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Sample records for ipsilateral femoral shaft

  1. Hemi-arthroplasty of the hip followed by ipsilateral fracture of the femoral shaft.

    PubMed

    Barfod, G; Steen Jensen, J; Hansen, D; Larsen, E; Menck, H; Olsen, B; Rosenklint, A

    1986-03-01

    In a series of 74 ipsilateral fractures of the femoral shaft in relation to hemi-arthroplasties, treatment by a cemented long-stem total hip replacement was found to be superior to conservative treatment or internal fixation without removal of the prosthesis. Acceptable clinical results were obtained in 89 per cent of these cases.

  2. Special topic: Ipsilateral femoral neck and shaft fractures--does evidence give us the answer?

    PubMed

    Boulton, Christina L; Pollak, Andrew N

    2015-03-01

    Ipsilateral fractures of the femoral neck and shaft are rare, high-energy injuries that typically occur in young polytrauma patients. The associated fracture of the neck is often vertical in nature and is more frequently non-displaced than in isolated femoral neck fractures. Historically the diagnosis of an associated femoral neck fracture was delayed or missed in approximately one third of cases. Studies have shown that detection can be significantly improved with the implementation of a protocolized approach to hip imaging in all patients with femoral shaft fractures. Prompt recognition of an associated femoral neck fracture allows for timely stabilization and may decrease the risks of non-union and avascular necrosis. In contrast, failure to recognize a non-displaced or minimally displaced associated neck fracture prior to fixation of the shaft can lead to displacement, a decrease in neck fixation options, a technically challenging secondary procedure and increased risk of long-term sequelae. A vast array of treatment strategies have been described for this combined injury. Published options range from spica casting to open reduction and internal fixation of both fractures and include almost all conceivable combinations in between. While timely surgical stabilization is now universally recommended for both shaft and neck, no consensus exists as to the most appropriate method of fixation for either fracture. Most authors recommend prompt, but not emergent, surgery with priority given to anatomic reduction and stabilization of the neck fracture by either closed or open methods. Fixation of the shaft fracture follows as patient condition allows. The rare nature of this injury makes it very challenging to study and most published series' are retrospective with very small sample sizes. In short, no scientificallycompelling study is available to definitively support any one implant choice or method of stabilzation over another for the treatment of associated fractures

  3. [Femoral shaft fractures in children].

    PubMed

    Dietz, H-G; Schlickewei, W

    2011-05-01

    Femoral shaft fractures in children represent 1.5% of all fractures in childhood. Up to the age of 4 years, conservative treatment in a hip spica or short-term overhead traction is the therapy of choice. Femoral shaft fractures between the age of 5 and 16 years should be treated surgically. In over 90% of these cases elastic stable intramedullary nailing (ESIN) is the premier treatment option. Additional end caps can be used for unstable fractures and in length discrepancy. The external fixator and the locking plate are reserved for fractures with severe soft tissue injuries, vascular problems and some specific situations mentioned later on. By adhering to these standards good results can be achieved with a low complication rate.

  4. [Reconstruction intramedullary nailing for treatment of ispsilateral femoral neck and shaft fractures].

    PubMed

    Wang, Hao; Li, Lian-hua; Liu, Zhi; Zhang, Jian-zheng; Guo, Yong-zhi

    2015-09-01

    To evaluate the curative effect and surigical skills of reconstruction intramedullary nailing in the treatment of ipsilateral femoral neck and shaft fractures. From January 2007 to January 2013, 13 patients with ipsilateral femoral neck and shaft fractures were treated by reconstruction intramedullary nailing including 11 males and 2 females with an average age of 38.9 yeas old ranging from 25 to 53 years old. For femoral neck fractures,10 cases were basilar neck fracture, 3 were transcervical fractures and according to Garden classification,10 were type II, 2 were type III and 1 was type IV. For feormal shaft fracture, 5 were type I, 4 were type II, 3 were type III and 1 was type IV according to Winquist classification. The location of all 13 feormal shaft fractures were all in the uper 3/4 of the feormal shaft. Complications and postoperative function were recorded and evaluated. Eleven patients were followed up for 23.45 months (12 to 36 months). Time from injury to operation was 5.9 days in average. Malunion of femoral neck fracture happened in 1 patient, nonunion of femoral shaft fracture happened in 2 patients. NO femoral head osteonecrosis, infection and malunion of femoral shaft fracture happened. According to Friedman-Wyman classification, 8 cases get good result, 2 get faii and 1 get poor. Reconstruction intramedullary nailing is a good choice for the ipsilateral femoral neck and shaft fractures with the advantages of less soft-tissue trauma and complications.

  5. Current Concepts in Paediatric Femoral Shaft Fractures

    PubMed Central

    John, Rakesh; Sharma, Siddhartha; Raj, Gopinathan Nirmal; Singh, Jujhar; C., Varsha; RHH, Arjun; Khurana, Ankit

    2017-01-01

    Pediatric femoral shaft fractures account for less than 2% of all fractures in children. However, these are the most common pediatric fractures necessitating hospitalization and are associated with prolonged hospital stay, prolonged immobilization and impose a significant burden on the healthcare system as well as caregivers. In this paper, the authors present a comprehensive review of epidemiology, aetiology, classification and managemement options of pediatric femoral shaft fractures. PMID:28603567

  6. Is reconstruction nailing of all femoral shaft fractures cost effective? A decision analysis.

    PubMed

    Faucett, Scott C; Collinge, Cory A; Koval, Kenneth J

    2012-11-01

    Femoral shaft fractures are usually treated with anterograde or retrograde nails that typically do not provide femoral neck fixation. Ipsilateral femoral neck fractures occur with 2.5%-10% of femoral shaft fractures; 19%-55% of associated femoral neck fractures are missed with plain films and 5%-22% with computed tomography (CT). This study was performed to determine if routine reconstruction nailing of all femoral shaft fractures with or without occult femoral neck fractures is cost effective. A decision tree model examined the cost effectiveness of reconstruction nailing over standard intramedullary nailing for all femoral shaft fractures in which an associated femoral neck fracture was not identified on plain radiographs. As a base model, we assumed that 5% of shaft fractures had an ipsilateral femoral neck fracture, and 37% were missed and required further surgery. We assigned a small morbidity and additional cost ($680) for the use of a reconstruction nail and 2 screws. Model inputs including costs, clinical outcome probabilities, and health utilities were derived from the literature, estimated from institutional data, or assumed by the authors. Sensitivity analyses evaluated the effect of the rate of associated femoral neck fracture, the rate of missed femoral neck fracture, the complication rate of reconstruction screws, the cost of the extra reconstruction screws, and the utilities of each outcome on the incremental cost effectiveness (ICER) of both strategies. Current practice in cost-effectiveness analysis uses a threshold of $100,000 per quality-adjusted life year gained as cost effective. A secondary analysis of the use CT scans to reduce missed femoral neck fractures was also performed. The base model showed that the placement of reconstruction nails in all isolated femur fractures was not cost effective. Sensitivity analysis demonstrated that the ICER was most sensitive to the cost of the reconstruction nail, hemiarthroplasty, and a missed femoral

  7. Femoral shaft medialisation and neck-shaft angle in unstable pertrochanteric femoral fractures.

    PubMed

    Pajarinen, J; Lindahl, J; Savolainen, V; Michelsson, O; Hirvensalo, E

    2004-12-01

    We analysed the time-dependent mean changes in the femoral neck length, neck-shaft angle and hip offset in a randomised study comprising 48 patients who were treated with the dynamic hip screw (DHS) or the proximal femoral nail (PFN) for an unstable intertrochanteric femoral fracture. As a consequence of fracture compression, the mean post-operative neck length was significantly shorter in patients treated with the DHS. During the first 6 weeks after the operation, a mean decrease of 4.6 degrees was observed in the neck-shaft angle, but there was not a significant difference between the treatment groups. The radiographic measures remained virtually unaffected during the interval from 6 weeks to 4 months in both groups. When the operated hip was compared to the opposite hip, patients who had received the DHS showed significantly greater medialisation of the femoral shaft at 4 months than those treated with the PFN. We thus recommend that unstable intertrochanteric fractures should be initially reduced in a slight valgus position in order to achieve an outcome after healing that is as normal as possible. As a result of differences in operative technique and implant stability, the PFN may be superior to the DHS in retaining the anatomical relations in the hip region in unstable intertrochanteric fractures.

  8. Subtrochanteric Femoral Fracture during Trochanteric Nailing for the Treatment of Femoral Shaft Fracture

    PubMed Central

    Oh, Chi Hun; Yi, Ju Won

    2013-01-01

    We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nailing for femoral shaft fractures to improve its application and prevent implant-derived complications. PMID:24009910

  9. Simultaneous ipsilateral femoral and tibial lengthening with the Ilizarov method.

    PubMed

    Curran, A R; Kuo, K N; Lubicky, J P

    1999-01-01

    Eight pediatric patients who underwent nine simultaneous ipsilateral femoral and tibial lengthenings with the Ilizarov external fixator were reviewed. The patient's demographics, diagnoses, corticotomy levels, mechanical axes, healing indices, amounts of lengthening, and complications were recorded. The patients' average age was 8 years 10 months (5 years 4 months-15 years 10 months) with an average follow-up of 49 months (30-88 months). The percentage of femoral lengthening averaged 16.7% (8-23%) with an average healing index of 28 days/cm (20-38 days/cm). The percentage of tibial lengthening averaged 18% (9.6-23.6%) with an average healing index of 29 days/cm (1940 days/cm). Four complications in three patients occurred as a direct result of the lengthening process. Three of the complications involved soft-tissue contractures, which were each successfully treated with one additional surgical procedure, whereas the fourth complication involved poor bone regeneration and required bone grafting and additional immobilization.

  10. [Elbow dislocation with ipsilateral proximal radial shaft fracture and radial head dislocation].

    PubMed

    Köhn, N; Mendel, T; Ullrich, B W

    2015-11-01

    Elbow dislocation with ipsilateral proximal radial shaft fracture and dislocated radial head is a rarely described injury. In this article we present the case of a 23-year-old man with this injury. After the initial diagnostics, the radial shaft fracture was osteosynthetically fixed, whereby the anatomical positions of all parts of the elbow joint were correctly aligned and the medial collateral ligament was reconstructed. After 4.5 months the radial shaft fracture was healed with nearly complete functional recovery of the upper extremity. Thus, a good outcome can be expected when all aspects of bony and ligamentous injuries are accurately addressed.

  11. Algorithm for the management of femoral shaft fractures in children.

    PubMed

    Sanzarello, I; Calamoneri, E; D'Andrea, L; Rosa, M A

    2014-06-01

    Pediatric closed femoral shaft fractures are commonly related to a good prognosis. There is no consensus on treatment. We aimed to evaluate the treatment, features, radiological findings and management strategies, creating an algorithm of treatment. Fifty-two simple femoral shaft fractures in children were retrospectively evaluated for age and gender distribution, side of the fracture, etiology of injuries, limb length discrepancy, range of knee and hip motion and parents satisfaction with a mean clinical and radiographic follow-up of 3 years and 6 months. Twenty-eight patients were treated with reduction and early hip spica cast while 24 patients were treated with external fixation (EF). Nearly 58 % of the cases were caused by traffic accidents and were predominantly male (61.5 %). Most of the fractures were of the middle femoral shaft (57.6 %). Muscle strength was normal (MRC scale) in all patients with no pain (NIPS and PRS scale). Knee and Hip range of motion were similar in both types of treatment. Patients treated with EF had shorter limb length discrepancy compared with SC. There were no reports of re-fracture. We found a higher familiar satisfaction in patients treated with EF. An algorithm for the management of femoral shaft fractures in the pediatric population is proposed. Results on the study population gave raise to a satisfactory clinical and radiological results.

  12. Femoral neck shaft angle in men with fragility fractures.

    PubMed

    Tuck, S P; Rawlings, D J; Scane, A C; Pande, I; Summers, G D; Woolf, A D; Francis, R M

    2011-01-01

    Introduction. Femoral neck shaft angle (NSA) has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men. Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric), symptomatic vertebral (91), and distal forearm (67) fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm(2): lumbar spine, femoral neck, and total femur) measurements were performed. Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately), nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2° versus 131°: P = 0.001), but larger in those with distal forearm fractures (129.8° versus 128.5°: P = 0.01). Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

  13. Femoral torsion and neck-shaft angles in cerebral palsy.

    PubMed

    Laplaza, F J; Root, L; Tassanawipas, A; Glasser, D B

    1993-01-01

    Excessive femoral and coxa valga have been reported to be major contributors leading to hip dislocation in patients with cerebral palsy (CP). Femoral torsion angle (FT) and neck-shaft angle (NSA) were measured by the radiographic technique described by Rippstein and Müller in 157 patients with CP (289 hips). Factors associated with the degree of FT and NSA were evaluated. The researchers explored the correlation between the two angles and hip pathology. A large database of measurements was constructed. Our findings suggest that age and ambulatory status are the main factors correlated with FT and NSA.

  14. Treatment strategies for intramedullary nailing of femoral shaft fractures.

    PubMed

    Wild, Michael; Gehrmann, Sebastian; Jungbluth, Pascal; Hakimi, Mohssen; Thelen, Simon; Betsch, Marcel; Windolf, Joachim; Wenda, Klaus

    2010-10-11

    Intramedullary nailing has become the gold standard to treat femoral shaft fractures. It is unknown which nailing technique orthopedic surgeons prefer. The goal of this study was to determine current techniques and perioperative complications of intramedullary nailing of diaphyseal femoral fractures. Fifty-one institutions in 26 countries participated in an international survey to assess detailed descriptions of preferred operative strategies and perioperative complications. Altogether, 517 cases of diaphyseal femoral fractures were collected. The Internet-based survey incorporated information about fracture classification, time to operation, Injury Severity Score, type of nail, and operative technique, as well as perioperative complications such as infection, femoral neck fracture, and hardware failure. The preferred position for implantation was supine (91.1%). Most surgeons used a traction table (57.1%) and an antegrade implantation technique (84.5%). Intraoperative fractures of the femoral neck occurred in 1.2% of cases when a traction table was used and in 0.2% if no traction table was used, but without statistical significance (P>.16). In 59.2% of the cases, an isolated femur fracture was present, while the rest sustained multiple injuries. In polytrauma patients and patients with severe thorax injuries, most surgeons chose a delayed treatment with intramedullary femoral nails. Interestingly, 38.0% of the patients with severe thorax injuries were treated on the first day with intramedullary femoral nails. The total rate of complications for intramedullary femoral nailing was low (4.9%), but a high rate of intraoperative femoral neck fractures was observed (1.4%). Copyright 2010, SLACK Incorporated.

  15. [Osteosynthesis of hip and femoral shaft fractures using the PFN-long].

    PubMed

    Pavelka, T; Houcek, P; Linhart, M; Matejka, J

    2007-04-01

    A group of 79 patients with ipsilateral fractures of the hip and femoral shaft treated with the use of a long proximal femoral nail (PFN-long) was retrospectively evaluated. From January 1998 to February 2005, 79 patients were treated surgically. The group included 42 men and 37 women at an average age of 56.6 years. In 47 patients (37 men and 10 women; average age, 38 years; range, 18-72 years) the fractures were due to a high-energy trauma. In the remaining 32 patients (six men and 25 women; average age, 77.6 years), the cause of fracture was a low-energy trauma, most frequently an ordinary fall. The fractures were categorized according to the Dousa, Bartonícek and Krbec classification. Type IV fractures, i. e., subtrochanteric fractures involving the whole upper half of the femur, were most frequent. The Synthes PFN-long is based on the PFN and partly also UFN implants. The nail is matched to femoral shaft antecurvation, and femoral neck screws have a 10 degrees anteversion. The nail is cannulated, is 10 mm thick and is available in three lengths with a distal dynamic opening. The results are based on the evaluation of 65 patients followed up for at least 12 months. At 12 months bone union was achieved in all patients; in 38 patients (58 %) it occurred by 6 months and in 59 patients (91 %) by 9 months. The outcomes were excellent in 42 (64 %), good in 18 (28 %) and satisfactory in 5 patients (8 %). Thirteen intra-operative complications (27 %) in nine patients were recorded, with the necessity of repeat surgery in four cases. Two problems were involved: incomplete reduction (nine fractures) and incorrect implant insertion (four fractures). Early complications included hematoma in the wound in five cases and one infected wound.A late complication was delayed union in two cases. The management of ipsilateral fractures of the hip and femoral shaft is still associated with a high percentage of complications, mostly due to reduction being difficult. The PFN-long is

  16. Iatrogenic Femoral Pseudoaneurysm and Secondary Ipsilateral Deep Vein Thrombosis: An Indication for Early Surgical Exploration.

    PubMed

    Papadakis, Marios; Zirngibl, Hubert; Floros, Nikolaos

    2016-07-01

    Pseudoaneurysm formation often complicates transfemoral interventional procedures. Nonsurgical treatment consists of femoral compression and thrombin injection under ultrasound guidance. We report a 74-year-old man who was diagnosed with a pseudoaneurysm, following coronary angiography. Duplex ultrasound revealed deep vein thrombosis of the ipsilateral common femoral vein. Ultrasound-guided thrombin injection was unsuccessfully performed, and the patient subsequently underwent surgical exploration for repair of the pseudoaneurysm and release of the venous compression. The increased local inflammation, because of the thrombosis, added in surgical difficulties. We conclude that early surgical intervention should be considered as a primary strategy in patients with femoral pseudoaneurysms and deep vein thrombosis secondary to femoral compression.

  17. A locked hip screw-intramedullary nail (cephalomedullary nail) for the treatment of fractures of the proximal part of the femur combined with fractures of the femoral shaft.

    PubMed

    Alho, A; Ekeland, A; Grøgaard, B; Dokke, J R

    1996-01-01

    Twenty-seven patients with complex femoral fractures (combined shaft and proximal femoral fractures) were treated with a modified Grosse-Kempf slotted locking nail (cephalomedullary nail), wherein two screws were inserted in the hip. Four types of complex, multifocal femoral fractures were represented in the series. Eleven of the femoral shaft fractures were secondary to a previous, internally fixed, not yet united hip fracture (type I). Ten comminuted peritrochanteric fractures occurred in normal bone (type II). Three similar fractures were pathologic because of metastasis. Two patients had an ipsilateral fracture of the femoral shaft and the trochanteric area (type III), and one of the shaft and the femoral neck (type IV). Locking was made static in 24 cases. Additional cerclage wiring was used in three type II fractures. Five complications were as follows: one cutting out of a screw in the femoral head, two fractures of the nail, one deep venous thrombosis, and one wound hematoma. Reoperations were two salvage operations using a new nail and one evacuation of hematoma. One patient with multiple injuries and four elderly patients died within 2 months. Eighteen patients with fractures in normal bone were followed for a median of 20 (6 to 37) months. All fractures united. Two nails were removed. The end result was excellent in ten patients, good in seven, and fair in one (2-cm shortening and 20-degree external rotation). We conclude that a locked intramedullary construct with locking screws in femoral neck and distal femur controls a complex fracture situation well.

  18. Correlation Between Femoral Neck Shaft Angle and Surgical Management in Trainees With Femoral Neck Stress Fractures.

    PubMed

    Chalupa, Robyn L; Rivera, Jessica C; Tennent, David J; Johnson, Anthony E

    2016-01-01

    The most common overuse injury leading to medical discharge of military recruits is a stress fracture. One of the high-risk stress fractures is of the lateral femoral neck which risks osteonecrosis of the femoral head, the need for arthroplasty and permanent disability. To prevent fracture progression early surgical intervention is recommended. Surgical repairs are performed in about 25% of cases of femoral neck stress fractures at military treatment facilities. Hip geometry is an important intrinsic risk for stress fractures. Loads in the average loading direction will not cause a fracture, but loads of extreme magnitude or extreme orientation may. The purpose of this study was to determine if, in the presence of femoral neck stress fracture, there is a correlation between femoral neck shaft angle, surgical treatment and outcomes. The results of this study suggest there is no correlation between return to full military duty rates, treatment, femoral neck shaft angle or fracture grade on MRI. Patients who underwent surgical fixation had greater fracture grade and pain than those that did not have surgery. Individuals who did not return to duty tended to have higher pain scores at initial evaluation.

  19. [Classification of femoral shaft fractures in hip arthroplasties].

    PubMed

    Baulot, E; Chabernaud, D; Grammont, P M

    1995-12-01

    Fractures of the femoral shaft around cemented hip prosthesis have become increasingly common and are difficult to manage. These fractures are often complex and may occur late after the insertion of a cemented prosthesis. They often occur in relation to cortical defects produced by cement and previous surgery. The main classifications already described can be divided into "anatomic" classifications (founded on the level of the fracture on the shaft: Parrish 1964, Ali Khan 1977, Van Elegem 1979) or into "prosthetic" classifications (founded on the level of the fracture with respect to the tip of the prosthesis: Johansson 1981, Bethea 1982, Cooke 1988). But these classifications give few guideliness to help the choice of the most appropriate form of treatment. The aim of treatment, which remains controversial, is to return to weight-bearing and mobility as promptly as possible so preventing the complications of immobilization which are frequent and serious in the often elderly population.

  20. Femoral shaft osteotomy for obligate outward rotation due to SCFE.

    PubMed

    Stevens, Peter M; Anderson, Lucas; MacWilliams, Bruce A

    2017-04-01

    Slipped capital femoral epiphysis (SCFE) is an adolescent disease that leads to retroversion of the femoral neck and shaft, relative to the head. Observing that patients with SCFE must walk with an outward foot progression angle and externally rotate the leg in order to flex the hip, we have been performing a femoral shaft rotational osteotomy wherein we rotate the lower femur 45° inward, relative to the upper femur. By correcting retroversion, our goal is to improve functional hip and knee motion, thereby mitigating the effects of SCFE impingement. This is a retrospective review of five hips in four patients (two boys and two girls), average age 14.7 years (range 11 + 7-18 years) who underwent femoral midshaft rotational osteotomy for correction of acquired retroversion of the femur secondary to severe SCFE. We compared clinical findings at the outset to those at an average follow-up of 46 months (range 24-74 months). Pre- and post-gait analysis was performed in three patients. Two of the patients underwent elective arthroscopic osteochondroplasty to alleviate residual FAI: contralateral arthroscopy is pending in one. The first patient in this series received a hip arthroplasty, 62 months after his osteotomy, at age 23. Following midshaft osteotomy, all patients experienced improvement in comfort, gait and activities of daily living. With the patella neutral, they had improved range of hip flexion from an average preoperative flexion of <25° to a postoperative flexion of >90°. Two patients (both male) had delayed union and some loss of correction, secondary to broken interlocking screws; each healed with reamed, exchange nailing. The interlocking screws have since been redesigned and enlarged. Femoral shaft rotational osteotomy restores the functional range of hip motion, while correcting obligate out-toeing and improving knee kinematics. This procedure is technically straightforward, permitting progressive weight bearing, while avoiding the risk of AVN

  1. A very rare Presentation of Bifocal Non Union Radius with Ipsilateral Ulnar Shaft Non Union: Case Report

    PubMed Central

    Padha, Vikas; Awasthi, Bhanu; Singh, Dhananjay; Kalia, Sandeep

    2016-01-01

    Introduction: A bifocal non-union of shaft of radius associated with ipsilateral non-union shaft of ulna in an adult has not been reported in the literature till date to the best of our knowledge, though few similar cases of fresh fractures have been reported. The case being reported by us is the first of its kind. Case Presentation: We report a case of bifocal non-union of shaft radius with non-union ipsilateral shaft of ulna in a 48-year-old right handed male along with discussion of alternative treatment options. Conclusion: We describe an extremely rare and complicated non-union in which our patient got excellent results along with satisfactory functional recovery as a result of appropriate surgical treatment. PMID:27299137

  2. Home traction of femoral shaft fractures in younger children.

    PubMed

    Boman, A; Gardell, C; Janarv, P M

    1998-01-01

    The study describes a home traction program of femoral shaft fractures in preschool children using the 90-90 traction technique. A special bed stretcher was designed for the program and adapted for use in ordinary ambulances and in all types of homes. Twenty-four patients, 2.2-5.9 years of age, were followed. The average hospital stay was 7.0 days, and the average home traction period was 22.1 days. One patient had a superficial pin tract infection. The treatment was uneventful in all other cases. All fractures healed with a shortening of < or = 1 cm. The angulation was < or = 10 degrees in all cases but one, which healed with a valgus angulation of 15 degrees but without functional disability. Interviews showed that the parents were very satisfied with the treatment program. The cost savings are obvious compared to traction treatment in the hospital.

  3. Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report.

    PubMed

    Jain, Mantu; Bihari, Amar Jyoti; Sriramka, Bhavna

    2013-01-01

    Neglected hip dislocation is rare in today's world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient's is a challenge to the treating surgeon and need to be tailored suiting to patient's demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite "some problems" which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA) at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS - 49.6 and MCS - 51.9. Ipsilateral shaft femur fracture in chronically dislocated prosthesis, done for fracture neck of femur is

  4. Location of atypical femoral fracture can be determined by tensile stress distribution influenced by femoral bowing and neck-shaft angle: a CT-based nonlinear finite element analysis model for the assessment of femoral shaft loading stress.

    PubMed

    Oh, Yoto; Fujita, Koji; Wakabayashi, Yoshiaki; Kurosa, Yoshiro; Okawa, Atsushi

    2017-09-27

    Loading stress due to individual variations in femoral morphology is thought to be strongly associated with the pathogenesis of atypical femoral fracture (AFF). In Japan, studies on AFF regarding pathogenesis in the mid-shaft are well-documented and a key factor in the injury is thought to be femoral shaft bowing deformity. Thus, we developed a CT-based finite element analysis (CT/FEA) model to assess distribution of loading stress in the femoral shaft. A multicenter prospective study was performed at 12 hospitals in Japan from August 2015 to February 2017. We assembled three study groups-the mid-shaft AFF group (n=12), the subtrochanteric AFF group (n=10), and the control group (n=11)-and analyzed femoral morphology and loading stress in the femoral shaft by nonlinear CT/FEA. Femoral bowing in the mid-shaft AFF group was significantly greater (lateral bowing, p<0.0001; anterior bowing, p<0.01). Femoral neck-shaft angle in the subtrochanteric AFF group was significantly smaller (p<0.001). On CT/FEA, both the mid-shaft and subtrochanteric AFF group showed maximum tensile stress located adjacent to the fracture site. Quantitatively, there was a correlation between femoral bowing and the ratio of tensile stress, which was calculated between the mid-shaft and subtrochanteric region (lateral bowing, r=0.6373, p<0.0001; anterior bowing, r=-0.5825, p<0.001). CT/FEA demonstrated that tensile stress by loading stress can cause AFF. The location of AFF injury could be determined by individual stress distribution influenced by femoral bowing and neck-shaft angle. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Profunda Anchor Technique for Ipsilateral Antegrade Approach in Endovascular Treatment of Superficial Femoral Artery Ostial Occlusion

    SciTech Connect

    Pua, Uei

    2015-04-15

    Endovascular treatment of the superficial femoral artery (SFA) is challenging in the presence of flush ostial occlusion. One of the main challenges is the availability of access sites for intervention. Contralateral retrograde femoral access followed by cross-over and antegrade intervention while commonly used, may not be feasible in cases of altered iliac anatomy (e.g. kissing iliac stents). Ipsilateral antegrade intervention using common femoral artery (CFA) access in these instances while possible is typically challenging due to inadequate working length of the CFA for interrogation of the SFA ostium, compounded by the lack of sheath stability. The “profunda anchor” technique uses a buddy wire in the profunda femoris artery (PFA) to stabilize the sheath and allow catheter manipulation for antegrade intervention at the level of the SFA ostium. The PFA is further used as a conduit for deployment of closure device to avoid interference with the treated SFA.

  6. Femoral neck shaft angles: A radiological anthropometry study.

    PubMed

    Adekoya-Cole, Thomas Oduntan; Akinmokun, Olasode Israel; Soyebi, Kofoworola O; Oguche, Omachoko Emmanuel

    2016-01-01

    Most of the available orthopaedic implants were designed and manufactured based on data from Western population whose skeletal dimensions are different from those of Africans. This study was conducted to determine the value of the neck-shaft angle (NSA) of Nigerians living in Lagos for the purpose of adequate planning, preparation, and pre-operative selection of orthopaedic implants for surgeries involving the femoral neck and stocking of orthopaedic implants in hospitals located in resource poor countries like Nigeria. This was a retrospective study which involved measuring the NSAs of anterior-posterior views of pelvic radiographs of adult patients reported "normal study" by the radiologist. A total of 264 femoral necks were analysed from 132 patients' radiographs comprising of 68 males and 64 females. The average NSA for an adult Nigerian living in Lagos is 130.77° ± 6.03° with mean NSA value of 131.28° ± 6.56° for the right and 130.22° ± 5.18° for the left. The mean value of NSA for an adult male is 131.57° ± 5.66° whereas the mean value for an adult female is 129.97° ± 6.33°. The value of NSA obtained from this study should be considered during the surgical fixation of the neck of femur fractures or osteotomies around the neck of the femur of adult Nigerians. It should also be noted during designing and bioengineering construction of orthopaedic implants and hip prosthesis for Nigerians.

  7. Unreamed intramedullary nailing of femoral shaft fractures: operative technique and early clinical experience with the standard locking option.

    PubMed

    Krettek, C; Rudolf, J; Schandelmaier, P; Guy, P; Könemann, B; Tscherne, H

    1996-05-01

    Nailing techniques have changed in recent years in ways which are not just limited to omitting the reaming process. These changes concern positioning patients, techniques of reduction and selecting implants. Techniques of approach and exposure have been modified to new, less-invasive procedures to fulfill technical, functional and cosmetic requirements. In addition, techniques have been developed to avoid fragment diastasis, rotational and sagittal malalignment, and leg-length discrepancy. Finally, simple algorithms have been elaborated for the management of specific fracture patterns (bilateral shaft fractures, ipsilateral tibial fractures or associated femoral neck fractures) and to determine the number and location of locking bolts. We developed these algorithms, techniques and procedures in a series of 133 femoral shafts, which were stabilized with the AO unreamed femoral nail (URFN) in a prospective study between 1991 and 1994. Of these, the first 57 cases with a mean follow-up of 17.9 months (range, 5-44) after injury were reviewed. Fractures were classified according to Müller's 1990 system: 12 type A, 29 type B and 16 type C. Closed soft-tissue injuries were classified by our classification of 1982: 17 type C 0/I, 42 type C II. Of 15 open fractures, six were OI, six OII, two OIIIA and one was OIIIB by Gustilo's classification of 1984. The major complications were two broken locking bolts, one nail breaking after 9 weeks, one case of osteitis and one of intra-operative lung embolism.

  8. The tolerance of the femoral shaft in combined axial compression and bending loading.

    PubMed

    Ivarsson, B Johan; Genovese, Daniel; Crandall, Jeff R; Bolton, James R; Untaroiu, Costin D; Bose, Dipan

    2009-11-01

    The likelihood of a front seat occupant sustaining a femoral shaft fracture in a frontal crash has traditionally been assessed by an injury criterion relying solely on the axial force in the femur. However, recently published analyses of real world data indicate that femoral shaft fracture occurs at axial loads levels below those found experimentally. One hypothesis attempting to explain this discrepancy suggests that femoral shaft fracture tends to occur as a result of combined axial compression and applied bending. The current study aims to evaluate this hypothesis by investigating how these two loading components interact. Femoral shafts harvested from human cadavers were loaded to failure in axial compression, sagittal plane bending, and combined axial compression and sagittal plane bending. All specimens subjected to bending and combined loading fractured midshaft, whereas the specimens loaded in axial compression demonstrated a variety of failure locations including midshaft and distal end. The interaction between the recorded levels of applied moment and axial compression force at fracture were evaluated using two different analysis methods: fitting of an analytical model to the experimental data and multiple regression analysis. The two analysis methods yielded very similar relationships between applied moment and axial compression force at midshaft fracture. The results indicate that posteroanterior bending reduces the tolerance of the femoral shaft to axial compression and that that this type of combined loading therefore may contribute to the high prevalence of femoral shaft fracture in frontal crashes.

  9. Nonisthmal femoral shaft nonunion as a risk factor for exchange nailing failure.

    PubMed

    Yang, Kyu Hyun; Kim, Jung Ryul; Park, Jin

    2012-02-01

    Although nail exchange with a larger diameter nail after additional reaming is typically considered the gold standard for failed femoral nailing, some reports question the role of exchange nailing. The purpose of this study was to evaluate the risk factors affecting the outcome of exchange nailing for femoral shaft nonunion after initial nailing. Forty-one consecutive patients treated with exchange nailing between November 1996 and March 2010 for femoral shaft nonunion that was initially managed with an intramedullary nailing were retrospectively reviewed. Possible risk factors and outcome (bony union) of exchange nailing were evaluated. Of the 41 femoral shaft nonunions treated with exchange nailing, 9 (22%) failed to achieve bony union. The union rate for isthmal nonunions was 87% (27 of 31 cases) and for nonisthmal nonunions was 50% (5 of 10 cases). Univariate and multivariate logistic regression analyses demonstrated that the anatomic site (isthmal vs. nonisthmal) was a significant risk factor for exchange nailing failure (univariate, p = 0.021; multivariate, p = 0.016). Although exchange nailing is an excellent choice for aseptic isthmal femoral shaft nonunion occurring after the initial nailing, other treatment options such as augmentative plating should be considered for nonisthmal femoral shaft nonunions.

  10. Treatment of Femoral Shaft Fracture with an Interlocking Humeral Nail in Older Children and Adolescents

    PubMed Central

    Park, Hoon

    2012-01-01

    Purpose Rigid interlocking nailing for femoral shaft fracture is ideal for use in adolescents in terms of stability of the fracture and convenience for the patient. However, numerous authors have reported that rigid interlocking nailing has some limitations in this age group due to the risk of complications. We evaluated the results of intramedullary nailing for femoral shaft fractures with an interlocking humeral nail in older children and adolescents. Materials and Methods We retrospectively reviewed records of patients treated with an interlocking humeral nail. Radiographs were examined for proximal femoral change and evidence of osteonecrosis. Outcomes were assessed by major or minor complications that occurred after operative treatment. Results Twenty-four femoral shaft fractures in 23 patients were enrolled. The mean age at the time of operation was 12 years and 8 months and the mean follow-up period was 21 months. Bony union was achieved in all patients without any complications related to the procedure such as infection, nonunion, malalignment and limb length discrepancy. All fractures were clinically and radiographically united within an average eight weeks. No patients developed avascular necrosis of the femoral head and coxa valga. Conclusion Intramedullary nailing through the greater trochanter using a rigid interlocking humeral nail is effective and safe for the treatment of femoral shaft fractures in older children and adolescents. PMID:22318831

  11. Correlation of Trochanter-Shaft Angle in Selection of Entry Site in Antegrade Intramedullary Femoral Nail

    PubMed Central

    Lakhwani, O. P.

    2012-01-01

    Background. Selection of entry point for nail insertion is controversial and lack firm anatomical basis. The study is done to analyze the proximal anthropometry of femur and measure the Trochanter-Shaft Angle to find its relation and significance in selection of entry point for antegrade uniplanar femoral nail. Materials and Methods. Study involves the measurement of trochanter-shaft angle and other anthropometric measurements on 50 dry femora and on digital radiogram. Results. Trochanter-Shaft angle ranges between 5–17 degrees in anthropometric study and 4–14 degrees in radiological study. Over all in 27 cases (54%), exit points of reamur fall in the middle quadrant in sagittal and coronal plane, which corresponds to the T-S angle of 6–12 degrees. Discussion and Conclusion. Proximal femoral Anthropometry and Trochanter-shaft angle is variable; hence it is difficult to fix any anatomical point as a universal entry point for antegrade femoral nail insertion. Trochanter shaft angle (TSA) can be well accessed radiologically and serve as a guide for selection of proper entry point.for safe nail insertion. Clinical Relevance. Individual variations in the proximal femur anatomy for safe nail insertion can be correlated with Trochanter shaft angle to serve safe entry site. PMID:24977077

  12. Increased morbidity and mortality after bilateral femoral shaft fractures: myth or reality in the era of damage control?

    PubMed

    Kobbe, Philipp; Micansky, Fabian; Lichte, Philipp; Sellei, Richard Martin; Pfeifer, Roman; Dombroski, Derek; Lefering, Rolf; Pape, Hans Christoph

    2013-02-01

    Bilateral femoral shaft fractures have been reported to be an independent risk factor for morbidity and mortality; however, the value of these studies is limited due to small sample sizes and the timing of these studies before the establishment of damage control orthopaedics. The objective of this study was to compare the incidence of morbidity and mortality in patients with bilateral vs. unilateral femoral shaft fractures in the era of damage control orthopaedics. Retrospective analysis of the TraumaRegister DGU from 2002 to 2005. Inclusion criteria were uni- or bilateral femoral shaft fractures and complete demographic data documentation. Univariate data analysis and logistic regression analysis were performed with SPSS. Between 2002 and 2005, 776 patients with unilateral and 118 patients with bilateral femoral shaft fractures were identified. Patients with bilateral femoral shaft fractures had a significantly higher Injury Severity Score (ISS) (29.5 vs. 25.7 points), a significantly higher incidence of pulmonary (34.7% vs. 20.6%) and multiple organ failure (25.0% vs. 14.6%) as well as a significantly higher mortality rate (16.9% vs. 9.4%). In the overall patient population, early total care (ETC) was significantly more often performed in patients with unilateral femoral shaft fractures (50.9% vs. 33.6%). Logistic regression analysis revealed no significant association between bilateral femoral shaft fractures and multiple organ failure or mortality; however, bilateral femoral shaft fractures are an independent risk factor for pulmonary failure. Subgroup analysis revealed that the impact of the bilateral femoral shaft fracture was especially pronounced in patients with an ISS<25 points. Bilateral femoral shaft fractures are an independent risk factor for pulmonary failure but not for multiple organ failure or mortality. The impact of the additional femoral shaft fracture for pulmonary failure appears to be especially pronounced in the less severely injured

  13. Effectiveness of exchange nailing and augmentation plating for femoral shaft nonunion after nailing.

    PubMed

    Wang, Zhen; Liu, Chunfeng; Liu, Chaoqun; Zhou, Qing; Liu, Jinlian

    2014-11-01

    We assessed indications and outcomes of exchange nailing and augmentation plating for femoral shaft nonunion following femoral nail failure. We retrospectively reviewed the records of 21 consecutive patients with femoral shaft nonunion treated with femoral nailing from August 2008 to June 2013. Nonunion cases with infection were excluded from this study. The study population consisted of nine men and 12 women, with an average age of 40 (range 21-61) years. All patients received internal fixation using exchange nailing and an augment plate coupled with decortication and bone graft. All patients in our study obtained osseous union with a mean time of six (range four to12) months. Mean operation time was three hours (range two to five hours), and mean blood loss was 800 ml (range 500-950 ml). There were no postoperative complications. At the last follow-up, all patients could flex their knees > 110°. Exchange nailing and augment plating coupled with decortication and bone graft is an effective treatment option for femoral shaft nonunion and has more indications and higher union rate than the popular exchange nailing treatment.

  14. FEMORAL SHAFT FRACTURES—A Study of Closed Reduction and Open Treatment

    PubMed Central

    Ramey, Ernest Edgar

    1960-01-01

    A comparative study was made of 58 cases of closed femoral shaft fractures treated by skeletal traction, and 24 cases of closed femoral shaft fractures treated by open reduction with internal fixation. Although complications occurred in some cases, intramedullary nailing appeared to be the most satisfactory method, resulting in primary union, in decreased time of recumbency and time in hospital, in earlier ambulation and in less residual disability. Success of intramedullary nailing depends largely upon adequate training or experience of the surgeon in the technical operative aspects of the procedure and in postoperative management. Placing supplemental autogenous iliac bone chips at the fracture site in closed femoral fractures in which intramedullary nailing is performed appears to enhance callus formation and bony consolidation. Skeletal traction should be utilized on all patients whose general physical condition does not permit operative intervention. ImagesFigure 1.Figure 2.Figure 3. PMID:14436039

  15. Locking attachment plate fixation around a well-fixed stem in periprosthetic femoral shaft fractures.

    PubMed

    Kim, Min Bom; Cho, Jae-Woo; Lee, Young Ho; Shon, Won-Yong; Park, Jung Wee; Kim, Jinil; Oh, Jong-Keon

    2017-07-08

    Periprosthetic fractures are difficult to manage. Plating technique has been considered a reliable form of management of periprosthetic fractures with a well-fixed stem, but a dependable and stable method of plate fixation to the bone is lacking. This study reports the clinical results using a locking attachment plate (LAP) instead of cable fixation to fix locking plates to a periprosthetic femoral shaft fracture. Nineteen patients with periprosthetic femoral shaft fractures around well-fixed stemmed implants were studied between August 2012 and December 2014. Patients were followed up for at least 1 year postoperatively. Median age was 74 years (range 56-96 years). Fractures were classified according to the Unified Classification System, Vancouver classification, and Su classification. Open reduction was performed under minimal incision and the locking plate was fixed to the lateral cortex of the femoral shaft. The part of the shaft without a stem was fixed to the plate using 5.0-mm locking screws, and the part with an underlying stem was fixed using 3.5-mm locking screws through the LAP instead of cables. Postoperatively, patients were managed using general principles for femoral shaft fractures. Average follow-up was 16 months (range 12-36 months). All cases achieved fracture healing without loss of reduction. There were no cases of implant breakage or stem loosening at final follow-up. The average number of LAPs per fixation construct was 2.1 (range 1-4), and the average number of 3.5-mm locking screws through each LAP was 3.3 (range 2-4). The average value of plate screw density was 0.55 (range 0.37-0.8), and the average working length was four holes (range 2-8). Using the LAP to manage periprosthetic fractures with a well-fixed stem could obviate the need for cable around the stem area and yield acceptable outcomes.

  16. A comparison of locked versus nonlocked Enders rods for length unstable pediatric femoral shaft fractures.

    PubMed

    Ellis, Henry Bone; Ho, Christine A; Podeszwa, David A; Wilson, Philip L

    2011-12-01

    Stainless steel flexible Enders rods have been used for intramedullary fixation of pediatric femur fractures with good success. Despite intraoperative anatomic alignment, length unstable femur fractures can present postoperatively with fracture shortening. The purpose of this study was to review all length unstable pediatric femoral shaft fractures in which Enders rods were used and compare those that were locked to those that were not locked. A retrospective clinical and radiographic review of all patients at a single institution undergoing flexible intramedullary fixation for length unstable femoral shaft fractures from 2001 to 2008. A length unstable fracture was defined as either a comminuted fracture or a spiral fracture longer than twice the diameter of the femoral shaft. A total of 107 length unstable femoral shaft fractures fixed with Enders rods were identified, of which 37 cases (35%) had both Enders rods "locked" through the eyelet in the distal femur with a 2.7 mm fully threaded cortical screw. Patient demographics, clinical course, complications, fracture characteristics, and radiographic outcomes were compared for the locked and nonlocked groups. There were no statistical differences between the groups in demographic data, operative variables, fracture pattern, fracture location, time to union, femoral alignment, or major complications. Shortening of the femur and nail migration measured at 1 to 6 weeks postoperatively was significantly greater for the nonlocked cases. The medial and lateral locked Enders rods moved 1.3 and 1.9 mm, respectively, and the unlocked Enders each moved 12.1 mm (P < 0.05). At final follow-up there were significantly more (P < 0.05) clinical complaints in nonlocked group, including limp, clinical shortening, and painful palpable rods. Locking Enders rods for length unstable pediatric fractures is an excellent option to prevent shortening and resulted in no additional complications, added surgical time, or increased blood loss

  17. Current trends in the treatment of femoral shaft fractures in children and adolescents.

    PubMed

    Buckley, S L

    1997-05-01

    Healthcare cost containment and a desire for early discharge of the pediatric patient to the home environment have become important factors in the treatment of femoral shaft fractures in children. As a result, newer techniques of treatment have become popular. The immediate hip spica cast remains the primary method of treatment for most children 6 years of age and younger. The treatment for children between the ages of 6 and 10 years is the most controversial. Many such patients may be treated successfully with immediate hip spica casts. However, external fixation and flexible intramedullary rod fixation are being used more frequently, particularly in patients with multiple trauma. The initial enthusiasm for rigid intramedullary rod fixation of adolescent femoral fractures has been tempered by recent reports of femoral head avascular necrosis. Avoiding the piriformis fossa during rod insertion may prevent this complication. Most children and adolescents with femoral fractures can be treated successfully with a brief hospital course without compromising care or outcome.

  18. Anterior knee dislocation with ipsilateral open tibial shaft fracture: a 5-year clinical follow-up of a professional athlete.

    PubMed

    Aydın, Adem; Atmaca, Halil; Müezzinoğlu, Ümit Sefa

    2013-08-01

    Traumatic dislocation of the knee joint is an uncommon complex, multiple ligamentous injury resulting from a high-energy trauma. Significant lack of functions can be seen because of both early and late complications of these injuries such as popliteal artery disruption, peroneal nerve injury, persistent instability and posttraumatic arthritis. Therefore, the emergency surgery is necessary due to possibility of neurovascular compromise and limb loss. Controversies over operative versus closed immobilization of traumatic complex, multiple ligamentous knee injury are still debated. We report a case of traumatic anterior dislocation of the right knee with an ipsilateral tibial shaft fracture in association with right popliteal artery occlusion of a professional athlete who was returned to his sports activity by surgical treated tibia fracture and conservative treatment of the knee dislocation.

  19. Longitudinal femoral shaft due to bone insufficiency. A review of three cases.

    PubMed

    Maraval, Anne; Grados, Franck; Royant, Valérie; Damade, Richard; Boulu, Gilles; Fardellone, Patrice

    2003-12-01

    We report three new cases of longitudinal femoral shaft fracture due to bone insufficiency and review the eight cases reported in the literature. The typical patient is a woman older than 65 years of age who present with mechanical pain in the thigh and/or groin. Palpation of the thigh may reproduce the pain. The diagnosis is often made late because the radiographs are normal initially. However, an early and consistent finding is increased radionuclide uptake along the femoral shaft. The fracture line is readily evidenced by computed tomography but may be difficult to see on magnetic resonance imaging. Use of crutches for 6 weeks to protect the bone from weight bearing ensures healing of the fracture.

  20. Structural Femoral Shaft Allografts for Anterior Spinal Column Reconstruction in Osteoporotic Spines

    PubMed Central

    Chang, Bong-Soon; Jung, Jong-Hun; Park, Sang-Min; Lee, Seung Hoo; Lee, Choon-Ki

    2016-01-01

    This study was to investigate the clinical and radiographical outcomes of anterior spinal column reconstruction using structural femoral shaft allografts in osteoporotic patients. Retrospective analyses of medical records, radiographic parameters, and postoperative complications were performed in twenty-one patients who underwent anterior spinal column reconstruction surgery for osteoporotic vertebral collapse or nonunion. Surgical invasiveness, clinical outcomes, postoperative complications, and radiographic outcomes were evaluated. Ambulatory status and back pain significantly improved. The Cobb's angle of segmental kyphosis significantly improved immediately after surgery with slight progression at the final follow-up. There were two cases of failed reconstruction with marked progression of kyphosis; both were related to loosening of screws rather than subsidence of the graft. Anterior spinal column reconstruction using femoral shaft allografts improved kyphosis and resulted in minimal subsidence and therefore is recommended as an effective treatment option for dealing with osteoporotic vertebral collapse and kyphotic deformity. PMID:27995144

  1. Structural Femoral Shaft Allografts for Anterior Spinal Column Reconstruction in Osteoporotic Spines.

    PubMed

    Chang, Bong-Soon; Jung, Jong-Hun; Park, Sang-Min; Lee, Seung Hoo; Lee, Choon-Ki; Kim, Hyoungmin

    2016-01-01

    This study was to investigate the clinical and radiographical outcomes of anterior spinal column reconstruction using structural femoral shaft allografts in osteoporotic patients. Retrospective analyses of medical records, radiographic parameters, and postoperative complications were performed in twenty-one patients who underwent anterior spinal column reconstruction surgery for osteoporotic vertebral collapse or nonunion. Surgical invasiveness, clinical outcomes, postoperative complications, and radiographic outcomes were evaluated. Ambulatory status and back pain significantly improved. The Cobb's angle of segmental kyphosis significantly improved immediately after surgery with slight progression at the final follow-up. There were two cases of failed reconstruction with marked progression of kyphosis; both were related to loosening of screws rather than subsidence of the graft. Anterior spinal column reconstruction using femoral shaft allografts improved kyphosis and resulted in minimal subsidence and therefore is recommended as an effective treatment option for dealing with osteoporotic vertebral collapse and kyphotic deformity.

  2. Increased Hip Stresses Resulting From a Cam Deformity and Decreased Femoral Neck-Shaft Angle During Level Walking.

    PubMed

    Ng, K C Geoffrey; Mantovani, Giulia; Lamontagne, Mario; Labrosse, Michel R; Beaulé, Paul E

    2017-04-01

    It is still unclear why many individuals with a cam morphology of the hip do not experience pain. It was recently reported that a decreased femoral neck-shaft angle may also be associated with hip symptoms. However, the effects that different femoral neck-shaft angles have on hip stresses in symptomatic and asymptomatic individuals with cam morphology remain unclear. We examined the effects of the cam morphology and femoral neck-shaft angle on hip stresses during walking by asking: (1) Are there differences in hip stress characteristics among symptomatic patients with cam morphology, asymptomatic individuals with cam morphology, and individuals without cam morphology? (2) What are the effects of high and low femoral neck-shaft angles on hip stresses? Six participants were selected, from a larger cohort, and their cam morphology and femoral neck-shaft angle parameters were measured from CT data. Two participants were included in one of three groups: (1) symptomatic with cam morphology; (2) asymptomatic with a cam morphology; and (3) asymptomatic control with no cam morphology with one participant having the highest femoral neck-shaft angle and the other participant having the lowest in each subgroup. Subject-specific finite element models were reconstructed and simulated during the stance phase, near pushoff, to examine maximum shear stresses on the acetabular cartilage and labrum. The symptomatic group with cam morphology indicated high peak stresses (6.3-9.5 MPa) compared with the asymptomatic (5.9-7.0 MPa) and control groups (3.8-4.0 MPa). Differences in femoral neck-shaft angle influenced both symptomatic and asymptomatic groups; participants with the lowest femoral neck-shaft angles had higher peak stresses in their respective subgroups. There were no differences among control models. Our study suggests that the hips of individuals with a cam morphology and varus femoral neck angle may be subjected to higher mechanical stresses than those with a normal femoral

  3. Proximal third femoral shaft fractures in children: prevention of angular deformities using bilateral Thomas splints.

    PubMed

    Kamal, M H; Razak, M; Ibrahim, S; Lim, A

    2000-09-01

    This is a prospective study to look at the outcome of unilateral proximal third femoral shaft fractures in children treated with a bilateral Thomas splint in the Department of Orthopaedic Surgery Universiti Kebangsaan Malaysia between the period of January 1996 and June 1998. Eighteen children aged between 2 years and 12 years old with unilateral proximal third fractures of the femoral shaft were treated using a bilateral Thomas splint. Angular deformities were measured using a goniometer metric scale before and after Thomas splints. The percentage of varus tilt corrected ranged from 17% to 72% with an average correction of 29% from the initial deformity and the difference was statistically significant (p < 0.05). The percentage of posterior tilt corrected ranged from 19% to 60% with the average correction of 20% from the initial deformity. The difference was statistically significant (p < 0.05). From this study, we conclude that bilateral Thomas splints can give a better correction of angular deformity for proximal third femoral shaft fractures in children below twelve years of age.

  4. Atypical subtrochanteric and femoral shaft fractures and possible association with bisphosphonates.

    PubMed

    Nieves, Jeri W; Cosman, Felicia

    2010-03-01

    Several case series and multiple individual case reports suggest that some subtrochanteric and femoral shaft fractures might occur in patients who have been treated with long-term bisphosphonates. Several unique clinical and radiographic features are emerging: prodromal thigh pain prior to the fracture, complete absence of trauma precipitating the fracture, and bilateral fractures in some patients. Radiographic features include presence of stress reaction, transverse or short oblique fractures, and thick femoral cortices. The overall incidence of subtrochanteric and shaft fractures combined is below 30 per 100,000 person-years, so this type of fracture is much less common than proximal femur (hip) fracture. Furthermore, the unique "atypical" fracture type is a subset of all subtrochanteric and femoral shaft fractures. The putative mechanism is unknown, and more research is needed to identify distinctive characteristics and the pathophysiology of these atypical fractures. There is no rationale to withhold bisphosphonate therapy from patients with osteoporosis, although continued use of bisphosphonate therapy beyond a treatment period of 3 to 5 years should be re-evaluated annually.

  5. Stress fractures of the femoral shaft in athletes: a new treatment algorithm

    PubMed Central

    Ivkovic, A; Bojanic, I; Pecina, M

    2006-01-01

    Background Femoral shaft stress fractures in athletes are not common but pose a great diagnostic challenge to clinicians. Because of few clinical signs, diagnosis and treatment are often delayed. Furthermore, if not treated correctly, these fractures are well known for complications and difficulties. Objective To develop a well structured and reproducible treatment algorithm for athletes with femoral shaft stress fractures. Methods The proposed algorithm is carried out in four phases, each lasting three weeks, and the move to the next phase is based on the result of the tests carried out at the end of the previous phase. Over nine years, we treated seven top level athletes, aged 17–21. In all athletes, diagnosis was based on physical examination, plain radiographs, and bone scan. Results As a result of the treatment method, all the athletes were fully engaged in athletic activity 12–18 weeks after the beginning of treatment. After completion of the treatment, the athletes were followed up for 48–96 months. During the follow up, there was no recurrence of discomfort or pain, and all the athletes eventually returned to competition level. Conclusion These results and data available from the literature suggest that the algorithm is the optimal treatment protocol for femoral shaft stress fractures in athletes, avoiding the common complications and difficulties. PMID:16720887

  6. KIRSCHNER WIRE VERSUS TITANIUM ELASTIC NAILS IN PEDIATRIC FEMORAL SHAFT FRACTURES

    PubMed Central

    Isik, Cengiz; Kurtulmus, Tuhan; Saglam, Necdet; Saka, Gursel; Akpinar, Fuat; Sarman, Hakan

    2015-01-01

    ABSTRACT Objective: To evaluate the effectiveness of intramedullary fixation using the Kirschner-wire (K-wire) compared to the titanium elastic nail (TEN) in pediatric femoral shaft fractures. Methods: A sample of 42 pediatric patients with a mean age of 6.55±2.42 years (range 4-11 years) presenting femoral shaft fractures underwent intramedullary fixation using the K-wire or TEN. Results: There was no significant difference found between groups, of which 16 (38.1%) patients were treated with K-wire and 26 (61.9%) patients were treated with TEN in terms of union duration. Moreover, none of the patients showed nonunion or a delayed union. Conclusions: The use of adjusted K-wire instead of TEN in the intramedullary fixation of femoral shaft fractures in selected children may be an advantageous surgical option due to the lower cost, easy accessibility and no need for a second surgery for implant removal. Level of Evidence III, Retrospective Study. PMID:26981033

  7. Femoral Version, Neck-Shaft Angle, and Acetabular Anteversion in Chinese Han Population

    PubMed Central

    Jiang, Nan; Peng, Lin; Al-Qwbani, Mohammed; Xie, Guo-Ping; Yang, Qin-Meng; Chai, Yu; Zhang, Qing; Yu, Bin

    2015-01-01

    Abstract Anatomic data regarding femoral version, neck-shaft angle, and acetabular anteversion are still limited in Chinese Han adult population. The aim of this study was to investigate the effects of age, sex, and body laterality on the 3 important anatomic indicators in Chinese Han healthy adults. Measurements were performed independently by 3 experienced observers using the picture archiving and communication system (PACS) in healthy adults who had received imaging tests of the femur and acetabulum between January 2009 and October 2014. Relevant data were measured and analyzed. A total of 466 adults (353 males and 113 females) were included. The mean femoral version, neck-shaft angle, and acetabular anteversion for all were 10.62, 133.02, and18.79, respectively. Age-based analysis showed that adults younger than 60 years had a significantly higher neck-shaft angle (P < 0.001) but a significantly lower acetabular anteversion (P < 0.001) than those older than 60 years. Sex-based analysis revealed that females had significantly higher values of femoral version (P < 0.001) and acetabular anteversion (P < 0.001) than males. Laterality-based analysis found the left side had a significantly lower acetabular anteversion (P < 0.001) than the right side. Outcomes of multiple linear regression analysis indicated that femoral version may be associated with sex (P < 0.001) but not age (P = 0.076) or laterality (P = 0.430), neck-shaft angle may be associated with age (P < 0.001) but not sex (P = 0.378) or laterality (P = 0.233), and acetabular anteversion may be associated with age (P < 0.001) and sex (P < 0.001) but not laterality (P = 0.060). In this representative Chinese cohort, neck-shaft angle may decrease, whereas acetabular anteversion may increase with age, females may have higher values of femoral version and acetabular anteversion than males, and the right body side may have a higher value of acetabular

  8. Muscle function and functional outcome following standard antegrade reamed intramedullary nailing of isolated femoral shaft fractures.

    PubMed

    Helmy, Nader; Jando, Victor T; Lu, Thomas; Chan, Holman; O'Brien, Peter J

    2008-01-01

    To evaluate the functional outcomes and long-term effects on muscle strength of femoral shaft fractures treated with intramedullary (IM) antegrade nailing using a standard piriformis start point. Retrospective Outcome Study. Tertiary Level Teaching Hospital and Referral Centre for the Province of British Columbia. Twenty-one patients (7 female, 14 male; mean age 34.5 years, range 16-56 years) with isolated femoral shaft fractures who were treated with standard antegrade reamed interlocking IM nailing and who had a minimum 1-year follow-up were identified through the Orthopaedic Trauma Database. All patients had isokinetic muscle testing of their hip abductors, hip extensors, and knee extensors using the KinCom muscle testing machine. Of the patients, 10 underwent formal gait lab analysis. All of the patients answered a questionnaire and completed the Short Form (SF)-36 and Musculoskeletal Functional Assessment outcome measures. Antegrade reamed interlocking IM nailing of femoral shaft fractures using a standard trochanteric fossa (also referred to as piriformis fossa) starting point. Examination of muscle strength, using 2 different objective measures (KinCom and gait analysis). The KinCom muscle testing machine was used for isokinetic muscle testing of hip abductors, hip extensors, and knee extensors. Outcome questionnaires were used to evaluate function (Musculoskeletal Functional Assessment) and general health (SF-36). Isokinetic muscle testing showed a statistically significant lower peak torque generation by the hip abductors (P=0.003) and hip extensors (P=0.046) from the uninjured contralateral side. The gait lab analysis did not show important changes in gait pattern. Scores for the SF-36 were 51.77+/-7.55 and 53.73+/-8.70. Scores for the Short Musculoskeletal Functional Assessment (S-MFA) were 7.74 and 8.66. Both scores did not indicate any significant disability. Antegrade reamed interlocking IM nailing of femoral shaft fractures using a standard

  9. Acromioclavicular Joint Dislocation with Ipsilateral Mid Third Clavicle, Mid Shaft Humerus and Coracoid Process Fracture - A Case Report.

    PubMed

    Sharma, Naveen; Mandloi, Avinash; Agrawal, Ashish; Singh, Shailendra

    2016-01-01

    The clavicle, humerus and acromioclavicular (AC) joint separately are very commonly involved in traumatic injuries around the shoulder. Acromioclavicular joint dislocation with distal clavicle fracture is a well recognized entity in clinical practice. AC joint dislocation with mid shaft clavicle fracture is uncommon and only few cases have been reported in literature. However, to the best of our knowledge, this is the first case report to describe an acromioclavicular dislocation with ipsilateral mid shaft clavicle, mid shaft humerus and coracoid process fracture. Fractures of the humerus and clavicle along with the acromioclavicular joint dislocation were fixed at the same setting. A 65-year-old male met with a high velocity road traffic accident. Plain radiographs showed displaced mid third clavicle fracture with acromioclavicular joint dislocation with mid shaft humerus fracture. Surgical fixation was planned for humerus with interlocking nail, clavicle with locking plate and acromioclavicular joint with reconstruction of coracoclavicular ligaments. Intraoperatively, coracoid process was found to have a comminuted fracture. The operative plan had to be changed on table as coracoclavicular fixation was not possible. So acromioclavicular joint fixation was done using tension band wiring and the coracoclavicular ligament was repaired using a 2-0 ethibond. The comminuted coracoid fracture was managed conservatively. K wires were removed at 6 weeks. Early mobilization was started. In acromioclavicular joint injuries, clavicle must be evaluated for any injury. Although it is more commonly associated with distal clavicle fractures, it can be associated with middle third clavicle fractures. As plain radiographs, AP view are most of the times insufficient for viewing integrity of coracoid process, either special views like Stryker notch or CT scan may help in diagnosing such concealed injuries. When associated with fractures of the humerus and clavicle, anatomical

  10. Patterns of sexual, bilateral and interpopulational variation in human femoral neck-shaft angles

    PubMed Central

    ANDERSON, JOHN Y.; TRINKAUS, ERIK

    1998-01-01

    Data on femoral neck-shaft angles were collected for 30 modern, historic and prehistoric human population samples, and analysed with respect to sexual dimorphism, bilateral asymmetry, geographical patterning and general economic level. Although some samples had modest sexual dimorphism in this angle, and some individuals exhibited clear asymmetry, there were no consistent patterns of sexual or side differences across human populations. Similarly, there was no evidence for geographic differences, since broad regional groups lacked significant differences and mean angles were not correlated with latitude. However, there is a significant increase in mean neck-shaft angles across populations with an increasingly sedentary existence and with mechanisation. The last reflects the developmental plasticity of this feature with respect to habitual load levels during ontogeny of the hip region. PMID:9643428

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

    PubMed Central

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

    2016-01-01

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

  12. Traumatic posterior hip dislocation and ipsilateral distal femoral fracture in a 22-month-old child: a case report.

    PubMed

    Ciftdemir, Mert; Aydin, Deniz; Ozcan, Mert; Copuroglu, Cem

    2014-11-01

    Minor trauma may cause hip dislocation in young children because of physiologic hip joint laxity and the soft cartilaginous structure of the acetabulum. In this work, we report on a 22-month-old boy with right-sided traumatic posterior hip dislocation and ipsilateral distal femoral fracture because of an outdoor motor vehicle accident. The patient was treated with emergency closed reduction and one and a half hip spica under general anaesthesia. The femoral fracture and hip dislocation were healed smoothly without any complication. Traumatic hip dislocation is rare in children, which may occur after trivial trauma. Prognosis is better in younger patients with low-energy trauma and in cases treated early.

  13. Osteochondral Autograft from the Ipsilateral Femoral Head by Surgical Dislocation for Treatment of Femoral Head Fracture Dislocation: A Case Report.

    PubMed

    Won, Yougun; Lee, Gi Soo; Kim, Sang Bum; Kim, Sun Joong; Yang, Kyu Hyun

    2016-11-01

    As anatomical reduction of the articular surface of femoral head fractures and restoration of damaged cartilage are essential for good long-term results, many treatment options have been suggested, including fixation of the fracture using various surgical exposures and implants, as well as arthroscopic irrigation and debridement, bone marrow stimulating techniques, osteochondral allograft, autograft, and autogenous chondrocyte implantation. We report a case of osteochondral autograft harvested from its own femoral articular surface through surgical hip dislocation. The osteochondral graft was harvested from the inferior non-weight-bearing articular surface and grafted to the osteochondral defect. One year later, the clinical and radiological results were good, without the collapse of the femoral head or arthritic change. This procedure introduced in our case is considered convenient and able to lessen surgical time without morbidity of the donor site associated with the harvest.

  14. The femoral neck-shaft angle on plain radiographs: a systematic review.

    PubMed

    Boese, Christoph Kolja; Dargel, Jens; Oppermann, Johannes; Eysel, Peer; Scheyerer, Max Joseph; Bredow, Jan; Lechler, Philipp

    2016-01-01

    The femoral neck-shaft angle (NSA) is an important measure for the assessment of the anatomy of the hip and planning of operations. Despite its common use, there remains disagreement concerning the method of measurement and the correction of hip rotation and femoral version of the projected NSA on conventional radiographs. We addressed the following questions: (1) What are the reported values for NSA in normal adult subjects and in osteoarthritis? (2) Is there a difference between non-corrected and rotation-corrected measurements? (3) Which methods are used for measuring the NSA on plain radiographs? (4) What could be learned from an analysis of the intra- and interobserver reliability? A systematic literature search was performed including 26 publications reporting the measurement of the NSA on conventional radiographs. The mean NSA of healthy adults (5,089 hips) was 128.8° (98-180°) and 131.5° (115-155°) in patients with osteoarthritis (1230 hips). The mean NSA was 128.5° (127-130.5°) for the rotation-corrected and 129.5° (119.6-151°) for the non-corrected measurements. Our data showed a high variance of the reported neck-shaft angles. Notably, we identified the inconsistency of the published methods of measurement as a central issue. The reported effect of rotation-correction cannot be reliably verified.

  15. Treatment of femoral shaft fractures in children using the "Tobruk" method.

    PubMed

    O'Donnell, Turlough M P; Murphy, Diarmuid P; Mullett, Hannan; Moore, David P; Fogarty, Esmond E; Dowling, Frank E

    2006-08-01

    The "Tobruk" technique of plaster augmentation of a Thomas' splint can be used for the treatment of femoral shaft fractures in children. The radiological and clinical data of 118 patients treated using this method were reviewed over a consecutive 3-year period. The mean age of the patients was 4.25 years. Mean hospital stay was 14.11 days. Mean time spent in the "Tobruk" splint was 44.77 days. Loss of reduction during splintage occurred in 9.32% of patients. Skin complications occurred in 5 patients (4.2%), and cast repairs were necessary in 3 patients. "Tobruk" splinting is a relatively safe and effective way of treating femoral shaft fractures in children. Although its use is not widespread, especially in the United States, until better results are achieved with spica casting and elastic stable intramedullary nails, it does provide a valid option in the treatment of these fractures. A controlled randomized prospective trial with long-term follow-up is needed to fully elucidate its value.

  16. Twenty-Year Experience with Rigid Intramedullary Nailing of Femoral Shaft Fractures in Skeletally Immature Patients.

    PubMed

    Crosby, Samuel N; Kim, Elliott J; Koehler, Daniel M; Rohmiller, Michael T; Mencio, Gregory A; Green, Neil E; Lovejoy, Steven A; Schoenecker, Jonathan G; Martus, Jeffrey E

    2014-07-02

    Debate exists over the safety of rigid intramedullary nailing of femoral shaft fractures in skeletally immature patients. The goal of this study was to describe functional outcomes and complication rates of rigid intramedullary nailing in pediatric patients. A retrospective review was performed of femoral shaft fractures in skeletally immature patients treated with trochanteric rigid intramedullary nailing from 1987 to 2009. Radiographs made at initial injury, immediately postoperatively, and at the latest follow-up were reviewed. Patients were administered the Nonarthritic Hip Score and a survey. The study population of 241 patients with 246 fractures was primarily male (75%) with a mean age of 12.9 years (range, eight to seventeen years). The majority of fractures were closed (92%) and associated injuries were common (45%). The mean operative time was 119 minutes, and the mean estimated blood loss was 202 mL. The mean clinical follow-up time was 16.2 months (range, three to seventy-nine months), and there were ninety-three patients with a minimum two-year clinical and radiographic follow-up. An increase of articulotrochanteric distance of >5 mm was noted in 15.1% (fourteen of ninety-three patients) at a minimum two-year follow-up; however, clinically relevant growth disturbance was only observed in two patients (2.2%) with the development of asymptomatic coxa valga. There was no femoral head osteonecrosis. Among the 246 fractures, twenty-four complications (9.8%) occurred. At the time of the latest follow-up, 1.7% (four of 241 patients) reported pain. The average Nonarthritic Hip Score was 92.4 points (range, 51 to 100 points), and 100% of patients reported satisfaction with their treatment. Rigid intramedullary nailing is an effective technique for treatment of femoral shaft fractures in pediatric patients with an acceptable rate of complications. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright

  17. Histomorphometric and osteocytic characteristics of cortical bone in male subtrochanteric femoral shaft.

    PubMed

    Tong, Xiaoyu; Malo, Markus K H; Burton, Inari S; Jurvelin, Jukka S; Isaksson, Hanna; Kröger, Heikki

    2017-08-07

    The histomorphometric properties of the subtrochanteric femoral region have rarely been investigated. The aim of this study was to investigate the age-associated variations and regional differences of histomorphometric and osteocytic properties in the cortical bone of the subtrochanteric femoral shaft, and the association between osteocytic and histological cortical bone parameters. Undecalcified histological sections of the subtrochanteric femoral shaft were obtained from cadavers (n = 20, aged 18-82 years, males). They were cut and stained using modified Masson-Goldner stain. Histomorphometric parameters of cortical bone were analysed with ×50 and ×100 magnification after identifying cortical bone boundaries using our previously validated method. Within cortical bone areas, only complete osteons with typical concentric lamellae and cement line were selected and measured. Osteocytic parameters of cortical bone were analyzed under phase contrast microscopy and epifluorescence within microscopic fields (0.55 mm(2) for each). The cortical widths of the medial and lateral quadrants were significantly higher than other quadrants (P < 0.01). Osteonal area per cortical bone area was lower and cortical porosities were higher in the posterior quadrant than in the other quadrants (P < 0.05). Osteocyte lacunar number per cortical bone area was found higher in the young subjects (≤ 50 years) than in the older ones (> 50 years) both before and after adjustments for body height and weight (P < 0.05). Moreover, significant but low correlations were found between the cortical bone and osteocytic parameters (0.20 ≤ R(2)  ≤ 0.35, P < 0.05). It can be concluded that in healthy males, the cortical histomorphometric parameters differ between the anatomical regions of the subtrochanteric femoral shaft, and are correlated with the osteocytic parameters from the same site. These findings may be of use when discussing mechanisms that predispose patients to

  18. The Intramedullary Nailing of Adult Femoral Shaft Fracture by the Way of Open Reduction is a Disadvantage or Not?

    PubMed

    Burç, Halil; Atay, Tolga; Demirci, Demir; Baykal, Y Barbaros; Kirdemir, Vecihi; Yorgancigil, Hüseyin

    2015-12-01

    The purpose of this study is that to evaluate superiority and results of open technique in the treatment of femoral shaft fracture with interlocking intramedullary nailing. The retrospective study is designed to evaluate results of our technique. In this study, the patients that were admitted to the Orthopedics and Traumatology Department of University Hospital that is third level of trauma center. We claim that open technique is not a disadvantage during union process over closed technique in treatment of femoral shaft fracture with interlocking nailing. In this study, 44 patients that were consulted for adult femoral shaft fracture between January 2008 to July 2010 were included. Patients with open fractures, gunshot wounds, neurovascular injuries, and patients that did not have isolated femoral diaphysis fractures were excluded from the study. Clinical and radiological results of the patients were checked periodically. The open interlocking intramedullary nailing was used in treatment. Complete union rate was 90.9 % in 40 patients who were treated with open interlocking intramedullary nailing for adult femoral shaft fracture, and nonunion rate was 9.1 % in four patients. Mean union time was 18.3 weeks (12-36 weeks). Evaluation of 44 patients according to Thoresen criteria was excellent in 22 patients, good in 6 patients, and bad in 4 patients. We think that open technique is an acceptable technique because all results of our study were similar to results of closed intramedullary nailing technique in literature and some advantages of open technique over closed technique.

  19. Application of rapid computer modeling in the analysis of the stabilization method in intraoperative femoral bone shaft fracture during revision hip arthroplasty - a case report.

    PubMed

    Lorkowski, Jacek; Mrzygłód, Mirosław M; Kotela, Andrzej; Kotela, Ireneusz

    2014-08-15

    Fractures of the femoral bone shaft during and after hip arthroplasty are a serious clinical problem. The paper presents the use of rapid computer modeling FEM 2D to optimize the stabilization of femoral shaft fracture in case of hip revision arthroplasty. Using the FEM modeling may be helpful for planning and assessment of orthopaedic treatment in similar cases.

  20. Three-point fixation walking spica cast: an alternative to early or immediate casting of femoral shaft fractures in children.

    PubMed

    Guttmann, G G; Simon, R

    1988-01-01

    A retrospective review of 28 children treated for middle and proximal femoral shaft fractures was undertaken. Following preliminary traction, a modified pantaloon walking spica, utilizing the principle of total contact and three-point fixation molding, was applied, followed by immediate ambulation. The mean anterior bow was 5 degrees varus/valgus, 6.5 degrees angulation, and 1.2 cm shortening. There were no significant differences in the results when age groups or proximal to mid-shaft fractures were compared. No further shortening or angulation occurred with ambulation. The advantages of early ambulation and better control of proximal shaft fractures are discussed.

  1. Regional Heterogeneity in the Configuration of the Intracortical Canals of the Femoral Shaft.

    PubMed

    Perilli, Egon; Bala, Yohann; Zebaze, Roger; Reynolds, Karen J; Seeman, Ego

    2015-10-01

    Three-dimensional (3D) characterization of cortical porosity, most of which is under 100 µm in diameter, is usually confined to measurements made in 3-4 mm diameter cylinders of bone. We used micro-computed tomography (micro-CT) scanning of entire transaxial cross sections of human proximal femoral shafts (30-35 mm diameter) to quantify regional variation in porosity within the same scan. Complete, up to 10-mm-thick, transaxial slices of femoral upper shafts from 8 female cadavers were studied (n = 3 aged 29-37 years, n = 5 aged 72-90 years). Scanning was performed using high-resolution micro-CT (8.65 µm/voxel). Micro-CT volumes (10 × 10 × 5 mm) were selected via software in the anterior, medial and lateral regions. Images were segmented with voids appearing as 3D-interconnected canals. The percent void-to-tissue volume (Vo.V/TV) and the corresponding void surface area/TV were 86-309% higher in older than younger subjects in anterior (p = 0.034), medial (p = 0.077), and lateral aspects (p = 0.034). Although not significant, void separation was reciprocally lower by 19-39%, and void diameter was 65% larger in older than younger subjects; void number tended to be 24-25% higher medially and laterally but not anteriorly. For all specimens combined, medially there was higher Vo.V/TV and void surface area/TV than anteriorly (+48%, p = 0.018; +33%, p = 0.018) and laterally (+56%, p = 0.062; +36%, p = 0.043). There is regional heterogeneity in the 3D microarchitecture of the intracortical canals of the femoral shaft. The higher void volume in advanced age appears to be due to larger, rather than more, pores. However, creation of new canals from existing canals may contribute, depending on the location. High-resolution micro-computed tomography scanning of entire bone segments enables quantification of the 3D microanatomy of the intracortical void network at multiple locations.

  2. Delayed internal fixation of femoral shaft fracture reduces mortality among patients with multisystem trauma.

    PubMed

    Morshed, Saam; Miclau, Theodore; Bembom, Oliver; Cohen, Mitchell; Knudson, M Margaret; Colford, John M

    2009-01-01

    Fractures of the femoral shaft are common and have potentially serious consequences in patients with multiple injuries. The appropriate timing of fracture repair is controversial. The purpose of the present study was to assess the effect of timing of internal fixation on mortality in patients with multisystem trauma. We performed a retrospective cohort study with use of data from public and private trauma centers throughout the United States that were reported to the National Trauma Data Bank (version 5.0 for 2000 through 2004). The study included 3069 patients with multisystem trauma (Injury Severity Score, > or =15) who underwent internal fixation of a femoral shaft fracture. The time to treatment was defined in categories as the time from admission to internal fixation: t(0) (twelve hours or less), t(1) (more than twelve hours to twenty-four hours), t(2) (more than twenty-four hours to forty-eight hours), t(3) (more than forty-eight hours to 120 hours), and t(4) (more than 120 hours). The relative risk of in-hospital mortality when the four later periods were compared with the earliest one was estimated with inverse probability of treatment-weighted analysis. Subgroups with serious head or neck, chest, abdominal, and additional extremity injury were investigated. When compared with that during the first twelve hours after admission, the estimated mortality risk was significantly lower in three time categories: t(1) (relative risk, 0.45; 95% confidence interval, 0.15 to 0.98; p = 0.03), t(3) (relative risk, 0.58; 95% confidence interval, 0.28 to 0.93; p = 0.03), and t(4) (relative risk, 0.43; 95% confidence interval, 0.10 to 0.94; p = 0.03). Patients with serious abdominal trauma (Abbreviated Injury Score, > or =3) experienced the greatest benefit from a delay of internal fixation beyond twelve hours (relative risk, 0.82 [95% confidence interval, 0.54 to 1.35] for patients with an Abbreviated Injury Score of <3, compared with 0.36 [95% confidence interval, 0

  3. EPIDEMIOLOGICAL AND RADIOLOGICAL EVALUATION OF FEMORAL SHAFT FRACTURES: STUDY OF 200 CASES

    PubMed Central

    de Moraes, Frederico Barra; da Silva, Luciano Lucindo; Ferreira, Fábio Vieira; Ferro, Ademar Martins; da Rocha, Valney Luís; Teixeira, Kim-Ir-Sen Santos

    2015-01-01

    Objective: to evaluate epidemiological and radiological characteristics of the femoral shaft fractures, surgically treated from 1990 to 2005 at Hospital de Acidentados – Clínica Santa Isabel – in Goiânia, Goiás, aiming to contribute to better preventive and therapeutic measures planning to adopt on those fractures. Methods: 200 patients' files and x-rays with femoral shaft fractures have been retrospectively evaluated. Patients below the age of 10 years were not included because the treatment for this group was conservative. 25 files have been discarded for not supplying all the necessary data to the study. The patients were assessed for sex, age, side of the fracture, bone exposure, mechanisms of trauma, classification of the fractures, associated trauma, time for bone healing and types of surgical devices. Statistic analyses were made by chi-squared, Fisher and Student's-t tests, adopting as a significance level p<0.05. Results: significant results (p < 0.05) were found in: 70% of men, 80% closed fractures and 65% of women above the age of 60. Fractures resulting from simple falls were more frequent in women, above 60 years old, with simpler traces, and the ones caused by projectiles of firearm in men, from 20 to 60 years, with unstable traces. Trampling accidents were prevalent among youngsters between 10 and 19 years old. Car accidents showed all the types of fractures, mostly associated to other traumas, reaching its peak incidence in the age group of 20-30 years. The treatment with Küntscher Nail resulted in a longer mean consolidation time, as well as fractures with unstable traces (B3,C1,C2,C3). Conclusion: we found a bi-modal characteristic the femoral shaft fractures, consistently to literature data, where the high energy mechanisms (traffic accidents, high falls and wounds from firearms), have been more frequent in young adults, men, generating unstable traces of fractures, with more serious associated trauma, while the other group with low

  4. Distribution of mesoscale elastic properties and mass density in the human femoral shaft.

    PubMed

    Rohrbach, Daniel; Grimal, Quentin; Varga, Peter; Peyrin, Francoise; Langer, Max; Laugier, Pascal; Raum, Kay

    2015-04-01

    Cortical bone properties are determined by tissue composition and structure at several hierarchical length scales. In this study, the spatial distribution of micro- and mesoscale elastic properties within a human femoral shaft has been investigated. Microscale tissue degree of mineralization (DMB), cortical vascular porosity Ct.Po and the average transverse isotropic stiffness tensor C(Micro) of cylindrical-shaped samples (diameter: 4.4 mm, N = 56) were obtained from cortical regions between 20 and 85% of the total femur length and around the periphery (anterior, medial, posterior and lateral quadrants) by means of synchrotron radiation µCT (SRµCT) and 50-MHz scanning acoustic microscopy (SAM). Within each cylinder, the volumetric bone mineral density (vBMD) and the mesoscale stiffness tensor C(Meso) were derived using a numerical homogenization approach. Moreover, microelastic maps of the axial elastic coefficient c33 measured by SAM at distinct cross-sectional locations along the femur were used to construct a 3-D multiscale elastic model of the femoral shaft. Variations of vBMD (6.1%) were much lower than the variations of mesoscale elastic coefficients (11.1-21.3%). The variation of DMB was only a minor predictor for variations of the mesoscale elastic properties (0.05 ≤ R(2) ≤ 0.34). Instead, variations of the mesoscale elastic properties could be explained by variations of cortical porosity and microscale elastic properties. These data were suitable inputs for numerical evaluations and may help to unravel the relations between structure and composition on the elastic function in cortical bone.

  5. An Effective Approach for Optimization of a Composite Intramedullary Nail for Treating Femoral Shaft Fractures.

    PubMed

    Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

    2015-12-01

    The high stiffness of conventional intramedullary (IM) nails may result in stress shielding and subsequent bone loss following healing in long bone fractures. It can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. This paper introduces a new approach for the optimization of a fiber-reinforced composite nail made of carbon fiber (CF)/epoxy based on a combination of the classical laminate theory, beam theory, finite-element (FE) method, and bone remodeling model using irreversible thermodynamics. The optimization began by altering the composite stacking sequence and thickness to minimize axial stiffness, while maximizing torsional stiffness for a given range of bending stiffnesses. The selected candidates for the seven intervals of bending stiffness were then examined in an experimentally validated FE model to evaluate their mechanical performance in transverse and oblique femoral shaft fractures. It was found that the composite nail having an axial stiffness of 3.70 MN and bending and torsional stiffnesses of 70.3 and 70.9 N⋅m², respectively, showed an overall superiority compared to the other configurations. It increased compression at the fracture site by 344.9 N (31%) on average, while maintaining fracture stability through an average increase of only 0.6 mm (49%) in fracture shear movement in transverse and oblique fractures when compared to a conventional titanium-alloy nail. The long-term results obtained from the bone remodeling model suggest that the proposed composite IM nail reduces bone loss in the femoral shaft from 7.9% to 3.5% when compared to a conventional titanium-alloy nail. This study proposes a number of practical guidelines for the design of composite IM nails.

  6. Long-term pattern of opioid prescriptions after femoral shaft fractures.

    PubMed

    Al Dabbagh, Z; Jansson, K Å; Stiller, C O; Montgomery, S; Weiss, R J

    2016-05-01

    The use of opioids in non-cancer-related pain following skeletal trauma is controversial due to the presumed risk of dose escalation and dependence. We therefore examined the pattern of opioid prescriptions, that is, those actually dispensed, in patients with femoral shaft fractures. We analysed data from the Swedish National Hospital Discharge Register and the Swedish Prescribed Drug Register between 2005 and 2008. We identified 1471 patients with isolated femoral shaft fractures. The median age was 75 (16-102) years and 56% were female. In this cohort, 891 patients (61%) received dispensed opioid prescriptions during a median follow-up of 20 months (interquartile range 11-32). In the age- and sex-matched comparison cohort (7339 individuals) without fracture, 25% had opioid prescriptions dispensed during the same period. The proportions of patients receiving opioid analgesics at 6 and 12 months after the fracture were 45% (95% CI 42-49) and 36% (32-39), respectively. The median daily morphine equivalent dose (MED) was between 15 and 17 mg 1-12 months post-fracture. After 3 months, less than 5% used prescription doses higher than 20 mg MED per day. Older age (≥ 70 compared with < 70 years) was a significant predictor of earlier discontinuation of opioid use (Hazard ratio [HR] 1.9). A notable proportion of patients continued to receive dispensed prescriptions for opioids for over 6 months (45%) and more than a third of them (36%) continued treatment for at least 12 months. However, the risk of dose escalation seems to be small in opioid-naïve patients. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  7. Treatment of the femoral shaft nonunion with double plate fixation and bone grafting: A case series of 14 patients.

    PubMed

    Maimaitiyiming, Asihaerjiang; Amat, Abdusami; Rehei, Aili; Tusongjiang, Mamatkeremula; Li, Cao

    2015-01-01

    The management of femoral shaft nonunion still remains a challenge in orthopaedic surgery. It represents a serious postoperative problem for the patient, associated with plate breakage and loosening, bone defect, shortening deformity and infection. A double plate fixation combined with bone grafting may become a promising therapeutic strategy for the treatment of patients with femoral shaft nonunion. In this study, our goal was to evaluate the clinical outcome of a novel approach for 14 consecutive patients with femoral shaft nonunion using double plate fixation with bone grafting. Retrospective data from June 2010 to August 2012 were obtained from records for 14 consecutive femoral shaft aseptic nonunion patients treated with double plate fixation combined with bone grafting. Nine patients were men and five patients were woman and average age of the patients was 26 years (range from 22 to 32 years). The mean time since injury was 26.2 months. The nonunion had resulted from repeated internal fixation failure (including plate or intramedullary nail fixation) in nine cases and primary internal fixation in five cases. All the 14 patients were followed up for an average of 14.8 (10-25) months. All cases achieved bony union without wound infection or fixation failure and the mean time to union was 5.2 months (range 4-7 months). Double plate fixation and bone grafting are a promising method for femoral shaft nonunion. In addition, this strategy is useful for such a nonunion caused by a repeated plate or intramedullary nail fixation failure with bone defect due to its strong stability with three-dimensional fixation and fully bone graft availability. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. [Atipic osteosarcoma in the femoral shaft case report and review of the literature].

    PubMed

    Clara-Altamirano, M A; García-Ortega, D Y; Martínez-Tlahuel, J L; Martínez-Said, H; Caro-Sánchez, C H S; García-Ruíz, G C; Mejía-Salazar, C R; Cuellar-Hubbe, M

    2016-01-01

    Osteosarcoma is the most frequent primary malignant bone tumor. It is characterized by osteoid production by tumor cells. Its most frequent location is in the metaphyses of long bones, but a purely diaphyseal presentation is reported in 10% of cases. We report the case of a female 25 year-old patient whose symptoms of pain and swelling of the right mid thigh started four months before, without an apparent cause. Femur X-rays showed a tumor in the femoral shaft. The MRI showed extension to soft tissues with no compromise of the neurovascular bundle. The histopathologic report of the incisional biopsy was osteoblastic and chondroblastic osteosarcoma, classified as Enneking IIB, AJCC IIB. Treatment consisted of three cycles of neoadjuvant chemotherapy. Then intercalary femur resection plus reconstruction with centromedullary nailing and a diaphyseal spacer were performed. The histopathologic report was 95% necrosis (Huvos grade III). Three cycles of adjuvant chemotherapy were given and now, 18 months after completing the latter, the patient has no signs of local or distant tumor activity, and she can walk unassisted. Despite the fact that osteosarcoma does not occur usually in the mid shaft of long bones, we should always bear it in mind as part of the differential diagnosis for other conditions that occur more frequently in that region. Such location allows for a broad gamut of surgical approaches that spare the adjacent joints.

  9. Reversed Contralateral LISS Plate for Vancouver B1 Periprosthetic Femoral Shaft Fractures.

    PubMed

    Russo, Matthew; Malekzadeh, A Stephen; Hampton, Chadwick; Hymes, Robert; Schwartzbach, Cary; Schulman, Jeffrey

    2015-06-01

    The authors reviewed all patients treated for periprosthetic femur fractures between March 1, 2007, and January 31, 2010 at the senior author's institution. Demographic features, mechanism of injury, radiographs, and computed tomography scans were reviewed to determine the type and stability of the femoral implant at the time of injury. All Vancouver B1 fractures were treated with a novel technique that used a contoured distal femoral locking plate intended for the contralateral femur and reversed to accommodate the ipsilateral femoral bow and contour of the proximal femur. Fixation was achieved around the implant with percutaneously placed unicortical and/or bicortical screws. Radiographs were reviewed for fracture healing, malunion, implant failure, and prosthetic loosening. Fifteen patients were identified and underwent the procedure as described. One patient died soon after surgery of complications from a ruptured preexisting esophageal ulcer. Of the remaining 14 patients, the average duration of follow-up was 25 months (range, 6-31 months). Two patients did not achieve union; however, repeat interpretation of the presenting radiographs showed likely misdiagnosed Vancouver B2 fractures. The first patient had late aseptic loosening and underwent revision surgery 22 weeks postoperatively. The other had early loss of fixation that required revision with a long stem prosthesis. Other complications included 1 deep venous thrombosis and 2 superficial wound infections. The infections were successfully treated with a single formal irrigation and debridement, primary closure, and a short course of oral antibiotics. Ultimately, in 86% of patients (12/14), fracture healing occurred with this biologically friendly technique. Copyright 2015, SLACK Incorporated.

  10. Incidence of stress fractures of the femoral shaft in women treated with bisphosphonate

    PubMed Central

    Schilcher, Jörg

    2009-01-01

    Background Recent case reports have identified an association between long-term bisphosphonate treatment and stress fractures of the femoral shaft. The risk of such fractures in bisphosphonate users has not been determined. Methods We identified women over 55 years of age with the specific fracture pattern by searching the operation registry of the hospitals in 2 healthcare districts. Prevalence of bisphosphonate treatment was provided by a Swedish national registry covering all drugs delivered to all individuals since 2005. Results The number of women on bisphosphonate treatment was 3,087. Of these, 5 had femoral stress fractures. They had been taking bisphosphonates for 3.5 to 8.5 years. The incidence density for a patient on bisphosphonate was 1/1,000 per year (95% CI: 0.3–2). In the remaining 88,869 women who were not taking bisphosphonates, there were 3 stress fractures. Thus, their risk (without correction for inhomogeneity in age distribution) was 46 times less (95% CI: 11–200). Interpretation These results are rough estimations based on a comparatively small material. Still, a treatment-associated incidence density of 1/1,000 is acceptable, considering that bisphosphonate treatment is likely to reduce the incidence density of any fracture by 15/1,000 according to a large randomized trial (Black et al. 1996). PMID:19568963

  11. Ipsilateral distal femoral and proximal tibial epiphyseal growth plate injury: a case report

    PubMed Central

    2013-01-01

    Introduction Both the isolated distal femoral epiphysiolysis and the isolated proximal tibial epiphysiolysis are the least common epiphyseal injuries. Even though they are uncommon, they have a high incidence rate of complications. Case presentation We present a case with Gustilo-Anderson grade 3b open and Salter-Harris type 1 epiphysiolysis of the distal femur and proximal tibia caused by a farm machinery accident. The patient was a 10-year-old boy, treated by open reduction and internal fixation. Conclusion Although distal femoral and proximal tibial growth plate injuries are rarely seen benign fractures, their management requires meticulous care. Anatomic reduction is important, especially to minimize the risk of growth arrest and the development of degenerative arthritis. However, there is a high incidence of growth arrest and neurovascular injury with these type of fractures. PMID:23724954

  12. Ipsilateral distal femoral and proximal tibial epiphyseal growth plate injury: a case report.

    PubMed

    Gulabi, Deniz; Erdem, Mehmet; Bulut, Guven; Avci, Cem Coskun; Asci, Murat

    2013-05-31

    Both the isolated distal femoral epiphysiolysis and the isolated proximal tibial epiphysiolysis are the least common epiphyseal injuries. Even though they are uncommon, they have a high incidence rate of complications. We present a case with Gustilo-Anderson grade 3b open and Salter-Harris type 1 epiphysiolysis of the distal femur and proximal tibia caused by a farm machinery accident. The patient was a 10-year-old boy, treated by open reduction and internal fixation. Although distal femoral and proximal tibial growth plate injuries are rarely seen benign fractures, their management requires meticulous care. Anatomic reduction is important, especially to minimize the risk of growth arrest and the development of degenerative arthritis. However, there is a high incidence of growth arrest and neurovascular injury with these type of fractures.

  13. Intraoperative cone-beam CT for correction of periaxial malrotation of the femoral shaft: A surface-matching approach

    SciTech Connect

    Khoury, Amal; Whyne, Cari M.; Daly, Michael; Moseley, Douglas; Bootsma, Greg; Skrinskas, Tomas; Siewerdsen, Jeffrey; Jaffray, David

    2007-04-15

    Limb length, alignment and rotation can be difficult to determine in femoral shaft fractures. Shaft axis rotation is particularly difficult to assess intraoperatively. Femoral malpositioning can cause deformity, pain and secondary degenerative joint damage. The aim of this study is to develop an intraoperative method based on cone-beam computed tomography (CBCT) to guide alignment of femoral shaft fractures. We hypothesize that bone surface matching can predict malrotation even with severe comminution. A cadaveric femur was imaged at 16 femoral periaxial malrotations (-51.2 deg. to 60.1 deg.). The images were processed resulting in an unwrapped bone surface plot consisting of a pattern of ridges and valleys. Fracture gaps were simulated by removing midline CT slices. The gaps were reconstituted by extrapolating the existing proximal and distal fragments to the midline of the fracture. The two bone surfaces were then shifted to align bony features. Periaxial malrotation was accurately assessed using surface matching (r{sup 2}=0.99, slope 1.0). The largest mean error was 2.20 deg. and the average difference between repeated measurements was 0.49 deg. CBCT can provide intraoperative high-resolution images with a large field of view. This quality of imaging enables surface matching algorithms to be utilized even with large areas of comminution.

  14. Minimally invasive treatment of displaced femoral shaft fractures with a teleoperated robot-assisted surgical system.

    PubMed

    Zhu, Qing; Liang, Bin; Wang, Xingsong; Sun, Xiaogang; Wang, Liming

    2017-10-01

    Minimally invasive surgical operation of intramedullary (IM) nailing is a standard technique for treating diaphyseal fractures. However, in addition to its advantages, there are some drawbacks such as the frequent occurrence of malalignment, physical fatigue and high radiation exposure to medical staff. The use of robotic and navigation techniques is promising treatments for femoral fractures. This paper presents a novel robot-assisted manipulator for femoral shaft fracture reduction with indirect contact with the femur. An alternative clinical testing model was proposed for orthopedic surgeons to practice femoral fracture reduction. This model imitates the human musculoskeletal system in shape and functional performance. The rubber tube simulate muscles providing contraction forces, and the silicone simulates passive elasticity of muscles. Two-group experiments were performed for studying feasibility of the teleoperated manipulator. The average operative time was about 7min. In the first group experiments, the femur axial, antero-posterior (AP) and lateral views mean errors were 2.2mm, 0.7mm and 1.1mm, respectively, and their maximums were 3.0mm, 0.9mm and 1.5mm; the mean errors of rotation were 0.8° around x-axis, 1.6° around y-axis, 2.0° around z-axis, and their maximums were 1.1°, 2.2°, 2.9°, respectively. For the second group experiments, the femur axial, AP and lateral views mean errors were 1.8mm, 0.4mm and 0.8mm, respectively, and their maximums were 2.2mm, 0.7mm and 1.1mm; the mean errors of rotation were 1.2° around x-axis, 1.6° around y-axis, 1.9° around z-axis, and their maximums were 2.4°, 1.8°, 2.7°, respectively. Reduction for AP view displacement is easier than lateral (p<0.05) because of the tube-shaped anatomy and the muscle contraction forces. Errors around x-axis are smaller than those around y-, and z- axes (p<0.05), i.e., electro-mechanical actuator is easier to control than pneumatic. An experimental model for simulating human

  15. [Electromagnetic navigation interlocking intramedullary nail technology for treatment of femoral shaft fractures].

    PubMed

    Zuo, Kangkang; Qin, Wei; Guo, Qing; Palati-Ababaikeli; Qiao, Peiliu; Shen, Mingquan; Yin, Lele; Pan, Qilin; Xu, Xiaoxiong

    2014-10-01

    To explore the value of electromagnetic navigation interlocking intramedullary nail in the treatment of femoral shaft fracture. Between July 2012 and October 2013, 53 cases of femoral shaft fracture were treated. There were 40 males and 13 females, aged 16-52 years (mean, 38.3 years). The causes of injury were traffic accident in 28 cases, falling from height in 11 cases, falling in 7 cases, crush injury in 4 cases, and other in 3 cases. Of 53 cases, there were 3 cases of open fracture (Gustilo I degree) and 50 cases of closed fracture. Fracture was located in the proximal femur in 17 cases, middle femur in 29 cases, and distal femur in 7 cases. According to Winquist classification, 7 cases were rated as type I, 8 cases as type II, 22 cases as type III, and 16 cases as type IV; according to AO classification, 18 cases were rated as type 32-A, 28 cases as type 32-B, and 7 cases as type 32-C. The time from injury to operation was 3-11 days (mean, 5 days). Distal interlocking intramedullary nail was implanted using electromagnetic navigation. The distal locking nail operation with interlocking intramedullary nail was successfully completed under electromagnetic navigation; the one-time success rate of distal locking nail operation reached 100%; and the locking nail time was 5.0-9.5 minutes (mean, 7.0 minutes). Healing of incision by first intention was obtained after operation, and no complication of skin necrosis, infection, and sinus tract occurred. Fifty-three cases were all followed up 5-12 months (mean, 9 months). One case had hip pain and weaken middle gluteal muscle strength, and the symptoms disappeared after removing the nail. During the follow-up period, no broken nails, nail exit, infection, or re-fracture occurred. All fractures achieved clinical healing, and the healing time was 8-22 weeks (mean, 14.5 weeks). In 49 patients followed up 8 months, the Lysholm score was excellent in 44 cases, good in 4 cases, and acceptable in 1 case, with an excellent and

  16. A biomechanical comparison of the antegrade inserted universal femoral nail with the retrograde inserted universal tibial nail for use in femoral shaft fractures.

    PubMed

    Frankle, M; Cordey, J; Sanders, R W; Koval, K; Perren, S M

    1999-01-01

    Femoral shaft fractures with and without bony contact were simulated in cadaver specimens fixed with one of two different types of intramedullary locked nail systems; conventional antegrade nail fixation of the femur with the universal AO femoral nail or retrograde insertion in the femur with the universal tibial nail (a smaller diameter slotted nail) were utilized. Mechanical testing simulated one leg stance, and resultant deformation was measured in bending, torsion, and shortening. In stable fractures, fracture stability was similar to both devices, while in unstable fractures, the larger femoral nail was more stable. Furthermore, the simulation of single leg stance led to a coupled deformation of varus bending, axial shortening, and external rotation, which was dependent on bone geometry.

  17. Development of a fixation device for robot assisted fracture reduction of femoral shaft fractures: a biomechanical study.

    PubMed

    Weber-Spickschen, T S; Oszwald, M; Westphal, R; Krettek, C; Wahl, F; Gosling, T

    2010-01-01

    Robot assisted fracture reduction of femoral shaft fractures provides precise alignment while reducing the amount of intraoperative imaging. The connection between the robot and the fracture fragment should allow conventional intramedullary nailing, be minimally invasive and provide interim fracture stability. In our study we tested three different reduction tools: a conventional External Fixator, a Reposition-Plate and a Three-Point-Device with two variations (a 40 degrees and a 90 degrees version). We measured relative movements between the tools and the bone fragments in all translation and rotation planes. The Three-Point-Device 90 degrees showed the smallest average relative displacement and was the only device able to withstand the maximum applied load of 70 Nm without failure of any bone fragment. The Three-Point-Device 90 degrees complies with all the stipulated requirements and is a suitable interface for robot assisted fracture reduction of femoral shaft fractures.

  18. Prediction of the structural response of the femoral shaft under dynamic loading using subject-specific finite element models.

    PubMed

    Park, Gwansik; Kim, Taewung; Forman, Jason; Panzer, Matthew B; Crandall, Jeff R

    2017-08-01

    The goal of this study was to predict the structural response of the femoral shaft under dynamic loading conditions using subject-specific finite element (SS-FE) models and to evaluate the prediction accuracy of the models in relation to the model complexity. In total, SS-FE models of 31 femur specimens were developed. Using those models, dynamic three-point bending and combined loading tests (bending with four different levels of axial compression) of bare femurs were simulated, and the prediction capabilities of five different levels of model complexity were evaluated based on the impact force time histories: baseline, mass-based scaled, structure-based scaled, geometric SS-FE, and heterogenized SS-FE models. Among the five levels of model complexity, the geometric SS-FE and the heterogenized SS-FE models showed statistically significant improvement on response prediction capability compared to the other model formulations whereas the difference between two SS-FE models was negligible. This result indicated the geometric SS-FE models, containing detailed geometric information from CT images with homogeneous linear isotropic elastic material properties, would be an optimal model complexity for prediction of structural response of the femoral shafts under the dynamic loading conditions. The average and the standard deviation of the RMS errors of the geometric SS-FE models for all the 31 cases was 0.46 kN and 0.66 kN, respectively. This study highlights the contribution of geometric variability on the structural response variation of the femoral shafts subjected to dynamic loading condition and the potential of geometric SS-FE models to capture the structural response variation of the femoral shafts.

  19. Femoral Shaft Torsion in Injured and Uninjured Ballet Dancers and Its Association with Other Hip Measures: A Cross-sectional Study.

    PubMed

    Hafiz, Eliza; Hiller, Claire E; Nicholson, Leslie L; Nightingale, Elizabeth J; Grimaldi, Alison; Refshauge, Kathryn M

    2016-03-01

    Low range femoral torsion, termed "lateral shaft torsion," has been associated with greater range of hip external rotation and turnout in dancers. It is also hypothesized that achieving greater turnout at the hip minimizes torsion at the knee, shank, ankle, and foot, and consequently reduces incidence of lower limb injuries. The primary aims of this study were to investigate: 1. differences in range of femoral shaft torsion between dancers with and without lower limb injuries; and 2. the relationship between femoral shaft torsion, hip external rotation range, and turnout. A secondary aim was to examine the relationship between femoral shaft torsion and other hip measures: hip strength, lower limb joint hypermobility, hip stability, and foot progression angle, as explanatory variables. Demographic, dance, and injury data were collected, along with physical measures of femoral shaft torsion, hip rotation range of motion, and turnout. Hip strength, control, lower limb hypermobility, and foot progression angle were also measured. Eighty female dancers, 50 with lower limb injury (20.7 ± 4.8 years of age) and 30 without lower limb injury (17.8 ± 4.1 years of age), participated in the study. There was no difference in range of femoral shaft torsion between the groups (p = 0.941). Femoral shaft torsion was weakly correlated with range of hip external rotation (r = -0.034, p = 0.384) and turnout (r = -0.066, p = 0.558). Injured dancers had a significantly longer training history than non-injured dancers (p = 0.001). It was concluded that femoral shaft torsion does not appear to be associated with the overall incidence of lower limb injury in dancers or to be a primary factor influencing extent of turnout in this population.

  20. Flexible intramedullary nails with traction versus plaster cast for treating femoral shaft fractures in children: comparative retrospective study.

    PubMed

    Nascimento, Fabiano Prata do; Santili, Cláudio; Akkari, Miguel; Waisberg, Gilberto; Braga, Susana dos Reis; Fucs, Patrícia Maria Moraes de Barros

    2013-01-01

    CONTEXT AND OBJECTIVE Femoral fractures are common in children between 2 and 12 years of age, and 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as conservative treatment. However, in some situations, a surgical approach is recommended. The objective here was to compare treatments for femoral shaft fractures using intramedullary nails (titanium elastic nails, TEN) versus traction and plaster casts in children. The hypothesis was that TEN might provide better treatment, with good clinical results in comparison with plaster casts. DESIGN AND SETTING This retrospective comparative study was conducted in a public university hospital. METHODS Sixty children with femoral fractures were evaluated; 30 of them underwent surgical treatment with TEN and 30 were treated conservatively using plaster casts. The patients' ages ranged from 5 to 13 years (mean of 9 years). RESULTS The mean duration of hospitalization was nine days for the surgical group and 20 days for the conservative group. The incidence of overgrowth in the patients treated with TEN was 60.0% and, for those treated conservatively, 13.3%. Partial weight-bearing was allowed after 3.5 weeks in the surgical group and after 9.6 weeks in the conservative group. New hospitalization was required for 90.0% in the surgical group and 16.7% in the conservative group. Patients treated with plaster casts presented higher incidence of complications, such as loss of reduction. CONCLUSIONS The surgical method presented better results for children.

  1. Bisphosphonates and risk of subtrochanteric, femoral shaft, and atypical femur fracture: a systematic review and meta-analysis.

    PubMed

    Gedmintas, Lydia; Solomon, Daniel H; Kim, Seoyoung C

    2013-08-01

    Although there is strong evidence that bisphosphonates prevent certain types of osteoporotic fractures, there are concerns that these medications may be associated with rare atypical femoral fractures (AFF). Recent published studies examining this potential association are conflicting regarding the existence and strength of this association. We conducted a systematic review and meta-analysis of published studies examining the association of bisphosphonates with subtrochanteric, femoral shaft, and AFF. The random-effects model was used to calculate the pooled estimates of adjusted risk ratios (RR). Subgroup analysis was performed by study design, for studies that used validated outcome definitions for AFF, and for studies reporting on duration of bisphosphonate use. Eleven studies were included in the meta-analysis: five case-control and six cohort studies. Bisphosphonate exposure was associated with an increased risk of subtrochanteric, femoral shaft, and AFF, with adjusted RR of 1.70 (95% confidence interval [CI], 1.22-2.37). Subgroup analysis of studies using the American Society for Bone and Mineral Research criteria to define AFF suggests a higher risk of AFF, with bisphosphonate use with RR of 11.78 (95% CI, 0.39-359.69) as compared to studies using mainly diagnosis codes (RR, 1.62; 95% CI, 1.18-2.22), although there is a wide confidence interval and severe heterogeneity (I(2)  = 96.15%) in this subgroup analysis. Subgroup analysis of studies examining at least 5 years of bisphosphonate use showed adjusted RR of 1.62 (95% CI, 1.29-2.04). This meta-analysis suggests there is an increased risk of subtrochanteric, femoral shaft, and AFF among bisphosphonate users. Further research examining the risk of AFF with long-term use of bisphosphonates is indicated as there was limited data in this subgroup. The public health implication of this observed increase in AFF risk is not clear.

  2. Femoral neck-shaft angle and climate-induced body proportions.

    PubMed

    Child, Stephanie L; Cowgill, Libby W

    2017-09-23

    Declination in femoral neck-shaft angle (NSA) is commonly linked to an increased level of physical activity during life. More recently, however, research suggests that lower NSA might also be explained, in part, as the mechanical consequence of differences in ecogeographic body proportions. This study tests the proposed link between NSA and climatic-induced body proportions, using relative body mass (RBM), throughout the course of development. NSA and RBM were collected for 445 immature remains from five geographic locations. NSA and RBM were standardized for age-effects. ANOVA was used to examine when population differences emerged in both NSA and RBM. Regression analyses were used to examine the pattern of relationship between NSA and RBM. Populations differ significantly in NSA and RBM before skeletal maturity, and these differences occur early in life. While both NSA and RBM change over the course of development, no significant relationship was found between NSA and RBM for any sample, or any age category (p = .244). Individuals who have relatively greater relative body mass do not necessarily have lower NSA. Population differences in NSA were found to be variable, while differences in RBM remained consistent across the developmental span. Taken together, these results suggest that regardless of body proportions, the degree of declination of NSA is presumed to be similar among individuals with similar gait and ambulatory behaviors. Conversely, populations differ in RBM from birth, and these differences are consistent throughout development. These two measures likely are responsive to diffing stimuli, and any potential relationship is likely complex and multifactorial. © 2017 Wiley Periodicals, Inc.

  3. Bryant traction in paediatric femoral shaft fractures, home traction versus hospitalisation.

    PubMed

    Scheerder, F J M; Schnater, J M; Sleeboom, Chr; Aronson, D C

    2008-04-01

    To evaluate Bryant traction at home in terms of feasibility, morbidity, effect on length of hospital stay, outcome and costs. Retrospective analysis of 54 children treated for femoral shaft fracture (1991-2004). Results of 'home traction' (A, n=38) and 'hospital traction' (B, n=16) were compared. Data were collected regarding demographics, length of hospital stay, traction period, various aspects of the fractures, co-morbidity, morbidity, and follow-up. The parents' experience was evaluated by telephone questionnaire. Two early treatment failures occurred. One patient stopped home traction at 8 days due to skin problems and had a spica cast applied at another hospital, with subsequent development of a compartment syndrome. The other patient was placed in a hip spica after 2 weeks of hospital traction because of difficulty in getting satisfactory X-rays. At follow-up, one unacceptable shortening of 3 cm had occurred in the home traction group. There was only a significant difference in hospital stay (A 7.0 days versus B 22.5 days), total traction period (A 28.0 days versus B 22.5 days) and costs (group B 3x versus group A). The parents were overall pleased with traction at home. Complications occurred as much in the home traction group as in the control group and fracture position at union was equal in both groups. Treatment with home traction is feasible, simple and effective; it reduces hospital stay to 1 week, and costs to one-third. Good patient selection and instructions of the parents are mandatory.

  4. Treatment of pediatric femoral shaft fractures by stainless steel and titanium elastic nail system: A randomized comparative trial.

    PubMed

    Gyaneshwar, Tank; Nitesh, Rustagi; Sagar, Tomar; Pranav, Kothiyal; Rustagi, Nitesh

    2016-08-01

    Literature suggests that the lower modulus of elasticity of titanium makes it ideal for use in children compared with stainless steel. Better fracture stability was observed in association with titanium nails on torsional and axial compression testing. However, stainless steel nails are stiffer than titanium counterparts, which may provide a rigid construct when fixing paediatric femoral shaft fractures. Complications have been observed more frequently by various researchers when titanium nails are used for fracture fixation in patients with increasing age or weight. The concept of this study was to compare the functional outcome after internal fixation with titanium elastic nail system and stainless steel elastic nail system in paediatric femoral shaft fractures. The study was conducted on 34 patients admitted in the department of orthopaedics, LLRM Medical College & SVBP Hospital, Meerut, India from January 2013 to August 2014. We included patients aged 5-12 years with fracture of the femoral shaft, excluding compound fractures, pathological fractures and other lower limb fractures. Patients were treated by titanium (n=17) or stainless steel (n=17) elastic nail system and followed up for one year. The clinical parameters like range of motion at hip and knee joints, time to full weight bearing on the operated limb and radiological parameters like time to union were compared between two groups. A special note was made of intra- and post-operative complications. Functional outcomes were analysed according to Flynn criteria. Based on the Flynn criteria, 59% of patients had excellent results, 41% had satisfactory results, and no one showed poor results. There was no clinically significant difference between the two groups with respect to time to union and full weight bearing. But the incidence of puncture of the opposite cortex while inserting the nail and trying to advance it through the diaphysis during operation is greatly different. Only one such case was observed

  5. The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis.

    PubMed

    Boese, Christoph Kolja; Frink, Michael; Jostmeier, Janine; Haneder, Stefan; Dargel, Jens; Eysel, Peer; Lechler, Philipp

    2016-01-01

    Background. The femoral neck-shaft angle (NSA) is of high importance for the diagnostics and treatment of various conditions of the hip. However, rotational effects limit its precision and applicability using plain radiographs. This study introduces a novel method to measure the femoral NSA: the modified NSA (mNSA), possibly being less susceptible against rotational effects compared to the conventional NSA. Patients and Methods. The method of measurement is described and its applicability was tested in 400 pelvis computed tomography scans (800 hips). Age- and gender-dependent reference values are given and intra- and interrater reliability are analyzed. Results. The mean age of all 400 patients (800 hips) was 54.32 years (18-100, SD 22.05 years). The mean mNSA was 147.0° and the 95% confidence interval was 146.7°-147.4°. Differences of the mNSA between sexes, age groups, and sides were nonsignificant. The absolute difference between NSA and mNSA was 16.3° (range 3-31°; SD 4.4°); the correlation was high (0.738; p < 0.001). Overall, the intra- and interrater reliability were excellent for the mNSA. Interpretation. We introduced a novel concept for the analysis of the neck-shaft angle. The high reliability of the measurement has been proven and its robustness to hip rotation was demonstrated.

  6. Intravenous morphine titration as a rapid and efficient analgesia for adult patients with femoral shaft fractures after injury.

    PubMed

    Pan, Zhengqi; Qi, Yongjian; Wen, Yinxian; Chen, Liaobin

    2016-11-01

    This study aimed to compare the analgesic effects of intravenous ibuprofen and intravenous morphine titration for femoral shaft fractures in adult patients. In total, 293 participants were enrolled and randomly received intravenous ibuprofen or intravenous morphine titration. Their visual analogue scale (VAS) results were recorded every 5 minutes after the first administration. The VAS scores before and during transport were also measured. Meanwhile, the type and frequency of the adverse effects were also recorded in both groups. Patients treated with morphine showed a faster and greater reduction in the VAS than those in the ibuprofen group within 1 hour after the first administration. Interestingly, intravenous morphine titration provided consistent analgesia even during the further transport. No significant immediate adverse event was observed in all of the participants, except for sedation, which might be beneficial for keeping the patient quiet and might not be arbitrarily attributed to adverse effects. No addiction was noted in the morphine group. This study demonstrated that intravenous morphine titration is a faster and more efficient analgesia for femoral shaft fractures than ibuprofen in adult patients immediately after injury.

  7. The Modified Femoral Neck-Shaft Angle: Age- and Sex-Dependent Reference Values and Reliability Analysis

    PubMed Central

    Jostmeier, Janine; Haneder, Stefan; Dargel, Jens; Eysel, Peer; Lechler, Philipp

    2016-01-01

    Background. The femoral neck-shaft angle (NSA) is of high importance for the diagnostics and treatment of various conditions of the hip. However, rotational effects limit its precision and applicability using plain radiographs. This study introduces a novel method to measure the femoral NSA: the modified NSA (mNSA), possibly being less susceptible against rotational effects compared to the conventional NSA. Patients and Methods. The method of measurement is described and its applicability was tested in 400 pelvis computed tomography scans (800 hips). Age- and gender-dependent reference values are given and intra- and interrater reliability are analyzed. Results. The mean age of all 400 patients (800 hips) was 54.32 years (18–100, SD 22.05 years). The mean mNSA was 147.0° and the 95% confidence interval was 146.7°–147.4°. Differences of the mNSA between sexes, age groups, and sides were nonsignificant. The absolute difference between NSA and mNSA was 16.3° (range 3–31°; SD 4.4°); the correlation was high (0.738; p < 0.001). Overall, the intra- and interrater reliability were excellent for the mNSA. Interpretation. We introduced a novel concept for the analysis of the neck-shaft angle. The high reliability of the measurement has been proven and its robustness to hip rotation was demonstrated. PMID:28070521

  8. Bisphosphonates and Risk of Subtrochanteric, Femoral Shaft, and Atypical Femur Fracture: Sensitivity and Trim and Fill Studies

    PubMed Central

    Liu, Jie; Zhang, Hong-xin; Lu, Xiong-xiong; Hu, Jia-jia

    2014-01-01

    Objective: This study carried out sensitivity analysis and trim-fill analysis between bisphosphonates and subtrochanteric, femoral shaft, and atypical femur fracture. Methods: A random-effects model was used finally. Sensitivity, trim and fill, and publication bias analyses were done. Results: Under a random-effects model (I2=87.535), the Z-value=5.672, p-value of test of null<0.001. Bisphosphonate exposure was associated with an increased risk of atypical femur fracture (3.243 [95% CI 2.160–4.870]). When any study is removed, the remaining sensitivity analysis results are still significant. Trim and fill results show that two studies were missed. After filling them, a funnel plot of precision by log risk ratio was more symmetrical. Conclusion: This study suggests that (1) there is an increased risk of subtrochanteric, femoral shaft, and atypical femur fracture in bisphosphonate users; (2) any single study does not influence the total sensitivity; (3) two studies have been lost, theoretically. PMID:24205872

  9. Design, morphometry and development of the secondary osteonal system in the femoral shaft of the rabbit

    PubMed Central

    Pazzaglia, Ugo E; Bonaspetti, Giovanni; Rodella, Luigi F; Ranchetti, Federico; Azzola, Flavio

    2007-01-01

    The architecture of the diaphyseal bone is closely correlated with the cortical vessel network, whose pattern develops in the course of growth. Various methods have been applied to clarify the three-dimensional anatomy of the cortical canal system, but there is still disagreement about the geometry, blood supply, flux dynamics and factors controlling canal geometry during bone growth and remodeling. A modification of the currently employed dye-injection method was applied to study the vessel network of the whole hemi-shaft of the rabbit femur in mature bones (8-month-old rabbits) and growing bones (1.5-month-old rabbits). The cortical vascular tree of the hemi-shaft of the femur was injected with black China ink and observed in full-thickness specimens of the cortex. The same specimens were then processed for histology. A comparative study of the middle diaphysis (mid-shaft) with the distal extremity (distal shaft) was performed in both young and old rabbit femurs. The longitudinally oriented pattern of the vessel network was seen to develop in the diaphysis of mature femurs, while at the extremity of the shaft of the same specimen the network showed a reticular organization without a dominant polarization. The vessels were significantly higher in the mid-shaft than in the distal shaft of the old femurs (P < 0.0001), as was their diameter (P < 0.05). In the group of young rabbits at mid-shaft level the longitudinally oriented pattern of the vessel network was not yet completely developed, without their being significant differences in length and diameter between the mid-shaft and distal shaft. The differentiation of the mid-shaft from the distal shaft was confirmed histologically by the presence, in the latter, of longitudinal calcified cartilage septa between osteons. This pattern of structural organization and development of the intracortical vascular network has not been previously reported. The cells primarily involved in polarization of the remodeling process

  10. Design, morphometry and development of the secondary osteonal system in the femoral shaft of the rabbit.

    PubMed

    Pazzaglia, Ugo E; Bonaspetti, Giovanni; Rodella, Luigi F; Ranchetti, Federico; Azzola, Flavio

    2007-09-01

    The architecture of the diaphyseal bone is closely correlated with the cortical vessel network, whose pattern develops in the course of growth. Various methods have been applied to clarify the three-dimensional anatomy of the cortical canal system, but there is still disagreement about the geometry, blood supply, flux dynamics and factors controlling canal geometry during bone growth and remodeling. A modification of the currently employed dye-injection method was applied to study the vessel network of the whole hemi-shaft of the rabbit femur in mature bones (8-month-old rabbits) and growing bones (1.5-month-old rabbits). The cortical vascular tree of the hemi-shaft of the femur was injected with black China ink and observed in full-thickness specimens of the cortex. The same specimens were then processed for histology. A comparative study of the middle diaphysis (mid-shaft) with the distal extremity (distal shaft) was performed in both young and old rabbit femurs. The longitudinally oriented pattern of the vessel network was seen to develop in the diaphysis of mature femurs, while at the extremity of the shaft of the same specimen the network showed a reticular organization without a dominant polarization. The vessels were significantly higher in the mid-shaft than in the distal shaft of the old femurs (P < 0.0001), as was their diameter (P < 0.05). In the group of young rabbits at mid-shaft level the longitudinally oriented pattern of the vessel network was not yet completely developed, without their being significant differences in length and diameter between the mid-shaft and distal shaft. The differentiation of the mid-shaft from the distal shaft was confirmed histologically by the presence, in the latter, of longitudinal calcified cartilage septa between osteons. This pattern of structural organization and development of the intracortical vascular network has not been previously reported. The cells primarily involved in polarization of the remodeling process

  11. Stress fractures of the femoral shaft in women's college lacrosse: a report of seven cases and a review of the literature.

    PubMed

    Kang, L; Belcher, D; Hulstyn, M J

    2005-12-01

    Stress fractures do not often occur in the shaft of the femur. They are more common in the femoral neck, the tibial shaft, the metatarsals, and other bones of the foot. In female athletes, stress fractures classically afflict the distance runner, the ballerina, the gymnast, and the figure skater. To describe the clinical presentation, diagnosis, treatment, and outcome of seven college female lacrosse players with femoral shaft stress fractures, and review the literature. The unusual results of this study support the principle that clinical suspicion should be high when treating any female athlete regardless of the sport. In this case series, an abrupt change in the quality of the running surface during the competitive training season was the only underlying common thread among the athletes. The findings suggest that risk factors for the female athlete are variable and are no longer limited to the undernourished or overtrained.

  12. Stress fractures of the femoral shaft in women's college lacrosse: a report of seven cases and a review of the literature

    PubMed Central

    Kang, L; Belcher, D; Hulstyn, M

    2005-01-01

    Background: Stress fractures do not often occur in the shaft of the femur. They are more common in the femoral neck, the tibial shaft, the metatarsals, and other bones of the foot. In female athletes, stress fractures classically afflict the distance runner, the ballerina, the gymnast, and the figure skater. Objectives: To describe the clinical presentation, diagnosis, treatment, and outcome of seven college female lacrosse players with femoral shaft stress fractures, and review the literature. Results: The unusual results of this study support the principle that clinical suspicion should be high when treating any female athlete regardless of the sport. In this case series, an abrupt change in the quality of the running surface during the competitive training season was the only underlying common thread among the athletes. Conclusion: The findings suggest that risk factors for the female athlete are variable and are no longer limited to the undernourished or overtrained. PMID:16306496

  13. The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture

    PubMed Central

    Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

    2016-01-01

    Abstract The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery. We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey. At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group. In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate. PMID:27537579

  14. Analysis of Bony and Internal Organ Injuries Associated With 26,357 Adult Femoral Shaft Fractures and Their Impact on Mortality.

    PubMed

    Anandasivam, Nidharshan S; Russo, Glenn S; Fischer, Jennifer M; Samuel, Andre M; Ondeck, Nathaniel T; Swallow, Matthew S; Chung, Sophie H; Bohl, Daniel D; Grauer, Jonathan N

    2017-03-30

    The spectrum of injuries associated with femoral shaft fractures and those injuries' association with mortality have not been well delineated previously. Patients in the National Trauma Data Bank who presented with femoral shaft fractures from 2011 to 2012 were analyzed in 3 age groups (18-39, 40-64, and 65+ years). For each group, modified Charlson Comorbidity Index (CCI), mechanism of injury (MOI), injury severity score (ISS), and associated injuries were reported. Multivariate logistic regression was used to identify predictors of mortality. Among the 26,357 patients with femoral shaft fractures, modified CCIs gradually increased with increasing age category and ISS decreased. Motor vehicle accidents were the most common MOI in the younger 2 age groups, whereas falls were the most common MOI in the 65 years and older age group. The top 3 associated bony injuries for the study cohort as a whole were tibia/fibula (20.5%), ribs/sternum (19.1%), and non-shaft femur (18.9%, of which 5.8% of the total cohort were femoral neck) fractures. The top 3 associated internal organ injuries were lung (18.9%), intracranial (13.5%), and liver (6.2%), injuries. A multivariate mortality analysis showed that increasing age, increasing comorbidity burden, and associated injuries all had independent associations with mortality. The injuries most associated with mortality were thoracic organ injuries (adjusted odds ratio [AOR]=3.53), head injuries (AOR=2.93), abdominal organ injuries (AOR=2.78), and pelvic fractures (AOR=1.80). This study used a large, nationwide sample of trauma patients to profile injuries associated with femoral shaft fractures. Associations between injuries and mortality underscore the importance of these findings. [Orthopedics. 201x; xx(x):xx-xx.].

  15. Treatment of Adult Femoral Shaft Fractures Using the Perkins Traction at Addis Ababa Tikur Anbessa University Hospital: The Ethiopian Experience

    PubMed Central

    Bezabeh, Bahiru; Wamisho, Biruk L.; Coles, Maxime J.M.

    2012-01-01

    This is a prospective study to evaluate the efficacy of the Perkins traction in the treatment of adult femoral shaft fractures from October 1, 2007, to the present at the Black Lion Hospital in Addis Ababa University Hospital in Ethiopia. All femur fractures admitted to the hospital were reviewed and evaluated for treatment. Black Lion Hospital (Tikur Anbessa) is the university hospital in Addis Ababa and the highest tertiary teaching hospital in a country of 85 million inhabitants. A 67-bed orthopedic department offers the main ground for teaching to the undergraduate medical students. The hospital is also the pivotal center for the formation of the orthopedic residents. Patients from different parts of the country are referred to this institution for orthopedic care. A total of 68 adult (older than 16 years) patients with 69 femoral shaft fractures were considered for treatment during the study period. Consent was obtained and prospective treatment initiated. A standard Perkins traction was applied by an orthopedic team composed of consultants, orthopedic residents, physical therapists, and nurses. A protocol was developed for patients undergoing such traction. The physiotherapists will supervise all individual or group therapy sessions. Progressive knee range of motion to facilitate quadriceps and hamstring muscle strengthening exercises were implemented four times a day and recorded. Demographic information, fracture patterns, duration of traction, thigh circumference leg length discrepancy, and pin sites were routinely monitored and charted. Data were computerized and analyzed weekly, and appropriate adjustments were made accordingly. Clinical evidence of a competent callus and confirmation by radiographic studies will influence the cessation of traction to allow gait training with toe-touch crutch ambulation. Progress will be monitored during the following outpatient visits in the fracture clinic. A total of 68 consecutive patients with 69 femoral shaft

  16. Early intramedullary nailing of femoral shaft fracture on outcomes in patients with severe chest injury: A meta-analysis

    PubMed Central

    Jiang, Meng; Li, Changli; Yi, Chengla; Tang, Shaotao

    2016-01-01

    Early intramedullary nailing (IMN) within the first 24 hours for multiply injured patients with femoral fracture and concomitant severe chest injury is still controversial. This review aimed to investigate the association between early IMN and pulmonary complications in such patients. We searched the literature up to Jan 2016 in the main electronic databases (PubMed, Web of Science, Cochrane library databases) to identify eligible studies. Data were extracted and analyzed using a Mantel–Haenszel method with random-effects model to estimate pooled odds ratio (OR) and 95% confidence intervals (CIs). Seven retrospective cohort studies were identified eventually. The pooled estimates demonstrated that the application of early IMN did not significantly increase the risk of adult respiratory distress syndrome (ARDS) (OR, 0.65; 95% CI: 0.38–1.13), mortality (OR, 0.79; 95% CI: 0.43–1.47), pneumonia (OR, 0.92; 95% CI: 0.55–1.54), multiple organ failure (MOF) (OR, 0.87; 95% CI: 0.45–1.71) and pulmonary embolism (OR, 1.81; 95% CI: 0.28–11.83). In subgroup analysis according to the type of IMN (reamed or undreamed), we did not find any significant difference either. Our results indicated that early IMN of femoral shaft fracture was not associated with increased rates of pulmonary complications in severe chest-injured patients. PMID:27457468

  17. Early urbanization and mobility at Tell Brak, NE Syria: the evidence from femoral and tibial external shaft shape.

    PubMed

    Sołtysiak, Arkadiusz

    2015-04-01

    Urbanization at Tell Brak began in the late 5th millennium BCE and the site reached its maximum size in the Late Chalcolithic (LC) 3, ca. 3900-3600 BCE. During that time, a large midden was formed at the edge of the early city, now known as Tell Majnuna. Rescue excavations at Tell Majnuna revealed several clusters of commingled human remains and a cemetery on the top. Several human skeletons dated to the LC 3 and Early Bronze Age (EBA) were found also at Tell Brak itself and it was possible to investigate differences in cross-sectional femoral and tibial shaft shapes between LC 3 and EBA to test the hypothesis that rapid and extensive urbanization in the LC 3 induced increase in mobility. External midshaft and subtrochanteric measurements of at least 152 femora and measurements of 55 tibiae at the nutrient foramen were taken to investigate the differences in the level of terrestrial mobility between four LC 3 and one EBA chronological subsets. Also the correlation was examined between shaft cross-sectional shapes and frequency of linear enamel hypoplasia (LEH) in canines, as a proxy indicator of population stress. Due to post-mortem damage, sex assessment was based only on the size of measured bones. In spite of the limited quality of the gathered data, significant differences in femoral midshaft shape in males were observed between the LC 3 and EBA subsets and the average shape index scores appeared to be correlated with the LEH frequencies. No such result was obtained for females, suggesting that only males were more mobile in the LC 3 and their mobility level was associated with general population stress. In contrast, in females the average shape of subtrochanteric femoral cross-section was more variable between temporal subsets. The patterns of temporal differences in tibial cross-section at the nutrient foramen were not conclusive due to the small sample size. Obtained results suggest that males in the LC 3, the period of rapid urbanization, were more mobile

  18. Computer-assisted three-dimensional correlation between the femoral neck-shaft angle and the optimal entry point for antegrade nailing.

    PubMed

    Anastopoulos, George; Chissas, Dionisios; Dourountakis, Joseph; Ntagiopoulos, Panagiotis G; Magnisalis, Evaggelos; Asimakopoulos, Antonios; Xenakis, Theodore A

    2010-03-01

    Optimal entry point for antegrade femoral intramedullary nailing (IMN) remains controversial in the current medical literature. The definition of an ideal entry point for femoral IMN would implicate a tenseless introduction of the implant into the canal with anatomical alignment of the bone fragments. This study was undertaken in order to investigate possible existing relationships between the true 3D geometric parameters of the femur and the location of the optimum entry point. A sample population of 22 cadaveric femurs was used (mean age=51.09+/-14.82 years). Computed-tomography sections every 0.5mm for the entire length of femurs were produced. These sections were subsequently reconstructed to generate solid computer models of the external anatomy and medullary canal of each femur. Solid models of all femurs were subjected to a series of geometrical manipulations and computations using standard computer-aided-design tools. In the sagittal plane, the optimum entry point always lied a few millimeters behind the femoral neck axis (mean=3.5+/-1.5mm). In the coronal plane the optimum entry point lied at a location dependent on the femoral neck-shaft angle. Linear regression on the data showed that the optimal entry point is clearly correlated to the true 3D femoral neck-shaft angle (R(2)=0.7310) and the projected femoral neck-shaft angle (R(2)=0.6289). Anatomical parameters of the proximal femur, such as the varus-valgus angulation, are key factors in the determination of optimal entry point for nailing. The clinical relevance of the results is that in varus hips (neck-shaft angle shaft angle between 120 degrees and 130 degrees , the optimal entry point lies just medially to the trochanter tip (at the piriformis fossa) and the use of stiff implants is safe. In hips with neck-shaft angle over 130 degrees the anatomical

  19. Correlation of femoral artery flow velocity waveform with ipsilateral iliac artery stenoses assessed with magnetic resonance imaging.

    PubMed

    Wikström, J; Johansson, L; Karacagil, S; Ahlström, H

    2007-05-01

    Magnetic resonance (MR) permits quantitative flow velocity measurements that could be used to detect changes in the curve profile downstream of a high-grade stenosis. To assess whether MR flow measurements can be used to detect iliac artery stenoses. Contrast-enhanced magnetic resonance angiography (MRA) and quantitative flow measurements in the lower aorta and proximal femoral arteries were performed in 29 patients with suspected iliac artery stenoses. Stenoses were graded into five degrees: 0%, 1-49%, 50-74%, 75-99%, and 100% diameter reduction. The femoral artery waveforms were evaluated qualitatively by two independent reviewers regarding peak systolic velocity (PSV), aortofemoral difference in time-to-peak (DeltaTTP), systolic acceleration (SA), curve-shape index (CSI), and the presence of an early diastolic flow reversal. The correlation between these parameters and the degree of stenosis was assessed. A significant correlation with degree of stenosis was observed for the qualitative flow waveform evaluations, with a high degree of interobserver agreement (kappa = 0.84). A significant correlation was also found between degree of stenosis and PSV, DeltaTTP, SA, CSI, and presence of diastolic flow reversal. The flow velocity pattern, however, remained unchanged, both qualitatively and quantitatively, up to a stenosis degree of at least 75%. Iliac artery stenoses cause femoral artery flow waveform changes that can be detected with MRI, but only at high-grade levels.

  20. 3D atlas-based registration can calculate malalignment of femoral shaft fractures in six degrees of freedom

    PubMed Central

    Crookshank, Meghan C.; Beek, Maarten; Hardisty, Michael R.; Schemitsch, Emil H.

    2014-01-01

    Objective This study presents and evaluates a semi-automated algorithm for quantifying malalignment in complex femoral shaft fractures from a single intraoperative cone-beam CT (CBCT) image of the fractured limb. Methods CBCT images were acquired of complex comminuted diaphyseal fractures created in 9 cadaveric femora (27 cases). Scans were segmented using intensity-based thresholding, yielding image stacks of the proximal, distal and comminuted bone. Semi-deformable and rigid affine registrations to an intact femur atlas (synthetic or cadaveric-based) were performed to transform the distal fragment to its neutral alignment. Leg length was calculated from the volume of bone within the comminution fragment. The transformations were compared to the physical input malalignments. Results Using the synthetic atlas, translations were within 1.71 ± 1.08 mm (medial/lateral) and 2.24 ± 2.11 mm (anterior/posterior). The varus/valgus, flexion/extension and periaxial rotation errors were 3.45 ± 2.6°, 1.86 ± 1.5° and 3.4 ± 2.0°, respectively. The cadaveric-based atlas yielded similar results in medial/lateral and anterior/posterior translation (1.73 ± 1.28 mm and 2.15 ± 2.13 mm, respectively). Varus/valgus, flexion/extension and periaxial rotation errors were 2.3 ± 1.3°, 2.0 ± 1.6° and 3.4 ± 2.0°, respectively. Leg length errors were 1.41 ± 1.01 mm (synthetic) and 1.26 ± 0.94 mm (cadaveric). The cadaveric model demonstrated a small improvement in flexion/extension and the synthetic atlas performed slightly faster (6 min 24 s ± 50 s versus 8 min 42 s ± 2 min 25 s). Conclusions This atlas-based algorithm quantified malalignment in complex femoral shaft fractures within clinical tolerances from a single CBCT image of the fractured limb. PMID:24720491

  1. [Long-Term Outcomes of the Treatment of Pediatric Femoral Shaft Fractures Treated with Bryant's Vertical Traction].

    PubMed

    Urban, J; Toufar, P; Kloub, M

    2017-01-01

    PURPOSE OF THE STUDY The paper aimed to evaluate the long-term outcomes of the treatment of diaphyseal femur fractures in children treated with Bryant's vertical traction. Moreover, we also assessed the size of overgrowth in the injured femur. MATERIAL AND METHODS The study included 23 patients with 23 femoral shaft fractures treated with Bryant's vertical traction at our department in 2009-2014. The following parameters were assessed: sex, ïnjured side, weight, age, mechanism of injury, potential abuse, type of fracture, duration of traction, and total length of hospital stay. The healing time of the fracture was the same as the duration of traction. Also assessed was the size of femoral shortening after the removal of traction, the presence of skin complications in the course of treatment and potential development of compartment syndrome. At the mean follow-up of 47.8 months (range 22-85 months) from the date of injury the patients were evaluated clinically and radiologically for: length of limbs, presence of rotational deformity, range of motion of knee and hip joints, potential pain or limping, potential scoliosis of the spine and presence of scars after traction. Finally, through a questionnaire we learned about the opinions of parents as to the treatment method and about the possibility of home traction. RESULTS All the fractures healed. There was a total of 17 injured boys and 6 injured girls. Whereas 12 patients sustained a fracture of the left femur, 11 patients sustained a fracture of the right femur. The mean weight of patients at the time of injury was 13.9 kg (range 5-20 kg). The mean age at the time of traction was 30.8 months (range 1-70 months). The injury most frequently occurred from various falls, altogether in 15 cases (65.2%). Traffic accidents were registered as the cause of injury in 3 cases (13%). No abuse was confirmed. The average duration of traction was 19.8 days (range 8-26 days). The total length of hospital stay took on average 23

  2. Ipsilateral total hip arthroplasty in patient with an above-knee amputee for femoral neck fracture: a case report

    PubMed Central

    Ma, Chunhui; Lv, Qi; Yi, Chengqing; Ma, Jinzhong; Zhu, Libo

    2015-01-01

    There is limited literature about the outcomes of total hip arthroplasty (THA) as a surgical option for above-knee amputees. Here, we described one case of femoral neck fracture with above-knee amputation. Two-year follow-up revealed an excellent clinical and radiological outcome. The main challenge of THA posed by the amputation was control of the lower extremity. We recommend inserting a pin at the greater trochanter of the femur to improve control of traction or rotation. PMID:25932163

  3. Femoral Neck Anteversion and Neck Shaft Angles: Determination and their Clinical Implications in Fetuses of Different Gestational Ages.

    PubMed

    Souza, A D; Ankolekar, V H; Padmashali, S; Das, A; Souza, Asd; Hosapatna, M

    2015-07-01

    Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. The present study was undertaken on 48 fetal femurs to calculate the NSA and FNA in fetuses digitally. End on images of upper end of the femurs were taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t test showed the FNA and NSA of femur did not vary significantly during the third trimester.

  4. Sex-specific developmental changes in muscle size and bone geometry at the femoral shaft.

    PubMed

    Högler, W; Blimkie, C J R; Cowell, C T; Inglis, D; Rauch, F; Kemp, A F; Wiebe, P; Duncan, C S; Farpour-Lambert, N; Woodhead, H J

    2008-05-01

    When expressed as a percentage of the average result in young adults, bone mineral content lags behind bone length before puberty. Even though this observation has led to speculation about bone fragility in children, such relationships could simply be due to scaling effects when measures with different geometrical dimensions are compared. The study population comprised 145 healthy subjects (6-25 years, 94 females). Magnetic resonance imaging and dual-energy X-ray absorptiometry were used to determine femur length, bone mineral content, cortical bone mineral density, cross-sectional bone geometry (bone diameter; cortical thickness; total, cortical and medullary areas; cross-sectional and polar moments of area; bone strength index) and muscle area at the proximal one-third site of the femur. Results were dimensionally scaled by raising two-, three- and four-dimensional variables to the power of 1/2, 1/3 and 1/4, respectively. Sex-differences were also assessed before and after functionally adjusting variables for femur length and weight or muscle size. In prepubertal children, unscaled results expressed as percentages of adult values were lowest for variables with the highest dimensions (e.g., moments of areafemoral length, diameter, mass and strength appears well coordinated before

  5. 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.

  6. Atypical subtrochanteric femoral shaft fractures: role for mechanics and bone quality.

    PubMed

    van der Meulen, Marjolein C H; Boskey, Adele L

    2012-08-29

    Bisphosphonates are highly effective agents for reducing osteoporotic fractures in women and men, decreasing fracture incidence at the hip and spine up to 50%. In a small subset of patients, however, these agents have recently been associated with 'atypical femoral fractures' (AFFs) in the subtrochanteric region or the diaphysis. These fractures have several atypical characteristics, including occurrence with minimal trauma; younger age than typical osteoporotic fractures; occurrence at cortical, rather than cancellous sites; early radiographic appearance similar to that of a stress fracture; transverse fracture pattern rather than the familiar spiral or transverse-oblique morphologies; initiation on the lateral cortex; and high risk of fracture on the contralateral side, at the same location as the initial fracture. Fracture is a mechanical phenomenon that occurs when the loads applied to a structure such as a long bone exceed its load-bearing capacity, either due to a single catastrophic overload (traumatic failure) or as a result of accumulated damage and crack propagation at sub-failure loads (fatigue failure). The association of AFFs with no or minimal trauma suggests a fatigue-based mechanism that depends on cortical cross-sectional geometry and tissue material properties. In the case of AFFs, bisphosphonate treatment may alter cortical tissue properties, as these agents are known to alter bone remodeling. This review discusses the use of bisphosphonates, their effects on bone remodeling, mechanics and tissue composition, their significance as an effective therapy for osteoporosis, and why these agents may increase fracture risk in a small population of patients.

  7. An analytical approach to study the intraoperative fractures of femoral shaft during total hip arthroplasty.

    PubMed

    Malekmotiei, Leila; Farahmand, Farzam; Shodja, Hossein M; Samadi-Dooki, Aref

    2013-04-01

    An analytical approach which is popular in micromechanical studies has been extended to the solution for the interference fit problem of the femoral stem in cementless total hip arthroplasty (THA). The multiple inhomogeneity problem of THA in transverse plane, including an elliptical stem, a cortical wall, and a cancellous layer interface, was formulated using the equivalent inclusion method (EIM) to obtain the induced interference elastic fields. Results indicated a maximum interference fit of about 210 μm before bone fracture, predicted based on the Drucker-Prager criterion for a partially reamed section. The cancellous layer had a significant effect on reducing the hoop stresses in the cortical wall; the maximum press fit increased to as high as 480 μm for a 2 mm thick cancellous. The increase of the thickness and the mechanical quality, i.e., stiffness and strength, of the cortical wall also increased the maximum interference fit before fracture significantly. No considerable effect was found for the implant material on the maximum allowable interference fit. It was concluded that while larger interference fits could be adapted for younger patients, care must be taken when dealing with the elderly and those suffering from osteoporosis. A conservative reaming procedure is beneficial for such patients; however, in order to ensure sufficient primary stability without risking bone fracture, a preoperative analysis might be necessary.

  8. Do post-operative changes of neck-shaft angle and femoral component anteversion have an effect on clinical outcome following uncemented total hip arthroplasty?

    PubMed

    Müller, M; Abdel, M P; Wassilew, G I; Duda, G; Perka, C

    2015-12-01

    The accurate reconstruction of hip anatomy and biomechanics is thought to be important in achieveing good clinical outcomes following total hip arthroplasty (THA). To this end some newer hip designs have introduced further modularity into the design of the femoral component such that neck-shaft angle and anteversion, which can be adjusted intra-operatively. The clinical effect of this increased modularity is unknown. We have investigated the changes in these anatomical parameters following conventional THA with a prosthesis of predetermined neck-shaft angle and assessed the effect of changes in the hip anatomy on clinical outcomes. In total, 44 patients (mean age 65.3 years (standard deviation (SD) 7); 17 male/27 female; mean body mass index 26.9 (kg/m²) (SD 3.1)) underwent a pre- and post-operative three-dimensional CT scanning of the hip. The pre- and post-operative neck-shaft angle, offset, hip centre of rotation, femoral anteversion, and stem alignment were measured. Additionally, a functional assessment and pain score were evaluated before surgery and at one year post-operatively and related to the post-operative anatomical changes. The mean pre-operative neck-shaft angle was significantly increased by 2.8° from 128° (SD 6.2; 119° to 147°) to 131° (SD 2.1; 127° to 136°) (p = 0.009). The mean pre-operative anteversion was 24.9° (SD 8; 7.9 to 39.1) and reduced to 7.4° (SD 7.3; -11.6° to 25.9°) post-operatively (p < 0.001). The post-operative changes had no influence on function and pain. Using a standard uncemented femoral component, high pre- and post-operative variability of femoral anteversion and neck-shaft angles was found with a significant decrease of the post-operative anteversion and slight increase of the neck-shaft angles, but without any impact on clinical outcome.

  9. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    PubMed Central

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  10. Femoral neck-shaft angle in humans: variation relating to climate, clothing, lifestyle, sex, age and side

    PubMed Central

    Gilligan, Ian; Chandraphak, Supichya; Mahakkanukrauh, Pasuk

    2013-01-01

    The femoral neck-shaft angle (NSA) varies among modern humans but measurement problems and sampling limitations have precluded the identification of factors contributing to its variation at the population level. Potential sources of variation include sex, age, side (left or right), regional differences in body shape due to climatic adaptation, and the effects of habitual activity patterns (e.g. mobile and sedentary lifestyles and foraging, agricultural, and urban economies). In this study we addressed these issues, using consistent methods to assemble a global NSA database comprising over 8000 femora representing 100 human groups. Results from the analyses show an average NSA for modern humans of 127° (markedly lower than the accepted value of 135°); there is no sex difference, no age-related change in adults, but possibly a small lateral difference which could be due to right leg dominance. Climatic trends consistent with principles based on Bergmann's rule are evident at the global and continental levels, with the NSA varying in relation to other body shape indices: median NSA, for instance, is higher in warmer regions, notably in the Pacific (130°), whereas lower values (associated with a more stocky body build) are found in regions where ancestral populations were exposed to colder conditions, in Europe (126°) and the Americas (125°). There is a modest trend towards increasing NSA with the economic transitions from forager to agricultural and urban lifestyles and, to a lesser extent, from a mobile to a sedentary existence. However, the main trend associated with these transitions is a progressive narrowing in the range of variation in the NSA, which may be attributable to thermal insulation provided by improved cultural buffering from climate, particularly clothing. PMID:23781912

  11. Femoral neck-shaft angle in humans: variation relating to climate, clothing, lifestyle, sex, age and side.

    PubMed

    Gilligan, Ian; Chandraphak, Supichya; Mahakkanukrauh, Pasuk

    2013-08-01

    The femoral neck-shaft angle (NSA) varies among modern humans but measurement problems and sampling limitations have precluded the identification of factors contributing to its variation at the population level. Potential sources of variation include sex, age, side (left or right), regional differences in body shape due to climatic adaptation, and the effects of habitual activity patterns (e.g. mobile and sedentary lifestyles and foraging, agricultural, and urban economies). In this study we addressed these issues, using consistent methods to assemble a global NSA database comprising over 8000 femora representing 100 human groups. Results from the analyses show an average NSA for modern humans of 127° (markedly lower than the accepted value of 135°); there is no sex difference, no age-related change in adults, but possibly a small lateral difference which could be due to right leg dominance. Climatic trends consistent with principles based on Bergmann's rule are evident at the global and continental levels, with the NSA varying in relation to other body shape indices: median NSA, for instance, is higher in warmer regions, notably in the Pacific (130°), whereas lower values (associated with a more stocky body build) are found in regions where ancestral populations were exposed to colder conditions, in Europe (126°) and the Americas (125°). There is a modest trend towards increasing NSA with the economic transitions from forager to agricultural and urban lifestyles and, to a lesser extent, from a mobile to a sedentary existence. However, the main trend associated with these transitions is a progressive narrowing in the range of variation in the NSA, which may be attributable to thermal insulation provided by improved cultural buffering from climate, particularly clothing.

  12. 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

  13. Potential pathogenic mechanism for stress fractures of the bowed femoral shaft in the elderly: Mechanical analysis by the CT-based finite element method.

    PubMed

    Oh, Yoto; Wakabayashi, Yoshiaki; Kurosa, Yoshiro; Fujita, Koji; Okawa, Atsushi

    2014-11-01

    Stress fractures of the bowed femoral shaft (SBFs) may be one of the causes of atypical femoral fractures (AFFs). The CT-based finite element method (CT/FEM) can be used to structurally evaluate bone morphology and bone density based on patient DICOM data, thereby quantitatively and macroscopically assessing bone strength. Here, we clarify the pathogenic mechanism of SBFs and demonstrate this new understanding of AFFs through mechanical analysis by CT/FEM. A prospective clinical study was performed from April 2012 to February 2014. We assembled two study groups, the bowed AFF group (n=4 patients; mean age, 78.0 years) including those with a prior history of AFF associated with bowing deformity and the thigh pain group (n=14 patients; mean age, 78.6 years) comprising outpatients with complaints of thigh pain and tenderness. Stress concentration in the femoral shaft was analysed by CT/FEM, and the visual findings and extracted data were assessed to determine the maximum principal stress (MPS) and tensile stress-strength ratio (TSSR). In addition, we assessed femoral bowing, bone density, and bone metabolic markers. Wilcoxon's rank sum test was used for statistical analysis. All patients in the bowed AFF group showed a marked concentration of diffuse stress on the anterolateral surface. Thirteen patients in the thigh pain group had no significant findings. However, the remaining 1 patient had a finding similar to that observed in the bowed AFF group, with radiographic evidence of bowing deformity and a focally thickened lateral cortex. Patients were reclassified as having SBF (n=5) or non-SBF (n=13). Statistical analysis revealed significant differences in MPS (p=0.0031), TSSR (p=0.0022), and femoral bowing (lateral, p=0.0015; anterior, p=0.0022) between the SBF and non-SBF groups, with no significant differences in bone density or bone metabolic markers. Significant tensile stress due to bowing deformity can induce AFFs. SBFs should be considered a novel subtype of

  14. The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women. A case control morphology and anthropometric study

    PubMed Central

    Fearon, AM; Stephens, S; Cook, JL; Smith, PN; Neeman, T; Cormick, W; Scarvell, JM

    2012-01-01

    Objective To evaluate if pelvic or hip width predisposed women to developing greater trochanteric pain syndrome (GTPS). Design Prospective case control study. Participants Four groups were included in the study: those gluteal tendon reconstructions (n=31, GTR), those with conservatively managed GTPS (n=29), those with hip osteoarthritis (n=20, OA) and 22 asymptomatic participants (ASC). Methods Anterior-posterior pelvic x-rays were evaluated for femoral neck shaft angle; acetabular index, and width at the lateral acetabulum, and the superior and lateral aspects of the greater trochanter. Body mass index, and waist, hip and greater trochanter girth were measured. Data were analysed using a one-way analysis of variance (ANOVA; posthoc Scheffe analysis), then multivariate analysis. Results The GTR group had a lower femoral neck shaft angle than the other groups (p=0.007). The OR (95% CI) of having a neck shaft angle of less than 134°, relative to the ASC group: GTR=3.33 (1.26 to 8.85); GTPS=1.4 (0.52 to 3.75); OA=0.85 (0.28 to 2.61). The OR of GTR relative to GTPS was 2.4 (1.01 to 5.6). No group difference was found for acetabular or greater trochanter width. Greater trochanter girth produced the only anthropometric group difference (mean (95% CI) in cm) GTR=103.8 (100.3 to 107.3), GTPS=105.9 (100.2 to 111.6), OA=100.3 (97.7 to 103.9), ASC=99.1 (94.7 to 103.5), (ANOVA: p=0.036). Multivariate analysis confirmed adiposity is associated with GTPS. Conclusion A lower neck shaft angle is a risk factor for, and adiposity is associated with, GTPS in women. PMID:22547561

  15. Intramedullary nailing of femoral shaft fractures in polytraumatized patients. a longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses.

    PubMed

    Husebye, Elisabeth E; Lyberg, Torstein; Opdahl, Helge; Aspelin, Trude; Støen, Ragnhild O; Madsen, Jan Erik; Røise, Olav

    2012-01-05

    Early intramedullary nailing (IMN) of long bone fractures in severely injured patients has been evaluated as beneficial, but has also been associated with increased inflammation, multi organ failure (MOF) and morbidity. This study was initiated to evaluate the impact of primary femoral IMN on coagulation-, fibrinolysis-, inflammatory- and cardiopulmonary responses in polytraumatized patients. Twelve adult polytraumatized patients with femoral shaft fractures were included. Serial blood samples were collected to evaluate coagulation-, fibrinolytic-, and cytokine activation in arterial blood. A flow-directed pulmonary artery (PA) catheter was inserted prior to IMN. Cardiopulmonary function parameters were recorded peri- and postoperatively. The clinical course of the patients and complications were monitored and recorded daily. Mean Injury Severity Score (ISS) was 31 ± 2.6. No procedure-related effect of the primary IMN on coagulation- and fibrinolysis activation was evident. Tumor necrosis factor alpha (TNF-α) increased significantly from 6 hours post procedure to peak levels on the third postoperative day. Interleukin-6 (IL-6) increased from the first to the third postoperative day. Interleukin-10 (IL-10) peaked on the first postoperative day. A procedure-related transient hemodynamic response was observed on indexed pulmonary vascular resistance (PVRI) two hours post procedure. 11/12 patients developed systemic inflammatory response syndrome (SIRS), 7/12 pneumonia, 3/12 acute lung injury (ALI), 3/12 adult respiratory distress syndrome (ARDS), 3/12 sepsis, 0/12 wound infection. In the polytraumatized patients with femoral shaft fractures operated with primary IMN we observed a substantial response related to the initial trauma. We could not demonstrate any major additional IMN-related impact on the inflammatory responses or on the cardiopulmonary function parameters. These results have to be interpreted carefully due to the relatively few patients included

  16. Intramedullary nailing of femoral shaft fractures in polytraumatized patients. a longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses

    PubMed Central

    2012-01-01

    Background Early intramedullary nailing (IMN) of long bone fractures in severely injured patients has been evaluated as beneficial, but has also been associated with increased inflammation, multi organ failure (MOF) and morbidity. This study was initiated to evaluate the impact of primary femoral IMN on coagulation-, fibrinolysis-, inflammatory- and cardiopulmonary responses in polytraumatized patients. Methods Twelve adult polytraumatized patients with femoral shaft fractures were included. Serial blood samples were collected to evaluate coagulation-, fibrinolytic-, and cytokine activation in arterial blood. A flow-directed pulmonary artery (PA) catheter was inserted prior to IMN. Cardiopulmonary function parameters were recorded peri- and postoperatively. The clinical course of the patients and complications were monitored and recorded daily. Results Mean Injury Severity Score (ISS) was 31 ± 2.6. No procedure-related effect of the primary IMN on coagulation- and fibrinolysis activation was evident. Tumor necrosis factor alpha (TNF-α) increased significantly from 6 hours post procedure to peak levels on the third postoperative day. Interleukin-6 (IL-6) increased from the first to the third postoperative day. Interleukin-10 (IL-10) peaked on the first postoperative day. A procedure-related transient hemodynamic response was observed on indexed pulmonary vascular resistance (PVRI) two hours post procedure. 11/12 patients developed systemic inflammatory response syndrome (SIRS), 7/12 pneumonia, 3/12 acute lung injury (ALI), 3/12 adult respiratory distress syndrome (ARDS), 3/12 sepsis, 0/12 wound infection. Conclusion In the polytraumatized patients with femoral shaft fractures operated with primary IMN we observed a substantial response related to the initial trauma. We could not demonstrate any major additional IMN-related impact on the inflammatory responses or on the cardiopulmonary function parameters. These results have to be interpreted carefully due to the

  17. Prediction of incident hip fracture by femoral neck bone mineral density and neck-shaft angle: a 5-year longitudinal study in post-menopausal females.

    PubMed

    Gnudi, S; Sitta, E; Pignotti, E

    2012-08-01

    To compare hip fracture incidence in post-menopausal females who were differently stratified for the fracture risk according to bone mineral density and proximal femur geometry. In a 5 year follow-up study, the hip fracture incidence in 729 post-menopausal females (45 of whom suffered from incident hip fracture) was assessed and compared. Forward logistic regression was used to select independent predictors of hip fracture risk, including age, age at menopause, height, weight, femoral neck bone mineral density (FNBMD), neck-shaft angle (NSA), hip axis length, femoral neck diameter and femoral shaft diameter as covariates. Fracture incidence was then calculated for the categories of young/old age, high/low FNBMD and wide/narrow NSA, which were obtained by dichotomising each hip fracture independent predictor at the value best separating females with and without a hip fracture. The hip fracture incidence of the whole cohort was significantly higher in females with a wide NSA (8.52%) than in those with a narrow NSA (3.51%). The combination of wide NSA and low FNBMD had the highest hip fracture incidence in the whole cohort (17.61%) and each age category. The combinations of narrow/wide NSA with low/high FNBMD, respectively, gave a significantly higher fracture incidence in older than in younger women, whereas women with a combined wide NSA and low FNBMD had no significantly different fracture incidence in young (14.60%) or old age (21.62%). Our study showed that NSA is effective at predicting the hip fracture risk and that the detection in early post-menopause of a wide NSA together with a low FNBMD should identify females at high probability of incident hip fracture.

  18. Prediction of incident hip fracture by femoral neck bone mineral density and neck–shaft angle: a 5-year longitudinal study in post-menopausal females

    PubMed Central

    Gnudi, S; Sitta, E; Pignotti, E

    2012-01-01

    Objective To compare hip fracture incidence in post-menopausal females who were differently stratified for the fracture risk according to bone mineral density and proximal femur geometry. Methods In a 5 year follow-up study, the hip fracture incidence in 729 post-menopausal females (45 of whom suffered from incident hip fracture) was assessed and compared. Forward logistic regression was used to select independent predictors of hip fracture risk, including age, age at menopause, height, weight, femoral neck bone mineral density (FNBMD), neck–shaft angle (NSA), hip axis length, femoral neck diameter and femoral shaft diameter as covariates. Fracture incidence was then calculated for the categories of young/old age, high/low FNBMD and wide/narrow NSA, which were obtained by dichotomising each hip fracture independent predictor at the value best separating females with and without a hip fracture. Results The hip fracture incidence of the whole cohort was significantly higher in females with a wide NSA (8.52%) than in those with a narrow NSA (3.51%). The combination of wide NSA and low FNBMD had the highest hip fracture incidence in the whole cohort (17.61%) and each age category. The combinations of narrow/wide NSA with low/high FNBMD, respectively, gave a significantly higher fracture incidence in older than in younger women, whereas women with a combined wide NSA and low FNBMD had no significantly different fracture incidence in young (14.60%) or old age (21.62%). Conclusion Our study showed that NSA is effective at predicting the hip fracture risk and that the detection in early post-menopause of a wide NSA together with a low FNBMD should identify females at high probability of incident hip fracture. PMID:22096224

  19. The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture: A retrospective case-control study.

    PubMed

    Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

    2016-08-01

    The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery.We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey.At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group.In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate.

  20. Retrograde femoral interlocking nail in complex fractures.

    PubMed

    Anup, Khare; Mehra, M M

    2002-06-01

    Retrograde interlocking nail was used as the method of fixation in 35 different cases of combination of complex femoral fractures. We performed this procedure in fractures of femoral shaft associated with fracture neck femur, pathological fractures of proximal third of femur with trochanteric pathology, ipsilateral fracture of femur and tibia in polytrauma cases with multiple other injuries, in highly obese patients with fracture shaft femur. This technique was also used in cases of pregnancy with fracture shaft femur and in unstable pelvic fracture or dislocation hip associated with fracture shaft femur. Operative technique involved with retrograde insertion of un-reamed, non-cannulated custom made nail through entrance portal in intercondylar notch was applied for fixation of the shaft femur fracture. The other associated fracture around hip was stabilized separately using suitable implant according to type of fracture. In cases of ipsilateral fracture of femur and tibia, femur was stabilized by retrograde interlocking nail and tibia was stabilized by antigrade interlocking nail through same incision at the same sitting. The case was followed up for three years; the average union time was 12 to 18 weeks. Out of 35 cases, 31 cases regained full knee movement. Out of the remaining 4 cases, 2 cases could regain up to 90 degrees of movement, these were old fractures and non-cooperative patients. In one case, patellofemoral arthritis was developed because of an operative error where a nail was not put inside the articular surface. Mal-union was observed in an early case of the series and implant failure was nil. Retrograde interlocking nail was used as the method of fixation in complex fracture problems. Multiple fractures of long bones can be stabilized in one stage, preventing multiple operations at different stages in polytraumatized patients. This resulted in early recovery, lesser hospital stay, and early rehabilitation of patient with good results and is

  1. Severe hypoplasia of the right femur, ipsilateral agenesia of the fibula and twisted right foot in a 24-week-old fetus with proximal femoral focal deficiency (PFFD).

    PubMed

    La Torre, R; Mastrone, M; Coacci, F; Labi, L; Palma, E; Di Giusto, M; Patella, A; Cosmi, E V

    2003-01-01

    A case of a 24-week-old fetus of non consanguineous parents with an ultrasonographic diagnosis of a short right femur, ipsilateral agenesia of the fibula and a twisted right foot is described. Cordocentesis revealed a normal 46XY karyotype. The parents were informed on treatment options and after psychological counselling they decided to undergo an abortion. Post mortem examination confirmed the diagnosis of a severe right limb malformation.

  2. Socioeconomic Factors Are Associated With Trends in Treatment of Pediatric Femoral Shaft Fractures, and Subsequent Implant Removal in New York State.

    PubMed

    Dodwell, Emily; Wright, James; Widmann, Roger; Edobor-Osula, Flo; Pan, Ting-Jung; Lyman, Stephen

    2016-01-01

    Disparities exist in access to outpatient pediatric orthopaedic care. The purpose of this study was to assess whether disparities also exist in elective pediatric orthopaedic surgical procedures such as implant removal, and to determine which demographic and socioeconomic factors may be associated with differences in treatment. Children aged 7 to 18 inclusive who sustained femoral shaft fractures between the years 1997 and 2010 were identified in the New York State SPARCS database. Patient age, sex, race/ethnicity, insurance status, education, and poverty were identified. Factors associated with the method of fracture treatment were assessed through multivariate regression analysis. The subset of patients that received internal fixation were followed up until 2011 inclusive for implant removal. Factors associated with implant removal were assessed using a Cox proportional hazards survival analysis (time to implant removal). Of the 3220 closed femoral shaft fractures identified, 2609 (81%) were treated with internal fixation, 9 (0.3%) had open treatment without implants, 203 (6.3%) were treated with external fixation, and 399 (12.4%) with closed methods. Patients with No Fault/Accident insurance by No Fault/Accident insurance were more likely to undergo internal fixation compared with patients with private insurance (P<0.001). Of the 3220 patients, 2572 were included in the implant removal subanalysis. Implant removal was performed in 725 (28.2%) patients. In the multivariate model, patients were more likely to undergo removal if they were younger (P<0.001), white [vs. black (P<0.001), vs. Hispanic (P=0.035), vs. other (P=0.001)], and lived in neighborhoods with less poverty (P=0.016). Insurance status was not a statistically significant predictor of implant removal. There is an association between implant removal and younger age, white race, and higher socioeconomic status in children. Awareness of these disparities should prompt further evaluation of causation

  3. The remodeling of the neck-shaft angle after proximal femoral varus osteotomy for the treatment of Legg-Calve-Perthes syndrome.

    PubMed

    Chiarapattanakom, Pariyut; Thanacharoenpanich, Songkiat; Pakpianpairoj, Charoenchai; Liupolvanish, Prasert

    2012-10-01

    To study the corrections of the neck-shaft angle (NSA) and the related clinical symptoms after proximal femoral varus osteotomy (PFVO) for the treatment of Legg-Calve-Perthes syndrome (LCPS). Retrospective cohort study. Consecutive cases of LCPS treated at Lerdsin General Hospital during 1999 to 2010 were reviewed. The patients were excluded if they had less than 3 years of follow-up, there was incomplete data, and bilateral involvement. Demographic data and clinical symptoms were collected. The NSA were measured before and after PFVO. Twenty-two patients were treated by PFVO. The mean pre-operative NSA was 140 degrees. The mean varus angle created by PFVO was 20 degrees. The mean post-operative NSA at 6 weeks, 6 months, 1 year, 2 years and 3 years were 119, 119, 118, 120 and 120 degrees respectively. No statistical difference between the mean NSA at 6 weeks and 3 years (p = 0.65). There were 9 patients whose NSA increased more than 5 degrees at 3 years after operation. This group of patients had a more varus angulation at the early post-operative period. No physeal arrest was detected in any cases at 3 years after PFVO. No correlation between the NSA and pain or limitation of the hip abduction were observed. There were 3 patients, who had NSA less than 110 degrees after PFVO, had limping gait. It is difficult to predict the degree of remodeling of an individual hip after proximal femoral varus osteotomy. Special attention should be paid to avoid excessive varus of the proximal femur less than 110 degrees whenever PFVO is performed.

  4. Biomechanical assessment of composite versus metallic intramedullary nailing system in femoral shaft fractures: A finite element study.

    PubMed

    Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

    2014-08-01

    Intramedullary nails are the primary choice for treating long bone fractures. However, complications following nail surgery including non-union, delayed union, and fracture of the bone or the implant still exist. Reducing nail stiffness while still maintaining sufficient stability seems to be the ideal solution to overcome the abovementioned complications. In this study, a new hybrid concept for nails made of carbon fibers/flax/epoxy was developed in order to reduce stress shielding. The mechanical performance of this new implant in terms of fracture stability and load sharing was assessed using a comprehensive non-linear FE model. This model considers several mechanical factors in nine fracture configurations at immediately post-operative, and in the healed bone stages. Post-operative results showed that the hybrid composite nail increases the average normal force at the fracture site by 319.23N (P<0.05), and the mean stress in the vicinity of fracture by 2.11MPa (P<0.05) at 45% gait cycle, while only 0.33mm and 0.39mm (P<0.05) increases in the fracture opening and the fragments' shear movement were observed. The healed bone results revealed that implantation of the titanium nail caused 20.2% reduction in bone stiffness, while the composite nail lowered the stiffness by 11.8% as compared to an intact femur. Our results suggest that the composite nail can provide a preferred mechanical environment for healing, particularly in transverse shaft fractures. This may help bioengineers better understand the biomechanics of fracture healing, and aid in the design of effective implants. Copyright © 2014. Published by Elsevier Ltd.

  5. Shared Human-Chimpanzee Pattern of Perinatal Femoral Shaft Morphology and Its Implications for the Evolution of Hominin Locomotor Adaptations

    PubMed Central

    Morimoto, Naoki; Zollikofer, Christoph P. E.; Ponce de León, Marcia S.

    2012-01-01

    Background Acquisition of bipedality is a hallmark of human evolution. How bipedality evolved from great ape-like locomotor behaviors, however, is still highly debated. This is mainly because it is difficult to infer locomotor function, and even more so locomotor kinematics, from fossil hominin long bones. Structure-function relationships are complex, as long bone morphology reflects phyletic history, developmental programs, and loading history during an individual’s lifetime. Here we discriminate between these factors by investigating the morphology of long bones in fetal and neonate great apes and humans, before the onset of locomotion. Methodology/Principal Findings Comparative morphometric analysis of the femoral diaphysis indicates that its morphology reflects phyletic relationships between hominoid taxa to a greater extent than taxon-specific locomotor adaptations. Diaphyseal morphology in humans and chimpanzees exhibits several shared-derived features, despite substantial differences in locomotor adaptations. Orangutan and gorilla morphologies are largely similar, and likely represent the primitive hominoid state. Conclusions/Significance These findings are compatible with two possible evolutionary scenarios. Diaphyseal morphology may reflect retained adaptive traits of ancestral taxa, hence human-chimpanzee shared-derived features may be indicative of the locomotor behavior of our last common ancestor. Alternatively, diaphyseal morphology might reflect evolution by genetic drift (neutral evolution) rather than selection, and might thus be more informative about phyletic relationships between taxa than about locomotor adaptations. Both scenarios are consistent with the hypothesis that knuckle-walking in chimpanzees and gorillas resulted from convergent evolution, and that the evolution of human bipedality is unrelated to extant great ape locomotor specializations. PMID:22848680

  6. Do we really know our patient population in database research? A comparison of the femoral shaft fracture patient populations in three commonly used national databases.

    PubMed

    Samuel, A M; Lukasiewicz, A M; Webb, M L; Bohl, D D; Basques, B A; Varthi, A G; Leslie, M P; Grauer, J N

    2016-03-01

    While use of large national clinical databases for orthopaedic trauma research has increased dramatically, there has been little study of the differences in populations contained therein. In this study we aimed to compare populations of patients with femoral shaft fractures across three commonly used national databases, specifically with regard to age and comorbidities. Patients were identified in the Nationwide Inpatient Sample (NIS), National Surgical Quality Improvement Program (NSQIP) and National Trauma Data Bank (NTDB). The distributions of age and Charleston comorbidity index (CCI) reflected a predominantly older population with more comorbidities in NSQIP (mean age 71.5; sd 15.6), mean CCI 4.9; sd 1.9) than in the NTDB (mean age 45.2; sd 21.4), mean CCI = 2.1; sd 2.0). Bimodal distributions in the NIS population showed a more mixed population (mean age 56.9; sd 24.9), mean CCI 3.2; sd 2.3). Differences in age and CCI were all statistically significant (p < 0.001). While these databases have been commonly used for orthopaedic trauma research, differences in the populations they represent are not always readily apparent. Care must be taken to understand fully these differences before performing or evaluating database research, as the outcomes they detail can only be analysed in context. Researchers and those evaluating research should be aware that orthopaedic trauma populations contained in commonly studied national databases may differ substantially based on sampling methods and inclusion criteria. ©2016 The British Editorial Society of Bone & Joint Surgery.

  7. Applying low-intensity pulsed ultrasounds (LIPUS) to a zoledronate-associated atypical femoral shaft fracture without cessation of zoledronate therapy for 3 years follow up: a case report

    PubMed Central

    Arakawa, Shoutaro; Saito, Mitsuru; Kubota, Makoto; Suzuki, Hidehiko; Tsuchida, Shigeki; Hashimoto, Kurando; Marumo, Keishi

    2015-01-01

    Summary Reports are increasing regarding atypical femoral fractures (AFFs) caused by minor trauma in patients using bisphosphonates (BPs) for long periods. Patients with malignant skeletal metastases potentially are at greater risk for these AFFs, especially considering the high dose and the duration of treatment with BPs. We evaluated a case of atypical femoral shaft fracture treated with an intramedullary nail in a patient treated for five years with zoledronate who had breast cancer with metastases to bone. Although bone union was achieved without cessation of zoledronate therapy by applying low-intensity pulsed ultrasounds (LIPUS), the remodeling phase of the fracture healing process was delayed. For BPs-associated AFFs, LIPUS is an alternative to parathyroid hormone (PTH) analogs such as teriparatide that are contraindicated in patients with malignant skeletal metastases. LIPUS is an effective treatment for fracture healing and may avoid the necessity to discontinue BP therapy. PMID:26811711

  8. Risk of hip, subtrochanteric, and femoral shaft fractures among mid and long term users of alendronate: nationwide cohort and nested case-control study

    PubMed Central

    Abrahamsen, Bo; Eiken, Pia; Eastell, Richard

    2016-01-01

    Objectives To determine the skeletal safety and efficacy of long term (≥10 years) alendronate use in patients with osteoporosis. Design Open register based cohort study containing two nested case control studies. Setting Nationwide study of population of Denmark. Participants 61 990 men and women aged 50-94 at the start of treatment, who had not previously taken alendronate, 1996-2007. Interventions Treatment with alendronate. Main outcome measures Incident fracture of the subtrochanteric femur or femoral shaft (ST/FS) or the hip. Non-fracture controls from the cohort were matched to fracture cases by sex, year of birth, and year of initiation of alendronate treatment. Conditional logistic regression models were fitted to calculate odds ratios with and without adjustment for comorbidity and comedications. Sensitivity analyses investigated subsequent treatment with other drugs for osteoporosis. Results 1428 participants sustained a ST/FS (incidence rate 3.4/1000 person years, 95% confidence interval 3.2 to 3.6), and 6784 sustained a hip fracture (16.2/1000 person years, 15.8 to 16.6). The risk of ST/FS was lower with high adherence to treatment with alendronate (medication possession ratio (MPR, a proxy for compliance) >80%) compared with poor adherence (MPR <50%; odds ratio 0.88, 0.77 to 0.99; P=0.05). Multivariable adjustment attenuated this association (adjusted odds ratio 0.88, 0.77 to 1.01; P=0.08). The risk was no higher in long term users (≥10 dose years; 0.70, 0.44 to 1.11; P=0.13) or in current compared with past users (0.91, 0.79 to 1.06; P=0.22). Similarly, MPR >80% was associated with a decreased risk of hip fracture (0.73, 0.68 to 0.78; P<0.001) as was longer term cumulative use for 5-10 dose years (0.74, 0.67 to 0.83; P<0.001) or ≥10 dose years (0.74, 0.56 to 0.97; P=0.03). Conclusions These findings support an acceptable balance between benefit and risk with treatment with alendronate in terms of fracture outcomes, even for over 10

  9. Shaft adjuster

    DOEpatents

    Harry, H.H.

    1988-03-11

    Abstract and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus. 3 figs.

  10. Shaft adjuster

    DOEpatents

    Harry, Herbert H.

    1989-01-01

    Apparatus and method for the adjustment and alignment of shafts in high power devices. A plurality of adjacent rotatable angled cylinders are positioned between a base and the shaft to be aligned which when rotated introduce an axial offset. The apparatus is electrically conductive and constructed of a structurally rigid material. The angled cylinders allow the shaft such as the center conductor in a pulse line machine to be offset in any desired alignment position within the range of the apparatus.

  11. Posterolateral elbow dislocation with ipsilateral radial and ulnar diaphyseal fractures: a case report.

    PubMed

    Kose, O; Durakbasa, M O; Islam, N C

    2008-04-01

    Elbow dislocation associated with both ipsilateral radial and ulnar shaft fractures is a rare pattern of injury, although it is common for elbow dislocation and forearm fractures to occur separately. We report a case of an 80-year-old woman who had a posterolateral elbow dislocation and ipsilateral radial and ulnar shaft fractures and underwent closed reduction and plate fixation. She had an excellent outcome after 22 months of follow-up.

  12. Shaft balancing

    DOEpatents

    Irwin, John A.

    1979-01-01

    A gas turbine engine has an internal drive shaft including one end connected to a driven load and an opposite end connected to a turbine wheel and wherein the shaft has an in situ adjustable balance system near the critical center of a bearing span for the shaft including two 360.degree. rings piloted on the outer diameter of the shaft at a point accessible through an internal engine panel; each of the rings has a small amount of material removed from its periphery whereby both of the rings are precisely unbalanced an equivalent amount; the rings are locked circumferentially together by radial serrations thereon; numbered tangs on the outside diameter of each ring identify the circumferential location of unbalance once the rings are locked together; an aft ring of the pair of rings has a spline on its inside diameter that mates with a like spline on the shaft to lock the entire assembly together.

  13. Antegrade versus retrograde nailing techniques and trochanteric versus piriformis intramedullary nailing entry points for femoral shaft fractures: a systematic review and meta-analysis

    PubMed Central

    Hussain, Nasir; Hussain, Farrah Naz; Sermer, Corey; Kamdar, Hera; Schemitsch, Emil H.; Sternheim, Amir; Kuzyk, Paul

    2017-01-01

    Background There are several different techniques commonly used to perform intramedullary (IM) nailing of the femur to fix femoral fractures. We sought to identify significant differences in outcomes of studies comparing 1) trochanteric and piriformis entry and 2) antegrade and retrograde entry in IM nailing of the femur. Methods We searched MEDLINE, Cochrane and Embase databases and the Orthopaedic Trauma Association and American Academy of Orthopaedic Surgeons websites for comparative studies published from inception to November 2015. Criteria used to select articles for detailed review included use of antegrade and retrograde entry point or use of trochanteric and piriformis entry point for IM nailing of the femur in adult patients. Functional and technical outcomes were extracted from accepted studies. Results We identified 483 potential studies, of which 52 were eligible. Of these, we included 13 publications and 2 abstracts (2 level I, 7 level II and 6 level III studies). Trochanteric entry significantly reduced operative duration by 14 min compared with piriformis entry (p = 0.030). Retrograde nailing had a greater risk of postoperative knee pain than antegrade nailing (p = 0.05). On the other hand, antegrade nailing had significantly more postoperative hip pain (p = 0.003) and heterotopic ossification (p < 0.001) than retrograde nailing. No significant differences in functional outcomes were observed. Conclusion Although some significant differences were found, the varying quality of studies made recommendation difficult. Our meta-analysis did not confirm superiority of either antegrade over retrograde or trochanteric over piriformis entry for IM nailing of the femur. Level of evidence Level III therapeutic. PMID:28234586

  14. Femoral bowing plane adaptation to femoral anteversion

    PubMed Central

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Background: Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21–84 years). Results: The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78–102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P < 0.001; r = 0.680 and r = −0.682, respectively). Combined correlation is perfect (R2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning

  15. Acute thigh compartment syndrome post femoral vein catheterization: a case report.

    PubMed

    Asplund, Mark W

    2008-08-01

    This case report presents a previously unreported etiology of acute thigh compartment syndrome following ipsilateral femoral vein catheterization, including clinical results and a brief review of the literature.

  16. Tissue sparing total femoral arthroplasty: technical note.

    PubMed

    Willimon, Samuel Clifton; Bolognesi, Michael P; Attarian, David E

    2011-01-01

    It is predicted that the number of revision hip and knee arthroplasties will double by the years 2026 and 2015, respectively. As the burden of end-stage prosthetic disease increases, there will be a greater potential need for total femoral arthroplasty. This report describes a patient with a femoral neck fracture nonunion with an ipsilateral multiply revised failed total knee arthroplasty treated by a tissue sparing total femoral arthroplasty. The technique is described, and potential benefits are reviewed.

  17. Difference in the trajectory of change in bone geometry as measured by hip structural analysis in the narrow neck, intertrochanteric region, and femoral shaft between men and women following hip fracture.

    PubMed

    Rathbun, Alan M; Shardell, Michelle; Orwig, Denise; Hebel, J Richard; Hicks, Gregory E; Beck, Thomas J; Magaziner, Jay; Hochberg, Marc C

    2016-11-01

    Prior studies have shown that women have declines in bone structure and strength after hip fracture, but it is unclear whether men sustain similar changes. Therefore, the objective was to examine sex differences in proximal femur geometry following hip fracture. Hip structural analysis was used to derive metrics of bone structure and strength: aerial bone mineral density, cross-sectional bone area (CSA), cortical outer diameter, section modulus (SM), and buckling ratio (BR) from dual-energy x-ray absorptiometry scans performed at baseline (within 22days of hospital admission), two, six, or twelve months after hip fracture in men and women (n=282) enrolled in the Baltimore Hip Studies 7th cohort. Weighted estimating equations were used to evaluate sex differences at the narrow neck (NN), intertrochanteric (IT), and femoral shaft (FS). Men had significantly different one year NN changes compared to women in CSA: -6.33% (-12.47, -0.20) vs. 1.37% (-3.31, 6.43), P=0.049; SM: -4.98% (-11.08, 1.10) vs. 3.94% (-2.51, 10.42), P=0.042; and BR: 7.50% (0.65, 14.36) vs. -1.20% (-6.41, 4.00), P=0.044. One year IT changes displayed similar patterns, but the sex differences were not statistically significant for CSA: -4.07% (-10.83, 2.67) vs. 0.41% (-3.41, 4.24), P=0.252; SM: -4.78% (-12.10, 5.53) vs. -0.31 (-4.74, 4.11), P=0.287; and BR: 4.59% (-0.65, 9.84) vs. 1.52% (-4.23, 7.28), P=0.425. Differences in FS geometric parameters were even smaller in magnitude and not significantly different by sex. Women generally experienced non-significant increases in bone tissue and strength following hip fracture, while men had structural declines that were statistically greater at the NN region. Reductions in the mechanical strength of the proximal femur after hip fracture could put men at higher risk for subsequent fractures of the contralateral hip. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Posterior dislocation of hip with ipsilateral intertrochanteric fracture: A report of two cases

    PubMed Central

    Ul Haq, Rehan; Kumar, Jaswant; Dhammi, IK; Jain, Anil K

    2016-01-01

    Posterior dislocations of the hip are known to be associated with fractures of the femoral head, neck, shaft, or posterior acetabular wall. However, its association with ipsilateral intertrochanteric fracture has only been anecdotally described in the English literature. We report two such cases managed by open reduction (OR) of the hip and internal fixation (IF) of the intertrochanteric fracture. The first case was a 26-year-old male who was managed by OR of the hip with IF of the intertrochanteric fracture with a dynamic hip screw and had a good functional result at 1-year followup. The second case was a 36-year-old female who was also managed by OR of the hip with IF of the head fragments with Herbert screw and IF of the intertrochanteric fracture with a dynamic condylar screw. The patient had a fair, functional result at 1-year followup. With the increase in high energy trauma, these fracture patterns have become more common, and there is an urgent need to review the existing classifications so that these fractures are better categorized, and treatment guidelines defined. PMID:27746503

  19. Shaft Adapter For Data Coupler

    NASA Technical Reports Server (NTRS)

    Elliott, James R.; Lord, Mark T.

    1990-01-01

    Shaft adapter developed to provide means for securing Acurex 1200B universal data coupler to rotating instrumented shaft. Consists of two major parts: shaft sleeve and shaft clamp. Provides for accurate measurements of stresses and strains in shaft.

  20. Shaft speed control

    NASA Technical Reports Server (NTRS)

    Ford, A. G.

    1979-01-01

    Simple mechanism controls rotation of heavy-duty shaft by mechanical comparison with rotation of small, precise, stepper motor. Mechanism can be used to limit winding and unwinding speeds of large spools and reels and to control speed of other rotating shafts. Setup incorporates reference shaft geared down from stepper motor and feedback shaft geared up from shaft to be controlled. Feedback and reference shafts are coupled with brake assembly inside stationary cylinder. When work shaft speeds up, brakes are activated automatically to slow it down.

  1. Shaft-Rotation Detector

    NASA Technical Reports Server (NTRS)

    Randall, Richard L.

    1990-01-01

    Signal-processing subsystem generates signal indicative of rotation of shaft from output of accelerometer mounted on housing of bearing supporting shaft. Output of subsystem binary signal at frequency of rotation of shaft. Part of assembly of electronic equipment measuring vibrations in rotating machinery. Accelerometer mounted in such way sensitive to vibrations of shaft perpendicular to axis. Output of accelerometer includes noise and components of vibration at frequencies higher than rotational frequency of shaft.

  2. Blind shaft development

    SciTech Connect

    Fiscor, S.

    2009-02-15

    The article discusses how Shaft Drillers International (SDI) is breaking new ground in shaft development and ground stabilization. Techniques of blind shaft drilling and raise bore shaft development developed by SDI are briefly explained. An associated company, Coastal Drilling East, deals with all types of ground improvement such as pre-grouting work for shafts, grouting of poor soil and water leaks into the mine. 3 photos.

  3. Endovascular Treatment of a Ruptured Profunda Femoral Artery Branch After Fogarty Thrombectomy of a Femoro-Femoral Crossover Arterial Graft: A Case Report and Review of the Literature

    SciTech Connect

    Manousaki, Eirini; Tsetis, Dimitrios; Kostas, Theodoros; Katsamouris, Asterios

    2010-02-15

    We present a very rare case of a life-threatening rupture of a profunda femoral artery distal branch after a Fogarty thrombectomy of a thrombosed crossover synthetic graft between the ipsilateral common femoral artery and a contralateral iliac-popliteal graft; the bleeding profunda femoral artery branch was successfully embolized with metallic coils through the axillary artery approach.

  4. Bent shaft motor

    DOEpatents

    Benavides, Gilbert L.

    1998-01-01

    A nonelectromagnetic motor comprising a base, a bent shaft which is rotable relative to the base wherein the bent shaft comprises a straight portion aligned with a main axis and an offset portion that is offset with respect to the main axis; and a drive means for driving the offset portion of the bent shaft along a generally circular path in a plane perpendicular to the main axis to rotate the bent shaft. The bent shaft and drive means for driving the bent shaft can be selected from piezoelectric, magnetostrictive, rheological and shape memory alloys. The drive means of the nonelectromagnetic motor can additionally comprise a shell which shell surrounds and houses the bent shaft and precesses or gyrates which in turn causes the bent drive shaft to rotate. The nonelectromagnetic motor does not rely on friction for the application of torque upon a rotor.

  5. Bent shaft motor

    DOEpatents

    Benavides, G.L.

    1998-05-05

    A nonelectromagnetic motor comprising a base, a bent shaft which is rotatable relative to the base wherein the bent shaft comprises a straight portion aligned with a main axis and an offset portion that is offset with respect to the main axis; and a drive means for driving the offset portion of the bent shaft along a generally circular path in a plane perpendicular to the main axis to rotate the bent shaft. The bent shaft and drive means for driving the bent shaft can be selected from piezoelectric, magnetostrictive, rheological and shape memory alloys. The drive means of the nonelectromagnetic motor can additionally comprise a shell which shell surrounds and houses the bent shaft and precesses or gyrates which in turn causes the bent drive shaft to rotate. The nonelectromagnetic motor does not rely on friction for the application of torque upon a rotor. 11 figs.

  6. [The effect of verticalization of the resulting force (R) of weight bearing in the hip joint on morphologic characteristics of the medullary canal in the femoral shaft in patients with coxarthrosis].

    PubMed

    Jovanović, S

    1992-01-01

    An influence of verticalization of the resulting force of weight-bearing on the hip joint "R" on the morphological characteristics of the medullar canal on the proximal edge of the shaft of femur was researched. Progressive degenerative changes of the hip joint with a consequent sideways limping or changes of the collodiaphysial angle (ccd angle) were the cause of the verticalization of the resulting force "R". The analysis of patients treated and operated on The Orthopaedic Department of the General Hospital Osijek and The Orthopaedic Clinic of The Medical Faculty of The University of Zagreb. The research, undoubtedly, proved that the patients with coxarthrosis and side-ways in the hip or with changed collodiaphysial angle experienced verticalization of the resulting force of weigh-bearing of the hip joint and the proximal edge of femur which caused morphological changes of the medular canal of the shaft of femur.

  7. SEAL FOR ROTATING SHAFT

    DOEpatents

    Coffman, R.T.

    1957-12-10

    A seal is described for a rotatable shaft that must highly effective when the shaft is not rotating but may be less effective while the shaft is rotating. Weights distributed about a sealing disk secured to the shaft press the sealing disk against a tubular section into which the shiilt extends, and whem the shaft rotates, the centrifugal forces on the weights relieve the pressurc of the sealing disk against the tubular section. This action has the very desirible result of minimizing the wear of the rotating disk due to contact with the tubular section, while affording maximum sealing action when it is needed.

  8. Turbine shaft fuel pump

    SciTech Connect

    Smith, R.

    1991-08-27

    This patent describes a turbine engine having a support housing, a shaft rotatably mounted in the support housing, an annular combustion chamber coaxial with the shaft and the support housing, the shaft having an axial passageway, injector nozzles aligned for discharging fuel into the combustion chamber, and means for pumping and metering a supply of fuel to the injector nozzles, the pumping and metering means. It comprises a flow passageway extending from a first end of the shaft axial passageway and to the injector nozzles the flow passageway comprising an annular chamber formed between two axially spaced and radially inwardly extending walls in the shaft, the annular chamber is open to the axial passageway while a periphery of the annular chamber is open to the injector nozzles, and pumping vanes disposed in the annular chamber, the vanes being secured to the shaft so that, upon rotation of the shaft, the vanes provided pressurized fuel from the passageway to the injectors.

  9. 118. #3 SHAFT ALLEY (PROPELLER SHAFT) FORWARD LOOKING AFT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    118. #3 SHAFT ALLEY (PROPELLER SHAFT) - FORWARD LOOKING AFT ON PORT SIDE SHOWING THE SHAFT, SHAFT PACKING GLAND, SHAFT SEAL COOLING WATER LINE AND FIVE INCH FIRE MAIN PIPING. - U.S.S. HORNET, Puget Sound Naval Shipyard, Sinclair Inlet, Bremerton, Kitsap County, WA

  10. Amputated limb by cerclage wire of femoral diaphyseal fracture: a case report.

    PubMed

    Won, Yougun; Yang, Kyu-Hyun; Kim, Kwang-Kyoun; Weaver, M J; Allen, Elizabeth M

    2016-12-01

    An entrapment of the femoral artery by cerclage wiring is a rare complication after spiral diaphyseal femoral fractures. We report the case of an 82-year-old female treated by an antegrade intramedullary nailing and multiple cable augmentation, which was then complicated by injury to the femoral artery that resulted in ipsilateral leg necrosis and amputation. The entrapment was caused by direct belting by the cable and resulted in a total obstruction of the femoral artery.

  11. Designing Shafts For Long Life

    NASA Technical Reports Server (NTRS)

    Loewenthal, Stuart H.

    1988-01-01

    Improved method developed for choosing sizes of power-transmitting shafts for limited or unlimited service lives under variety of operating conditions. Stress versus fatigue life of proposed shaft design plotted, modified to account for expected operating conditions and used to calculate shaft diameter required for given fatigue life. If diameter of shaft represented by plot equals or exceeds required diameter, shaft considered adequate.

  12. Bell's palsy with ipsilateral numbness.

    PubMed

    Vanopdenbosch, L J; Verhoeven, K; Casselman, J W

    2005-07-01

    Bell's palsy is an idiopathic facial palsy of the peripheral type. A herpes virus is the most likely mechanism. We report a patient with the often encountered combination of a facial palsy with ipsilateral sensory changes. Magnetic resonance imaging showed had contrast enhancement in the greater petrosal nerve. Viral spread through anatomical connections could be an explanation for the association of facial palsy with numbness.

  13. Shaft-Motion-Analyzing System

    NASA Technical Reports Server (NTRS)

    Randall, Richard L.; Collins, John J.; Coleman, Paul T.; Roschak, Edmund J.

    1993-01-01

    Optoelectronic system to monitor motions of turbopump shaft developed. Optical sensors detect passage of reflective triangles on shaft. Optical measurements processed in real time into indications of speed of rotation and of axial and lateral displacements of shaft.

  14. Shaft-Motion-Analyzing System

    NASA Technical Reports Server (NTRS)

    Randall, Richard L.; Collins, John J.; Coleman, Paul T.; Roschak, Edmund J.

    1993-01-01

    Optoelectronic system to monitor motions of turbopump shaft developed. Optical sensors detect passage of reflective triangles on shaft. Optical measurements processed in real time into indications of speed of rotation and of axial and lateral displacements of shaft.

  15. Vertical shaft windmill

    NASA Technical Reports Server (NTRS)

    Grana, D. C.; Inge, S. V., Jr. (Inventor)

    1983-01-01

    A vertical shaft has several equally spaced blades mounted. Each blade consists of an inboard section and an outboard section skew hinged to the inboard section. The inboard sections automatically adjust their positions with respect to the fixed inboard sections with changes in velocity of the wind. This windmill design automatically governs the maximum rotational speed of shaft.

  16. Rotary shaft seal

    DOEpatents

    Langebrake, C.O.

    1984-01-01

    The invention is a novel rotary shaft seal assembly which provides positive-contact sealing when the shaft is not rotated and which operates with its sealing surfaces separated by a film of compressed ambient gas whose width is independent of the speed of shaft rotation. In a preferred embodiment, the assembly includes a disc affixed to the shaft for rotation therewith. Axially movable, non-rotatable plates respectively supported by sealing bellows are positioned on either side of the disc to be in sealing engagement therewith. Each plate carries piezoelectric transucer elements which are electrically energized at startup to produce films of compressed ambient gas between the confronting surfaces of the plates and the disc. Following shutdown of the shaft, the transducer elements are de-energized. A control circuit responds to incipient rubbing between the plate and either disc by altering the electrical input to the transducer elements to eliminate rubbing.

  17. Rotary shaft seal

    DOEpatents

    Langebrake, Clair O.

    1984-01-01

    The invention is a novel rotary shaft seal assembly which provides positive-contact sealing when the shaft is not rotated and which operates with its sealing surfaces separated by a film of compressed ambient gas whose width is independent of the speed of shaft rotation. In a preferred embodiment, the assembly includes a disc affixed to the shaft for rotation therewith. Axially movable, non-rotatable plates respectively supported by sealing bellows are positioned on either side of the disc to be in sealing engagement therewith. Each plate carries piezoelectric transducer elements which are electrically energized at startup to produce films of compressed ambient gas between the confronting surfaces of the plates and the disc. Following shutdown of the shaft, the transducer elements are de-energized. A control circuit responds to incipient rubbing between the plate and either disc by altering the electrical input to the transducer elements to eliminate rubbing.

  18. Crank shaft support assembly

    DOEpatents

    Natkin, Robert J.; Oltmans, Bret; Allison, John E.; Heater, Thomas J.; Hines, Joy Adair; Tappen, Grant K.; Peiskammer, Dietmar

    2007-10-23

    A crank shaft support assembly for increasing stiffness and reducing thermal mismatch distortion in a crank shaft bore of an engine comprising different materials. A cylinder block comprises a first material and at least two crank journal inserts are insert-molded into respective crank journal regions of the cylinder block and comprise a second material having greater stiffness and a lower thermal coefficient of expansion that the first material. At least two bearing caps are bolted to the respective crank journal inserts and define, along with the crank journal inserts, at least two crank shaft support rings defining a crank shaft bore coaxially aligned with a crank shaft axis. The bearing caps comprise a material having higher stiffness and a lower thermal coefficient of expansion than the first material and are supported on the respective crank journal inserts independently of any direct connection to the cylinder block.

  19. Cam shaft with expanded hollow shaft

    SciTech Connect

    Hughes, R.W.; Brisson, R.H.; Brisson, G.R.

    1987-09-15

    This patent describes a camshaft having lobes with irregularly shaped apertures spaced along the longitudinal axis of a hollow tubular shaft. The lobes are orientated radially and axially in predetermined positions along the hollow tubular shaft. The camshaft is characterized by the walls of the hollow shaft expanded outwardly into aperture portions in irregular engagement with the interior of the apertures of the lobes and the walls expanded outwardly radially farther into ballooned portions between adjacent lobes to create corresponding outside and inside shoulders extending between the aperture and ballooned portions. The outside shoulders are disposed immediately adjacent and abutting each side of the lobes circumferentially about the apertures therein to secure the lobes axially upon the shaft, the inside shoulders disposed directly opposite the outside shoulders to that shoulder extend annularly about each end of each of the apertures and the ballooned portions extend between shoulders at adjacent lobes, the exterior circumferences of the lobes being furnished to closer tolerances than the interior apertures and the exterior surfaces of the lobes being positioned radially relative to the longitudinal axis with the radial positions of the interior apertures being offset among adjacent lobes.

  20. Women with type 2 diabetes mellitus have lower cortical porosity of the proximal femoral shaft using low-resolution CT than nondiabetic women, and increasing glucose is associated with reduced cortical porosity.

    PubMed

    Osima, Marit; Kral, Rita; Borgen, Tove T; Høgestøl, Ingvild K; Joakimsen, Ragnar M; Eriksen, Erik F; Bjørnerem, Åshild

    2017-04-01

    Increased cortical porosity has been suggested as a possible factor increasing fracture propensity in patients with type 2 diabetes mellitus (T2DM). This is a paradox because cortical porosity is generally associated with high bone turnover, while bone turnover is reduced in patients with T2DM. We therefore wanted to test the hypothesis that women with T2DM have lower bone turnover markers (BTM) and lower cortical porosity than those without diabetes, and that higher serum glucose and body mass index (BMI) are associated with lower BTM, and with lower cortical porosity. This cross-sectional study is based on a prior nested case-control study including 443 postmenopausal women aged 54-94years from the Tromsø Study, 211 with non-vertebral fracture and 232 fracture-free controls. Of those 443 participants, 22 women exhibited T2DM and 421 women did not have diabetes. All had fasting blood samples assayed for procollagen type I N-terminal propeptide (PINP), C-terminal cross-linking telopeptide of type I collagen (CTX) and glucose, and femoral subtrochanteric architecture was quantified using low-resolution clinical CT and StrAx1.0 software. Women with T2DM had higher serum glucose (7.2 vs. 5.3mmol/L), BMI (29.0 vs. 26.4kg/m(2)), and higher femoral subtrochanteric total volumetric bone mineral density (vBMD) (783 vs. 715mgHA/cm(3)), but lower cortical porosity (40.9 vs. 42.8%) than nondiabetic women (all p<0.05). Each standard deviation (SD) increment in glucose was associated with 0.10-0.12 SD lower PINP and CTX, and 0.13 SD lower cortical porosity (all p<0.05). Each SD increment in BMI was associated with 0.10-0.18 SD lower serum PINP and CTX, and 0.19 SD thicker cortices (all p<0.05). Increasing glucose and BMI were associated with lower bone turnover suggesting that reduced intracortical and endocortical remodeling leads to reduced porosity and thicker cortices. Using low-resolution clinical CT, cortical porosity was lower in women with T2DM compared to women

  1. Fatal fat embolism following femoral head resection in total hip arthroplasty.

    PubMed

    Walker, N M; Bateson, T; Reavley, P; Prakash, D

    2008-01-01

    We report a rare complication during primary total hip arthroplasty. A fatal fat pulmonary embolism immediately followed removal of the femoral head, prior to further preparation of the acetabulum or femoral shaft. Fat embolism syndrome is a well-known complication during total joint arthroplasty, usually attributed to preparation of the femoral shaft, particularly intramedullary reaming and insertion of the prosthesis. These risk factors have previously been identified in the literature. We believe that this case highlights the need for further research to establish the intramedullary pressures during the processes of dislocation and resection of the femoral neck and the attendant risk.

  2. EPIDEMIOLOGICAL STUDY OF CHILDREN DIAPHYSEAL FEMORAL FRACTURES

    PubMed Central

    Hoffmann, Cassiano Ricardo; Traldi, Eduardo Franceschini; Posser, Alexandre

    2015-01-01

    Objective: To evaluate the personal, fracture, treatment and complication characteristics among patients with pediatric femoral shaft fractures attended at the pediatric orthopedic service of the Joana de Gusmão Children's Hospital. Methods: This was a retrospective cross-sectional study on a population consisting of patients with femoral shaft fractures, aged between birth and 14 years and 11 months, who were divided into four age groups. Information was obtained from medical records and was transferred to a survey questionnaire to present personal, fracture, treatment and complication variables. Results: The study population consisted of 96 patients. Their mean age was 6.8 years. The cases were predominantly among males, comprising closed fractures on the right side, in the middle third with a single line. Regarding fracture etiology, traffic accidents predominated overall in the sample. Most of the patients (74 to 77.1%) presented femoral fractures as their only injury. Conservative treatment predominated in the group younger than six years of age, and surgical treatment in the group aged 6 to 14 years and 11 months. The complications observed until bone union were: discrepancy, infection and movement limitation. The mean time taken for consolidation was 9.6 ± 2.4 weeks, varying with age. Conclusion: The features of these fractures were similar to those described in the literature and the treatment used showed good results. The Joana de Gusmão Children's Hospital has used the treatment proposed in the literature for pediatric femoral shaft fractures. PMID:27042619

  3. Fabricated torque shaft

    DOEpatents

    Mashey, Thomas Charles

    2002-01-01

    A fabricated torque shaft is provided that features a bolt-together design to allow vane schedule revisions with minimal hardware cost. The bolt-together design further facilitates on-site vane schedule revisions with parts that are comparatively small. The fabricated torque shaft also accommodates stage schedules that are different one from another in non-linear inter-relationships as well as non-linear schedules for a particular stage of vanes.

  4. Femoral neuropathy and meralgia paresthetica secondary to an iliacus hematoma.

    PubMed

    Yi, Tae Im; Yoon, Tae Hee; Kim, Joo Sup; Lee, Ga Eun; Kim, Bo Ra

    2012-04-01

    Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9×5×4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.

  5. Femoral Neuropathy and Meralgia Paresthetica Secondary to an Iliacus Hematoma

    PubMed Central

    Yi, Tae Im; Kim, Joo Sup; Lee, Ga Eun; Kim, Bo Ra

    2012-01-01

    Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9×5×4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence. PMID:22639754

  6. MULTIPLE SHAFT TOOL HEAD

    DOEpatents

    Colbert, H.P.

    1962-10-23

    An improved tool head arrangement is designed for the automatic expanding of a plurality of ferruled tubes simultaneously. A plurality of output shafts of a multiple spindle drill head are driven in unison by a hydraulic motor. A plurality of tube expanders are respectively coupled to the shafts through individual power train arrangements. The axial or thrust force required for the rolling operation is provided by a double acting hydraulic cylinder having a hollow through shaft with the shaft cooperating with an internally rotatable splined shaft slidably coupled to a coupling rigidly attached to the respectlve output shaft of the drill head, thereby transmitting rotary motion and axial thrust simultaneously to the tube expander. A hydraulic power unit supplies power to each of the double acting cylinders through respective two-position, four-way valves, under control of respective solenoids for each of the cylinders. The solenoids are in turn selectively controlled by a tool selection control unit which in turn is controlled by signals received from a programmed, coded tape from a tape reader. The number of expanders that are extended in a rolling operation, which may be up to 42 expanders, is determined by a predetermined program of operations depending upon the arrangement of the ferruled tubes to be expanded in the tube bundle. The tape reader also supplies dimensional information to a machine tool servo control unit for imparting selected, horizontal and/or vertical movement to the tool head assembly. (AEC)

  7. Intramedullary locking femoral nails. Experience with the AO nail.

    PubMed Central

    Fogarty, A. B.; Yeates, H. A.

    1991-01-01

    The AO interlocking nail was introduced to the Ulster Hospital, Dundonald in 1988 and since then has been used in over 50 patients with femoral shaft fractures. We have reviewed 45 patients with 46 femoral shaft fractures treated between June 1988 and April 1990. These included four compound fractures and 13 comminuted fractures. The results compare favourably with other series. The union rate was 98% and there were no instances of deep infection. The alternative treatment methods available are discussed along with a review of the relevant literature. Images Fig 3 Fig 5 PMID:1785145

  8. Parallel manipulator robot assisted femoral fracture reduction on traction table.

    PubMed

    Lin, H; Wang, J Q; Han, W

    2013-01-01

    The principle of femoral shaft fracture reduction is to restore its pre-fractured limb length and mechanical axis. The current documented treatment method with traction table reduction does not conform to the quantitative alignment and reduction. There is also a great amount of X-Ray radiation exposure to both surgeon and patient during the procedure. For this reason, we introduced an innovated Parallel Manipulator Robot (PMR) application: A Femoral Shaft Fracture Reduction with Parallel Manipulator Robot on Traction Table. With this application, the quantitative control on fracture reduction and alignment can be achieved and the radiation exposure to both surgeons and patients can be greatly reduced.

  9. Shaft Position Optical Sensor

    NASA Technical Reports Server (NTRS)

    Blumenstock, Kenneth A. (Inventor); Hakum, Claef F. (Inventor); Johnson, Clarence S. (Inventor)

    2001-01-01

    The present invention is an optical sensor that senses the movement of a shaft. Detection of radial movement is made when a portion of light incident on the shaft sensor-target is blocked. For detection of axial movement, a disk with flat surface is mounted and used to block a portion of light. The variation in the amount of light allowed to pass through is a measure of the position of the shaft. As proposed by this invention, significant improvement is made with respect to sensitivity and linearity of the system when the light is permanently partially blocked. To accomplish this goal this invention adds a boss to the system. To eliminate possible drift of system performance due to LED degradation or temperature variation, a feedback feature is added to the system.

  10. Femoral neck structure and function in early hominins.

    PubMed

    Ruff, Christopher B; Higgins, Ryan

    2013-04-01

    All early (Pliocene-Early Pleistocene) hominins exhibit some differences in proximal femoral morphology from modern humans, including a long femoral neck and a low neck-shaft angle. In addition, australopiths (Au. afarensis, Au. africanus, Au. boisei, Paranthropus boisei), but not early Homo, have an "anteroposteriorly compressed" femoral neck and a small femoral head relative to femoral shaft breadth. Superoinferior asymmetry of cortical bone in the femoral neck has been claimed to be human-like in australopiths. In this study, we measured superior and inferior cortical thicknesses at the middle and base of the femoral neck using computed tomography in six Au. africanus and two P. robustus specimens. Cortical asymmetry in the fossils is closer overall to that of modern humans than to apes, although many values are intermediate between humans and apes, or even more ape-like in the midneck. Comparisons of external femoral neck and head dimensions were carried out for a more comprehensive sample of South and East African australopiths (n = 17) and two early Homo specimens. These show that compared with modern humans, femoral neck superoinferior, but not anteroposterior breadth, is larger relative to femoral head breadth in australopiths, but not in early Homo. Both internal and external characteristics of the australopith femoral neck indicate adaptation to relatively increased superoinferior bending loads, compared with both modern humans and early Homo. These observations, and a relatively small femoral head, are consistent with a slightly altered gait pattern in australopiths, involving more lateral deviation of the body center of mass over the stance limb.

  11. Gravity in a Mine Shaft.

    ERIC Educational Resources Information Center

    Hall, Peter M.; Hall, David J.

    1995-01-01

    Discusses the effects of gravity, local density compared to the density of the earth, the mine shaft, centrifugal force, and air buoyancy on the weight of an object at the top and at the bottom of a mine shaft. (JRH)

  12. Gravity in a Mine Shaft.

    ERIC Educational Resources Information Center

    Hall, Peter M.; Hall, David J.

    1995-01-01

    Discusses the effects of gravity, local density compared to the density of the earth, the mine shaft, centrifugal force, and air buoyancy on the weight of an object at the top and at the bottom of a mine shaft. (JRH)

  13. Acoustical Measurement Of Mine-Shaft Length

    NASA Technical Reports Server (NTRS)

    Heyman, Joseph S.

    1988-01-01

    Acoustical system proposed to measure depth of a "blind" shaft. Acoustic wave guided by shaft and provides estimate of shaft length, from which volume estimated. Acoustic-generator system determines resonant-frequency difference to measure shaft length.

  14. Shaft seal system

    DOEpatents

    Kapich, Davorin D.

    1985-01-01

    A shaft seal system is disclosed for isolating two regions of different fluid mediums through which a rotatable shaft extends. The seal system includes a seal housing through which the shaft extends and which defines an annular land and an annular labyrinth both of which face on the shaft so that each establishes a corresponding fluid sealing annulus. A collection cavity is formed in communication with the annular sealing spaces, and fluids compatible with the fluids in each of the two regions to be isolated are introduced, respectively, into the annular sealing spaces and collected in the collection cavity from which the fluid mixture is removed and passed to a separator which separates the fluids and returns them to their respective annular sealing spaces in a recycling manner. In the illustrated embodiment, the isolated fluid mediums comprise a liquid region and a gas region. Gas is removed from the gas region and passed through a purifier and a gas pump operative to introduce the purified gas through the labyrinth sealing annulus to the collection cavity. After passing to the separator, the separated gas is passed through a dryer from which the dried gas is caused to pass through the labyrinth sealing annulus into the collection cavity independently of the purified gas so as to insure isolation of the gas region in the event of sealing gas pump malfunction.

  15. Polygonal shaft hole rotor

    DOEpatents

    Hussey, John H.; Rose, John Scott; Meystrik, Jeffrey J.; White, Kent Lee

    2001-01-23

    A laminated rotor for an induction motor has a plurality of ferro-magnetic laminations mounted axially on a rotor shaft. Each of the plurality of laminations has a central aperture in the shape of a polygon with sides of equal length. The laminations are alternatingly rotated 180.degree. from one another so that the straight sides of the polygon shaped apertures are misaligned. As a circular rotor shaft is press fit into a stack of laminations, the point of maximum interference occurs at the midpoints of the sides of the polygon (i.e., at the smallest radius of the central apertures of the laminations). Because the laminates are alternatingly rotated, the laminate material at the points of maximum interference yields relatively easily into the vertices (i.e., the greatest radius of the central aperture) of the polygonal central aperture of the next lamination as the shaft is inserted into the stack of laminations. Because of this yielding process, the amount of force required to insert the shaft is reduced, and a tighter fit is achieved.

  16. Geometry of proximal femur in the prediction of femoral neck fracture in the elderly female Thai population.

    PubMed

    Lektrakul, Nittaya; Ratarasarn, Onravee

    2009-09-01

    A retrospective study of two groups of 157 patients with one-sided hip fracture and 157 aged matched control group was performed in Siriraj hospital. Geometric measurement of femoral neck was performed as hip axis length (HAL), femoral neck length (FNL), femoral neck width (FNW), femoral head diameter (FHD), acetabular bone width (ABW), and femoral neck-shaft angle (NSA). All geographic parameters are higher in length/width or degree in the femoral neck fracture group than in the normal control group. Among these parameters, ABW has the strongest association with femoral neck fracture (p 0.000, odds ratio = 2.85), followed by FNW (p 0.001, odds ratio = 2.51). According to the low sensitivity and specificity, and ROC curve, using this parameter as a screening tool for femoral neck fracture is still questionable. Further prospective study with a standard position, interval changing of femoral geometry, or combined with bone density or femoral architecture is suggested.

  17. Femoral nerve dysfunction

    MedlinePlus

    Neuropathy - femoral nerve; Femoral neuropathy ... Craig EJ, Clinchot DM. Femoral neuropathy. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation . 3rd ...

  18. Dislocation of the elbow with ipsilateral forearm fracture. Six particular cases.

    PubMed

    Madhar, M; Saidi, H; Fikry, T; Cermak, K; Moungondo, F; Schuind, F

    2013-10-01

    Elbow dislocation associated with ipsilateral radial shaft fracture is an infrequent injury (nine cases reported in the literature). We present six new cases observed between 2006 and 2012, with an average age of 31 years and a mean follow-up of 18 months. The forearm fracture and ipsilateral dislocation of the elbow were probably caused by forearm hypersupination with extension of the elbow. The dislocation was reduced by manipulation before open reduction and osteosynthesis of the forearm fracture. Four elbows were stable after reduction; two markedly unstable elbows necessitated temporary humero-ulnar external fixation; one case needed a ligamentoplasty several months later. Despite the complexity of the traumatic lesion, the clinical and radiological outcomes were acceptable.

  19. Management and outcome of interprosthetic femoral fractures.

    PubMed

    Platzer, Patrick; Schuster, Rupert; Luxl, Monika; Widhalm, Harald Kurt; Eipeldauer, Stefan; Krusche-Mandl, Irena; Ostermann, Roman; Blutsch, Beate; Vécsei, Vilmos

    2011-11-01

    Interprosthetic femoral fractures following ipsilateral hip and knee arthroplasty are a rare but serious complication in clinical practice. In most cases, adequate management of these injuries might constitute a challenging problem. However, the literature provides only few data regarding the treatment and outcome of interprosthetic femoral fractures, and there are only few classifications available, which might assist in finding an appropriate treatment concept. The purpose of this study was to analyse our experience in the management of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. We reviewed the clinical and radiographic records of 23 patients (15 female and eight male, average age: 79.2 years) with an interprosthetic fracture after ipsilateral hip and knee joint replacement between 1992 and 2008. For the classification of interprosthetic femoral fractures, the fractures were divided into three types, depending on the fracture site and the adjacency to the prostheses. All patients underwent operative stabilisation, either by lateral plate fixation (n=19), by revision arthroplasty using a long stem (n=2) or by plate fixation and revision arthroplasty (n=2). Referring to the clinical outcome, 16 patients returned to their pre-injury activity level and were satisfied with their clinical outcome. In six patients, we saw a relevant decrease of hip or knee function and severe limitations in gait and activities of daily living. We had a mean Harris Hip Score (HHS) of 78.4 points, and a mean Knee injury and Osteoarthritis Outcome Score (KOOS) of 71.8 points. Relating to the radiographic outcome, successful fracture healing was achieved in 19 of 22 patients (86%) within 6 months. Failures of reduction and fixation were noted in four (18%) of 22 patients. We had a satisfactory outcome following individualised treatment of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. Compared to the rare

  20. Suprapatellar Nailing of Tibial Shaft Fractures in Total Knee Arthroplasty.

    PubMed

    Woyski, Dustin; Emerson, Jason

    2016-12-01

    Fractures of the tibial shaft in patients with ipsilateral total knee arthroplasty are rare but difficult to treat. Nonoperative treatment of these fractures with casting or bracing limits weight bearing for an extended period and can result in unacceptable malalignment. Operative fixation with plate and screws also limits early weight bearing and requires healing of soft tissue that is of poor quality. The authors present a method of internal fixation that uses a standard intramedullary tibial nail and suprapatellar instrumentation. This method can easily be performed, avoids the tibial baseplate, and does not require alteration of the instrumentation or intramedullary nail.

  1. Rotary shaft sealing assembly

    DOEpatents

    Dietle, Lannie L.; Schroeder, John E.; Kalsi, Manmohan S.; Alvarez, Patricio D.

    2010-09-21

    A rotary shaft sealing assembly in which a first fluid is partitioned from a second fluid in a housing assembly having a rotary shaft located at least partially within. In one embodiment a lip seal is lubricated and flushed with a pressure-generating seal ring preferably having an angled diverting feature. The pressure-generating seal ring and a hydrodynamic seal may be used to define a lubricant-filled region with each of the seals having hydrodynamic inlets facing the lubricant-filled region. Another aspect of the sealing assembly is having a seal to contain pressurized lubricant while withstanding high rotary speeds. Another rotary shaft sealing assembly embodiment includes a lubricant supply providing a lubricant at an elevated pressure to a region between a lip seal and a hydrodynamic seal with a flow control regulating the flow of lubricant past the lip seal. The hydrodynamic seal may include an energizer element having a modulus of elasticity greater than the modulus of elasticity of a sealing lip of the hydrodynamic seal.

  2. Rotary shaft sealing assembly

    DOEpatents

    Dietle, Lannie L; Schroeder, John E; Kalsi, Manmohan S; Alvarez, Patricio D

    2013-08-13

    A rotary shaft sealing assembly in which a first fluid is partitioned from a second fluid in a housing assembly having a rotary shaft located at least partially within. In one embodiment a lip seal is lubricated and flushed with a pressure-generating seal ring preferably having an angled diverting feature. The pressure-generating seal ring and a hydrodynamic seal may be used to define a lubricant-filled region with each of the seals having hydrodynamic inlets facing the lubricant-filled region. Another aspect of the sealing assembly is having a seal to contain pressurized lubricant while withstanding high rotary speeds. Another rotary shaft sealing assembly embodiment includes a lubricant supply providing a lubricant at an elevated pressure to a region between a lip seal and a hydrodynamic seal with a flow control regulating the flow of lubricant past the lip seal. The hydrodynamic seal may include an energizer element having a modulus of elasticity greater than the modulus of elasticity of a sealing lip of the hydrodynamic seal.

  3. Forging Long Shafts On Disks

    NASA Technical Reports Server (NTRS)

    Tilghman, Chris; Askey, William; Hopkins, Steven

    1989-01-01

    Isothermal-forging apparatus produces long shafts integral with disks. Equipment based on modification of conventional isothermal-forging equipment, required stroke cut by more than half. Enables forging of shafts as long as 48 in. (122 cm) on typical modified conventional forging press, otherwise limited to making shafts no longer than 18 in. (46cm). Removable punch, in which forged material cools after plastic deformation, essential novel feature of forging apparatus. Technology used to improve such products as components of gas turbines and turbopumps and of other shaft/disk parts for powerplants, drive trains, or static structures.

  4. Predicting shaft torque amplification

    SciTech Connect

    Achilles, R.A.

    1995-02-01

    Shaft Torque Amplification (STA) is the form of SSR characterized by the higher system-model complexity and computational requirements its simulation, normally in a time-domain environment, demands. A multi-modal approach drawing the turbogenerator torsional response to electrical torque impulses applied to the machine air-gap is introduced in this article as an alternative STA analysis frame. Peak torque results from the proposed algorithm are compared with similar ones obtained from EMTP runs. Loss-of-life calculations and a capacitor-reinsertion application as STA control means, are included.

  5. Adamantinoma of tibial shaft.

    PubMed

    A, Joshi; Kc, B R; Basnet, S B; Panth, R; Shrestha, R L; Chand, P; Thapa, B B

    2009-01-01

    Adamantinoma is an extremely rare primary bony neoplasm. Because of its malignant nature, accurate and early diagnosis is very important. On the other hand adamantinoma mimics many benign conditions, so it is doubly important to establish correct tissue diagnosis to avoid radical surgery with morbidities. Because of its rarity, diagnosing adamantinoma still remains difficult, even if when it occurs in classical sites. We report a case of adamantinoma of tibial shaft diaphysis in a 23 year male. In this case, because of classic clinic-radiological features, we were suspecting adamantinoma from very beginning but final diagnosis was delayed for nine months.

  6. Elbow dislocation with ipsilateral distal radius fracture

    PubMed Central

    Meena, Sanjay; Trikha, Vivek; Kumar, Rakesh; Saini, Pramod; Sambharia, Abhishek Kumar

    2013-01-01

    Elbow dislocation associated with ipsilateral distal radius fracture is a rare pattern of injury, although it is common for elbow dislocation and forearm fractures to occur separately. We report a rare case of a 20-year-old male who had a posterior elbow dislocation and ipsilateral distal radius fracture. Elbow dislocation was first reduced in extension and distal radius fracture was then reduced in flexion. Both the injuries were conservatively managed. At 6 months follow-up, the patient had no pain in his elbow and minimal pain in his wrist on heavy lifting and had resumed his work as a laborer. PMID:24082758

  7. Elbow dislocation with ipsilateral distal radius fracture.

    PubMed

    Meena, Sanjay; Trikha, Vivek; Kumar, Rakesh; Saini, Pramod; Sambharia, Abhishek Kumar

    2013-07-01

    Elbow dislocation associated with ipsilateral distal radius fracture is a rare pattern of injury, although it is common for elbow dislocation and forearm fractures to occur separately. We report a rare case of a 20-year-old male who had a posterior elbow dislocation and ipsilateral distal radius fracture. Elbow dislocation was first reduced in extension and distal radius fracture was then reduced in flexion. Both the injuries were conservatively managed. At 6 months follow-up, the patient had no pain in his elbow and minimal pain in his wrist on heavy lifting and had resumed his work as a laborer.

  8. Ketorolac Administered in the Recovery Room for Acute Pain Management Does Not Affect Healing Rates of Femoral and Tibial Fractures.

    PubMed

    Donohue, David; Sanders, Drew; Serrano-Riera, Rafa; Jordan, Charles; Gaskins, Roger; Sanders, Roy; Sagi, H Claude

    2016-09-01

    To determine whether ketorolac administered in the immediate perioperative period affects the rate of nonunion in femoral and tibial shaft fractures. Retrospective comparative study. Single Institution, Academic Level 1 Trauma Center. Three hundred and thirteen skeletally mature patients with 137 femoral shaft (OTA 32) and 191 tibial shaft (OTA 42) fractures treated with intramedullary rod fixation. Eighty patients with 33 femoral shaft and 52 tibial shaft fractures were administered ketorolac within the first 24 hours after surgery (group 1-study group). Two-hundred thirty-three patients with 104 femoral shaft and 139 tibial shaft fractures were not (group 2-control group). Rate of reoperation for repair of a nonunion and time to union. Average time to union of the femur was 147 days for group 1 and 159 days for group 2 (P = 0.57). Average time to union of the tibia was 175 days for group 1 and 175 days for group 2 (P = 0.57). There were 3 femoral nonunions (9%) in group 1 and eleven femoral nonunions (11.6%) in group 2 (P = 1.00). There were 3 tibial nonunions (5.8%) in group 1 and 17 tibial nonunions (12.2%) in group 2 (P = 0.29). The average dose of ketorolac for patients who healed their fracture was 85 mg, whereas it was 50 mg for those who did not (P = 0.27). All patients with a nonunion in the study group were current smokers. Ketorolac administered in the first 24 hours after fracture repair for acute pain management does not seem to have a negative impact on time to healing or incidence of nonunion for femoral or tibial shaft fractures. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  9. Femoral curvature variability in modern humans using three-dimensional quadric surface fitting.

    PubMed

    Chapman, Tara; Sholukha, Victor; Semal, Patrick; Louryan, Stéphane; Rooze, Marcel; Van Sint Jan, Serge

    2015-12-01

    This study analysed femoral curvature in a population from Belgium in conjunction with other morphological characteristics by the use of three-dimensional (3D) quadric surfaces (QS) modelled from the bone surface. 3D models were created from computed tomography data of 75 femoral modern human bones. Anatomical landmarks (ALs) were palpated in specific bony areas of the femur (shaft, condyles, neck and head). QS were then created from the surface vertices which enclose these ALs. The diaphyseal shaft was divided into five QS shapes to analyse curvature in different parts of the shaft. Femoral bending differs in different parts of the diaphyseal shaft. The greatest degree of curvature was found in the distal shaft (mean 4.5° range 0.2°-10°) followed by the proximal (mean 4.4° range 1.5°-10.2°), proximal intermediate (mean 3.7° range 0.9°-7.9°) and distal intermediate (mean 1.8° range 0.2°-5.6°) shaft sections. The proximal and distal angles were significantly more bowed than the intermediate proximal and the intermediate distal angle. There was no significant difference between the proximal and distal angle. No significant correlations were found between morphological characteristics and femoral curvature. An extremely large variability of femoral curvature with several bones displaying very high or low degrees of femoral curvature was also found. 3D QS fitting enables the creation of accurate models which can discriminate between different patterns in similar curvatures and demonstrates there is a clear difference between curvature in different parts of the shaft.

  10. Association of low-energy femoral fractures with prolonged bisphosphonate use: a case control study

    PubMed Central

    Lenart, B. A.; Neviaser, A. S.; Lyman, S.; Chang, C. C.; Edobor-Osula, F.; Steele, B.; van der Meulen, M. C. H.; Lorich, D. G.

    2015-01-01

    Summary Recent evidence has linked long-term bisphosphonate use with insufficiency fractures of the femur in postmenopausal women. In this case–control study, we have identified a significant association between a unique fracture of the femoral shaft, a transverse fracture in an area of thickened cortices, and long-term bisphosphonate use. Further studies are warranted. Introduction Although clinical trials confirm the anti-fracture efficacy of bisphosphonates over 3–5 years, the long-term effects of bisphosphonate use on bone metabolism are unknown. Femoral insufficiency factures in patients on prolonged treatment have been reported. Methods We performed a retrospective case–control study of postmenopausal women who presented with low-energy femoral fractures from 2000 to 2007. Forty-one subtrochanteric and femoral shaft fracture cases were identified and matched by age, race, and body mass index to one intertrochanteric and femoral neck fracture each. Results Bisphosphonate use was observed in 15 of the 41 subtrochanteric/shaft cases, compared to nine of the 82 intertrochanteric/femoral neck controls (Mantel–Haenszel odds ratio (OR), 4.44 [95% confidence interval (CI) 1.77–11.35]; P=0.002). A common X-ray pattern was identified in ten of the 15 subtrochanteric/shaft cases on a bisphosphonate. This X-ray pattern was highly associated with bisphosphonate use (OR, 15.33 [95% CI 3.06–76.90]; P< 0.001). Duration of bisphosphonate use was longer in subtrochanteric/shaft cases compared to both hip fracture controls groups (P=0.001). Conclusions We found a significantly greater proportion of patients with subtrochanteric/shaft fractures to be on long-term bisphosphonates than intertrochanteric/femoral neck fractures. Bisphosphonate use was highly associated with a unique X-ray pattern. Further studies are warranted. PMID:19066707

  11. [Humeral shaft fractures].

    PubMed

    Schittko, A

    2004-08-01

    Since Lorenz Böhler postulated in his 1964 summary with the title "Against the operative treatment of fresh humeral shaft fractures" that the operative treatment is the exception in the therapy of humeral fractures times have changed. In the last years a conservative treatment of a humeral fracture is the exception and only used after straight indications. The operative therapy nowadays is the gold standard because of the development of new intramedullar and rotation stable implants in addition to the classical osteosynthesis with the plate. But even the external fixator for primary stabilisation in polytrauma patients or as rescue procedure after complications should be in repertory of every orthopedic surgeon. Attention should be put on the avoidance of primary and the correct treatment of secondary nerval lesions, esp. of the radial nerve. Here we are tending to the operative revision of the nerve in indistinct cases. In the treatment of the seldom humeral shaft fracture of the child conservative treatment is to prefer; in complications a resolute shift to a final operative stabilisation of the fracture is necessary.

  12. Calibration of shaft alignment instruments

    NASA Astrophysics Data System (ADS)

    Hemming, Bjorn

    1998-09-01

    Correct shaft alignment is vital for most rotating machines. Several shaft alignment instruments, ranging form dial indicator based to laser based, are commercially available. At VTT Manufacturing Technology a device for calibration of shaft alignment instruments was developed during 1997. A feature of the developed device is the similarity to the typical use of shaft alignment instruments i.e. the rotation of two shafts during the calibration. The benefit of the rotation is that all errors of the shaft alignment instrument, for example the deformations of the suspension bars, are included. However, the rotation increases significantly the uncertainty of calibration because of errors in the suspension of the shafts in the developed device for calibration of shaft alignment instruments. Without rotation the uncertainty of calibration is 0.001 mm for the parallel offset scale and 0,003 mm/m for the angular scale. With rotation the uncertainty of calibration is 0.002 mm for the scale and 0.004 mm/m for the angular scale.

  13. Shaft seal assembly and method

    NASA Technical Reports Server (NTRS)

    Keba, John E. (Inventor)

    2007-01-01

    A pressure-actuated shaft seal assembly and associated method for controlling the flow of fluid adjacent a rotatable shaft are provided. The seal assembly includes one or more seal members that can be adjusted between open and closed positions, for example, according to the rotational speed of the shaft. For example, the seal member can be configured to be adjusted according to a radial pressure differential in a fluid that varies with the rotational speed of the shaft. In addition, in the closed position, each seal member can contact a rotatable member connected to the shaft to form a seal with the rotatable member and prevent fluid from flowing through the assembly. Thus, the seal can be closed at low speeds of operation and opened at high speeds of operation, thereby reducing the heat and wear in the seal assembly while maintaining a sufficient seal during all speeds of operation.

  14. Nonintrusive shaft speed sensor

    NASA Astrophysics Data System (ADS)

    Barkhoudarian, S.; Wyett, L.

    1985-04-01

    A computerized literature search on nonintrusive/noncontacting speed sensing technologies was performed, resulting in 550 abstracts and 42 articles. Fourteen techniques were identified and theoretically analyzed, resulting in the recommendation of the Microwave, Infrared, and Magnetic technologies for experimental evaluation. Test results with a novel magnetic approach, consisting of a permanent magnet placed on the rotating shaft and a pickup coil placed on the housing, indicated detection of a strong signal from 3.5 inches at the lowest required speed (600 rpm), through a 1.75-inch thick Inconel plate. Test results with microwave and infrared speed sensing approaches indicated transmission of sufficient microwave and infrared energy for detection even through heavily bubble-laden water (15 percent cavitation). Although all three techniques demonstrated feasibility, the magnetic sensor was recommended for preliminary design, which indicated no technical obstacles.

  15. Osteonecrosis of the Femoral Head in an Adolescent on Long-Term Inhalational Corticosteroids

    PubMed Central

    Ballock, R. Tracy

    2017-01-01

    A relationship between the development of osteonecrosis of the femoral head and systemic corticosteroids has been well established in the literature, particularly in adults. However, the link between osteonecrosis and inhaled corticosteroids is less researched and understood. We report an usual case report of a 10-year-old male who developed ipsilateral femoral head osteonecrosis after long-term inhalational corticosteroid and intermittent short courses of oral steroid usage with a unique presentation and delayed diagnosis. PMID:28337355

  16. Overgrowth of the femoral neck after hip fractures in children.

    PubMed

    Kuo, Feng-Chih; Kuo, Shu-Jui; Ko, Jih-Yang

    2016-04-26

    Overgrowth after pediatric femoral shaft fractures is well documented; however, overgrowth of the femoral neck after hip fractures has not been especially reported previously. The purpose of this study was to evaluate the incidence and characteristics of femoral neck overgrowth after hip fractures in children. From January 1990 to December 2012, there were 30 consecutive patients with pediatric hip fractures. We retrospectively reviewed the medical record of all the patients, including age at injury, gender, injury mechanism, fracture type, methods of treatment, time to bony union, and complications. The functional outcome was evaluated by Ratliff's criteria. The radiography of the pelvis was performed in controlled positions of abduction and external rotation. The length of the femoral neck was measured by two observers. The overgrowth of the femoral neck was defined as lengthening more than 3 mm in comparison with the uninjured hip. At a mean follow-up of 4.9 years (range 2-8 years), 12 patients (40 %) had an overgrowth of the femoral neck. The average overgrowth of the femoral neck was 6.2 mm (range 3.2-8.5 mm). The patients with femoral neck overgrowth were younger (p = 0.0002), have lower rate of avascular necrosis of the femoral head (p = 0.0006), and have better functional outcome (p = 0.0026). Our results provide evidence that overgrowth of the femoral neck following hip fractures may occur in children and the overgrowth phenomenon in the femoral neck was a predictor of good outcomes after treatment.

  17. Unilateral, Multifocal Fracture of Radial with Ipsilateral Midshaft Ulna Fracture - Two Such Unusual and Rarely Reported Cases

    PubMed Central

    Raval, Harsh; Panse, J.B.; Amin, Prakash; Pandit, Jyotindra

    2015-01-01

    Introduction: Diaphyseal fractures of both bones of the forearm are commonly encountered in clinical practice. Segmental radius shaft fractures are, however, less commonly seen. We hereby report two cases of segmental complex radius fracture with mid-shaft ulna fracture. Such type of cases are reported previously in children but rarely in adults. Case Report: In case-1, comminuted radius shaft fracture was fixed with square nails and ulna was fixed with Recon plate. In case-2, plating was done for radius mid-shaft, K-wiring for distal radius, and ulna was stabilized with a square nail. Details of both cases aredescribed and alternative management options are discussed. Conclusion: To the best of our knowledge, a segmental fracture of the radius associated with ipsilateral mid-shaft fracture of the ulna in an adult has been rarely reported in the literature to date. Optimal management of such fracture configuration has not been outlined in the literature. Prompt surgical management of such a complex fracture resulted in a rapid, full and satisfactory functional recovery for our patient. PMID:27299060

  18. Slipped capital femoral epiphysis

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000972.htm Slipped capital femoral epiphysis To use the sharing features on this page, please enable JavaScript. A slipped capital femoral epiphysis is a separation of the ball ...

  19. A Modified Ogata-Goldsand Technique for Simplified Intraoperative Measurement of Femoral Version.

    PubMed

    Morris, William Z; Henry, Havalee; Liu, Raymond W; Streit, Jonathan J; Grant, Richard E; Cooperman, Daniel R

    2015-09-01

    Femoral anteversion can be difficult to determine intraoperatively, particularly in cases with complicated deformity. Although biplanar methodology exists for measuring femoral anteversion, the measurements are generally based on the proximal femur, without consideration for the femoral bow. We directly measured femoral version in 70 mature cadaveric femora. Using the standard Ogata-Goldsand approach, femoral version was geometrically calculated after measuring apparent neck-shaft angle and the β-angle, which is the angle between the femoral neck and proximal femoral shaft on a direct lateral view. We then used a modified β-angle, measured between the femoral neck and a line representing the entire femur. Mean anatomic femoral anteversion was 20±11 degrees. Mean calculated femoral version using the standard Ogata-Goldsand technique was 32±13 degrees, whereas mean calculated femoral version using the modified Ogata-Goldsand technique was 22±12 degrees. Repeated measures ANOVA analysis found an overall statistically significant difference between the 3 groups (P<0.0001). Pairwise comparisons revealed a significant difference between directly measured version and the standard Ogata-Goldsand technique (P<0.0001) but not between directly measured version and the modified Ogata-Goldsand technique (P=0.76). Standard biplanar imaging techniques do not account for the femoral bow and can significantly overestimate femoral anteversion. If a line is drawn from the posterior femoral condyles to the posterior aspect of the greater trochanter, femoral anteversion is better approximated. Intraoperatively, we obtain this line by positioning a marker over the skin under fluoroscopy. Clinically, if one aims for a modified β-angle of 5 degrees, a postosteotomy anteroposterior radiograph is no longer necessary, given the knowledge that with apparent neck-shaft angles ranging from 115 to 155 degrees, version will lie within a generally accepted range between 2 and 11 degrees. In

  20. Dual rotating shaft seal apparatus

    DOEpatents

    Griggs, J.E.; Newman, H.J.

    1983-06-16

    The report is directed to apparatus suitable for transferring torque and rotary motion through a wall in a manner which is essentially gas impermeable. The apparatus can be used for pressurizing, agitating, and mixing fluids and features two ferrofluidic, i.e., ferrometic seals. Each seal is disposed on one of two supported shafts and each shaft is operably connected at one end to a gear mechanism and at its other end to an adjustable coupling means which is to be connected to a rotatable shaft extending through a wall through which torque and rotary motion are to be transferred.

  1. Herpes encephalitis preceded by ipsilateral vestibular neuronitis.

    PubMed

    Philpot, Stephen J; Archer, John S

    2005-11-01

    A 74-year-old woman developed vertigo and jerk nystagmus to the left with normal cerebral imaging. Three days later she developed fever, altered mental state and left medial temporal lobe hypodensity, confirmed on lumbar puncture to be due to herpes simplex type 1 encephalitis. We propose that the patient had vestibular neuronitis caused by HSV-1 that progressed to ipsilateral temporal lobe encephalitis.

  2. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

    PubMed Central

    Fujiwara, Yasuhiro; Hayashida, Tatsuro; Murakami, Koji; Makio, Satoshi; Shimizu, Yuichi; Oka, Yoshinobu; Kim, Wook-Choel; Ogura, Taku; Kubo, Toshikazu

    2017-01-01

    Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1); however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered. PMID:28154765

  3. 30 CFR 56.19102 - Shaft guides.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft guides. 56.19102 Section 56.19102 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Shafts § 56.19102 Shaft guides. A means shall be provided to guide the movement of a shaft conveyance....

  4. 30 CFR 57.19102 - Shaft guides.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft guides. 57.19102 Section 57.19102 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Personnel Hoisting Shafts § 57.19102 Shaft guides. A means shall be provided to guide the movement of a shaft conveyance....

  5. TIBIAL SHAFT FRACTURES.

    PubMed

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2011-01-01

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

  6. TIBIAL SHAFT FRACTURES

    PubMed Central

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2015-01-01

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

  7. Femoral neck radiography: effect of flexion on visualization.

    PubMed

    Garry, Steven C; Jhangri, Gian S; Lambert, Robert G W

    2005-06-01

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 degrees and flexion in 10 degrees increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 degree and 20 degrees flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (p < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15 degrees internal rotation to 30 degrees external rotation (p < 0.01). However, when 20 degrees flexion was applied to bones in external rotation, visualization significantly improved at 15 degrees (p < 0.05) and 30 degrees (p < 0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20 degrees) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg.

  8. Dynamic Balancing Of Turbomachinery Shafts And Rotors

    NASA Technical Reports Server (NTRS)

    Verhoff, Vincent G.

    1993-01-01

    Method for dynamic balancing of turbomachinery shafts and rotors developed with view toward reducing time spent in balancing process. Improved method based on existing dynamic-balancing techniques and equipment, incorporating use of balancing arbor, which is mandrel duplicating mounting geometry and dynamic-balance properties of shaft balanced. Once shaft balanced, not necessary to disassemble machinery and/or shaft completely and rebalance shaft when replacing rotor on shaft. Instead, one balances replacement rotor on balancing arbor, then installs balanced rotor on shaft.

  9. Femoral remodeling may influence patient outcomes in slipped capital femoral epiphysis.

    PubMed

    DeLullo, James A; Thomas, Eric; Cooney, Timothy E; McConnell, Sharon J; Sanders, James O

    2007-04-01

    Clinical studies of patients treated for slipped capital femoral epiphysis have found limited functional impairment and femoral neck deformity causing eventual coxarthrosis. Since patient-focused assessments minimize bias and reflect health-related quality of life status, we coupled their use to a clinical examination to obtain a more patient-centered picture of slipped capital femoral epiphyseal outcomes. The impact of residual deformity on outcomes also was examined. Of 78 patients treated for slipped capital femoral epiphyses between 1972 and 1998, 29 (38 hips) were evaluated at a mean followup of 7.6 years (range, 1.4-26 years). The average patient age was 21.8 years (range, 14.6-39 years), 55% were female, and the average body mass index was 28.7 (range, 16.1-50.2). Most slips were stable (92%, 35 of 38) and mild or moderate in severity (98%, 36 of 37). Followup examinations revealed slight deficits in range of motion, strength, and limb length. Radiographs showed slight improvements in head-shaft angle and reduced but persistent femoral neck deformity. Osteoarthritic changes were absent or negligible in 84% (32 of 38) of the hips. The average Iowa hip score was 90.5 (range, 51-100). Patient outcome scores for the AAOS Hip/Knee Questionnaire fell slightly below 50th percentile norms. Neither slip stability, severity, nor body mass index impacted outcome. Femoral neck deformity correlated with function, pain, and Boyer grade. Overall, patients had minor functional deficits and pain that may have been related to femoral neck deformity, but longer followup is warranted.

  10. The choice of locking plate in the treatment of peri-implant femoral fracture eight years after trans-trochanteric rotational osteotomy: A case report.

    PubMed

    Utsunomiya, Takeshi; Yamamoto, Takuaki; Motomura, Goro; Karasuyama, Kazuyuki; Sonoda, Kazuhiko; Kubo, Yusuke; Hatanaka, Hiroyuki; Iwamoto, Yukihide

    2016-01-01

    Transtrochanteric anterior rotational osteotomy of the femoral head (TRO) was developed as a joint preserving surgery for osteonecrosis of the femoral head. To the best of our knowledge, peri-implant fractures after femoral osteotomy have rarely been reported. We report a 58-year-old female who suffered a peri-implant femoral shaft fracture following a fall from a stepladder eight years after TRO. Fracture union was achieved six months after a preferred proximal femoral locking plate. The entry point of the ante-grade femoral nail would have been very close to the new position of the nutrient artery of the femoral head occasioned by the TRO and to avoid injury, we chose proximal femoral locking plate. It is important to consider the new position of the nutrient artery of the femoral head in the surgical planning of peri-implant fracture after TRO. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  11. Computer assisted measurement of femoral cortex thickening on radiographs

    NASA Astrophysics Data System (ADS)

    Yao, Jianhua; Liu, Yixun; Chen, Foster; Summers, Ronald M.; Bhattacharyya, Timothy

    2013-03-01

    Radiographic features such as femoral cortex thickening have been frequently observed with atypical subtrochanteric fractures. These features may be a valuable finding to help prevent fractures before they happen. The current practice of manual measurement is often subjective and inconsistent. We developed a semi-automatic tool to consistently measure and monitor the progress of femoral cortex thickening on radiographs. By placing two seed points on each side of the femur, the program automatically extracts the periosteal and endosteal layers of the cortical shell by active contour models and B-spline fitting. Several measurements are taken along the femur shaft, including shaft diameter, cortical thickness, and integral area for medial and lateral cortex. The experiment was conducted on 52 patient datasets. The semi-automatic measurements were validated against manual measurements on 52 patients and demonstrated great improvement in consistency and accuracy (p<0.001).

  12. Resilient shaft mounting for pump

    SciTech Connect

    Valentine, W.

    1990-06-12

    This patent describes a pump. It comprises: a tube having a centrifugal pump mounted on an upper end thereof, the centrifugal pump having an inlet coaxial with the tube, an outlet disposed radially and an impeller rotatable in a housing to pump a liquid; at least one propeller disposed in the tube below the centrifugal pump, the propeller being rotatable to draw fluid upwardly in the tube; a shaft connecting the impeller of the centrifugal with the propeller in the tube; at least one triangular support for the shaft, having three resilient planar plates dimensioned to be bowed inwardly in the tube and enclosing the shaft. The plates are discrete sections, each having ends disposed against an inner surface of the tube and against an adjoining one of the plates, an intermediate portion of each of the plates resiliently bearing inwardly toward the shaft; and, a resilient bushing disposed between the plates and the shaft, the resilient bushing being a round tube deformed into a triangular shape by pressure of the plates; whereby the shaft is supported coaxially in the tube.

  13. Biomechanical analyses of static and dynamic fixation techniques of retrograde interlocking femoral nailing using nonlinear finite element methods.

    PubMed

    Shih, Kao-Shang; Hsu, Ching-Chi; Hsu, Tzu-Pin; Hou, Sheng-Mou; Liaw, Chen-Kun

    2014-02-01

    Femoral shaft fractures can be treated using retrograde interlocking nailing systems; however, fracture nonunion still occurs. Dynamic fixation techniques, which remove either the proximal or distal locking screws, have been used to solve the problem of nonunion. In addition, a surgical rule for dynamic fixation techniques has been defined based on past clinical reports. However, the biomechanical performance of the retrograde interlocking nailing systems with either the traditional static fixation technique or the dynamic fixation techniques has not been investigated by using nonlinear numerical modeling. Three-dimensional nonlinear finite element models were developed, and the implant strength, fixation stability, and contact area of the fracture surfaces were evaluated. Three types of femoral shaft fractures (a proximal femoral shaft fracture, a middle femoral shaft fracture, and a distal femoral shaft fracture) fixed by three fixation techniques (insertion of all the locking screws, removal of the proximal locking screws, or removal of the distal locking screws) were analyzed. The results showed that the static fixation technique resulted in sufficient fixation stability and that the dynamic fixation techniques decreased the failure risk of the implant and produced a larger contact area of the fracture surfaces. The outcomes of the current study could assist orthopedic surgeons in comprehending the biomechanical performances of both static and dynamic fixation techniques. In addition, the surgeons could also select a fixation technique based on the specific patient situation using the numerical outcomes of this study.

  14. Subtrochanteric Femoral Insufficiency Fracture Following Bisphosphonate Therapy for Osseous Metastases.

    PubMed

    Bush, Lisabeth A; Chew, Felix S

    2008-01-01

    We present the case of an insufficiency fracture of the femoral shaft in a 61-year-old man who had received bisphosphonate therapy to reduce the fracture risk from lytic renal cell carcinoma metastases to the spine. Approximately 1.5 years after beginning monthly intravenous infusions of zoledronic acid (Zometa), the patient complained of persistent thigh pain. Radionuclide bone scan showed mildly increased activity in the lateral subtrochanteric cortex of the right femur, where there was focally increased T2 signal on MRI and a small, triangular ridge or cortical beak on radiographs. The lesion was initially thought to represent a metastasis, but after the patient returned with a transverse femoral shaft fracture through the ridge following minimal trauma, MRI and biopsy of the lesion failed to show any evidence of tumor. We suggest that this fracture is similar to the low-energy proximal femoral shaft fractures recently reported in postmenopausal women who have received oral bisphosphonates for osteoporosis. Suppression of bone turnover may play a role in the development of these fractures.

  15. Unilateral nevoid telangiectasia associated with ipsilateral melorheostosis.

    PubMed

    Kim, Jihyun; Cho, Sung Bin; Cho, Suhyun; Bang, Dongsik

    2012-05-01

    Melorheostosis is a rare disorder characterized by irregular, flowing hyperostosis in long bones, commonly described on radiographs as wax flowing down a candle. In addition to bony sclerosis, cutaneous manifestations overlying the involved bones have been reported including linear scleroderma, neurofibromatosis, and vascular and lymphatic malformations. Unilateral nevoid telangiectasia (UNT) is a rare primarily cutaneous condition characterized by linearly arranged small dilated blood vessels in dermatomal or Blaschkoid patterns on the skin. Here, we present the case of a nine-year-old Korean male with UNT associated with ipsilateral melorheostosis.

  16. First bite syndrome following ipsilateral carotid endarterectomy.

    PubMed

    Wang, Tom Kai Ming; Bhamidipaty, Venu; MacCormick, Murray

    2013-02-01

    First bite syndrome (FBS) is characterized by unilateral pain in the parotid region after the first bite of each meal, usually following ipsilateral neck surgery. The proposed mechanism is sympathetic denervation of the parotid gland, from iatrogenic injury to the sympathetic trunk supplying this gland. Local botulinum toxin injection has emerged as a promising treatment option with favorable results. To date, there are 3 published cases in the literature describing FBS after carotid endarterectomy. We present a case of a 75-year-old gentleman who developed FBS after carotid endarterectomy, to raise the awareness of this unusual and uncommon complication.

  17. Ipsilateral neglect during intracarotid amobarbital test.

    PubMed

    Na, D L; Adair, J C; Kim, G M; Seo, D W; Hong, S B; Heilman, K M

    1998-07-01

    Neglect usually occurs in the space contralateral to brain injury. Recent studies describe ipsilateral neglect (IN) whereby patients with right hemisphere injury misbisect lines to the left of midpoint. IN usually develops after contralateral neglect (CN) resolves. We observed whether IN occurs during intracarotid amobarbital infusion. After clinical testing but before resolution of barbiturate effect, 20 right-handed subjects bisected lines until baseline performance returned. More than half (12 of 20) showed transient CN. IN occurred in 40% (8 of 20) of patients, always during the recovery stage of anesthesia, and most frequently followed initial CN.

  18. Melorheostosis with ipsilateral nevus sebaceus (didymosis melorheosebacea).

    PubMed

    Tinschert, Sigrid; Stein, Anette; Göldner, Burkhard; Dietel, Manfred; Happle, Rudolf

    2003-01-01

    We report an unusual case of unilateral melorheostosis and ipsilateral extensive sebaceous nevus. Because the two conditions affected the same side of the body, we hypothesize that they originated from a common genetic mechanism. The temporal and spatial co-occurrence may represent a further example of non-allelic didymosis (twin spotting). The embryo would carry two different recessive mutations at one gene locus or at linked loci on either of a pair of homologous chromosomes. Postzygotic recombination occurring during early embryonic development would result in two different populations of cells homozygous for either mutation. If this concept holds true, the present case may be described as " didymosis melorheosebacea ".

  19. Unilateral Nevoid Telangiectasia Associated with Ipsilateral Melorheostosis

    PubMed Central

    Kim, Jihyun; Cho, Sung Bin; Cho, Suhyun

    2012-01-01

    Melorheostosis is a rare disorder characterized by irregular, flowing hyperostosis in long bones, commonly described on radiographs as wax flowing down a candle. In addition to bony sclerosis, cutaneous manifestations overlying the involved bones have been reported including linear scleroderma, neurofibromatosis, and vascular and lymphatic malformations. Unilateral nevoid telangiectasia (UNT) is a rare primarily cutaneous condition characterized by linearly arranged small dilated blood vessels in dermatomal or Blaschkoid patterns on the skin. Here, we present the case of a nine-year-old Korean male with UNT associated with ipsilateral melorheostosis. PMID:22577274

  20. Effects of intertrochanteric osteotomy plane and preoperative femoral anteversion on the postoperative morphology of the proximal femur in transtrochanteric anterior rotational osteotomy: 3D CT-based simulation study.

    PubMed

    Sonoda, K; Motomura, G; Ikemura, S; Kubo, Y; Yamamoto, T; Nakashima, Y

    2017-08-03

    Transtrochanteric anterior rotational osteotomy (ARO) is joint-preserving surgery for patients with osteonecrosis of the femoral head (ONFH). During ARO, femoral neck-shaft varus angulation by changing intertrochanteric osteotomy plane is often designed to obtain a sufficient postoperative intact ratio. However, the effect of intertrochanteric osteotomy plane on postoperative femoral anteversion has not been well examined. Therefore, we performed a simulation study of ARO to determine how intertrochanteric osteotomy plane and preoperative femoral anteversion affect both femoral neck-shaft varus angle and postoperative femoral anteversion. Both femoral neck-shaft varus angle and postoperative femoral anteversion are predicted by intertrochanteric osteotomy plane and preoperative femoral anteversion in ARO. Using CT-data obtained from 10 hips in 10 patients with ONFH, ARO was simulated. On anteroposterior view, basic intertrochanteric osteotomy line (AP-view line) was defined as the perpendicular line to the femoral neck axis. On lateral view, basic intertrochanteric osteotomy line (lateral-view line) made through the cut surface of greater trochanter was defined as the perpendicular line to the lateral axis of the femur. By changing either AP-view or lateral-view line, 49 ARO models/hip were produced, in which femoral neck-shaft varus angle and postoperative femoral anteversion were assessed. With increase in the vertically-inclined degree of AP-view line, both neck-shaft varus angle and postoperative femoral anteversion increased. With increase in the posteriorly-tilted degree of lateral-view line, neck-shaft varus angle increased, whereas postoperative femoral anteversion decreased. The approximation equations based on the multiple regression analyses were as follows: neck-shaft varus angle≈vertically-inclined degree of AP-view line×0.9+posteriorly-tilted degree of lateral-view line×0.8+preoperative femoral anteversion×0.7; postoperative femoral anteversion

  1. Femoral impaction grafting

    PubMed Central

    Scanelli, John A; Brown, Thomas E

    2013-01-01

    Femoral impaction grafting is a reconstruction option applicable to both simple and complex femoral component revisions. It is one of the preferred techniques for reconstructing large femoral defects when the isthmus is non-supportive. The available level of evidence is primarily derived from case series, which shows a mean survivorship of 90.5%, with revision or re-operation as the end-point, with an average follow-up of 11 years. The rate of femoral fracture requiring re-operation or revision of the component varies between several large case series, ranging from 2.5% to 9%, with an average of 5.4%. PMID:23362469

  2. Multiple components of ipsilaterally evoked inhibition in the inferior colliculus.

    PubMed

    Klug, A; Bauer, E E; Pollak, G D

    1999-08-01

    The central nucleus of the inferior colliculus (ICc) receives a large number of convergent inputs that are both excitatory and inhibitory. Although excitatory inputs typically are evoked by stimulation of the contralateral ear, inhibitory inputs can be recruited by either ear. Here we evaluate ipsilaterally evoked inhibition in single ICc cells in awake Mexican free-tailed bats. The principal question we addressed concerns the degree to which ipsilateral inhibition at the ICc suppresses contralaterally evoked discharges and thus creates the excitatory-inhibitory (EI) properties of ICc neurons. To study ipsilaterally evoked inhibition, we iontophoretically applied excitatory neurotransmitters and visualized the ipsilateral inhibition as a gap in the carpet of background activity evoked by the transmitters. Ipsilateral inhibition was seen in 86% of ICc cells. The inhibition in most cells had both glycinergic and GABAergic components that could be blocked by the iontophoretic application of bicuculline and strychnine. In 80% of the cells that were inhibited, the ipsilateral inhibition and contralateral excitation were temporally coincident. In many of these cells, the ipsilateral inhibition suppressed contralateral discharges and thus generated the cell's EI property in the ICc. In other cells, the ipsilateral inhibition was coincident with the initial portion of the excitation, but the inhibition was only 2-4 ms in duration and suppressed only the first few contralaterally evoked discharges. The suppression was so slight that it often could not be detected as a decrease in the spike count generated by increasing ipsilateral intensities. Twenty percent of the cells that expressed inhibition, however, had inhibitory latencies that were longer than the excitatory latencies. In these neurons, the inhibition arrived too late to suppress most or any of the discharges. Finally, in the majority of cells, the ipsilateral inhibition persisted for tens of milliseconds beyond

  3. Subtrochanteric fractures after retrograde femoral nailing

    PubMed Central

    Mounasamy, Varatharaj; Mallu, Sathya; Khanna, Vishesh; Sambandam, Senthil

    2015-01-01

    Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis. PMID:26495251

  4. An exploratory shaft facility in SALT: Draft shaft study plan

    SciTech Connect

    Not Available

    1987-03-01

    This draft Shaft Study Plan describes a program of testing and monitoring in the Exploratory Shafts of a candidate high-level nuclear waste repository site in Deaf Smith County, Texas. The purpose of the programs to assist with site characterization in support of a determination of site suitability for development as a repository design and performance assessment evaluations. The program includes a variety of geological, geophysical, geomechanical, thermomechanical, and geohydrological testing and monitoring. The program is presented as a series of separate studies concerned with geological, geomechanical, and geohydrological site characterization, and with evaluating the mechanical and hydrological response of the site to construction of the shafts. The various studies, and associated test or monitoring methods are shown. The procedure used in developing the test program has been to initially identify the information necessary to satisfy (1) federal, state, and local requirements, and (2) repository program requirements. These information requirements have then been assessed to determine which requirements can be addressed wholly or in significant part by monitoring and testing from within the shafts. Test methods have been identified to address specific information requirements. 67 refs., 39 figs., 31 tabs.

  5. [Antegrade femoral intramedullary nailing in a lateral position].

    PubMed

    Friederichs, J; von Rüden, C; Hierholzer, C; Bühren, V

    2015-04-01

    Intramedullary nailing is the gold standard for the treatment of femoral shaft fractures; however, rotational malalignment remains a common complication. The patient can be positioned on the fracture table in a supine position or alternatively in the lateral decubitus position without any traction. The aim of this article is to describe an effective method to control intraoperative torsion of the femur. The surgical technique described in this article is the standard procedure for femoral shaft fractures and subtrochanteric fractures in this level 1 trauma center. The patient is positioned in a lateral position on a radiolucent table with free draping of the injured leg. Using the C-arm, reduction can be performed with this technique with precise placing of the nails and torsion can be exactly adjusted and controlled with the aid of the femoral neck axis, the distal locking holes and both parallel femoral condyles. The described technique represents an effective method for the intraoperative control of femoral torsion. With an acceptable and most probably clinically irrelevant bias, this technique is able to avoid significant rotational malalignment. It does not prolong the operative procedure and does not require additional navigation settings. It has also been shown to be helpful in the treatment of subtrochanteric fractures. The surgical technique of anterograde intramedullary nailing using the lateral decubitus position without any traction device and free draping of the injured leg represents a safe and reliable treatment concept and offers logistical advantages compared to the supine position of the patient on a fracture table. Together with other described methods of intraoperative torsional control of femoral fractures, the radiological technique described in this study is an easily applicable and safe method, which needs to be confirmed in clinical studies.

  6. Outcome of Titanium Elastic Intramedullary Nail in the Treatment of Shaft of Femur Fracture in Children.

    PubMed

    Khan, J A; Singh, G P; Pandey, A

    2015-01-01

    Background Femoral-shaft fractures are among the most common fractures of the lower extremity in children. There are several different options for treating femoral-shaft fractures in children. Elastic stable intramedullary nailing (ESIN) has become the standard treatment for fractures of shaft of femur in children for reasons including mini-invasive surgery, no need for casting, early mobilization and discharge as well as growing concerns toward cost-effectiveness. Objective To demonstrate the effectiveness of intramedullary fixation of fracture shaft of femur in skeletally immature children using the titanium elastic intramedullary nails. Method Forty children who underwent fixation with titanium intramedullary nails because of fracture of shaft of femur (Winquist and Hansen type 1 and 2) were reviewed. There were 60% male and 40% female patients and mean follow-up was six months. Time of union, deformity at fracture site, limb length discrepancy, knee range of motion and complications were assessed. Result Average age of the patients was 5.17 years (range 3 to 10). All patients achieved complete healing at a mean 12.8 weeks (range 10 to 20 weeks). Average limb length discrepancy was -0.16 cm (range -1.0 to 1.1 cm) average knee range of motion was 137.55 degrees (range 118 to 152 degrees). Complications were recorded in 13 (31.7%) patients and included: Five malunion which did not show any deformity or functional impairment and eight superficial wound infections which were healed after removal of nail. All patients were active as their pre injury levels at six months follow up. Conclusion Elastic stable intramedullary nailing is the method of choice for the simple pediatrics fracture shaft of femur, as it is minimally invasive and shows good functional and cosmetic results. It allows short hospital stay and quick recovery from pain and is cast-free.

  7. Geotechnical instrumentation for repository shafts

    SciTech Connect

    Lentell, R.L.; Byrne, J.

    1993-09-01

    The US Congress passed the Nuclear Waste Policy Act in 1980, which required that three distinctly different geologic media be investigated as potential candidate sites for the permanent disposal of high-level nuclear waste. The three media that were selected for study were basalt (WA), salt (TX, LA, MS, UT), and tuff (NV). Preliminary Exploratory Shaft Facilities (ESF) designs were prepared for seven candidate salt sites, including bedded and domal salt environments. A bedded-salt site was selected in Deaf Smith County, TX for detailed site characterization studies and ESF Final Design. Although Congress terminated the Salt Repository Program in 1988, Final Design for the Deaf Smith ESF was completed, and much of the design rationale can be applied to subsequent deep repository shafts. This paper presents the rationale for the geotechnical instrumentation that was designed for construction and operational performance monitoring of the deep shafts of the in-situ test facility. The instrumentation design described herein can be used as a general framework in designing subsequent instrumentation programs for future high-level nuclear waste repository shafts.

  8. Does Orientation of the Femoral Head Affect Acetabular Development? An Experimental Study in Lamb.

    PubMed

    Moraleda, Luis; Bravo, Christian; Forriol, Francisco; Albiñana, Javier

    2017-03-21

    Derotational osteotomy of the proximal femur has proved to be effective in the treatment of residual acetabular dysplasia. However, the reason why this osteotomy is effective remains debatable. The purpose of this study is to investigate if an alteration of femoral head orientation affects acetabular growth. A proximal femoral osteotomy was performed in 21 lambs aged 3 months: 5 varus osteotomies (110 degrees), 4 valgus osteotomies (150 degrees), and 12 derotation osteotomies. Results were compared with a control group (5 animals). Osteotomy was fixed with a screw-plate device. Version was controlled intraoperatively with K-wires. Animals were killed 3 months after surgical procedure. A morphometric study of both proximal femur and acetabulum was performed, including deepness, volume and diameters of the acetabulum, neck-shaft angle and femoral version. The average neck-shaft angle for the normal, anteversion, and retroversion groups was 129 degrees, whereas it was 110 degrees for the varus group and 149 degrees for the valgus group. The average femoral version for the normal, valgus, and varus groups was 21 degrees of anteversion, whereas it was 38 degrees of anteversion for the so-called anteversion group and 17 degrees of retroversion for the retroversion group. Nor the neck-shaft angle, nor the femoral version correlated with the acetabular anteroposterior diameter (P=0.698, 0.6, respectively), the acetabular inferosuperior diameter (P=0.083, 0.451, respectively) or the acetabular deepness (P=0.14, 0.371, respectively). The neck-shaft angle correlated significantly with acetabular volume (P=0.023), so that the lower the neck-shaft angle, the higher the acetabular volume (r=-0.453). The femoral version did not correlated with acetabular volume (P=0.381). Decreasing the neck-shaft angle provokes an increase in acetabular volume, whereas changes in femoral version do not affect the acetabular growth. Extra-articular osteotomies that alter femoral orientation

  9. Elbow dislocation with ipsilateral diaphyseal forearm bone fracture: A rare injury report with literature review.

    PubMed

    Goni, Vijay; Behera, Prateek; Meena, Umesh Kumar; Gopinathan, Nirmal raj; Akkina, Narendranadh; Arjun, R H H

    2015-01-01

    Dislocation of the elbow along with shaft fractures of both bones of the ipsilateral forearm is a rare injury though elbow dislocation or fracture of the forearm bones may occur separately. Such injuries need a concentric reduction of the dislocation and an anatomical fixation of forearm bones for optimal functional outcomes. We report a case of elbow dislocation with fracture of the lateral condyle of the humerus along with fractures of shafts of the radius and ulna in a 44-year-old female. Closed reduction of the elbow and operative stabilization of all fractures were done with good clinical, radiological and functional outcomes in 2 years follow-up period. A significant degree of force is needed to produce a combined dislocation of a joint and fracture of bones around that joint and these complex injuries may be missed if the clinician is not aware of the possibility of such injuries. The fact that the previously reported cases had a posterolateral dislocation while our case had a posteromedial dislocation and a fracture of the lateral humeral condyle as well makes it unique in its presentation and worth reporting. We have also included an up to date literature review on this topic.

  10. Shaft Coupler With Friction and Spline Clutches

    NASA Technical Reports Server (NTRS)

    Thebert, Glenn W.

    1987-01-01

    Coupling, developed for rotor of lift/cruise aircraft, employs two clutches for smooth transmission of power from gas-turbine engine to rotor. Prior to ascent, coupling applies friction-type transition clutch that accelerates rotor shaft to speeds matching those of engine shaft. Once shafts synchronized, spline coupling engaged and friction clutch released to provide positive mechanical drive.

  11. Repairing A Shaft Prone To Fatigue

    NASA Technical Reports Server (NTRS)

    Sharp, Roger A.; Larsen, David V.; Bates, Garold A.

    1991-01-01

    Shaft of hydraulic motor now outlives its bearings. Procedure for repairing John Deere Series 50 (or equivalent) hydraulic motor solves problem posed by common type of fatigue failure of shaft. Includes forming internally threaded hole in end of shaft, inserting double-threaded end stud, and adding washers and collars.

  12. 30 CFR 57.19133 - Shaft.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft. 57.19133 Section 57.19133 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Maintenance § 57.19133 Shaft. Shafts that have not been inspected within the past 7 days shall not be...

  13. Optoelectronic Shaft-Angle Encoder Tolerates Misalignments

    NASA Technical Reports Server (NTRS)

    Osborne, Eric P.

    1991-01-01

    Optoelectronic shaft-angle encoder measures angle of rotation of shaft with high precision while minimizing effects of eccentricity and other misalignments. Grooves on disk serve as reference marks to locate reading heads and measure increments of rotation of disk. Shaft-angle encoder, resembling optical compact-disk drive, includes two tracking heads illuminating grooves on disk and measures reflections from them.

  14. Metal-To-Composite Shaft Splice

    NASA Technical Reports Server (NTRS)

    Kish, Jules; Nguyen, Dean; Lauder, Tim

    1992-01-01

    Strong, lightweight shaft formed without awkward bolted flanges. Composite and metal portions of shaft joined by winding composite portion onto outer surface and into spiral groove of metal portion. Groove and composite material constitute structural bond. If opposing spiral grooves used, then two shafts locked together against torques in both directions.

  15. 30 CFR 56.19133 - Shaft.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft. 56.19133 Section 56.19133 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Maintenance § 56.19133 Shaft. Shafts that have not been inspected within the past 7 days shall not be...

  16. Noncontact Measurements Of Torques In Shafts

    NASA Technical Reports Server (NTRS)

    Schwartzbart, Aaron

    1991-01-01

    Additional information extracted from eddy-current proximeter. Positioned over rotating shaft, measures both displacement of and torsion in shaft. Torque applied to shaft calculable from output of proximeter. Possible to extract torsion information from existing tape-recorded proximeter data.

  17. 30 CFR 57.19106 - Shaft sets.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Shaft sets. 57.19106 Section 57.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND....19106 Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  18. 30 CFR 56.19106 - Shaft sets.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Shaft sets. 56.19106 Section 56.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  19. 30 CFR 56.19106 - Shaft sets.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Shaft sets. 56.19106 Section 56.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  20. 30 CFR 57.19106 - Shaft sets.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Shaft sets. 57.19106 Section 57.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND....19106 Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  1. 30 CFR 57.19106 - Shaft sets.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Shaft sets. 57.19106 Section 57.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND....19106 Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  2. 30 CFR 57.19106 - Shaft sets.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Shaft sets. 57.19106 Section 57.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND....19106 Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  3. 30 CFR 56.19106 - Shaft sets.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Shaft sets. 56.19106 Section 56.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  4. 30 CFR 56.19106 - Shaft sets.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Shaft sets. 56.19106 Section 56.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  5. 30 CFR 57.19106 - Shaft sets.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft sets. 57.19106 Section 57.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND....19106 Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  6. 30 CFR 56.19106 - Shaft sets.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft sets. 56.19106 Section 56.19106 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Shaft sets. Shaft sets shall be kept in good repair and clean of hazardous material....

  7. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  8. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must have...

  9. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must have...

  10. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must have...

  11. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must have...

  12. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  13. 14 CFR 27.935 - Shafting joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Shafting joints. 27.935 Section 27.935... STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must have...

  14. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  15. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  16. 14 CFR 29.935 - Shafting joints.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting joints. 29.935 Section 29.935... STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.935 Shafting joints. Each universal joint, slip joint, and other shafting joints whose lubrication is necessary for operation must...

  17. Relationship between proximal femoral and acetabular alignment in normal hip joints using 3-dimensional computed tomography.

    PubMed

    Buller, Leonard T; Rosneck, James; Monaco, Feno M; Butler, Robert; Smith, Travis; Barsoum, Wael K

    2012-02-01

    The bony architecture of the hip depends upon functional adaptation to mechanical usage via the dynamic interaction between the acetabulum and femoral head. Acetabular retroversion is thought to be a contributing factor of pincer-type femoroacetabular impingement. Studies of pathological hip joints suggest proximal femoral anatomy compensates for acetabular retroversion. HYPOTHESIS/ PURPOSE: The purpose of this study was to determine if a predictable relationship exists between proximal femoral and acetabular angles, age, and gender in normal hip joints. We hypothesized that, through functional adaptation to mechanical loading, a complementary developmental relationship exists between the acetabulum and proximal femur. Descriptive laboratory study. The femoral neck version, femoral neck shaft angle, acetabular version, acetabular inclination, and center edge angle were measured in 230 normal hip joints in 115 adults using 3-dimensional reconstruction software. Correlations between the angles, age, and gender were examined using the methods of stepwise regression and backward elimination. Regarding side-to-side comparison and variability, there was no statistically significant difference between the left and right sides in the average value of each angle measurement. The correlations specifically between angles, age, and gender were similar on the left and right sides for all pairs except femoral version and acetabular inclination. Regarding significant findings of the study, a positive correlation (P < .05) was found between femoral version and acetabular version (0.38° to 1°). A positive correlation was found between femoral neck shaft angle and acetabular version (0.21° to 1°). A negative correlation was found between femoral neck shaft angle and age (-0.17° to 1°). A positive correlation was found between acetabular version and female gender (2.6° to 1°). A positive correlation was found between center edge angle and female gender (2.8° to 1°). A

  18. Does Tranexamic Acid Reduce Bleeding during Femoral Fracture Operation?

    PubMed

    Haghighi, Mohammad; Ettehad, Hossein; Mardani-Kivi, Mohsen; Mirbolook, Ahmadreza; Nabi, Bahram Naderi; Moghaddam, Roya; Sedighinejad, Abbas; Khanjanian, Gita

    2017-03-01

    Proximal Femoral shaft fractures are commonly associated with marked blood loss which can lead to postoperative acute anemia and some other complications. Tranexamic acid (TA) is an antifibrinolytic medication that reduces intra-and postoperative blood loss and transfusion requirements during some elective surgeries. The aim of this study is to evaluate the effect of intravenous Tranexamic acid (TA) on intraoperative blood loss and a subsequent need for transfusion in patients who were undergoing surgery for femoral shaft fractures in trauma setting. Thirty-eight ASA grade I-II patients undergoing proximal femoral shaft fracture surgery with intra medullary nailing were included in this double blind randomized controlled clinical trial. They were allocated into two groups. Group I, the intervention group with eighteen patients received 15 mg/kg (TA) via intravenous infusion before surgical incision. Patients in the placebo group received an identical volume of normal saline. Hemoglobin level was measured four hours before and after the surgeries. Postoperative blood loss and hemoglobin change as well as transfusion rates and volumes were compared between the two groups. Mean Percentage fall in hemoglobin after surgery were 1.75±0.84 and 2.04±1.9 in the study and placebo groups, respectively (P=0.570). Hemoglobin loss was higher in the placebo group. Transfusion rates was lower in TA group (5.6%) compared to the placebo group (30%) (P=0.06). No significant difference in The Allowable Blood Loss during the surgery was found between the two groups (P=0.894). Preoperative treatment with TA reduces postoperative blood loss and the need for blood transfusion during traumatic femoral fracture operation.

  19. Does Tranexamic Acid Reduce Bleeding during Femoral Fracture Operation?

    PubMed Central

    Haghighi, Mohammad; Ettehad, Hossein; Mardani-Kivi, Mohsen; Mirbolook, Ahmadreza; Nabi, Bahram Naderi; Moghaddam, Roya; Sedighinejad, Abbas; Khanjanian, Gita

    2017-01-01

    Background: Proximal Femoral shaft fractures are commonly associated with marked blood loss which can lead to postoperative acute anemia and some other complications. Tranexamic acid (TA) is an antifibrinolytic medication that reduces intra-and postoperative blood loss and transfusion requirements during some elective surgeries. The aim of this study is to evaluate the effect of intravenous Tranexamic acid (TA) on intraoperative blood loss and a subsequent need for transfusion in patients who were undergoing surgery for femoral shaft fractures in trauma setting. Methods: Thirty-eight ASA grade I-II patients undergoing proximal femoral shaft fracture surgery with intra medullary nailing were included in this double blind randomized controlled clinical trial. They were allocated into two groups. Group I, the intervention group with eighteen patients received 15 mg/kg (TA) via intravenous infusion before surgical incision. Patients in the placebo group received an identical volume of normal saline. Hemoglobin level was measured four hours before and after the surgeries. Postoperative blood loss and hemoglobin change as well as transfusion rates and volumes were compared between the two groups. Results: Mean Percentage fall in hemoglobin after surgery were 1.75±0.84 and 2.04±1.9 in the study and placebo groups, respectively (P=0.570). Hemoglobin loss was higher in the placebo group. Transfusion rates was lower in TA group (5.6%) compared to the placebo group (30%) (P=0.06). No significant difference in The Allowable Blood Loss during the surgery was found between the two groups (P=0.894). Conclusion: Preoperative treatment with TA reduces postoperative blood loss and the need for blood transfusion during traumatic femoral fracture operation. PMID:28497100

  20. Anatomic compatibility of femoral intramedullary implants: a cadaveric study.

    PubMed

    Biçer, Ömer Sunkar; Huri, Gazi; Tekin, Mustafa; Mirioğlu, Akif; Aydın, Ahmet; Tan, İsmet

    2016-01-01

    The purpose of this study was to describe the morphology of the proximal and diaphysis of femur, distribution of neck version, neck-shaft angles, and radius of anterior curvature in a Turkish population to compare with that of femoral intramedullary implants. Using 84 cadaveric femora, three-dimensional (3D) modeling was performed with a light scanner, data were transferred to Solidworks 2013 software (Solidworks, Waltham, MA, USA) to determine the variability in the femoral length (FL), neck version, neck-shaft angle (NSA), and anterior bow. Three independent observers' measurements were tested with a reliability analysis and then evaluated using Cronbach's alpha value, after which they were compared with the neck-shaft angles, and the radii of curvature (RAC) of intramedullary femoral nails, as stated on the official manufacturer websites. Mean FL, femoral neck anteversion (FNA), and NSA had ranges of 346.1-454.1 mm, -11.3-40.4°, and 105.9-149.0°, respectively, and RAC was between 1.0 and 1.2 m. The correlation coefficient and 95% confidence intervals (CI) were 0.89 (CI 0.849-0.928), 0.86 (CI 0.799-0.904), and 0.85 (95% CI 0.785-0.898) for FL, FNA, and NSA, respectively. FNA was <10° in 32 femora (37.6%) and >14° 38 (44.7%). NSA was between 130° and 135° in 40 femora (47.1%), and RAC ranged from 0.5 to 1.5 m in 76 femora (91.6%), <1 m in 38 (45.8%), and >1.5 m in 7 (8.4%). FNA and NSA show a wide distribution, mostly out of the range of intramedullary implants. There is a need for implants that are compatible with a range of NSAs and versions, so that they are suitable for use with a variety of morphologies.

  1. Ipsilateral directional encoding of joystick movements in human cortex.

    PubMed

    Sharma, Mohit; Gaona, Charles; Roland, Jarod; Anderson, Nick; Freudenberg, Zachary; Leuthardt, Eric C

    2009-01-01

    The majority of Brain Computer Interfaces have relied on signals related to primary motor cortex and the operation of the contralateral limb. Recently, the physiology associated with same-sided (ipsilateral) motor movements has been found to have a unique cortical physiology. This study sets out to assess whether more complex motor movements can be discerned utilizing ipsilateral cortical signals. In this study, three invasively monitored human subjects were recorded while performing a center out joystick task with the hand ipsilateral to the hemispheric subdural grid array. It was found that directional tuning was present in ipsilateral cortex. This information was encoded in both distinct anatomic populations and spectral distributions. These findings support the notion that ipsilateral signals may provide added information for BCI operation in the future.

  2. Shaft Diameter Measurement Using Structured Light Vision

    PubMed Central

    Liu, Siyuan; Tan, Qingchang; Zhang, Yachao

    2015-01-01

    A method for measuring shaft diameters is presented using structured light vision measurement. After calibrating a model of the structured light measurement, a virtual plane is established perpendicular to the measured shaft axis and the image of the light stripe on the shaft is projected to the virtual plane. On the virtual plane, the center of the measured shaft is determined by fitting the projected image under the geometrical constraints of the light stripe, and the shaft diameter is measured by the determined center and the projected image. Experiments evaluated the measuring accuracy of the method and the effects of some factors on the measurement are analyzed. PMID:26274963

  3. Shaft Diameter Measurement Using Structured Light Vision.

    PubMed

    Liu, Siyuan; Tan, Qingchang; Zhang, Yachao

    2015-08-12

    A method for measuring shaft diameters is presented using structured light vision measurement. After calibrating a model of the structured light measurement, a virtual plane is established perpendicular to the measured shaft axis and the image of the light stripe on the shaft is projected to the virtual plane. On the virtual plane, the center of the measured shaft is determined by fitting the projected image under the geometrical constraints of the light stripe, and the shaft diameter is measured by the determined center and the projected image. Experiments evaluated the measuring accuracy of the method and the effects of some factors on the measurement are analyzed.

  4. Open Galeazzi fracture with ipsilateral elbow dislocation.

    PubMed

    Adanır, Oktay; Yüksel, Serdar; Beytemur, Ozan; Güleç, M Akif

    2016-08-01

    Combination of the Galeazzi fracture and dislocation of the elbow joint in same extremity is very rare. In this article, we report a 26-year-old male patient with a posterolateral dislocation of the elbow and ipsilateral volar type Galeazzi fracture. We performed closed reduction for the elbow dislocation during admission to the emergency department. Patient was taken to the operating room in the sixth hour of his application to emergency department and open wound on the ulnovolar region of the wrist was closed primarily after irrigation and debridement. We performed open reduction and internal fixation of the radial fracture with a dynamic compression plate. After fixation, we evaluated the stability of the elbow joint and distal radioulnar joint. Distal radioulnar joint was unstable under fluoroscopic examination and fixed with one 1.8 mm Kirschner wire in a pronated position. Then, elbow joint was stable. One year after surgery, patient had no pain or sings of instability. At the last follow-up, range of motion of the elbow was 10°-135° and forearm pronation and supination were 70°.

  5. Hermetic seal for a shaft

    NASA Technical Reports Server (NTRS)

    Lombardi, F. (Inventor)

    1982-01-01

    An hermetic seal for a linear rod having a portion thereof projected axially through a port defined in a wall for a pressure chamber and supported thereby for omni-directional motion is described. The seal is characterized by a resilient, impervious, cylindrical body having a first section concentrically related to the shaft and integrally affixed thereto comprising a linear ordered array of annular flutes. A second section integrally is affixed to the wall of the chamber and concentrically related to the port comprising a second linear ordered array of annular flutes. A third section is interposed between the first and second sections and integrally affixed in coaxial alignment therewith comprising an annular ordered array of linear flutes concentrically related to the shaft, whereby axial, angular, and pivotal motion of the rod is accommodated.

  6. Avascular necrosis of the femoral head presenting as trochanteric bursitis.

    PubMed Central

    Mandell, B F

    1990-01-01

    Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluated with appropriate studies, such as magnetic resonance imaging, to prevent weight bearing at an early stage and permit possible surgical decompression in the hope of postponing or obviating the need for total hip replacement. PMID:2241294

  7. Subtalar Fusion Rate in Patients With Previous Ipsilateral Ankle Arthrodesis.

    PubMed

    Zanolli, Diego H; Nunley, James A; Easley, Mark E

    2015-09-01

    Isolated subtalar arthrodesis is generally successful, with reported fusion rates of 84% to 100%. However, alteration of subtalar joint mechanics and talar body vasculature after ankle fusion may negatively influence subsequent ipsilateral subtalar joint fusion. Because there is very limited information on the subtalar fusion rate in patients with previous ipsilateral ankle fusion, the purpose of this study was to describe fusion rates in subtalar joint arthrodesis with and without preexisting ankle fusion in a large consecutive series of primary subtalar arthrodesis cases. All primary subtalar fusions performed between January 2000 and December 2010 were reviewed. Thirteen of 151 consecutive cases were in patients with existing ipsilateral ankle fusions. All patients were evaluated for clinical and radiographic evidence of nonunion at follow-up, and fusion rates in the groups with and without previous ipsilateral ankle fusion were compared. Five nonunions occurred in the 13 cases with prior ipsilateral ankle arthrodesis, a 61.5% fusion rate. Twelve nonunions were identified in the 138 cases without prior ankle arthrodesis, a significantly higher fusion rate of 91.3% (P = .007). In our series, the subtalar fusion rate in patients with previous ipsilateral ankle arthrodesis was significantly lower than that for subtalar arthrodesis in the absence of ipsilateral ankle arthrodesis. Level III, retrospective comparative study. © The Author(s) 2015.

  8. Low-energy fractures of the humeral shaft and bisphosphonate use.

    PubMed

    Yavropoulou, Maria P; Giusti, Andrea; Ramautar, Sharita R; Dijkstra, Sander; Hamdy, Neveen A T; Papapoulos, Socrates E

    2012-06-01

    Atypical fractures of the femur have been reported to occur in patients on long-term treatment with bisphosphonates; however, causality has not been proven, and it is not known whether similar fractures may occur in other long bones. We addressed this issue by examining the relationship between humeral shaft fractures and bisphosphonate use. We identified all patients aged ≥50 years consecutively admitted to a single center with a new fracture of the humerus. All individual radiographs were examined and fracture site was classified. A case-control study was undertaken in patients with humeral shaft fractures, and controls were sex- and age-matched patients with proximal humeral fractures in a 1:4 ratio. Patients with shaft fractures and radiographic characteristics similar to those of atypical femoral fractures were compared with those with ordinary shaft fractures. The association between "atypical" fractures and bisphosphonate or glucocorticoid use was examined. A total of 198 patients had a low-energy fracture of the humerus; 20 of these patients had a shaft fracture (10%). These 20 patients (cases) were matched with 80 patients with proximal fractures (controls). Bisphosphonates were used by 5% of cases and by 6.3% of controls (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.09-6.85); glucocorticoids were used by 10% of cases and 8.8% of controls (OR, 1.15; 95% CI, 0.23-5.83). There was no difference in cortical thickness between cases and controls and bisphosphonate or glucocorticoid users and nonusers. Four of the 20 patients with shaft fractures had "atypical" radiographic features, with significantly increased cortical thickness, but none of these had ever been treated with bisphosphonates or glucocorticoids. Our results show that low-energy fractures of the humeral shaft with "atypical" radiographic characteristics are infrequent and are not associated with the use of bisphosphonates or glucocorticoids. Copyright © 2012 American Society for Bone

  9. The effect of valgus and varus femoral osteotomies on measures of anteversion in the dog.

    PubMed

    Adams, Rachel W; Gilleland, Brad; Monibi, Farrah; Franklin, Samuel P

    2017-05-22

    To determine whether femoral osteotomies that change frontal plane alignment without affecting torsion influence anteversion and inclination. Femurs without deformity were scanned to create three-dimensional reconstructions. The femoral head-neck axis was identified by placement of a virtual intramedullary pin. A proximal osteotomy was simulated to create three conditions while keeping torsion constant: Normal, Coxa Valga (neck-shaft angle increased by 12°), and Coxa Vara (neck-shaft angle decreased by 12°). Femoral anteversion was measured from an axial image in all three conditions. Femoral inclination was calculated for all conditions using the neck-shaft and anteversion angles. Changes in anteversion and inclination were calculated and compared using a one-way repeated measures analysis of variance. Distal femoral osteotomies were then simulated with the native femurs, inducing 18° of distal varus with no change to torsion. Changes in anteversion and inclination for the Normal and Distal Varus conditions were calculated and compared by a paired t-test. Version changed by a mean of 13.9° (± 1.5; p <0.0001) from the Coxa Valga to Coxa Vara conditions while inclination changed by a mean of 1.3° (± 0.39; p <0.01). Version changed by a mean of 6.6° (± 0.7; p <0.0001) between the Distal Varus and Normal conditions while inclination changed by a mean of -3.8° (± 0.75; p <0.001). Femoral version changes with changing frontal plane alignment even when torsion is constant. This should be considered when correcting femoral deformities.

  10. Ipsilateral Hemichorea-hemiballism in a Case of Postoperative Stroke

    PubMed Central

    Kannepalli, Narasinga Rao V. L.; Yadav, Ravi; Vazhayil, Vikas; Somanna, Sampath; Pal, Pramod Kumar

    2016-01-01

    Background Ipsilateral hemiballismus refers to the rare occurrence of hemiballism developing on the same side of a brain lesion. Case report We describe a rare case of postoperative ipsilateral hemiballism in a patient who underwent pituitary adenoma resection and experienced a right internal cerebral artery territory infarct. We review the literature on hemichorea hemiballismus (HCHB) and explore various mechanisms for its occurrence. Discussion Only three cases of ipsilateral hemiballism have been described, and the exact pathophysiology remains unknown. A dominant left hemisphere with corpus callosal connections to the right basal ganglia is the most probable explanation for this unusual event. PMID:27127720

  11. Does kidney transplantation to iliac artery deteriorate ischemia in the ipsilateral lower extremity with peripheral arterial disease?

    PubMed

    Northcutt, Ashley; Zibari, Gazi; Tan, Tze-Woei; Coulter, Amy H; Zhang, Wayne W

    2015-10-01

    This study was conducted to investigate the progression of lower extremity ischemia following kidney transplantation to iliac artery in patients with peripheral arterial disease. A retrospective chart review of all renal transplant patients completed at a university teaching medical center from January 2006 to December of 2011 was performed. A total of 219 patients underwent successful kidney transplantation to the common, external, or internal iliac artery. Pre- and post-transplantation ischemic changes in the ipsilateral lower extremity were reviewed and analyzed. Thirty-eight of the 219 patients had ipsilateral peripheral arterial disease and seven of them were symptomatic. Six of the seven symptomatic patients remained stable and one patient's rest pain improved, postoperatively. Eight patients developed new symptoms of ischemia 12 months later, including four with claudication, two with ischemic ulcers, and two with gangrene toes. The ulcers were healed following superficial femoral artery stenting and wound care. Toe amputation was performed in two patients with gangrene. No major amputation was required up to 48 months of follow-up. Transplanted kidney to iliac artery does not significantly deteriorate ischemia in adults with ipsilateral lower extremity peripheral arterial disease. Late developed ischemic complications may be due to the progression of underlying arterial disease. © The Author(s) 2014.

  12. Shaft mount for data coupler system

    NASA Technical Reports Server (NTRS)

    Elliott, James R., Jr. (Inventor); Lord, Mark T. (Inventor)

    1993-01-01

    A device for mounting a data transmission apparatus to a rotating, tapered, and instrumented shaft is provided. This device permits attachment without interfering with shaft rotation or the accuracy of data output, and prevents both radial and axial slippage of the data transmission apparatus. The mounting device consists of a sleeve assembly which is attached to the shaft by means of clamps that are situated at some distance removed from the instrumented area of the shaft. The data transmission device is secured to the sleeve such that the entire assembly rotates with the shaft. Shim adjustments between sleeve sections assure that a minimum compressive load is transferred to the instrumented area of the shaft and a rubber lining is affixed to a large portion of the interior surface of the sleeve to absorb vibration.

  13. Securing Bearing Races To Turbopump Shafts

    NASA Technical Reports Server (NTRS)

    Blount, Dale H.

    1990-01-01

    Proposed method of attaching inner race of roller bearing to shaft prevents loosening now caused by difference between coefficients of thermal expansion of race and shaft materials. Intended for cryogenic turbopump in which race made of 440C stainless-steel alloy and shaft made of Inconel(R) 100 nickel alloy. Flanges of race replaced by tension bands that shrink faster as they are cooled. Tension band engages race on slightly sloping surface so axial forces do not dislodge it.

  14. Securing Bearing Races To Turbopump Shafts

    NASA Technical Reports Server (NTRS)

    Blount, Dale H.

    1990-01-01

    Proposed method of attaching inner race of roller bearing to shaft prevents loosening now caused by difference between coefficients of thermal expansion of race and shaft materials. Intended for cryogenic turbopump in which race made of 440C stainless-steel alloy and shaft made of Inconel(R) 100 nickel alloy. Flanges of race replaced by tension bands that shrink faster as they are cooled. Tension band engages race on slightly sloping surface so axial forces do not dislodge it.

  15. Structure of cam shaft for engine

    SciTech Connect

    Sato, M.; Nakamizo, K.; Mitadera, T.

    1989-02-21

    This patent describes the structure of a cam shaft for an engine having a crankshaft provided with a helical crank gear and a cam shaft provided with a helical cam gear meshing with the crank gear and rotatably supported at both ends thereof by journal bearing boxes, characterized inn that either one of the journal bearing boxes is communicated with a pressure oil supply passage, thereby causing the oil pressure produced within the one journal bearing box to act upon the end face of the cam shaft so that the cam shaft is normally biased in a constant axial direction.

  16. Forelimb training drives transient map reorganization in ipsilateral motor cortex.

    PubMed

    Pruitt, David T; Schmid, Ariel N; Danaphongse, Tanya T; Flanagan, Kate E; Morrison, Robert A; Kilgard, Michael P; Rennaker, Robert L; Hays, Seth A

    2016-10-15

    Skilled motor training results in reorganization of contralateral motor cortex movement representations. The ipsilateral motor cortex is believed to play a role in skilled motor control, but little is known about how training influences reorganization of ipsilateral motor representations of the trained limb. To determine whether training results in reorganization of ipsilateral motor cortex maps, rats were trained to perform the isometric pull task, an automated motor task that requires skilled forelimb use. After either 3 or 6 months of training, intracortical microstimulation (ICMS) mapping was performed to document motor representations of the trained forelimb in the hemisphere ipsilateral to that limb. Motor training for 3 months resulted in a robust expansion of right forelimb representation in the right motor cortex, demonstrating that skilled motor training drives map plasticity ipsilateral to the trained limb. After 6 months of training, the right forelimb representation in the right motor cortex was significantly smaller than the representation observed in rats trained for 3 months and similar to untrained controls, consistent with a normalization of motor cortex maps. Forelimb map area was not correlated with performance on the trained task, suggesting that task performance is maintained despite normalization of cortical maps. This study provides new insights into how the ipsilateral cortex changes in response to skilled learning and may inform rehabilitative strategies to enhance cortical plasticity to support recovery after brain injury.

  17. 30 CFR 57.19100 - Shaft landing gates.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft landing gates. 57.19100 Section 57.19100... Shafts § 57.19100 Shaft landing gates. Shaft landings shall be equipped with substantial safety gates so... unloading shaft conveyances....

  18. 30 CFR 57.19111 - Shaft-sinking ladders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft-sinking ladders. 57.19111 Section 57... Hoisting Shafts § 57.19111 Shaft-sinking ladders. Substantial fixed ladders shall be provided from the collar to as near the shaft bottom as practical during shaft-sinking operations, or an escape...

  19. 30 CFR 56.19111 - Shaft-sinking ladders.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft-sinking ladders. 56.19111 Section 56... Shafts § 56.19111 Shaft-sinking ladders. Substantial fixed ladders shall be provided from the collar to as near the shaft bottom as practical during shaft-sinking operations, or an escape hoist powered...

  20. Pitfalls of femoral titanium elastic nailing.

    PubMed

    Salonen, A; Lahdes-Vasama, T; Mattila, V M; Välipakka, J; Pajulo, O

    2015-06-01

    Despite several potential complications of elastic intramedullary nailing, it is currently the treatment of choice for femoral diaphyseal fractures in school-aged children. This study aimed to critically evaluate the complications of titanium elastic nailing in pediatric femoral shaft fractures. This study evaluated patients with a diaphyseal femoral fracture treated with titanium elastic nailing (TEN) in Tampere University Hospital in Finland. The study group included 32 children with a mean age of 9 years during a 5-year period, from 1 January 2003 to 31 December 2007. Data were collected from medical records and x-rays. Mean follow-up time was 42 months. Of 32 patients, 9 (28%) reported a postoperative complication. Complications were associated with nail prominence in five (16%) patients and instability in four (12%) patients. In patients with nail prominence, the titanium elastic nailing-nail ends were unbent and 10-35 mm outside the cortex of the distal femur. The nail prominence caused pain and delayed knee mobilization until the nail was removed after a mean time of 4 months. In patients with fracture instability, the mean titanium elastic nailing-nail/medullary canal diameter ratio was 46% and periosteal callus formation was 5.4 mm at the first control. In those with stable fractures, the values were 66% and 9.2 mm, respectively. Based on this study, two types of pitfalls in a small volume center were found. Titanium elastic nail ends were left unbent and too long. We recommend palpating the nail ends to exclude nail prominence and to verify free movement of the knee after nail cutting and bending. Fracture instability was caused by inserting titanium elastic nailing-nails that were too narrow. To avoid this complication, careful preoperative planning to select the proper-size titanium elastic nailing-nails and intraoperative testing of fracture stability under continuous fluoroscopy after the operation is advised. © The Finnish Surgical Society 2014.

  1. Anthropometric measurements to design best-fit femoral stem for the Indian population.

    PubMed

    Rawal, Br; Ribeiro, Rahul; Malhotra, Rajesh; Bhatnagar, Naresh

    2012-01-01

    The standard commercially available marketed prostheses sometimes may not be the best fit to Indian patients because of the large anatomic variation. Orthopedic surgeons always stress the need for a proper implant-patient match in hip joint replacements, in particular, for a cementless femoral stem. The complications of mismatch are aseptic loosening, improper load distribution, and discomfort. The present study was undertaken to compare the differences in dimensions between femurs of elderly Indians and those of populations from other regions in order to solve the problem of a possible geometric mismatch between a selected implant and the hip joint as far as Indian patients are concerned. Measurements were made using computer aided design techniques on computed tomography (CT) scanned images of 98 femurs (56 left and 42 right). The software used to convert the CT images into solid models was MIMICS(®) (Materialize, Inc., Leuven, Belgium). The geometrical parameters, viz., the femoral head offset, femoral head center (HC), femoral head diameter, femoral head relative position, position of shaft isthmus, neck-shaft angle, bow angle, femoral neck length, canal flare index, femoral length, and canal width at various locations, were chosen to design best-fit standard femoral stems for cementless insertion. These data were compared with the published data of other countries. A difference of 16.8% was found in the femoral head offset between Indian and Swiss populations, which can affect soft tissue tension and range of motion. At a distance of 20 mm above the lesser trochanter (LT), the anteroposterior (AP) canal width was found to differ by 45.4%, when compared with a French population which can affect the mechanical stability of femoral stem. Femoral dimensions of Indian male and female subjects have also been compared and differences evaluated. At the LT, the aspect ratio (ratio of mediolateral canal width and AP canal width) in case of males (1.198) is

  2. [Slipped capital femoral epiphysis].

    PubMed

    Klein, C; Haraux, E; Leroux, J; Gouron, R

    2017-03-01

    Slipped capital femoral epiphysis (SFCE) is a disorder of the hip, characterized by a displacement of the capital femoral epiphysis from the metaphysic through the femoral growth plate. The epiphysis slips posteriorly and inferiorly. SCFE occurs during puberty and metabolic and epidemiologic risk factors, such as obesity are frequently found. Most chronic slips are diagnosed late. Sagittal hip X-rays show epiphysis slip. In case of untreated SCFE, a slip progression arises with an acute slip risk. Treatment is indicated to prevent slip worsening. The clinical and radiological classification is useful to guide treatment and it is predictive of the prognosis. In situ fixation of stable and moderately displaced SCFE with cannulated screws gives excellent results. Major complications are chondrolysis and osteonecrosis and the major sequelae are femoroacetabular impingement and early arthritis.

  3. Symptomatic atypical femoral fractures are related to underlying hip geometry.

    PubMed

    Taormina, David P; Marcano, Alejandro I; Karia, Raj; Egol, Kenneth A; Tejwani, Nirmal C

    2014-06-01

    The benefits of bisphosphonates are well documented, but prolonged use has been associated with atypical femur fractures. Radiographic markers for fracture predisposition could potentially aid in safer medication use. In this case-control designed study, we compared hip radiographic parameters and the demographic characteristics of chronic bisphosphonate users who sustained an atypical femoral fracture with a group of chronic bisphosphonate users who did not sustain an atypical femur fracture and also a group who sustained an intertrochanteric hip fracture. Radiographic parameters included were neck-shaft angle (NSA), hip-axis length (HAL) and center-edge angle (CE). Multivariate regression was used to evaluate the relationship between radiographic measures and femur fracture. Receiver-operating characteristic analysis determined cut-off points for neck-shaft angle and risk of atypical femur fracture. Ultimately, pre-fracture radiographs of 53 bisphosphonate users who developed atypical fracture were compared with 43 asymptomatic chronic bisphosphonate users and 64 intertrochanteric fracture patients. Duration of bisphosphonate use did not statistically differ between users sustaining atypical fracture and those without fracture (7.9 [±3.5] vs. 7.7 [±3.3] years, p=0.7). Bisphosphonate users who fractured had acute/varus pre-fracture neck-shaft angles (p<0.001), shorter hip-axis length (p<0.01), and narrower center-edge angles (p<0.01). Regression analysis revealed associations between neck-shaft angle (OR=0.89 [95% CI=0.81-0.97; p=0.01), center edge angle (OR=0.89 [95% CI=0.80-0.99]; p=0.03), and BMI (OR=1.15 [95% CI=1.02-1.31; p=0.03) with fracture development. ROC curve analysis (AUC=0.67 [95% CI=0.56-0.79]) determined that a cut-off point for neck-shaft angle <128.3° yielded 69% sensitivity and 63% specificity for development of atypical femoral fracture. Ultimately, an acute/varus angle of the femoral neck, high BMI, and narrow center-edge angle were

  4. Bilateral femoral neck stress fractures in military recruits with unilateral hip pain.

    PubMed

    Moo, Ing How; Lee, Y H D; Lim, K K; Mehta, K V

    2016-10-01

    Femoral neck stress fractures are rare and can be easily missed and failure to diagnose these injuries early can lead to avascular necrosis, malunion and osteoarthritis. It is important to have a high index of suspicion for femoral neck stress fractures in military recruits. We present three cases of bilateral femoral neck fractures in military recruits, all presenting with unilateral hip symptoms and signs. All the asymptomatic contralateral hips had femoral neck stress fractures diagnosed by screening MRI. Tension type and displaced femoral neck fractures were treated surgically. All the fractures managed healing without complications. Military recruits with unilateral groin pain should have an early referral for MRI hip to rule out femoral neck stress fractures and those military personnel with ipsilateral femoral neck fracture should have MRI of the contralateral hip. Two of the patients had vitamin D deficiency, of which one had elevated parathyroid hormones and low bone mineral density. Our case series highlights the significance of vitamin D deficiency among military recruits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. [Fractures of the tibial shaft].

    PubMed

    Märdian, S; Schwabe, P; Schaser, K-D

    2015-02-01

    The tibia shaft is the most often fractured long bone of human beings. Among others traffic accidents (37.5 %), falls (17.8 %), sport accidents (30.9 %) and assaults (4.5 %) are typical mechanisms. A brief clinical examination including the correct classification of the fracture pattern and even more important the degree of the soft tissue damage are the most crucial factors for the following therapeutic cascade. This follows a defined algorithm based on the degree of soft tissue damage. As biplanar X-ray diagnostics are obligatory, CT scans are subject to complex fracture patterns and accompanying intraarticular pathologies.The treatment of tibial shaft fractures is the preserve of operative stabilization, which should be done primarily depending on the degree of the soft tissue injury. Here intramedullary methods - especially intramedullary nailing - are the golden standard.The most serious complication of these fractures is the development of a compartment syndrome. This requires rapid diagnosis and an adequate surgical management in order to avoid extensive muscle necrosis with ischaemic contractures and irreversible neurovascular deficits. Apart from postoperative infections, which are the predominant complication especially in open injuries, non union provide typical and late complications which are partly difficult to treat. These should, depending on their type, follow a dedicated treatment algorithm.

  6. Vibration control of rotor shaft

    NASA Technical Reports Server (NTRS)

    Nonami, K.

    1985-01-01

    Suppression of flexural forced vibration or the self-excited vibration of a rotating shaft system not by passive elements but by active elements is described. The distinctive feature of this method is not to dissipate the vibration energy but to provide the force cancelling the vibration displacement and the vibration velocity through the bearing housing in rotation. Therefore the bearings of this kind are appropriately named Active Control Bearings. A simple rotor system having one disk at the center of the span on flexible supports is investigated in this paper. The actuators of the electrodynamic transducer are inserted in the sections of the bearing housing. First, applying the optimal regulator of optimal control theory, the flexural vibration control of the rotating shaft and the vibration control of support systems are performed by the optimal state feedback system using these actuators. Next, the quasi-modal control based on a modal analysis is applied to this rotor system. This quasi-modal control system is constructed by means of optimal velocity feedback loops. The differences between optimal control and quasi-modal control are discussed and their merits and demerits are made clear. Finally, the experiments are described concerning only the optimal regulator method.

  7. Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 cases

    PubMed Central

    2011-01-01

    Background Flexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up. Material and methods We included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined. Results Mean age at final follow up was 15.5 years (10-21 years). Mean follow up was 7.16 years (5.0-8.6 years). Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures. All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection(2), proximal migration of nail(3), irritation at nail insertion site(5) and penetration of femoral neck with nail tip(1). There were 59 excellent, 10 satisfactory and 4 poor results. Conclusion Flexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures. PMID:22192682

  8. Femoral neck fractures in osteogenesis imperfecta treated with bisphosphonates

    PubMed Central

    Papanna, M. C.; Tafazal, S.; Bell, M. J.; Giles, S. N.; Fernandes, J. A.

    2017-01-01

    Abstract Purpose Osteogenesis imperfecta (OI) is a condition characterised by bone fragility and multiple fractures, which cause considerable morbidity in the affected patients. Most cases are associated with mutations in one of the type I collagen genes. Recently, bisphosponates have been used widely to reduce pain and the incidence of fragility fractures in OI in children, even though there have been concerns raised regarding the long-term complications of it due to their effect on the bone. The fragility fractures involving the neck of the femur in children with intramedullary rods in the femoral shaft are very difficult to treat. Although these fractures are frequently un-displaced, they require optimal internal fixation to achieve fracture union. The aim of this study was to assess the clinical and radiological outcomes of OI patients with intracapsular femoral neck fracture treated with headless compression screws. Method and results At our institute, we identified seven patients (11 hips) with OI who underwent internal fixation with headless compression screws for a neck of femur fracture between June 2010 and Dec 2012. The time to fractures healing was on average 14 weeks (12 to 16). All patients gained their pre-injury ambulatory status. Conclusion It is very challenging and technically demanding for orthopaedic surgeons when treating the fragility fracture of the neck of femur in patients with intramedullary rod in the femoral shaft. The published data regarding the management of these complex conditions are very limited. We describe our experience with the technique of percutaneous headless compression screw fixation for treating the femoral neck fractures in OI patients. PMID:28828062

  9. Bone shaft bending strength index is unaffected by exercise and unloading in mice.

    PubMed

    Wallace, Ian J; Gupta, Shikha; Sankaran, Jeyantt; Demes, Brigitte; Judex, Stefan

    2015-03-01

    Anthropologists frequently use the shaft bending strength index to infer the physical activity levels of humans living in the past from their lower limb bone remains. This index is typically calculated as the ratio of bone shaft second moments of area about orthogonal principal axes (i.e. I(max)/I(min)). Individuals with high I(max)/I(min) values are inferred to have been very active, whereas individuals with low values are inferred to have been more sedentary. However, there is little direct evidence that activity has a causal and predictable effect on the shaft bending strength index. Here, we report the results of two experiments that were designed to test the model within which anthropologists commonly interpret the shaft bending strength index. In the first experiment, mice were treated daily with treadmill exercise for 1 month to simulate a high-activity lifestyle. In the second experiment, in an attempt to simulate a low-activity lifestyle, functional weight-bearing was removed from the hindlimbs of mice for 1 month. Femoral mid-shaft structure was determined with μCT. We found that while exercise resulted in significant enhancement of I(max) and I(min) compared with controls, it failed to significantly increase the I(max)/I(min)index. Similarly, stunted bone growth caused by unloading resulted in significantly diminished I(max) and I(min) compared with controls, but low activity did not lead to significantly decreased I(max)/I(min)compared with normal activity. Together, these results suggest that caution is required when the bone shaft bending strength index is used to reconstruct the activity levels of past humans.

  10. Bone shaft bending strength index is unaffected by exercise and unloading in mice

    PubMed Central

    Wallace, Ian J; Gupta, Shikha; Sankaran, Jeyantt; Demes, Brigitte; Judex, Stefan

    2015-01-01

    Anthropologists frequently use the shaft bending strength index to infer the physical activity levels of humans living in the past from their lower limb bone remains. This index is typically calculated as the ratio of bone shaft second moments of area about orthogonal principal axes (i.e. Imax/Imin). Individuals with high Imax/Imin values are inferred to have been very active, whereas individuals with low values are inferred to have been more sedentary. However, there is little direct evidence that activity has a causal and predictable effect on the shaft bending strength index. Here, we report the results of two experiments that were designed to test the model within which anthropologists commonly interpret the shaft bending strength index. In the first experiment, mice were treated daily with treadmill exercise for 1 month to simulate a high-activity lifestyle. In the second experiment, in an attempt to simulate a low-activity lifestyle, functional weight-bearing was removed from the hindlimbs of mice for 1 month. Femoral mid-shaft structure was determined with μCT. We found that while exercise resulted in significant enhancement of Imax and Imin compared with controls, it failed to significantly increase the Imax/Imin index. Similarly, stunted bone growth caused by unloading resulted in significantly diminished Imax and Imin compared with controls, but low activity did not lead to significantly decreased Imax/Imin compared with normal activity. Together, these results suggest that caution is required when the bone shaft bending strength index is used to reconstruct the activity levels of past humans. PMID:25645569

  11. Synchronous Ipsilateral High Submuscular Placement of Prosthetic Balloons and Reservoirs.

    PubMed

    Kavoussi, Nicholas L; Hofer, Matthias D; Viers, Boyd R; Cordon, Billy H; Mooney, Ryan P; Pagliara, Travis J; Scott, Jeremy M; Morey, Allen F

    2017-02-01

    Synchronous ipsilateral high submuscular placement of artificial urinary sphincter (AUS) pressure-regulating balloons (PRBs) and inflatable penile prosthesis (IPP) reservoirs in a single submuscular tunnel is a novel strategy that could be advantageous for patients who have had major pelvic surgery. To report our initial experience with synchronous ipsilateral vs bilateral placement of AUS PRBs and IPP reservoirs in men undergoing implant surgery. We retrospectively reviewed all patients undergoing synchronous AUS and IPP placement from 2007 through 2015 by a single surgeon at our tertiary center. Patients were stratified according to ipsilateral vs bilateral placement of the AUS PRB and IPP reservoir. Reoperation rates because of infectious or erosive complications and mechanical failure were assessed. Of the 968 implant surgeries during the study period, 47 men had synchronous device placement, of whom 17 (36%) underwent ipsilateral placement of the PRB and reservoir. During a median follow-up of 19 months (range = 1-84 months), reoperations were necessary in 12 of 47 (26%) and were similar between groups (ipsilateral, 5 of 17, 29%; bilateral, 7 of 30, 23%; P = .73). Most reoperations were due to AUS-related complications (10 of 12, 83%) and nearly all patients with reoperation (10 of 12, 83%) had compromised urethras (ie, prior urethral surgery, radiation, or prior AUS implantation). The most common indication for reintervention was cuff erosion (4 of 47, 9%), with no difference between groups (ipsilateral, 3 of 17, 18%; bilateral, 1 of 30, 3%; P = .13). Synchronous ipsilateral high submuscular placement of urologic prosthetic balloons could safely facilitate prosthetic surgery in patients with a history of major pelvic and inguinal surgery. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  12. A Prospective Study of Pain Reduction and Knee Dysfunction Comparing Femoral Skeletal Traction and Splinting in Adult Trauma Patients

    PubMed Central

    Bumpass, David B.; Ricci, William M.; McAndrew, Christopher M.; Gardner, Michael J.

    2014-01-01

    Objectives 1) Determine if distal femoral traction pins result in knee dysfunction in femoral or pelvic fracture patients, and 2) to determine if skeletal traction relieves pain more effectively than splinting for femoral shaft fractures. Design Prospective cohort trial. Setting Level I urban trauma center. Patients/Participants 120 adult patients with femoral shaft, acetabular, and unstable pelvic fractures. Intervention Patients with femoral shaft fractures were placed into distal femoral skeletal traction or a long-leg splint, based on an attending-specific protocol. Pelvic or acetabular fracture patients with instability or intra-articular bone fragments were placed into skeletal traction. Main Outcome Measurements An initial Lysholm knee survey was administered to assess pre-injury knee pain and function; the survey was repeated at 3- and 6-month follow-up visits. Also, a 10-point visual analog scale (VAS) was used to document pain immediately before, during, and immediately after fracture immobilization with traction or splinting. Results Thirty-five patients (29%) were immobilized with a long-leg splint, and 85 (71%) were immobilized with a distal femoral traction pin. Eighty-four patients (70%) completed 6-month follow-up. Lysholm scores decreased by a mean 9.3 points from pre-injury baseline to 6 months post-injury in the entire cohort (p<0.01); no significant differences were found between the splint and traction pin groups. During application of the immobilization, VAS pain scores were significantly lower in traction patients as compared to splinted patients (mean 1.9 points less, p<0.01). Traction pins caused no infections, neurovascular injuries, or iatrogenic fractures. Conclusions Distal femoral skeletal traction does not result in detectable knee dysfunction at six months post-insertion, and results in less pain during and after immobilization than long-leg splinting. PMID:25050750

  13. Unitary Shaft-Angle and Shaft-Speed Sensor Assemblies

    NASA Technical Reports Server (NTRS)

    Alhorn, Dean C.; Howard, David E.; Smith, Dennis A.

    2006-01-01

    The figure depicts a unit that contains a rotary-position or a rotary-speed sensor, plus electronic circuitry necessary for its operation, all enclosed in a single housing with a shaft for coupling to an external rotary machine. This rotation sensor unit is complete: when its shaft is mechanically connected to that of the rotary machine and it is supplied with electric power, it generates an output signal directly indicative of the rotary position or speed, without need for additional processing by other circuitry. The incorporation of all of the necessary excitatory and readout circuitry into the housing (in contradistinction to using externally located excitatory and/or readout circuitry) in a compact arrangement is the major difference between this unit and prior rotation-sensor units. The sensor assembly inside the housing includes excitatory and readout integrated circuits mounted on a circular printed-circuit board. In a typical case in which the angle or speed transducer(s) utilize electromagnetic induction, the assembly also includes another circular printed-circuit board on which the transducer windings are mounted. A sheet of high-magnetic permeability metal ("mu metal") is placed between the winding board and the electronic-circuit board to prevent spurious coupling of excitatory signals from the transducer windings to the readout circuits. The housing and most of the other mechanical hardware can be common to a variety of different sensor designs. Hence, the unit can be configured to generate any of variety of outputs by changing the interior sensor assembly. For example, the sensor assembly could contain an analog tachometer circuit that generates an output proportional (in both magnitude and sign or in magnitude only) to the speed of rotation.

  14. Cortical bone distribution in the femoral neck of hominoids: implications for the locomotion of Australopithecus afarensis.

    PubMed

    Ohman, J C; Krochta, T J; Lovejoy, C O; Mensforth, R P; Latimer, B

    1997-09-01

    Contiguous high resolution computed tomography images were obtained at a 1.5 mm slice thickness perpendicular to the neck axis from the base of the femoral head to the trochanteric line in a sample of 10 specimens each of Homo sapiens, Pan troglodytes, and Gorilla gorilla, plus five specimens of Pan paniscus. Superior, inferior, anterior, and posterior cortical thicknesses were automatically measured directly from these digital images. Throughout the femoral neck H. sapiens displays thin superior cortical bone and inferior cortical bone that thickens distally. In marked contrast, cortical bone in the femoral neck of African apes is more uniformly thick in all directions, with even greater thickening of the superior cortical bone distally. Because the femoral neck acts as a cantilevered beam, its anchorage at the neck-shaft junction is subjected to the highest bending stresses and is the most biomechanically relevant region to inspect for response to strain. As evinced by A.L. 128-1, A.L. 211-1 and MAK-VP-1/1, Australopithecus afarensis is indistinguishable from H. sapiens, but markedly different from African apes in cortical bone distribution at the femoral neck-shaft junction. Cortical distribution in the African ape indicates much greater variation in loading conditions consistent with their more varied locomotor repertoire. Cortical distribution in hominids is a response to the more stereotypic loading pattern imposed by habitual bipedality, and thin superior cortex in A. afarensis confirms the absence of a significant arboreal component in its locomotor repertoire.

  15. Pertrochanteric osteotomy and distraction femoral neck lengthening for treatment of proximal hip ischemic deformities in children.

    PubMed

    Teplenky, Mikhail; Mekki, Waleed

    2016-02-01

    Proximal femoral ischemic deformities in the pediatric population is a challenging pathological situation. Many surgical techniques have been proposed to treat this problem, with variable reported results. We believe that a C-shaped pertrochanteric osteotomy plus neck lengthening utilizing distraction osteogenesis principles would restore the femoral anatomical ratios between neck, shaft, and the head, and redress the biomechanics of the proximal femur with resultant sufficient containment of the femoral head within the acetabulum. We reviewed the results of 19 patients divided into two groups with proximal femoral ischemic deformities. Between 2002 and 2009, preoperative and postoperative clinical examination and radiographs were assessed measuring the neck-shaft angle (NSA), neck-epiphyseal angle (NEA), articulo-trochanteric distance (ATD), lateralization of the greater trochanter (LT), the angle of Wiberg (CEA), index of lateral head displacement by Reimers (IM), and lateral angle of displacement (LDA). All patients were followed prospectively. Clinical outcome was assessed using Colton's criteria, which showed average good improvement in function (58.9 %). Radiological indicators were assessed using Kruczynski's criteria. For group I, the postoperative NSA, NEA, and CEA showed significant change (p < 0.01, p < 0.001, and p < 0.001, respectively). For group II, the postoperative NSA, NEA, and CEA showed significant change (p < 0.001, p < 0.001, and p < 0.001, respectively). The midterm functional results are favorable for the implementation of pertrochanteric osteotomy and distraction osteogenesis to treat proximal femoral ischemic deformities in the pediatric population.

  16. Surgical treatment of femoral bending deformity in a patient with vitamin D-resistant rickets.

    PubMed

    Platzer, Patrick; Thalhammer, Gerhild; Vecsei, Vilmos; Wozasek, Gerald E

    2005-10-01

    Surgical treatment of patients with vitamin D-resistant rickets is reserved for management of severe deformities or pathological fractures of the lower limbs. This case report describes the operative management of a child with vitamin D-resistant rickets suffering from a pathological fracture and a bending deformity of the right femoral bone. A modified technique of fragmentation and realignment by intramedullary fixation was performed using an unreamed humerus nail. We corrected the anatomical proximal femoral shaft angle (aMPFA) from 68 degrees to 84 degrees and achieved three more centimetres of femoral length. The same procedure was performed on the left femur and corrected the aMPFA from 108 degrees to 89 degrees and gained 2.5 more centimetres of femoral length. Thus the legs were almost equal in length. We preferred the modified technique of multiple osteotomies and intramedullary fixation by nailing (originally described by Sofield and Millar) because the correction of angulation and rotation of the femoral shaft in one step appeared to be much easier than with plate fixation. Moreover, this method seems to reduce the number of refractures and enables the patients to approach the normal activities of growing children.

  17. Unusual Foreign Bone Fragment in Femoral Open Fracture

    PubMed Central

    Sadoni, Hanon; Arti, Hamidreza

    2016-01-01

    Introduction: Femoral shaft fracture is one of the typical bone fractures due to high energy trauma and may occur as an open fracture. Some foreign materials may enter the fracture site such as sand, cloth particles and so on. Case Presentation: A 28-year-old motorcycle riding military member and his collaborator were received in the hospital because of multiple traumas due to a fall in a hollow during a surveillance mission. His collaborator died because of head trauma and multiple severe open fractures. When fixing the patients femoral fracture, a large femoral butterfly fragment was removed from the patient’s thigh as a foreign segment. The patient’s femur was fixed with a plate and screws. No femoral defect was detected during surgery or post-operative X-rays and CT scan. The removed segment was not a part of the patient’s femur. Conclusions: Surgical and post-surgical findings showed that this segment was not related to the patient’s femur. The foreign segment may have belonged to the other victim of this trauma. PMID:27218050

  18. Modelling the deflection of rowing oar shafts.

    PubMed

    Laschowski, Brock; Hopkins, Cameron C; de Bruyn, John R; Nolte, Volker

    2017-03-01

    The deflection of rowing oar shafts subjected to a static load was investigated. Two sets of sculling oars of different design stiffness were tested at three different lengths from 2.66 to 2.70 m. Loads up to 201 N were applied to the blade end of the oar shafts, and deflections were measured at six positions along the length of the shafts. The experimental results were compared with theoretical predictions obtained by modelling the oar shafts as homogenous end-loaded cantilever beams. The results show that the oar shafts are not uniform, in contradiction to the assumed model, but rather are most compliant near the sleeves and up to 80% stiffer towards the blades. The effect of oar shaft stiffness and length on the deflection angle at the blade end of the oar shaft was at most 1.18 ± 0.01°. The measured variation of stiffness along the shaft has implications for boat propulsion and rowing performance.

  19. Spiral groove seal. [for rotating shaft

    NASA Technical Reports Server (NTRS)

    Ludwig, L. P.; Strom, T. N. (Inventor)

    1974-01-01

    Mating flat surfaces inhibit leakage of a fluid around a stationary shaft. A spiral groove produces a pumping action toward the fluid when the shaft rotates. This prevents leakage while a generated hydraulic lifting force separates the mating surfaces to minimize wear. Provision is made for placing these spiral grooves in communication with the fluid to accelerate the generation of the hydraulic lifting force.

  20. Online shaft encoder geometry compensation for arbitrary shaft speed profiles using Bayesian regression

    NASA Astrophysics Data System (ADS)

    Diamond, D. H.; Heyns, P. S.; Oberholster, A. J.

    2016-12-01

    The measurement of instantaneous angular speed is being increasingly investigated for its use in a wide range of condition monitoring and prognostic applications. Central to many measurement techniques are incremental shaft encoders recording the arrival times of shaft angular increments. The conventional approach to processing these signals assumes that the angular increments are equidistant. This assumption is generally incorrect when working with toothed wheels and especially zebra tape encoders and has been shown to introduce errors in the estimated shaft speed. There are some proposed methods in the literature that aim to compensate for this geometric irregularity. Some of the methods require the shaft speed to be perfectly constant for calibration, something rarely achieved in practice. Other methods assume the shaft speed to be nearly constant with minor deviations. Therefore existing methods cannot calibrate the entire shaft encoder geometry for arbitrary shaft speeds. The present article presents a method to calculate the shaft encoder geometry for arbitrary shaft speed profiles. The method uses Bayesian linear regression to calculate the encoder increment distances. The method is derived and then tested against simulated and laboratory experiments. The results indicate that the proposed method is capable of accurately determining the shaft encoder geometry for any shaft speed profile.

  1. Endoscope shaft-rigidity control mechanism: "FORGUIDE".

    PubMed

    Loeve, Arjo J; Plettenburg, Dick H; Breedveld, Paul; Dankelman, Jenny

    2012-02-01

    Recent developments in flexible endoscopy and other fields of medical technology have raised the need for compact slender shafts that can be made rigid and compliant at will. A novel compact mechanism, named FORGUIDE, with this functionality was developed. The FORGUIDE shaft rigidifies due to friction between a ring of cables situated between a spring and an inflated tube. A mathematical model for the FORGUIDE mechanism working principle was made and used to obtain understanding of this mechanism, predict the maximum rigidity of a FORGUIDE shaft design, and tune its design variables. The mathematical model gave suggestions for significant performance improvement by fine-tuning the design. A prototype FORGUIDE shaft was built and put to a series of bench tests. These tests showed that the FORGUIDE mechanism provides a reliable and simple way to control the rigidity of a flexible shaft.

  2. Passive magnetic bearing for a horizontal shaft

    DOEpatents

    Post, Richard F.

    2003-12-02

    A passive magnetic bearing is composed of a levitation element and a restorative element. The levitation element is composed of a pair of stationary arcuate ferromagnetic segments located within an annular radial-field magnet array. The magnet array is attached to the inner circumference of a hollow shaft end. An attractive force between the arcuate segments and the magnet array acts vertically to levitate the shaft, and also in a horizontal transverse direction to center the shaft. The restorative element is comprised of an annular Halbach array of magnets and a stationary annular circuit array located within the Halbach array. The Halbach array is attached to the inner circumference of the hollow shaft end. A repulsive force between the Halbach array and the circuit array increases inversely to the radial space between them, and thus acts to restore the shaft to its equilibrium axis of rotation when it is displaced therefrom.

  3. Shaft Sinking at the Nevada Test Site, U1h Shaft Project

    SciTech Connect

    B. Briggs; R. Musick

    2001-03-01

    The U1h Shaft Project is a design/build subcontract to construct one 6.1 meter (m) (20 feet (ft)) finished diameter shaft to a depth of 321.6 m (1,055 ft.) at the Nevada Test Site. Atkinson Construction was subcontracted by Bechtel Nevada to construct the U1h Shaft for the U.S. Department of Energy. The project consists of furnishing and installing the sinking plant, construction of the 321.6 m (1,055 ft.) of concrete lined shaft, development of a shaft station at a depth of 297.5 m (976 ft.), and construction of a loading pocket at the station. The outfitting of the shaft and installation of a new hoist may be incorporated into the project at a later date. This paper will describe the design phase, the excavation and lining operation, shaft station construction and the contractual challenges encountered on this project.

  4. Unilateral tilted disc and ipsilateral keratoconus in the same eye

    PubMed Central

    Ciftci, Suleyman

    2011-01-01

    The objective of this case was to report unilateral tilted disc in a boy with ipsilateral keratoconus. The tilted disc syndrome is a non-hereditary bilateral condition. This configuration is accompanied by situs inversus of the retinal vessels, congenital inferonasal conus, thinning of the inferonasal retinal pigment epithelium and choroid, and myopic astigmatism. Unilateral tilted disc syndrome is a rare condition. Keratoconus is a disorder characterised by progressive corneal steepening. The author present a case of unilateral tilted disc in a boy with ipsilateral keratoconus. Pterygium is a common disorder and tilted disc syndrome is a bilateral condition. But unilateral tilted disc in a boy with ipsilateral keratoconus is the first report in literature. Due to these clinical presentation, this report is an exception in literature and reported an unknown clinical coincident. PMID:22692492

  5. Wing-Wake Interactions between Ipsilateral Wings in Dragonfly Flight

    NASA Astrophysics Data System (ADS)

    Dong, Haibo; Liang, Zongxian

    2009-11-01

    Bilateral and ipsilateral wing-wing interactions can be commonly observed in insect flights. As a representative example of ipsilateral wing-wing interaction, dragonflies in flight have been widely studied. An important fact is that the flow over their hindwings is affected by the presence of the forewings. Wake capture and phase-change play very important role on aerodynamic performance of the hindwings We present a direct numerical simulation of a modeled dragonfly (Aeshna juncea) in slow flight as studied in Azuma et al (JEB 1985). Realistic morphologies of wing, body, and kinematics are used for maximum including wing and body features of a dragonfly. This work aims to study the relations between wake-topology and aerodynamic performance due to wing-wing and wing-wake interactions of dragonfly ipsilateral wings. DNS results are also compared with Local Momentum Theory (Azuma et al).

  6. Combined autologous chondrocyte implantation (ACI) with supra-condylar femoral varus osteotomy, following lateral growth-plate damage in an adolescent knee: 8-year follow-up

    PubMed Central

    2011-01-01

    We report the 8-year clinical and radiographic outcome of an adolescent patient with a large osteochondral defect of the lateral femoral condyle, and ipsilateral genu valgum secondary to an epiphyseal injury, managed with autologous chondrocyte implantation (ACI) and supracondylar re-alignment femoral osteotomy. Long-term clinical success was achieved using this method, illustrating the effective use of re-alignment osteotomy in correcting mal-alignment of the knee, protecting the ACI graft site and providing the optimum environment for cartilage repair and regeneration. This is the first report of the combined use of ACI and femoral osteotomy for such a case. PMID:21418566

  7. Combined autologous chondrocyte implantation (ACI) with supra-condylar femoral varus osteotomy, following lateral growth-plate damage in an adolescent knee: 8-year follow-up.

    PubMed

    Vijayan, Sridhar; Bentley, George

    2011-03-18

    We report the 8-year clinical and radiographic outcome of an adolescent patient with a large osteochondral defect of the lateral femoral condyle, and ipsilateral genu valgum secondary to an epiphyseal injury, managed with autologous chondrocyte implantation (ACI) and supracondylar re-alignment femoral osteotomy. Long-term clinical success was achieved using this method, illustrating the effective use of re-alignment osteotomy in correcting mal-alignment of the knee, protecting the ACI graft site and providing the optimum environment for cartilage repair and regeneration. This is the first report of the combined use of ACI and femoral osteotomy for such a case.

  8. Shaft/shaft-seal interface characteristics of a multiple disk centrifugal blood pump.

    PubMed

    Manning, K B; Miller, G E

    1999-06-01

    A multiple disk centrifugal pump (MDCP) is under investigation as a potential left ventricular assist device. As is the case with most shaft driven pumps, leakage problems around the shaft/shaft seal interface are of major interest. If leakage were to occur during or after implantation, potential events such as blood loss, clotting, blood damage, and/or infections might result in adverse effects for the patient. Because these effects could be quite disastrous, potential shaft and shaft seal materials have been investigated to determine the most appropriate course to limit these effects. Teflon and nylon shaft seals were analyzed as potential candidates along with a stainless steel shaft and a Melonite coated shaft. The materials and shafts were evaluated under various time durations (15, 30, 45, and 60 min), motor speeds (800, 1,000, 1,200, and 1,400 rpm), and outer diameters (1/2 and 3/4 inches). The motor speed and geometrical configurations were typical for the MDCP under normal physiologic conditions. An air and water study was conducted to analyze the inner diameter wear, the inner temperature values, and the outer temperature values. Statistical comparisons were computed for the shaft seal materials, the shafts, and the outer diameters along with the inner and outer temperatures. The conclusions made from the results indicate that both the tested shaft seal materials and shaft materials are not ideal candidates to be used for the MDCP. Teflon experienced a significant amount of wear in air and water studies. Nylon did experience little wear, but heat generation was an evident problem. A water study on nylon was not conducted because of its molecular structure.

  9. Calibration of ipsilateral stimulus transducer for acoustic reflex measurements.

    PubMed

    Olsen, S; Osterhammel, P A; Rasmussen, A N; Nielsen, L H

    1995-01-01

    Pure-tone Reference Equivalent Threshold Sound Pressure Level (RETSPL) of the ipsilateral stimulus receiver for acoustic reflex measurements on Madsen Electronics type Zodiac 901 impedance audiometer is provided. The results, obtained from 20 normal-hearing subjects, are achieved by comparing hearing threshold levels measured using a TDH 39 telephone (calibrated to ISO 389) with thresholds recorded using the ipsilateral stimulus insert phone. The calibration is referenced to an IEC-711 ear simulator and comprises the following frequencies: 125, 250, 500, 750, 1000, 1500, 2000, 3000, 4000, 6000, 8000 Hz.

  10. Psychogenic unilateral ptosis with ipsilateral muscle spasm of orbicular oculi.

    PubMed

    Matsumoto, Hideyuki; Shimizu, Takahiro; Igeta, Yukifusa; Hashida, Hideji

    2012-07-01

    This report describes the rare case of a 27-year-old female patient with conversion disorder who presented unilateral ptosis with ipsilateral muscle spasm of orbicular oculi. The co-existing of ptosis and muscle spasm of orbicular oculi indicates that, in accord with prior reports, the overactivity of orbicular oculi is essential in psychogenic pseudoptosis. The co-existing of unilateral ptosis and ipsilateral muscle spasm of orbicular oculi in the present case leads us to the conclusion that the overactivity of orbicular oculi is essential in psychogenic pseudoptosis.

  11. Becker's nevus with ipsilateral breast hypoplasia: improvement with spironolactone.

    PubMed

    Hoon Jung, Jae; Chan Kim, You; Joon Park, Hyang; Woo Cinn, Yong

    2003-02-01

    Ipsilateral breast hypoplasia is a rare abnormality in Becker's nevus. The pathogenesis of the breast hypoplasia is not understood, but an increased level of androgenic receptor in the affected area may play a role. We report a case of Becker's nevus with ipsilateral breast hypoplasia. Spironolactone, an anti-androgenic agent, was tried for treatment of the hypoplasia, and, one month later, breast enlargement was seen in only the hypoplastic breast with Becker's nevus. This finding supports the theory that breast hypoplasia in Becker's nevus is related to an increase in androgenic receptor.

  12. Turbocharger with improved roller bearing shaft support

    SciTech Connect

    Gutknecht, D.A.

    1991-10-08

    This paper describes an exhaust gas driven turbocharger. It comprises: a housing, a shaft within the housing having a pair of ends, a compressor wheel mounted within the housing on one end of the shaft for rotation therewith, a turbine wheel mounted within the housing on the other end of the shaft for rotation therewith, means for communicating air through the compressor wheel, means for communicating exhaust gas through the turbine wheel to cause the latter to rotate the shaft and the compressor wheel mounted thereon to compress the air communicated through the compressor wheel, and bearing means mounting the shaft for rotation relative to the housing, the bearing means including a bearing outer ring, a bearing inner ring, and ball bearing elements supporting the bearing outer ring on the bearing inner ring, the ball bearing elements includes a first set of the elements and a second set of the elements spaced axially from the first set, the bearing outer ring being a rigid, uninterrupted member providing an uninterrupted structural link between the first and second sets to establish the axial spacing between the sets, a pair of axially spaced faying surfaces on the inner ring engaging corresponding faying surfaces on the shaft to support the inner ring on the shaft, the shaft defining a circumferentially extending surface between the faying surfaces on the inner ring cooperating with the shaft to define an air gap therebetween, one of the faying surfaces on the inner ring having a diameter greater than the diameter of the other of the faying surfaces on the inner ring.

  13. Femoral fractures in children, is early interventional treatment beneficial?

    PubMed

    Sturdee, S W; Templeton, P A; Dahabreh, Z; Cullen, E; Giannoudis, P V

    2007-08-01

    A protocol of early intervention (flexible intramedullary nails, early hip spica, and external fixation) was started in 1999 and during a 3-year period there were 25 children who sustained a femoral shaft fracture (early intervention group). These were prospectively reviewed with a minimum follow up of 24 months (Range 24-35 months). A historical control group of 41 children was used. These children were injured between February 1996 and February 1999 and were retrospectively reviewed. They had traditional in patient treatments with either Gallows or Thomas splint traction (traditional treatment group). Over the 6-year period from 1996 to 2002 there were a total of 66 femoral shaft fractures in the study that presented to our hospital. The mean length of hospital stay was 29 nights in the traditional group and 10 nights in the early intervention group. This difference is significant (p<0.001). The malunion rate was slightly higher in the early active group at radiological union but most of these remodelled over the 2 years of follow up. The protocol of early intervention used in our institution, of flexible nails, early hip spica or external fixation depended on the age of the child, and has resulted in a shorter hospital stay for the children. This has benefits for the child, the family and the hospital.

  14. Stress Analysis of Pallet Lever Shaft

    DTIC Science & Technology

    1976-03-01

    AD-A03/ ^17 FA-TR-76028 STI(ESS ANALYSIS OF PALLET LEVER SHAFT by ?aul F. Gordon Fee Hen Lee Ramesh Kajaria TECHNICAL LIBRARY March 1976...for FA Report TR-76028 (March 1976) tITLE: Stress Analysis of Pallet Lever Shaft "AUTHORS: Paul F. Gordon, Fee M. Lee, Ramesh Kajaria 𔄃...force of magnitude Fw and a couple (see Fig 4, page 13). This force, Fw, acts on the shaft at the center of the pallet , and its distance M, from

  15. Computing Thermal Performances Of Shafts And Bearings

    NASA Technical Reports Server (NTRS)

    Woods, Claudia M.

    1992-01-01

    SHABERTH computer program developed to predict steady-state and transient thermal performance of multi-bearing shaft system operating with either wet or dry friction. Calculates loads, torques, temperatures, and fatigue lives for ball and/or roller bearings on single shaft. Enables study of many causes of instabilities in bearings. Also provides for analysis of reaction of system to termination of supply of lubricant to bearings and other lubricated mechanical elements. Valuable software tool in design and analysis of shaft bearing systems. Written in FORTRAN IV.

  16. Computing Thermal Performances Of Shafts And Bearings

    NASA Technical Reports Server (NTRS)

    Woods, Claudia M.

    1992-01-01

    SHABERTH computer program developed to predict steady-state and transient thermal performance of multi-bearing shaft system operating with either wet or dry friction. Calculates loads, torques, temperatures, and fatigue lives for ball and/or roller bearings on single shaft. Enables study of many causes of instabilities in bearings. Also provides for analysis of reaction of system to termination of supply of lubricant to bearings and other lubricated mechanical elements. Valuable software tool in design and analysis of shaft bearing systems. Written in FORTRAN IV.

  17. Valgus slipped capital femoral epiphysis: subcapital growth plate orientation analysis.

    PubMed

    Koczewski, Paweł

    2013-11-01

    The aim of the study was to determine the risk factors of unusual, lateral direction of epiphyseal displacement in primarily unilateral slipped capital femoral epiphysis (SCFE) patients with a special focus on radiological parameters of an unaffected hip. A total of 115 patients (75 boys, 40 girls), mean age 13.2 years (8.4-18.6), were analyzed. The mean follow-up time was 11 years (2-29). The proportion of valgus slip among SCFE patients was 11 of 115 cases (9.6%). The patients with valgus slip compared with the classic ones were predominantly females (55 vs. 33%), were younger (11.1 vs. 13.4 years), had a greater epiphyseal-shaft angle (67.4 vs. 59.1°), smaller displacement in the frontal plane (absolute value 6.7 vs. 15°), and a lower risk of contralateral slip (27 vs. 65%). There was no difference in the neck-shaft angle and epiphyseal-neck angle value. A more horizontal orientation of the subcapital growth plate, assessed by epiphyseal-shaft angle, can be considered a conducive factor in the valgus direction of epiphyseal slip in SCFE. In valgus SCFE cases, there is a smaller degree of epiphyseal displacement in both the sagittal and the coronal plane and a lower risk of consecutive contralateral slip.

  18. 30 CFR 56.19100 - Shaft landing gates.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft landing gates. 56.19100 Section 56.19100... SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Personnel Hoisting Shafts § 56.19100 Shaft landing gates. Shaft landings shall be equipped with substantial safety gates...

  19. 30 CFR 57.19109 - Shaft inspection and repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft inspection and repair. 57.19109 Section 57.19109 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Hoisting Shafts § 57.19109 Shaft inspection and repair. Shaft inspection and repair work in vertical...

  20. 30 CFR 56.19109 - Shaft inspection and repair.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft inspection and repair. 56.19109 Section 56.19109 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Hoisting Shafts § 56.19109 Shaft inspection and repair. Shaft inspection and repair work in vertical...

  1. 30 CFR 75.1711-1 - Sealing of shaft openings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Sealing of shaft openings. 75.1711-1 Section 75... shaft openings. Shaft openings required to be sealed under § 75.1711 shall be effectively capped or filled. Filling shall be for the entire depth of the shaft and, for the first 50 feet from the bottom...

  2. 30 CFR 56.19104 - Clearance at shaft stations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Clearance at shaft stations. 56.19104 Section 56.19104 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Hoisting Shafts § 56.19104 Clearance at shaft stations. Suitable clearance at shaft stations shall...

  3. 30 CFR 57.19104 - Clearance at shaft stations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Clearance at shaft stations. 57.19104 Section 57.19104 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Hoisting Shafts § 57.19104 Clearance at shaft stations. Suitable clearance at shaft stations shall...

  4. 30 CFR 77.1911 - Ventilation of slopes and shafts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Ventilation of slopes and shafts. 77.1911... COAL MINES Slope and Shaft Sinking § 77.1911 Ventilation of slopes and shafts. (a) All slopes and shafts shall be ventilated by mechanical ventilation equipment during development. Such equipment...

  5. 30 CFR 77.1911 - Ventilation of slopes and shafts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Ventilation of slopes and shafts. 77.1911... COAL MINES Slope and Shaft Sinking § 77.1911 Ventilation of slopes and shafts. (a) All slopes and shafts shall be ventilated by mechanical ventilation equipment during development. Such equipment...

  6. 30 CFR 77.1911 - Ventilation of slopes and shafts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Ventilation of slopes and shafts. 77.1911... COAL MINES Slope and Shaft Sinking § 77.1911 Ventilation of slopes and shafts. (a) All slopes and shafts shall be ventilated by mechanical ventilation equipment during development. Such equipment...

  7. 119. #3 SHAFT ALLEY AFT LOOKING FORWARD ON STARBOARD ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    119. #3 SHAFT ALLEY - AFT LOOKING FORWARD ON STARBOARD SIDE SHOWING #3 SHAFT COUPLING WITH LOCKING DEVICE INSTALLED, SHAFT SPRING BEARING, SHAFT SEAL COOLING WATER LINE, FIVE INCH FIRE MAIN AND BALLASTING MANIFOLD. - U.S.S. HORNET, Puget Sound Naval Shipyard, Sinclair Inlet, Bremerton, Kitsap County, WA

  8. Flexible shaft and roof drilling system

    SciTech Connect

    Blanz, J.H.

    1981-09-22

    A system for drilling holes in the roof of a mine has a flexible shaft with a pair of oppositely wound, coaxial flat bands. One of the flat bands defines an inner spring that is wound right handed into a helical configuration, adjacent convolutions being in nesting relationship to one another. The other flat band defines an outer spring that is wound left handed into a helical configuration about the inner band, adjacent convolutions being nesting relationship with one another. A transition member that is configured to hold a rock bit is mounted to one end of the flexible shaft. When torque and thrust are applied to the flexible shaft by a driver, the inner spring expands outwardly and the outer spring contracts inwardly to form a relatively rigid shaft.

  9. Development of variable-shaft-speed alternator

    NASA Astrophysics Data System (ADS)

    Rothbart, G.; Fullwood, R.

    1982-02-01

    A variable shaft speed alternator (VSSA) consists of an ordinary unmodified 1-1/2 Hp wound-rotor motor, with polyphase excitation controlled by solid state switching and a hybrid of analog and digital circuitry. This circuitry senses both shaft speed and line phase resulting in logic levels which control the current flow in each rotor coil. A first order polynomial was found using the least-squares regression method which accurately expressed the relationship among shaft speed, excitation power, and output power, VSSA torque was inferred from observations to be proportional to output power. Efficiency for converting mechanical power to electrical was inferred over a range of shaft speeds. A break-even speed below which no net power is produced was observed to be 0.375 of the synchronous speed for all output power levels. Similar behavior was observed with power fed to the power network (grid). Additional measurements involved VSSA performance at various power factors.

  10. Reliability assessment of underground shaft closure

    SciTech Connect

    Fossum, A.F.

    1994-12-31

    The intent of the WIPP, being constructed in the bedded geologic salt deposits of Southeastern New Mexico, is to provide the technological basis for the safe disposal of radioactive Transuranic (TRU) wastes generated by the defense programs of the United States. In determining this technological basis, advanced reliability and structural analysis techniques are used to determine the probability of time-to-closure of a hypothetical underground shaft located in an argillaceous salt formation and filled with compacted crushed salt. Before being filled with crushed salt for sealing, the shaft provides access to an underground facility. Reliable closure of the shaft depends upon the sealing of the shaft through creep closure and recompaction of crushed backfill. Appropriate methods are demonstrated to calculate cumulative distribution functions of the closure based on laboratory determined random variable uncertainty in salt creep properties.

  11. Thermal performance of shaft bearing system

    NASA Technical Reports Server (NTRS)

    Crecelius, W.

    1978-01-01

    Computer program calculates loads, torques, temperature, and fatigue life of multibearing shaft system operating with either wet or dry friction. Program is also capable of predicting system reactive to termination of lubricant supply to bearings and other lubricated mechanical elements.

  12. New motor shaft angular accelerometer concept

    NASA Technical Reports Server (NTRS)

    Smetana, F. O.

    1973-01-01

    Concept permits measurement of the acceleration of continuously rotating shafts without use of slip rings or telemetry and with little additional inertial load. Concept has application in servomotor control circuits and easy-to-fly airplane controls.

  13. Flexible shaft and roof drilling system

    DOEpatents

    Blanz, John H.

    1981-01-01

    A system for drilling holes in the roof of a mine has a flexible shaft with a pair of oppositely wound, coaxial flat bands. One of the flat bands defines an inner spring that is wound right handed into a helical configuration, adjacent convolutions being in nesting relationship to one another. The other flat band defines an outer spring that is wound left handed into a helical configuration about the inner band, adjacent convolutions being nesting relationship with one another. A transition member that is configured to hold a rock bit is mounted to one end of the flexible shaft. When torque and thrust are applied to the flexible shaft by a driver, the inner spring expands outwardly and the outer spring contracts inwardly to form a relatively rigid shaft.

  14. Monocular Patching May Induce Ipsilateral “Where” Spatial Bias

    PubMed Central

    Chen, Peii; Erdahl, Lillian; Barrett, Anna M.

    2009-01-01

    Spatial bias is an asymmetry of perception and/or representation of spatial information —“where” bias —, or of spatially directed actions — “aiming” bias. A monocular patch may induce contralateral “where” spatial bias (the Sprague effect; Sprague (1966) Science, 153, 1544–1547). However, an ipsilateral patch-induced spatial bias may be observed if visual occlusion results in top-down, compensatory re-allocation of spatial perceptual or representational resources toward the region of visual deprivation. Tactile distraction from a monocular patch may also contribute to an ipsilateral bias. To examine these hypotheses, neurologically normal adults bisected horizontal lines at baseline without a patch, while wearing a monocular patch, and while wearing tactile-only and visual-only monocular occlusion. We fractionated “where” and “aiming” spatial bias components using a video apparatus to reverse visual feedback for half of the test trials. The results support monocular patch-induced ipsilateral “where” spatial errors, which are not consistent with the Sprague effect. Further, the present findings suggested that the induced ipsilateral bias may be primarily induced by visual deprivation, consistent with compensatory “where” resource re-allocation. PMID:19100274

  15. Calcaneal Insufficiency Fracture after Ipsilateral Total Knee Arthroplasty

    PubMed Central

    Jeong, Min; Shin, Sung Jin; Kang, Byoung Youl

    2016-01-01

    Insufficiency fracture of the calcaneus is a rare entity. In the absence of trauma, evaluating a painful ankle in an elderly patient can be difficult and also it might be overlook the insufficiency fracture. We experienced a case of insufficiency calcaneus fracture that occurred after ipsilateral total knee arthroplasty. Here, we report our case with a review of literatures. PMID:26981521

  16. Ipsilateral Floating Hip and Floating Knee - A Rare Entity.

    PubMed

    Yashavantha Kumar, C; Nalini, K B; Nagaraj, Prashanth; Jawali, Abhijith

    2013-01-01

    Ipsilateral floating hip and floating knee are very rare injuries. These injuries so uncommon that only three cases of similar kind have been reported. These injuries are due to high velocity injuries following motor vehicle accidents. Management of such complex injuries is a challenging task even in experienced hands as there are no standard treatment guidelines for such fractures. We hereby report a 20 yr old male who sustained ipsilateral floating hip and ipsilateral floating knee injuries following motor vehicle accident. Patient was stabilized initially and later taken up for surgery. Patient was treated with interlocking nail for femur and tibia in the same sitting whereas acetabulam fracture was managed conservatively. At five months all the fractures united well with restoration of good range of motion in both hip and knee. Ipsilateral floating knee and floating hip are very rare injuries seen following high velocity motor vehicle accidents. There are no standard guidelines for treatment of those fractures as only a few cases of similar kind have been reported in literature. Early fixation and aggressive mobilization ensures fracture union and fewer complications.

  17. Speed-Dependent Contribution of Callosal Pathways to Ipsilateral Movements

    PubMed Central

    Tazoe, Toshiki

    2013-01-01

    Transcallosal inhibitory interactions between primary motor cortices are important to suppress unintended movements in a resting limb during voluntary activation of the contralateral limb. The functional contribution of transcallosal inhibition targeting the voluntary active limb remains unknown. Using transcranial magnetic stimulation, we examined transcallosal inhibition [by measuring interhemispheric inhibition (IHI) and the ipsilateral silent period (iSP)] in the preparatory and execution phases of isotonic slower self-paced and ballistic movements performed by the ipsilateral index finger into abduction and the elbow into flexion in intact humans. We demonstrate decreased IHI in the preparatory phase of self-paced and ballistic index finger and elbow movements compared to rest; the decrease in IHI was larger during ballistic than self-paced movements. In contrast, in the execution phase, IHI and the iSP increased during ballistic compared to self-paced movements. Transcallosal inhibition was negatively correlated with reaction times in the preparatory phase and positively correlated with movement amplitude in the execution phase. Together, our results demonstrate a widespread contribution of transcallosal inhibition to ipsilateral movements of different speeds with a functional role during rapid movements; at faster speeds, decreased transcallosal inhibition in the preparatory phase may contribute to start movements rapidly, while the increase in the execution phase may contribute to stop the movement. We argue that transcallosal pathways enable signaling of the time of discrete behavioral events during ipsilateral movements, which is amplified by the speed of a movement. PMID:24107950

  18. Risk of atypical femoral fracture during and after bisphosphonate use

    PubMed Central

    Schilcher, Jörg; Koeppen, Veronika; Aspenberg, Per; Michaëlsson, Karl

    2015-01-01

    Background and purpose Use of bisphosphonates in women is associated with higher risk of atypical femoral fractures. The risk in terms of timing of use and type of bisphosphonate, and in men, remains unclear. Patients and methods We reviewed radiographs of 5,342 Swedish women and men aged 55 years or more who had had a fracture of the femoral shaft in the 3-year period 2008–2010 (97% of those eligible), and found 172 patients with atypical fractures (93% of them women). We obtained data on medication and comorbidity. The risk of atypical fracture associated with bisphosphonate use was estimated in a nationwide cohort analysis. In addition, we performed a case-control analysis with comparison to 952 patients with ordinary shaft fractures. A short report of the findings has recently been presented (Schilcher et al. 2014a). Here we provide full details. Results The age-adjusted relative risk (RR) of atypical fracture associated with bisphosphonate use was 55 (95% CI: 39–79) in women and 54 (CI: 15–192) in men. In bisphosphonate users, women had a 3-fold higher risk than men (RR = 3.1, CI: 1.1–8.4). Alendronate users had higher risk than risedronate users (RR = 1.9, CI: 1.1–3.3). The RR after 4 years or more of use reached 126 (CI: 55–288), with a corresponding absolute risk of 11 (CI: 7–14) fractures per 10,000 person-years of use. The risk decreased by 70% per year since last use. Interpretation Women have a higher risk of atypical femoral fracture than men. The type of bisphosphonate used may affect risk estimates and the risk decreases rapidly after cessation. PMID:25582459

  19. Prospective evaluation of femoral head viability following femoral neck fracture

    SciTech Connect

    Binkert, B.; Kroop, S.A.; Nepola, I.V.; Grantham, A.S.; Alderson, P.O.

    1984-01-01

    The bone scans of 33 patients (pts) with recent subcapital fractures (fx) of the femur were evaluated prospectively to determine their value in predicting femoral head visability. Each of the 33 pts (ll men, 22 women, age range 30-92) had a pre-operative bone scan within 72 hrs of the fx (23 pts within 24 hrs). Anterior and posterior planar views of both hips and pinhole views (50% of pts) were obtained 2 hrs after administration of Tc-99m HDP. The femoral head was classified as perfused if it showed the same activity as the opposite normal side or if it showed only slightly decreased activity. Femoral heads showing absent activity were classified as nonperfused. Overall, 20 of the 33 pts showed a photopenic femoral head on the side of the fx. Only 2 pts showed increased activity at hte site of the fx. Internal fixation of the fx was performed in 23 pts, 12 of whom had one or more follow-up scans. Five of these 12 pts showed absent femoral head activity on their initial scan, but 2 showed later reperfusion. The other 7 pts showed good perfusion initially, with only 1 later showing decreased femoral head activity. The other 10 pts (7 of whom had absent femoral head activity) had immediate resection of the femoral head and insertion of a Cathcart prosthesis. The results suggest that femoral head activity seen on a bone scan in the immediate post-fx period is not always a reliable indicator of femoral head viability. Decreased femoral head activity may reflect, in part, compromised perfusion secondary to post-traumatic edema, with or without anatomic disruption of the blood supply.

  20. Laparoscopic repair of femoral hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, especially the differences to laparoscopic repair of inguinal hernia are discussed in this article. PMID:27826574

  1. Integrated controls and health monitoring fiberoptic shaft monitor

    NASA Technical Reports Server (NTRS)

    Coleman, P.; Darejeh, H.; Collins, J. J.

    1989-01-01

    Recent work was performed on development optical technology to provide real time monitoring of shaft speed, shaft axial displacement, and shaft orbit of the OTVE hydrostatic bearing tester. Results show shaft axial displacement can be optically measured (at the same time as shaft orbital motion and speed) to within 0.3 mills by two fiber optic deflectometers. The final results of this condition monitoring development effort are presented.

  2. Femoral fracture repair using a locking plate technique in an adult captive polar bear (Ursus maritimus).

    PubMed

    Zimmerman, Dawn M; Dew, Terry; Douglass, Michael; Perez, Edward

    2010-02-01

    To report successful femoral fracture repair in a polar bear. Case report. Female polar bear (Ursus maritimus) 5 years and approximately 250 kg. A closed, complete, comminuted fracture of the distal midshaft femur was successfully reduced and stabilized using a compression plating technique with 2 specialized human femur plates offering axial, rotational, and bending support, and allowing the bone to share loads with the implant. Postoperative radiographs were obtained at 11.5 weeks, 11 months, and 24 months. Bone healing characterized by marked periosteal reaction was evident at 11 months with extensive remodeling evident at 24 months. No complications were noted. Distal mid shaft femoral fracture was reduced, stabilized, and healed in an adult polar bear with a locking plate technique using 2 plates. Previously, femoral fractures in polar bears were considered irreparable. Use of 2 plates applied with a locking plate technique can result in successful fracture repair despite large body weight and inability to restrict postoperative activity.

  3. Calculation of pediatric femoral fracture rotation from direct roentgenograms.

    PubMed

    Ozel, M S; Ketenci, I E; Kaya, E; Tuna, S; Saygi, B

    2013-12-01

    Radiologic determination of pediatric femoral fracture rotation has been debated. Measuring the antetorsion angle of the fractured femur by computed tomography and comparing it with the opposite side has been the method of choice for this purpose. However, no simple method for direct measurement of femoral fracture rotation exists in the literature. In this study, our aim was to test a mathematical method of measuring the axial plane malrotation from direct roentgenograms. A pediatric femoral shaft fracture model was produced. The bone was secured to a wooden frame that allowed the distal part of the fracture to rotate around an axis. Radiographs were taken at known intervals of rotation ranging from the neutral position to 60° external rotation and to 60° internal rotation in 5° increments of rotation. Five independent, blinded observers measured the radiographs and calculated the fracture rotation according to a standard formula. Calculated rotation values were compared with known rotation values. Calculated rotation values were close to actual rotation values throughout the arc of rotation. The mean absolute error of five observers for all measurements of external and internal rotation was 3.97° (±0.83). The correlation coefficient between calculated and actual rotation values was 0.9927. The interobserver intraclass correlation coefficient for calculated rotation was 0.997. Absolute error and correlation coefficient values indicate that this method is accurate and reliable in determining the fracture rotation.

  4. A Technical Note for Extracting an Incarcerated Femoral Kuntscher Nail

    PubMed Central

    Marí, R; Vilamala, D Valverde; García, A León; Guirro, P; López, F Marqués

    2016-01-01

    Introduction: The use of the Kuntscher nail has been the most important advancement in trauma surgery. One of the problems is the difficulty to remove it. A new extraction technique is described in the present case report. Case Report: A 46-year-old man was referred for hip osteoarthritis. He had an acetabulum fracture and a femoral shaft fracture treated 30 years ago with a reamed Kuntscher femoral nail. Lateral hip approach was performed and after attempting to remove the nail with the specific tools being unsuccessful we decided to be more aggressive. Firstly, we performed a simple unicortical osteotomy on the lateral side from the proximal part to below the callus in order to decompress the femoral canal without success. Secondly, a trench in the greater trochanter around the proximal hole was performed to hit the nail from below which was still insufficient and furthermore, the hole broke when hitting the nail so we needed to drill a new hole distally. Finally, the Kuntscher nail was removed. Several cerclages closed the osteotomy and a bone graft was used to close the trench. The patient had a good evolution at one year of follow-up. Conclusion: With this case report, we present a new salvage technique to remove an incarcerated Kuntscher nail when all the described methods have failed. PMID:28116256

  5. Mycotic femoral aneurysm.

    PubMed

    Wilson, Richard Scott; Bennett, Kenneth R

    2007-05-01

    After several weeks of fever and chills, a 31-year-old logger developed pain in his right thigh. Upon examination a tender, pulsating upper thigh mass was found with a long loud bruit arising from it. Severe aortic insufficiency was present; however, blood cultures were negative. An angiogram, captured blood with contrast spewing from the profunda femoral artery to fill a 5 x 10 cm sac. A false aneurysm was diagnosed and resected; numerous gram positive cocci were present in cut sections, but cultures from the cavity grew the gram negative bacteria Salmonella and Alcaligenes. After one month of intravenous ampicillin the aortic valve was replaced after being destroyed by endocarditis. Ampicillin was continued and recovery was uneventful. Mycotic aneurysms are commonly caused by Salmonella (10%), which was second only to Staphylococcus (30%). The femoral artery accounts for 38% of all mycotic aneurysms. They typically present with a pulsatile mass (52%), bruit (50%), and fever (48%). This diagnosis can be supported by leukocytosis (64-71%), positive blood cultures (50-85%), and a history of arterial trauma (51%) (injection drug use, intravascular procedure, or trauma) or endocarditis (10%).

  6. Ipsilateral coordination features for automatic classification of Parkinson's disease

    NASA Astrophysics Data System (ADS)

    Sarmiento, Fernanda; Atehortúa, Angélica; Martínez, Fabio; Romero, Eduardo

    2015-12-01

    A reliable diagnosis of the Parkinson Disease lies on the objective evaluation of different motor sub-systems. Discovering specific motor patterns associated to the disease is fundamental for the development of unbiased assessments that facilitate the disease characterization, independently of the particular examiner. This paper proposes a new objective screening of patients with Parkinson, an approach that optimally combines ipsilateral global descriptors. These ipsilateral gait features are simple upper-lower limb relationships in frequency and relative phase spaces. These low level characteristics feed a simple SVM classifier with a polynomial kernel function. The strategy was assessed in a binary classification task, normal against Parkinson, under a leave-one-out scheme in a population of 16 Parkinson patients and 7 healthy control subjects. Results showed an accuracy of 94;6% using relative phase spaces and 82;1% with simple frequency relations.

  7. Constant-mesh, multiple-shaft transmission

    SciTech Connect

    Rea, J.E.; Mills, D.D.; Sewell, J.S.

    1992-04-21

    This patent describes a multiple-shaft, constant-mesh transmission adapted to establish selectively a reverse torque delivery path and a forward drive torque delivery path and having a torque input means including a torque input shaft, a mainshaft aligned with the input shaft, a countershaft geared to the input shaft in spaced, parallel relationship with respect to the mainshaft, a torque output shaft joined to the mainshaft; multiple mainshaft gear elements journalled on the main airshaft, multiple cluster gear elements carried by the countershaft in meshing engagement with the mainshaft gear elements, one of the cluster gear elements being rotatably journalled on the countershaft; a reverse idle gear, a reverse gear journalled on the countershaft, the reverse idler gear being in constant mesh with the reverse gear and one of the mainshaft gear elements; first clutch means for connecting selectively the reverse gear and the countershaft; second synchronizer clutch means for connecting selectively the one of the mainshaft gear elements to the mainshaft; and third synchronizer clutch means for selectively connecting another of the mainshaft gear elements to the mainshaft; the first clutch means being a double-acting clutch with a first common axially movable clutch element adapted upon movement in one axial direction to drivably connected the reverse gear to the countershaft and adapted upon movement in the opposite axial direction to connect the one cluster gear element to the countershaft.

  8. Instability of asymmetric continuous shaft system

    NASA Astrophysics Data System (ADS)

    Srinath, R.; Sarkar, Abhijit; Sekhar, A. S.

    2016-11-01

    In this work, the governing equation of asymmetric continuous shaft in inertial frame of reference is studied. In particular, determination of the parameter ranges for the stability or instability of the shaft response is the focus of the present work. The governing equations are a fourth-order coupled partial differential equations containing time dependent coefficients. The equations are non-dimensionalized in terms of two parameters related to the average moment of inertia and the difference of moments of inertia about the principal axes. Using the latter as the asymptotic parameter and employing modal superposition, a formal methodology based on perturbation methods is developed to ascertain the stability and instability characteristics. The methodology is applicable to shafts subjected to some of the classical boundary conditions viz. simply supported, cantilever, and fixed-fixed. Similar stability curves are obtained for each mode for these different boundary conditions. The novel non-dimensionalization scheme chosen leads to the stability boundaries as well as the loci of varying speeds to be in the form of straight lines. The intersection of these lines determine the stable and unstable speed ranges of different asymmetric shafts. The results are generalized for different material and geometric properties of the shaft.

  9. CENTRIFUGAL PUMP AND SHAFT SEALING MEANS

    DOEpatents

    Rushing, F.C.

    1960-09-01

    A description is given of sealing means between a hollow rotatable shaft and a stationary member surrounding the shaft which defines therewith a sealing space of annular cross-section, comprising a plurality of axially spaced rings held against seats by ring springs which serve to subdivide the sealing space- into a plurality of zones. Process gas introduced into the hollow shaft through a port communicating with a centrally located zone which iu turn communicates with a bore in the sleeve, is removed from the shaft through a second port communicating with an adjacent central zone and discharged through a second bore. A sealant gas is supplied to an end zone under a pressure sufficient to cause it to flow axially into adjacent zones and then maintained at a lower pressure than either the sealant gas source or the process gas inlet zone, preventing the sealant gas from entering the shaft and allowing gases leaking into the sealant gas to be withdrawn and led to a separator.

  10. High Pressure Rotary Shaft Sealing Mechanism

    DOEpatents

    Dietle, Lannie; Gobeli, Jeffrey D.

    2001-05-08

    A laterally translatable pressure staged rotary shaft sealing mechanism having a seal housing with a shaft passage therein being exposed to a fluid pressure P1 and with a rotary shaft being located within the shaft passage. At least one annular laterally translatable seal carrier is provided. First and second annular resilient sealing elements are supported in axially spaced relation by the annular seal carriers and have sealing relation with the rotary shaft. The seal housing and at least one seal carrier define a first pressure staging chamber exposed to the first annular resilient sealing element and a second pressure staging chamber located between and exposed to the first and second annular resilient sealing elements. A first fluid is circulated to the first pressure chamber at a pressure P1, and a second staging pressure fluid is circulated to the second pressure chamber at a fraction of pressure P1 to achieve pressure staging, cooling of the seals. Seal placement provides hydraulic force balancing of the annular seal carriers.

  11. Design and validation of automated femoral bone morphology measurements in cerebral palsy.

    PubMed

    Park, Noyeol; Lee, Jehee; Sung, Ki Hyuk; Park, Moon Seok; Koo, Seungbum

    2014-04-01

    Accurate quantification of bone morphology is important for monitoring the progress of bony deformation in patients with cerebral palsy. The purpose of the study was to develop an automatic bone morphology measurement method using one or two radiographs. The study focused on four morphologic measurements-neck-shaft angle, femoral anteversion, shaft bowing angle, and neck length. Fifty-four three-dimensional (3D) geometrical femur models were generated from the computed tomography (CT) of cerebral palsy patients. Principal component analysis was performed on the combined data of geometrical femur models and manual measurements of the four morphologic measurements to generate a statistical femur model. The 3D-2D registration of the statistical femur model for radiography computes four morphological measurements of the femur in the radiographs automatically. The prediction performance was tested here by means of leave-one-out cross-validation and was quantified by the intraclass correlation coefficient (ICC) and by measuring the absolute differences between automatic prediction from two radiographs and manual measurements using original CT images. For the neck-shaft angle, femoral anteversion, shaft bowing angle, and neck length, the ICCs were 0.812, 0.960, 0.834, and 0.750, respectively, and the mean absolute differences were 2.52°, 2.85°, 0.92°, and 1.88 mm, respectively. Four important dimensions of the femur could be predicted from two views with very good agreement with manual measurements from CT and hip radiographs. The proposed method can help young patients avoid instances of large radiation exposure from CT, and their femoral deformities can be quantified robustly and effectively from one or two radiograph(s).

  12. Exchange nailing with enhanced distal fixation is effective for the treatment of infraisthmal femoral nonunions.

    PubMed

    Kim, Joon-Woo; Yoon, Yong-Cheol; Oh, Chang-Wug; Han, Seung-Beom; Sim, Jae-Ang; Oh, Jong-Keon

    2017-09-27

    The treatment options for nonunions of infraisthmal femoral shaft fractures after internal fixation are controversial. Methods such as exchanging an existing nail with a nail of a larger size, dynamization, removal of the nail followed by plating, and bone grafting have all been reported. Among those options, exchange nailing seems to be the most popular choice. In this study, a Poller screw, or an additional interlocking screw, was used in conjunction with exchange intramedullary nailing. The purpose of this study was to evaluate the effectiveness of treating femoral shaft nonunions using insertion of a Poller screw or an additional interlocking screw in conjunction with intramedullary nail fixation. This study included 18 patients who presented with nonunion of femur shaft fractures after internal fixation at the infraisthmal level. These patients included 13 men and 5 women, with a mean age of 46.8 years (range 15-78 years). The mean postsurgical period of nonunion was 7.8 months (range 6-12 months). The patients were classified into two groups: the atrophic nonunion group and the hypertrophic nonunion group. In all patients, nailing was enhanced with a Poller screw or additional interlocking screws. All patients were followed up with plain film examinations and were assessed for their functional recovery status to determine the osseous union conditions. All 18 patients achieved postoperative bony union after a mean time of 7.5 months (range 3-12 months), and all patients were able to walk with full weight-bearing and without pain within 3 months. There were no significant complications, such as broken hardware, implant back-outs, axial or rotational malalignments, or deep infections. Poller screws and additional interlocking screws, along with intramedullary nailing exchange, may be an effective and reliable alternative for treating infraisthmal femoral shaft nonunions.

  13. Analysis of ipsilateral and bilateral ratios in male amateur golfers.

    PubMed

    Song, Jae-Yoon; Park, Jae-Wan; Lee, Chan-Bok; Eun, Denny; Jang, Jung-Hoon; Lee, Ho-Jin; Hyun, Gwang-Suk; Park, Jung-Min; Cha, Jun-Youl; Cho, Nam-Heung; Ko, Il-Gyu; Jin, Jun-Jang; Jin, Yong-Yun; Ham, Do-Woong; Jee, Yong-Seok

    2016-04-01

    The number of injuries that force golfers to quit is also increasing. In particular, the upper body injuries are concerns for amateur golfers. This study was conducted not only to investigate muscular balance, such as ipsilateral and bilateral ratios of the upper body, but to also evaluate the possible problems of muscular joints in amateur golfers. Male golfers (n=10) and a healthy control group (n=10) were recruited for the assessment of muscular function in the upper body, which was measured by an isokinetic dynamometer at 60°/sec. The tested parts were trunk, wrist, forearm, elbow, and shoulder joints. Mann-Whitney U-test was used to evaluate the significance of the differences between groups. The ipsilateral ratios of peak torque or work per repetition (WR) of trunk flexor and extensor in the golfers were not significantly different compared to those of the control group. These results were similar to the shoulder horizontal abductor and adductor. However, there were significant differences in the ipsilateral and bilateral ratios of the wrist, forearm, and elbow joints. Especially, the WR of the wrist flexor, forearm pronator, and elbow flexor on the left side of amateur golfers showed imbalances in bilateral ratios. Moreover, the WR of the wrist and elbow flexors on the left side of amateur golfers were lower than those of the wrist and elbow extensors. Therefore, amateur golfers should strive to prevent injuries of the wrist, forearm, and elbow joints and to reinforce the endurance on those parts of the left side.

  14. Hearing outcome of recurrent sudden deafness: ipsilateral versus contralateral types.

    PubMed

    Kuo, Yen-Lin; Young, Yi-Ho

    2012-03-01

    Patients with recurrent sudden deafness demonstrating normal vestibular-evoked myogenic potentials (VEMPs) in the lesion ear of the second episode may indicate a good hearing outcome. This study retrospectively reviewed our experience of patients with recurrent sudden deafness during the past 20 years. Sixteen (1.4 %) of 1156 patients with sudden deafness were diagnosed as having a recurrent episode, including ipsilateral type in 7 and contralateral type in 9. All patients underwent an audiovestibular test battery and blood and MRI examinations. After 2000, nine patients underwent the VEMP test. In the ipsilateral type, the mean interval between two episodes was 2 ± 2 years, which did not differ significantly from 3 ± 3 years in the contralateral type. There were no significant differences in relation to age at onset of the second episode, inter-episode interval, gender, presence of vertigo, and abnormal caloric results. However, abnormal rate of VEMP test in the contralateral type (five of five patients) was significantly higher than that in the ipsilateral type (none of four patients). At the second episode, all four patients with normal VEMPs on the lesion ear had improved hearing, while four of five patients with absent or delayed VEMPs showed unchanged hearing. Altogether, the hearing improvement rate in both types of recurrent sudden deafness was 50%.

  15. Coupled shaft-torsion and blade-bending vibrations of a rotating shaft-disk-blade unit

    SciTech Connect

    Huang, S.C.; Ho, K.B.

    1996-01-01

    A new approach to analyzing the dynamic coupling between shaft torsion and blade bending of a rotating shaft-disk-blade unit is introduced. The approach allows the shaft to vibrate freely around its rotation axis instead of assuming a periodic perturbation of the shaft speed that may accommodate the shaft flexibility only to a limited extent. A weighted residual method is applied, and the receptances at the connections of blades and shaft-disk are formulated. Numerical examples are given for cases with between two and six symmetrically arranged blades. The results show not only coupling between the shaft, disk, and blades, but also coupling between individual blades where the shaft acts as a rigid support and experiences no torsional vibration. The blade-coupling modes occurred only in repeated frequencies. Finally, the effect of shaft speed on the modal frequencies was investigated. Plots illustrating the occurrence of critical speeds and flutter instabilities are presented.

  16. Rotating flexible disk under shaft temperature increment

    NASA Astrophysics Data System (ADS)

    Pei, Yong-Chen; He, Ling; Wang, Ji-Xin

    2010-08-01

    A rotating flexible annular thin disk subjected to the temperature increment of the shaft clamping the disk was modeled in this paper. At disk top and bottom surfaces and free outer edge, the heat convection boundaries were assumed. Disk transverse deflection was considered as a function of both disk radial and circumferential coordinates, and temperature distribution was solved along disk thickness and radial directions simultaneously. As a result, the shaft temperature increment causes thermo-elastic instability of some disk modes. Effects of the shaft temperature increment, ratio of disk convective heat transfer coefficient to thermal conductivity, disk thickness, nodal circle and diameter numbers of disk mode on the natural frequencies, thermo-elastic instability and critical angular speed of the disk were discussed.

  17. Extra-anatomical veno-venous surgical bypass for central vein occlusion in patients with ipsilateral arterio-venous fistula (AVF) for haemodialysis - A single centre experience.

    PubMed

    Saravana, K S; Zainal, A A

    2017-02-01

    Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention. They underwent extra-anatomical vein to vein surgical bypass. The axillary and iliac or femoral veins were approached via infraclavicular and extraperitoneal groin incisions respectively. In all the patients, an externally supported 6 or 8 mm polytetrafluoroethylene (PTFE) graft was used as a conduit and was tunnelled extra-anatomical. All patients had double antiplatelet (Aspirin and Clopidogrel) therapy post-operatively. Substantial improvement in the facial, neck and upper limb swelling was noticed following this diversion surgery. The vein to vein bypass was patent at 12 months in 10 out of 20 patients. Graft infection occurred in two (10%) cases. Re-thrombectomy or assisted patency procedure (stent/plasty) was done in four (20%) cases. The patients with preoperative fistula flow rate of more than 1500 ml/min and post-operative graft flow rate of more than a 1000 ml/min were patent at 12 months (P=0.025 and p=0.034 respectively). Axillary to iliac/femoral vein bypass can salvage functioning ipsilateral fistula threatened by occluded upper central vein.

  18. Femoral offset following trochanteric femoral fractures: a prospective observational study.

    PubMed

    Buecking, Benjamin; Boese, Christoph Kolja; Seifert, Vinzenz; Ruchholtz, Steffen; Frink, Michael; Lechler, Philipp

    2015-10-01

    Reconstruction of the femoral offset reportedly improves outcome following total hip arthroplasty, but little is known of its influence following hip fractures. We aimed to establish the effect of the femoral offset on the medium-term functional outcome in elderly patients who had sustained trochanteric fractures requiring proximal femoral nailing. We measured the rotation corrected femoral offset (FORC) and relative femoral offset (FORL) on plain anteroposterior radiographs of the hip in 188 patients (58 male, 130 female) with a trochanteric fracture who underwent proximal femoral nailing at our institution. The primary outcome measure was the Harris hip score (HSS) 6 and 12 months postoperatively; the Barthel index was assessed as a secondary outcome. The mean FORC after surgery was 58 mm (±11 mm), while the mean FORL was 1.21 (±0.22). At final follow up, we found significant inverse relationships (Spearman's rank correlation coefficient, ρ) between FORC and FORL and the functional outcome assessed by the HSS (FORC: ρ = -0.207, p = 0.036; FORL: ρ = -0.247, p = 0.012), and FORL and the Barthel index (FORC: ρ = -147, p = 0.129; FORL: ρ = -0.192, p = 0.046). A consistent trend was observed after adjustment for confounding variables. Our results underline the biomechanical importance of the femoral offset for medium-term outcomes in elderly patients with trochanteric fractures. In contrast with the published findings on total hip arthroplasty, we found an inverse correlation between functional outcome and the extent of the reconstructed femoral offset. Level I - Prognostic study. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Automobile transmission with output shaft parallel to crank shaft and parking gear fixed to the output shaft

    SciTech Connect

    Kubo, S.; Kuramochi, K.; Kyushima, T.

    1987-06-30

    A driving device is described for an automobile having axles, driving wheels supported by the axles and an engine located proximate the driving wheels, having a crankshaft disposed substantially parallel to the axles supporting the driving wheels, the device comprising: a fluid-type torque converter having coaxial input and output members and disposed on one axial side of the engine connected to and coaxial with the crankshaft; an auxiliary speed change gear assembly having coaxial input and output members and disposed on one axial side of the torque converter remote from the engine with the input member connected to and coaxial of the torque converter; the output member of the auxiliary speed change gear assembly is provided in the shape of a gear; a transmission shaft disposed substantially parallel to the auxiliary speed change gear assembly; a driven gear having a disc portion and toothed peripheral portion; a drive gear drivingly connected to the other end of the transmission shaft closer to the torque converter than the one end of the transmission shaft; a final reduction gear disposed between the driving wheels to be in meshing engagement with the drive gear to transmit power to the axles; a parking gear comprising an annular gear element fixed by bolts proximate the toothed peripheral portion to the axial side surface from which the transmission shaft extends toward the other end. The parking gear is supported by the disc portion for rotation with the driven gear; and means for selectively engaging the parking gear to prevent rotation of shaft when automobile is in parking condition.

  20. Differences in Femoral Geometry and Structure Due to Immobilization

    NASA Technical Reports Server (NTRS)

    Kiratli, Beatrice Jenny; Yamada, M.; Smith, A.; Marcus, R. M.; Arnaud, S.; vanderMeulen, M. C. H.; Hargens, Alan R. (Technical Monitor)

    1996-01-01

    Reduction in bone mass of the lower extremity is well documented in individuals with paralysis resulting from spinal cord injury (SCI). The consequent osteopenia leads to elevated fracture risk with fractures occurring more commonly in the femoral shaft and supracondylar regions than the hip. A model has recently been described to estimate geometry and structure of the femoral midshaft from whole body scans by dual X-ray absorptiometry (DXA). Increases in femoral geometric and structural properties during growth were primarily related to mechanical loading as reflected by body mass. In this study, we investigate the relationship between body mass and femoral geometry and structure in adults with normal habitual mechanical loading patterns and those with severely reduced loading. The subjects were 78 ambulatory men (aged 20-72 yrs) and 113 men with complete paralysis from SCI of more than 4 years duration (aged 21 73 yrs). Subregional analysis was performed on DXA whole body scans to obtain bone mineral content (BMC, g), cortical thickness (cm), crosssectional moment of inertia (CSMI, cm4), and section modulus (cm3) of the femoral midshaft. All measured bone variables were significantly lower in SCI compared with ambulatory subjects: -29% (BMC), -33% (cortical thickness), -23% (CSMI), and -22% (section modulus) while body mass was not significantly different. However, the associations between body mass and bone properties were notably different; r2 values were higher for ambulatory than SCI subjects in regressions of body mass on BMC (0.48 vs 0.20), CSMI (0.59 vs 0.32), and section modulus (0.59 vs 0.31). No association was seen between body mass and cortical thickness for either group. The greatest difference between groups is in the femoral cortex, consistent with reduced bone mass via endosteal expansion. The relatively lesser difference in geometric and structural properties implies that there is less effect on mechanical integrity than would be expected from

  1. Differences in Femoral Geometry and Structure Due to Immobilization

    NASA Technical Reports Server (NTRS)

    Kiratli, Beatrice Jenny; Yamada, M.; Smith, A.; Marcus, R. M.; Arnaud, S.; vanderMeulen, M. C. H.; Hargens, Alan R. (Technical Monitor)

    1996-01-01

    Reduction in bone mass of the lower extremity is well documented in individuals with paralysis resulting from spinal cord injury (SCI). The consequent osteopenia leads to elevated fracture risk with fractures occurring more commonly in the femoral shaft and supracondylar regions than the hip. A model has recently been described to estimate geometry and structure of the femoral midshaft from whole body scans by dual X-ray absorptiometry (DXA). Increases in femoral geometric and structural properties during growth were primarily related to mechanical loading as reflected by body mass. In this study, we investigate the relationship between body mass and femoral geometry and structure in adults with normal habitual mechanical loading patterns and those with severely reduced loading. The subjects were 78 ambulatory men (aged 20-72 yrs) and 113 men with complete paralysis from SCI of more than 4 years duration (aged 21 73 yrs). Subregional analysis was performed on DXA whole body scans to obtain bone mineral content (BMC, g), cortical thickness (cm), crosssectional moment of inertia (CSMI, cm4), and section modulus (cm3) of the femoral midshaft. All measured bone variables were significantly lower in SCI compared with ambulatory subjects: -29% (BMC), -33% (cortical thickness), -23% (CSMI), and -22% (section modulus) while body mass was not significantly different. However, the associations between body mass and bone properties were notably different; r2 values were higher for ambulatory than SCI subjects in regressions of body mass on BMC (0.48 vs 0.20), CSMI (0.59 vs 0.32), and section modulus (0.59 vs 0.31). No association was seen between body mass and cortical thickness for either group. The greatest difference between groups is in the femoral cortex, consistent with reduced bone mass via endosteal expansion. The relatively lesser difference in geometric and structural properties implies that there is less effect on mechanical integrity than would be expected from

  2. 17. TRACTOR ENGINE POWERING SHAFT SYSTEM IN FOREGROUND, BELT CONNECTS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. TRACTOR ENGINE POWERING SHAFT SYSTEM IN FOREGROUND, BELT CONNECTS WITH MAIN SHAFT LOOKING EAST. - W. A. Young & Sons Foundry & Machine Shop, On Water Street along Monongahela River, Rices Landing, Greene County, PA

  3. 8. IRON MOUNTAIN SHAFT ROOM TO UNIT #5 SHOWING TYPICAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. IRON MOUNTAIN SHAFT ROOM TO UNIT #5 SHOWING TYPICAL ARRANGEMENT OF SHAFT AND PUMP IN COLORADO RIVER AQUEDUCT PUMPHOUSES. - Iron Mountain Pump Plant, South of Danby Lake, north of Routes 62 & 177 junction, Rice, San Bernardino County, CA

  4. 6. VIEW OF DRIFT SHAFT, HOIST MOTOR, WORM WHEEL GEAR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. VIEW OF DRIFT SHAFT, HOIST MOTOR, WORM WHEEL GEAR ASSEMBLY, CROSS SHAFT, AND INTERMEDIATE GEAR HOIST ASSEMBLY FOR CONTROL GATE NO. 6, LOOKING WEST - Long Lake Hydroelectric Plant, Spillway Dam, Spanning Spokane River, Ford, Stevens County, WA

  5. 161. BLACKSMITH SHOP, OVERHEAD SHAFT. BELT ON LEFT CONNECTS TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    161. BLACKSMITH SHOP, OVERHEAD SHAFT. BELT ON LEFT CONNECTS TO SHAFTS WHICH RUN POWER PRESS AND HYDRAULIC TIRE SETTER. - Gruber Wagon Works, Pennsylvania Route 183 & State Hill Road at Red Bridge Park, Bernville, Berks County, PA

  6. Transmission with two parallel driving shafts bearing two driving gears each meshed with same driven gear on parallel driven shaft

    SciTech Connect

    Akashi, T.; Ito, H.; Yamada, S.

    1986-06-17

    A transmission mechanism for a vehicle is described for receiving input of rotational power from a power supply member which rotates in a particular rotational direction and for outputting rotational power to a power receiving member which includes: an input member connected to the power supply member and which is rotatably mounted and receives supplying of the rotational power from the power supply member; a first driving gear wheel shaft; a second driving gear wheel shaft mounted generally parallel to the first driving gear wheel shaft; a driven gear wheel shaft mounted generally parallel to the first and second driving gear wheel shafts, the driven gear wheel shaft being rotationally connected to the power receiving member; a first driven gear wheel fixedly mounted on the driven gear wheel shaft; a first driving gear wheel which is rotatably mounted on the first driving gear wheel shaft and is constant mesh with the driven gear wheel, the first driving and driven gear wheels providing a first reduction gear ratio from the first driving gear wheel shaft to the driven gear wheel shaft; a second driven gear wheel fixedly mounted on the driven gear wheel shaft; a second driving gear wheel which is rotatably mounted on the second driving gear wheel shaft and is in constant mesh with the first driven gear wheel, the second driving and the first driven gear wheels providing a second reduction gear ratio smaller than the first reduction gear ratio from the second driving gear wheel shaft to the driven gear wheel shaft; a third driving gear wheel which is rotatably mounted on the first driving gear wheel shaft and is in constant mesh with the second driven gear wheel, the third driving and the second driven gear wheels providing a third reduction gear ratio smaller than the second reduction gear ratio from the first driving gear wheel shaft to the driven gear wheel shaft.

  7. Factors that affect the fatigue strength of power transmission shafting

    NASA Technical Reports Server (NTRS)

    Loewenthal, S. H.

    1984-01-01

    A long standing objective in the design of power transmission shafting is to eliminate excess shaft material without compromising operational reliability. A shaft design method is presented which accounts for variable amplitude loading histories and their influence on limited life designs. The effects of combined bending and torsional loading are considered along with a number of application factors known to influence the fatigue strength of shafting materials. Among the factors examined are surface condition, size, stress concentration, residual stress and corrosion fatigue.

  8. Hyperacute cerebral fat embolism in a patient with femoral shaft fracture.

    PubMed

    Chen, Po-Chuan; Hsu, Chin-Wang; Liao, Wen-I; Chen, Yu-Long; Ho, Cheng-Hsuan; Tsai, Shih-Hung

    2013-09-01

    Fat embolism syndrome is a potentially fatal complication and occurs most commonly after long bone fracture. In patients who sustained severe trauma, both cerebral fat embolism(CFE) and diffuse axonal injury (DAI) could be the cause of altered consciousness in the absence of marked intracranial lesions in cranial computed tomography. However, distinguishing CFE and DAI can be difficult clinically. Generally, DAI develops immediately after the insult, whereas CFE occurs 48 to 72 hours after the trauma and even after internal fixation for the fractures. Fat embolism syndrome develops within an average of 48.5 hours after long bone fracture [1] but has never been reported to occur in less than 2 hours. Here, we present a patient who developed hyperacute CFE and eventually had poor neurological outcome, in contrast to previous reports stating that CFE usually has a long latent period and favorable outcomes.

  9. Stress analyses after femoral shaft osteotomy fixed by various plates with different rigidities in simulation test.

    PubMed

    Xu, X X; Zhang, X; Liu, J G; Wang, J B; Shi, D G; Liu, S X

    1993-02-01

    Three pairs of human cadaver femora were used for strain measurement under a weight-bearing simulation test, which was performed on intact bone and osteotomized bone fixed by 3 types of plates with different rigidities respectively. The plates with uniform thickness did not adhere to the uniform stress distribution along the plate. The stress between both central screw holes was significantly great. However, the device of trapezoidal plate conformed to the uniform stress distribution along it, and the safety factors of 3 different types of the plates were proposed. The osteotomy site was mainly subjected to compression stress in standing phase with load on both femora, but subjected to bending stress mostly with load on the single femur. The total compression strain at the osteotomy site was greater than that on intact bone while the load was adding over twice body weight with load on both legs, and nearly normal with load on one leg. We believe that the bone structural changes caused by stress shielding and limb disuse etc can be overcome by using optimal plate and normal weight bearing.

  10. [Differential circulatory value of various femoral shaft areas--experimental studies in rabbits].

    PubMed

    Nutz, V

    1988-01-01

    15 rabbits underwent osteotomia of the left femur including lesion of the medullary vessels, 5 times in the proximal, 5 times in the middle, 5 times in the distal diaphysis. Changes in blood flow before and after osteotomia were measured by the "tracer microspheres" -method in the proximal, middle, and distal diaphysis of the femur and the tibia, in the marrow of femur and tibia, in the m. rectus femoris, and the m. tibialis anterior. After lesion of the femur diaphysis a significant reduction of blood flow was found in all tissues of the left leg which must have been caused by arterial spasm. In the diaphysis and marrow of femur, however, the reduction of blood flow was even greater and showed a characteristic pattern concerning the lesion of the medullary vessels. Osteotomia in the proximal diaphysis led to a greater reduction of blood flow in diaphysis and marrow than osteotomia in the middle and distal diaphysis did. The alteration of the diaphysis blood flow is different in the proximal, middle, and distal part in all cases of osteotomia. The characteristic pattern of diaphysis blood flow alteration by osteotomia can be explained by topography of the femur vessels. Their relations to clinical observations are discussed.

  11. [Fractures of the shaft of the femur].

    PubMed

    Lögters, T; Windolf, J; Flohé, S

    2009-07-01

    The femur is the largest, longest and strongest bone in the human skeleton. Fractures of the shaft of the femur can result from high energy as well as low energy trauma and 30% of patients have multiple injuries. In the clinical diagnostic special attention must be paid to the peripheral neurovascular status as well as the possibility of a compartment syndrome. Fractures of the femur shaft are defined according to the AO classification. Treatment is as a rule operative, except for children up the end of 4 years old. Medullary nailing is nowadays the method of choice and the nails can be implanted in an anterograde or retrograde direction. The introduction of nails after boring out the medullar is associated with an increased healing rate in comparison to non-boring techniques. Various techniques are available for the often promising method of repositioning and the intraoperative controls. Plating is reserved only for special situations. External fixation is of great value in adults for temporary fixation of fractures of the femur shaft. Full weight bearing is possible immediately following the operation depending on the type of fracture and method of treatment. Uncomplicated fracture healing does not result in a reduction in the ability to work. Despite the generally good prognosis and improvement in design and technology of implants, fractures of the femur shaft still represent a special challenge for the treating casualty surgeon.

  12. Analysis of ipsilateral and bilateral ratios in male amateur golfers

    PubMed Central

    Song, Jae-Yoon; Park, Jae-Wan; Lee, Chan-Bok; Eun, Denny; Jang, Jung-Hoon; Lee, Ho-Jin; Hyun, Gwang-Suk; Park, Jung-Min; Cha, Jun-Youl; Cho, Nam-Heung; Ko, Il-Gyu; Jin, Jun-Jang; Jin, Yong-Yun; Ham, Do-Woong; Jee, Yong-Seok

    2016-01-01

    The number of injuries that force golfers to quit is also increasing. In particular, the upper body injuries are concerns for amateur golfers. This study was conducted not only to investigate muscular balance, such as ipsilateral and bilateral ratios of the upper body, but to also evaluate the possible problems of muscular joints in amateur golfers. Male golfers (n=10) and a healthy control group (n=10) were recruited for the assessment of muscular function in the upper body, which was measured by an isokinetic dynamometer at 60°/sec. The tested parts were trunk, wrist, forearm, elbow, and shoulder joints. Mann–Whitney U-test was used to evaluate the significance of the differences between groups. The ipsilateral ratios of peak torque or work per repetition (WR) of trunk flexor and extensor in the golfers were not significantly different compared to those of the control group. These results were similar to the shoulder horizontal abductor and adductor. However, there were significant differences in the ipsilateral and bilateral ratios of the wrist, forearm, and elbow joints. Especially, the WR of the wrist flexor, forearm pronator, and elbow flexor on the left side of amateur golfers showed imbalances in bilateral ratios. Moreover, the WR of the wrist and elbow flexors on the left side of amateur golfers were lower than those of the wrist and elbow extensors. Therefore, amateur golfers should strive to prevent injuries of the wrist, forearm, and elbow joints and to reinforce the endurance on those parts of the left side. PMID:27162771

  13. 30 CFR 56.19130 - Conveyance shaft test.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Conveyance shaft test. 56.19130 Section 56... Inspection and Maintenance § 56.19130 Conveyance shaft test. Before hoisting persons and to assure that the... round trip after: (a) Any hoist or shaft repairs or related equipment repairs that might restrict...

  14. Influence of Rocket Engine Characteristics on Shaft Sealing Technology Needs

    NASA Technical Reports Server (NTRS)

    Keba, John E.

    1999-01-01

    This paper presents viewgraphs of The Influence of Rocket Engine Characteristics on Shaft Sealing Technology Needs. The topics include: 1) Rocket Turbomachinery Shaft Seals (Inter-Propellant-Seal (IPS) Systems, Lift-off Seal Systems, and Technology Development Needs); 2) Rocket Engine Characteristics (Engine cycles, propellants, missions, etc., Influence on shaft sealing requirements); and 3) Conclusions.

  15. 30 CFR 57.19130 - Conveyance shaft test.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Conveyance shaft test. 57.19130 Section 57... Hoisting Inspection and Maintenance § 57.19130 Conveyance shaft test. Before hoisting persons and to assure... least one round trip after— (a) Any hoist or shaft repairs or related equipment repairs that...

  16. Synchronous Control Effort Minimized for Magnetic-Bearing-Supported Shaft

    NASA Technical Reports Server (NTRS)

    Brown, Gerald V.

    2001-01-01

    Various disturbances that are synchronous with the shaft speed can complicate radial magnetic bearing control. These include position sensor target irregularities (runout) and shaft imbalance. The method presented here allows the controller to ignore all synchronous harmonics of the shaft position input (within the closed-loop bandwidth) and to respond only to asynchronous motions. The result is reduced control effort.

  17. 30 CFR 57.4261 - Shaft-station waterlines.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Shaft-station waterlines. 57.4261 Section 57... and Control Firefighting Equipment § 57.4261 Shaft-station waterlines. Waterline outlets that are located at underground shaft stations and are part of the mine's fire protection system shall have...

  18. 30 CFR 57.19135 - Rollers in inclined shafts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Rollers in inclined shafts. 57.19135 Section 57... Hoisting Inspection and Maintenance § 57.19135 Rollers in inclined shafts. Rollers used in operating inclined shafts shall be lubricated, properly aligned, and kept in good repair....

  19. Design criteria monograph on turbopump shafts and couplings

    NASA Technical Reports Server (NTRS)

    1974-01-01

    Monograph reviews and assesses current design practices, and considers all aspects of turbopump system shaft dynamics peculiar to and necessary to shaft and coupling design. Associated components (bearings, housing, etc.) that influence shaft or coupling design are treated to extent necessary to define that influence.

  20. 14 CFR 27.931 - Shafting critical speed.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting critical speed. 27.931 Section 27... AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.931 Shafting critical speed. (a) The critical speeds of any shafting must be determined by demonstration except...

  1. 14 CFR 29.931 - Shafting critical speed.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Shafting critical speed. 29.931 Section 29... AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.931 Shafting critical speed. (a) The critical speeds of any shafting must be determined by demonstration except...

  2. Poland syndrome associated with ipsilateral lipoma and dextrocardia.

    PubMed

    Li, Wenya; Zhang, Lin; Zhang, Qigang; Du, Jiang; Zhang, Shuguang; Liu, Xiangli

    2011-12-01

    A 22-year-old man was admitted with a rapidly enlarging soft mass on the left chest wall, which was diagnosed as lipoma by postoperative pathology. A chest roentgenogram revealed a defect of the fourth rib, scoliosis, dextrocardia, and diaphragmatic hernia. A computed tomographic scan showed maldevelopment of the pectoralis major and minor muscles. This is the first reported case of Poland syndrome with ipsilateral lipoma of the chest wall. Dextrocardia associated with Poland syndrome may be considered dextroposition, rather than a dextroinversion, and it may arise as a result of Poland syndrome. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Recurrent ectopic pregnancy after ipsilateral partial salpingectomy: a case report.

    PubMed

    Lee, D H

    2015-01-01

    Ectopic pregnancy is associated with maternal morbidity and mortality during early pregnancy. Ectopic pregnancy occurs in approximately 2% of all pregnancies, and the risk of ectopic pregnancy is increased by eight-fold in women with a history of eopic pregnancy. However, recurrent ectopic pregnancy after ipsilateral partial salpingectomy is quite rare. The authors experienced a case of recurrent ectopic pregnancy in the distal remnant after right partial salpingectomy. In this case report, they discuss this unusual case and provide a brief review of the literature.

  4. Clipping of ipsilateral posterior communicating and superior cerebellar artery aneurysms.

    PubMed

    Welch, Babu G

    2015-01-01

    The case is a 55-year-old female who presented with dizziness as the chief complaint. She has a family history of two relatives with subarachnoid hemorrhage. Digital subtraction angiography revealed the presence of a left-sided posterior communicating artery aneurysm and an ipsilateral superior cerebellar artery (SCA) aneurysm. Due to the smaller nature of the SCA, a decision was made to proceed with surgical clipping of both lesions through a pterional approach. A narrated video with illustrations depicts the intraoperative management of these lesions with postoperative angiography results. The video can be found here: http://youtu.be/HCHToSsXv-4 .

  5. Femoral curvature in Neanderthals and modern humans: a 3D geometric morphometric analysis.

    PubMed

    De Groote, Isabelle

    2011-05-01

    Since their discovery, Neanderthals have been described as having a marked degree of anteroposterior curvature of the femoral shaft. Although initially believed to be pathological, subsequent discoveries of Neanderthal remains lead femoral curvature to be considered as a derived Neanderthal feature. A recent study on Neanderthals and middle and early Upper Palaeolithic modern humans found no differences in femoral curvature, but did not consider size-corrected curvature. Therefore, the objectives of this study were to use 3D morphometric landmark and semi-landmark analysis to quantify relative femoral curvature in Neanderthals, Upper Palaeolithic and recent modern humans, and to compare adult bone curvature as part of the overall femoral morphology among these populations. Comparisons among populations were made using geometric morphometrics (3D landmarks) and standard multivariate methods. Comparative material involved all available complete femora from Neanderthal and Upper Palaeolithic modern human, archaeological (Mesolithic, Neolithic, Medieval) and recent human populations representing a wide geographical and lifestyle range. There are significant differences in the anatomy of the femur between Neanderthals and modern humans. Neanderthals have more curved femora than modern humans. Early modern humans are most similar to recent modern humans in their anatomy. Femoral curvature is a good indicator of activity level and habitual loading of the lower limb, indicating higher activity levels in Neanderthals than modern humans. These differences contradict robusticity studies and the archaeological record, and would suggest that femoral morphology, and curvature in particular, in Neanderthals may not be explained by adult behavior alone and could be the result of genetic drift, natural selection or differences in behavior during ontogeny.

  6. Medullary infarcts may cause ipsilateral masseter reflex abnormalities.

    PubMed

    Thömke, Frank; Marx, Jürgen J; Cruccu, Giorgio; Stoeter, Peter; Hopf, Hanns C

    2007-10-01

    There is a suprasegmental influence on the masseter reflex (MassR) in animals, which is mediated via the fifth nerve spinal nucleus (5SpN). Corresponding data in humans are lacking. Out of 268 prospectively recruited patients with clinical signs of acute brainstem infarctions, we identified 38 with magnetic resonance imaging (MRI)-documented unilateral infarcts caudal to the levels of the fifth nerve motor and main sensory nuclei. All had biplanar T2- and echo planar diffusion-weighted MRI and MassR testing. Five patients (13%) had ipsilateral MassR abnormalities. In all, the infarcts involved the region of the 5SpN. Patients with medullary infarcts involving the region of the 5SpN may thus have ipsilateral MassR abnormalities. This possibly represents an interruption of an excitatory projection mediated via the 5SpN to masseter motoneurons in the fifth nerve motor nucleus. MassR abnormalities with medullary lesions restrict the topodiagnostic value of the MassR.

  7. Tachometer Derived From Brushless Shaft-Angle Resolver

    NASA Technical Reports Server (NTRS)

    Howard, David E.; Smith, Dennis A.

    1995-01-01

    Tachometer circuit operates in conjunction with brushless shaft-angle resolver. By performing sequence of straightforward mathematical operations on resolver signals and utilizing simple trigonometric identity, generates voltage proportional to rate of rotation of shaft. One advantage is use of brushless shaft-angle resolver as main source of rate signal: no brushes to wear out, no brush noise, and brushless resolvers have proven robustness. No switching of signals to generate noise. Another advantage, shaft-angle resolver used as shaft-angle sensor, tachometer input obtained without adding another sensor. Present circuit reduces overall size, weight, and cost of tachometer.

  8. Tachometer Derived From Brushless Shaft-Angle Resolver

    NASA Technical Reports Server (NTRS)

    Howard, David E.; Smith, Dennis A.

    1995-01-01

    Tachometer circuit operates in conjunction with brushless shaft-angle resolver. By performing sequence of straightforward mathematical operations on resolver signals and utilizing simple trigonometric identity, generates voltage proportional to rate of rotation of shaft. One advantage is use of brushless shaft-angle resolver as main source of rate signal: no brushes to wear out, no brush noise, and brushless resolvers have proven robustness. No switching of signals to generate noise. Another advantage, shaft-angle resolver used as shaft-angle sensor, tachometer input obtained without adding another sensor. Present circuit reduces overall size, weight, and cost of tachometer.

  9. Safety of the shaft-wheel assembly of electric locomotives

    NASA Astrophysics Data System (ADS)

    Todic, M.; Golubovic-Bugarski, V.

    2017-05-01

    Shafts of electric locomotives are exposed to complex normal and tangential stresses during its exploitation. These stresses could have extremely high level producing the breakage of the shaft. It is well known that shafts have much longer service life than wheels. However, since the stresses in shaft’s material are high, it is possible to micro-cracks appear and propagate until the shaft’s breakage. The breakage of the shaft may cause the great human and material losses. Because of that, during manufacturing these assemblies it must be taken into account all parameters which can initiate shaft crack. Geometric measure of seating and shaft are recommended by UIC regulations having great influence to quality and safety of realized assembly. The influence of contact surfaces and their lubrication during manufacturing the shaft - wheel assembly is shown in this paper.

  10. Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

    PubMed

    Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

    2015-02-15

    During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. Copyright © 2015 the American Physiological Society.

  11. An in Vivo 3D Computed Tomographic Analysis of Femoral Tunnel Geometry and Aperture Morphology Between Rigid and Flexible Systems in Double-Bundle Anterior Cruciate Ligament Reconstruction Using the Transportal Technique.

    PubMed

    Kim, Jae Gyoon; Chang, Min Ho; Lim, Hong Chul; Bae, Ji Hoon; Lee, Seung Yup; Ahn, Jin Hwan; Wang, Joon Ho

    2015-07-01

    The aim of this study was to compare femoral tunnel length, femoral graft-bending angle, posterior wall breakage, and femoral aperture morphologic characteristics between rigid and flexible systems after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction using the transportal (TP) technique. We evaluated 3-dimensional computed tomography (3D-CT) results for 54 patients who underwent DB ACL reconstruction using the TP technique with either a flexible system (n = 27) or a rigid system (n = 27). The femoral tunnel length, femoral graft-bending angle, posterior wall breakage, femoral tunnel aperture height to width (H:W) ratio, aperture axis angle, and femoral tunnel position were assessed using OsiriX Imaging Software and Geomagic Qualify 2012 (Geomagic, Cary, NC). The mean anteromedial (AM) femoral tunnel length of the flexible group was significantly longer than that of the rigid group (P = .009). The mean femoral graft-bending angles in the flexible group were significantly less acute than those in the rigid group (AM, P < .001; posterolateral [PL], P = .003]. Posterior wall breakage was observed in both groups (P = 1.00). The mean H:W ratios in the rigid group were significantly larger (more elliptical) than those of the flexible group (AM, P < .001; PL, P = .006). The mean aperture axis angle of the PL femoral tunnel in the rigid group was more parallel to the femoral shaft axis than that in the flexible group (P < .001). There were no significant differences in femoral tunnel position between the 2 groups. The AM femoral tunnel length and the AM/PL femoral graft-bending angle of the flexible system were significantly longer and less acute than those of the rigid system. However, the aperture morphologic characteristics of the AM/PL femoral tunnel and the aperture axis angle of the PL femoral tunnel in the rigid system were significantly more elliptical and closer to parallel to the femoral shaft axis than those of the flexible system. Level

  12. Lunar vertical-shaft mining system

    NASA Technical Reports Server (NTRS)

    Introne, Steven D. (Editor); Krause, Roy; Williams, Erik; Baskette, Keith; Martich, Frederick; Weaver, Brad; Meve, Jeff; Alexander, Kyle; Dailey, Ron; White, Matt

    1994-01-01

    This report proposes a method that will allow lunar vertical-shaft mining. Lunar mining allows the exploitation of mineral resources imbedded within the surface. The proposed lunar vertical-shaft mining system is comprised of five subsystems: structure, materials handling, drilling, mining, and planning. The structure provides support for the exploration and mining equipment in the lunar environment. The materials handling subsystem moves mined material outside the structure and mining and drilling equipment inside the structure. The drilling process bores into the surface for the purpose of collecting soil samples, inserting transducer probes, or locating ore deposits. Once the ore deposits are discovered and pinpointed, mining operations bring the ore to the surface. The final subsystem is planning, which involves the construction of the mining structure.

  13. Treatment shaft for combined sewer overflow detention.

    PubMed

    Wright, Steven J; Ghalib, Saad; Eloubaidy, Aziz

    2010-05-01

    A deep, large-diameter underground shaft to provide detention storage for combined sewer overflow control may be advantageous in urban environments, where space limitations require solutions with a small footprint. An underflow baffle wall is provided at the center of the treatment shaft to prevent short-circuiting of the flow. An additional objective is to maintain low headlosses through the structure. A physical model study was conducted to determine the effect of the bottom elevation of the baffle wall on the headloss and breakthrough curve for dye injected to the inflow. It was found that there is a considerable range of elevations for which the structure behaves acceptably in providing adequate contact time for disinfectant while maintaining small headlosses.

  14. Lowest critical velocity of rotating shafts.

    NASA Technical Reports Server (NTRS)

    Atzori, B.; Curti, G.

    1973-01-01

    The effect of the gyroscopic moment on the appearance of a first imaginary critical velocity (minimum negative value of lambda) is investigated and shown to have an important effect on the computation of the first critical velocity. A numerical procedure is developed which can be used for overcoming the difficulties arising when the first real and the first imaginary roots are similar in modulus. As an example, a real shaft with two supports was analyzed. For the computation the real shaft was subdivided into ten sections, and for two of them (representing compressor and turbine) the gyroscopic moment was taken into account. The present method is especially useful when high speed computational facilities are not available.

  15. Proximal Femoral Morphology and the Relevance to Design of Anatomically Precontoured Plates: A Study of the Chinese Population

    PubMed Central

    Lin, Kang-Ping; Lee, Pei-Yuan

    2014-01-01

    Adequately shaped femoral plate is critical for the fixation of fracture in the pertrochanteric regions. Lateral aspect of greater trochanter is an important region where the proximal femoral plate anchored. However, little is known regarding the morphology of greater trochanter. The objective of this study was to measure main dimensions of greater trochanter and other regions in the proximal end of the femur to provide an anatomical basis for the design of the proximal femoral plate. Anthropometric data on the proximal femur were performed utilizing three-dimensional computational modeling. Computed tomography images of healthy femurs in 53 women and 47 men were contributed to three-dimensional femur modeling. All data were compared between male and female femora. The results showed that mean values for male group were found to be greater in most of measured femoral dimensions. Oppositely, females demonstrated higher neck-shaft angle on anteroposterior view and femoral anteversion angle. The anthropometric data can be used for the anatomical shape design of femoral plates for osteosynthesis of fractures in the trochanteric regions. A distinct plate design may be necessary to accommodate differences between the genders. PMID:25530989

  16. The role of altered proximal femoral geometry in impaired pelvis stability and hip control during CP gait: A simulation study.

    PubMed

    Bosmans, Lode; Jansen, Karen; Wesseling, Mariska; Molenaers, Guy; Scheys, Lennart; Jonkers, Ilse

    2016-02-01

    Children with cerebral palsy (CP) often present aberrant hip geometry, more specifically increased femoral anteversion and neck-shaft angle. Furthermore, altered gait patterns are present within this population. This study analyzed the effect of aberrant femoral geometry, as present in subjects with CP, on the ability of muscles to control hip and knee joint kinematics. Given the specific gait deficits observed during crouch gait, increased ability to abduct, externally rotate the hip and extend the knee and hip were denoted as beneficial effects. We ran dynamic simulations of CP and normal gait using two musculoskeletal models, one reflecting normal femoral geometry and one reflecting proximal femoral deformities. The results show that the combination of aberrant bone geometry and CP-specific gait characteristics beneficially increased the ability of gluteus medius and maximus to extend the hip and knee. In contrast, the potentials of the hamstrings to extend the hip decreased whereas the potentials to flex the knee increased. These changes closely followed the observed changes in the muscle moment arm lengths. In conclusion, this study emphasizes the concomitant effect of the presence of proximal femoral deformity and CP gait characteristics on the muscle control of hip and knee joint kinematics during single stance. Not accounting for subject-specific geometry will affect the calculated muscles' potential during gait. Therefore, the use of generic models to assess muscle function in the presence of femoral deformity and CP gait should be treated with caution. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Methods of Erecting Supports in Mine Shafts,

    DTIC Science & Technology

    2014-09-26

    erecting permanent supports in mine shafts * which are sunk with the pre-freezing of the rock and where a concrete * casing is sunk parallel with the...carried out independent of the construction of a concrete casing * with a space left which is filled with sand or gravel. This provides for an...which is sunk a concrete casing and then tubbing is erected in an upward direction with a space left which is filled with sand or gravel. In the

  18. Vibration reduction on automotive shafts using piezoceramics

    NASA Astrophysics Data System (ADS)

    Kunze, Holger; Riedel, Mathias; Schmidt, Knut; Bianchini, Emanuele

    2003-08-01

    This paper reports an experimental study on active vibration reduction for automotive shafts with the use of piezoelectric material. The work focuses on an axle of an Audi A2. The demand in the automobile sector for higher comfort in the vehicle is of a great importance alongside the requirements of lighter weight and low fuel consumption. These requirements are typically in conflict with each other. One solution is the use of intelligent materials instead of viscoelastic materials and proof mass absorbers. These solutions are quite heavy especially at low frequencies. Active vibration control and piezoelectric devices are advantageous in this application due to their low mass to performance ratio. Our research study explores the use of such piezoelectric devices for an axle. In conjunction with electronics it will reduce vibrations in the first natural bending mode of the axle. Laboratory tests simulated the condition present in the road. At first a stationary set up was used, then a simulated disturbance was input at the attachment points of the shaft. Finally, a test with rotating shaft was performed. Piezoelectric devices (custom QuickPacks from ACX, a Division of Cymer) were used as sensors and as actuators to properly control the axle during the different operating conditions. The power consumption of each actuator pair was less than 20W. The work described here details the test setup, the control strategy, the hardware implementation as well as the test results obtained.

  19. Expressive Single Scattering for Light Shaft Stylization.

    PubMed

    Kol, Timothy R; Klehm, Oliver; Seidel, Hans-Peter; Eisemann, Elmar

    2016-04-14

    Light scattering in participating media is a natural phenomenon that is increasingly featured in movies and games, as it is visually pleasing and lends realism to a scene. In art, it may further be used to express a certain mood or emphasize objects. Here, artists often rely on stylization when creating scattering effects, not only because of the complexity of physically correct scattering, but also to increase expressiveness. Little research, however, focuses on artistically influencing the simulation of the scattering process in a virtual 3D scene. We propose novel stylization techniques, enabling artists to change the appearance of single scattering effects such as light shafts. Users can add, remove, or enhance light shafts using occluder manipulation. The colors of the light shafts can be stylized and animated using easily modifiable transfer functions. Alternatively, our system can optimize a light map given a simple user input for a number of desired views in the 3D world. Finally, we enable artists to control the heterogeneity of the underlying medium. Our stylized scattering solution is easy to use and compatible with standard rendering pipelines. It works for animated scenes and can be executed in real time to provide the artist with quick feedback.

  20. Task-specific role of ipsilateral pathways: somatosensory evoked potentials during cooperative hand movements.

    PubMed

    Schrafl-Altermatt, Miriam; Dietz, Volker

    2014-12-17

    Task-specific neural coupling during cooperative hand movements has been described in healthy volunteers, manifested by bilateral reflex electromyographic responses in forearm muscles following unilateral ulnar nerve stimulation and by task-specific activation of secondary somatosensory cortical areas (S2) in functional MRI. The aim of this study was to investigate the role of sensory input to the ipsilateral and contralateral cortex during a cooperative task. Somatosensory evoked potentials from the ulnar nerve were recorded over the ipsilateral and contralateral cortex during resting and during cooperative and noncooperative hand movements. Ipsilateral potentials with smaller amplitude were present under all conditions in almost all participants. In relation to the resting condition, the amplitudes of both the ipsilateral and the contralateral potential were reduced during the cooperative and the noncooperative tasks. Nevertheless, the reduction in amplitude was similar for the ipsilateral and the contralateral potentials in the noncooperative task, but less on the ipsilateral compared with the contralateral side during the cooperative task. The ratio of ipsilateral/contralateral somatosensory evoked potential amplitude was thus significantly larger during the cooperative task compared with the control task and the resting condition. This indicates a functional role of ipsilateral pathways connecting the cervical spinal cord with the cortex during the cooperative task. These observations favor the idea of a task-specific mediation of sensory input from both hands to the ipsilateral and contralateral hemispheres as the basis of neuronal coupling.

  1. Ipsilateral blinking seizures during left fronto-temporal ictal pattern on scalp EEG.

    PubMed

    Pestana, Elia M; Gupta, Ajay

    2007-12-01

    We report an infant with left eye blinking seizures accompanying a left (ipsilateral) fronto-temporal scalp EEG ictal pattern. The epileptogenic lesion was a left frontal encephalomalacia along the ventriculo-peritoneal shunt tract. The shunt was inserted for treatment of communicating hydrocephalus. This case illustrates the lateralizing value of the ictal blinking. Review of the literature suggests that seizures with unilateral blinking are likely to be produced by activation of ipsilateral trigeminal fibers innervating subdural intracranial structures and pial vessels in temporal and frontal lobes. Ipsilateral blinking could also be produced by activation of the ipsilateral cerebellar hemisphere.

  2. Horner's syndrome and ipsilateral laryngeal hemiplegia in three cats.

    PubMed

    Holland, C T

    1996-09-01

    Horner's syndrome is described in three cats associated with wounds to the ventrolateral neck. In each case, ipsilateral laryngeal hemiplegia was observed on laryngoscopy. This finding provided strong evidence to support a diagnosis of second order Horner's syndrome due to disruption of the cervical sympathetic trunk, as motor fibres innervating laryngeal abductors also traverse the neck; both as descending fibres within the contiguous cervical vagus and as ascending fibres within the recurrent laryngeal nerve. Notably, the ability to vocalise was unimpaired in all cases and, in two cats, neck wounds were not apparent until the neck had been clipped and closely examined. These findings indicate that assessment of laryngeal function is of value when localising the site of the neural defect responsible for selected cases of second order Horner's syndrome.

  3. Becker Nevus Syndrome Presented with Ipsilateral Breast Hypoplasia

    PubMed Central

    Pektas, Suzan Demir; Akoglu, Gulsen; Metin, Ahmet; Adiyaman, Nuran Sungu; Demirseren, Mustafa Erol

    2014-01-01

    Becker nevus syndrome (BNS) is a rare epidermal nevus syndrome characterized with Becker nevus and ipsilateral breast gland hypoplasia or other skin, skeletal and/or muscle tissue disorders. A 24-year-old woman presented with brown, irregular bordered patch with a diameter of approximately 10 cm which consisted of several small macules on the left breast skin. The ultrasonography and magnetic resonance imaging revealed left breast hypoplasia. Histopathological examination demonstrated minimal acanthosis, papillomatosis, increase in basal layer melanin and hypertrophy of the erector pili muscle. Immunohistochemical staining was positive for androgen in the epidermis, dermal stromal cells and skin appendages. Depending on the clinical and histopathological findings, the patient was diagnosed as BNS. Diagnosis of BNS needs careful examination of pigmented macules and patches since non-hairy BN may be easily overlooked. Patients with BN should be evaluated for associated abnormalities of BNS, in which the severity and extend of ectodermal involvement may differ from patient to other. PMID:25484431

  4. Atypical Femoral Fractures Can Happen Even With Short Duration Bisphosphonate Treatment.

    PubMed

    Kohli, Ritesh; Siva, Chokkalingam

    2015-08-01

    Bisphosphonates remain the mainstay of the pharmacological approach to reduce the risk of fractures. Clinical trials have demonstrated their efficacy in reducing the frequency of osteoporosis-related vertebral and nonvertebral fractures. In the last few years, there have been several reports of increased risk of subtrochanteric and femoral shaft fractures also known as "atypical femoral fractures" (AFF) among patients receiving long-term bisphosphonate treatment. Most of these reports have been on alendronate, the most extensively used bisphosphonate. There is paucity of data to link ibandronate to AFF. We report a 66-year-old female presenting with AFF within three years of starting ibandronate and after receiving a total of 27 doses. Prescribers should be aware that AFF can happen even during the early course of bisphosphonate treatment and not necessarily only after prolonged treatment for several years.

  5. Alendronate-Related Femoral Fracture in a premenopausal glucocorticoid treated patient

    PubMed Central

    Mobini, Maryam

    2014-01-01

    Background: Alendronate is a bisphosphonate that is approved to reduce bone loss in glucocorticoid treated patients. In this paper, we present a case of femoral fracture following the use of Alendronate. Case presentation: A- 46 year old woman who was a known case of hemolytic anemia has been treated by prednisolone (with different doses from 7.5 to 75 mg/day), calcium-D 500 mg/day and alendronate 70 mg/week for 3 years. Despite improvement of bone density, she experienced a low truama femoral shaft fracture. Conclusion: This case shows a rare complication of treatment by alendronate. It may be needed to evaluate patients with long term usage of bisphosphonates for cortical thickness. PMID:24490015

  6. Alendronate-Related Femoral Fracture in a premenopausal glucocorticoid treated patient.

    PubMed

    Mobini, Maryam

    2014-01-01

    Alendronate is a bisphosphonate that is approved to reduce bone loss in glucocorticoid treated patients. In this paper, we present a case of femoral fracture following the use of Alendronate. A- 46 year old woman who was a known case of hemolytic anemia has been treated by prednisolone (with different doses from 7.5 to 75 mg/day), calcium-D 500 mg/day and alendronate 70 mg/week for 3 years. Despite improvement of bone density, she experienced a low truama femoral shaft fracture. This case shows a rare complication of treatment by alendronate. It may be needed to evaluate patients with long term usage of bisphosphonates for cortical thickness.

  7. Shaft-Angle Sensor Based on Tunnel-Diode Oscillator

    NASA Technical Reports Server (NTRS)

    Chui, Talso

    2008-01-01

    A proposed brushless shaft-angle sensor for use in extreme cold would offer significant advantages over prior such sensors: (1) It would be capable of operating in extreme cold; and (2) Its electronic circuitry would be simpler than that of a permanent-magnet/ multiple-Hall-probe shaft-angle sensor that would otherwise ordinarily be used to obtain comparable angular resolution. The principle of operation of the proposed shaft-angle sensor requires that the shaft (or at least the portion of the shaft at the sensor location) be electrically insulating. The affected portion of the shaft would be coated with metal around half of its circumference. Two half-circular-cylinder electrodes having a radius slightly larger than that of the shaft would be mounted on the stator, concentric with the shaft, so that there would be a small radial gap between them and the outer surface of the shaft. Hence, there would be a capacitance between each stationary electrode and the metal coat on the shaft.

  8. Biomechanical analysis of a novel femoral neck locking plate for treatment of vertical shear Pauwel's type C femoral neck fractures.

    PubMed

    Nowotarski, Peter J; Ervin, Bain; Weatherby, Brian; Pettit, Jonathan; Goulet, Ron; Norris, Brent

    2012-06-01

    The purpose of this study is to determine the biomechanical stability of a novel prototype femoral neck locking plate (FNLP) for treatment of Pauwels type C femoral neck fractures compared with other current fixation methods. Forty femur sawbones were divided into groups and a vertical femoral neck fracture was made. Each group was repaired with one of the following: (CS) three parallel cancellous screws; (XCS) two cancellous lag screws into the head and one transverse lag screw into the calcar; and (FNLP) a novel FNLP with two 5.7 mm locking, one lag screw into the calcar and two screws into the shaft; and (AMBI) a two-hole, 135° AMBI plate with a derotation screw. All groups were tested for change in axial stiffness over 20000 cycles, and rotational stiffness was measured before and after cyclic testing. A maximum load to failure test was also conducted. Results were compared with one-way analysis of variance (ANOVA) and Fisher protected least significant difference (PLSD). Results for axial stiffness show that AMBI, CS, XCS and FNLP are 2779.0, 2207.2, 3029.9 and 3210.7 N-m mm(-1), respectively. Rotational rigidity results are 4.5, 4.1, 17.1 and 18.7 N-m mm(-1). The average cyclic displacements were 0.75, 0.88, 0.80 and 0.65 mm, respectively. Destructive failure loads for AMBI, CS, XCS and FNLP were 2.3, 1.7, 1.6 and 1.9 kN, respectively. The results of this experiment show statistically significant increases in axial stiffness for the FNLP compared with three traditional fixation methods. The FNLP demonstrates increased mechanical stiffness and combines the desirable features of current fixation methods. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Comparative study of the proximal femoral nail antirotation versus the reconstruction nail in the treatment of comminuted proximal femoral fracture.

    PubMed

    Huang, Fu-Ting; Lin, Kai-Cheng; Yang, Shan-Wei; Renn, Jenn-Huei

    2012-01-16

    The purpose of our study was to compare the proximal femoral nail antirotation (PFNA; Synthes, Paoli, Pennsylvania) with a reconstruction nail (Recon; Zimmer, Warsaw, Indiana) in the treatment of comminuted proximal femoral fractures. Between 2003 and 2010, twenty-three consecutive patients with AO/Orthopaedic Trauma Association 31-A3 fractures combined with proximal 32 fractures who had a minimum 18-month follow-up were evaluated retrospectively. There were 10 patients (age range, 18-74 years) in the Recon nail group and 13 patients (age range, 22-90 years) in the PFNA nail group. Patients treated with Recon nails experienced a longer operation time (P=.006) and more blood loss (P=.012) than patients treated with the PFNA nail. On postoperative radiographs, the change in the neck-shaft angle was 8.8° in the Recon nail group and 4.7° in the PFNA nail group (P=.048). The fracture union time averaged 31.8 weeks in the Recon nail group and 21.5 weeks in the PFNA nail group (P=.148). More patients in the Recon nail group underwent major or minor reoperation (P=.038) compared with the PFNA nail group. No implant failure occurred in either group. The functional results were similar in the 2 groups. For the treatment of comminuted proximal femoral fractures, use of either the PFNA and Recon nail is clinically effective. However, the PFNA nail provides a shorter operation time, less blood loss, and better realignment ability and reduces the incidence of reoperation. Therefore, the PFNA nail can be considered a better device than the Recon nail. Copyright 2012, SLACK Incorporated.

  10. Femoral Head and Neck Excision.

    PubMed

    Harper, Tisha A M

    2017-07-01

    Femoral head and neck excision is a surgical procedure that is commonly performed in small animal patients. It is a salvage procedure that is done to relieve pain in the coxofemoral joint and restore acceptable function of the limb. Femoral head and neck excision is most commonly used to treat severe osteoarthritis in the coxofemoral joint and can be done in dogs and cats of any size or age. The procedure should not be overused and ideally should not be done when the integrity of the coxofemoral joint can be restored. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Effect of growth plate geometry and growth direction on prediction of proximal femoral morphology.

    PubMed

    Yadav, Priti; Shefelbine, Sandra J; Gutierrez-Farewik, Elena M

    2016-06-14

    Mechanical stimuli play a significant role in the process of endochondral growth. Thus far, approaches to understand the endochondral mechanical growth rate have been limited to the use of approximated location and geometry of the growth plate. Furthermore, growth has been simulated based on the average deflection of the growth plate or of the femoral neck. It has also been reported in the literature that the growth plate lies parallel to one of the principal stresses acting on it, to reduce the shear between epiphysis and diaphysis. Hence the current study objectives were (1) to evaluate the significance of a subject-specific finite element model of the femur and growth plate compared to a simplified growth plate model and (2) to explore the different growth direction models to better understand proximal femoral growth mechanisms. A subject-specific finite element model of an able-bodied 7-year old child was developed. The muscle forces and hip contact force were computed for one gait cycle and applied to a finite element model to determine the specific growth rate. Proximal femoral growth was simulated for two different growth direction models: femoral neck deflection direction and principal stress direction. The principal stress direction model captured the expected tendency for decreasing the neck shaft angle and femoral anteversion for both growth plate models. The results of this study suggest that the subject-specific geometry and consideration of the principal stress direction as growth direction may be a more realistic approach for correct prediction of proximal femoral growth morphology.

  12. Effect of femoral neck modularity upon the prosthetic range of motion in total hip arthroplasty.

    PubMed

    Turley, Glen A; Griffin, Damian R; Williams, Mark A

    2014-08-01

    In total hip arthroplasty, aseptic loosening and dislocation are associated with not being able to achieve the correct prosthetic component orientation. Femoral neck modularity has been proposed as a solution to this problem by allowing the surgeon to alter either the neck-shaft or version angle of the prosthetic femoral component intra-operatively. A single replicate full factorial design was used to evaluate how effective a modular femoral neck cementless stem was in restoring a healthy prosthetic range of motion in comparison with a leading fixed-neck cementless stem with the standard modular parameters. It was found that, if altered to a large enough degree, femoral neck modularity can increase the amount of prosthetic motion as well as alter its position to where it is required physiologically. However, there is a functional limit to the amount that can be corrected and there is a risk with regard to the surgeon having to select the optimum modular neck before any benefit is realised.

  13. Femoral morphology and femoropelvic musculoskeletal anatomy of humans and great apes: a comparative virtopsy study.

    PubMed

    Morimoto, Naoki; Ponce de León, Marcia S; Nishimura, Takeshi; Zollikofer, Christoph P E

    2011-09-01

    The proximal femoral morphology of fossil hominins is routinely interpreted in terms of muscular topography and associated locomotor modes. However, the detailed correspondence between hard and soft tissue structures in the proximal femoral region of extant great apes is relatively unknown, because dissection protocols typically do not comprise in-depth osteological descriptions. Here, we use computed tomography and virtopsy (virtual dissection) for non-invasive examination of the femoropelvic musculoskeletal anatomy in Pan troglodytes, P. paniscus, Gorilla gorilla, Pongo pygmaeus, and Homo sapiens. Specifically, we analyze the topographic relationship between muscle attachment sites and surface structures of the proximal femoral shaft such as the lateral spiral pilaster. Our results show that the origin of the vastus lateralis muscle is anterior to the insertion of gluteus maximus in all examined great ape specimens and humans. In gorillas and orangutans, the insertion of gluteus maximus is on the inferior (anterolateral) side of the lateral spiral pilaster. In chimpanzees, however, the maximus insertion is on its superior (posteromedial) side, similar to the situation in modern humans. These findings support the hypothesis that chimpanzees and humans exhibit a shared-derived musculoskeletal topography of the proximal femoral region, irrespective of their different locomotor modes, whereas gorillas and orangutans represent the primitive condition. Caution is thus warranted when inferring locomotor behavior from the surface topography of the proximal femur of fossil hominins, as the morphology of this region may contain a strong phyletic signal that tends to blur locomotor adaptation.

  14. Dynamic analysis method of rotating shaft with magnetic pattern

    NASA Astrophysics Data System (ADS)

    Hsiao, Heng-Sheng; Shih, Shuo-Wu; Chang, Jen-Yuan (James)

    2017-05-01

    Vibration issue in rotating system has existed mostly due to imbalance response of a rotating shaft. In general, accelerometers or eddy current probes are commonly used to measure the shaft's dynamic changes in form of acceleration and displacement. Originated from coding and operating algorithm of hard disk drive, a method to detect the position error of read head is applied on measuring and analyzing dynamic response of rotating shaft system. By magnetizing the pattern on magnetic medium surrounded on the rotating shaft, analog signal can be acquired to determine the shaft's axial and radial displacement. In this paper, a method of dynamic measuring on rotating shaft is proposed by using magnetic pattern and validated through calibrated experiments.

  15. Twin-capacitive shaft angle encoder with analog output signal

    NASA Technical Reports Server (NTRS)

    Hruby, R. J.; Wilson, R. L. (Inventor)

    1977-01-01

    A precision capacitive shaft encoder providing a dc signal corresponding to the angular position of a shaft is described. Two variable capacitances are coupled in tandem by a rotatable shaft. Each capacitor has a capacitance that varies linearly with a change in the angular position of the shaft. The sum of the two capacitances is always constant for any angular position of the shaft. Each capacitance is alternately coupled to a reference dc voltage and a discharge circuit. The capacitances are electrically coupled in series and the charge periodically acquired at the junction of the capacitance is a function of the position of the shaft. An error-compensating voltage is imposed on the junction when the capacitances are coupled to the reference voltages. The junction is coupled to sample-and-hold apparatus provided with a error-correcting circuit.

  16. A 42-year-old patient presenting with femoral head migration after hemiarthroplasty performed 22 years earlier: a case report.

    PubMed

    Kanda, Akio; Kaneko, Kazuo; Obayashi, Osamu; Mogami, Atsuhiko

    2015-01-15

    Treatment of femoral neck fractures in young adults may require total hip arthroplasty or hip hemiarthroplasty using a bipolar cup. The latter can, however, result in migration of the femoral head and poor long-term results. We report a case of femoral head migration after hemiarthroplasty performed for femoral neck fracture that had occurred 22 years earlier, when the patient (a Japanese man) was 20 years old. He experienced peri-prosthetic fracture of the femur, subsequent migration of the prosthesis, and a massive bone defect of the pelvic side acetabular roof. After bone union of the femoral shaft fracture, the patient was referred to our hospital for reconstruction of the acetabular roof. Intra-operatively, we placed two alloimplants of bone from around the transplanted femoral head into the weight-bearing region of the acetabular roof using an impaction bone graft method. We then implanted an acetabular roof reinforcement plate and a cemented polyethylene cup in the position of the original acetabular cup. Eighteen months post-operatively, X-rays showed union of the transplanted bone. Treatment of femoral neck fractures in young adults is usually accomplished by osteosynthesis, but it may be complicated by femoral head avascular necrosis or by infection or osteomyelitis. In such cases, once an infection has subsided, either hip hemiarthroplasty using a bipolar cup or total hip arthroplasty may be required. However, if the acetabular side articular cartilage is damaged, a bipolar cup should not be used. Total hip arthroplasty should be performed to prevent migration of the implant.

  17. Femoral head cartilage disarticulation disorder

    USDA-ARS?s Scientific Manuscript database

    Femoral head cartilage disarticulation disorder and necrosis is a major skeletal problem in broiler breeders since they are maintained for a long time in the farm. The etiology of this disease is not well understood. A field study was conducted to understand the basis of this metabolic disease. Six ...

  18. Cardiac resynchronization therapy: Femoral approach.

    PubMed

    Brandão, Luís; Miranda, Rita; Almeida, Sofia; Ribeiro, Luciano; Alvarenga, Carlos; João, Isabel; Pereira, Hélder

    2017-04-01

    We describe the case of a 62-year-old female patient with bilateral subclavian vein occlusion, in whom a cardiac resynchronization system was implanted via a femoral vein. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Neural pattern similarity between contra- and ipsilateral movements in high-frequency band of human electrocorticograms.

    PubMed

    Fujiwara, Yusuke; Matsumoto, Riki; Nakae, Takuro; Usami, Kiyohide; Matsuhashi, Masao; Kikuchi, Takayuki; Yoshida, Kazumichi; Kunieda, Takeharu; Miyamoto, Susumu; Mima, Tatsuya; Ikeda, Akio; Osu, Rieko

    2017-02-15

    The cortical motor areas are activated not only during contralateral limb movements but also during ipsilateral limb movements. Although these ipsilateral activities have been observed in several brain imaging studies, their functional role is poorly understood. Due to its high temporal resolution and low susceptibility to artifacts from body movements, the electrocorticogram (ECoG) is an advantageous measurement method for assessing the human brain function of motor behaviors. Here, we demonstrate that contra- and ipsilateral movements share a similarity in the high-frequency band of human ECoG signals. The ECoG signals were measured from the unilateral sensorimotor cortex while patients conducted self-paced movements of different body parts, contra- or ipsilateral to the measurement side. The movement categories (wrist, shoulder, or ankle) of ipsilateral movements were decoded as accurately as those of contralateral movements from spatial patterns of the high-frequency band of the precentral motor area (the primary motor and premotor areas). The decoder, trained in the high-frequency band of ipsilateral movements generalized to contralateral movements, and vice versa, confirmed that the activity patterns related to ipsilateral limb movements were similar to contralateral ones in the precentral motor area. Our results suggest that the high-frequency band activity patterns of ipsilateral and contralateral movements might be functionally coupled to control limbs, even during unilateral movements.

  20. [Should ipsilateral adrenalectomy be performed systematically during radical nephrectomy for renal cancer?].

    PubMed

    Joual, A; Fekak, H; Rabii, R; Hafiani, M; el Mrini, M; Benjelloun, S

    1999-01-01

    The authors present a retrospective study of 46 patients with renal cell carcinoma treated by radical nephrectomy including ipsilateral adrenalectomy. CT scan showed a normal adrenal gland in all patients. Histology revealed the absence of adrenal metastasis in all patients. Ipsilateral adrenalectomy is not systematically required in radical nephrectomy.

  1. 5. SPARE SHIPPER SHAFT IN MIDDLE OF PHOTOGRAPH. NOTE PINION ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. SPARE SHIPPER SHAFT IN MIDDLE OF PHOTOGRAPH. NOTE PINION GEARS ON SHAFT. END OF DIPPER STICK IN FOREGROUND, NOTE RACK IRON ON BOTTOM OF STICK, WHICH MESHES WITH GEARS ON SHIPPER SHAFT. LIVING QUARTERS IN BACKGROUND. CYLINDER AND SHEAVES FOR OPERATING BULL WHEEL (FOR SWINGING BOOM) ON LOWER RIGHT. - Dredge CINCINNATI, Docked on Ohio River at foot of Lighthill Street, Pittsburgh, Allegheny County, PA

  2. 10. Photocopied August 1978. CLOSEUP VIEW OF TURBINE SHAFT PENETRATING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. Photocopied August 1978. CLOSE-UP VIEW OF TURBINE SHAFT PENETRATING THE STEEL PLATE BULKHEAD THROUGH A STUFFING BOX AND AND ALSO SHOWING THE CONTROL GATE SHAFT. THIS PARTICULAR UNIT WAS INSTALLED IN 1916. THE ADMISSION OF WATER TO ALL FOUR RUNNERS IN A PENSTOCK UNIT COULD SIMULTANEOUSLY BE CONTROLLED BY THE CONTROL SHAFT ON THE LEFT. (899) - Michigan Lake Superior Power Company, Portage Street, Sault Ste. Marie, Chippewa County, MI

  3. Proposed design procedure for transmission shafting under fatigue loading

    NASA Technical Reports Server (NTRS)

    Loewenthal, S. H.

    1978-01-01

    A new standard for the design of transmission shafting is reported. Computed was the diameter of rotating solid steel shafts under combined cyclic bending and steady torsion is presented. The formula is based on an elliptical variation of endurance strength with torque exhibited by combined stress fatigue data. Fatigue factors are cited to correct specimen bending endurance strength data for use in the shaft formula. A design example illustrates how the method is to be applied.

  4. Gearbox Reliability Collaborative High-Speed Shaft Calibration

    SciTech Connect

    Keller, J.; McNiff, B.

    2014-09-01

    Instrumentation has been added to the high-speed shaft, pinion, and tapered roller bearing pair of the Gearbox Reliability Collaborative gearbox to measure loads and temperatures. The new shaft bending moment and torque instrumentation was calibrated and the purpose of this document is to describe this calibration process and results, such that the raw shaft bending and torque signals can be converted to the proper engineering units and coordinate system reference for comparison to design loads and simulation model predictions.

  5. 9. Interior view, overhead line shafting and lathe workbench, east ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. Interior view, overhead line shafting and lathe workbench, east shop, ground floor, looking northwest. - Larrabee & Hingston Company, Main Shop Building, 19 Howley Street, Peabody, Essex County, MA

  6. Evaluation of steel shafts for magnetostrictive torque sensors (abstract)

    SciTech Connect

    Koga, F.; Yoshida, K.; Sasada, I.

    1997-04-01

    Based on the magnetostrictive effect in steel, a robust, noncontacting shaft torque sensor can be obtained. A fundamental problem is compatibility between mechanical strength required for a shaft and a magnetic one needed for a torque sensor. To find shaft material accommodating these two requirements, we investigated basic characteristics, such as hysteresis, linearity, and zero-level fluctuation associated with shaft rotation, of the magnetostrictive torque sensor for various nickel chromium molybdenum steel shafts (SNCM in Japanese Industrial Standard) subjected to case hardening. We prepared three kinds of shafts of 25 mm in diameter: SNCM 420 (Ni=1.69{percent}, C=0.2{percent}), SNCM 616 (Ni=2.91{percent}, C=0.15{percent}), and SNCM 447 (Ni=1.67{percent}, C=0.49{percent}). Shafts of the first two materials were carburized, whereas those of the last one were quenched. We used a magnetic head-type torque sensor consisting of a pair of cross-coupled figure-eight coils (14 turn). The hysteresis in the input{endash}output relationship was measured for the excitation current from 0.1 to 1.0 A at 60 kHz. The hysteresis of the SNCM 420 shaft changes from negative to positive with the increase in excitation current and that of the SNCM 616 shaft decreases monotonically but never reaches zero, whereas that of the SNCM 447 shaft exhibits minimum. The smallest values obtained are nearly zero for the SNCM 420 shaft at 0.3 A, 1.5{percent}/(full scale (FS)=400 Nm) for the SNCM 616 shaft at 1.0 A and 0.7{percent}/FS for the SNCM 447 shaft at 0.8 A, respectively. The linearity measured for the SNCM 420 shaft, which has the smallest hysteresis of the three, at 0.3 A and 60 kHz was virtually straight for the applied torque range {minus}400{endash}400 Nm and 0.8{percent} of nonlinearity error for the range {minus}1000{endash}1000 Nm. The zero-level fluctuation was measured for the SNCM 420 shaft by rotating the shaft without applying torque. (Abstract Truncated)

  7. The role of the shaft in the golf swing.

    PubMed

    Milne, R D; Davis, J P

    1992-09-01

    Current marketing of golf clubs places great emphasis on the importance of the correct choice of shaft in relation to the golfer. The design of shafts is based on a body of received wisdom for which there appears to be little in the way of hard evidence, either of a theoretical or experimental nature. In this paper the behaviour of the shaft in the golf swing is investigated using a suitable dynamic computer simulation and by making direct strain gauge measurements on the shaft during actual golf swings. The conclusion is, contrary to popular belief, that shaft bending flexibility plays a minor dynamic role in the golf swing and that the conventional tests associated with shaft specification are peculiarly inappropriate to the swing dynamics; other tests are proposed. A concomitant conclusion is that it should be difficult for the golfer to actually identify shaft flexibility. It is found that if golfers are asked to hit golf balls with sets of clubs having different shafts but identical swingweights the success rate in identifying the shaft is surprisingly low.

  8. 23. VIEW SECOND FLOOR, ELEVATOR SHAFT SAFETY NET ACCESS, NORTHWEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. VIEW SECOND FLOOR, ELEVATOR SHAFT SAFETY NET ACCESS, NORTHWEST ELEVATOR LOADING DOOR. - Bates Manufacturing Company, Storehouse, Northeast corner of Chestnut Street & Hines Alley, Lewiston, Androscoggin County, ME

  9. 21. VIEW SECOND FLOOR, ELEVATOR SHAFT, TOP ELEVATOR SUPPORT, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    21. VIEW SECOND FLOOR, ELEVATOR SHAFT, TOP ELEVATOR SUPPORT, LOOKING NORTHWEST - Bates Manufacturing Company, Storehouse, Northeast corner of Chestnut Street & Hines Alley, Lewiston, Androscoggin County, ME

  10. 20. VIEW OF ELEVATOR SHAFT FROM FIRST FLOOR TO SKYLIGHT, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. VIEW OF ELEVATOR SHAFT FROM FIRST FLOOR TO SKYLIGHT, LOOKING SKYWARD, NORTH - Bates Manufacturing Company, Storehouse, Northeast corner of Chestnut Street & Hines Alley, Lewiston, Androscoggin County, ME

  11. Telemetry of forces from proximal femoral replacements and relevance to fixation.

    PubMed

    Taylor, S J; Perry, J S; Meswania, J M; Donaldson, N; Walker, P S; Cannon, S R

    1997-03-01

    Two proximal femoral replacements were instrumented to enable axial forces to be determined at two sites within the prosthesis: in the main shaft and near the tip of the intramedullary stem. The goal was to measure the changes in force distribution over time, as indicated by the ratio of the two forces. Inductive coupling between a coil worn around the leg and a small implanted coil was used, both to supply power to electronic circuits sealed into a welded cavity in the prosthesis and to telemeter data from the prosthesis. Data from both subjects were recorded over the first two years following surgery. For the first subject, there was an increase in mean shaft force excursions (peak force minus resting force) during level walking from 0.53 x BW after 1 week 2.77 x BW after 23 months. The corresponding mean tip force excursions were 0.13 x BW and 1.74 x BW, respectively. The ratio of mean tip force excursions to shaft force excursions steadily increased over the same period from 25 to 63%. Similar increases over time in the tip/shaft ratio were found during treadmill walking, stair climbing and stair descending. Data from the second subject were obtained for the shaft forces only, and were consistent with those from the first subject. The progressive transfer of axial load from the proximal to the distal part of the IM stem recorded telemetrically, together with radiographic observations, suggested that bone remodelling had taken place together with a less stable interface around the proximal part of the stem. This process evidently began soon after implantation.

  12. Ipsilateral jugular access to treat an otherwise inaccessible puncture-related arteriovenous fistula pseudoaneurysm: a technical note.

    PubMed

    Rabellino, Martin; Rosa-Diez, Guillermo; Peralta, Oscar; Shinzato, Sergio; Crucelegui, Maria Soledad; Serra, Diego; Garcia-Monaco, Ricardo

    2014-01-01

    The standard approach for the endovascular treatment of a dysfunctional or occluded hemodialysis access in the upper limbs includes a direct intervention through the access itself or alternatively, when not feasible, through the brachial or radial artery access. Nonetheless, there are certain circumstances in which these approaches are not easily achieved. An 89-year-old male with end-stage renal disease developed a pseudoaneurysm after an hemorrhagic complication of a recently transposed native basilic arteriovenous fistula secondary to a needle puncture. Dehiscence of the injured access with spontaneous arterial bleeding evolved as a consequence of the upper limb swelling, rendering therapeutic intervention of the access through a conventional route impossible. A fistulogram through puncture of the common femoral artery was performed to obtain an accurate diagnosis. However, this approach was insufficient to advance the covered stent with the intention of excluding the pseudoaneurysm, as the stent delivery system could not reach the desired site. Given that the covered stent insertion required a 9 Fr introducer, the radial artery approach was ruled out. Therefore, we chose a venous access via the ipsilateral internal jugular vein, which was punctured under ultrasound guidance. This strategy was useful to advance the stent and exclude the pseudoaneurysm successfully. This technique should be considered for those individuals in whom conventional routes of approach for repairing dialysis accesses are not feasible or are extremely risky.

  13. 30 CFR 56.19105 - Landings with more than one shaft entrance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Landings with more than one shaft entrance. 56... Personnel Hoisting Shafts § 56.19105 Landings with more than one shaft entrance. A safe means of passage around open shaft compartments shall be provided on landings with more than one entrance to the shaft....

  14. Ten-m3 Is Required for the Development of Topography in the Ipsilateral Retinocollicular Pathway

    PubMed Central

    Dharmaratne, Nuwan; Glendining, Kelly A.; Young, Timothy R.; Tran, Heidi; Sawatari, Atomu; Leamey, Catherine A.

    2012-01-01

    Background The alignment of ipsilaterally and contralaterally projecting retinal axons that view the same part of visual space is fundamental to binocular vision. While much progress has been made regarding the mechanisms which regulate contralateral topography, very little is known of the mechanisms which regulate the mapping of ipsilateral axons such that they align with their contralateral counterparts. Results Using the advantageous model provided by the mouse retinocollicular pathway, we have performed anterograde tracing experiments which demonstrate that ipsilateral retinal axons begin to form terminal zones (TZs) in the superior colliculus (SC), within the first few postnatal days. These appear mature by postnatal day 11. Importantly, TZs formed by ipsilaterally-projecting retinal axons are spatially offset from those of contralaterally-projecting axons arising from the same retinotopic location from the outset. This pattern is consistent with that required for adult visuotopy. We further demonstrate that a member of the Ten-m/Odz/Teneurin family of homophilic transmembrane glycoproteins, Ten-m3, is an essential regulator of ipsilateral retinocollicular topography. Ten-m3 mRNA is expressed in a high-medial to low-lateral gradient in the developing SC. This corresponds topographically with its high-ventral to low-dorsal retinal gradient. In Ten-m3 knockout mice, contralateral ventrotemporal axons appropriately target rostromedial SC, whereas ipsilateral axons exhibit dramatic targeting errors along both the mediolateral and rostrocaudal axes of the SC, with a caudal shift of the primary TZ, as well as the formation of secondary, caudolaterally displaced TZs. In addition to these dramatic ipsilateral-specific mapping errors, both contralateral and ipsilateral retinocollicular TZs exhibit more subtle changes in morphology. Conclusions We conclude that important aspects of adult visuotopy are established via the differential sensitivity of ipsilateral and

  15. Using the sensors of shaft position for simulation of misalignments of shafting supports of turbounits

    NASA Astrophysics Data System (ADS)

    Kumenko, A. I.; Kostyukov, V. N.; Kuz'minykh, N. Yu.; Timin, A. V.; Boichenko, S. N.

    2017-09-01

    Examples of using the method developed for the earlier proposed concept of the monitoring system of the technical condition of a turbounit are presented. The solution methods of the inverse problem—the calculation of misalignments of supports based on the measurement results of positions of rotor pins in the borings of bearings during the operation of a turbounit—are demonstrated. The results of determination of static responses of supports at operation misalignments are presented. The examples of simulation and calculation of misalignments of supports are made for the three-bearing "high-pressure rotor-middle-pressure rotor" (HPR-MPR) system of a turbounit with 250 MW capacity and for 14-supporting shafting of a turbounit with 1000 MW capacity. The calculation results of coefficients of the stiffness matrix of shaftings and testing of methods for solving the inverse problem by modeling are presented. The high accuracy of the solution of the inverse problem at the inversion of the stiffness matrix of shafting used for determining the correcting centerings of rotors of multisupporting shafting is revealed. The stiffness matrix can be recommended to analyze the influence of displacements of one or several supports on changing the support responses of shafting of the turbounit during adjustment after assembling or repair. It is proposed to use the considered methods of evaluation of misalignments in the monitoring systems of changing the mutual position of supports and centerings of rotors by half-couplings of turbounits, especially for seismically dangerous regions and regions with increased sagging of foundations due to watering of soils.

  16. Total knee arthroplasty in patients with prior ipsilateral hip fusion.

    PubMed

    Romness, D W; Morrey, B F

    1992-03-01

    Sixteen total knee arthroplasties performed between 1977 and 1985 in 13 patients with prior ipsilateral hip arthrodesis or ankylosis were studied to determine the preferred sequence and long-term follow-up of procedures in this clinical setting. Twelve of 16 underwent fusion takedown and total hip arthroplasty prior to knee replacement. The average age at total knee arthroplasty was 52.7 years and the average time from hip fusion to total knee arthroplasty was 36.3 years. Mean follow-up after total knee arthroplasty was 5.5 years (range, 2.3 to 10 years). The Hospital for Special Surgery knee score increased from a mean of 31.8 preoperatively to 72.2 after surgery. In patients who had conversion of the hip fusion prior to knee replacement, knee scores were 28 before and 72.5 after both procedures. Patients who retained their hip fusion had mean scores of 43.5 and 72.1, respectively. None of the knees has been removed and 14 of 16 had no pain at last follow-up. One had mild pain and one had moderate pain attributed to pes anserine bursitis. Although the numbers are small, this experience reveals that takedown of the fusion with total hip arthroplasty is an effective technique before performing the knee replacement. Though successful in some instances, the experience is too small to show that if hip fusion is in good position, knee replacement without fusion takedown is acceptable.

  17. Mirror therapy activates outside of cerebellum and ipsilateral M1.

    PubMed

    Shinoura, Nobusada; Suzuki, Yuichi; Watanabe, Yasuko; Yamada, Ryozi; Tabei, Yusuke; Saito, Kuniaki; Yagi, Kazuo

    2008-01-01

    Mirror therapy is effective in the rehabilitation of patients with hemiparesis, but its mechanism is not clear. In this study, a patient with brain tumor (patient 1) who underwent mirror therapy after surgery and showed drastic recovery of hand paresis, a patient with visual memory disturbance (patient 2), and five normal volunteers performed tasks related to mirror therapy in fMRI study. In patient 1 and all normal volunteers, right and left hand clenching with looking at a mirror (eye open) activated outside of cerebellum, while right and left hands clenching with eye closed activated inside of cerebellum. In patient 2, mirror therapy did not activate outside of cerebellum. In patient 1, and 3 out of 5 normal volunteers, the area of right (affected) M1 activated by right and left hands clenching with eye open was more than that by right and left hands clenching with eye closed, and that right M1 was activated by right hand clenching with eye open. In conclusion, mirror therapy facilitate the paresis of patients by activating ipsilateral M1 and outside of cerebellum, which is possibly related to visual memory function.

  18. Contralateral genitofemoral sympathetic nerve discharge increases following ipsilateral testicular torsion.

    PubMed

    Otçu, Selçuk; Durakoğugil, Murat; Orer, Hakan S; Tanyel, Feridun C

    2002-10-01

    The decrease in blood flow due to the activation of sympathetic system has been suggested to play a role in contralateral testicular deterioration associated with unilateral testicular torsion. Sympathetic nerve discharges (SND) from the genitofemoral nerve were evaluated before and during unilateral testicular torsion. Under urethane anesthesia, arterial blood pressure and SND from splanchnic and right genitofemoral nerves were recorded in 12 male Sprague-Dawley rats, 8 of which were included in subsequent analyses. After control recordings of basal discharges for 2 min the left testis was twisted 720 degrees counterclockwise, and recording was resumed for an additional 30 min. Changes in nerve activity were calculated by measuring the area under the autospectrum curve, and alterations were compared. Following testicular torsion no significant changes were obtained for splanchnic SND, but the amplitude of SND from contralateral genitofemoral nerve showed an overall increase of 21.20+/-7.03% in six rats. This increase lasted about 10-15 min and activities returned to pretorsion levels. In two other rats no significant change was observed in either splanchnic or genitofemoral SND. Ipsilateral testicular torsion results in a transient increase in genitofemoral SND. A possible autonomic reflex mechanism may exist, and it may be activated by noxious stimuli from contralateral side. This reflex mechanism may initiate a series of events that lead to the injury of contralateral testis.

  19. Acute Facial Nerve Palsy With Ipsilateral Soft Palate Ulcers.

    PubMed

    Mauprivez, Cédric; Comte, Clément; Labrousse, Marc; Khonsari, Roman H

    2017-09-01

    Ramsay-Hunt syndrome (RHS) is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus (VZV) infection occurs in the geniculate ganglion. Major clinical findings are peripheral facial nerve palsy accompanied by ipsilateral ear pain and erythematous vesicular rash on the external ear (herpes zoster oticus) and in the mouth. Thus, diagnosis of RHS is usually clinical. However, auricular herpetic eruption is not always present, making diagnosis more difficult. This report describes a case of RHS with left facial palsy without skin lesions in 60-year-old woman. Multiple ulcers were found on her left soft palate. Polymerase chain reaction analysis on oral mucosa biopsy samples and serologic assays allowed the identification of VZV as the causal agent. Knowledge of the anatomy of the facial nerve is important for oral and maxillofacial surgeons when dealing with patients with RHS, especially in unusual and clinically misleading forms of this syndrome. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Optimization of mirror therapy to excite ipsilateral primary motor cortex.

    PubMed

    Hadoush, Hikmat; Mano, Hirofumi; Sunagawa, Toru; Nakanishi, Kazuyoshi; Ochi, Mitsu

    2013-01-01

    Mirror illusion therapy (mirror therapy) is based on the experimental substrate of a visual illusion of active hand movement to excite ipsilateral primary motor cortex (iM1). We tested whether iM1 excitability could be modulated by enabling or disabling vision of the active hand during mirror therapy. Motor cortical activations of healthy right-handed participants were identified by magnetoencephalography. Participants performed voluntary index finger extension of their dominant and non-dominant hands, separately, while viewing mirror reflection images of their active hand superimposed upon their hidden inactive hand. This was performed either with vision of the active hand (uncovered viewing condition) or without vision of the active hand (covered viewing condition). In the covered viewing condition, the iM1could be excited in all participants (n = 10) and this excitation did not differ whether the active hand was the dominant or non-dominant hand. However, in the uncovered viewing condition, dominant and non-dominant hands were able to excite iM1 only in some participants (n = 4 and n = 7, respectively). Moreover, the participants' responses to the illusion validation questionnaire revealed that the covered viewing condition could cause clearer visual illusion for the active hand than the uncovered viewing condition. Disabling vision of the active hand during mirror therapy was more effective to excite iM1 responses by creating more immersive visual illusion of the active hand.

  1. Case report: severe melorheostosis involving the ipsilateral extremities.

    PubMed

    Long, Hai-Tao; Li, Kang-Hua; Zhu, Yong

    2009-10-01

    Melorheostosis is a rare, noninheritable bone dysplasia characterized by its classic radiographic feature of flowing hyperostosis resembling dripping candle wax, generally on one side of the long bone. The condition originally was described by Leri and Joanny in 1922. Its etiology remains speculative, and treatment in most instances has been symptomatic. Melorheostosis usually affects one limb, more often the lower extremity, and rarely the axial skeleton. We report a rare case of severe melorheostosis in the ipsilateral upper and lower extremities with normal contralateral extremities. The plain radiographs revealed almost all the bones in the affected extremities, from clavicle and scapula to distal phalanges of the fingers and from femur to distal phalanges of the toes, presented extensive, dense hyperostosis and heterotopic ossification in the periarticular soft tissue. Physical examination showed considerable swelling and deformities of the left limbs, stiffness and distortion of the joints, and anesthesia in the left ulnar regions of the forearm and hand. The examination of the right side was normal. Computed tomography scans showed multiple areas of classic candle wax-like hyperostosis and narrowing or disappearance of the medullary cavity. Histologic analysis confirmed the clinical and imaging diagnosis and revealed extremely dense sclerotic bone of cortical pattern.

  2. Meningeal melanocytoma of Meckel's cave associated with ipsilateral Ota's nevus.

    PubMed

    Botticelli, A R; Villani, M; Angiari, P; Peserico, L

    1983-06-15

    A case of meningeal melanocytoma of the left Meckel's cave associated with ipsilateral Ota's nevus in a 43-year-old woman, was studied by light and electron microscopy. The cells of the tumor were characterized by the presence of dendritic cytoplasmic processes, melanosomes and premelanosomes; hence, they were deemed as neoplastic melanocytes. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic Schwannoma and primary meningeal melanoma. The prolonged clinical course was different from primary and metastatic malignant melanomas of the meninges. The best treatment appears to be radical excision, when possible; otherwise, the local or partial enucleation followed by radiation therapy has been found to be the best curative to date. On the whole, meningeal melanocytoma cannot be considered as entirely benign, given its morphologic patterns that resemble those of uveal melanoma, and its potential for recurrence. The association of this tumor with Ota's nevus is referred to as having a common origin from an arrested migration of melanoblasts at different stages.

  3. [Osteonecrosis of the femoral head].

    PubMed

    Lafforgue, Pierre

    2002-03-15

    The femoral head is the main location of avascular osteonecrosis. The lesion remains asymptomatic for several months or years before causing non specific hip pain. Risk factors have been identified, mainly femoral neck fractures, corticosteroid therapy and related conditions (lupus erythematosus, organ transplantations), alcohol abuse, dyslipidemia, sickle cell disease, HIV infection, caisson workers, Gaucher's disease, male sex. When typical radiological signs are lacking, MRI is the best investigation. Progression toward hip joint damage highly depends on the necrotic volume assessed at MRI. The combination of plain radiographs which help staging the severity of osteonecrosis, and MRI which indicates the prognosis of the lesion, determines the therapeutic options: symptomatic pain relief therapies or surgical treatment (core decompression, osteotomy or total hip replacement).

  4. Ipsilateral and Contralateral Retinal Ganglion Cells Express Distinct Genes during Decussation at the Optic Chiasm

    PubMed Central

    Marcucci, Florencia; Cerullo, Isadora

    2016-01-01

    The increasing availability of transcriptomic technologies within the last decade has facilitated high-throughput identification of gene expression differences that define distinct cell types as well as the molecular pathways that drive their specification. The retinal projection neurons, retinal ganglion cells (RGCs), can be categorized into distinct morphological and functional subtypes and by the laterality of their projections. Here, we present a method for purifying the sparse population of ipsilaterally projecting RGCs in mouse retina from their contralaterally projecting counterparts during embryonic development through rapid retrograde labeling followed by fluorescence-activated cell sorting. Through microarray analysis, we uncovered the distinct molecular signatures that define and distinguish ipsilateral and contralateral RGCs during the critical period of axonal outgrowth and decussation, with more than 300 genes differentially expressed within these two cell populations. Among the differentially expressed genes confirmed through in vivo expression validation, several genes that mark “immaturity” are expressed within postmitotic ipsilateral RGCs. Moreover, at least one complementary pair, Igf1 and Igfbp5, is upregulated in contralateral or ipsilateral RGCs, respectively, and may represent signaling pathways that determine ipsilateral versus contralateral RGC identity. Importantly, the cell cycle regulator cyclin D2 is highly expressed in peripheral ventral retina with a dynamic expression pattern that peaks during the period of ipsilateral RGC production. Thus, the molecular signatures of ipsilateral and contralateral RGCs and the mechanisms that regulate their differentiation are more diverse than previously expected. PMID:27957530

  5. 29. Basement under central corridor. Shaft on right actuates cross ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    29. Basement under central corridor. Shaft on right actuates cross over valve. Shaft at left operates main flood valve to admit water into the bed. - Lake Whitney Water Filtration Plant, Filtration Plant, South side of Armory Street between Edgehill Road & Whitney Avenue, Hamden, New Haven County, CT

  6. Convertible turbo-fan, turbo-shaft aircraft propulsion system

    SciTech Connect

    Ossi, R.R.

    1987-03-24

    A composite gas turbine engine propulsion system for aircraft which includes a propulsion fan for providing forward thrust as a first mode of operation and a turbo-shaft power output for driving an external load as a second mode of operation and means for selectably changing between the modes of operation and combinations thereof comprising: a gas turbine engine mounted to a frame providing power to a drift shaft; first transmission means connected to the drive shaft for providing a power output suitable for driving the external load; second transmission means connected to the drive shaft for providing a variable power output suitable for driving the propulsion fan, the second transmission comprising; a gear reduction system operatively connected to the drive shaft and constructed to provide output power to an output shaft suitable for driving the fan, the gear reduction system comprising a sun gear operatively connected for rotation with the drive shaft; a planet gear carrier fixed to the engine frame; planet gears mounted in the planet gear carrier in operative engagement with the sun gear; a bell gear mounted for rotation in operative engagement with the planet gears and having a shaft extending therefrom to provide the output of the gear reduction system; and a torque converter.

  7. 30 CFR 56.19135 - Rollers in inclined shafts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Rollers in inclined shafts. 56.19135 Section 56.19135 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL... Inspection and Maintenance § 56.19135 Rollers in inclined shafts. Rollers used in operating inclined...

  8. Improved Rotary Transformer For Shaft-Position Indicator

    NASA Technical Reports Server (NTRS)

    Mclyman, W. T.

    1991-01-01

    Improved rotary transformer for Inductosyn (or equivalent) shaft-position-indicating circuit has pair of ferrite cores instead of the solid-iron cores. Designed with view toward decreasing excitation power (to maximum allowable 2 W) supplied to shaft-position-indicating circuit to increase its output signal and make tracking system less vulnerable to electromagnetic interference.

  9. 7. DETAIL VIEW NORTH OF TURBINE OUTPUT SHAFT, FLYWHEEL (RIGHT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. DETAIL VIEW NORTH OF TURBINE OUTPUT SHAFT, FLYWHEEL (RIGHT CENTER), VERTICAL SHAFT TO GOVERNOR WITH RACK-AND-PINION GEARING (LEFT), AND BELTS - Willimantic Linen Company, Mill No. 1, Immediately West of South Main Street, North Bank of Willimantic River, Windham, Windham County, CT

  10. 27. VIEW OF CRANK SHAFTS FROM TRIPLE EXPANSION ENGINE CONNECTED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    27. VIEW OF CRANK SHAFTS FROM TRIPLE EXPANSION ENGINE CONNECTED TO THE MAIN SHAFT LOCATED IN ENGINE ROOM CLOSEST CRANK IS IN THE UP POSITION. VIEW IS FROM NUMBER 2 END. - San Mateo Ferry, South end of Lake Union, Seattle, King County, WA

  11. 14 CFR 29.931 - Shafting critical speed.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting critical speed. 29.931 Section 29.931 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 29.931 Shafting...

  12. 14 CFR 27.931 - Shafting critical speed.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Shafting critical speed. 27.931 Section 27.931 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: NORMAL CATEGORY ROTORCRAFT Powerplant Rotor Drive System § 27.931 Shafting...

  13. BASE OF BULLWHEEL DRIVE SHAFT IN VAULT MOTOR ROOM, CONNECTING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    BASE OF BULLWHEEL DRIVE SHAFT IN VAULT MOTOR ROOM, CONNECTING TO REDUCTION GEAR SHAFTING. FERREL SPEED REDUCER IN FOREGROUND, FACING WEST. NOTE TWO DIAGONAL LINES: TORQUE CONVERTER CABLE (IN PIECE OF WHITE GUTTER), THROTTLE CABLE (IN LOWER STEEL TUBING). - Mad River Glen, Single Chair Ski Lift, 62 Mad River Glen Resort Road, Fayston, Washington County, VT

  14. 30 CFR 77.1911 - Ventilation of slopes and shafts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Ventilation of slopes and shafts. 77.1911 Section 77.1911 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Slope and Shaft Sinking § 77.1911...

  15. BASE OF BULLWHEEL DRIVE SHAFT IN VAULT MOTOR ROOM, CONNECTING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    BASE OF BULLWHEEL DRIVE SHAFT IN VAULT MOTOR ROOM, CONNECTING TO REDUCTION GEAR SHAFTING. FERREL SPEED REDUCER IN FOREGROUND, FACING WEST. NOTE TWO DIAGONAL LINES: TORQUE CONVERTER CABLE (IN PIECE OF WHITE GUTTER), THROTTLE CABLE (IN LOWER STEEL TUBING). - Mad River Glen, Single Chair Ski Lift, 62 Mad River Glen Resort Road, Fayston, Washington County, VT

  16. 7. ENTRANCE VIEW OF ELEVATOR SHAFT AT GROUND LEVEL. VIEW ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. ENTRANCE VIEW OF ELEVATOR SHAFT AT GROUND LEVEL. VIEW SHOWS VERTICAL LADDER AND CAGE ALONG ELEVATOR SHAFT. - U.S. Naval Base, Pearl Harbor, Signal Tower, Corner of Seventh Street & Avenue D east of Drydock No. 1, Pearl City, Honolulu County, HI

  17. 8. Generator Barrel and Shaft of Unit 1, view to ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. Generator Barrel and Shaft of Unit 1, view to the northwest, with turbine shaft and thrust bearing visible in upper center of photograph. - Washington Water Power Clark Fork River Noxon Rapids Hydroelectric Development, Powerhouse, South bank of Clark Fork River at Noxon Rapids, Noxon, Sanders County, MT

  18. Bone scintigraphy depicts bilateral atypical femoral stress fractures with metachronous presentation, long before a complete fracture occurs.

    PubMed

    Spyridonidis, Trifon J; Mousafiris, Kostantinos V; Rapti, Efi K; Apostolopoulos, Dimitris J

    2014-01-01

    Atypical femoral fractures (AFF), although rare, are recognized more often during the last decade. They are located in the subtrochanteric region or the femoral shaft, may be bilateral, can evolve to complete fractures after bone overload or minimal trauma and have specific radiological features. The complete fractures have horizontal or slightly oblique configuration accompanied by a medial spike, are non-comminuted, and extend to both cortices. There is also generalized cortical thickening of femoral shaft. Newer evidence suggests that AFF are stress or insufficiency fractures, possibly associated with long-term use of bisphoshonates (BP). AFF can also occur in oncologic patients referred for bone scintigraphy and, in such a case, they should be differentiated from bone metastases. We present here a case with bilateral AFF with metachronous appearance in a female patient with a history of breast cancer and osteoporosis. The first AFF had been depicted on bone scintigraphy 3 years before a complete fracture occurred at this site, but the finding was overlooked. A second bone scan performed shortly after the fracture in order to exclude underlying bone metastases disclosed an additional unsuspected incomplete AFF in the contralateral femur, which was confirmed by radiography. In conclusion, oncologists should consider other causes of bone pain besides bone metastatic disease, and physicians interpreting whole body bone scans of oncologic patients should be aware of the entity of AFF, in order to avoid false positive results and provide early information about an impending complete AFF.

  19. Arthroplasty in Femoral Head Osteonecrosis

    PubMed Central

    Nam, Dong Cheol; Jung, Kwangyoung

    2014-01-01

    Osteonecrosis of the femoral head is a destructive joint disease requiring early hip arthroplasty. The polyethylene-metal design using a 22-mm femoral head component, introduced by Charnley in 1950, has been widely used for over half a century. Since then, different materials with the capacity to minimize friction between bearing surfaces and various cement or cementless insert fixations have been developed. Although the outcome of second and third generation designs using better bearing materials and technologies has been favorable, less favorable results are seen with total hip arthroplasty in young patients with osteonecrosis. Selection of appropriate materials for hip arthroplasty is important for any potential revisions that might become inevitable due to the limited durability of a prosthetic hip joint. Alternative hip arthroplasties, which include hemiresurfacing arthroplasty and bipolar hemiarthroplasty, have not been found to have acceptable outcomes. Metal-on-metal resurfacing has recently been suggested as a feasible option for young patients with extra physical demands; however, concerns about complications such as hypersensitivity reaction or pseudotumor formation on metal bearings have emerged. To ensure successful long-term outcomes in hip arthroplasty, factors such as insert stabilization and surfaces with less friction are essential. Understanding these aspects in arthroplasty is important to selection of proper materials and to making appropriate decisions for patients with osteonecrosis of the femoral head. PMID:27536561

  20. [Slipped upper femoral epiphysis (SUFE)].

    PubMed

    Wirth, T

    2011-08-01

    A slipped upper femoral epiphysis (SUFE) is the most common disease of the hip among adolescents. In the light of our current knowledge on the development of coxarthrosis, it represents a first line model case that has led to a series of novel ideas in the therapy for SUFE. The development of coxarthrosis from a cam impingement, i.e., the loss of offset of the neck of the femur and degenerative damage to the acetabular lip as its early form, is seen again in the clinical picture of slipped upper femoral epiphysis. Depending on the degree of slippage, we see a varying severity of the loss of offset and thus also different extents of the potential damage to the hip joint. This knowledge is by no means new. The questions of reorientation of the epiphysis of the humeral head and thus restoration of the anatomy of the coxal end of the femur have been addressed by renowned surgeons and answered with the development of widely varying procedures for surgical correction. However, within the framework of the surgical techniques introduced for treatment of impingement syndromes of the hip, these therapeutic options have been supplemented and broadened. The current discussion about the best therapeutic strategies emphasizes the fascination of the clinical entity of upper femoral epiphysis and constitutes a central component of this article. © Georg Thieme Verlag KG Stuttgart · New York.

  1. New methodology for shaft design based on life expectancy

    NASA Technical Reports Server (NTRS)

    Loewenthal, S. H.

    1986-01-01

    The design of power transmission shafting for reliability has not historically received a great deal of attention. However, weight sensitive aerospace and vehicle applications and those where the penalties of shaft failure are great, require greater confidence in shaft design than earlier methods provided. This report summarizes a fatigue strength-based, design method for sizing shafts under variable amplitude loading histories for limited or nonlimited service life. Moreover, applications factors such as press-fitted collars, shaft size, residual stresses from shot peening or plating, corrosive environments can be readily accommodated into the framework of the analysis. Examples are given which illustrate the use of the method, pointing out the large life penalties due to occasional cyclic overloads.

  2. Shaft instantaneous angular speed for blade vibration in rotating machine

    NASA Astrophysics Data System (ADS)

    Gubran, Ahmed A.; Sinha, Jyoti K.

    2014-02-01

    Reliable blade health monitoring (BHM) in rotating machines like steam turbines and gas turbines, is a topic of research since decades to reduce machine down time, maintenance costs and to maintain the overall safety. Transverse blade vibration is often transmitted to the shaft as torsional vibration. The shaft instantaneous angular speed (IAS) is nothing but the representing the shaft torsional vibration. Hence the shaft IAS has been extracted from the measured encoder data during machine run-up to understand the blade vibration and to explore the possibility of reliable assessment of blade health. A number of experiments on an experimental rig with a bladed disk were conducted with healthy but mistuned blades and with different faults simulation in the blades. The measured shaft torsional vibration shows a distinct difference between the healthy and the faulty blade conditions. Hence, the observations are useful for the BHM in future. The paper presents the experimental setup, simulation of blade faults, experiments conducted, observations and results.

  3. The effect of shaft flexibility on junior golfers' performance.

    PubMed

    Stanbridge, K; Jones, R; Mitchell, S

    2004-05-01

    The aims of this study were to examine the effect of shaft flexibility on the performance of junior golfers and to determine whether there is a relationship between golfers' physical characteristics (16 anthropometric measures, age, experience, strength), performance and shaft flexibility. We assessed the performance of 30 male golfers, aged 7-10 years, with three 7-iron golf clubs of different shaft flexibility at a driving range. The performance parameters measured for equipment evaluation were ball distance achieved, shot dispersion and impact position of the ball on the clubface. The results suggest that there is no particular shaft flex suitable for the age group considered and that experience, strength and arm span are the significant factors when selecting optimal shaft flexibility for children.

  4. Shaft mines can get power without armor

    SciTech Connect

    Brezovec, D.

    1984-02-01

    A Pennsylvania coal operator has been able to install neoprene jacketed mine power feeder (MPF) cable in an airshaft without the use of expensive armored power cables. Armored cables traditionally have been favored in applications where the cable is dropped vertically because their galvanized metal shielding protects the cable as it is dragged across rough ground and stretched by its own weight as it is lowered into the hole. But armored cable poses some problems. It is as much as $20 per foot more expensive than MPF cable. Also, sinking armored cables is particularly difficult when space is limited because the cable must be laid out on the ground before it is lowered into the hole. The technique that allowed Pennsylvania Mines Corp. to install two 750-ft-long, 15-kv cables at is 400,000-tpy Tunnelton mine, near New Alexandria, Pa., was devised by J.H. Service Co.'s Indianola, Pa., branch office. The method involves feeding MPF cable from a spool on a truck equipped with special braking devices, over a steel drum that acts as a sheave, directly into a mine shaft or borehole. Robert C. Kadyk, a sales manager with J.H. Service, says that while this is not the first time standard MPF cable has been used in a borehole or shaft, the cables are not usually used in these cases because there were no dependable methods for holding the cable steady as it was lowered into the hole to keep it from abrading against the sides of the borehole or shaft. Also, dragging MPF cable through the woods invariably damages it. With its cable sinking method, J.H. Service vulcanizes stainless steel kellems grips into the cable about every 100 ft. The interval varies with the weight and diameter of the cable, depth of the hole, and length of the kellems grip. One twisted steel messenger wire is attached to each kellems grip to displace the weight of the cable as it takes its trip to the mine floor.

  5. Ipsilateral fracture dislocation of the shoulder and elbow: A case report and literature review.

    PubMed

    Behr, Ian; Blint, Andy; Trenhaile, Scott

    2013-12-01

    Ipsilateral dislocation of the shoulder and elbow is an uncommon injury. A literature review identified nine previously described cases. We are reporting a unique case of ipsilateral posterior shoulder dislocation and anterior elbow dislocation along with concomitant intra-articular fractures of both joints. This is the first report describing this combination of injuries. Successful treatment generally occurs with closed reduction of ipsilateral shoulder and elbow dislocations, usually reducing the elbow first. When combined with a fracture at one or both locations, closed reduction of the dislocations in conjunction with appropriate fracture management can result in a positive functional outcome.

  6. Ipsilateral fracture dislocation of the shoulder and elbow: A case report and literature review

    PubMed Central

    Behr, Ian; Blint, Andy; Trenhaile, Scott

    2013-01-01

    Ipsilateral dislocation of the shoulder and elbow is an uncommon injury. A literature review identified nine previously described cases. We are reporting a unique case of ipsilateral posterior shoulder dislocation and anterior elbow dislocation along with concomitant intra-articular fractures of both joints. This is the first report describing this combination of injuries. Successful treatment generally occurs with closed reduction of ipsilateral shoulder and elbow dislocations, usually reducing the elbow first. When combined with a fracture at one or both locations, closed reduction of the dislocations in conjunction with appropriate fracture management can result in a positive functional outcome. PMID:26403884

  7. Random vibrations of a damped rotating shaft

    NASA Astrophysics Data System (ADS)

    Dimentberg, M. F.; Ryzhik, B.; Sperling, L.

    2005-01-01

    Response of a simple Jeffcott rotor to random excitation is considered with both external and internal damping taken into account. Mean square responses are predicted by the method of moments for the cases of transverse and angular (tilting) oscillations. Contrary to unbalance-induced response the random vibrations are shown to depend on the internal or "rotating" damping; in particular, their level increases with approaching threshold speed for dynamic instability. Procedure for estimating this threshold from on-line measurements of the shaft's random vibrations at a constant rotation speed is outlined based on the calculating coherence function of lateral displacements in two perpendicular directions for the case of transverse vibrations and that of tilting angles about two perpendicular axes for the case of tilting oscillations. Dependence of the mean square responses on the rotation speed can also be used for the stability margin evaluation.

  8. Industrial Applications Of Optical Shaft Encoders

    NASA Astrophysics Data System (ADS)

    Edmister, Brian W.

    1980-11-01

    The development of the microprocessor and mini-computer for industrial process control has made the optical shaft angle encoder a natural choice for a position feedback transducer. Many of these applications, however, require the encoder to operate reliably in extremely hostile environments. In response to this, the encoder manufacturer has been faced with reliability problems which fall into the following general categories: 1. Exposure to weather 2. Wide operating and storage temperature range 3. Exposure to corrosive chemicals 4. Severe shock and vibration 5. High electrical noise levels 6. Severe blows to encoder housing 7. Operation in explosive atmospheres Three of these applications expose the encoder to most of these environmental conditions: 1. A jack-up control position feedback for an offshore oil well drilling rig 2. A depth measurement system for oil well logging instrumentation 3. Elevation and azimuth feedback for a solar power plant heliostat

  9. Finite element analysis of the equivalent stress distribution in Schanz screws during the use of a femoral fracture distractor.

    PubMed

    Giordano, Vincenzo; Godoy-Santos, Alexandre Leme; Belangero, William Dias; Pires, Robinson Esteves Santos; Labronici, Pedro José; Koch, Hilton Augusto

    2017-01-01

    To evaluate the mechanical stress and elastic deformation exercised in the thread/shaft transition of Schanz screws in assemblies with different screw anchorage distances in the entrance to the bone cortex, through the distribution and location of tension in the samples. An analysis of 3D finite elements was performed to evaluate the distribution of the equivalent stress (triple stress state) in a Schanz screw fixed bicortically and orthogonally to a tubular bone, using two mounting patterns: (1) thread/shaft transition located 20 mm from the anchorage of the Schanz screws in the entrance to the bone cortex and (2) thread/shaft transition located 3 mm from the anchorage of the Schanz screws in entrance to the bone cortex. The simulations were performed maintaining the same direction of loading and the same distance from the force vector in relation to the center of the hypothetical bone. The load applied, its direction, and the distance to the center of the bone were constant during the simulations in order to maintain the moment of flexion equally constant. The present calculations demonstrated linear behavior during the experiment. It was found that the model with a distance of 20 mm between the Schanz screws anchorage in the entrance to the bone cortex and the thread/shaft transition reduces the risk of breakage or fatigue of the material during the application of constant static loads; in this model, the maximum forces observed were higher (350 MPa). The distance between the Schanz screws anchorage at the entrance to the bone cortex and the smooth thread/shaft transition of the screws used in a femoral distractor during acute distraction of a fracture must be farther from the entrance to the bone cortex, allowing greater degree of elastic deformation of the material, lower mechanical stress in the thread/shaft transition, and minimized breakage or fatigue. The suggested distance is 20 mm.

  10. A Very Rare Presentation of Type 1 Monteggia Equivalent Fracture with Ipsilateral Fracture of Distal Forearm-approach with Outcome: Case Report

    PubMed Central

    Singh, Dhananjay; Awasthi, Bhanu; Padha, Vikas; Thakur, Sanjay

    2016-01-01

    Introduction: We report a case of Type 1 Monteggia equivalent injury with intact radio-capitellar congruity, associated with epiphyseal fracture of distal radius and distal ulna shaft in an 11-year-old boy. There are only a few cases of Monteggia or Monteggia equivalent injury with ipsilateral forearm fractures in children, and injury pattern being reported by us is not only rare but also the only case reported thus far to the best of our knowledge, Sood et al. described Type 1 equivalent with epiphyseal injuries of both radius and ulna Osada et al. also described injury pattern same as Sood et al. with epiphyseal separation in both distal radius and ulna. Our case was slightly different than above two in that distally, there was ulna shaft fracture with Salter Harris Type 2 epiphyseal separation in the radius. Case Report: An 11-year-old, right-hand dominant boy presented in casualty with a history of fall one day back with pain, swelling and deformity in the left forearm with bleeding from left forearm and loss of movement of fingers and thumb of the left hand. On examination, there was a wound of size one centimeter on mid-forearm over the ulnar aspect. Extension of fingers and thumb at metacarpophalangeal joints was lost with intact sensations suggestive of posterior interosseus nerve involvement. No vascular was deficit was present. X-rays were performed which suggested type two epiphyseal separation proximal radius with fracture shaft ulna with lateral angulation in elbow and proximal forearm. Radiocapitellar joint congruity was maintained in the views performed. X-rays of wrist suggested fracture both bones distal forearm epiphysis in distal radius and distal shaft in ulna. The patient was operated with toileting, debridement, and open reduction of proximal ulnar fracture with K-wire. Proximal radius epiphyseal separation was approached by Kocher approach and fixed with two K-wires, while for distal radius epiphyseal separation open reduction and internal

  11. Femoral Nerve Palsy with Patella Fracture

    PubMed Central

    Lee, Sang Hyoung; Lee, Tong Joo; Woo, Min Su

    2013-01-01

    Femoral neuropathy may be associated with various etiologies and can cause severe walking disability. We present the case of a 25-year-old woman who underwent surgical repair for a patella fracture and complained of lower extremity pain, paresthesia, and weakness postoperatively. Electromyography and magnetic resonance imaging (MRI) revealed partial peripheral neuropathy of the left femoral nerve associated with the patella fracture. To our knowledge, this is the first reported case of femoral neuropathy associated with a patella fracture. PMID:24369003

  12. Assessment of the equivalence of a generic to a branded femoral stem

    PubMed Central

    Hothi, H.; Henckel, J.; Shearing, P.; Holme, T.; Cerquiglini, A.; Laura, A. Di; Atrey, A.; Skinner, J.; Hart, A.

    2017-01-01

    Aims The aim of this study was to compare the design of the generic OptiStem XTR femoral stem with the established Exeter femoral stem. Materials and Methods We obtained five boxed, as manufactured, implants of both designs at random (ten in total). Two examiners were blinded to the implant design and independently measured the mass, volume, trunnion surface topography, trunnion roughness, trunnion cone angle, Caput-Collum-Diaphyseal (CCD) angle, femoral offset, stem length, neck length, and the width and roughness of the polished stem shaft using peer-reviewed methods. We then compared the stems using these parameters. Results We found that the OptiStems were lighter (p < 0.001), had a rougher trunnion surface (p < 0.001) with a greater spacing and depth of the machined threads (p < 0.001), had greater trunnion cone angles (p = 0.007), and a smaller radius at the top of the trunnion (p = 0.007). There was no difference in stem volume (p = 0.643), CCD angle (p = 0.788), offset (p = 0.993), neck length (p = 0.344), stem length (p = 0.808), shaft width (p = 0.058 to 0.720) or roughness of the polished surface (p = 0.536). Conclusion This preliminary investigation found that whilst there were similarities between the two designs, the generic OptiStem is different to the branded Exeter design. Cite this article: Bone Joint J 2017;99-B:310–16. PMID:28249969

  13. Lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy.

    PubMed

    Li, Xiaodi; Wang, Yuzhou

    2014-04-01

    Here, we present a rare case of a lateral medullary infarction with ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy. In this case, we proved Opalski's hypothesis by diffusion tensor tractography that ipsilateral hemiparesis in a medullary infarction is due to the involvement of the decussated corticospinal tract. We found that the clinical triad of ipsilateral hemiparesis, lemniscal sensation loss and hypoglossal nerve palsy, which had been regarded as a variant of medial medullary syndrome, turned out to be caused by lateral lower medullary infarction. Therefore, this clinical triad does not imply the involvement of the anteromedial part of medulla oblongata, when it is hard to distinguish a massive lateral medullary infarction from a hemimedullary infarction merely from MR images. At last, we suggest that hyperreflexia and Babinski's sign may not be indispensable to the diagnosis of Opalski's syndrome and we propose that "hemimedullary infarction with ipsilateral hemiparesis" is intrinsically a variant of lateral medullary infarction.

  14. Transient ipsilateral retinal ganglion cell projections to the brain: Extent, targeting and disappearance

    PubMed Central

    Soares, Célia A.; Mason, Carol A.

    2015-01-01

    During development of the mammalian eye, the first retinal ganglion cells (RGCs) that extend to the brain are located in the dorsocentral retina. These RGCs extend to either ipsilateral or contralateral targets, but the ipsilateral projections do not survive into postnatal periods. The function and means of disappearance of the transient ipsilateral projection are not known. We have followed the course of this transient early ipsilateral cohort of RGCs, paying attention to how far they extend, whether they enter targets and if so, which ones, and the time course of their disappearance. The dorsocentral ipsilateral RGC axons were traced using DiI labeling at E13.5 and 15.5 to compare the proportion of ipsi-versus contralateral projections during the first period of growth. In utero electroporation of E12.5 retina with GFP constructs was used to label axons that could be visualized at succeeding time points into postnatal ages. Our results show that the earliest ipsilateral axons grow along the cellular border of the brain, and are segregated from the laterally-postioned contralateral axons from the same retinal origin. In agreement with previous reports, although many early RGCs extend ipsilaterally, after E16 their number rapidly declines. Nonetheless, some ipsilateral axons from the dorsocentral retina enter the superior colliculus (SC) and arborize minimally, but very few enter the dorsal lateral geniculate nucleus (dLGN) and those that do extend only short branches. While the mechanism of selective axonal disappearance remains elusive, these data give further insight into establishment of the visual pathways. PMID:25788284

  15. Transient ipsilateral retinal ganglion cell projections to the brain: Extent, targeting, and disappearance.

    PubMed

    Soares, Célia A; Mason, Carol A

    2015-12-01

    During development of the mammalian eye, the first retinal ganglion cells (RGCs) that extend to the brain are located in the dorsocentral (DC) retina. These RGCs extend to either ipsilateral or contralateral targets, but the ipsilateral projections do not survive into postnatal periods. The function and means of disappearance of the transient ipsilateral projection are not known. We have followed the course of this transient early ipsilateral cohort of RGCs, paying attention to how far they extend, whether they enter targets and if so, which ones, and the time course of their disappearance. The DC ipsilateral RGC axons were traced using DiI labeling at E13.5 and E15.5 to compare the proportion of ipsi- versus contralateral projections during the first period of growth. In utero electroporation of E12.5 retina with GFP constructs was used to label axons that could be visualized at succeeding time points into postnatal ages. Our results show that the earliest ipsilateral axons grow along the cellular border of the brain, and are segregated from the laterally positioned contralateral axons from the same retinal origin. In agreement with previous reports, although many early RGCs extend ipsilaterally, after E16 their number rapidly declines. Nonetheless, some ipsilateral axons from the DC retina enter the superior colliculus and arborize minimally, but very few enter the dorsal lateral geniculate nucleus and those that do extend only short branches. While the mechanism of selective axonal disappearance remains elusive, these data give further insight into establishment of the visual pathways.

  16. Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality

    PubMed Central

    Shemisa, Kamal; Hass, Chris J.; Foote, Kelly D.; Okun, Michael S.; Wu, Samuel S.; Jacobson, Charles E.; Dai, Yunfeng; Oyama, Genko; Fernandez, Hubert H.

    2013-01-01

    Purpose Researchers have consistently observed in right-handed individuals across normal and disease states that the ‘dominant’ left hemisphere has greater ipsilateral control of the left side than the right hemisphere has over the right. We sought to determine whether this ipsilateral influence of the dominant hemisphere reported in Parkinson’s disease extends to treatments such as deep brain stimulation (DBS) and whether it affects outcome. We hypothesised that among Parkinson right-handers, unilateral left DBS would provide greater ipsilateral motor improvement compared with the ipsilateral motor improvement experienced on the right side. Scope A total of 73 Parkinson patients who underwent unilateral DBS of the subthalamic nucleus (STN) or globus palidus internus (GPi) participated. Left and right ‘composite scores’, were computed by separately adding all items on the left and right side from the motor section of the Unified Parkinson Disease Rating Scale. The change in the pre- and 4-month post-implantation score was the primary outcome measure. The mean motor scores improved by 4.96 ± 11.79 points (p < 0.001) post-surgery on the ipsilateral side of the DBS implantation. Regression analyses revealed that the side (left vs. right) and target (STN vs. GPi) did not significantly contribute in the effect of ipsilateral motor improvement (p = 0.3557). Conclusion While DBS on the ‘dominant’ left side failed to exert a greater ipsilateral influence compared with DBS on the non-dominant right side, significant ipsilateral motor improvements were observed after unilateral stimulation regardless of site of implantation and laterality. PMID:21856205

  17. DC Control Effort Minimized for Magnetic-Bearing-Supported Shaft

    NASA Technical Reports Server (NTRS)

    Brown, Gerald V.

    2001-01-01

    A magnetic-bearing-supported shaft may have a number of concentricity and alignment problems. One of these involves the relationship of the position sensors, the centerline of the backup bearings, and the magnetic center of the magnetic bearings. For magnetic bearings with permanent magnet biasing, the average control current for a given control axis that is not bearing the shaft weight will be minimized if the shaft is centered, on average over a revolution, at the magnetic center of the bearings. That position may not yield zero sensor output or center the shaft in the backup bearing clearance. The desired shaft position that gives zero average current can be achieved if a simple additional term is added to the control law. Suppose that the instantaneous control currents from each bearing are available from measurements and can be input into the control computer. If each control current is integrated with a very small rate of accumulation and the result is added to the control output, the shaft will gradually move to a position where the control current averages to zero over many revolutions. This will occur regardless of any offsets of the position sensor inputs. At that position, the average control effort is minimized in comparison to other possible locations of the shaft. Nonlinearities of the magnetic bearing are minimized at that location as well.

  18. DC Control Effort Minimized for Magnetic-Bearing-Supported Shaft

    NASA Technical Reports Server (NTRS)

    Brown, Gerald V.

    2001-01-01

    A magnetic-bearing-supported shaft may have a number of concentricity and alignment problems. One of these involves the relationship of the position sensors, the centerline of the backup bearings, and the magnetic center of the magnetic bearings. For magnetic bearings with permanent magnet biasing, the average control current for a given control axis that is not bearing the shaft weight will be minimized if the shaft is centered, on average over a revolution, at the magnetic center of the bearings. That position may not yield zero sensor output or center the shaft in the backup bearing clearance. The desired shaft position that gives zero average current can be achieved if a simple additional term is added to the control law. Suppose that the instantaneous control currents from each bearing are available from measurements and can be input into the control computer. If each control current is integrated with a very small rate of accumulation and the result is added to the control output, the shaft will gradually move to a position where the control current averages to zero over many revolutions. This will occur regardless of any offsets of the position sensor inputs. At that position, the average control effort is minimized in comparison to other possible locations of the shaft. Nonlinearities of the magnetic bearing are minimized at that location as well.

  19. Rotating Shaft Tilt Angle Measurement Using an Inclinometer

    NASA Astrophysics Data System (ADS)

    Luo, Jun; Wang, Zhiqian; Shen, Chengwu; Wen, Zhuoman; Liu, Shaojin; Cai, Sheng; Li, Jianrong

    2015-10-01

    This paper describes a novel measurement method to accurately measure the rotating shaft tilt angle of rotating machine for alignment or compensation using a dual-axis inclinometer. A model of the rotating shaft tilt angle measurement is established using a dual-axis inclinometer based on the designed mechanical structure, and the calculation equation between the rotating shaft tilt angle and the inclinometer axes outputs is derived under the condition that the inclinometer axes are perpendicular to the rotating shaft. The reversal measurement method is applied to decrease the effect of inclinometer drifts caused by temperature, to eliminate inclinometer and rotating shaft mechanical error and inclinometer systematic error to attain high measurement accuracy. The uncertainty estimation shows that the accuracy of rotating shaft tilt angle measurement depends mainly on the inclinometer uncertainty and its uncertainty is almost the same as the inclinometer uncertainty in the simulation. The experimental results indicate that measurement time is 4 seconds; the range of rotating shaft tilt angle is 0.002° and its standard deviation is 0.0006° using NS-5/P2 inclinometer, whose precision and resolution are ±0.01° and 0.0005°, respectively.

  20. Research on imaging system of vision measurement for the shaft

    NASA Astrophysics Data System (ADS)

    Yang, Zhao; Wang, Xingdong; Liu, Yuanjiong; Liu, Zhao; Gao, Qing

    2015-12-01

    An imaging system is researched for the shaft size measurement, thus to replace the on-line manual measuring method, which is used to measuring diametric sizes and axial sizes of the shaft. Through the research of the characteristics of illumination, a kind of backlight was designed, which could improve the quality of image. For one CCD camera to the large size of the shaft is not easy to achieve, to continue research two CCD cameras imaging, the use of two cameras shoot the shaft two ends, to reduce the field of view to improve accuracy. At the same time, using the drive device to the relative position of the two cameras to achieve measure a variety of specifications of the shaft, improve compatibility. Because of the shaft parts for curved surface, need to extract the characteristics are not in the same plane, the telecentric lens of large depth of field was selected, to ensure the accuracy of image information. The image processing based on HALCON. From the measurement results, the shaft size measurement system measuring accuracy is high.

  1. Disrupted Ipsilateral Network Connectivity in Temporal Lobe Epilepsy

    PubMed Central

    Vega-Zelaya, Lorena; Pastor, Jesús; de Sola, Rafael G.; Ortega, Guillermo J.

    2015-01-01

    increasing global synchronization and a more ordered spectral content of the signals, indicated by lower spectral entropy. The interictal connectivity imbalance (lower ipsilateral connectivity) is sustained during the seizure, irrespective of any appreciable imbalance in the spectral entropy of the mesial recordings. PMID:26489091

  2. Construction features of the exploratory shaft at Yucca Mountain

    SciTech Connect

    Adair, G.W.; Fiore, J.N.

    1984-12-31

    The Exploratory Shaft (ES) at Yucca Mountain is planned to be constructed during 1985 and 1986 as part of the detailed site characterization for one of three sites which may be selected as candidates for location of a high-level radioactive waste repository. Conventional mining methods will be used for the shaft sinking phase of the ES project. The ES will be comprised of surface support facilities, a 1480-ft-deep circular shaft lined with concrete to a finished inside diameter of 12 ft, lateral excavations and test installations extending up to 200 ft from the shaft, and long lateral borings extending up to 2300 ft from the shaft. The estimated time for sinking the shaft to a total depth of about 1480 ft and completing the lateral excavations and borings is about two years. The major underground development planned for the primary test level at a depth of 1200 ft consists of the equivalent of 1150 ft of 15- by 15-ft drift. The total volume of rock to be removed from the shaft proper and the lateral excavations totals about 1/2 million cubic feet. Construction equipment for the shaft and underground excavation phases consists of conventional mine hoisting equipment, shot hole and rock bolt drilling jumbos, mucking machines, and hauling machines. The desire to maintain relatively uniform and even walls in selected shaft and drift intervals will require that controlled blasting techniques be employed. Certain lateral boring operations associated with tests to be conducted in the underground development may pose some unusual problems or require specialized equipment. One of the operations is boring and lining a 30-in.-diam by 600-ft-long horizontal hole with a boring machine being developed under the direction of Sandia National Laboratories. Another special operation is coring long lateral holes (500 to 2000 ft) with minimum use of liquid circulating fluids. 8 figures.

  3. The representation of the ipsilateral visual field in human cerebral cortex

    PubMed Central

    Tootell, Roger B. H.; Mendola, Janine D.; Hadjikhani, Nouchine K.; Liu, Arthur K.; Dale, Anders M.

    1998-01-01

    Previous studies of cortical retinotopy focused on influences from the contralateral visual field, because ascending inputs to cortex are known to be crossed. Here, functional magnetic resonance imaging was used to demonstrate and analyze an ipsilateral representation in human visual cortex. Moving stimuli, in a range of ipsilateral visual field locations, revealed activity: (i) along the vertical meridian in retinotopic (presumably lower-tier) areas; and (ii) in two large branches anterior to that, in presumptive higher-tier areas. One branch shares the anterior vertical meridian representation in human V3A, extending superiorly toward parietal cortex. The second branch runs antero-posteriorly along lateral visual cortex, overlying motion-selective area MT. Ipsilateral stimuli sparing the region around the vertical meridian representation also produced signal reductions (perhaps reflecting neural inhibition) in areas showing contralaterally driven retinotopy. Systematic sampling across a range of ipsilateral visual field extents revealed significant increases in ipsilateral activation in V3A and V4v, compared with immediately posterior areas V3 and VP. Finally, comparisons between ipsilateral stimuli of different types but equal retinotopic extent showed clear stimulus specificity, consistent with earlier suggestions of a functional segregation of motion vs. form processing in parietal vs. temporal cortex, respectively. PMID:9448246

  4. [Effect of continuous femoral nerve catheter length on blockade of femoral nerve, lateral femoral cutaneous nerve and obturator nerve].

    PubMed

    Zhu, Feng; Hu, Yan; Zhang, Wei

    2013-02-18

    To assess the effects of length of continuous femoral catheter on blockade of femoral nerve, lateral femoral cutaneous nerve and obturator nerve. In the study, 70 patients with American Association of Anesthesiologist grades I-II undergoing total knee arthroplasty were randomly divided into three groups, femoral nerve catheters were inserted 5 cm, 10 cm or 20 cm with assistance of a nerve stimulator, patient-controlled analgesia pumps were connected after load of 30 mL 0.3% ropivacaine via the catheters. Sensory blockade of the femoral nerve, lateral femoral cutaneous nerve and obturator nerve were recorded at 24 h postoperatively. Visual analog scale (VAS) pain scores during rest and motion were recorded at 24 h and 48 h postoperatively. The blockade effect of lateral femoral nerve in the 20 cm group was the best. There was no significant difference in sensory blockade between the 5 cm group and the 10 cm group. There was no significant difference in VAS score among the three groups. When continuous femoral nerve block is used for postoperative analgesia after total knee arthroplasty surgery, the catheters that are inserted 5 cm, 10 cm or 20 cm could provide similar and satisfying analgesia effect.

  5. 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.

  6. Hip spica versus Rush pins for management of femoral diaphyseal fractures in children

    PubMed Central

    Ruhullah, Mohammad; Singh, Hare Ram; Shah, Sanjay; Shrestha, Dipak

    2014-01-01

    Background: Femoral fractures are common in children between 2 and 12 years of age and 75% of the lesions affect the femoral shaft. Traction followed by a plaster cast is universally accepted as conservative treatment. We compared primary hip spica with closed reduction and fixation with retrogradely passed crossed Rush pins for diaphyseal femur fracture in children. The hypothesis was that Rush pin might provide better treatment with good clinical results in comparison with primary hip spica. Materials and Methods: Fifty children with femoral fractures were evaluated; 25 of them underwent conservative treatment using immediate hip spica (group A) and 25 were treated with crossed retrograde Rush pins (group B). The patients ages ranged from 3 to 13 years (mean of 9 years). Results: Mean duration of fracture union was 15 weeks in group A and 12 weeks in group B. Mean duration of weight bearing 14 weeks in group and 7 weeks in group B. Mean hospital stay was 4 days in group A and 8 days in group B. Mean followup period in group A was 16 months and group B was 17 months. Complications such as angulation, shortening, infection were compared. Conclusions: Closed reduction and internal fixation with crossed Rush pins was superior in terms of early weight bearing and restoration of normal anatomy. PMID:25298556

  7. Stability and migration across femoral varus derotation osteotomies in children with neuromuscular disorders

    PubMed Central

    Buxbom, Peter; Sonne-Holm, Stig; Ellitsgaard, Niels; Wong, Christian

    2017-01-01

    Background and purpose Studies have indicated that one-third of children with cerebral palsy (CP) develop dislocation of the hip that needs surgical intervention. When hip dislocation occurs during childhood surgical treatment consists of tenotomies, femoral varus derotation osteotomy (VDRO), and acetabuloplasty. Relapse is observed in one-fifth of cases during adolescence. In this prospective cohort study, we performed a descriptive evaluation of translation and rotation across VDROs in children with neuromuscular disorders and syndromes by radiostereometric analysis (RSA). We assessed "RSA stability" and migration across the VDROs. Patients and methods Children with a neuromuscular disorder were set up for skeletal corrective surgery of the hip. RSA follow-ups were performed postoperatively, at 5 weeks, and 3, 6, and 12 months after surgery. Results 27 femoral VDROs were included; 2 patients were excluded during the study period. RSA data showed stability across the VDRO in the majority of cases within the first 5 weeks. At the 1-year follow-up, the mean translations (SD) of the femoral shaft distal to the VDRO were 0.51 (1.12) mm medial, 0.69 (1.61) mm superior, and 0.21 (1.28) mm posterior. The mean rotations were 0.39° (2.90) anterior tilt, 0.02° (3.07) internal rotation, and 2.17° (2.29) varus angulation. Interpretation The migration stagnates within the first 5 weeks, indicating stability across the VDRO in most patients. PMID:27892801

  8. Outcomes after trifocal femoral fractures.

    PubMed

    Griffin, Michelle; Dick, Alastair G; Umarji, Shamim

    2014-01-01

    Trifocal femur fractures are those of the femoral neck, diaphysis, and distal femur. These high-energy injuries predominantly occur in young people with the potential for long-term complications and disability. We present the cases of two men who were treated with proximal dynamic hip screws and distal periarticular locking plates to effectively manage trifocal femur fractures. Our cases have shown union at 2 years with good functional outcomes without the need for reintervention. We provide evidence for a successful surgical treatment option for these rare and complex injuries.

  9. Outcomes after Trifocal Femoral Fractures

    PubMed Central

    Griffin, Michelle; Dick, Alastair G.; Umarji, Shamim

    2014-01-01

    Trifocal femur fractures are those of the femoral neck, diaphysis, and distal femur. These high-energy injuries predominantly occur in young people with the potential for long-term complications and disability. We present the cases of two men who were treated with proximal dynamic hip screws and distal periarticular locking plates to effectively manage trifocal femur fractures. Our cases have shown union at 2 years with good functional outcomes without the need for reintervention. We provide evidence for a successful surgical treatment option for these rare and complex injuries. PMID:24800097

  10. Application of hydraulically assembled shaft coupling hubs to large agitators

    SciTech Connect

    Murray, W.E.; Anderson, T.D.; Bethmann, H.K.

    1991-12-31

    This paper describes the basis for and implementation of hydraulically assembled shaft coupling hubs for large tank-mounted agitators. This modification to the original design was intended to minimize maintenance personnel exposure to ionizing radiation and also provide for disassembly capability without damage to shafts or hubs. In addition to realizing these objectives, test confirmed that the modified couplings reduced agitator shaft end runouts approximately 65%, thereby reducing bearing loads and increasing service life, a significant enhancement for a nuclear facility. 5 refs.

  11. Application of hydraulically assembled shaft coupling hubs to large agitators

    SciTech Connect

    Murray, W.E.; Anderson, T.D. ); Bethmann, H.K. )

    1991-01-01

    This paper describes the basis for and implementation of hydraulically assembled shaft coupling hubs for large tank-mounted agitators. This modification to the original design was intended to minimize maintenance personnel exposure to ionizing radiation and also provide for disassembly capability without damage to shafts or hubs. In addition to realizing these objectives, test confirmed that the modified couplings reduced agitator shaft end runouts approximately 65%, thereby reducing bearing loads and increasing service life, a significant enhancement for a nuclear facility. 5 refs.

  12. Thermal regime of ventilation shafts and its regulation

    SciTech Connect

    Petrov, N.N.; Timoshenko, N.I.

    1986-03-01

    This paper evaluates the regime of air flow through a ventilation shaft and the nondimensional heat-exchange criteria. It is shown that the air temperature in the shaft is affected more by the walls than by the reinforcement structure metal and that the heat released by internal combustion engines could be an alternative source for heating the air. High bypass aircraft turbojet engines decommissioned after their maximum surface life on planes could be used for this purpose. The study of the thermal regime in the shaft in the case of a sudden change of air temperature such as occurs during ventilation reversals has established the requirements for air heating equipment.

  13. Reactor coolant pump shaft seal stability during station blackout

    SciTech Connect

    Rhodes, D B; Hill, R C; Wensel, R G

    1987-05-01

    Results are presented from an investigation into the behavior of Reactor Coolant Pump shaft seals during a potential station blackout (loss of all ac power) at a nuclear power plant. The investigation assumes loss of cooling to the seals and focuses on the effect of high temperature on polymer seals located in the shaft seal assemblies, and the identification of parameters having the most influence on overall hydraulic seal performance. Predicted seal failure thresholds are presented for a range of station blackout conditions and shaft seal geometries.

  14. Noncontact Measurement Of Shaft Speed, Torque, And Power

    NASA Technical Reports Server (NTRS)

    Madzsar, George C.

    1993-01-01

    Noncontact fiber-optic sensor and associated electronic equipment measure twist and speed of rotation of shaft. Measurements determine torque and power. Response of sensor remains linear even at cryogenic temperatures. Reflective strips on rotating shaft reflect two series of light pulses back into optical system. Bidirectional coupler in each of two optical fiber paths separates reflected light from incident light, sending it to photodiode for output to analog-to-digital converter and computer. Sensor requires no slip rings or telemetry to transfer signals from shaft. Well suited for providing data on performances of turbopumps for such cryogenic fluids as liquid oxygen and liquid hydrogen.

  15. Mechanical coupling for a rotor shaft assembly of dissimilar materials

    DOEpatents

    Shi, Jun [Glastonbury, CT; Bombara, David [New Hartford, CT; Green, Kevin E [Broad Brook, CT; Bird, Connic [Rocky Hill, CT; Holowczak, John [South Windsor, CT

    2009-05-05

    A mechanical coupling for coupling a ceramic disc member to a metallic shaft includes a first wedge clamp and a second wedge clamp. A fastener engages a threaded end of a tie-bolt to sandwich the ceramic disc between the wedge clamps. An axial spring is positioned between the fastener and the second wedge clamp to apply an axial preload along the longitudinal axis. Another coupling utilizes a rotor shaft end of a metallic rotor shaft as one wedge clamp. Still another coupling includes a solid ceramic rotor disc with a multiple of tie-bolts radially displaced from the longitudinal axis to exert the preload on the solid ceramic rotor disc.

  16. Computing Operating Characteristics Of Bearing/Shaft Systems

    NASA Technical Reports Server (NTRS)

    Moore, James D.

    1996-01-01

    SHABERTH computer program predicts operating characteristics of bearings in multibearing load-support system. Lubricated and nonlubricated bearings modeled. Calculates loads, torques, temperatures, and fatigue lives of ball and/or roller bearings on single shaft. Provides for analysis of reaction of system to termination of supply of lubricant to bearings and other lubricated mechanical elements. Valuable in design and analysis of shaft/bearing systems. Two versions of SHABERTH available. Cray version (LEW-14860), "Computing Thermal Performances Of Shafts and Bearings". IBM PC version (MFS-28818), written for IBM PC-series and compatible computers running MS-DOS.

  17. Computing Operating Characteristics Of Bearing/Shaft Systems

    NASA Technical Reports Server (NTRS)

    Moore, James D.

    1996-01-01

    SHABERTH computer program predicts operating characteristics of bearings in multibearing load-support system. Lubricated and nonlubricated bearings modeled. Calculates loads, torques, temperatures, and fatigue lives of ball and/or roller bearings on single shaft. Provides for analysis of reaction of system to termination of supply of lubricant to bearings and other lubricated mechanical elements. Valuable in design and analysis of shaft/bearing systems. Two versions of SHABERTH available. Cray version (LEW-14860), "Computing Thermal Performances Of Shafts and Bearings". IBM PC version (MFS-28818), written for IBM PC-series and compatible computers running MS-DOS.

  18. Atypical femoral fractures in Italy: a retrospective analysis in a large urban emergency department during a 7-year period (2007-2013).

    PubMed

    Pedrazzoni, Mario; Giusti, Andrea; Girasole, Giuseppe; Abbate, Barbara; Verzicco, Ignazio; Cervellin, Gianfranco

    2016-11-09

    The aim of this study was to determine the incidence of atypical femoral fractures (AFFs) seen in a large emergency department in Italy. It was a retrospective study of all men and women aged 40 years or older admitted to the Emergency Department of Parma University Hospital for a femoral fracture. Cases were identified in the hospital database with use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 820 or 821 or text strings. All the radiographic images of fractures not clearly identified as proximal or condylar were retrieved and evaluated by three independent reviewers. Fractures were considered as atypical if all three reviewers agreed on at least four of five major features defined by the 2013 American Society for Bone and Mineral Research criteria. In the 7-year period (2007-2013), with a total follow-up of 1,383,154 patient-years, we found 22 AFFs in 21 patients, accounting for 7.1% of low-trauma subtrochanteric/femoral shaft fractures and 0.6% of all femoral fractures. The incidence was very low (1.6 in 100,000 patient-years in both sexes combined). In contrast, the incidence of classic fractures of the proximal end of the femur was at least two orders of magnitude higher (typical/atypical rate ratio 152). Bisphosphonate use was reported in 13 patients (62%; mean treatment duration 9 years; range 5-14 years). Among 286 patients with typical subtrochanteric/femoral shaft fractures, 20 were being treated with bisphosphonate (7%; odds ratio 22; 95% confidence interval 8-58; p < 0.001). This study confirms the very low incidence of AFFs in the largest Italian cohort of patients to date. Even though the risk is higher in patients treated with bisphosphonates, AFFs are very rare, and typical femoral fractures are at least 100-fold more frequent.

  19. Periosteal vascularization of the distal femur in relation to distal femoral osteotomies: a cadaveric study.

    PubMed

    van der Woude, J A D; van Heerwaarden, R J; Bleys, R L A W

    2016-12-01

    The purpose of this study was to investigate periosteal vessels location as intra-operative landmarks in distal femoral osteotomies and focused on the branching pattern of the vascular supply of the medial and lateral femoral condyle, its constancy, and the relationship to the height of distal femoral osteotomies. Anastomoses of relevant vessels were studied to analyze the risk of vascular insufficiency after transection of landmark vessels. A human cadaver dissection study on the vascular supply of the medial and lateral side of the distal femur was conducted. Surgical dissection was performed in eight knees in total. Distances between the vascular supply and bony landmarks were calculated. Relation of the vascular structures to the transverse bone cuts of distal femoral osteotomies was described, as well as anastomoses of relevant vessels. On the medial side of the distal femur the periosteum was primarily supplied by the descending genicular artery (DGA) in 87.5 % of the specimens. In the absence of the DGA, the superior medial genicular artery was the supplier. Vascularization took place through two constant branches, the upper transverse artery (UTA) and the central longitudinal artery. The UTA originated at a mean distance of 6.9 cm (range 5.9-7.9 cm) above the knee joint line. On the lateral side of the distal femur the superior lateral genicular artery was the main vessel. In all dissected knees it gave off the lateral transverse artery (LTA). The LTA originated at a mean distance of 6.9 cm (range 5.8-7.6 cm) above the knee joint line. Anastomoses between the UTA, LTA and the longitudinal arch of the femoral shaft were found that could prevent vascular insufficiencies after transection of the UTA and LTA. The vascular supply of the medial and lateral aspects of the femoral condyle is highly constant. Both the UTA, on the medial side, and the LTA, on the lateral side, can serve as a landmark for orthopedic surgeons in determining the height of the

  20. Influence of muscle groups' activation on proximal femoral growth tendency.

    PubMed

    Yadav, Priti; Shefelbine, Sandra J; Pontén, Eva; Gutierrez-Farewik, Elena M

    2017-06-22

    Muscle and joint contact force influence stresses at the proximal growth plate of the femur and thus bone growth, affecting the neck shaft angle (NSA) and femoral anteversion (FA). This study aims to illustrate how different muscle groups' activation during gait affects NSA and FA development in able-bodied children. Subject-specific femur models were developed for three able-bodied children (ages 6, 7, and 11 years) using magnetic resonance images. Contributions of different muscle groups-hip flexors, hip extensors, hip adductors, hip abductors, and knee extensors-to overall hip contact force were computed. Specific growth rate for the growth plate was computed, and the growth was simulated in the principal stress direction at each element in the growth front. The predicted growth indicated decreased NSA and FA (of about [Formula: see text] over a four-month period) for able-bodied children. Hip abductors contributed the most, and hip adductors, the least, to growth rate. All muscles groups contributed to a decrease in predicted NSA ([Formula: see text]0.01[Formula: see text]-0.04[Formula: see text] and FA ([Formula: see text]0.004[Formula: see text]-[Formula: see text]), except hip extensors and hip adductors, which showed a tendency to increase the FA ([Formula: see text]0.004[Formula: see text]-[Formula: see text]). Understanding influences of different muscle groups on long bone growth tendency can help in treatment planning for growing children with affected gait.