6-months following a fracture ranged from $5707 (radius) to $39,041 (multiple fractures). Incremental absenteeism costs ranged from $950 (radius) to $2600 (multiple fractures), while incremental short-term disability costs ranged from $2050 (radius) to $4600 (multiple fractures). The results of this study indicate that long bone fractures are costly, both in terms of direct medical costs and lost productivity. Workplace absences and short-term disability represent a significant component of the burden of long bone fractures. These results may not be generalizable to all patients with fractures in the US, and do not reflect the burden of undiagnosed or sub-clinical fractures.

The effect of early operative stabilization on late displacement of zone I and II sacral fractures.

PubMed

Emohare, Osa; Slinkard, Nathaniel; Lafferty, Paul; Vang, Sandy; Morgan, Robert

2013-02-01

This study was designed to evaluate the effect on displacement of early operative stabilization on unstable fractures when compared to stable fractures of the sacrum. Patient consisted of those sustaining traumatic pelvic fractures that also included sacral fractures of Denis type I and type II classification, who were over 18 at the time of the study. Patients were managed emergently, as judged appropriate at the time and then subsequently divided into two cohorts, comprising those who were either treated operatively or non-operatively. The operative group comprised those treated with either internal fixation or external fixation. Twenty-eight patients had zone II fractures, and 20 had zone I fractures. Zone II fractures showed average displacements of 6.5mm and 6.9mm in the rostral-caudal and anteroposterior directions, respectively, at final follow up. Zone I fractures had average displacements of 6.6mm and 6.1mm in both directions. There were no significant differences between zone I and II sacral fractures (rostral-caudal P=0.74, anteroposterior P=0.24). Average changes in fracture displacement in patients with zone I fractures were 0.6-1.0mm in both directions. Average changes in zone II fractures were 1.8-1.5mm in both directions. There were no significant differences between the average changes in zone I and II fractures in any direction (rostral-caudal P=0.64, anteroposterior P=0.68) or in average displacements at final follow up in any of zone or the entire cohort. Statistically significant differences were noted in average changes in displacement in zone II fractures in the anteroposterior plane (P=0.03) and the overall cohort in the anteroposterior plane (P=0.02). Operative fixation for unstable sacral fractures ensures displacement at follow up is comparable with stable fractures treated non operatively. Copyright © 2012 Elsevier Ltd. All rights reserved.

Outcomes of tibia shaft fractures caused by low energy gunshot wounds.

PubMed

Su, Charles A; Nguyen, Mai P; O'Donnell, Jeffrey A; Vallier, Heather A

2018-05-16

The purpose of this project was to compare the rates of infections, nonunions, malunions, and secondary operations in tibia fractures resultant from low energy GSWs versus those seen in open and closed tibia fractures resultant from blunt trauma. A secondary objective was to assess the utility of using the traditional Gustilo-Anderson classification system for open fractures to describe fractures secondary to low energy GSW. A retrospective review of 327 patients with tibia shaft fractures was conducted at our level I trauma center. Patients underwent a variety of interventions depending on their injury. Standard fixation techniques were utilized. Outcome measures include: mechanism of injury, rates of superficial and deep infection, nonunion, malunion, and secondary operations. Deep infection after low energy GSW tibia fractures was uncommon and seen in only 2.3% of patients. Rates of infection after low energy GSWs were similar to low and high energy closed tibia fractures resultant from blunt trauma, but significantly less than that seen in open type II (25%, p < 0.05), type IIIA (19.5%, p < 0.05), and type IIIB fractures (47%, p < 0.01). There were no nonunions following GSW fractures, versus 3.7% after closed tibia fractures from blunt trauma (p = 0.2). Nonunions were more common after open fractures from blunt trauma (11%, p < 0.05) versus GSWs. Differences in infection and nonunion were associated with more secondary operations (18%, p < 0.01) in the open tibia fracture group compared with GSWs (2.3%) and closed fractures (7.9% p = 0.19). While GSWs are traditionally thought of as open injuries, low energy GSW tibia fractures had a low rate of infection and no nonunions, and resulted in a reoperation rate similar to closed blunt tibia shaft fractures and significantly lower than open tibia fractures. Copyright © 2018. Published by Elsevier Ltd.

3D convection in a fractured porous medium : influence of fracture network parameters and comparison to homogeneous approach.

NASA Astrophysics Data System (ADS)

Mezon, Cécile; Mourzenko, Valeri; François Thovert, Jean; Antoine, Raphael; Fontaine, Fabrice; Finizola, Anthony; Adler, Pierre Michel

2016-04-01

In the crust, fractures/faults can provide preferential pathways for fluid flow or act as barriers preventing the flow across these structures. In hydrothermal systems (usually found in fractured rock masses), these discontinuities may play a critical role at various scales, controlling fluid flows and heat transfer. The thermal convection is numerically computed in 3D fluid satured isotropically fractured porous media. Fractures are inserted as 2D convex polygons, which are randomly located. The fluid is assumed to satisfy 2D and 3D Darcy's law in the fractures and in the porous medium, respectively; exchanges take place between these two structures. First, checks were performed on an unfractured porous medium and the convection cells do start for the theoretical value of Ra, namely 4pi². 2D convection was verified up to Ra=800. Second, all fractured simulations were made for Rayleigh numbers (Ra) < 150, cubic boxes and closed-top conditions. The influence of parameters such as fracture aperture (or fracture transmissivity) and fracture density on the heat released by the whole system is studied. Then, the effective permeability of each fractured system is calculated. This last calculation enables the comparison between all fractured models and models of homogeneous medium with the same macroscopic properties. First, the heat increase released by the system as a function of fracture transmissivity and fracture density is determined. Second, results show that the effective approach is valid for low Ra (< 70), and that the mismatch between the full calculations and the effective medium approach for Ra higher than 70 depends on the fracture density in a crucial way. Third, the study also reveals that equivalent properties could be deduced from these computations in order to estimate the heat released by a fractured system from an homogeneous approach.

Effects of exercise on fracture reduction in older adults: a systematic review and meta-analysis.

PubMed

Kemmler, W; Häberle, L; von Stengel, S

2013-07-01

In this meta-analysis, we evaluated the effect of exercise on fracture reduction in the elderly. Our results determined a significantly positive effect on overall fractures, whereas the possibility of a publication bias indicates the need for well-designed (multi-center) trials that generate enough power to focus on osteoporotic fractures. The preventive effect of exercise on fracture incidence has not been clearly determined yet. Thus, the purpose of this study is to evaluate the effectiveness of exercise in preventing overall and vertebral fractures in older adults by meta-analyses technique. This study followed the PRISMA recommendations for systematic reviews and meta-analyses. A systematic review of English articles between 1980 and March 2012 was performed. Terms used were: "exercise", "fractures", "bone", "falls", "osteoporosis", "BMD", "BMC", "bone turnover", while the search was limited to "clinical trial" and "humans". Controlled exercise trials that reported fracture number as endpoint or observation in subjects 45 years and older were included. Ten controlled exercise trials that reported overall fractures and three exercise trials that reported vertebral fractures met our inclusion criteria. Overall fracture number in the exercise group was 36 (n = 754) compared with 73 fractures in the CG (n = 670) (relative risk [RR] = 0.49; 95 % confidence interval [CI], 0.31-0.76). No significant heterogeneity of trial results (p = 0.28; I (2) = 17) was determined; however, there was some evidence to suggest a publication bias. The overall RR for vertebral fracture number (0.56; 95 % CI, 0.30-1.04) (EG: 19 fractures/103 subjects vs. CG: 31 fractures/102 subjects) was borderline non-significant while the heterogeneity of trial results also cannot be ruled out. Although there is evidence that exercise reduces overall and, to a lesser degree, vertebral fractures in the elderly, the possibility of publication bias weakens our result and demonstrates the imperative for large exercise studies with dedicated exercise protocols that focus on fractures as a primary endpoint.

[Diagnosis of the scaphoid bone : Fractures, nonunion, circulation, perfusion].

PubMed

Kahl, T; Razny, F K; Benter, J P; Mutig, K; Hegenscheid, K; Mutze, S; Eisenschenk, A

2016-11-01

The clinical relevance of scaphoid bone fractures is reflected by their high incidence, accounting for approximately 60 % among carpal fractures and for 2-3 % of all fractures. With adequate therapy most scaphoid bone fractures heal completely without complications. Insufficient immobilization or undiagnosed fractures increase the risk of nonunion and the development of pseudarthrosis.X-ray examination enables initial diagnosis of scaphoid fracture in 70-80 % of cases. Positive clinical symptoms by negative x‑ray results require further diagnostics by multi-slice spiral CT (MSCT) or MRI to exclude or confirm a fracture. In addition to the diagnosis and description of fractures MSCT is helpful for determining the stage of nonunion. Contrast enhanced MRI is the best method to assess the vitality of scaphoid fragments.