Fracture resistance of Nd:YAG laser-welded cast titanium joints with various clinical thicknesses and welding pulse energies.

PubMed

Lin, Mau-Chin; Lin, Sheng-Chieh; Wang, Yu-Tsai; Hu, Suh-Woan; Lee, Tzu-Hsin; Chen, Li-Kai; Huang, Her-Hsiung

2007-05-01

The purpose of this study was to evaluate the fracture resistance of Nd:YAG laser-welded cast titanium (Ti) joints with various clinical thicknesses and welding pulse energies. A four-point bending test was used to assess the effects of various specimen thicknesses (1-3 mm) and welding pulse energies (11-24 J) on the fracture resistance of Nd:YAG laser-welded Ti dental joints. Fracture resistance was evaluated in terms of the ratio of the number of fractured specimens to the number of tested specimens. As for the fracture frequencies, they were compared using the Cochran-Mantel-Haenszel test. Morphology of the fractured Ti joints was observed using a scanning electron microscope. Results showed that decreasing the specimen thickness and/or increasing the welding pulse energy, i.e., increasing the welded area percentage, resulted in an increase in the fracture resistance of the Ti joint. Where fracture occurred, the fracture site would be at the center of the weld metal.

Ball-joint versus single monolateral external fixators for definitive treatment of tibial shaft fractures.

PubMed

Beltsios, Michail; Mavrogenis, Andreas F; Savvidou, Olga D; Karamanis, Eirineos; Kokkalis, Zinon T; Papagelopoulos, Panayiotis J

2014-07-01

To compare modular monolateral external fixators with single monolateral external fixators for the treatment of open and complex tibial shaft fractures, to determine the optimal construct for fracture union. A total of 223 tibial shaft fractures in 212 patients were treated with a monolateral external fixator from 2005 to 2011; 112 fractures were treated with a modular external fixator with ball-joints (group A), and 111 fractures were treated with a single external fixator without ball-joints (group B). The mean follow-up was 2.9 years. We retrospectively evaluated the operative time for fracture reduction with the external fixator, pain and range of motion of the knee and ankle joints, time to union, rate of malunion, reoperations and revisions of the external fixators, and complications. The time for fracture reduction was statistically higher in group B; the rate of union was statistically higher in group B; the rate of nonunion was statistically higher in group A; the mean time to union was statistically higher in group A; the rate of reoperations was statistically higher in group A; and the rate of revision of the external fixator was statistically higher in group A. Pain, range of motion of the knee and ankle joints, rates of delayed union, malunion and complications were similar. Although modular external fixators are associated with faster intraoperative fracture reduction with the external fixator, single external fixators are associated with significantly better rates of union and reoperations; the rates of delayed union, malunion and complications are similar.

Microseismic monitoring of columnar jointed basalt fracture activity: a trial at the Baihetan Hydropower Station, China

NASA Astrophysics Data System (ADS)

Chen, Bing-Rui; Li, Qing-Peng; Feng, Xia-Ting; Xiao, Ya-Xun; Feng, Guang-Liang; Hu, Lian-Xing

2014-10-01

Severe stress release has occurred to the surrounding rocks of the typically columnar jointed basalt after excavation at the Baihetan Hydropower Station, Jinsha River, China, where cracking, collapse, and other types of failure may take place occasionally due to relaxation fracture. In order to understand the relaxation fracture characteristics of the columnar jointed basalt in the entire excavation process at the diversion tunnel of the Baihetan Hydropower Station, real-time microseismic monitoring tests were performed. First, the applicability of a geophone and accelerometer was analyzed in the columnar jointed basalt tunnel, and the results show that the accelerometer was more applicable to the cracking monitoring of the columnar jointed basalt. Next, the waveform characteristics of the microseismic signals were analyzed, and the microseismic signals were identified as follows: rock fracture signal, drilling signal, electrical signal, heavy vehicle passing signal, and blast signal. Then, the attenuation characteristics of the microseismic signals in the columnar jointed basalt tunnel were studied, as well as the types and characteristics of the columnar jointed basalt fracture. Finally, location analysis was conducted on the strong rock fracture events, in which four or more sensors were triggered, to obtain the temporal and spatial evolution characteristics and laws of the columnar jointed basalt relaxation fracture after excavation. The test results are not only of important reference value to the excavation and support of diversion tunnel at the Baihetan Hydropower Station, but also of great referential significance and value to the conduction of similar tests.

Incorporation of Interfacial Intermetallic Morphology in Fracture Mechanism Map for Sn-Ag-Cu Solder Joints

NASA Astrophysics Data System (ADS)

Huang, Z.; Kumar, P.; Dutta, I.; Sidhu, R.; Renavikar, M.; Mahajan, R.

2014-01-01

A fracture mechanism map (FMM) is a powerful tool which correlates the fracture behavior of a material to its microstructural characteristics in an explicit and convenient way. In the FMM for solder joints, an effective thickness of the interfacial intermetallic compound (IMC) layer ( t eff) and the solder yield strength ( σ ys,eff) are used as abscissa and ordinate axes, respectively, as these two predominantly affect the fracture behavior of solder joints. Earlier, a definition of t eff, based on the uniform thickness of IMC ( t u) and the average height of the IMC scallops ( t s), was proposed and shown to aptly explain the fracture behavior of solder joints on Cu. This paper presents a more general definition of t eff that is more widely applicable to a range of metallizations, including Cu and electroless nickel immersion gold (ENIG). Using this new definition of t eff, mode I FMM for SAC387/Cu joints has been updated and its validity was confirmed. A preliminary FMM for SAC387/Cu joints with ENIG metallization is also presented.

Probabilistic Simulation of Progressive Fracture in Bolted-Joint Composite Laminates

NASA Technical Reports Server (NTRS)

Minnetyan, L.; Singhal, S. N.; Chamis, C. C.

1996-01-01

This report describes computational methods to probabilistically simulate fracture in bolted composite structures. An innovative approach that is independent of stress intensity factors and fracture toughness was used to simulate progressive fracture. The effect of design variable uncertainties on structural damage was also quantified. A fast probability integrator assessed the scatter in the composite structure response before and after damage. Then the sensitivity of the response to design variables was computed. General-purpose methods, which are applicable to bolted joints in all types of structures and in all fracture processes-from damage initiation to unstable propagation and global structure collapse-were used. These methods were demonstrated for a bolted joint of a polymer matrix composite panel under edge loads. The effects of the fabrication process were included in the simulation of damage in the bolted panel. Results showed that the most effective way to reduce end displacement at fracture is to control both the load and the ply thickness. The cumulative probability for longitudinal stress in all plies was most sensitive to the load; in the 0 deg. plies it was very sensitive to ply thickness. The cumulative probability for transverse stress was most sensitive to the matrix coefficient of thermal expansion. In addition, fiber volume ratio and fiber transverse modulus both contributed significantly to the cumulative probability for the transverse stresses in all the plies.

Intra-articular calcaneal fractures: effect of open reduction and internal fixation on the contact characteristics of the subtalar joint.

PubMed

Mulcahy, D M; McCormack, D M; Stephens, M M

1998-12-01

Intra-articular calcaneal fractures are associated with significant long-term morbidity, and considerable controversy exists regarding the optimum method of treating them. The contact characteristics in the intact subtalar joint were determined at known loads and for different positions of the ankle and subtalar joint, using pressure-sensitive film (Super Low; Fuji, Itochu Canada Ltd, Montreal, Quebec). We measured the contact area to joint area ratio (pressure > 5 kg force/cm2 [kgf/cm2]) which normalizes for differences in joint size and the ratio of high pressure zone (>20 kgf/cm2) as a reflection of overall increase in joint pressure. Three simulated fracture patterns were then created and stabilized with either 1 or 2 mm of articular incongruity. Eight specimens were prepared with a primary fracture line through the posterior facet, eight with a joint depression-type fracture, and six with a central joint depression fracture. A measure of 1 to 2 mm of incongruity in the posterior facet for all three fracture patterns produced significant unloading of the depressed fragment, with a redistribution of the overall pattern of pressure distribution to parts of the facet that were previously unloaded.

Minimally invasive treatment for pubic ramus fractures combined with a sacroiliac joint complex injury.

PubMed

Yu, Xiaowei; Tang, Mingjie; Zhou, Zubin; Peng, Xiaochun; Wu, Tianyi; Sun, Yuqiang

2013-08-01

Fractures of the pubic rami due to low energy trauma are common in the elderly, with an incidence of 26 per 100,000 people per year in those aged more than 60 years. The purpose of this study was to evaluate the clinical application of this minimally invasive technique in patients with pubic ramus fractures combined with a sacroiliac joint complex injury, including its feasibility, merits, and limitations. Fifteen patients with pubic ramus fractures combined with sacroiliac joint injury were treated with the minimally invasive technique from June 2008 until April 2012. The quality of fracture reduction was evaluated according to the Matta standard. Fourteen cases were excellent (93.3 %), and one case was good (6.7 %). The fracture lines were healed 12 weeks after the surgery. The 15 patients had follow-up visits between four to 50 months (mean, 22.47 months). All patients returned to their pre-injury jobs and lifestyles. One patient suffered a deep vein thrombosis during the peri-operative period. A filter was placed in the patient before the surgery and was removed six weeks later. There was no thrombus found at the follow-up visits of this patient. The minimally invasive technique in patients with pubic ramus fractures combined with a sacroiliac joint complex injury provided satisfactory efficacy.

[Application of temporomandibular joint dics reduction in the operation of condylar sagittal fracture].

PubMed

Wenli, Zeng; Wuchao, Zhou; Jingkun, Zhang; Yisen, Shao; Weihong, Xi

2017-10-01

To explore the selection of temporomandibular joint (TMJ) disc reduction and fixation methods in condylar sagittal fracture surgery. A total of 36 patients with condylar fractures were chosen. The follow-up period was more 6 months. All 36 cases of condylar sagittal fracture were fixed with long screw. In the operation, the displaced joint disc was repositioned and fixed. The fixed method included direct suture (22 cases) and anchorage (14 cases). Clinical followups were performed before surgery and 1 month, 3 months, 6 months and 1 year after surgery. Clinicians recorded data related to the Fricton craniomandibular index (CMI) and evaluated the postoperative joint function during followup before surgery and 6 months after surgery. In both groups, function of TMJ significantly improved after surgery. The CMI decreased from 0.213±0.162 and 0.273±0.154 to 0.059±0.072 and 0.064±0.068 (P<0.05), respectively. No statistical difference was observed between the two groups in palpation index (PI), dysfunction index (DI) and CMI (P>0.05) before or after surgery. Both methods could effectively improve the dysfunction of the TMJ caused by trauma. The selection of joint disc reduction and fixation methods is based on the displacement and damage degree of the joint disc.

[Arthroscopic therapy of ankle joint impingement syndrome after operation of ankle joint fracture dislocation].

PubMed

Feng, Zhibin; Mi, Kun; Wei, Renzhi; Liu, Wu; Wang, Bin

2011-07-01

To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, there were 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from -20 to -5 degrees (mean, -10.6 degrees), and the palmar flexion was 30-40 degrees (mean, 35.5 degrees). The total score was 48.32 +/- 9.24 and the pain score was 7.26 +/- 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25 degrees (mean, 19.6 degrees) and the palmar flexion was 35-45 degrees (mean, 40.7 degrees). Eight patients had mild limited ROM; the dorsal extension was 5-15 degrees (mean, 7.2 degrees) and the palmar flexion was 35-45 degrees (mean, 39.5 degrees). Four patients had mild limited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5 degrees (mean, 2.6 degrees) and the palmar flexion was 35-40 degrees (mean, 37.5 degrees). The total score was 89.45 +/- 9.55 and the pain score was 1.42 +/- 1.26 after

Direct hip joint distraction during acetabular fracture surgery using the AO universal manipulator.

PubMed

Calafi, L Afshin; Routt, M L Chip

2010-02-01

Certain acetabular fractures may necessitate distraction of the hip joint for removal of intra-articular debris and assessment of reduction. Distraction can be accomplished by manual traction, using a traction table or an AO universal manipulator (UM). The UM is a relatively simple and an inexpensive device that can provide focal distraction in a controlled manner without the risks associated with the use of a traction table. We describe a technique using the UM for hip joint distraction during acetabular fracture surgery through a Kocher-Langenbeck surgical exposure.

Evaluation of an Image-Based Tool to Examine the Effect of Fracture Alignment and Joint Congruency on Outcomes after Wrist Fracture.

PubMed

Lalone, Emily A; Grewal, Ruby; King, Graham W; MacDermid, Joy C

2015-01-01

Some mal-alignment of the wrist occurs in up to 71% of patients following a distal radius fracture. A multiple case study was used to provide proof of principle of an image-based technique to investigate the evolution and impact of post-traumatic joint changes at the distal radioulnar joint. Participants who had a unilateral distal radius fracture who previously participated in a prospective study were recruited from a single tertiary hand center. Long term follow-up measures of pain, disability, range of motion and radiographic alignment were obtained and compared to joint congruency measures. The inter-bone distance, a measure of joint congruency was quantified from reconstructed CT bone models of the distal radius and ulna and the clinical outcome was quantified using the patient rated wrist evaluation. In all four cases, acceptable post-reduction alignment and minimal pain/disability at 1-year suggested good clinical outcomes. However, 10 years following injury, 3 out of 4 patients had radiographic signs of degenerative changes occurring in their injured wrist (distal radioulnar joint/radio-carpal joint). Proximity maps displaying inter-bone distances showed asymmetrical congruency between wrists in these three patients. The 10-year PRWE (patient rated wrist evaluation) varied from 4 to 60, with 3 reporting minimal pain/disability and one experiencing high pain/disability. These illustrative cases demonstrate long-term joint damage post-fracture is common and occurs despite positive short-term clinical outcomes. Imaging and functional outcomes are not necessarily correlated. A novel congruency measure provides an indicator of the overall impact of joint mal-alignment that can be used to determine predictors of post-traumatic arthritis and is viable for clinical or large cohort studies.

Clavicle Fractures are Associated With Arthritis of the Glenohumeral Joint in a Large Osteological Collection.

PubMed

Weinberg, Douglas S; Vallier, Heather A; Gaumer, Gregory A; Cooperman, Daniel R; Liu, Raymond W

2016-11-01

Recent data has challenged the historical precedent of nonoperative care for many clavicle fractures; clinical and biomechanical studies have shown altered joint-contact forces occur in the glenohumeral joint (GHJ) after fracture and shortening of the clavicle. However, to date, there have been no analyses documenting the long-term effects of these altered shoulder girdle mechanics on the GHJ. The clavicles of 2899 cadaveric skeletons were manually inspected for evidence of fracture. Shortening, fracture location, and laterality were recorded along with demographic information. Degenerative joint disease of the GHJ was graded. Correlations between the presence of a clavicle fracture and ipsilateral GHJ osteoarthritis were evaluated with multiple regression analysis using an age-, gender-, race-, and laterality-matched control group of 1154 GHJs. One hundred three specimens had 104 clavicle fractures, a prevalence of 3.6% (103/2899) in this collection. There was a strong correlation between the presence of an ipsilateral clavicle fracture (standardized beta 0.108, P < 0.001), age (standardized beta 0.332, P < 0.001), male gender (standardized beta -0.069, P = 0.009), and laterality (right sided, standardized beta 0.056, P = 0.032) on the development of GHJ arthritis. There was a trend toward increased GHJ arthritis in specimens with shortening >20 mm (standardized beta 0.156, P = 0.109), although this subanalysis may have been underpowered. This is the first study to report long-term consequences of clavicle fracture on the development of ipsilateral GHJ osteoarthritis; clavicle fractures were shown to have a higher degree of GHJ osteoarthritis. Future clinical studies are needed to confirm these relationships.

[Repair and reconstruction for severe fracture and dislocation of ankle joint].

PubMed

Yin, Qingwei; Jiang, Yi; Xiao, Lianping; Li, Xiaodong; Fu, Jiaxin; Tian, Yonggang; Han, Liqiang; Liu, Zhi

2008-06-01

To summarize the technique and effect of the therapy for severe fracture and dislocation of ankle joint by operation. From March 2003 to February 2006, 76 cases were treated with primary open restoration and internal fixation for dislocated ankle joint fracture, with 47 males and 29 females, with the average age of 36.4 years (ranging from 18 years to 65 years). According to AO criterion, these fresh fractures were classified into 13 cases for type C3-1, 45 cases for type C3-2 and 18 cases for type C3-3. Based on the Gustilo-Anderson standard, 23 open fractures were classified into 17 cases for type II and 6 cases for type III A. The operation was delayed from 1 hours to 24 hours after the injury. All incisions healed at the first stage except 4 cases which delayed union because of simple infection by revision with ointment. A total of 72 cases were followed up, with the average time of 18.5 months (from 12 months to 35 months). The time of bone union was from 12 weeks to 24 weeks. The screws of fixation for lower tibia-fibula joint were found to be ruptured in 2 cases when further consultation was performed in the 16th and 20th week after the operation, respectively, and were broken within 1 year after the operation. These screws were taken out 12 weeks postoperative in 28 cases, while the whole internal fixations of the rest cases were taken out 1 year after the operation. The postoperative function of malleolus extended from 21.7 degrees to 26.8 degrees and flection from 38.5 degrees to 44.7 degrees. Assessed by the American Orthopaedic Foot and Ankle Society Clinical Rating Scales, 23 cases were excellent, 36 good, 13 fair, and the choiceness rate reached 81.94%. These procedures, together with reduction by twist after hospital, open and internal fixation in time, and parenchyma managed with internal fixation, are important to attain satisfactory effect for the treatment of severe fracture and dislocation of ankle joint.

[Antero-medial incision of knee joint for the treatment of intercondylar fracture of femur].

PubMed

Yin, Zi-Fei; Sun, Bin-Feng; Yang, Xiao-Hai; Wang, Qing; Qian, Ping-Kang; Wu, Xiao-Feng; Xu, Feng

2017-12-25

To explore the clinical effect of antero-medial incision of knee joint in treating intercondylar fracture of femur. From September 2012 to March 2015, 24 patients with intercondylar fracture of femur were selected, including 17 males and 7 females, aged from 20 to 65 years old with an average of(38.3±9.5) years old. Among them, 12 cases were caused by traffic accident, 8 cases were caused by falling injury and 4 cases were caused by falling down. All patients were closed fractures. The time from injury to hospital was from 30 min to 8 h with an average of(2.2±0.3) h. According to AO classification, 4 cases were type B1, 3 type B2, 2 type B3, 5 type C1, 6 type C2 and 4 type C3. All patients were treated with antero-medial incision of knee joint. Operative time, blood loss and postoperative complications were observed and recovery of keen function was evaluated by Kolmert scoring. All patients were followed-up from 6 to 12 months with average of (9.0±1.7) months. Operative time ranged from 50 to 90 min with an average of (70.0±8.2) min; blood loss ranged from 90 to 400 ml with an average of (180±36) ml; negative pressure flow was from 30 to 90 ml, with an average of (50.0±7.1) ml. All fracture were healed at stage I without loosening of internal fixator, fracture nonunion, and deep vein thrombosis. According to Kolmert scoring, 16 patients got excellent result, 5 patients good and 3 fair. Antero-medial incision of knee joint in treating intercondylar fracture of femur, which has advantages of good fracture reduction, less injury of soft tissue and simple operation, could obtain good clinical results.

[Joint dislocation after total knee arthroplasty as an ankle fracture complication. Case report].

PubMed

Hrubina, M; Skoták, M

2012-01-01

Joint dislocation after total knee arthroplasty is a rare complication. It is described as the result of ligamentous instability. Here we report the case of an 82-year-old women who underwent primary total knee arthroplasty (TKA) for advanced primary grade III gonarthrosis. At 3 post-operative months the joint was stable and painless, with radiographic evidence of good TKA alignment and integration. At 4 months the patient suffered injury to the ankle involving a bimalleolar fracture and damage to knee soft tissues. The fracture was surgically treated. Subsequently, dorsal tibial dislocation was manifested. This was managed by individual intramedullary nail arthrodesis. At 8 months following the operation, the knee condition was satisfactory, with rigid arthrodesis and leg shortening of 4 cm. The patient was satisfied because she was free of pain and able to walk. Arthrodesis of the knee joint with an individual nail is an option for a definitive treatment of TKA instability. When other joints, such as ankle or hip joints, are injured, it is recommended to pay attention also to any TKA implanted previously because of potential development of instability or infection.

[Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate].

PubMed

Zhu, Yi-Yong; Cui, Heng-Yan; Jiang, Pan-Qiang; Wang, Jian-Liang

2013-11-01

To investigate the causes and prevention of the complications about treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II) with clavicular hook plate. From January 2001 to December 2011, 246 patients with acromioclavicular joint dislocation (Tossy III) and 222 patients with unstable distal clavicular fracture (Neer II) were treated with acromioclvicular hook plate fixation,including 348 males and 120 females with an average age of 45.4 years old ranging from 21 to 80 years old. The mean time from injury to operation was 30.8 hours (ranged from 1 h to 15 d). All patients had normal shoulder function before injury. According to Karlsson evaluation standard, the cases with excellent and good function of the shoulder joint were regarded as the normal group, and the cases with poor function of shoulder joint as the abnormal group. The comparison of the range of forward flexion,backward stretch, adduction, abduction and elevation of shoulder joints between two groups was performed. The data of impingement, subacromial osteolysis, acromioclavicular arthritis, clavicular stress fracture, downward acromioclavicular joint subluxation, hook cut-out and hook break were summarized. All patients were followed up from 8 to 48 months with an average of 12.5 months. The results were excellent in 308 cases,good in 76,and poor in 84 according to Karlsson evaluation. The excellent and good rate was 82.1%. The difference of the range of forward flexion, backward stretch, adduction, abduction and elevation of shoulder joints between two groups had a statistically significant difference (P < 0.01). Among 84 poor cases, there were 41 (8.76%) in acromial impingement or inadequate place of plate hook, 12 (2.56%) with subacromial osteolysis or/and bursitis, 10 (2.14%) with acromioclavicular arthritis or painful shoulder caused by delayed dirigation,7 (1.50%) with clavicular stress fracture or interal plate upward, 6 (1.28%) with

A rare combined injury of dorsal fracture-dislocation of four carpometacarpal joints and trapezium, trapezoid and distal radius bone fractures.

PubMed

Touloupakis, Georgios; Stuflesser, Wilfried; Antonini, Guido; Ferrara, Fabrizio; Crippa, Cornelio; Lettera, Maria Gabriella

2016-05-06

Incorrect or delayed diagnosis and treatment of the carpometacarpal fracture-dislocations is often associated with poor prognosis. We present a rare case of unusual pattern of injury, involving dorsal dislocation of four ulnar carpometacarpal joints, associated with fracture of the trapezium, a burst fracture of the trapezoid  bone and an extra-articular fracture of the third distal  of the radius. The first surgical intervention was followed by unsatisfactory results, confirmed by the CT scans. A second surgery followed and an open reduction and pinning with K wires performed. Post-operative follow up lasting for nine months revealed a very good surgical outcome.

[Case control study of fractures-dislocations of ankle joint with conservative and operative treatment].

PubMed

Zhang, Song-Tu; Lin, Yi-Rong; Chen, Lian-Yuan

2010-10-01

To compare the clinical efficacy of grade III, IV supination-eversion fractures-dislocations of ankle joint between manipulative treatment and operative treatment. From September 2007 to December 2008, the clinical data of 60 patients with grade III, IV supination-eversion fractures-dislocations of ankle joint were retrospectively analyzed. There were 32 males and 28 females, ranging in age from 18 to 70 years with an average age of 38.17 years. All patients were respectively treated with manipulative treatment (conservative group, 30 cases) and operative treatment (operative group, 30 cases). The joint function was compared with Mazur standard; the reduction and shifting of fractures were observed with X-ray; the hospitalization day and the therapeutic cost were compared between two groups. All patients were followed up with an average of 15.27 months (ranged, 6 to 25 months). In conservative group, 16 cases got excellent result in joint function, 10 good, 3 fair, 1 poor; in operative group, 20 cases got excellent result, 8 good, 2 fair, 0 poor. In conservative group in the X-ray showed 25 cases obtained excellent and good reduction, 4 fair, 1 poor; and in operative group in the X-ray showed 28 cases obtained excellent and good reduction, 2 fair, 0 poor. There was no significant difference at the joint function and X-ray film after treatment between two groups (P > 0.05). The hospital day was respectively (7.87 +/- 3.34), (17.37 +/- 4.64) d in conservative group and operative group; and the therapeutic cost was respectively (2 506.67 +/- 649.10), (11 473.33 +/- 1 564.90) yuan. There was significant difference at hospital day and therapeutic cost between two groups (P < 0.05). Conservative treatment and operative treatment can both reach a very good result in treating grade III, IV supination-eversion fractures and dislocations of ankle joint. However, conservative treatment has advantage of high safety factor, low therapeutic cost, can reduce medical costs for

CLINICAL AND TREATMENT FEATURES OF OPEN INFECTED FRACTURES IN THE KNEE JOINT REGION IN CONJUNCTION WITH RADIATION SICKNESS (EXPERIMENTAL STUDY)

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

Sakharov, B.V.

1963-08-01

Clinical aspects and the course of treatment of open infected fractures in the knee joint region against a background of moderate and severe radiation sickness are discussed. The experiment involved 35 healthy dogs of both sexes. In all, three experiments were involved: on open infected fractures in the knee joint region in conjunction with radiation sickness; open infected fractures in the knee joint region without radiation sickness; radiation sickness without trauma. Infected open injury to the knee joint against a radiation sickness background is a severe affection. The use of delayed surgical and drug treatment (antibiotics, vitamins, antihistamine preparations) affordedmore » survival of at least one-half of the animals. Oral use of phenoxymethyl-penicillin in large doses established in the blood and synovial fluid of the damaged knee joint a therapeutic concentration of antibiotic of long duration (not less than a day). In radiation damage to knee joint accompanied by fracture of the bone fragment, the best method of surgical treatment is osteosynthesis using metal parts. In open infection of a damaged knee joint against a radiation sickness background, even with proper treatment a tendency toward formation of deforming arthrosis was observed. (OTS)« less

Charcot joint-like changes following ankle fracture in a patient with no underlying disease: report of a rare case.

PubMed

Kumagai, Masaru; Yokota, Kiyoshi; Endoh, Toshiya; Takemoto, Hitoshi; Nagata, Kensei

2002-01-01

Charcot joint is a disease that often occurs in patients with diabetes mellitus, tabes dorsalis, syringomyelia, chronic alcoholism, leprosy, trauma, or infection after fractures and dislocations. The treatment for Charcot joint has various complications, such as skin lesions, infections, and delayed union. We present our experience with a male patient who developed Charcot joint-like changes without diabetes mellitus or any other disease after an ankle fracture due to minor trauma.

[Topographological-anatomic changes in the structure of temporo-mandibular joint in case of fracture of the mandible condylar process at cervical level].

PubMed

Volkov, S I; Bazhenov, D V; Semkin, V A

2011-01-01

Pathological changes in soft tissues surrounding the fracture site as well as in the structural elements of temporo-mandibular joint always occured in condylar process fracture with shift at cervical mandibular jaw level. Other changes were also seen in the joint on the opposite normal side. Modelling of condylar process fracture at mandibular cervical level by means of three-dimensional computer model of temporo-mandibular joint contributed to proper understanding of this pathology emergence as well as to prediction and elimination of disorders arising in adjacent to the fracture site tissues.

Identification of the Cause of the Stem Neck Fracture in the Hip Joint Endoprosthesis

NASA Astrophysics Data System (ADS)

Ryniewicz, A. M.; Bojko, Ł.; Ryniewicz, A.; Pałka, P.; Ryniewicz, W.

2018-02-01

Endoprosthesis stem fractures are among the rarest complications that occur after hip joint arthroplasty. The aim of this paper is to evaluate the causes of the fractures of the Aura II stem neck, which is an element of an endoprosthesis implanted in a patient. In order to achieve it, a radiogram was evaluated, the FEM analysis was carried out for the hip joint replaced using the Aura II prosthesis and scanning tests as well as a chemical analysis were performed for the focus of fatigue. The tests performed indicate that the most probable causes leading to the fatigue fracture of the Aura II stem under examination were material defects in the process of casting and forging (forging the material with delamination and the presence of brittle oxides and carbides) that resulted in a significant reduction of strength and resistance to corrosion. In the light of an unprecedented stem neck fracture, this information should be an indication for non-destructive tests of ready-made stems aiming to discover the material and technological defects that may arise in the process of casting and drop forging.

Early diagnostics of temporomandibular joint structural elements injures caused by traumatic mandibular bone fractures.

PubMed

Pohranychna, Kh R; Stasyshyn, A R; Matolych, U D

2017-06-30

A rapidly increasing number of mandibular condylar fractures and some complications related to injuries of temporomandibular elements make this study important. Intra-articular disorders lead to secondary pathological findings such as osteoarthritis, deforming osteoarthrosis, and temporomandibular joint ankylosis that limits mouth opening, mastication, swallowing, breathing, and decreased/lost working capacity or disability. Early diagnosis of intra-articular disorders can prevent from long-lasting functional complications caused by temporomandibular joint injuries. This study was performed for the purpose of early detection and investigation of organic pathological changes in the cartilaginous and osseous tissues of the temporomandibular joint caused by traumatic fractures of the mandibular condyle. Twenty patients underwent a general clinical examination, magnetic resonance imaging (MRI), and immune-enzyme testing for biochemical markers of connective tissue injury (pyridinoline and deoxypyridinoline) in urine. Disk dislocation, deformation, adhesion, perforation or squeeze, tension or disruption of ligaments, and injury of articular surfaces are among complications of mandibular fractures that can be revealed on MRI. As regards biochemical findings, we revealed a sharp rise in the levels of pyridinoline and deoxypyridinoline before treatment and a lack of stabilization within 21 days of treatment.

Analysis on the Fracture of Al-Cu Dissimilar Materials Friction Stir Welding Lap Joint

NASA Astrophysics Data System (ADS)

Sun, Hongyu; Zhou, Qi; Zhu, Jun; Peng, Yong

2017-12-01

Friction stir welding (FWS) is regarded as a more plausible alternative to other welding methods for Al-Cu dissimilar joining. However, the structure of an FSW joint is different from others. In this study, lap joints of 6061 aluminum alloy and commercially pure copper were produced by FSW, and the effects of rotation rate on macromorphology, microstructure and mechanical properties were investigated. In addition, a fracture J integral model was used to analyze the effect of microstructure on the mechanical properties. The results revealed that the macrodefect-free joints were obtained at a feed rate of 150 mm/min and 1100 rpm and that the failure load of the joint reached as high as 4.57 kN and only reached 2.91 kN for the 900 rpm, where tunnel defects were identified. Particle-rich zones composed of Cu particles dispersed in an Al matrix, and "Flow tracks" were observed by the EDS. The J integral results showed that the microdefects on the advancing side cause serious stress concentration compared with the microdefects located on the Al-Cu interface, resulting in the fracture of the joints.

[Conventional X-Rays of Ankle Joint Fractures in Older Patients are Not Always Predictive].

PubMed

Jubel, A; Faymonville, C; Andermahr, J; Boxberg, S; Schiffer, G

2017-02-01

Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69.9 years. Operation reports and preoperative X-rays were analysed with respect to four relevant lesions: multifragmentary fracture pattern of the lateral malleolus, involvement of the medial malleolus, posterior malleolar fractures and bony avulsion of anterior syndesmosis. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and prevalence were calculated. Results: The prevalence of specific ankle lesions in the analyzed cohort was 24 % for the multifragmentary fracture pattern of the lateral malleolus, 38 % for fractures of the medial malleolus, 25 % for posterior malleolar fractures and 22.6 % for bony avulsions of the anterior syndesmosis. Multifragmentary fracture patterns of the lateral malleolus (sensitivity 0 %) and bony avulsions of the anterior syndesmosis (sensitivity 5 %) could not be detected in plain X-rays of the ankle joint at all. Fractures of the medial malleolus and involvement of the dorsal tibial facet were detected with a sensitivity of 96.8 % and 76.2 %, respectively, and specificity of 100 % in both cases. Conclusions: This study confirms that complex fracture patterns, such as multifragmentary involvement of the lateral malleolus, additional fracture of the medial malleolus, involvement of the dorsal tibial facet or bony avulsion of the anterior syndesmosis are common in ankle fractures of the elderly. Therefore, CT scans should be routinely considered for primary

An Incidental Finding of a Talonavicular and Talocalcaneal Joint Coalition After a Tibial Pilon Fracture: A Case Report.

PubMed

Godoy, Heidi M; Micciche, Mark J

It has been proposed that patients with talocalcaneal and talonavicular coalitions have decreased ankle joint range of motion. It has also been reported that rotational forces regularly absorbed by the talocalcaneal joint are transferred to the ankle joint in patients with coalitions, increasing the stress on the ankle joint after trauma. To the best of our knowledge, only 1 reported study has detailed the increased stress placed on the ankle joint secondary to a coalition. We present a case study of a 53-year-old female who experienced a traumatic fall and subsequent right ankle fracture. Advanced imaging studies revealed a comminuted tibial pilon fracture and talocalcaneal and talonavicular joint coalitions. She underwent open reduction and internal fixation for treatment of the fracture, and the coalitions were not treated because they were asymptomatic. She was kept non-weightbearing for 6 weeks postoperatively and was returned to a regular sneaker at 10 weeks postoperatively. The postoperative films revealed stable intact fixation and pain-free gait with no increased restriction in her ankle joint range of motion. The hardware was removed at 13 months postoperatively. She had not experienced increased pain or arthritic changes at 15 months postoperatively. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Do joints initiate as sharp mode I fractures or finite thickness dilatancy bands? Insights from laboratory experiments and field data

NASA Astrophysics Data System (ADS)

Petit, J.; Chemenda, A. I.; Jorand, C.

2011-12-01

Terminology on fracture and discontinuities in geological objects mainly relies on distinguishing between tabular and sharp forms of deformation localization/failure structures (Aydin et al, JSG 2006; Shultz and Fossen, AAPG, 2009). On this basis joints (considered as mode I fractures) and dilation bands (very rarely observed) are distinguished among extension discontinuities. The former propagate with the separation of the fracture walls due to strong stress concentration at the fracture tips. The plumose features or hackles typical of joints (these terms cover a wide variety of diverging fractographic features) are believed to result from the fracture front breakdown due to the loading mode change (the origin of this change remains unclear). This view is called into question by recent experimental results of extension tests conducted on a synthetic physical rock analogue (granular, frictional, cohesive and dilatant) material (GRAM1) and by field observations of embryonic (not yet open) joints in highly jointed dolomicrite Chemenda et al., JGR, 2011). The initial porosity and grain size of both materials are very different, but at SEM scale, both experimental and natural unopened discontinuities reveal a comparable dilatancy (dilation) band structure with a porosity increase over a width of several grains. This suggests that the distinction between tabular and sharp is a matter of observation scale. Both axisymetric and poly-axial extension tests show that dilatancy bands form at elevated mean stress and have plumose morphology. Mode I cracking occurs only at very low mean stres and the forming fractures do not bear plumose features. Thus the absence of plumose structures can be considered as the signature of mode I fracturing. Consequently, we propose that non- plumose bearing natural joints (provided their fractography is not eroded) could originate as mode I fractures and call them "mode I joints". We call the joints formed as closed dilatancy bands propagating

[Surgery of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws].

PubMed

Zhang, P; Dong, Q R; Wang, Z Y; Chen, B; Wan, J H; Wang, L

2016-11-08

Objective: To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results. Method: From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31.5 years.The fractures occurred on the right side in 9 patients and on the left side in 4 patients.Three cases had the complication of medial malleolar fracture.Ten cases had the complication of medial and lateral malleolar fracture. Totally 11 cases were made calcaneal skeletal traction, and all the were made CT with three-dimensional image reconstruction.Two cases were treated with emergency operation.Eleven cases were treated with selective operation.The operation time was 5 hours-10 days after injury. The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS). Result: The average duration of follow-up was 22.6 months (range, 14-65 months). There was skin necrosis in one cases, no incision infection, malunion and nonunion of the fractures and loss of reduction. At final follow-up, AOFAS ankle score was 75.2 (range, 42 to 93), higher than preoperative 39.2 (range, 23 to 60), the difference was statistically significant ( P =0.023). The result was excellent in 4 cases, good in 5 cases, fair in 3 cases and 1 cases in poor, and the overall excellent or good rate was 69.2%. Avascular necrosis occurred in 3 cases (23.1%, 3/13). Traumatic arthritis was found in 5 cases (38.5%, 5/13), involved tibial astragaloid joint in 2 cases, involved subtalar joint in 1 case, involved tibial astragaloid joint and subtalar joint in 2 cases. Conclusion: The effect of surgical treatment for ipsilateral

The Joint Strength and Fracture Mechanisms of TC4/TC4 and TA0/TA0 Brazed with Ti-25Cu-15Ni Braze Alloy

NASA Astrophysics Data System (ADS)

Zou, Zhihuan; Zeng, Fanhao; Wu, Haobo; Liu, Jian; Li, Yi; Gu, Yi; Yuan, Tiechui; Zhang, Fuqin

2017-05-01

In this paper, Ti-25Cu-15Ni (mass ratio) braze alloys were prepared by vacuum arc melting. Additionally, the TA0 pure titanium and TC4 titanium alloy were brazed with the Ti-25Cu-15Ni braze alloy at 960, 980, 1000, 1020, and 1040 °C. The effects of the braze temperature on the tensile strength of the TA0 and TC4 joints and their fracture mechanisms were studied. The maximum tensile strength of the TA0 joints of 219.9 ± 0.1 MPa was achieved at a brazing temperature of 980 °C, and the maximum tensile strength of the TC4 joints of 832.9 ± 0.1 MPa was achieved at the same brazing temperature. These results indicate that their ideal joint strength is comparable. According to the fractography results of the TA0 joints, a mixed fracture morphology is indicated. The TA0 fracture surface is dominated by cleavage fracture with a small contribution from ductile fracture. The TC4 joint fracture arises from cleavage.

Vision-based real-time position control of a semi-automated system for robot-assisted joint fracture surgery.

PubMed

Dagnino, Giulio; Georgilas, Ioannis; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

2016-03-01

Joint fracture surgery quality can be improved by robotic system with high-accuracy and high-repeatability fracture fragment manipulation. A new real-time vision-based system for fragment manipulation during robot-assisted fracture surgery was developed and tested. The control strategy was accomplished by merging fast open-loop control with vision-based control. This two-phase process is designed to eliminate the open-loop positioning errors by closing the control loop using visual feedback provided by an optical tracking system. Evaluation of the control system accuracy was performed using robot positioning trials, and fracture reduction accuracy was tested in trials on ex vivo porcine model. The system resulted in high fracture reduction reliability with a reduction accuracy of 0.09 mm (translations) and of [Formula: see text] (rotations), maximum observed errors in the order of 0.12 mm (translations) and of [Formula: see text] (rotations), and a reduction repeatability of 0.02 mm and [Formula: see text]. The proposed vision-based system was shown to be effective and suitable for real joint fracture surgical procedures, contributing a potential improvement of their quality.

Temporomandibular joint dysfunction after mandibular fracture in children: a 10-year review.

PubMed

Leuin, Shelby C; Frydendall, Emily; Gao, Dexiang; Chan, Kenny H

2011-01-01

To collect demographic and clinical data on pediatric mandibular fractures and to assess temporomandibular joint (TMJ) dysfunction in patients with condylar and subcondylar (C/SC) fractures. Retrospective case series of pediatric mandibular fractures (1999-2009) with follow-up telephone questionnaire of patients with C/SC fractures. Collected data included age, gender, unilateral vs bilateral C/SC fracture, presence of concomitant fracture, velocity of injury, and treatment modality. Tertiary care children's hospital. Of 164 patients with mandibular fractures, 83 (50.6%) had C/SC fractures, of which 45 (54.2%) completed the questionnaire. Helkimo Anamnestic Dysfunction Index (A(i)) quantification of TMJ dysfunction after C/SC fracture and treatment modality of C/SC fractures. Of the 164 patients, 122 (74.4%) were male (median age, 10.4 years; age range, 0.6-19.0 years). Of the 83 patients with C/SC fractures, 61 (73.5%) were male (median age, 9.1 years; age range, 1.1-18.7 years); 66 (79.5%) had unilateral fractures and 17 (20.5%) had bilateral fractures. The A(i) distribution of the 45 patients who completed the questionnaire was as follows: 15 (33.3%) none, 6 (13.3%) mild, and 24 (53.3%) severe. Females have more severe dysfunction than do males (95% confidence interval, 1.6-140.0; P = .02). No other significant predictors of treatment modality or TMJ dysfunction were identified. Patients with bilateral fracture are 8.1 times (95% confidence interval, 1.0-66.1 times; P = .05) more likely to have closed reduction than are those with unilateral fracture. This is one of the largest series of pediatric C/SC fractures reported in the recent literature. Findings are significant for increased severity of TMJ dysfunction in females and higher incidence of closed reduction in patients with bilateral C/SC fracture.

Ceramic-on-ceramic bearing fractures in total hip arthroplasty: an analysis of data from the National Joint Registry.

PubMed

Howard, D P; Wall, P D H; Fernandez, M A; Parsons, H; Howard, P W

2017-08-01

Ceramic-on-ceramic (CoC) bearings in total hip arthroplasty (THA) are commonly used, but concerns exist regarding ceramic fracture. This study aims to report the risk of revision for fracture of modern CoC bearings and identify factors that might influence this risk, using data from the National Joint Registry (NJR) for England, Wales, Northern Ireland and the Isle of Man. We analysed data on 223 362 bearings from 111 681 primary CoC THAs and 182 linked revisions for bearing fracture recorded in the NJR. We used implant codes to identify ceramic bearing composition and generated Kaplan-Meier estimates for implant survivorship. Logistic regression analyses were performed for implant size and patient specific variables to determine any associated risks for revision. A total of 222 852 bearings (99.8%) were CeramTec Biolox products. Revisions for fracture were linked to seven of 79 442 (0.009%) Biolox Delta heads, 38 of 31 982 (0.119%) Biolox Forte heads, 101 of 80 170 (0.126%) Biolox Delta liners and 35 of 31 258 (0.112%) Biolox Forte liners. Regression analysis of implant size revealed smaller heads had significantly higher odds of fracture (chi-squared 68.0, p < 0.001). The highest fracture risk was observed in the 28 mm Biolox Forte subgroup (0.382%). There were no fractures in the 40 mm head group for either ceramic type. Liner thickness was not predictive of fracture (p = 0.67). Body mass index (BMI) was independently associated with revision for both head fractures (odds ratio (OR) 1.09 per unit increase, p = 0.031) and liner fractures (OR 1.06 per unit increase, p = 0.006). We report the largest independent study of CoC bearing fractures to date. The risk of revision for CoC bearing fracture is very low but previous studies have underestimated this risk. There is good evidence that the latest generation of ceramic has greatly reduced the odds of head fracture but not of liner fracture. Small head size and high patient BMI are associated with an increased

Spinopelvic Fixation of Sacroiliac Joint Fractures and Fracture-Dislocations: A Clinical 8 Years Follow-Up Study.

PubMed

Sobhan, Mohammad R; Abrisham, Seyed Mohammad J; Vakili, Mahmood; Shirdel, Saeed

2016-10-01

Pelvic ring injuries and sacroiliac dislocations have significant impacts on patient's quality of life. Several techniques have been described for posterior pelvic fixation. The current study has been designed to evaluate the spinopelvic method of fixation for sacroiliac fractures and fracture-dislocations. Between January 2006 and December 2014, 14 patients with sacroiliac joint fractures, dislocation and fracture-dislocation were treated by Spinopelvic fixation at Shahid Sadoughi Training Hospital, Yazd, Iran. Patients were seen in follow up, on average, out to 32 months after surgery. Computed tomographic (CT) scans of patients with sacral fractures were reviewed to determine the presence of injuries. A functional assessment of the patients was performed using Majeed's score. Patient demographics, reduction quality, loss of fixation, outcomes and complications, return to activity, and screw hardware characteristics are described. The injury was unilateral in 11 (78.5%) patients and bilateral in 3 (21.5%). Associated injuries were present in all patients, including fractures, dislocation and abdominal injuries. Lower limb length discrepancy was less than 10 mm in all patients except two. Displacement, as a measure of quality of reduction was less than 5 mm in 13 patients. The mean Majeed score was 78/100. Wound infection and hardware failure were observed in 3 (21.4%) and 1 (7.1%) cases, respectively. In this study most patients (85%) return to work postoperatively. According to the findings, spinopelvic fixation is a safe and effective technique for treatment of sacroiliac injuries. This method can obtain early partial to full weight bearing and possibly reduce the complications.

The effect of variable size posterior wall acetabular fractures on contact characteristics of the hip joint.

PubMed

Olson, S A; Bay, B K; Pollak, A N; Sharkey, N A; Lee, T

1996-01-01

The indications for open reduction and internal fixation of posterior wall acetabular fractures associated with a clinically stable hip joint are unclear. In previous work a large posterior wall defect (27% articular surface area) resulted in significant alteration of load transmission across the hip; specifically, there was a transition from evenly distributed loading along the acetabular articular surface to loading concentrated mainly in the superior portion of the articular surface during simulated single leg stance. However, the majority of posterior wall fractures involve a smaller amount of the articular surface. Posterior wall acetabular fractures not associated with instability of the hip are commonly treated nonoperatively. This practice does not account for the size of the posterior wall fracture. To study the biomechanical consequences of variably sized articular defects, a laboratory experiment was conducted evaluating three progressively larger posterior wall defects of the acetabulum during simulated single leg stance using superlow Fuji prescale film (Itochu International, New York): (a) 1/3 articular surface width through a 50 degrees arc along the posterior wall of the acetabulum, (b) 2/3, and (c) 3/3 articular width defects through the same 50 degrees arc along the posterior wall of the acetabulum. In the intact acetabulum, 48% of the total articular contact was located in the superior acetabulum. Twenty-eight percent of articular contact was in the anterior wall region of the acetabulum and 24% in the posterior wall region. After the 1/3 width posterior wall defect, 64% of the articular contact was located in the superior acetabulum (p = 0.0011). The 2/3 width posterior wall defect resulted in 71% of articular contact area being located in the superior acetabulum (p = 0.0006). After the 3/3 width posterior wall defect, 77% of articular contact was located in the superior acetabulum, significantly greater than the intact condition (p < 0

[Posttraumatic deformities of the knee joint : Intra-articular osteotomy after malreduction of tibial head fractures].

PubMed

Frosch, K-H; Krause, M; Frings, J; Drenck, T; Akoto, R; Müller, G; Madert, J

2016-10-01

Malreduction of tibial head fractures often leads to malalignment of the lower extremity, pain, limited range of motion and instability. The extent of the complaints and the degree of deformity requires an exact analysis and a standardized approach. True ligamentous instability should be distinguished from pseudoinstability of the joint. Also extra- and intra-articular deformities have to be differentiated. In intra-articular deformities the extent of articular surface displacement, defects and clefts must be accurately evaluated. A specific surgical approach is necessary, which allows adequate visualization, correct osteotomy and refixation of the fractured area of the tibial head. In the long-term course good clinical results are described for intra-articular osteotomies. If the joint is damaged to such an extent that it cannot be reconstructed or in cases of advanced posttraumatic osteoarthritis, total knee arthroplasty may be necessary; however, whenever possible and reasonable, anatomical reconstruction and preservation of the joint should be attempted.

The surface geometry of inherited joint and fracture trace patterns resulting from active and passive deformation

NASA Technical Reports Server (NTRS)

Podwysocki, M. H.; Gold, D. P.

1974-01-01

Hypothetical models are considered for detecting subsurface structure from the fracture or joint pattern, which may be influenced by the structure and propagated to the surface. Various patterns of an initially orthogonal fracture grid are modeled according to active and passive deformation mechanisms. In the active periclinal structure with a vertical axis, fracture frequency increased both over the dome and basin, and remained constant with decreasing depth to the structure. For passive periclinal features such as a reef or sand body, fracture frequency is determined by the arc of curvature and showed a reduction over the reefmound and increased over the basin.

[Clinical observation on the effect of joint mobilization in treating elderly patients after distal radius fractures operation].

PubMed

Jia, Xue-Feng; Cai, Hong-Xin; Lin, Ge-Sheng; Fang, Ji-Shi; Wang, Yong; Wu, Zhi-Yong; Tu, Xu-Hui

2017-07-25

To investigate the effect of joint mobilization on postoperative wrist joint function, pain and grip strength for elderly patients with distal radius fracture. From January 2015 to June 2016, a total of 67 elderly patients with distal radius fracture were randomly divided into routine exercise group and joint mobilization group. Among them, 37 patients in the routine exercise group underwent conventional distal radius fracture postoperative joint function exercise regimen, including 16 males and 21 females with a mean age of (67.8±3.2) years old ranging from 60 to 72 years old;the injured side was dominant in 23 cases and non-dominant in 14 cases;injury mechanism was fall in 26 cases, traffic accident in 11 cases; for AO type, 6 cases were type B3, 18 cases were type C1, 7 cases were type C2, 6 cases was type C3. Other 30 patients in the joint mobilization group underwent joint mobilization on the basis of the routine exercise group including 14 males and 16 females with a mean age of (67.1±4.0) years old ranging from 61 to 74 years old; the injured side was dominant in 21 cases and non-dominant in 9 cases;injury mechanism was fall in 25 cases, traffic accident in 5 cases;for AO type, 8 cases were type B3, 13 cases were type C1, 6 cases were type C2, 9 cases were type C3. The wrist joint activity, Gartland-Werley wrist joint function score, VAS pain score and grip strength were observed at 3 months afrer treatment. After 3 months' treatment, the VAS in the routine exercise group was higher than that of the joint mobilization group ( P <0.05). The grip strength of affected side in both groups were lower than that of contralateral side, but the average grip strength of affected side in joint mobilization group was higher than that in routine exercise group( P <0.05). In routine exercise group, the average angle of flexion, extension, radial deviation were significantly higher than those of joint mobilization group( P <0.05). But ulnar deviation angle in routine

Joint Distraction Treatments of Intra-Articular Fracture-Induced Posttraumatic Osteoarthritis in a Large Animal Model

DTIC Science & Technology

2017-10-01

that was developed this Year for use in the upcoming Aim 2 studies. 15. SUBJECT TERMS External Fixator, Fracture Fixation Delay, Yucatan Minipig 16... Yucatan minipig model of PTOA after IAF that was developed during our previous work (W81XWH-10-1-0864) to investigate the use of joint distraction to...proactive treatment for PTOA. 2. KEYWORDS Post-traumatic Osteoarthritis Intra-articular Fracture Yucatan Miniature Pig Impact Ankle Cartilage

Angular stable plates in proximal meta-epiphyseal tibial fractures: study of joint restoration and clinical and functional evaluation.

PubMed

Giannotti, S; Giovannelli, D; Dell'Osso, G; Bottai, V; Bugelli, G; Celli, F; Citarelli, C; Guido, G

2016-04-01

The tibial plateau fractures involve one of the main weight bearing joints of the human body. The goals of surgical treatment are anatomical reduction, articular surface reconstruction and high primary stability. The aim of this study was to evaluate the clinical and functional outcomes after internal plate fixation of this kind of fractures. From January 2009 to December 2012, we treated 75 cases of tibial plateau fracture with angular stable plates. We used Rasmussen Score and the Knee Society Score for the clinical and functional evaluation. Twenty-five cases that underwent hardware removal had arthroscopic and CT evaluation of the joint. No complications occurred. The clinical and functional evaluation, performed by the KSS and Rasmussen Score, highlighted the high percentage of good-to-excellent results (over 90 %). In every case, the range of motion was good with flexion >90°. Arthroscopy showed the presence of chondral damage in 100 % of patients. In all the cases, we found that X-ray images seem better than the CT images. Angular stable plates allow to obtain a good primary stability, permitting an early joint recovery with an excellent range of motion. Avoiding to perform a knee arthrotomy at the time of fracture reduction could prove to be an advantage in terms of functional recovery. The meniscus on the injured bone should be preserved in order to maintain good function of the joint. X-ray images remain the gold standard in checking the progression of post-traumatic osteoarthritis.

Survivorship of the native hip joint after percutaneous repair of acetabular fractures in the elderly.

PubMed

Gary, Joshua L; Lefaivre, Kelly A; Gerold, Frank; Hay, Michael T; Reinert, Charles M; Starr, Adam J

2011-10-01

Our purpose was to examine survivorship of the native hip joint in patients ages 60 and over who underwent percutaneous reduction and fixation of acetabular fractures. A retrospective review at a University Level I Trauma Center was performed. Our institutional trauma database was reviewed. Patients aged 60 or older treated with percutaneous reduction and fixation of acetabular fractures between 1994 and 2007 were selected. 79 consecutive patients with 80 fractures were identified. Rate of conversion to total hip arthroplasty were used to construct a Kaplan-Meier curve showing survivorship of the native hip joint after treatment. 75 fractures had adequate clinical follow-up with a mean of 3.9 years (range 0.5-11.9 years). Average blood loss was 69 cc and there were no postoperative infections. 19/75 (25%) were converted to total hip arthroplasty at a mean time of 1.4 years after the index procedure. Survivorship analysis demonstrated a cumulative survival of 65% at 11.9 years of follow-up. There were no conversions to arthroplasty beyond 4.7 years postoperatively. There were no statistically significant associations between conversion to arthroplasty and age, sex, closed vs. limited open reduction, and simple vs. complex fracture pattern. Percutaneous fixation is a viable treatment option for patients age 60 or greater with acetabular fractures. Rates of conversion to total hip arthroplasty are comparable to open treatment methods and if conversion is required, soft tissues are preserved for future surgery. Copyright © 2010 Elsevier Ltd. All rights reserved.

[Treatment of ulnar collateral ligament avulsion fracture of thumb metacarpophalangeal joint using a combination of Kirschner wire and silk tension band].

PubMed

Gao, Shunhong; Feng, Shiming; Jiao, Cheng

2012-12-01

To investigate the effectiveness of Kirschner wire combined with silk tension band in the treatment of ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint. Between September 2008 and October 2011, 14 patients with ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint were treated using a combination of Kirschner wire and silk tension band. There were 8 males and 6 females, aged 23-55 years (mean, 40.8 years). The causes of injury were machinery twist injury in 5 cases, manual twist injury in 4 cases, falling in 4 cases, sports injury in 1 case. The time from injury to operation was 2 hours-14 days. All the patients presented pain over the ulnar aspect of the metacarpophalangeal joint of the thumb, limitation of motion, and joint instability with pinch and grip. The lateral stress testing of the metacarpophalangeal joint was positive. Function training was given at 2 weeks after operation. All incisions healed by first intention. The lateral stress testing of the metacarpophalangeal joint was negative. All the patients were followed up 6-18 months (mean, 13.1 months). The X-ray films showed good fracture reduction and healing with an average time of 7 weeks (range, 4-10 weeks). At last follow-up, the thumbs had stable flexion and extension of the metacarpophalangeal joint, normal opposition function and grip and pinch strengths. According to Saetta et al. criteria for functional assessment, the results were excellent in 11 cases and good in 3 cases; the excellent and good rate was 100%. It is an easy and simple method to treat ulnar collateral ligament avulsion fracture of the thumb metacarpophalangeal joint using Kirschner wire combined with silk tension band, which can meet the good finger function.

Use of a Multivector Mandibular Distractor for Treatment of Pediatric Proximal Interphalangeal Joint Pilon Fractures: A Case-Based Review.

PubMed

Pedreira, Rachel; Cho, Brian H; Geer, Angela; DeJesus, Ramon A

2018-04-01

The difficulties in surgical treatment of pilon fractures of the finger include fragment reconstitution and posthealing stiffness. In adults, external fixation with traction and early active range of motion (AROM)/passive range of motion (PROM) during healing is considered necessary for avoiding joint stiffness and attaining realignment. The authors present a unique approach to pediatric pilon fractures that uses open reduction and multivector external fixation with delayed AROM/PROM. Initial immobilization and significant traction allowed for joint realignment and prevented noncompliance with staged distraction. The authors believe this immobilization leads to a superior outcome because, unlike adults, children tend to avoid stiffness and a larger distraction force allowed for sufficient joint realignment to regain range of motion (ROM). A right-handed 13-year-old boy sustained a right ring finger fracture and presented 12 days later. Radiographs revealed a comminuted Salter-Harris 4 fracture of the middle phalanx. The patient underwent open reduction and placement of multivector external fixation using a pediatric mandibular distractor/fixator. Significant traction was applied to distract the finger to length. Hardware was removed 6 weeks postoperatively and AROM was initiated after splinting. The patient started PROM 8 weeks postoperatively. Strengthening was initiated 2 weeks later. ROM improved and rehabilitation was continued. The patient exhibited nearly equal grip strength 12 weeks postoperatively. At 14 months follow-up, radiographs showed complete healing and joint realignment. There was no deformity or pain and finger length was restored. Management of pediatric pilon fractures is rarely described and presents unique considerations. Early-stage traction and immobilization using a multivector mandibular fixator/distractor is suitable in a child because noncompliance is avoided and there is a decreased risk for stiffness. Combining early immobilization

Facet joint injections as a means of reducing the need for vertebroplasty in insufficiency fractures of the spine.

PubMed

Wilson, David J; Owen, Sara; Corkill, Rufus A

2011-08-01

Recent publications compared treatment of vertebral fractures reporting improvement in the majority but with no significant difference between the local anaesthetic and vertebroplasty groups. Potential explanations include placebo response or therapeutic response to the "control procedure". We investigated whether preliminary facet joint injection can identify those patients whose pain arises from paravertebral structures rather than the vertebral insufficiency fracture itself. Patients referred for treatment by vertebroplasty were first offered local anaesthetic and steroid facet joint injection (FJI) at the most painful level. Those who failed to respond were offered a vertebroplasty. Ninety one patients referred, 16 went straight to vertebroplasty. Sixty one of 75 were initially offered FJI. Twenty one were successful; two relapsed, had further FJIs with good results; three declined treatment; 5 had temporary benefit; 1 died from unrelated causes. Of 29 who failed to respond to FJIs, 24 underwent vertebroplasty and 23 had a successful outcome. A third of patients technically suitable for vertebroplasty responded beneficially to FJI. In this group the pain mediator maybe one of instability and overload on the facet joints produced by adjacent wedge fracture. This protocol allows more selective and more successful vertebroplasty.

Does metaphyseal cement augmentation in fracture management influence the adjacent subchondral bone and joint cartilage?: an in vivo study in sheep stifle joints.

PubMed

Goetzen, Michael; Hofmann-Fliri, Ladina; Arens, Daniel; Zeiter, Stephan; Stadelmann, Vincent; Nehrbass, Dirk; Richards, R Geoff; Blauth, Michael

2015-01-01

Augmentation of implants with polymethylmethacrylate (PMMA) bone cement in osteoporotic fractures is a promising approach to increase implant purchase. Side effects of PMMA for the metaphyseal bone, particularly for the adjacent subchondral bone plate and joint cartilage, have not yet been studied. The following experimental study investigates whether subchondral PMMA injection compromises the homeostasis of the subchondral bone and/or the joint cartilage.Ten mature sheep were used to simulate subchondral PMMA injection. Follow-ups of 2 (4 animals) and 4 (6 animals) months were chosen to investigate possible cartilage damage and subchondral plate alterations in the knee. Evaluation was completed by means of high-resolution peripheral quantitative computed tomography (HRpQCT) imaging, histopathological osteoarthritis scoring, and determination of glycosaminoglycan content in the joint cartilage. Results were compared with the untreated contralateral knee and statistically analyzed using nonparametric tests.Evaluation of the histological osteoarthritis score revealed no obvious cartilage damage for the treated knee; median histological score after 2 months 0 (range 4), after 4 months 1 (range 5). There was no significant difference when compared with the untreated control site after 2 and 4 months (P = 0.23 and 0.76, respectively). HRpQCT imaging showed no damage to the metaphyseal trabeculae. Glycosaminoglycan measurements of the treated joint cartilage after 4 months revealed no significant difference compared with the untreated cartilage (P = 0.24).The findings of this study support initial clinical observation that PMMA implant augmentation of metaphyseal fractures appears to be a safe procedure for fixation without harming the subchondral bone plate and adjacent joint cartilage.

Inverse Dynamics Model for the Ankle Joint with Applications in Tibia Malleolus Fracture

NASA Astrophysics Data System (ADS)

Budescu, E.; Merticaru, E.; Chirazi, M.

The paper presents a biomechanical model of the ankle joint, in order to determine the force and the torque of reaction into the articulation, through inverse dynamic analysis, in various stages of the gait. Thus, knowing the acceleration of the foot and the reaction force between foot and ground during the gait, determined by experimental measurement, there was calculated, for five different positions of the foot, the joint reaction forces, on the basis of dynamic balance equations. The values numerically determined were compared with the admissible forces appearing in the technical systems of osteosynthesis of tibia malleolus fracture, in order to emphasize the motion restrictions during bone healing.

Cervical hip fractures do not occur in arthrotic joints. A clinicoradiographic study of 256 patients.

PubMed

Dretakis, E K; Steriopoulos, K A; Kontakis, G M; Giaourakis, G; Economakis, G; Dretakis, K E

1998-08-01

We studied endogenic factors for the occurrence of cervical hip fractures in 256 patients. 230 underwent hemiarthroplasty, and 26 were treated with internal fixation or without surgery. The condition of the fractured hip and of the ipsilateral knee, as well as the mobility of the patient before the fracture, were studied in all 256 patients. The removed femoral heads were examined, photographed and radiographs were taken with sensitive film. The acetabulum and the femoral head were macroscopically normal in all 230 cases and there was no radiographic evidence of arthrosis. 64% of the patients were fully mobile before the fracture, 34% were mobile with the aid of a cane and 2% were dependent. In 88%, the ipsilateral knee was normal both clinically and radiographically, and in 12%, there was moderate arthrosis. When comparing the mobility before the fracture and the condition of the ipsilateral hip and knee in 100 patients having a cervical fracture with 100 patients having a trochanteric fracture matched for age and sex, we found that a normal hip joint was sine qua non while a normal ipsilateral knee and a fully mobile individual were important additional conditions for the occurrence of a cervical hip fracture, instead of a trochanteric one, after a fall in an elderly person.

An unusual variety of simultaneous fracture dislocation pattern: medial swivel dislocation of talonavicular joint with displaced fractures of the fourth and fifth metatarsals.

PubMed

Inal, Sermet; Inal, Canan

2013-01-01

In published studies, a very rare, special type of Chopart dislocation termed a swivel dislocation has been reported. This injury is characterized by dislocation of the talonavicular joint, but the calcaneocuboid joint remains intact. The foot creates a typical rotational movement without inversion or eversion. The axis of rotation is the interosseous talocalcaneal ligament, which remains intact. We report the case of an 18-year-old male who had experienced a medial swivel dislocation of the talonavicular joint associated with displaced fractures of the fourth and fifth metatarsals. The occurrence, features, and method of treatment of this rare injury are presented. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[Case-control study on bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle joint].

PubMed

Qi, Yue-Feng; Chen, Fa-Lin; Bao, Shu-Ren; Li, Cheng-Huan; Zhao, Xing-Wei; Liu, Shi-Ming; Chen, Wen-Xue; Li, Ye; Wang, Peng

2012-08-01

To explore therapeutic effects of bone setting manipulation for the treatment of over degree II supination-eversion fractures of ankle,and analyze manipulative reduction mechanism. From 2005 to 2008, 95 patients with over degree II supination-eversion fractures of ankle were treated respectively by manipulation and operation. There were 43 cases [11 males and 32 females with an average age of (44.95 +/- 12.65) years] in manipulation group, and 2 cases were degree II, 11 cases were degree III, and 30 cases were degree IV. There were 52 cases [21 males and 31 females with an average age of (39.96 +/- 13.28) years] in operative group,and 6 cases were degree II, 18 cases were degree III, and 28 cases were degree IV. Bone setting manipulation and hard splint external fixation were applied to manipulative group. Operative reduction internal fixation was performed in operative group. X-ray was used to evaluate reduction of fracture before and after treatment, 2 months after treatment. Ankle joint function was evaluated according to Olerud-Molander scoring system after 6 months treatment. All patients were followed up with good reduction. Three cases occurred wound complication in operative group, but not in manipulative group. In manipulation group, 19 cases got excellent results, 20 cases good and 4 cases fair; while in operative group, 30 cases got excellent results, 20 cases good and 2 cases poor. There were no significant differences in fracture reduction and ankle joint function recovery between two groups (P > 0.05). Efficacy of operative treatment was better than that of manipulative treatment at degree IV fracture (P < 0.05). Bone setting manipulation is a good method for treating supination-eversion ankle joint fractures, which has advantages of simple and safe operation, reliable efficacy. For ankle join fracture at degree IV, manipulative reduction should be adopted earlier, and operative treatment also necessary

Preliminary results on the fracture analysis of multi-site cracking of lap joints in aircraft skins

NASA Astrophysics Data System (ADS)

Beuth, J. L., Jr.; Hutchinson, John W.

1992-07-01

Results of a fracture mechanics analysis relevant to fatigue crack growth at rivets in lap joints of aircraft skins are presented. Multi-site damage (MSD) is receiving increased attention within the context of problems of aging aircraft. Fracture analyses previously carried out include small-scale modeling of rivet/skin interactions, larger-scale two-dimensional models of lap joints similar to that developed here, and full scale three-dimensional models of large portions of the aircraft fuselage. Fatigue testing efforts have included flat coupon specimens, two-dimensional lap joint tests, and full scale tests on specimens designed to closely duplicate aircraft sections. Most of this work is documented in the proceedings of previous symposia on the aging aircraft problem. The effect MSD has on the ability of skin stiffeners to arrest the growth of long skin cracks is a particularly important topic that remains to be addressed. One of the most striking features of MSD observed in joints of some test sections and in the joints of some of the older aircraft fuselages is the relative uniformity of the fatigue cracks from rivet to rivet along an extended row of rivets. This regularity suggests that nucleation of the cracks must not be overly difficult. Moreover, it indicates that there is some mechanism which keeps longer cracks from running away from shorter ones, or, equivalently, a mechanism for shorter cracks to catch-up with longer cracks. This basic mechanism has not been identified, and one of the objectives of the work is to see to what extent the mechanism is revealed by a fracture analysis of the MSD cracks. Another related aim is to present accurate stress intensity factor variations with crack length which can be used to estimate fatigue crack growth lifetimes once cracks have been initiated. Results are presented which illustrate the influence of load shedding from rivets with long cracks to neighboring rivets with shorter cracks. Results are also included

Preliminary results on the fracture analysis of multi-site cracking of lap joints in aircraft skins

NASA Technical Reports Server (NTRS)

Beuth, J. L., Jr.; Hutchinson, John W.

1992-01-01

Results of a fracture mechanics analysis relevant to fatigue crack growth at rivets in lap joints of aircraft skins are presented. Multi-site damage (MSD) is receiving increased attention within the context of problems of aging aircraft. Fracture analyses previously carried out include small-scale modeling of rivet/skin interactions, larger-scale two-dimensional models of lap joints similar to that developed here, and full scale three-dimensional models of large portions of the aircraft fuselage. Fatigue testing efforts have included flat coupon specimens, two-dimensional lap joint tests, and full scale tests on specimens designed to closely duplicate aircraft sections. Most of this work is documented in the proceedings of previous symposia on the aging aircraft problem. The effect MSD has on the ability of skin stiffeners to arrest the growth of long skin cracks is a particularly important topic that remains to be addressed. One of the most striking features of MSD observed in joints of some test sections and in the joints of some of the older aircraft fuselages is the relative uniformity of the fatigue cracks from rivet to rivet along an extended row of rivets. This regularity suggests that nucleation of the cracks must not be overly difficult. Moreover, it indicates that there is some mechanism which keeps longer cracks from running away from shorter ones, or, equivalently, a mechanism for shorter cracks to catch-up with longer cracks. This basic mechanism has not been identified, and one of the objectives of the work is to see to what extent the mechanism is revealed by a fracture analysis of the MSD cracks. Another related aim is to present accurate stress intensity factor variations with crack length which can be used to estimate fatigue crack growth lifetimes once cracks have been initiated. Results are presented which illustrate the influence of load shedding from rivets with long cracks to neighboring rivets with shorter cracks. Results are also included

Clinical therapeutic effects of AO/ASIF clavicle hook plate on distal clavicle fractures and acromioclavicular joint dislocations.

PubMed

Dou, Qingjun; Ren, Xiaofeng

2014-07-01

The aim of this study was to evaluate the security and effectiveness of AO/ASIF clavicle hook plate in the treatment of distal clavicle fractures and acromioclavicular joint dislocations. One hundred patients with distal clavicle fractures and acromioclavicular joint dislocations who were admitted in our hospital from January 2012 to January 2013 were selected as the study subjects. They were then randomly divided into a control group and an observation group (n=50). The observation group was treated with AO/ASIF clavicle hook plates, and the control group was treated with Kirschner-wire tension bands. The outcomes were recorded and compared. The JOA scores of the two groups were similar before surgery (P>0.05). The two groups both had obviously increased JOA scores in the postoperative 6th and 12th weeks, and the score in the postoperative 12th week was higher. There were statistically significant intra-group differences (P<0.05). The postoperative 6th-week and 12th-week JOA scores of the observation group were (83.2±1.8) and (97.4±1.5) respectively, and those of the control group were (71.6±2.2) and (82.3±2.6) respectively, with statistically significant inter-group differences (P<0.05). Significantly more patients in the observation group (100%) were evaluated as excellent or good outcomes after fixation than those in the control group (60%). After removal of the surgical apparatus, the recurrence rates of bone fracture and joint dislocation in the observation group were significantly lower than those of the control group (P<0.05). AO/ASIF clavicle hook plate functioned more effectively than Kirschner-wire tension band in clinical treatment of distal clavicle fractures and acromioclavicular joint dislocations. The former protocol enjoyed small incisions, firm fixation and early shoulder mobility. Therefore, it is a safe and effective surgical method that is worthy of being widely applied in clinical practice.

Cretaceous joints in southeastern Canada: dating calcite-filled fractures

NASA Astrophysics Data System (ADS)

Schneider, David; Spalding, Jennifer; Gautheron, Cécile; Sarda, Philippe; Davis, Donald; Petts, Duane

2017-04-01

To resolve the timing of brittle tectonism is a challenge since the classical chronometers required for analyses are not often in equilibrium with the surrounding material or simply absent. In this study, we propose to couple LA-ICP-MS U-Pb and (U-Th)/He dating with geochemical proxies in vein calcite to tackle this dilemma. We examined intracratonic Middle Ordovician limestone bedrock that overlies Mesoproterozoic crystalline basement, which are cut by NE-trending fault zones that have historic M4-5 earthquakes along their trace. E-W to NE-SW vertical joint sets, the relatively youngest stress recorded in the bedrock, possess 1-7 mm thick calcite veins that seal fractures or coat fracture surfaces. The veins possess intragranular calcite that are lined with fine-grained calcite along the vein margin and can exhibit µm- to mm-scale offset (e.g. displaced fossil fragments in host rock). Calcite d18O and d13C values are analogous to the bulk composition of Middle to Late Ordovician limestones, and suggest vein formation from a source dominated by connate fluids. The calcite contain trails of fluid inclusions commonly along fractures, and 3He/4He analyses indicate a primitive, deep fluid signature (R/Ra: 0.5-2.7). Trace element geochemistry of the calcite is highly variable, generally following the elevated HREE and lower LREE of continental crust trends but individual crystals from a single vein may vary by three orders of magnitude. LA-ICP-MS geochemical traverse across veins show elevated concentrations along (sub)grain boundaries and the vein-host rock contact. Despite abundant helium concentrations, (U-Th)/He dating was unsuccessful yielding highly dispersed dates likely from excess helium derived from the fluid inclusions. However, LA-ICP-MS U-Pb dating on calcite separated from the veins yielded model ages of 110.7 ± 6.8 Ma (MSWD: 0.53; n: 16) to 81.4 ± 8.3 Ma (MSWD: 2.6; n: 17). Since all veins are from the same ENE-trend, we regressed all the calcite dates

Comminuted Distal Radial Fracture with Large Rotated Palmar Medial Osteochondral Fragment in the Joint.

PubMed

Gökkus, Kemal; Sagtas, Ergin; Kesgin, Engin; Aydin, Ahmet Turan

2018-01-01

Intra-articular distal radius fractures have long been massively discussed in the literature, but regarding to fractures that possess rotated volar medial fragment in the joint a few amount papers has been written. In this article, we would like to emphasize the significance of the rotated palmar medial (lunate facet) fragment. A 39-year-old man fell from a height of about 3 m and landed on his right outstretched hand; within 40 min, he arrived at our clinic presenting with a severe pain and swelling in his right wrist. Initial X-rays of the wrist revealed dorsal subluxation of the radiocarpal joint with dorsal comminution of the radial articular surface and fracture of the radial styloid process, with (nearly inverted) ~ 140-150° rotation of the palmar medial fragment. With an additional volar approach, the fragment reduced and stabilized with two K-wires and wrist immobilized in external fixator. The patient returned to daily activities without any discomfort and pain after the 1 year from the surgery. Overlooking of palmar rotated osteochondral fragment will cause deficiency to build proper pre-operative strategy to approach the reduction of the fragment. The incompetence of reduction will deteriorate the articular surface and lead to early osteoarthritis of the wrist. The surgeon should detect this fragment and should be familiar with volar approaches of the wrist. Above average surgical experience would be needed for successful reduction.

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

PubMed

Beytemür, Ozan; Albay, Cem; Adanır, Oktay; Yüksel, Serdar; Güleç, Mehmet Akif

2016-12-01

This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion. Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient. Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.

[Treatment of metacarpal fractures].

PubMed

Prokop, A; Jubel, A; Helling, H J; Kulus, S; Rehm, K E

2002-09-01

Conservative treatment of metacarpal fractures is recommended if there is no joint displacement, malrotation, displacement of over 30 degrees ad axim and shortening of over 5 mm. Surgery should be performed in open fractures and serial fractures of metacarpal bone. Early functional treatment should be carried out in stable, not displaced fractures. A cast can be used for a short period in full extended position of fingers and flexion in metacarpo-phalangeal joint in 60 - 90 degrees. Twin-tape fixation allows functional treatment after soft-tissue swelling has disappeared. Closed reduction of displaced fractures of the fifth metacarpal bone (boxer's fracture) is not successful. Cases with displacement of over 30 degrees may be treated surgically by intramedullary stabilisation.

[Internal fixation with one-hole microplate for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture].

PubMed

Wang, Xi-Xun; Sun, De-Tao; Chen, Xu-Hui; Li, Jun; Cui, Yan; Hu, Ji-Chao; Shu, Zheng-Hua; He, Jian; Ding, Chao-Qi; Chen, Bo

2015-03-01

To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture. Twenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries (< 2 weeks) and 4 had old injuries (> 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm. The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good. The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

[Classification and Treatment of Sacroiliac Joint Dislocation].

PubMed

Tan, Zhen; Huang, Zhong; Li, Liang; Meng, Wei-Kun; Liu, Lei; Zhang, Hui; Wang, Guang-Lin; Huang, Fu-Guo

2017-09-01

To develop a renewed classification and treatment regimen for sacroiliac joint dislocation. According to the direction of dislocation of sacroiliac joint,combined iliac,sacral fractures,and fracture morphology,sacroiliac joint dislocation was classified into 4 types. Type Ⅰ (sacroiliac anterior dislocation): main fracture fragments of posterior iliac wing dislocated in front of sacroiliac joint. Type Ⅱ (sacroiliac posterior dislocation): main fracture fragments of posterior iliac wing dislocated in posterior of sacroiliac joint. Type Ⅲ (Crescent fracturedislocation of the sacroiliac joint): upward dislocation of posterior iliac wing with oblique fracture through posterior iliac wing. Type ⅢA: a large crescent fragment and dislocation comprises no more than onethird of sacroiliac joint,which is typically inferior. Type ⅢB: intermediatesize crescent fragment and dislocation comprises between one and twothirds of joint. Type ⅢC: a small crescent fragment where dislocation comprises most,but not the entire joint. Different treatment regimens were selected for different types of fractures. Treatment for type Ⅰ sacroiliac joint dislocation: anterior iliac fossa approach pry stripping reset; sacroiliac joint fixed with sacroiliac screw through percutaneous. Treatment for type Ⅱ sacroiliac joint dislocation: posterior sacroiliac joint posterior approach; sacroiliac joint fixed with sacroiliac screw under computer guidance. Treatment for type ⅢA and ⅢB sacroiliac joint dislocation: posterior sacroiliac joint approach; sacroiliac joint fixed with reconstruction plate. Treatment for type ⅢC sacroiliac joint dislocation: sacroiliac joint closed reduction; sacroiliac joint fixed with sacroiliac screw through percutaneous. Treatment for type Ⅳ sacroiliac joint dislocation: posterior approach; sacroiliac joint fixed with spinal pelvic fixation. Results of 24 to 72 months patient follow-up (mean 34.5 months): 100% survival,100% wound healing,and 100

Modified Labial Button Technique for Maintaining Occlusion After Caudal Mandibular Fracture/Temporomandibular Joint Luxation in the Cat.

PubMed

Goodman, Alice E; Carmichael, Daniel T

2016-03-01

Maxillofacial trauma in cats often results in mandibular symphyseal separation in addition to injuries of the caudal mandible and/or temporomandibular joint (TMJ). Caudal mandibular and TMJ injuries are difficult to access and stabilize using direct fixation techniques, thus indirect fixation is commonly employed. The immediate goals of fixation include stabilization for return to normal occlusion and function with the long-term objective of bony union. Indirect fixation techniques commonly used for stabilization of caudal mandibular and temporomandibular joint fracture/luxation include maxillomandibular fixation (MMF) with acrylic composite, interarcade wiring, tape muzzles, and the bignathic encircling and retaining device (BEARD) technique. This article introduces a modification of the previously described "labial reverse suture through buttons" technique used by Koestlin et al and the "labial locking with buttons" technique by Rocha et al. In cases with minimally displaced subcondylar and pericondylar fractures without joint involvement, the labial button technique can provide sufficient stabilization for healing. Advantages of the modified labial button technique include ease of application, noninvasive nature, and use of readily available materials. The construct can remain in place for a variable of amount of time, depending on its intended purpose. It serves as an alternative to the tape muzzle, which is rarely tolerated by cats. This technique can be easily used in conjunction with other maxillomandibular repairs, such as cerclage wire fixation of mandibular symphyseal separation. The purpose of this article is to demonstrate a modified labial button technique for maintaining occlusion of feline caudal mandibular fractures/TMJ luxations in a step-by-step fashion.

Expedited patient-specific assessment of contact stress exposure in the ankle joint following definitive articular fracture reduction.

PubMed

Kern, Andrew M; Anderson, Donald D

2015-09-18

Acute injury severity, altered joint kinematics, and joint incongruity are three important mechanical factors linked to post-traumatic osteoarthritis (PTOA). Finite element analysis (FEA) was previously used to assess the influence of increased contact stress due to joint incongruity on PTOA development. While promising agreement with PTOA development was seen, the inherent complexities of contact FEA limited the numbers of subjects that could be analyzed. Discrete element analysis (DEA) is a simplified methodology for contact stress computation, which idealizes contact surfaces as a bed of independent linear springs. In this study, DEA was explored as an expedited alternative to FEA contact stress exposure computation. DEA was compared to FEA using results from a previously completed validation study of two cadaveric human ankles, as well as a previous study of post-operative contact stress exposure in 11 patients with tibial plafond fracture. DEA-computed maximum contact stresses were within 19% of those experimentally measured, with 90% of the contact area having computed contact stress values within 1MPa of those measured. In the 11 fractured ankles, maximum contact stress and contact area differences between DEA and FEA were 0.85 ± 0.64 MPa and 22.5 ± 11.5mm(2). As a predictive measure for PTOA development, both DEA and FEA had 100% concordance with presence of OA (KL grade ≥ 2) and >95% concordance with KL grade at 2 years. These results support DEA as a reasonable alternative to FEA for computing contact stress exposures following surgical reduction of a tibial plafond fracture. Copyright © 2015 Elsevier Ltd. All rights reserved.

Contact characteristics of the subtalar joint after a simulated calcaneus fracture.

PubMed

Sangeorzan, B J; Ananthakrishnan, D; Tencer, A F

1995-06-01

A simple calcaneus fracture consisting of two parts was modeled in nine fresh cadaver hindfoot specimens to assess changes in subtalar joint contact characteristics with increasing plantar depression of the posterolateral fracture component. To perform the experiment, rods were placed in the tibial and fibular shafts of each specimen, which was mounted in a frame in neutral stance. A pneumatic cylinder was used to deliver a vertical compressive load through the rods into the foot while permitting free motion of the foot in the horizontal plane. Sealed packets of pressure-sensitive film were inserted into the anterior-middle and posterior facets of the talocalcaneal articulation, and a 700-N load was applied. After testing of the intact foot, a primary fracture line was created using a microoscillating saw. The osteotomized posterolateral component was anatomically reduced and fixed, the film inserted, and the load reapplied. The test was repeated after the posterolateral fragment was displaced 2, 5, and 10 mm in a plantar direction. The resulting pressure prints were scanned along with pressure/color density calibration strips using a flat-bed scanner, and an image analysis system was used to determine contact areas within specified pressure intervals. The contact area (> 0.5 MPa) of the posterior facet was significantly decreased with 2, 5, and 10 mm displacements of the posterolateral calcaneus fracture component. The ratio of high-pressure area (< 5.0 MPa) to contact area in the posterior facet was significantly increased only with displacements of 5 and 10 mm. There were no significant changes in any contact parameters in the anterior-middle facet.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of Segregation of Secondary Phase Particles and "S" Line on Tensile Fracture Behavior of Friction Stir-Welded 2024Al-T351 Joints

NASA Astrophysics Data System (ADS)

Zhang, Z.; Xiao, B. L.; Ma, Z. Y.

2013-09-01

A 5-mm-thick 2024Al-T351 plate was friction stir welded (FSWed) at welding speeds of 100, 200, and 400 mm min-1 with a constant rotation rate of 800 rpm, and the microstructure and tensile fracture behavior of the joints were investigated in detail. FSW resulted in the redistribution of secondary phase particles along the recrystallized grain boundaries at the nugget zone (NZ), forming linear segregation bands consisting of secondary phase particles. The segregation bands, mainly present in the shoulder-driven zone, were believed to result from periodic material flow, with the average band spacing on the longitudinal and horizontal cross sections equal to the tool advancement per revolution. At a low welding speed of 100 mm min-1, in spite of the highest density of segregation bands, the FSWed 2024Al-T351 joint fractured along the low hardness zone (LHZ) of the heat-affected zone because of large hardness gap between NZ and LHZ. Increasing the welding speed to 200 and 400 mm min-1 reduced both the hardness gap between NZ and LHZ and the density of segregation bands. In this case, the segregation bands played a role, resulting in unusual fracture of the joints along the segregation bands. The "S" line originated from the oxide film on the initial butting surfaces and did not affect the fracture behavior of the FSWed 2024Al-T351 joints.

[Conservative treatment of metacarpal fracture].

PubMed

Prokop, A; Helling, H J; Kulus, S; Rehm, K E

2002-01-01

Conservative treatment of meatacarpale fracture is recommended if there are no joint displacement, rotation failures, displacement over 30 degrees ad axim and shortening over 5 mm. Operative procedures should be done in open fractures and serial of fractures of metacarpale bones. Early functionally treatment should be done in stable, not displaced fractures. Cast can be used only for a short time in full extended position of fingers and flexion in metacarpo-phalangeal joint in 60-90 degrees. Twin-tapes after reduction of edema allowed free range of motion by fixed rotation. Closed reduction of displaced fractures of fifth metacarpal bone (boxer's fracture) isn't successful. Cases with displacement over 30 degrees may be operatively treated by intramedullary stabilization.

Ductile fracture mechanism of low-temperature In-48Sn alloy joint under high strain rate loading.

PubMed

Kim, Jong-Woong; Jung, Seung-Boo

2012-04-01

The failure behaviors of In-48Sn solder ball joints under various strain rate loadings were investigated with both experimental and finite element modeling study. The bonding force of In-48Sn solder on an Ni plated Cu pad increased with increasing shear speed, mainly due to the high strain-rate sensitivity of the solder alloy. In contrast to the cases of Sn-based Pb-free solder joints, the transition of the fracture mode from a ductile mode to a brittle mode was not observed in this solder joint system due to the soft nature of the In-48Sn alloy. This result is discussed in terms of the relationship between the strain-rate of the solder alloy, the work-hardening effect and the resulting stress concentration at the interfacial regions.

Undiagnosed mandibular condylar fractures causing temporomandibular joint ankylosis: A problem in northern India.

PubMed

Nagori, Shakil Ahmed; Jose, Anson; Bhutia, Ongkila; Roychoudhury, Ajoy

2014-01-01

Temporomandibular joint (TMJ) ankylosis due to undiagnosed condylar fractures has a high incidence in India compared to western countries. We evaluated the demographics, injury pattern, hospital reporting and referral pattern of undiagnosed condylar fractures complicating TMJ ankylosis in northern India. We did a retrospective analysis by retrieving medical records of patients with post-traumatic TMJ ankylosis reporting to the Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences between 1 July 2012 and 30 June 2013. Of 90 patients with post-traumatic TMJ ankylosis, 74 (82.2%) resided in rural areas. Sixty-three (70%) patients were from the states of Uttar Pradesh, Bihar and Jharkhand. Only 8.8% had higher education and 10% had an annual income of more than `2 lakh. In 69 (84.4%) patients, fall was the aetiological factor. Primary health centres (42%) and private clinics (20.5%) received the major share of patients immediately following injury. Few patients (19.3%) had some radiographic examination done and only 17% were referred by the primary healthcare provider. Of those referred only 3 were examined by a dental practitioner. Only 10% of all were diagnosed with condylar fractures. Patients with TMJ ankylosis presenting to us have poor literacy and income levels. A missed diagnosis of condylar fractures by rural healthcare providers contributes to its high incidence in India. Improving awareness of clinicians and improved rural healthcare infrastructure can help prevent this complication. Copyright 2014, NMJI.

[The randomized controlled trial of influences of T shape approach on the function of knee joint in the treatment of proximal tibial fractures].

PubMed

Peng, Wei-xiong; Zhang, Zhi; Liang, Jie-hong

2008-04-01

To investigate the clinical value of T shape approach in the treatment of proximal tibial fractures. One handrend and thirteen patients of proximal tibial fractures were randomly divided into two groups. Group A: 62 cases underwent the traditional exposure approach. According to Schatzker classification,the cases of II to VI type was 25, 10, 16, 6, 5 respectively. Group B:51 cases underwent T shape approach ahead of knee joint, the cases of II to VI type was 21, 8, 13, 5, 4 respectively. All data were analyzed by SPSS 10.0 to compare operation time, blood loss, duration of hospitalization, healing time, the time of osseous union and complications after operation. Sixty patients in group A and 50 patients in group B were followed-up from 12 to 24 months. (1) Operation time:group B was longer than A (P < 0.01). (2) Mean blood loss and duration of hospitalization was the same. (3) Clinical healing time:group B was shorter. (4) Mean time of osseous union: 48 group B was shorter. Function of knee: group B was better than group A. (Complication: group B was less than group A. As compared with traditional exposure approach, T shape approach of knee joint had advantages of small scar, fewer complications, faster union of fracture and earlier recovery of joint function. The approach is valuable for the treatment of proximal tibial fractures.

[Efficacy of Sacroiliac Joint Anterior Approach with Double Reconstruction Plate and Computer Assisted Navigation Percutaneous Sacroiliac Screw for Treating Tile C1 Pelvic Fractures].

PubMed

Tan, Zhen; Fang, Yue; Zhang, Hui; Liu, Lei; Xiang, Zhou; Zhong, Gang; Huang, Fu-Guo; Wang, Guang-Lin

2017-09-01

To compare the efficacy of sacroiliac joint anterior approach with double reconstruction plate and computer assisted navigation percutaneous sacroiliac screw for treating Tile C1 pelvic fractures. Fifty patients with pelvic Tile C1 fractures were randomly divided into two groups ( n =25 for each) in the orthopedic department of West China Hospital of Sichuan University from December 2012 to November 2014. Patients in group A were treated by sacroiliac joint dislocation with anterior plate fixation. Patients in group B were treated with computerized navigation for percutaneous sacroiliac screw. The operation duration,intraoperative blood loss,incision length,and postoperative complications (nausea,vomiting,pulmonary infection,wound complications,etc.) were compared between the two groups. The postoperative fracture healing time,postoperative patient satisfaction,and postoperative fractures MATTA scores (to evaluate fracture reduction),postoperative MAJEED function scores,and SF36 scores of the patients were also recorded and compared. No significant differences in baseline characteristics were found between the two groups of patients. All of the patients in both groups had their operations successfully completed. Patients in group B had significantly shorter operations and lower intraoperative blood loss,incision length and postoperative complications than those in group A ( P <0.05). Patients in group B also had higher levels of satisfaction than those in group A ( P <0.05). No significant differences were found between the two groups in postoperative followup time,fracture healing time,postoperative MATTA scores,postoperative MAJEED function scores and SF36 scores ( P >0.05). Sacroiliac joint anterior approach with double reconstruction plate and computer assisted navigation percutaneous sacroiliac screws are both effective for treating Tile C1type pelvic fractures,with similar longterm efficacies. However,computer assisted navigation percutaneous sacroiliac screw

Traumatic ipsilateral multiple open metatarsal and calcaneal fractures with first metatarsophalangeal joint dislocation: a case report.

PubMed

Ozkan, Namik Kemal; Unay, Koray; Cift, Hakan; Eceviz, Engin; Ozkan, Korhan

2010-06-01

A 17-year-old man fell from a height of 10 m onto his right forefoot and sustained ipsilateral calcaneal, comminuted cuboid, and second, third, and fourth metatarsal neck fractures and first metatarsophalangeal joint open dislocation. This report discusses this rare injury. The authors believe that initial debridement with immediate surgical fixation and reduction with appropriate antibiotic treatment saved the patient's extremity.

A maximum entropy fracture model for low and high strain-rate fracture in TinSilverCopper alloys

NASA Astrophysics Data System (ADS)

Chan, Dennis K.

SnAgCu solder alloys exhibit significant rate-dependent constitutive behavior. Solder joints made of these alloys exhibit failure modes that are also rate-dependent. Solder joints are an integral part of microelectronic packages and are subjected to a wide variety of loading conditions which range from thermo-mechanical fatigue to impact loading. Consequently, there is a need for non-empirical rate-dependent failure theory that is able to accurately predict fracture in these solder joints. In the present thesis, various failure models are first reviewed. But, these models are typically empirical or are not valid for solder joints due to limiting assumptions such as elastic behavior. Here, the development and validation of a maximum entropy fracture model (MEFM) valid for low strain-rate fracture in SnAgCu solders is presented. To this end, work on characterizing SnAgCu solder behavior at low strain-rates using a specially designed tester to estimate parameters for constitutive models is presented. Next, the maximum entropy fracture model is reviewed. This failure model uses a single damage accumulation parameter and relates the risk of fracture to accumulated inelastic dissipation. A methodology is presented to extract this model parameter through a custom-built microscale mechanical tester for Sn3.8Ag0.7Cu solder. This single parameter is used to numerically simulate fracture in two solder joints with entirely different geometries. The simulations are compared to experimentally observed fracture in these same packages. Following the simulations of fracture at low strain rate, the constitutive behavior of solder alloys across nine decades of strain rates through MTS compression tests and split-Hopkinson bar are presented. Preliminary work on using orthogonal machining as novel technique of material characterization at high strain rates is also presented. The resultant data from the MTS compression and split-Hopkinson bar tester is used to demonstrate the

Prosthetic joint infection-a devastating complication of hemiarthroplasty for hip fracture.

PubMed

Guren, Ellen; Figved, Wender; Frihagen, Frede; Watne, Leiv Otto; Westberg, Marianne

2017-08-01

Background and purpose - Hemiarthroplasty is the most common treatment in elderly patients with displaced femoral neck fracture. Prosthetic joint infection (PJI) is a feared complication. The infection rate varies in the literature, and there are limited descriptive data available. We investigated the characteristics and outcome of PJI following hemiarthroplasty over a 15-year period. Patients and methods - Patients with PJI were identified among 519 patients treated with hemiarthroplasty for a femoral neck fracture at Oslo University Hospital between 1998 and 2012. We used prospectively registered data from previous studies, and recorded additional data from the patients' charts when needed. Results - Of the 519 patients, we identified 37 patients (6%) with early PJI. 20 of these 37 patients became free of infection. Soft tissue debridement and retention of implant was performed in 35 patients, 15 of whom became free of infection with an intact arthroplasty. The 1-year mortality rate was 15/37. We found an association between 1-year mortality and treatment failure (p = 0.001). Staphylococcus aureus and polymicrobial infection were the most common microbiological findings, each accounting for 14 of the 37 infections. Enterococcus spp. was found in 9 infections, 8 of which were polymicrobial. There was an association between polymicrobial infection and treatment failure, and between polymicrobial infection and 1-year mortality. Interpretation - PJI following hemiarthroplasty due to femoral neck fracture is a devastating complication in the elderly. We found a high rate of polymicrobial PJIs frequently including Enterococcus spp, which is different from what is common in PJI after elective total hip arthroplasty.

Biomechanical characteristics of hemi-hamate reconstruction versus volar plate arthroplasty in the treatment of dorsal fracture dislocations of the proximal interphalangeal joint.

PubMed

Tyser, Andrew R; Tsai, Michael A; Parks, Brent G; Means, Kenneth R

2015-02-01

To compare stability and range of motion after hemi-hamate reconstruction versus volar plate arthroplasty in a biomechanical proximal interphalangeal (PIP) joint fracture-dislocation model. Eighteen digits from 6 cadaver hands were tested. We created defects of 40%, 60%, and 80% in the palmar base of each digit's middle phalanx, simulating an acute PIP joint fracture-dislocation. Each defect scenario was reconstructed with a hemi-hamate arthroplasty followed by a volar plate arthroplasty. A computer-controlled mechanism was used to bring each digit's PIP joint from full extension to full flexion via the digital tendons in each testing state, and in the intact state. During each testing scenario we collected PIP joint cinedata in a true lateral projection using mini-fluoroscopy. A digital radiography program was used to measure the amount of middle phalanx dorsal translation (subluxation) in full PIP joint extension. We recorded the angle at which subluxation, if present, occurred during each testing scenario. Average dorsal displacement of the middle phalanx in relation to the proximal phalanx was 0.01 mm for the hemi-hamate reconstructed joints and -0.03 mm for the volar plate arthroplasty, compared with the intact state. Flexion contractures were noted in each of the specimens reconstructed with volar plate arthroplasty. Degree of contracture was directly correlated with defect size, averaging 20° for 40% defects, 35° for 60% defects, and 60° for 80% defects. We observed no flexion contractures in the hemi-hamate reconstructions. Surgeons can use both hemi-hamate and volar plate arthroplasty to restore PIP joint stability following a fracture dislocation with a large middle phalanx palmar base defect. Use of volar plate arthroplasty led to an increasing flexion contracture as the middle phalanx palmar base defect increased. Clinicians can use the information from this study to help with surgical decision-making and patient education. Copyright © 2015

[Fractures of the lower extremities in childhood : Part 2: lower leg and ankle fractures].

PubMed

Voth, M; Kremer, L; Marzi, I

2017-11-01

The treatment of pediatric patients in trauma surgery is a special situation in every aspect. For deciding on the correct treatment of fractures of the lower leg and ankle joint, various parameters, such as residual growth rate, skeletal age and height of the patient are decisive. The differences between fractures in children and adolescents are the open epiphyseal plate and the resulting residual growth. The bones of young children have a higher healing tendency and a greater potential for correction than in adolescents. Especially in the lower leg and the ankle joint, the potential for correction is decisive for the healing of fractures and for possible development of growth disorders. The limits of tolerance concerning axial malalignments and the expected spontaneous potential for correction must play an essential role for further treatment with conservative or operative therapy. This article deals with the special features of pediatric fractures of the lower leg and ankle joint.

Influence of structure on static cracking resistance and fracture of welded joints of pipe steels of strength class K60

NASA Astrophysics Data System (ADS)

Tereshchenko, N. A.; Tabatchikova, T. I.; Yakovleva, I. L.; Makovetskii, A. N.; Shander, S. V.

2017-07-01

The static cracking resistance of a number of welded joints made from pipe steels of K60 strength class has been determined. It has been established that the deformation parameter CTOD varies significantly at identical parameters of weldability of steels. The character of fracture has been investigated and the zone of local brittleness of welded joints has been studied. It has been shown that the ability of a metal to resist cracking is determined by the austenite grain size and by the bainite morphology in the region of overheating in the heat-affected zone of a welded joint.

[Development and clinical application of a new type of anatomical locking plate for sternoclavicular joint fracture and dislocation].

PubMed

Sun, Yuanlin; Yang, Yunkang; Ge, Jianhua; Yang, Kun; Xiang, Feifan; Zhou, Ju; Liang, Jie

2018-03-01

To report a new type of anatomical locking plate for sternocalvicular joint, and investigate its effectiveness in treatment of sternoclavicular joint fracture and dislocation. A new type of anatomical locking plate for sternoclavicular joint was developed, which accorded with the anatomical features and biomechanical characteristics of Chinese sternoclavicular joint. By adopting the method of clinical randomized controlled study, 32 patients with the sternoclavicular joint fracture and dislocation who met the selection criteria between June 2008 and May 2015 were randomly divided into groups A and B ( n =16), and the patients were treated with new anatomic locking plate and distal radial T locking plate internal fixation, respectively. There was no significant difference between 2 groups in gender, age, injured side, body mass index, cause of injury, type of injury, the time from injury to operation, and preoperative Rockwood grading score ( P >0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, and postoperative complications in 2 groups were recorded, and the effectiveness was evaluated by Rockwood grading score. The operations of 2 groups completed successfully. The operation time, intraoperative blood loss, and hospitalization time in group A were significantly less than those in group B ( P <0.05), but there was no significant difference in the incision length between 2 groups ( t =0.672, P =0.507). All the patients were followed up 18-30 months (mean, 24 months). In group A, there were 1 case of sternoclavicular joint pain and 2 cases of wound infection; in group B, there were 1 case of sternoclavicular joint pain, 1 case of internal fixation loosening, and 1 case of sternoclavicular joint re-dislocation; there was no significant difference in complication incidence between 2 groups ( P =1.000). The Rockwood grading scores at each time point after operation in 2 groups were significantly higher than those before

Prediction of fracture toughness and durability of adhesively bonded composite joints with undesirable bonding conditions

NASA Astrophysics Data System (ADS)

Musaramthota, Vishal

Advanced composite materials have enabled the conventional aircraft structures to reduce weight, improve fuel efficiency and offer superior mechanical properties. In the past, materials such as aluminum, steel or titanium have been used to manufacture aircraft structures for support of heavy loads. Within the last decade or so, demand for advanced composite materials have been emerging that offer significant advantages over the traditional metallic materials. Of particular interest in the recent years, there has been an upsurge in scientific significance in the usage of adhesively bonded composite joints (ABCJ's). ABCJ's negate the introduction of stress risers that are associated with riveting or other classical techniques. In today's aircraft transportation market, there is a push to increase structural efficiency by promoting adhesive bonding to primary joining of aircraft structures. This research is focused on the issues associated with the durability and related failures in bonded composite joints that continue to be a critical hindrance to the universal acceptance of ABCJ's. Of particular interest are the short term strength, contamination and long term durability of ABCJ's. One of the factors that influence bond performance is contamination and in this study the influence of contamination on composite-adhesive bond quality was investigated through the development of a repeatable and scalable surface contamination procedure. Results showed an increase in the contaminant coverage area decreases the overall bond strength significantly. A direct correlation between the contaminant coverage area and the fracture toughness of the bonded joint was established. Another factor that influences bond performance during an aircraft's service life is its long term strength upon exposure to harsh environmental conditions or when subjected to severe mechanical loading. A test procedure was successfully developed in order to evaluate durability of ABCJ's comprising severe

An instrumented pendulum system for measuring energy absorption during fracture insult to large animal joints in vivo.

PubMed

Diestelmeier, B W; Rudert, M J; Tochigi, Y; Baer, T E; Fredericks, D C; Brown, T D

2014-06-01

For systematic laboratory studies of bone fractures in general and intra-articular fractures in particular, it is often necessary to control for injury severity. Quantitatively, a parameter of primary interest in that regard is the energy absorbed during the injury event. For this purpose, a novel technique has been developed to measure energy absorption in experimental impaction. The specific application is for fracture insult to porcine hock (tibiotalar) joints in vivo, for which illustrative intra-operative data are reported. The instrumentation allowed for the measurement of the delivered kinetic energy and of the energy passed through the specimen during impaction. The energy absorbed by the specimen was calculated as the difference between those two values. A foam specimen validation study was first performed to compare the energy absorption measurements from the pendulum instrumentation versus the work of indentation performed by an MTS machine. Following validation, the pendulum apparatus was used to measure the energy absorbed during intra-articular fractures created in 14 minipig hock joints in vivo. The foam validation study showed close correspondence between the pendulum-measured energy absorption and MTS-performed work of indentation. In the survival animal series, the energy delivered ranged from 31.5 to 48.3 Js (41.3±4.0, mean±s.d.) and the proportion of energy absorbed to energy delivered ranged from 44.2% to 64.7% (53.6%±4.5%). The foam validation results support the reliability of the energy absorption measure provided by the instrumented pendulum system. Given that a very substantial proportion of delivered energy passed--unabsorbed--through the specimens, the energy absorption measure provided by this novel technique arguably provides better characterization of injury severity than is provided simply by energy delivery.

Regenerative Medicine and Restoration of Joint Function

DTIC Science & Technology

2014-12-01

to resist fracture and excessive deformation under antici- pated mechanical loading conditions both during the early healing process and for longer...per sample type), the results sug- gest a correlation between percent fractured sinter neck area and mechanical properties with the lowest bending...joint replacement are used to treat a joint with an intra-articular fracture or destroyed by a combat injury. Generation of personalized, anatomically

Semiextended approach for intramedullary nailing via a patellar eversion technique for tibial-shaft fractures: Evaluation of the patellofemoral joint.

PubMed

Yasuda, Tomohiro; Obara, Shu; Hayashi, Junji; Arai, Masayuki; Sato, Kaoru

2017-06-01

Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve. This method allows the articular surface to be monitored during intramedullary nail insertion. We arthroscopically assessed the effect of this technique on patellofemoral joint cartilage. The patellar eversion technique allows a direct view and protection of the patellofemoral joint without affecting the patella. Thus, damage to the patellofemoral joint cartilage can be avoided. Copyright © 2017 Elsevier Ltd. All rights reserved.

Anatomical predisposition of the ankle joint for lateral sprain or lateral malleolar fracture evaluated by radiographic measurements.

PubMed

Lee, Kyoung Min; Chung, Chin Youb; Sung, Ki Hyuk; Lee, SeungYeol; Kim, Tae Gyun; Choi, Young; Jung, Ki Jin; Kim, Yeon Ho; Koo, Seung Bum; Park, Moon Seok

2015-01-01

Injury mechanism and the amount of force are important factors determining whether a fracture or sprain occurs at the time of an ankle inversion injury. However, the anatomical differences between the ankle fracture and sprain have not been investigated sufficiently. This study was performed to investigate whether an anatomical predisposition of the ankle joint results in a lateral malleolar fracture or lateral ankle sprain. Two groups of consecutive patients, one with lateral malleolar fracture (274 patients, mean age 49.0 years) and the other with lateral ankle sprain (400 patients, mean age 38.4 years), were evaluated. Ankle radiographs were examined for 7 measures: distal tibial articular surface (DTAS) angle, bimalleolar tilt (BT), medial malleolar relative length (MMRL), lateral malleolar relative length (LMRL), medial malleolar slip angle (MMSA), anterior inclination of tibia (AI), and fibular position (FP). After an interobserver reliability test, the radiographic measurements were compared between the 2 groups. Linear regression analysis was performed to correct for age and sex effects between the groups. The fracture group and the sprain group showed significant differences in BT (P = .001), MMSA (P < .001), AI (P = .023), and FP (P < .001). In multiple regression analysis, after adjusting for age and sex effects, fracture and sprain groups showed a significant difference in BT (P = .001), MMRL (P < .001), MMSA (P < .001), and FP (P < .001). The lateral malleolar fracture group tended to show more bony constraint than that of the lateral ankle sprain group. Further 3-dimensional assessment of the bony structure and subsequent biomechanical studies are needed to elucidate the mechanism of injury according to the various types of ankle fractures and ankle sprain. Level III, retrospective comparative study. © The Author(s) 2014.

Arthroplasty for Unreconstructable Acute Fractures and Failed Fracture Fixation About the Hip and Knee in the Active Elderly: A New Paradigm.

PubMed

Kyle, Richard F; Duwelius, Paul J; Haidukewych, George J; Schmidt, Andrew H

2017-02-15

The techniques, materials, and designs for total joint arthroplasty underwent major improvements in the past 30 years. During this time, trauma surgeons classified the severity of fractures as well as identified certain articular fractures that do not have good outcomes and have a high rate of failure after internal fixation. Advanced improvements in arthroplasty have increased its reliability and longevity. Total joint arthroplasty is becoming a standard of care for some acute articular fractures, particularly displaced femoral neck fractures in the active elderly. Total joint arthroplasty also has become the standard of care after failed internal fixation in patients who have very complicated fractures about the knee, hip, and shoulder. As the population ages, fractures worldwide continue to rapidly increase. Elderly patients have a high risk for fractures that result from falls because of their poor bone quality. The current active elderly population participates in higher risk activities than previous elderly populations, which places them at risk for more injuries. This has become both a worldwide healthcare problem and an economic problem. Surgeons need to manage fractures in the active elderly with the latest advancements in technology and patient selection to ensure rapid recovery and the reduction of complications.

Computed tomography of calcaneal fractures

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

Heger, L.; Wulff, K.; Seddiqi, M.S.A.

1985-07-01

Computed tomography (CT) of 25 fractured calcanei was performed to investigate the potential of CT in evaluating the pattern and biomechanics of these fractures. The characteristic findings of typical fractures are presented, including the number and type of principal fragments, size and dislocation of the sustentacular fragment, and involvement of the anterior and posterior facets of the subtalar joint. In 17 cases, the calcaneus consisted of four or more fragments. Furthermore, in 17 cases the sustentacular fragment included all or part of the posterior facet joint. In 18 of the 25 cases, the sustentacular fragment was displaced. It is concludedmore » that well performed CT is an invaluable adjunct in understanding the fracture mechanism and in detecting pain-provoking impingement between the fibular malleolus and the tuberosity fragment.« less

Negative pressure wound therapy for the treatment of infected wounds with exposed knee joint after patellar fracture.

PubMed

Lee, Sang Yang; Niikura, Takahiro; Miwa, Masahiko; Sakai, Yoshitada; Oe, Keisuke; Fukazawa, Takahiro; Kawakami, Yohei; Kurosaka, Masahiro

2011-06-14

Treatment of soft tissue defects with exposed bones and joints, resulting from trauma, infection, and surgical complications, represents a major challenge. The introduction of negative pressure wound therapy has changed many wound management practices. Negative pressure wound therapy has recently been used in the orthopedic field for management of traumatic or open wounds with exposed bone, nerve, tendon, and orthopedic implants. This article describes a case of a patient with a large soft tissue defect and exposed knee joint, in which negative pressure wound therapy markedly improved wound healing. A 50-year-old man presented with an ulceration of his left knee with exposed joint, caused by severe wound infections after open reduction and internal fixation of a patellar fracture. After 20 days of negative pressure wound therapy, a granulated wound bed covered the exposed bones and joint.To our knowledge, this is the first report of negative pressure wound therapy used in a patient with a large soft tissue defect with exposed knee joint. Despite the chronic wound secondary to infection, healing was achieved through the use of the negative pressure wound therapy, thus promoting granulation tissue formation and closing the joint. We suggest negative pressure wound therapy as an alternative option for patients with lower limb wounds containing exposed bones and joints when free flap transfer is contraindicated. Our result added to the growing evidence that negative pressure wound therapy is a useful adjunctive treatment for open wounds around the knee joint. Copyright 2011, SLACK Incorporated.

Lisfranc fractures.

PubMed

Wright, Amanda; Gerhart, Ann E

2009-01-01

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

The Shear Strength and Fracture Behavior of Sn-Ag- xSb Solder Joints with Au/Ni-P/Cu UBM

NASA Astrophysics Data System (ADS)

Lee, Hwa-Teng; Hu, Shuen-Yuan; Hong, Ting-Fu; Chen, Yin-Fa

2008-06-01

This study investigates the effects of Sb addition on the shear strength and fracture behavior of Sn-Ag-based solders with Au/Ni-P/Cu underbump metallization (UBM) substrates. Sn-3Ag- xSb ternary alloy solder joints were prepared by adding 0 wt.% to 10 wt.% Sb to a Sn-3.5Ag alloy and joining them with Au/Ni-P/Cu UBM substrates. The solder joints were isothermally stored at 150°C for up to 625 h to study their microstructure and interfacial reaction with the UBM. Single-lap shear tests were conducted to evaluate the mechanical properties, thermal resistance, and failure behavior. The results show that UBM effectively suppressed intermetallic compound (IMC) formation and growth during isothermal storage. The Sb addition helped to refine the Ag3Sn compounds, further improving the shear strength and thermal resistance of the solders. The fracture behavior evolved from solder mode toward the mixed mode and finally to the IMC mode with increasing added Sb and isothermal storage time. However, SnSb compounds were found in the solder with 10 wt.% Sb; they may cause mechanical degradation of the solder after long-term isothermal storage.

The cyclic fatigue behavior of adhesive joints

NASA Astrophysics Data System (ADS)

Kinloch, A. J.; Toh, T.

1995-06-01

In the last six months we have: (1) Concentrated our efforts on the fatigue failure of carbon-fiber PEEK/AFl63 lap joints, and in particular we have started to predict the life time of single-lap joints under cyclic fatigue loading. The analysis is based on data obtained from double cantilever beam (DCB) fracture mechanics tests; (2) Further, we have been successful in measuring the rate of crack growth in lap joints during fatigue fracture using ultrasonic scanning; (3) Preliminary test data on the static fracture of glass-fiber reinforced poly(phenylene sulphide) (PPS)/AF163 joints have also been studied; and (4) A comparison has been made in computing the critical strain energy release rate G(sub c) for the glass-fiber PPS/AF163 joints based on the compliance method, beam theory and corrected beam theory. The last method accounts for large non-linear deflections and the associated crack root rotations along with the necessary corrections for the increase in stiffness introduced by the presence of end blocks.

Proceedings of the Joint IAEA/CSNI Specialists` Meeting on Fracture Mechanics Verification by Large-Scale Testing held at Pollard Auditorium, Oak Ridge, Tennessee

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

Pugh, C.E.; Bass, B.R.; Keeney, J.A.

This report contains 40 papers that were presented at the Joint IAEA/CSNI Specialists` Meeting Fracture Mechanics Verification by Large-Scale Testing held at the Pollard Auditorium, Oak Ridge, Tennessee, during the week of October 26--29, 1992. The papers are printed in the order of their presentation in each session and describe recent large-scale fracture (brittle and/or ductile) experiments, analyses of these experiments, and comparisons between predictions and experimental results. The goal of the meeting was to allow international experts to examine the fracture behavior of various materials and structures under conditions relevant to nuclear reactor components and operating environments. The emphasismore » was on the ability of various fracture models and analysis methods to predict the wide range of experimental data now available. The individual papers have been cataloged separately.« less

Fracture through a geode in the proximal ulna.

PubMed

Wordsworth, B P; Mowat, A G; Watson, N A

1984-05-01

Chronic joint pain in rheumatoid arthritis may mask that from other causes. Stress fractures, particularly in osteoporotic lower limb bones of such patients, are well described but can still cause diagnostic difficulty. These difficulties were highlighted by a case in which an unusual fracture occurred through a geode in the proximal ulna mimicking an exacerbation of synovitis in the elbow joint.

Relationships between fractures

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

[Surgical approaches to tibial plateau fractures].

PubMed

Krause, Matthias; Müller, Gunnar; Frosch, Karl-Heinz

2018-06-06

Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury patterns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture-specific access strategy is recommended to provide correct positioning of the plate osteosynthesis. While the anterolateral approach is used in the majority of lateral tibial plateau fractures, only one third of the joint surface is visible; however, posterolateral fragments require an individual approach, e. g. posterolateral or posteromedial. If necessary, osteotomy of the femoral epicondyles can improve joint access for reduction control. Injuries to the posterior columns should be anatomically reconstructed and biomechanically correctly addressed via posterior approaches. Bony posterior cruciate ligament tears can be refixed via a minimally invasive posteromedial approach.

Saw injuries causing phalangeal neck fractures in adults.

PubMed

Al-Qattan, Mohammad M

2012-07-01

The outcome of adult phalangeal neck fractures caused by saws has not been previously investigated. Over a 15-year period, a total of 36 cases of saw-related injuries resulting in phalangeal neck fractures of the middle phalanx of the finger or the proximal phalanx of the thumb were treated. All injuries were industrial and covered by insurance. They were all adult males with type II fractures. The fracture were managed by K-wire fixation, immobilizing the distal joint only. The proximal joints were mobilized immediately after surgery and the K-wire was removed after 5 weeks. The following 2 patterns of saw injuries were observed: dorsal impact injuries resulting in a phalangeal neck fracture and concurrent extensor tendon injury (group I, n = 20 patients), and dorsolateral impact injuries resulting in concurrent extensor (± partial flexor) tendon and nerve injury (group II, n = 16 patients). The outcome with respect to range of motion and return to work was significantly better in the former group. Major complications such as nonunion, malunion, avascular necrosis of the phalangeal head, osteomyelitis, or contractures of the proximal interphalangeal joints were not observed. Two patients (1 in each group) had superficial pin-site infection. It was concluded that adult phalangeal neck fractures caused by saws is a separate entity from the previously reported series of closed phalangeal neck fractures in adults.

Clinical comparative analysis on unstable pelvic fractures in the treatment with percutaneous sacroiliac screws and sacroiliac joint anterior plate fixation.

PubMed

Li, C-L

2014-01-01

To investigate clinical efficacy of unstable pelvic fractures in the treatment with percutaneous sacroiliac screws and sacroiliac joint anterior plate fixation. 64 patients with unstable pelvic fractures were selected in the hospital from January 2008 to June 2011, and were randomly divided into two groups.(32 patients with sacroiliac anterior plate fixation as the control group, and another 32 patients with percutaneous sacroiliac screw internal fixation as the observation group). The perioperative period clinical indicators, postoperative Matta score, postoperative Majeed function score of all patients were compared and analyzed. The operation time, intraoperative blood loss, wound total length, postoperative fever time, duration of hospitalization in the observation group were significantly less than those in the control group. The complication rate (3.1%) in the observation group was lower than that in the control group (21.9%). The rate of Matta score excellent (96.9%) in the observation group was higher than that in the control group (81.2%) after the treatment. The rate of Majeed function score excellent (93.8%) in the observation group was significantly higher than that in the control group (75%) after the treatment. Percutaneous sacroiliac screw internal fixation in the treatment of unstable pelvic fractures has less injury, less bleeding, less pain and rapid recovery which is a safe and effective minimally invasive operation method. The clinical curative effect of percutaneous sacroiliac screw internal fixation is better than anterior plate fixation for the treatment of sacroiliac joint. The full preparation before the surgery and patients with positive can substantially reduce the occurrence of complications rate.

[Staple fixation for the treatment of hamate metacarpal joint injury].

PubMed

Tang, Yang-Hua; Zeng, Lin-Ru; Huang, Zhong-Ming; Yue, Zhen-Shuang; Xin, Da-Wei; Xu, Can-Da

2014-03-01

To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury. From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method. All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case. The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.

Subcritical growth of natural hydraulic fractures

NASA Astrophysics Data System (ADS)

Garagash, D.

2014-12-01

Joints are the most common example of brittle tensile failure in the crust. Their genesis at depth is linked to the natural hydraulic fracturing, which requires pore fluid pressure in excess of the minimum in situ stress [Pollard and Aidyn, JSG1988]. Depending on the geological setting, high pore pressure can result form burial compaction of interbedded strata, diagenesis, or tectonics. Common to these loading scenarios is slow build-up of pore pressure over a geological timescale, until conditions for initiation of crack growth are met on favorably oriented/sized flaws. The flaws can vary in size from grain-size cracks in igneous rocks to a fossil-size flaws in clastic rock, and once activated, are inferred to propagate mostly subcritically [Segall JGR 1984; Olson JGR 1993]. Despite many observational studies of natural hydraulic fractures, the modeling attempts appear to be few [Renshaw and Harvey JGR 1994]. Here, we use boundary integral formulation for the pore fluid inflow from the permeable rock into a propagating joint [Berchenko et al. IJRMMS 1997] coupled with the criteria for subcritical propagation assisted by the environmental effects of pore fluid at the crack tip to solve for the evolution of a penny-shape joint, which, in interbedded rock, may eventually evolve to short-blade geometry (propagation confined to a bed). Initial growth is exceedingly slow, paced by the stress corrosion reaction kinetics at the crack tip. During this stage the crack is fully-drained (i.e. the fluid pressure in the crack is equilibrated with the ambient pore pressure). This "slow" stage is followed by a rapid acceleration, driven by the increase of the mechanical stress intensity factor with the crack length, towards the terminal joint velocity. We provide an analytical expression for the latter as a function of the rock diffusivity, net pressure loading at the initiation (or flaw lengthscale), and parameters describing resistance to fracture growth. Due to a much slower

Delayed presentation of a loose body in undisplaced paediatric talar neck fracture

PubMed Central

Patel, Vishal; Bloch, Benjamin; Johnson, Nicholas; Mangwani, Jitendra

2014-01-01

Fractures of the talus are rare in children. A high index of suspicion is needed to avoid missing such an injury, which is not an uncommon occurrence especially with undisplaced fractures. We present an unusual case of an undisplaced talar neck fracture in a five-year-old child leading to a delayed presentation of a symptomatic osteochondral loose body in the ankle joint. To our knowledge there are no reports in the literature of osteochondral loose bodies occurring in conjunction with an associated undisplaced talar neck fracture in either children or adults. The loose body was removed using anterior ankle arthroscopy. The child had an uneventful post operative recovery and regained full range of movement and function of his ankle joint and was discharged at one year follow-up. We aim to highlight the need to have a low threshold to further evaluate symptomatic children after fracture healing of an undisplaced talar neck fracture for a possible associated loose body in the ankle joint. PMID:25035846

[Operative treatment of displaced intra-articular calcaneal fractures].

PubMed

Zwipp, H; Rammelt, S; Amlang, M; Pompach, M; Dürr, C

2013-12-01

Anatomic reduction of displaced intra-articular calcaneal fractures with restoration of height, length, and axial alignment and reconstruction of the subtalar and calcaneocuboid joints. Displaced intra-articular calcaneal fractures with incongruity of the posterior facet of the subtalar joint, loss of height, and axial malalignment. High perioperative risk, soft tissue infection, advanced peripheral arterial disease (stage III), neurogenic osteoarthropathy, poor patient compliance (e. g., substance abuse). Extended lateral approach with the patient placed on the uninjured side. Reduction of the anatomic shape and joint surfaces according to the preoperative CT-based planning. Reduction of the medial wall and step-wise reconstruction of the posterior facet from medial to lateral. Reduction of the tuberosity and anterior process fragments to the posterior joint block and temporary fixation with Kirschner wires. Internal fixation with an anatomic lateral plate in a locking or nonlocking mode. Alternatively less invasive internal fixation with a calcaneus nail over a sinus tarsi approach for less severe fracture types. The lower leg is immobilized in a brace until the wound is healed. Range of motion exercises of the ankle and subtalar joints are initiated on the second postoperative day. Patients are mobilized in their own shoe with partial weight bearing of 20 kg for 6-12 weeks depending on fracture severity and bone quality. Over a 4-year period, 163 patients with 184 displaced, intra-articular calcaneal fractures were treated with a lateral plate via an extended approach. In all, 102 patients with 116 fractures were followed for a mean of 8 years. A surgical revision was necessary in 4 cases (3.4%) of postoperative hematoma, 2 (1.7%) superficial and 5 (4.3%) deep infections. Of the latter, 2 patients needed a free flap for definite wound coverage, no calcanectomy or amputation was needed. Secondary subtalar fusion for symptomatic posttraumatic arthritis was

A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints

DOE PAGES

Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.

2017-12-05

We investigate the microcracking mechanisms responsible for Ti 3SiC 2/SiC joint damage observed at the macroscopic scale after neutron irradiation experiments in detail. A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints is developed that uses a finely discretized two-phase domain based on a digital image of an actual microstructure involving embedded Ti 3SiC 2 and SiC phases. The behaviors of SiC and Ti 3SiC 2 in the domain are described by the continuum damage mechanics (CDM) model reported in Nguyen et al., J. Nucl. Mater., 2017, 495:504–515. This CDM model describes microcracking damage in brittlemore » ceramics caused by thermomechanical loading and irradiation-induced swelling. The dual-phase microstructural model is applied to predict the microcracking mechanisms occurring in a typical Ti 3SiC 2/SiC joint subjected to heating to 800 °C followed by irradiation-induced swelling at this temperature and cooling to room temperature after the applied swelling has reached the maximum swelling levels observed in the experiments for SiC and Ti 3SiC 2. The model predicts minor damage of the joint after heating but significant microcracking in the SiC phase and along the boundaries between SiC and Ti 3SiC 2 as well as along the bonding joint during irradiation-induced swelling and cooling to room temperature. Our predictions qualitatively agree with the limited experimental observations of joint damage at this irradiation temperature.« less

A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints

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

Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.

We investigate the microcracking mechanisms responsible for Ti 3SiC 2/SiC joint damage observed at the macroscopic scale after neutron irradiation experiments in detail. A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints is developed that uses a finely discretized two-phase domain based on a digital image of an actual microstructure involving embedded Ti 3SiC 2 and SiC phases. The behaviors of SiC and Ti 3SiC 2 in the domain are described by the continuum damage mechanics (CDM) model reported in Nguyen et al., J. Nucl. Mater., 2017, 495:504–515. This CDM model describes microcracking damage in brittlemore » ceramics caused by thermomechanical loading and irradiation-induced swelling. The dual-phase microstructural model is applied to predict the microcracking mechanisms occurring in a typical Ti 3SiC 2/SiC joint subjected to heating to 800 °C followed by irradiation-induced swelling at this temperature and cooling to room temperature after the applied swelling has reached the maximum swelling levels observed in the experiments for SiC and Ti 3SiC 2. The model predicts minor damage of the joint after heating but significant microcracking in the SiC phase and along the boundaries between SiC and Ti 3SiC 2 as well as along the bonding joint during irradiation-induced swelling and cooling to room temperature. Our predictions qualitatively agree with the limited experimental observations of joint damage at this irradiation temperature.« less

A dual-phase microstructural approach to damage and fracture of Ti3SiC2/SiC joints

NASA Astrophysics Data System (ADS)

Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.

2018-02-01

The microcracking mechanisms responsible for Ti3SiC2/SiC joint damage observed at the macroscopic scale after neutron irradiation experiments are investigated in detail. A dual-phase microstructural approach to damage and fracture of Ti3SiC2/SiC joints is developed that uses a finely discretized two-phase domain based on a digital image of an actual microstructure involving embedded Ti3SiC2 and SiC phases. The behaviors of SiC and Ti3SiC2 in the domain are described by the continuum damage mechanics (CDM) model reported in Nguyen et al., J. Nucl. Mater., 2017, 495:504-515. This CDM model describes microcracking damage in brittle ceramics caused by thermomechanical loading and irradiation-induced swelling. The dual-phase microstructural model is applied to predict the microcracking mechanisms occurring in a typical Ti3SiC2/SiC joint subjected to heating to 800 °C followed by irradiation-induced swelling at this temperature and cooling to room temperature after the applied swelling has reached the maximum swelling levels observed in the experiments for SiC and Ti3SiC2. The model predicts minor damage of the joint after heating but significant microcracking in the SiC phase and along the boundaries between SiC and Ti3SiC2 as well as along the bonding joint during irradiation-induced swelling and cooling to room temperature. These predictions qualitatively agree with the limited experimental observations of joint damage at this irradiation temperature.

Preoperative Radiographic and CT Findings Predicting Syndesmotic Injuries in Supination-External Rotation-Type Ankle Fractures.

PubMed

Choi, Young; Kwon, Soon-Sun; Chung, Chin Youb; Park, Moon Seok; Lee, Seung Yeol; Lee, Kyoung Min

2014-07-16

The Lauge-Hansen classification system does not provide sufficient data related to syndesmotic injuries in supination-external rotation (SER)-type ankle fractures. The aim of the present study was to investigate factors helpful for the preoperative detection of syndesmotic injuries in SER-type ankle fractures using radiographs and computed tomography (CT). A cohort of 191 consecutive patients (104 male and eighty-seven female patients with a mean age [and standard deviation] of 50.7 ± 16.4 years) with SER-type ankle fractures who had undergone operative treatment were included. Preoperative ankle radiographs and CT imaging scans were made for all patients, and clinical data, including age, sex, and mechanism of injury (high or low-energy trauma), were collected. Patients were divided into two groups: the stable syndesmotic group and the unstable syndesmotic group, with a positive intraoperative lateral stress test leading to syndesmotic screw fixation. Fracture height, fracture length, medial joint space, extent of fracture, and bone attenuation were measured on radiographs and CT images and were compared between the groups. Binary logistic regression analysis was performed to identify the factors that significantly contributed to unstable syndesmotic injuries. Receiver operating characteristic curves were calculated, and cutoff values were suggested to predict unstable syndesmotic injuries on preoperative imaging measurements. Of the 191 patents with a SER-type ankle fracture, thirty-eight (19.9%) had a concurrent unstable syndesmotic injury. Age, sex, mechanism of injury, fracture height, medial joint space, and bone attenuation were significantly different between the two groups. In the binary logistic analysis, fracture height, medial joint space, and bone attenuation were found to be significant factors contributing to unstable syndesmotic injuries. The cutoff values for predicting unstable syndesmotic injuries were a fracture height of >3 mm and a medial

Treatment of Peripheral Talus Fractures.

PubMed

Shank, John R; Benirschke, Stephen K; Swords, Michael P

2017-03-01

Peripheral talus fractures include injuries to the lateral process, posteromedial talar body, and talar head. These injuries are rare and are often missed. Nonunion with conservative treatment is high and excision can lead to joint instability, rapid arthrosis, and earlier need for arthrodesis. Open reduction internal fixation of most peripheral talus fractures is critical to achieving a good outcome. Open reduction leads to more rapid union and ability to mobilize the ankle and subtalar joints, quicker revascularization of the talus, and lower rates of arthrosis. Surgical treatment can lead to substantial functional improvement and a slowing of the degenerative process. Copyright © 2016 Elsevier Inc. All rights reserved.

Biomechanical Tolerance of Calcaneal Fractures

PubMed Central

Yoganandan, Narayan; Pintar, Frank A.; Gennarelli, Thomas A.; Seipel, Robert; Marks, Richard

1999-01-01

Biomechanical studies have been conducted in the past to understand the mechanisms of injury to the foot-ankle complex. However, statistically based tolerance criteria for calcaneal complex injuries are lacking. Consequently, this research was designed to derive a probability distribution that represents human calcaneal tolerance under impact loading such as those encountered in vehicular collisions. Information for deriving the distribution was obtained by experiments on unembalmed human cadaver lower extremities. Briefly, the protocol included the following. The knee joint was disarticulated such that the entire lower extremity distal to the knee joint remained intact. The proximal tibia was fixed in polymethylmethacrylate. The specimens were aligned and impact loading was applied using mini-sled pendulum equipment. The pendulum impactor dynamically loaded the plantar aspect of the foot once. Following the test, specimens were palpated and radiographs in multiple planes were obtained. Injuries were classified into no fracture, and extra-and intra-articular fractures of the calcaneus. There were 14 cases of no injury and 12 cases of calcaneal fracture. The fracture forces (mean: 7802 N) were significantly different (p<0.01) from the forces in the no injury (mean: 4144 N) group. The probability of calcaneal fracture determined using logistic regression indicated that a force of 6.2 kN corresponds to 50 percent probability of calcaneal fracture. The derived probability distribution is useful in the design of dummies and vehicular surfaces.

[Dislocation of the ankle without simoustaneously fracture of the bones].

PubMed

Qayyum, Faiza; Qayyum, Abbas Ali; Sahlstrüm, Sven Arne

2014-09-01

The ankle is a unique modified saddle joint that, together with the subtalar joint, provides range of motion in several physical planes while maintaining stability. The ankle complex functions as a pivoting structure positioned to bear the entire weight of the body which leaves it vulnerable to injuries. Pure dislocation without associated fracture is rare; however, cases of isolated ankle dislocation without fracture have been reported. We report a case of a closed ankle dislocation without an associated fracture in a 17-year-old boy.

Beyond-laboratory-scale prediction for channeling flows through subsurface rock fractures with heterogeneous aperture distributions revealed by laboratory evaluation

NASA Astrophysics Data System (ADS)

Ishibashi, Takuya; Watanabe, Noriaki; Hirano, Nobuo; Okamoto, Atsushi; Tsuchiya, Noriyoshi

2015-01-01

The present study evaluates aperture distributions and fluid flow characteristics for variously sized laboratory-scale granite fractures under confining stress. As a significant result of the laboratory investigation, the contact area in fracture plane was found to be virtually independent of scale. By combining this characteristic with the self-affine fractal nature of fracture surfaces, a novel method for predicting fracture aperture distributions beyond laboratory scale is developed. Validity of this method is revealed through reproduction of the results of laboratory investigation and the maximum aperture-fracture length relations, which are reported in the literature, for natural fractures. The present study finally predicts conceivable scale dependencies of fluid flows through joints (fractures without shear displacement) and faults (fractures with shear displacement). Both joint and fault aperture distributions are characterized by a scale-independent contact area, a scale-dependent geometric mean, and a scale-independent geometric standard deviation of aperture. The contact areas for joints and faults are approximately 60% and 40%. Changes in the geometric means of joint and fault apertures (µm), em, joint and em, fault, with fracture length (m), l, are approximated by em, joint = 1 × 102 l0.1 and em, fault = 1 × 103 l0.7, whereas the geometric standard deviations of both joint and fault apertures are approximately 3. Fluid flows through both joints and faults are characterized by formations of preferential flow paths (i.e., channeling flows) with scale-independent flow areas of approximately 10%, whereas the joint and fault permeabilities (m2), kjoint and kfault, are scale dependent and are approximated as kjoint = 1 × 10-12 l0.2 and kfault = 1 × 10-8 l1.1.

Fracture of the fabella.

PubMed

Woo, C C

1988-10-01

A very rare case of traumatic avulsion fracture of the fabella in a middle-age lady, presented as intermittent posterolateral localized knee pain accentuated by compression against the lateral femoral condyle and by active and passive knee extension, is illustrated. The accumulated chronic microtrauma of the osteoarthritic fabello femoral joint in this lady especially during the whip-kick of daily breaststroke swimming for over 30 yr, may precipitate a fabella stress fracture. Radiographs reveal bilateral fabellae with a left bipartite fabella as a stress fracture traversing it without displacement; this later became a completely displaced bipartite avulsion fracture after accidental knee hyperextension. Conservative treatment consisted of anti-inflammatory/analgesic cream, cryotherapy, TENS, strapping and avoiding knee hyperextension.

Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

PubMed

Wang, Chien-Shun; Tzeng, Yun-Hsuan; Lin, Chun-Cheng; Huang, Ching-Kuei; Chang, Ming-Chau; Chiang, Chao-Ching

2016-09-01

The aim of this prospective study was to evaluate the influence of sectioning the calcaneofibular ligament (CFL) during an extensile lateral approach during open reduction and internal fixation (ORIF) of calcaneal fractures on ankle joint stability. Forty-two patients with calcaneal fractures that received ORIF were included. Talar tilt stress and anterior drawer radiographs were performed on the operative and contralateral ankles 6 months postoperatively. The average degree of talar tilt on stress radiographs was 3.4 degrees (range, 0-12 degrees) on the operative side and 3.2 degrees (range, 0-14 degrees) on the contralateral side. The mean anterior drawer on stress radiographs of the CFL incised ankle was 6.1 mm (range, 2.4-11.8 mm) and on the contralateral ankle was 5.7 mm (range, 2.6-8.6 mm). There was no statistically significant difference of talar tilt and anterior drawer between the CFL incised side and the contralateral side (P = .658 and .302, respectively). The results suggest that sectioning of the CFL without any repair during ORIF of a calcaneal fracture does not have a negative effect on stability of the ankle. Repair of the CFL is, thus, probably not necessary following extended lateral approach for ORIF of calcaneal fractures. Level II, comparative study. © The Author(s) 2016.

Microstructure and Mechanical Properties of Reaction-Formed Joints in Reaction Bonded Silicon Carbide Ceramics

NASA Technical Reports Server (NTRS)

Singh, M.

1998-01-01

A reaction-bonded silicon carbide (RB-SiC) ceramic material (Carborundum's Cerastar RB-SIC) has been joined using a reaction forming approach. Microstructure and mechanical properties of three types of reaction-formed joints (350 micron, 50-55 micron, and 20-25 micron thick) have been evaluated. Thick (approximately 350 micron) joints consist mainly of silicon with a small amount of silicon carbide. The flexural strength of thick joints is about 44 plus or minus 2 MPa, and fracture always occurs at the joints. The microscopic examination of fracture surfaces of specimens with thick joints tested at room temperature revealed the failure mode to be typically brittle. Thin joints (<50-55 micron) consist of silicon carbide and silicon phases. The room and high temperature flexural strengths of thin (<50-55 micron) reaction-formed joints have been found to be at least equal to that of the bulk Cerastar RB-SIC materials because the flexure bars fracture away from the joint regions. In this case, the fracture origins appear to be inhomogeneities inside the parent material. This was always found to be the case for thin joints tested at temperatures up to 1350C in air. This observation suggests that the strength of Cerastar RB-SIC material containing a thin joint is not limited by the joint strength but by the strength of the bulk (parent) materials.

Microstructure-dependent fracture toughness (JIC) variations in dissimilar pipe welds for pressure vessel system of nuclear plants

NASA Astrophysics Data System (ADS)

Rathod, Dinesh W.; Pandey, Sunil; Singh, P. K.; Kumar, Suranjit

2017-09-01

In present study, dissimilar metal weld (DMW) joints between SA508Gr.3cl.1 ferritic steel and SS304LN pipes were prepared using Inconel 82/182, and Inconel 52/152 consumables. Metallurgical properties and their influence on fracture toughness of weldment regions and interfacial regions could play a significant role in integrity assessment of these joints. Ni-based consumables exhibit complex metallurgical properties at interfacial regions. The metallurgical characterization and fracture toughness studies of Inconel 82/182 and Inconel 52/152 joints have been carried out for determining the optimum consumable for DMW joint requirements and the effect of microstructure on fracture toughness in weldment regions. The present codes and procedures for integrity assessment of DMW joints have not given due considerations of metallurgical properties. The requirements for metallurgical properties by considering their effect on fracture toughness properties in integrity assessment have been discussed for reliable analysis. Inconel 82/182 is preferred over Inconel 52/152 joints owing to favorable metallurgical and fracture toughness properties across the interfacial and weldment regions.

Intra-operative fiducial-based CT/fluoroscope image registration framework for image-guided robot-assisted joint fracture surgery.

PubMed

Dagnino, Giulio; Georgilas, Ioannis; Morad, Samir; Gibbons, Peter; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

2017-08-01

Joint fractures must be accurately reduced minimising soft tissue damages to avoid negative surgical outcomes. To this regard, we have developed the RAFS surgical system, which allows the percutaneous reduction of intra-articular fractures and provides intra-operative real-time 3D image guidance to the surgeon. Earlier experiments showed the effectiveness of the RAFS system on phantoms, but also key issues which precluded its use in a clinical application. This work proposes a redesign of the RAFS's navigation system overcoming the earlier version's issues, aiming to move the RAFS system into a surgical environment. The navigation system is improved through an image registration framework allowing the intra-operative registration between pre-operative CT images and intra-operative fluoroscopic images of a fractured bone using a custom-made fiducial marker. The objective of the registration is to estimate the relative pose between a bone fragment and an orthopaedic manipulation pin inserted into it intra-operatively. The actual pose of the bone fragment can be updated in real time using an optical tracker, enabling the image guidance. Experiments on phantom and cadavers demonstrated the accuracy and reliability of the registration framework, showing a reduction accuracy (sTRE) of about [Formula: see text] (phantom) and [Formula: see text] (cadavers). Four distal femur fractures were successfully reduced in cadaveric specimens using the improved navigation system and the RAFS system following the new clinical workflow (reduction error [Formula: see text], [Formula: see text]. Experiments showed the feasibility of the image registration framework. It was successfully integrated into the navigation system, allowing the use of the RAFS system in a realistic surgical application.

Non-destructive and non-invasive observation of friction and wear of human joints and of fracture initiation by acoustic emission.

PubMed

Schwalbe, H J; Bamfaste, G; Franke, R P

1999-01-01

Quality control in orthopaedic diagnostics according to DIN EN ISO 9000ff requires methods of non-destructive process control, which do not harm the patient by radiation or by invasive examinations. To obtain an improvement in health economy, quality-controlled and non-destructive measurements have to be introduced into the diagnostics and therapy of human joints and bones. A non-invasive evaluation of the state of wear of human joints and of the cracking tendency of bones is, as of today's point of knowledge, not established. The analysis of acoustic emission signals allows the prediction of bone rupture far below the fracture load. The evaluation of dry and wet bone samples revealed that it is possible to conclude from crack initiation to the bone strength and thus to predict the probability of bone rupture.

[Compensatory joints at the pelvis (author's transl)].

PubMed

Schumacher, G; Weber, M

1980-10-01

An osteochondrosis ischio-pubica represents a "testing site" for the integrity of the pelvis not only during child age but in adults as well. If all naturally available compensatory mechanisms have been exhausted especially following a change of range of motion in the pelvis ring structure, fatigue fractures or zones in transformation in the area typical of osteochondrosis ischio-pubica may appear. These fractures or transformation zones respectively to our mind have joint character, because they are capable of temporarily replacing lost mobility of physiological joints. Healing is achieved through rest, muscular balance and a specific physiotherapy. The purpose of this muscular training is to cushion all unphysiological motions in the pelvis and to support and boost the function of those joints still well preserved.

Gradual Reduction of Chronic Fracture Dislocation of the Ankle Using Ilizarov/Taylor Spatial Frame

PubMed Central

Deland, Jonathan T.; Rozbruch, S. Robert

2010-01-01

With the advances in trauma care, chronic fracture dislocation of the ankle is not a condition commonly seen in modern clinical practice. When encountered, it can be difficult to preserve the ankle joint. We present a case of a 65-year-old female, with a chronic fracture dislocation of the ankle. The ankle joint was subluxated with posterior translation of the talus, displacement of the posterior malleolus fragment, and a distal fibula fracture. A minimally traumatic approach was devised to treat this complex fracture dislocation which included gradual reduction of the ankle with a Taylor spatial frame, followed by stabilization with internal fixation and removal of the frame. Bony union and restoration of the ankle joint congruency was achieved. PMID:22294963

[Eponyms of distal radius fractures. Colles-Pouteau, Smith-Goyrand and Barton fractures and their importance in the trauma surgery patient sample].

PubMed

Ebert, B; Müller, J E

1993-10-01

Fractures at the distal end of the radius are quite common. So, these fractures are well known to represent consequences of industrial accidents leading to temporary unfitness for work, too. Eponym descriptions of fractures may mislead authors and readers as well if used in a non-uniform way in medical literature. Using the original articles of the first describing authors a clear distinction of eponyms concerning fractures near to the wrist joint is given. The authors of this feature report of the clinical experience in treatment and results of distal radius fractures in combination with aspects of expert opinions on these fractures.

[Injuries of the acromioclavicular joint].

PubMed

Meeder, P J; Dannöhl, C

1988-07-01

The injuries of the acromio-clavicular joint require a differentiated diagnosis and treatment. The classification of the acromio-clavicular dislocations from grade I to grade III according to Tossy is proved. The diagnosis of a complete acromio-clavicular dislocation (Tossy III) is an indication for a surgical repair. Many and different methods are reported in the literature. 178 patients with a fresh acromio-clavicular dislocation (Typ Tossy II and III) were treated at the BG-Unfallklinik Tübingen from 1970 to 1987 by suturing the ligaments, inserting pins across the joint and tension wire bending. In old cases with Tossy III dislocation of the acromio-clavicular joint an oblique osteotomy combined with the reduction of the clavicle is recommended as a method of choice. The results of these procedures and there possible intra- and postoperative complications are reported. The incision along the clavicle quite often gives scar problems. Therefore the advantages of an arched incision across the acromio-clavicular joint is pointed out. Because of there biomechanical relationship fractures in the lateral third of the clavicle are similar to dislocations of the acromio-clavicular joint. The classification of these fractures according to Jäger, Buschle and Breitner allows a differentiated management of these lesions.

Fracture strength of different soldered and welded orthodontic joining configurations with and without filling material.

PubMed

Bock, Jens Johannes; Bailly, Jacqueline; Gernhardt, Christian Ralf; Fuhrmann, Robert Andreas Werner

2008-01-01

The aim of this study was to compare the mechanical strength of different joints made by conventional brazing, TIG and laser welding with and without filling material. Five standardized joining configurations of orthodontic wire in spring hard quality were used: round, cross, 3 mm length, 9 mm length and 7 mm to orthodontic band. The joints were made by five different methods: brazing, tungsten inert gas (TIG) and laser welding with and without filling material. For the original orthodontic wire and for each kind of joint configuration or connecting method 10 specimens were carefully produced, totalizing 240. The fracture strengths were measured with a universal testing machine (Zwick 005). Data were analyzed by ANOVA (p=0.05) and Bonferroni post hoc test (p=0.05). In all cases, brazing joints were ruptured on a low level of fracture strength (186-407 N). Significant differences between brazing and TIG or laser welding (p<0.05, Bonferroni post hoc test) were found in each joint configuration. The highest fracture strength means were observed for laser welding with filling material and 3 mm joint length (998 N). Using filling materials, there was a clear tendency to higher mean values of fracture strength in TIG and laser welding. However, statistically significant differences were found only in the 9-mm long joints (p<0.05, Bonferroni post hoc test). In conclusion, the fracture strength of welded joints was positively influenced by the additional use of filling material. TIG welding was comparable to laser welding except for the impossibility of joining orthodontic wire with orthodontic band.

FRACTURE STRENGTH OF DIFFERENT SOLDERED AND WELDED ORTHODONTIC JOINING CONFIGURATIONS WITH AND WITHOUT FILLING MATERIAL

PubMed Central

Bock, Jens Johannes; Bailly, Jacqueline; Gernhardt, Christian Ralf; Fuhrmann, Robert Andreas Werner

2008-01-01

The aim of this study was to compare the mechanical strength of different joints made by conventional brazing, TIG and laser welding with and without filling material. Five standardized joining configurations of orthodontic wire in spring hard quality were used: round, cross, 3 mm length, 9 mm length and 7 mm to orthodontic band. The joints were made by five different methods: brazing, tungsten inert gas (TIG) and laser welding with and without filling material. For the original orthodontic wire and for each kind of joint configuration or connecting method 10 specimens were carefully produced, totalizing 240. The fracture strengths were measured with a universal testing machine (Zwick 005). Data were analyzed by ANOVA (p=0.05) and Bonferroni post hoc test (p=0.05). In all cases, brazing joints were ruptured on a low level of fracture strength (186-407 N). Significant differences between brazing and TIG or laser welding (p<0.05, Bonferroni post hoc test) were found in each joint configuration. The highest fracture strength means were observed for laser welding with filling material and 3 mm joint length (998 N). Using filling materials, there was a clear tendency to higher mean values of fracture strength in TIG and laser welding. However, statistically significant differences were found only in the 9-mm long joints (p<0.05, Bonferroni post hoc test). In conclusion, the fracture strength of welded joints was positively influenced by the additional use of filling material. TIG welding was comparable to laser welding except for the impossibility of joining orthodontic wire with orthodontic band. PMID:19089229

Third tarsal bone fractures in the greyhound.

PubMed

Guilliard, M J

2010-12-01

To describe the signalment, morphology, response to treatment and prognosis of third tarsal bone fractures in the racing greyhound. All third tarsal bone fractures seen by the author over a ten year period were included in the study. Diagnosis was by radiography. Treatments were reconstruction with a lag screw, fragment removal, centrodistal joint arthrodesis or conservative management. Twenty-three cases were included in the study of which 16 cases were recent and seven cases chronic fractures. The chronic cases had been rested from between three and six months before an examination for recurrent lameness. There were five concomitant second tarsal bone fractures. Partial dorsal collapse was present in four cases. Thirteen dogs had lag screw fixation; three were lost to follow-up, seven returned to racing and three, all with partial tarsal collapse, failed to return to racing. Two dogs that had a centrodistal joint arthrodesis and one dog treated by rest alone raced again. Two dogs that had fragment removal failed to return to racing. Veterinary examination of greyhounds with third tarsal bone fractures is often not sought at the time of the initial injury due to the benign presenting signs. Recurrence of lameness after rest is common. The prognosis for a successful return to racing would appear to be good following fragment fixation in both acute and chronic cases without dorsal tarsal collapse. Centrodistal joint arthrodesis may encourage bone union. The prognosis for conconservatively treated cases is guarded. Fragment removal is not recommended as a treatment. © 2010 British Small Animal Veterinary Association.

Percolation Theory and Modern Hydraulic Fracturing

NASA Astrophysics Data System (ADS)

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

2015-12-01

During the past few years, we have been developing a percolation model for fracking. This model provides a powerful tool for understanding the growth and properties of the complex fracture networks generated during a modern high volume hydraulic fracture stimulations of tight shale reservoirs. The model can also be used to understand the interaction between the growing fracture network and natural reservoir features such as joint sets and faults. Additionally, the model produces a power-law distribution of bursts which can easily be compared to observed microseismicity.

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

NASA Astrophysics Data System (ADS)

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

2014-05-01

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

Mixed-mode fatigue fracture of adhesive joints in harsh environments and nonlinear viscoelastic modeling of the adhesive

NASA Astrophysics Data System (ADS)

Arzoumanidis, Alexis Gerasimos

A four point bend, mixed-mode, reinforced, cracked lap shear specimen experimentally simulated adhesive joints between load bearing composite parts in automotive components. The experiments accounted for fatigue, solvent and temperature effects on a swirled glass fiber composite adherend/urethane adhesive system. Crack length measurements based on compliance facilitated determination of da/dN curves. A digital image processing technique was also utilized to monitor crack growth from in situ images of the side of the specimen. Linear elastic fracture mechanics and finite elements were used to determine energy release rate and mode-mix as a function of crack length for this specimen. Experiments were conducted in air and in a salt water bath at 10, 26 and 90°C. Joints tested in the solvent were fully saturated. In air, both increasing and decreasing temperature relative to 26°C accelerated crack growth rates. In salt water, crack growth rates increased with increasing temperature. Threshold energy release rate is shown to be the most appropriate design criteria for joints of this system. In addition, path of the crack is discussed and fracture surfaces are examined on three length scales. Three linear viscoelastic properties were measured for the neat urethane adhesive. Dynamic tensile compliance (D*) was found using a novel extensometer and results were considerably more accurate and precise than standard DMTA testing. Dynamic shear compliance (J*) was determined using an Arcan specimen. Dynamic Poisson's ratio (nu*) was extracted from strain gage data analyzed to include gage reinforcement. Experiments spanned three frequency decades and isothermal data was shifted by time-temperature superposition to create master curves spanning thirty decades. Master curves were fit to time domain Prony series. Shear compliance inferred from D* and nu* compared well with measured J*, forming a basis for finding the complete time dependent material property matrix for this

Surgical Approaches to the Proximal Interphalangeal Joint.

PubMed

Cheah, Andre Eu-Jin; Yao, Jeffrey

2016-02-01

The proximal interphalangeal (PIP) joint may be affected by many conditions such as arthropathy, fractures, dislocations, and malunions. Whereas some of these conditions may be treated nonsurgically, many require open surgical intervention. Open interventions include implant arthroplasty or arthrodesis for arthropathy, open reduction internal fixation, or hemi-hamate arthroplasty for dorsal fracture-dislocations. Volar plate arthroplasty and corrective osteotomy for malunion about the PIP joint are also surgeries that may be required. The traditional approach to the PIP joint has been dorsal, which damages the delicate extensor apparatus with subsequent development of an extensor lag. This has led surgeons to explore volar and lateral approaches to the PIP joint. In this article, we describe each of these surgical approaches, discuss their advantages and disadvantages, and provide some guidance on which approach to choose based on the surgery that is to be performed. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Characterization of Sheet Fracture Patterns in Polygonal-Jointed Lavas at Kokostick Butte, OR, and Mazama Ridge, WA: Investigation and Interpretation of Their Formation and Significance

NASA Astrophysics Data System (ADS)

Lodge, R. W.; Lescinsky, D. T.

2006-12-01

Polygonal joints in lava flows ("columns") are commonly equant leading to a model of formation associated with cooling in an isotropic stress field. This model, however, does not explain rectangular columns, sheet-like fractures, fractures with crosscutting relationships, and fractures with orientations other than perpendicular to the cooling surface. These fracture patterns are often observed at glaciated volcanoes. The presence of preferential fracture orientations suggests an applied stress component likely due to environmental conditions such as the presence of glaciers or flow dynamics such as down-slope settling or flow margin inflation. During this study we investigated the formation and significance of these non-equant fracture patterns to propose a model for their formation. These `abnormal' fracture patterns have not been discussed in the literature and may be important to better understanding the cooling conditions of such lava flows. To test these possibilities we studied Kokostick Butte dacite flow, OR (near South Sister), and Mazama Ridge andesite flow at Mount Rainier, WA. Both of these flows have well developed sheet-like fractures and display evidence of ice-contact during eruption and emplacement. Sheet fractures are long and continuous fractures that have perpendicular connecting fractures forming rectangular columns. The sheet-like fractures are largely parallel to each other on the exposure surface and the connecting fractures vary locally from primary fractures (associated with cooling toward flow interior) to secondary fractures (associated with cooling by water infiltration). Detailed measurements of fracture orientations and spacing were collected at Kokostick Butte and Mazama Ridge to examine the relationship between the sheet fractures and flow geometry. Preliminary results support this relationship and suggest these patterns likely form due to shear associated with small amounts of flow advance by the rapidly cooling lava. Laboratory

An elastic-plastic fracture mechanics analysis of weld-toe surface cracks in fillet welded T-butt joint

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

Fu, B.

1994-12-31

This paper describes an elastic-plastic fracture mechanics (EPFM) study of shallow weld-toe cracks. Two limiting crack configurations, plane strain edge crack and semi-circular surface crack in fillet welded T-butt plate joint, were analyzed using the finite element method. Crack depth ranging from 2 to 40% of plate thickness were considered. The elastic-plastic analysis, assuming power-law hardening relationship and Mises yield criterion, was based on incremental plasticity theory. Tension and bending loads applied were monotonically increased to a level causing relatively large scale yielding at the crack tip. Effects of weld-notch geometry and ductile material modeling on prediction of fracture mechanicsmore » characterizing parameter were assessed. It was found that the weld-notch effect reduces and the effect of material modeling increases as crack depth increases. Material modeling is less important than geometric modeling in analysis of very shallow cracks but is more important for relatively deeper cracks, e.g. crack depth more than 20% of thickness. The effect of material modeling can be assessed using a simplified structural model. Weld magnification factors derived assuming linear elastic conditions can be applied to EPFM characterization.« less

Concurrent dorsal dislocations and fracture-dislocations of the index, long, ring, and small (second to fifth) carpometacarpal joints.

PubMed

Prokuski, L J; Eglseder, W A

2001-11-01

To review the outcome of patients with concurrent dorsal dislocations and fracture-dislocations of the second, third, fourth, and fifth carpometacarpal (CMC) joints treated with open reduction and internal fixation (ORIF). Retrospective review. Level 1 trauma center. Between 1991 and 1997, twelve multiply injured patients with the described CMC injury complex (one open injury) were treated with ORIF (eleven patients) or percutaneous wire fixation (one patient) by the same surgeon. Treatment consisted of ORIF with Kirschner wires followed by splints and immediate metacarpophalangeal and interphalangeal joint range of motion exercises. Grip strength, wrist and finger range of motion, pain, need for additional surgery, and return to work. Of the ten patients available for follow-up (mean, three years), all had been treated with ORIF (eight within forty-eight hours of injury and two had treatment delayed for four weeks because of delayed diagnosis and management of more serious injuries). Three patients had additional surgery (planned secondary second and third CMC arthrodeses). Grip strength of the operated hand in the five patients with JAMAR testing was 50 percent (n = 3), 75 percent (n = 1), and 90 percent (n = 1) of that in their contralateral hands. Five patients were pain-free, and five reported occasional, activity-related pain. The five patients who worked before the injury returned to their previous occupations (one with slightly modified duties). This is the largest series of patients with this CMC injury complex and the first report of open CMC dorsal dislocations and fracture-dislocations. Although early ORIF is suggested, delay of up to four weeks did not adversely affect results.

[Patella fractures in knee arthroplasty].

PubMed

Roth, A; Ghanem, M; Fakler, J

2016-05-01

Periprosthetic patella fractures occur both with and without retropatellar joint replacement. A non-operative treatment yields satisfactory results with low morbidity. It can be applied in minimally displaced fractures that have an intact retropatellar component and an intact extensor mechanism, combined with an initial immobilization. The surgical treatment is associated with relatively poor results and with high complication rates. There was only minor improvement of functional results, no matter which surgical technique was used. Surgical intervention is still required in fractures with a loosening of the patellar component, considerable dislocations of fragments, and damage to or rupture of the extensor mechanism. In particular, type II fractures require repair of the extensor mechanism and the fracture or patellectomy. Type III fractures require a revision or resection of the patella, a patelloplasty or total patellectomy. In addition, early or late reconstruction using allograft to restore the extensor mechanism can be taken in consideration.

A Clinically Realistic Large Animal Model of Intra-Articular Fracture

DTIC Science & Technology

2012-10-01

articular bone intact. The distal impact face is anchored to the talus using three “tripod” pins, for direct (i.e., no soft tissue intervention) delivery of...pilon) fractures. In this technique, the porcine hock joint (human ankle analogue) is subjected to an injurious transarticular compressive force pulse...fracture, to create fractures morphologically similar to human ankle anterior malleolar fractures. This cut was made on the anterior distal tibial cortex

Pediatric Ankle Fractures: Concepts and Treatment Principles

PubMed Central

Su, Alvin W.; Larson, A. Noelle

2016-01-01

Synopsis Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate exam, imaging, and knowledge of fracture patterns specific to children. Treatment is guided by patient history, physical examination, plain film radiographs and, in some instances, CT. Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity. PMID:26589088

[New techniques in the operative treatment of calcaneal fractures].

PubMed

Rammelt, S; Amlang, M; Sands, A K; Swords, M

2016-03-01

The ideal treatment of displaced intra-articular calcaneal fractures is still controversially discussed. Because of the variable fracture patterns and the vulnerable soft tissue coverage an individual treatment concept is advisable. In order to minimize wound edge necrosis associated with extended lateral approaches, selected fractures may be treated percutaneously or in a less invasive manner while controlling joint reduction via a sinus tarsi approach. Fixation in these cases is achieved with screws, intramedullary locking nails or modified plates that are slid in subcutaneously. A thorough knowledge of the three dimensional calcaneal anatomy and open reduction maneuvers is a prerequisite for good results with less invasive techniques. Early functional follow-up treatment aims at early rehabilitation independent of the kind of fixation. Peripheral fractures of the talus and calcaneus frequently result from subluxation and dislocation at the subtalar and Chopart joints. They are still regularly overlooked and result in painful arthritis if left untreated. If an exact anatomical reduction of these intra-articular fractures is impossible, resection of small fragments is indicated.

Pseudogout at the knee joint will frequently occur after hip fracture and lead to the knee pain in the early postoperative period.

PubMed

Harato, Kengo; Yoshida, Hiroki

2015-01-14

Symptomatic knee joint effusion is frequently observed after hip fracture, which may lead to postoperative knee pain during rehabilitation after hip fracture surgery. However, unfortunately, very little has been reported on this phenomenon in the literature. The purpose of the current study was to investigate the relationship between symptomatic knee effusion and postoperative knee pain and to clarify the reason of the effusion accompanied by hip fracture. A total of 100 patients over 65 years of age with an acute hip fracture after fall were prospectively followed up. Knee effusion was assessed on admission and at the operating room before the surgery. If knee effusion was observed at the time of the surgery, synovial fluid was collected into syringes to investigate the cause of the effusion using a compensated polarized light microscope. Furthermore, for each patient, we evaluated age, sex, radiographic knee osteoarthritis (OA), type of the fracture, laterality, severity of the fracture, and postoperative knee pain during rehabilitation. These factors were compared between patients with and without knee effusion at the time of the surgery. As a statistical analysis, we used Mann-Whitney U-test for patients' age and categorical variables were analyzed by chi-square test or Fisher's exact test. A total of 30 patients presented symptomatic knee effusion at the time of the surgery. In patients with knee effusion, numbers of intertrochanteric fracture, radiographic knee OA, and postoperative knee pain were significantly large compared to those without effusion. In terms of synovial fluid analysis, calcium pyrophosphate dihydrate crystals were observed in 80% of patients with knee effusion. From our study, approximately 63% of patients with knee effusion at the time of the surgery had postoperative knee pain. In addition, this effusion was basically related to pseudogout.

Investigation on the Cracking Character of Jointed Rock Mass Beneath TBM Disc Cutter

NASA Astrophysics Data System (ADS)

Yang, Haiqing; Liu, Junfeng; Liu, Bolong

2018-04-01

With the purpose to investigate the influence of joint dip angle and spacing on the TBM rock-breaking efficacy and cracking behaviour, experiments that include miniature cutter head tests are carried out on sandstone rock material. In the experiment, prefabricated joints of different forms are made in rock samples. Then theoretical analysis is conducted to improve the calculating models of the fractured work and crack length of rock in the TBM process. The experimental results indicate that lower rupture angles appear for specimens with joint dip angles between 45° and 60°. Meanwhile, rock-breaking efficacy for rock mass with joint dip angles in this interval is also higher. Besides, the fracture patterns are transformed from compressive shear mode to tensile shear mode as the joint spacing decreases. As a result, failure in a greater extent is resulted for specimens with smaller joint spacings. The results above suggest that joint dip angle between 45° and 60° and joint spacing of 1 cm are the optimal rock-breaking conditions for the tested specimens. Combining the present experimental data and taking the joint dip angle and spacing into consideration, the calculating model for rock fractured work that proposed by previous scholars is improved. Finally, theoretical solution of rock median and side crack length is also derived based on the analytical method of elastoplastic invasion fracture for indenter. The result of the analytical solution is also in good agreement with the actual measured experimental result. The present study may provide some primary knowledge about the rock cracking character and breaking efficacy under different engineering conditions.

The influence of joint parameters on normal fault evolution and geometry: a parameter study using analogue modeling

NASA Astrophysics Data System (ADS)

Kettermann, Michael; von Hagke, Christoph; Urai, Janos L.

2017-04-01

Dilatant faults often form in rocks containing pre-existing joints, but the effects of joints on fault segment linkage and fracture connectivity is not well understood. Studying evolution of dilatancy and influence of fractures on fault development provides insights into geometry of fault zones in brittle rocks and will eventually allow for predicting their subsurface appearance. In an earlier study we recognized the effect of different angles between strike direction of vertical joints and a basement fault on the geometry of a developing fault zone. We now systematically extend the results by varying geometric joint parameters such as joint spacing and vertical extent of the joints and measuring fracture density and connectivity. A reproducibility study shows a small error-range for the measurements, allowing for a confident use of the experimental setup. Analogue models were carried out in a manually driven deformation box (30x28x20 cm) with a 60° dipping pre-defined basement fault and 4.5 cm of displacement. To produce open joints prior to faulting, sheets of paper were mounted in the box to a depth of 5 cm at a spacing of 2.5 cm. We varied the vertical extent of the joints from 5 to 50 mm. Powder was then sieved into the box, embedding the paper almost entirely (column height of 19 cm), and the paper was removed. During deformation we captured structural information by time-lapse photography that allows particle imaging velocimetry analyses (PIV) to detect localized deformation at every increment of displacement. Post-mortem photogrammetry preserves the final 3-dimensional structure of the fault zone. A counterintuitive result is that joint depth is of only minor importance for the evolution of the fault zone. Even very shallow joints form weak areas at which the fault starts to form and propagate. More important is joint spacing. Very large joint spacing leads to faults and secondary fractures that form subparallel to the basement fault. In contrast, small

Knee joint effusion following ipsilateral hip surgery.

PubMed

Christodoulou, A G; Givissis, P; Antonarakos, P D; Petsatodis, G E; Hatzokos, I; Pournaras, J D

2010-12-01

To correlate patellar reflex inhibition with sympathetic knee joint effusion. 65 women and 40 men aged 45 to 75 (mean, 65) years underwent hip surgery. The surgery entailed dynamic hip screw fixation using the lateral approach with reflection of the vastus lateralis for pertrochantric fractures (n = 49), and hip hemiarthroplasty or total hip replacement using the Watson-Jones approach (n = 38) or hip hemiarthroplasty using the posterior approach (n = 18) for subcapital femoral fractures (n = 28) or osteoarthritis (n = 28). Knee joint effusion, patellar reflex, and thigh circumference were assessed in both legs before and after surgery (at day 0.5, 2, 7, 14, 30, and 45). Time-sequence plots were used for chronological analysis, and correlation between patellar reflex inhibition and knee joint effusion was tested. In the time-sequence plot, the peak frequency of patellar reflex inhibition (on day 0.5) preceded that of the knee joint effusion and the thigh circumference increase (on day 2). Patellar reflex inhibition correlated positively with the knee joint effusion (r = 0.843, p = 0.035). These 2 factors correlated significantly for all 3 surgical approaches (p < 0.0005). All 3 approaches were associated with patellar reflex inhibition on day 0.5 (p = 0.033) and knee joint effusion on day 2 (p = 0.051). Surgical trauma of the thigh may cause patellar reflex inhibition and subsequently knee joint effusion.

Ankle fractures have features of an osteoporotic fracture.

PubMed

Lee, K M; Chung, C Y; Kwon, S S; Won, S H; Lee, S Y; Chung, M K; Park, M S

2013-11-01

We report the bone attenuation of ankle joint measured on computed tomography (CT) and the cause of injury in patients with ankle fractures. The results showed age- and gender-dependent low bone attenuation and low-energy trauma in elderly females, which suggest the osteoporotic features of ankle fractures. This study was performed to investigate the osteoporotic features of ankle fracture in terms of bone attenuation and cause of injury. One hundred ninety-four patients (mean age 51.0 years, standard deviation 15.8 years; 98 males and 96 females) with ankle fracture were included. All patients underwent CT examination, and causes of injury (high/low-energy trauma) were recorded. Mean bone attenuations of the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis were measured on CT images. Patients were divided into younger age (<50 years) and older age (≥50 years) groups, and mean bone attenuation and causes of injury were compared between the two groups in each gender. Proportion of low-energy trauma was higher in the older age group than in the younger age group, but the difference was only significant in female gender (p = 0.011). The older age group showed significantly lower bone attenuation in the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis than the younger age group in both genders. The older age group showed more complex pattern of fractures than the younger age group. With increasing age, bone attenuations tended to decrease and the difference of bone attenuation between the genders tended to increase in the talus, medial malleolus, lateral malleolus, and distal tibial metaphysis. Ankle fracture had features of osteoporotic fracture that is characterized by age- and gender-dependent low bone attenuation. Ankle fracture should not be excluded from the clinical and research interest as well as from the benefit of osteoporosis management.

Influence of fragment size and postoperative joint congruency on long-term outcome of posterior malleolar fractures.

PubMed

Drijfhout van Hooff, Cornelis Christiaan; Verhage, Samuel Marinus; Hoogendoorn, Jochem Maarten

2015-06-01

One of the factors contributing to long-term outcome of posterior malleolar fractures is the development of osteoarthritis. Based on biomechanical, cadaveric, and small population studies, fixation of posterior malleolar fracture fragments (PMFFs) is usually performed when fragment size exceeds 25-33%. However, the influence of fragment size on long-term clinical and radiological outcome size remains unclear. A retrospective cohort study of 131 patients treated for an isolated ankle fracture with involvement of the posterior malleolus was performed. Mean follow-up was 6.9 (range, 2.5-15.9) years. Patients were divided into groups depending on size of the fragment, small (<5%, n = 20), medium (5-25%, n = 86), or large (>25%, n = 25), and presence of step-off after operative treatment. We have compared functional outcome measures (AOFAS, AAOS), pain (VAS), and dorsiflexion restriction compared to the contralateral ankle and the incidence of osteoarthritis on X-ray. There were no nonunions, 56% of patients had no radiographic osteoarthritis, VAS was 10 of 100, and median clinical score was 90 of 100. More osteoarthritis occurred in ankle fractures with medium and large PMFFs compared to small fragments (small 16%, medium 48%, large 54%; P = .006). Also when comparing small with medium-sized fragments (P = .02), larger fragment size did not lead to a significantly decreased function (median AOFAS 95 vs 88, P = .16). If the PMFF size was >5%, osteoarthritis occurred more frequently when there was a postoperative step-off ≥1 mm in the tibiotalar joint surface (41% vs 61%, P = .02) (whether the posterior fragment had been fixed or not). In this group, fixing the PMFF did not influence development of osteoarthritis. However, in 42% of the cases with fixation of the fragment a postoperative step-off remained (vs 45% in the group without fixation). Osteoarthritis is 1 component of long-term outcome of malleolar fractures, and the results of this study demonstrate that

Osteoligamentous injuries of the medial ankle joint.

PubMed

Lötscher, P; Lang, T H; Zwicky, L; Hintermann, B; Knupp, M

2015-12-01

Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ankle joint osteoarthritis.

Dissolution-Enlarged Fractures Imaging Using Electrical Resistivity Tomography (ERT)

NASA Astrophysics Data System (ADS)

Siami-Irdemoosa, Elnaz

In recent years the electrical imaging techniques have been largely applied to geotechnical and environmental investigations. These techniques have proven to be the best geophysical methods for site investigations in karst terrain, particularly when the overburden soil is clay-dominated. Karst is terrain with a special landscape and distinctive hydrological system developed by dissolution of rocks, particularly carbonate rocks such as limestone and dolomite, made by enlarging fractures into underground conduits that can enlarge into caverns, and in some cases collapse to form sinkholes. Bedding planes, joints, and faults are the principal structural guides for underground flow and dissolution in almost all karstified rocks. Despite the important role of fractures in karst development, the geometry of dissolution-enlarged fractures remain poorly unknown. These features are characterized by an strong contrast with the surrounding formations in terms of physical properties, such as electrical resistivity. Electrical resistivity tomography (ERT) was used as the primary geophysical tool to image the subsurface in a karst terrain in Greene County, Missouri. Pattern, orientation and density of the joint sets were interpreted from ERT data in the investigation site. The Multi-channel Analysis of Surface Wave (MASW) method and coring were employed to validate the interpretation results. Two sets of orthogonal visually prominent joints have been identified in the investigation site: north-south trending joint sets and west-east trending joint sets. However, most of the visually prominent joint sets are associated with either cultural features that concentrate runoff, natural surface drainage features or natural surface drainage.

Numerical Simulation of Tension Properties for Al-Cu Alloy Friction Stir-Welded Joints with GTN Damage Model

NASA Astrophysics Data System (ADS)

Sun, Guo-Qin; Sun, Feng-Yang; Cao, Fang-Li; Chen, Shu-Jun; Barkey, Mark E.

2015-11-01

The numerical simulation of tensile fracture behavior on Al-Cu alloy friction stir-welded joint was performed with the Gurson-Tvergaard-Needleman (GTN) damage model. The parameters of the GTN model were studied in each region of the friction stir-welded joint by means of inverse identification. Based on the obtained parameters, the finite element model of the welded joint was built to predict the fracture behavior and tension properties. Good agreement can be found between the numerical and experimental results in the location of the tensile fracture and the mechanical properties.

Tibial Plateau Fractures in Elderly Patients

PubMed Central

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

2016-01-01

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

Talar Fractures in Children: A Possible Injury After Go-Karting Accidents.

PubMed

Kamphuis, Saskia J M; Meijs, Claartje M E M; Kleinveld, Sanne; Diekerhof, Carel H; van der Heijden, Frank H W M

2015-01-01

Go-karting is an increasingly popular high-energy sport enjoyed by both children and adults. Because of the speeds involved, accidents involving go-karts can lead to serious injury. We describe 6 talar fractures in 4 patients that resulted from go-karting accidents. Talar fractures can cause severe damage to the tibiotalar joint, talocalcaneal or subtalar joint, and the talonavicular joint. This damage can, in turn, lead to complications such as avascular necrosis, arthritis, nonunion, delayed union, and neuropraxia, which have the potential to cause long-term disability in a child. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

A small punch test technique for characterizing the elastic modulus and fracture behavior of PMMA bone cement used in total joint replacement.

PubMed

Giddings, V L; Kurtz, S M; Jewett, C W; Foulds, J R; Edidin, A A

2001-07-01

Polymethylmethacrylate (PMMA) bone cement is used in total joint replacements to anchor implants to the underlying bone. Establishing and maintaining the integrity of bone cement is thus of critical importance to the long-term outcome of joint replacement surgery. The goal of the present study was to evaluate the suitability of a novel testing technique, the small punch or miniaturized disk bend test, to characterize the elastic modulus and fracture behavior of PMMA. We investigated the hypothesis that the crack initiation behavior of PMMA during the small punch test was sensitive to the test temperature. Miniature disk-shaped specimens, 0.5 mm thick and 6.4 mm in diameter, were prepared from PMMA and Simplex-P bone cement according to manufacturers' instructions. Testing was conducted at ambient and body temperatures, and the effect of test temperature on the elastic modulus and fracture behavior was statistically evaluated using analysis of variance. For both PMMA materials, the test temperature had a significant effect on elastic modulus and crack initiation behavior. At body temperature, the specimens exhibited "ductile" crack initiation, whereas at room temperature "brittle" crack initiation was observed. The small punch test was found to be a sensitive and repeatable test method for evaluating the mechanical behavior of PMMA. In light of the results of this study, future small punch testing should be conducted at body temperature.

Small-scale electrical resistivity tomography of wet fractured rocks.

PubMed

LaBrecque, Douglas J; Sharpe, Roger; Wood, Thomas; Heath, Gail

2004-01-01

This paper describes a series of experiments that tested the ability of the electrical resistivity tomography (ERT) method to locate correctly wet and dry fractures in a meso-scale model. The goal was to develop a method of monitoring the flow of water through a fractured rock matrix. The model was a four by six array of limestone blocks equipped with 28 stainless steel electrodes. Dry fractures were created by placing pieces of vinyl between one or more blocks. Wet fractures were created by injecting tap water into a joint between blocks. In electrical terms, the dry fractures are resistive and the wet fractures are conductive. The quantities measured by the ERT system are current and voltage around the outside edge of the model. The raw ERT data were translated to resistivity values inside the model using a three-dimensional Occam's inversion routine. This routine was one of the key components of ERT being tested. The model presented several challenges. First, the resistivity of both the blocks and the joints was highly variable. Second, the resistive targets introduced extreme changes the software could not precisely quantify. Third, the abrupt changes inherent in a fracture system were contrary to the smoothly varying changes expected by the Occam's inversion routine. Fourth, the response of the conductive fractures was small compared to the background variability. In general, ERT was able to locate correctly resistive fractures. Problems occurred, however, when the resistive fracture was near the edges of the model or when multiple fractures were close together. In particular, ERT tended to position the fracture closer to the model center than its true location. Conductive fractures yielded much smaller responses than the resistive case. A difference-inversion method was able to correctly locate these targets.

Value of Early Postoperative Computed Tomography Assessment in Ankle Fractures Defining Joint Congruity and Criticizing the Need for Early Revision Surgery.

PubMed

Palmanovich, Ezequiel; Brin, Yaron S; Kish, Benny; Nyska, Meir; Hetsroni, Iftach

2016-01-01

Previous investigators have questioned the reliability of plain radiographs in assessing the accuracy of ankle fracture reduction when these were compared with the computed tomography (CT) evaluation in the preoperative setting, in particular, in fractures with syndesmosis injuries or trimalleolar fragments. The role of CT assessment, however, has not been investigated in the early postoperative setting. In the early postoperative setting, reduction still relies most commonly on fluoroscopy and plain radiographs alone. In the present study, we hypothesized that early postoperative CT assessment of ankle fractures with syndesmosic injuries and posterior malleolar fragments can add valuable information about the joint congruity compared with plain radiographs alone and that this information could affect the decisions regarding the need for early revision surgery. A total of 352 consecutive operated ankle fractures were reviewed. Of these, 68 (19%) underwent early postoperative CT assessment and were studied further to identify the causes that prompted revision surgery. Of the 68 cases, despite acceptable reduction found on the plain radiographs, 20 (29%) underwent early (within 1 week) revision surgery after studying the CT scans, which revealed malreduction of the syndesmosis, malreduction of the posterior lip fragment, and intra-articular fragments. We concluded that in ankle fractures involving disruptions of the syndesmosis or posterior malleolar fragments, early postoperative CT assessment could be justified, because it will reveal malreduction and prompt early revision intervention for a substantial proportion of these patients. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Risk of Osteosarcoma in Dogs After Open Fracture Fixation.

PubMed

Arthur, Elizabeth G; Arthur, Gerald L; Keeler, Matthew R; Bryan, Jeffrey N

2016-01-01

To critically evaluate whether open fracture fixation is a significant risk factor for latent osteosarcoma development. Case-control study. Dogs undergoing open fracture repair and dogs diagnosed with osteosarcoma. Records were retrieved from the Veterinary Medical Database VMDB (1970-2000) for dogs undergoing surgical repair of a fracture and dogs diagnosed with osteosarcoma. Dogs with open reduction of joint luxation, dogs diagnosed with bacterial cystitis, and dogs diagnosed with urinary bladder transitional cell carcinoma (UBTCC) were queried as comparison populations. Relative risk for osteosarcoma development was determined. From a population of 19,041 fractures treated surgically, 15 of those dogs subsequently appeared in the VMDB with osteosarcoma affecting the same bone. The relative risk of a fracture repair and associated orthopedic implants and osteosarcoma occurrence was equivalent to the relative risk of open joint reduction and osteosarcoma occurrence (95% confidence interval; 0.998-1.00). The relative risk of having bacterial cystitis and appearing again in the VMDB with UBTCC was higher than the risk of open fracture repair and a subsequent diagnosis of osteosarcoma (P < .02). The incidence of fracture-related osteosarcoma may be significantly less than previously estimated based on cases queried from the VMDB. Although possible cases of implant-associated osteosarcoma were identified, their occurrence was rare. Elective implant removal for the purpose of reducing the risk of osteosarcoma after fracture repair may not be warranted and merits further investigation. © Copyright 2015 by The American College of Veterinary Surgeons.

[Missed diagnosis of hiding posterior marginal fracture of ankle with pronation-external rotation type and its treatment].

PubMed

Wang, Jia; Zhang, Yun-Tong; Zhang, Chun-Cai; Tang, Yang

2014-01-01

To analyze causes of missed diagnosis of hiding post-malleolar fractures in treating ankle joint fractures of pronation-external rotation type according to Lauge-Hansen classification and assess its medium-term outcomes. Among 103 patients with ankle joint fracture of pronation-external rotation type treated from March 2002 to June 2010,9 patients were missed diagnosis,including 6 males and 3 females,with a mean age of 35.2 years old (ranged, 18 to 55 years old) . Four patients were diagnosed during operation, 2 patients were diagnosed 2 or 3 days after first surgery and 3 patients came from other hospital. All the patients were treated remedially with lag screws and lock plates internal fixation. After operation,ankle joint function was evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS). All the 9 patients were followed up, and the duration ranged from 14 to 30 months (averaged, 17 months). No incision infection was found, and all incision healed at the first stage. At the latest follow-up, AOFAS was 83.0 +/- 4.4, the score of 4 patients diagnosed during operation was 85.0 +/- 2.9, and the score of 5 patients treated by secondary operation was 81.0 +/- 5.3. All the patients got fracture union observed by X-ray at a mean time of 2.2 months after operation. There were no complications such as internal fixation loosing, broken and vascular or nerve injuries. Ankle joint fracture of pronation-external rotation type may be combined with hiding post-malleolar fractures. So to patients with ankle joint fracture of pronation-external rotation type, lateral X-ray should be read carefully, and if necessary, CT or MRI examination should be performed. If adding lateral X-ray examination after reduction of exterior and interior ankle joint fixation, the missed diagnosis may be avoided.

Outcome of intramedullary interlocking SIGN nail in tibial diaphyseal fracture.

PubMed

Khan, Irfanullah; Javed, Shahzad; Khan, Gauhar Nawaz; Aziz, Amer

2013-03-01

To determine the outcome of intramedullary interlocking surgical implant generation network (SIGN) nail in diaphyseal tibial fractures in terms of union and failure of implant (breakage of nail or interlocking screws). Case series. Orthopaedics and Spinal Surgery, Ghurki Trust Teaching Hospital, Lahore Medical and Dental College, Lahore, from September 2008 to August 2009. Fifty patients aged 14 - 60 years, of either gender were included, who had closed and Gustilo type I and II open fractures reported in 2 weeks, whose closed reduction was not possible or was unsatisfactory and fracture was located 7 cm below knee joint to 7 cm above ankle joint. Fractures previously treated with external fixator, infected fractures and unfit patients were excluded. All fractures were fixed with intramedullary interlocking SIGN nail and were followed clinically and radiographically for union and for any implant failure. Forty one (88%) patients had united fracture within 6 months, 5 (10%) patients had delayed union while 4 (8%) patients had non-union. Mean duration for achieving union was 163 + 30.6 days. Interlocking screws were broken in 2 patients while no nail was broken in any patient. Intramedullary interlocking nailing is an effective measure in treating closed and grade I and II open tibial fractures. It provides a high rate of union less complications and early return to function.

[Trochanteric femoral fractures: anatomy, biomechanics and choice of implants].

PubMed

Bonnaire, F; Lein, T; Bula, P

2011-06-01

The objective of any surgical care of a trochanteric femoral fracture should be the achievement of a stable osteosynthesis that allows early full weight-bearing mobilisation of the patient, because long-term immobilisation soon becomes a vital threat to the affected patients who are usually elderly with correlating comorbidities. The anatomical references of the proximal femur and the structure of the hip joint contain some specifics that play an essential role in the incurrence of a trochanteric femoral fracture and the planning of the osteosynthesis as well. With reposition and fracture stabilisation particular importance must be attached to the collo-diaphyseal and the antetorsion angle so that they do not interfere with the functional interaction of the hip and knee joint. Uncomplex trochanteric fractures ordinarily stabilise sufficiently after reposition so that even an extramedullary implant can ensure full weight-bearing stability. With evermore distal fracture course and intertrochanteric comminution zone, rotational instability and pivot transfer of the fracture area to lateral and caudal are followed by an increase of the dislocating forces. These kinds of fractures (A2 and A3 according to the AO/ASIF classification) profit from an intramedullary and rotationally stable osteosynthesis. Basically primary total hip arthroplasty is a potential option for surgical care of a trochanteric fracture in elderly patients with relevant coxarthrosis. However this procedure can only be recommended in cases of a stable uncomplex fracture. The more the medial interlocking of the proximal femur is destroyed the more difficult it will be to primarily implant a total hip prosthesis with good offset and without a varus and rotational failure in the fracture zone.The current studies in the main show disadvantages due to increased complications in these patients, so that in cases of an unstable trochanteric fracture a primary osteosynthesis should be performed followed by

Biomechanical stability of intramedullary technique for fixation of joint depressed calcaneus fracture.

PubMed

Nelson, Joshua D; McIff, Terence E; Moodie, Patrick G; Iverson, Jamey L; Horton, Greg A

2010-03-01

Internal fixation of the os calcis is often complicated by prolonged soft tissue management and posterior facet disruption. An ideal calcaneal construct would include minimal hardware prominence, sturdy posterior facet fixation and nominal soft tissue disruption. The purpose of this study was to develop such a construct and provide a biomechanical analysis comparing our technique to a standard internal fixation technique. Twenty fresh-frozen cadaver calcanei were used to create a reproducible Sanders type-IIB calcaneal fracture pattern. One calcaneus of each pair was randomly selected to be fixed using our compressive headless screw technique. The contralateral matched calcaneus was fixed with a nonlocking calcaneal plate in a traditional fashion. Each calcaneus was cyclically loaded at a frequency of 1 Hz for 4000 cycles using an increasing force from 250 N to 1000 N. An Optotrak motion capturing system was used to detect relative motion of the three fracture fragments at eight different points along the fracture lines. Horizontal separation and vertical displacement at the fracture lines was recorded, as well as relative rotation at the primary fracture line. When the data were averaged, there was more horizontal displacement at the primary fracture line of the plate and screw construct compared to the headless screw construct. The headless screw construct also had less vertical displacement at the primary fracture line at every load. On average those fractures fixed with the headless screw technique had less rotation than those fixed with the side plate technique. A new headless screw technique for calcaneus fracture fixation was shown to provide stability as good as, or better than, a standard side plating technique under the axial loading conditions of our model. Although further testing is needed, the stability of the proposed technique is similar to that typically provided by intramedullary fixation. This fixation technique provides a biomechanically stable

An unusual fracture of the talus in a snowboarder.

PubMed

Vlahovich, A Tanja; Mehin, Ramin; O'Brien, Peter J

2005-08-01

Fractures of the talus are uncommon. However, snow- boarding and skateboarding are 2 activities that are specifically associated with talus fractures. These patients sustain occult lateral talus process fractures that present as a severe ankle injury. The diagnosis is difficult because of subtle clinical and plain radiographic findings. Computed tomography is a very useful tool for the assessment of these injuries. Although the majority of these athletes have lateral sided talus fractures, there are variants. We present an unusual case of a displaced intra-articular fracture of the subtalar joint involving the middle articular facet of the talus with extension of the fracture into the talar head. This highlights the importance of carefully assessing snowboarders' "ankle injuries."

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

PubMed

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

2014-01-01

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

THE PATHOMECHANICAL ETIOLOGY OF POST-TRAUMATIC OSTEOARTHRITIS FOLLOWING INTRAARTICULAR FRACTURES

PubMed Central

Anderson, Donald D; Marsh, J Lawrence; Brown, Thomas D

2011-01-01

Many intra-articular fracture patients eventually experience significant functional deficits, pain, and stiffness from post-traumatic osteoarthritis (PTOA). Over the last several decades, continued refinement of surgical reconstruction techniques has failed to markedly improve patient outcomes. New treatment paradigms are needed - ideally, bio/pharmaceutical. Progress in that direction has been impeded because the pathomechanical etiol-ogy of PTOA development is poorly understood. In particular, the relative roles and pathomechanisms of acute joint injury (from the initial trauma) versus chronic contact stress elevation (from residual incongruity) are unknown, primarily because there have been no objective methods for reliably quantifying either of these insult entities. Over the past decade, novel enabling technologies have been developed that provide objective biomechanical indices of injury severity and of chronic contact stress challenge to fractured joint surfaces. The severity of the initial joint injury is indexed primarily on the basis of the energy released in fracture, obtained from validated digital image analysis of CT scans. Chronic contact stress elevations are indexed by patient-specific finite element stress analysis, using models derived from post-reduction CT scans. These new measures, conceived in the laboratory, have been taken through the stage of validation, and then have been applied in studies of intra-articular fracture patients, to relate these biomechanical indices of cartilage insult to the incidence and severity of PTOA This body of work has provided a novel framework for developing and testing new approaches to forestall PTOA following intra-articular fractures. PMID:22096414

A likely universal model of fracture scaling and its consequence for crustal hydromechanics

NASA Astrophysics Data System (ADS)

Davy, P.; Le Goc, R.; Darcel, C.; Bour, O.; de Dreuzy, J. R.; Munier, R.

2010-10-01

We argue that most fracture systems are spatially organized according to two main regimes: a "dilute" regime for the smallest fractures, where they can grow independently of each other, and a "dense" regime for which the density distribution is controlled by the mechanical interactions between fractures. We derive a density distribution for the dense regime by acknowledging that, statistically, fractures do not cross a larger one. This very crude rule, which expresses the inhibiting role of large fractures against smaller ones but not the reverse, actually appears be a very strong control on the eventual fracture density distribution since it results in a self-similar distribution whose exponents and density term are fully determined by the fractal dimension D and a dimensionless parameter γ that encompasses the details of fracture correlations and orientations. The range of values for D and γ appears to be extremely limited, which makes this model quite universal. This theory is supported by quantitative data on either fault or joint networks. The transition between the dilute and dense regimes occurs at about a few tenths of a kilometer for faults systems and a few meters for joints. This remarkable difference between both processes is likely due to a large-scale control (localization) of the fracture growth for faulting that does not exist for jointing. Finally, we discuss the consequences of this model on the flow properties and show that these networks are in a critical state, with a large number of nodes carrying a large amount of flow.

The Unified Classification System (UCS): improving our understanding of periprosthetic fractures.

PubMed

Duncan, C P; Haddad, F S

2014-06-01

Periprosthetic fractures are an increasingly common complication following joint replacement. The principles which underpin their evaluation and treatment are common across the musculoskeletal system. The Unified Classification System proposes a rational approach to treatment, regardless of the bone that is broken or the joint involved. ©2014 The British Editorial Society of Bone & Joint Surgery.

Functional assessment of a surgical robot for reduction of lower limb fractures.

PubMed

Hung, Shuo-Suei; Lee, Ming-Yih

2010-12-01

This paper presents a novel robot designed for reduction of lower limb fractures, with the additional features of automatic controlled flexion of the knee joint, individual traction of thigh and leg, and foot rotation. The aim of this design is to assist the orthopaedic surgeon to perform better fracture reduction through motor control, in contrast to current manual control, and the results of assessments of its functions on normal subjects are presented in this paper. The robot was designed to be mounted onto the operation table, and was controlled through open switch relay. Functional assessments were conducted on six healthy volunteers in terms of knee joint motion and lower limb traction; measurement of angle and distance was calculated from data obtained by a 3D ultrasonic motion system (Zebris(®) ). The results showed a good correlation of the flexion angle between the robot and the subjects at the knee joint. In the traction tests, a steady lengthening of the proximal as well as the distal segment of the robot was observed, and a slight increase in subjects' limb length was also recorded, which might be due to distraction in the joint space. This automatic control fracture table has distinct features compared with the conventional ones, and it is believed to be of assistance to surgeons when performing fracture fixations. Copyright © 2010 John Wiley & Sons, Ltd.

Fractures of the talus: experience of two level 1 trauma centers.

PubMed

Elgafy, H; Ebraheim, N A; Tile, M; Stephen, D; Kase, J

2000-12-01

Fifty-eight patients with 60 talar fractures were retrospectively reviewed. There were 39 men and 19 women. The age average was 32 (range, 14-74). Eighty six percent of the patients had multiple injuries. The most common mechanism of injury was a motor vehicle accident. Twenty-seven (45%) of the fractures were neck, 22 (36.7%) process, and 11 (18.3%) body. Forty-eight fractures had operative treatment and 12 had non-operative management. The average follow-up period was 30 months (range, 24-65). Thirty-two fractures (53.3%) developed subtalar arthritis. Two patients had subsequent subtalar fusion. Fifteen fractures (25%) developed ankle arthritis. None of these patients required ankle fusion. Fractures of the body of the talus were associated with the highest incidence of degenerative joint disease of both the subtalar and ankle joints. Ten fractures (16.6%) developed avascular necrosis (AVN), only one of which had subsequent slight collapse. Avascular necrosis occurred mostly after Hawkins Type 3 and 2 fractures of the talar neck. Three rating scores were used in this series to assess the outcome: the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score, Maryland Foot Score, and Hawkins Evaluation Criteria. The outcome was different with every rating system. However, the outcome with AOFAS Ankle-Hindfoot Score and Hawkins Evaluation Criteria were almost equivalent. Assessment with the three rating scores showed that the process fractures had the best results followed by the neck and then the body fractures.

Joint-bounded crescentic scars formed by subglacial clast-bed contact forces: Implications for bedrock failure beneath glaciers

NASA Astrophysics Data System (ADS)

Krabbendam, M.; Bradwell, T.; Everest, J. D.; Eyles, N.

2017-08-01

Glaciers and ice sheets are important agents of bedrock erosion, yet the precise processes of bedrock failure beneath glacier ice are incompletely known. Subglacially formed erosional crescentic markings (crescentic gouges, lunate fractures) on bedrock surfaces occur locally in glaciated areas and comprise a conchoidal fracture dipping down-ice and a steep fracture that faces up-ice. Here we report morphologically distinct crescentic scars that are closely associated with preexisting joints, termed here joint-bounded crescentic scars. These hitherto unreported features are ca. 50-200 mm deep and involve considerably more rock removal than previously described crescentic markings. The joint-bounded crescentic scars were found on abraded rhyolite surfaces recently exposed (< 20 years) beneath a retreating glacier in Iceland, as well as on glacially sculpted Precambrian gneisses in NW Scotland and various Precambrian rocks in Ontario, glaciated during the Late Pleistocene. We suggest a common formation mechanism for these contemporary and relict features, whereby a boulder embedded in basal ice produces a continuously migrating clast-bed contact force as it is dragged over the hard (bedrock) bed. As the ice-embedded boulder approaches a preexisting joint in the bedrock, stress concentrations build up in the bed that exceed the intact rock strength, resulting in conchoidal fracturing and detachment of a crescentic wedge-shaped rock fragment. Subsequent removal of the rock fragment probably involves further fracturing or crushing (comminution) under high contact forces. Formation of joint-bounded crescentic scars is favoured by large boulders at the base of the ice, high basal melting rates, and the presence of preexisting subvertical joints in the bedrock bed. We infer that the relative scarcity of crescentic markings in general on deglaciated surfaces shows that fracturing of intact bedrock below ice is difficult, but that preexisting weaknesses such as joints greatly

Discrete element analysis is a valid method for computing joint contact stress in the hip before and after acetabular fracture.

PubMed

Townsend, Kevin C; Thomas-Aitken, Holly D; Rudert, M James; Kern, Andrew M; Willey, Michael C; Anderson, Donald D; Goetz, Jessica E

2018-01-23

Evaluation of abnormalities in joint contact stress that develop after inaccurate reduction of an acetabular fracture may provide a potential means for predicting the risk of developing post-traumatic osteoarthritis. Discrete element analysis (DEA) is a computational technique for calculating intra-articular contact stress distributions in a fraction of the time required to obtain the same information using the more commonly employed finite element analysis technique. The goal of this work was to validate the accuracy of DEA-computed contact stress against physical measurements of contact stress made in cadaveric hips using Tekscan sensors. Four static loading tests in a variety of poses from heel-strike to toe-off were performed in two different cadaveric hip specimens with the acetabulum intact and again with an intentionally malreduced posterior wall acetabular fracture. DEA-computed contact stress was compared on a point-by-point basis to stress measured from the physical experiments. There was good agreement between computed and measured contact stress over the entire contact area (correlation coefficients ranged from 0.88 to 0.99). DEA-computed peak contact stress was within an average of 0.5 MPa (range 0.2-0.8 MPa) of the Tekscan peak stress for intact hips, and within an average of 0.6 MPa (range 0-1.6 MPa) for fractured cases. DEA-computed contact areas were within an average of 33% of the Tekscan-measured areas (range: 1.4-60%). These results indicate that the DEA methodology is a valid method for accurately estimating contact stress in both intact and fractured hips. Copyright © 2017 Elsevier Ltd. All rights reserved.

Columnar jointing - the mechanics of thermal contraction in cooling lavas

NASA Astrophysics Data System (ADS)

Lavallée, Y.; Iddon, F.; Hornby, A. J.; Kendrick, J. E.; von Aulock, F. W.; Wadsworth, F. B.

2014-12-01

Columnar joints are spectacular features of volcanic rocks, which form by cracking during cooling-induced contraction of lava. The process, and resultant geometry, manifests a complex interplay between heat dissipation, contraction and tensile strength, yet the formation temperature of such joints remains elusive. Here, we present results from a combination of field survey, thermo-analytical characterisation and mechanical investigation to constrain conditions favourable for columnar jointing. Columnar joints at Seljavellir, a basaltic lava flow at the base of Eyjafjallajökull volcano (Iceland) produce quadratic to heptagonal cross sectional patterns with column widths ranging from 20 to 70 cm in size. The fracture surfaces are characterised by striae with spacing (between 1 to 6 cm) that shares a positive linear relationship to the joint spacing. The striae exhibit both a rough and smooth portion, interpreted to express a change in deformation regime from a ductile response as stress builds up to a fully brittle, mode-I fracture propagation at high stress accumulation. To test the thermo-mechanics of columnar joints we developed an experimental setup to investigate the stress, strain-to-failure and temperature at which basalts undergo tensile failure during cooling from the solidus temperature of 980 °C. We find that fractures initiate at ~800 °C, revealed by a change in stress accumulation (i.e., Young modulus), and complete failure completes after some 0.4% strain at ~670 °C. We interpret the two-stage fracture dynamics as the cause for the change in fracture surface roughness observed in nature. We coupled this dataset with Brazil tensile tests at 30, 400, 600, 800 and 1000 °C. We note that the strain to failure decrease from 1% (>800 °C) to 0.4% (<800 °C). Complementary dilatometric measurements (at 3mN of normal stress and a rate of 2 C/min) constrain the expansion coefficient to be linear and equal to 10-5/°C below the solid temperature. Simple ratio

Rehabilitation of neglected Monteggia fracture: Dislocations in children.

PubMed

Yıldırım, Azad; Nas, Kemal

2017-11-06

There are limited studies related to the rehabilitation of neglected Monteggia fracture-dislocations. This study reports the results of the rehabilitation of neglected Monteggia fractures and dislocations and the best treatment options available. Thirteen children were rehabilitated between 2009 and 2012. A retrospective chart review was conducted to record the following: age, gender, anatomic region of fractures, time delay from symptom onset to fracture, Bado classification, Mayo Elbow Performance Index (MEPI) which includes pain, range of motion and daily life comfort, surgeries, length of hospitalization, location and pattern of fracture, length of follow-up and complications. The study group included thirteen children and adolescents; eleven males and two females with a mean age of 8.5 (range 2-15) years. According to the Bado classification, 11 patients had type 1, one had type 3 and one had type 4 fracture-dislocations. For Mayo Elbow Performance Index (MEPI) scales, patients that were less than ten years old had greater mean scores. Two patients had superficial infection, one had subluxation, one had osteoarthritis, one had delayed bone union and two had rigidity at the elbow. The goals of elbow rehabilitation following Neglected Monteggia cases include restoring function by restoring motion and muscle performance; influencing scar remodeling and preventing joint contracture; and restoring or maintaining joint stability. Patients aged younger than 10 years and intervals of less than one-year, between trauma and diagnosis, as well as early and effective rehabilitation were found as important parameters regarding favorable outcomes.

Fractography applied to investigations of cores, outcrops, and fractured reservoirs

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

Kulander, B.

1995-11-01

Fractography focuses investigations on the topography of fracture surfaces. This topography is composed of fractographic features produced by changing stress magnitudes and directions along the advancing crack tip. Fractographic features commonly useful in core and outcrop analysis include the origin, twist hackle, inclusion hackle, and rib marks. These structures develop during brittle failure by Mode I loading at the crack tip and act together to form a hackle plume. Fractographic components throughout the plume record the dynamic history of fracture development. Components show, to the limit of visual scale, the principal stress directions, as well as relative stress magnitudes andmore » propagation velocities, that existed at the advancing fracture front. This information contributes to more meaningful conclusions in fracture investigations. In core studies, fractography aids identification of induced and natural fractures. Induced fractures and fractographic features show distinct geometry with that of the core and reflect the effects of the core boundary, in-situ stresses, drilling stresses, and rock anisotropies. Certain drilling- and coring-induced fractures possess orientations and fractographic features that suggest the direction of minimum in-situ stress and that this direction may change abruptly within the drilled volume of rock. Cored natural fractures generally originated away from the bit and possess fractographic features that bear no geometerical relationship to core parameters. Abrupt changes of natural fracture strike and development of twist hackle suggest locally complex paleostress distributions. A combined knowledge of in-situ stress and natural fracture trends is useful in predicting reservoir permeability. In outcrop, fractographic features, including abutting relationships between joints, more readily depict order of development, intrastratum distribution of fracturing stress, and size for joints in any set.« less

Effects of Facet Joint Injection Reducing the Need for Percutaneous Vertebroplasty in Vertebral Compression Fractures

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

Im, Tae Seong; Lee, Joon Woo; Lee, Eugene

ObjectiveTo evaluate the effects of facet joint injection (FJI) reducing the need for percutaneous vertebroplasty (PVP) in cases of vertebral compression fracture (VCF).Materials and MethodsA total of 169 patients who were referred to the radiology department of our institution for PVP between January 2011 and December 2014 were retrospectively evaluated. The effectiveness of FJI was evaluated by the proportion of patients who cancelled PVP and who experienced reduced pain. In addition, by means of medical chart and MRI review, those clinical factors (age, sex, history of trauma, amount of injected steroids and interval days elapsed between VCF and FJI) andmore » MR image factors (kyphosis angle, height loss, single or multiple level of VCF, burst fracture, central canal compromise, posterior element injury) that were believed to be significant for the effectiveness of FJI were statistically analysed.ResultsIn the 26 patients with FJI prior to PVP, six (23 %) patients cancelled PVP with considerable improvement in reported pain. In the 20 patients with PVP after FJI, improvement in pain after FJI was reported by six patients, resulting in a total of 12 patients (46 %) who experienced reduced pain after FJI. Clinical factors and MR image factors did not show any statistically significant difference between those groups, divided by PVP cancellation and by improvement of pain.ConclusionAfter FJI prior to PVP, about one quarter of patients cancelled PVP due to reduced pain and overall about half of the patients experienced reduced pain.« less

Appropriate hinge position for prevention of unstable lateral hinge fracture in open wedge high tibial osteotomy.

PubMed

Nakamura, R; Komatsu, N; Fujita, K; Kuroda, K; Takahashi, M; Omi, R; Katsuki, Y; Tsuchiya, H

2017-10-01

Open wedge high tibial osteotomy (OWHTO) for medial-compartment osteoarthritis of the knee can be complicated by intra-operative lateral hinge fracture (LHF). We aimed to establish the relationship between hinge position and fracture types, and suggest an appropriate hinge position to reduce the risk of this complication. Consecutive patients undergoing OWHTO were evaluated on coronal multiplanar reconstruction CT images. Hinge positions were divided into five zones in our new classification, by their relationship to the proximal tibiofibular joint (PTFJ). Fractures were classified into types I, II, and III according to the Takeuchi classification. Among 111 patients undergoing OWHTOs, 22 sustained lateral hinge fractures. Of the 89 patients without fractures, 70 had hinges in the zone within the PTFJ and lateral to the medial margin of the PTFJ (zone WL), just above the PTFJ. Among the five zones, the relative risk of unstable fracture was significantly lower in zone WL (relative risk 0.24, confidence interval 0.17 to 0.34). Zone WL appears to offer the safest position for the placement of the osteotomy hinge when trying to avoid a fracture at the osteotomy site. Cite this article: Bone Joint J 2017;99B10:1313-18. ©2017 The British Editorial Society of Bone & Joint Surgery.

[Particular posteromedial and posterolateral approaches for the treatment of tibial head fractures].

PubMed

Lobenhoffer, P; Gerich, T; Bertram, T; Lattermann, C; Pohlemann, T; Tscheme, H

1997-12-01

Tibial plateau fractures with depression of posterior aspects of the proximal tibia cause significant therapeutic problems. Posterior fractures on the medial side are mainly highly instable fracture-dislocations (Moore type I). Posterolateral fractures usually cause massive depression and destruction of the chondral surface. Surgical exposure of these fractures from anterior requires major soft tissue dissection and has a significant complication rate. However, incomplete restoration of the joint surface results in chronic postero-inferior joint subluxation, osteoarthritis and pain. We present new specific approaches for posterior fracture types avoiding large skin incisions, but allowing for atraumatic exposure, reduction and fixation. Posteromedial fracture-dislocations are exposed by a direct posteromedial skin incision and a deep incision between medial collateral ligament and posterior oblique ligament. The posteromedial pillar and the posterior flare of the proximal tibia are visualized. The inferior extent of the joint fragment can be reduced by indirect techniques or direct manipulation of the fragment. Fixation is achieved with subchondral lag screws and an anti-glide plate at the tip of the fragment. Posterolateral fractures are exposed by a transfibular approach: the skin is incised laterally, the peroneal nerve is dissected free. The fibula neck is osteotomized, the tibiofibular syndesmosis is divided and the fibula neck is reflected upwards in one layer with the meniscotibial ligament and the iliotibial tract attachment. Reflexion of the fibula head relaxes the lateral collateral ligament, allows for lateral joint opening and internal rotation of the tibia and thus exposes the posterolateral and posterior aspect of the tibial plateau. Fixation and buttressing on the posterolateral side can be achieved easily with this approach. In closure, the fibula head is fixed back with a lag screw or a tension-band system. These two exposures can be combined in

Literature Review on the Design of Composite Mechanically Fastened Joints (Revue de la Documentation sur la Conception des Joints a Liaison Mecanique en Composites),

DTIC Science & Technology

1986-02-01

mechanics Eisenmann (32) established a bolted joint static strength prediction model based on fracture mechanics for composite materials. The failure...34 Composite Materials, Volume 2, Academic Press, 1974, pp. 353-431. 32. Eisenmann , J.R., "Bolted Joint Static Strength Model for Composite Materials," NASA

Shatter cones at the Keurusselkä impact structure and their relation to local jointing

NASA Astrophysics Data System (ADS)

Hasch, Maximilian; Reimold, Wolf Uwe; Raschke, Ulli; Zaag, Patrice Tristan

2016-08-01

Shatter cones are the only distinct meso- to macroscopic recognition criterion for impact structures, yet not all is known about their formation. The Keurusselkä impact structure, Finland, is interesting in that it presents a multitude of well-exposed shatter cones in medium- to coarse-grained granitoids. The allegedly 27 km wide Keurusselkä impact structure was formed about 1150 Ma ago in rocks of the Central Finland Granitoid Complex. Special attention was paid in this work to possible relationships between shatter cones and local, as well as regionally occurring, fracture or joint systems. A possible shatter cone find outside the previously suggested edge of the structure could mean that the Keurusselkä impact structure is larger than previously thought. The spacing between joints/fractures from regional joint systems was influenced by the impact, but impact-induced fractures strongly follow the regional joint orientation trends. There is a distinct relationship between shatter cones and joints: shatter cones occur on and against joint surfaces of varied orientations and belonging to the regional orientation trends. Planar fractures (PF) and planar deformation features (PDF) were found in three shatter cone samples from the central-most part of the impact structure, whereas other country rock samples from the same level of exposure but further from the assumed center lack shock deformation features. PDF occurrence is enhanced within 5 mm of shatter cone surfaces, which is interpreted to suggest that shock wave reverberation at preimpact joints could be responsible for this local enhancement of shock deformation. Some shatter cone surfaces are coated with a quasi-opaque material which is also found in conspicuous veinlets that branch off from shatter cone surfaces and resemble pseudotachylitic breccia veins. The vein-filling is composed of two mineral phases, one of which could be identified as a montmorillonitic phyllosilicate. The second phase could not be

Base of coracoid process fracture with acromioclavicular dislocation in a child

PubMed Central

2010-01-01

Fracture of the coracoid process is a rare injury. It can be easily missed when associated with other injuries to the shoulder girdle, for instance, acromioclavicular joint (ACJ) dislocation. Clinical attention is easily drawn to the more obvious ACJ dislocation, hence, the need for further radiological evaluation. We report an unusual case of fracture of the base of coracoid process associated with a true acromioclavicular joint dislocation in a 12 year old boy, with no separation of the epiphyseal plate, as one might expect. Treatment also remains controversial. Our patient underwent open reduction internal fixation of the acromioclavicular joint and coracoid process. He subsequently made an uneventful progress with pain free full range of shoulder movement at 5 months, and was discharged at 9 months. PMID:20955595

Effect of composition on the tensile properties and fracture toughness of A7N01S-T5 aluminum alloys welded joints

NASA Astrophysics Data System (ADS)

Liu, Yali; Gou, Guoqing; Chen, Jia; Chen, Hui; Wang, Wanjng; Li, Xiaodong; Che, Xiaoli; Wang, Yirong

2017-07-01

In this paper, welded joints of four types of A7N01S-T5 aluminum alloy with different chemical compositions were investigated. The welding process was under 70% environmental humidity conditions at 10∘C with single-pulse GMAW welding technology. The strength and fracture toughness of the four types of samples were tested, and the microstructures were investigated by micro-X-ray fluorescence (SR-LXRF) technology and backscattered electron diffraction (EBSD) technology. The results showed that the #2 alloy that is composed of Zn: 4.59 wt.%, Mg: 1.56 wt.% Mn: 0.22 wt.%, Cr: 0.14 wt.%, Zr: 0.01 wt.% and Ti: 0.027 wt.% had the best combination of tensile strength and elongation, with the values of 302.35 MPa and 3.74%, respectively. The better result for the combination of the strength and elongation was mainly determined by the volume fraction and size. The fine grain size and compositions played important roles to obtain high fracture toughness.

External fixation techniques for distal radius fractures.

PubMed

Capo, John T; Swan, Kenneth G; Tan, Virak

2006-04-01

Fractures of the distal radius are common injuries. Low-energy or high-energy mechanisms may be involved. Unstable distal radius fractures present a challenge to the treating orthopaedic surgeon. External fixation is a valuable instrument for fracture reduction and stabilization. Limited open incisions, early range of motion, and treatment of complex wounds are a few of the benefits of external fixation. Fixators may be spanning or nonbridging and may be used alone or in combination with other stabilization methods to obtain and maintain distal radius fracture reduction. Augmentation with percutaneous wires allows for optimal fracture stabilization with physiologic alignment of the wrist. Moderate distraction at the carpus does not induce postoperative stiffness. The distal radioulnar joint must be assessed and may need to be stabilized. Complications of external fixation are usually minor, but must be anticipated and treated early. Level V (expert opinion).

[Triple fracture of the shoulder suspensory complex].

PubMed

Tamimi Mariño, I; Martin Rodríguez, I; Mora Villadeamigo, J

2013-01-01

The superior suspensory complex of the shoulder (SSCS) is a ring shaped structure composed of bones and soft tissues that play a fundamental role in the stability of the shoulder joint. Isolated injuries of the SSCS are relatively common, but injuries that affect 3 components are extremely unusual. We present a triple injury of the SSCS in a 26 year old patient with a Neer type ii clavicular fracture, a Kuhn type iii acromion fracture and an Ogawa type i coracoid fracture. An open reduction and stabilization of the clavicle was performed with 2 Kirschner nails. The acromial fracture was synthesized with 2 cannulated screws, and the coracoid fracture was treated conservatively. After 24 months of follow up the patient had an excellent functional outcome according to the Constat-Murley shoulder score and QuickDASH scoring system, and all the fractures healed correctly. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

Sub-Trochanteric Hip Fracture Following Core Decompression for Osteonecrosis in a Patient with a Pre-Existing Contralateral Occult Femoral Neck Fracture.

PubMed

Berger, Ryan J; Sultan, Assem A; Cole, Connor; Sodhi, Nipun; Khlopas, Anton; Mont, Michael A

2018-06-01

We present a unique case of a 62-year-old patient with bilateral osteonecrosis of the femoral heads secondary to corticosteroid use. She presented with an occult right femoral neck fracture and was treated with percutaneous pinning of the right femoral neck and a left-sided percutaneous drilling. Despite apparent appropriate technique, the patient sustained a left sub-trochanteric hip fracture while shifting in bed in the postoperative care unit and was taken back for cephalo-medullary nail fixation. Femoral head osteonecrosis may be an under-reported risk factor for development of pathological neck fractures. We present an overview of this topic along with suggestions for joint preservation treatment of similar patients at higher risk for perioperative fracture.

[CT morphometry for calcaneal fractures and comparison of the Zwipp and Sanders classifications].

PubMed

Andermahr, J; Jesch, A B; Helling, H J; Jubel, A; Fischbach, R; Rehm, K E

2002-01-01

The aim of the study is to correlate the CT-morphological changes of fractured calcaneus and the classifications of Zwipp and Sanders with the clinical outcome. In a retrospective clinical study, the preoperative CT scans of 75 calcaneal fractures were analysed. The morphometry of the fractures was determined by measuring height, length diameter and calcaneo-cuboidal angle in comparison to the intact contralateral side. At a mean of 38 months after trauma 44 patients were clinically followed-up. The data of CT image morphometry were correlated with the severity of fracture classified by Zwipp or Sanders as well as with the functional outcome. There was a good correlation between the fracture classifications and the morphometric data. Both fracture classifying systems have a predictive impact for functional outcome. The more exacting and accurate Zwipp classification considers the most important cofactors like involvement of the calcaneo-cuboidal joint, soft tissue damage, additional fractures etc. The Sanders classification is easier to use during clinical routine. The Zwipp classification includes more relevant cofactors (fracture of the calcaneo-cuboidal-joint, soft tissue swelling, etc.) and presents a higher correlation to the choice of therapy. Both classification systems present a prognostic impact concerning the clinical outcome.

Partial proximal tibia fractures

PubMed Central

Raschke, Michael J.; Kittl, Christoph; Domnick, Christoph

2017-01-01

Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component. High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density. Pre-operative classification of these fractures, by Müller AO, Schatzker or novel CT-based methods, helps to understand the fracture pattern and choose the surgical approach and treatment strategy in accordance with estimated bone mineral density and the individual history of each patient. Non-operative treatment may be considered for non-displaced intra-articular fractures of the lateral tibial condyle. Intra-articular joint displacement ⩾ 2 mm, open fractures or fractures of the medial condyle should be reduced and fixed operatively. Autologous, allogenic and synthetic bone substitutes can be used to fill bone defects. A variety of minimally invasive approaches, temporary osteotomies and novel techniques (e.g. arthroscopically assisted reduction or ‘jail-type’ screw osteosynthesis) offer a range of choices for the individual and are potentially less invasive treatments. Rehabilitation protocols should be carefully planned according to the degree of stability achieved by internal fixation, bone mineral density and other patient-specific factors (age, compliance, mobility). To avoid stiffness, early functional mobilisation plays a major role in rehabilitation. In the elderly, low-energy trauma and impression fractures are indicators for the further screening and treatment of osteoporosis. Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160067. Originally published online at www.efortopenreviews.org PMID:28630761

Safety assessment of Cracked K-joint Structure Based on Fracture Mechanics

NASA Astrophysics Data System (ADS)

Wang, Xin; Pengyu, Yan; Jianwei, Du; Fuhai, Cai

2017-05-01

The K-joint is the main bearing structure of lattice jib crane. During frequent operation of the crane, surface cracks often occur at its weld toe, and then continue to expand until failure. The safety of the weak structure K-joint of the crane jib can be evaluated by BS7910 failure assessment standard in order to improve its utilization. The finite element model of K-joint structure with cracks is established, and its mechanical properties is analyzed by ABAQUS software, the results show that the crack depth has a great influence on the bearing capacity of the structure compared with the crack length. It is assumed that the K-joint with the semi-elliptical surface crack under the action of the tension propagate stably under the condition that the c/a (ratio of short axis to long axis of ellipse) is about 0.3. The safety assessment of K-joint with different lengths crack is presented according to the 2A failure assessment diagram of BS7910, and the critical crack of K-joint under different loads can be obtained.

Prospective Computed Tomographic Analysis of Osteochondral Lesions of the Ankle Joint Associated With Ankle Fractures.

PubMed

Nosewicz, Tomasz L; Beerekamp, M Suzan H; De Muinck Keizer, Robert-Jan O; Schepers, Tim; Maas, Mario; Niek van Dijk, C; Goslings, J Carel

2016-08-01

Osteochondral lesions (OCLs) associated with ankle fracture correlate with unfavorable outcome. The goals of this study were to detect OCLs following ankle fracture, to associate fracture type to OCLs and to investigate whether OCLs affect clinical outcome. 100 ankle fractures requiring operative treatment were prospectively included (46 men, 54 women; mean age 44 ± 14 years, range 20-77). All ankle fractures (conventional radiography; 71 Weber B, 22 Weber C, 1 Weber A, 4 isolated medial malleolus and 2 isolated posterior malleolus fractures) were treated by open reduction and internal fixation. Multidetector computed tomography (CT) was performed postoperatively. For each OCL, the location, size, and Loomer OCL classification (CT modified Berndt and Harty classification) were determined. The subjective Foot and Ankle Outcome Scoring (FAOS) was used for clinical outcome at 1 year. OCLs were found in 10/100 ankle fractures (10.0%). All OCLs were solitary talar lesions. Four OCLs were located posteromedial, 4 posterolateral, 1 anterolateral, and 1 anteromedial. There were 2 type I OCLs (subchondral compression), 6 type II OCLs (partial, nondisplaced fracture) and 2 type IV OCLs (displaced fracture). Mean OCL size (largest diameter) was 4.4 ± 1.7 mm (range, 1.7 mm to 6.2 mm). Chi-square analysis showed no significant association between ankle fracture type and occurrence of OCLs. OCLs did occur only in Lauge-Hansen stage III/IV ankle fractures. There were no significant differences in FAOS outcome between patients with or without OCLs. Ten percent of investigated ankle fractures had associated OCLs on CT. Although no significant association between fracture type and OCL was found, OCLs only occurred in Lauge-Hansen stage III/IV ankle fractures. With the numbers available, OCLs did not significantly affect clinical outcome at 1 year according to FAOS. Level IV, observational study. © The Author(s) 2016.

[Septic arthrodesis of the talocrural joint].

PubMed

Laky, R; Gazsó, I

1991-01-01

Authors report on 20 arthrodeses of the talocrural joint performed in infected surrounding. The accident anamnesis was the following: Talar fracture (3 cases), malleolar fracture (10 cases), "pylon tibial" fracture (7 cases). The operative method was a simple transversal resection and fixation with fixateur externe. The average time of bony fusion was 9.9 months. The patients were controlled in average 3.8 years after the operation. 17 patients could be controlled, all of them could walk. 6 have their original jobs, 4 have an easier work, 7 are invalids. 12 patients have no pains, 5 have major or minor complaints. All patients judge their state as being better than before the operation.

Failure mechanisms in wood joints bonded with urea-formaldehyde adhesives

Treesearch

B.H. River; R.O. Ebewele; G.E. Myers

1994-01-01

Wood joints bonded with urea-formaldehyde (UF) are weakened by cyclic swelling and shrinking. To study the failure mechanisms in UF-bonded joints, specimens were bonded with unmodified, modified (amine), or phenol formaldehyde adhesive and subjected to accelerated aging. Modification of the adhesive properties increased the cleavage fracture toughness and shear...

The effect of shape on the fracture of a soft elastic gel subjected to shear load.

PubMed

Kundan, Krishna Kant; Ghatak, Animangsu

2018-02-21

For brittle solids, the fracture energy is the energy required to create a unit area of new surface through the process of division. For crosslinked materials, it is a function of the intrinsic properties like crosslinking density and bond strength of the crosslinks. Here we show that the energy released due to fracture can depend also on the shape of a joint made of this material. Our experiment involves two gel blocks connected via a thin gel disk. The disk is formed into different regular and exotic shapes, but with identical areas of cross-section. When one of the blocks is sheared with respect to the other, the shear load increases with vertical displacement, eventually causing a fracture at a threshold load. The maximum fracture load is different for different disks and among different regularly shaped disks, it is at a maximum for pentagon and hexagon shapes. The fracture energy release rate of the joint depends also on the aspect ratio (height/width) of the shapes. Our experiments also throw light on possible reasons for such a dependence on the shape of the joints.

[Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion].

PubMed

Wang, Shanxi; Li, Jun; Huang, Fuguo; Liu, Lei

2017-05-01

To review the application and research progress of subtalar distraction bone block arth-rodesis in the treatment of calcaneus fracture malunion. The recent literature concerning the history, surgical technique, postoperative complication, indications, and curative effect of subtalar distraction arthrodesis with bone graft block interposition in the treatment of calcaneus fracture malunion was summarized and analyzed. Subtalar distraction bone block arthrodesis is one of the main ways to treat calcaneus fracture malunion, including a combined surgery with subtalar arthrodesis and realignment surgery for hindfoot deformity using bone block graft. The advantage is on the base of subtalar joint fusion, through one-time retracting subtalar joint, the posterior articular surface of subtalar joint implants bone block can partially restore calcaneal height, thus improving the function of the foot. Compared with other calcaneal malunion treatments, subtalar distraction arthrodesis is effective to correct complications caused by calcaneus fracture malunion, and it can restore the height of talus and calcaneus, correct loss of talocalcaneal angle, and ease pain. Subtalar distraction bone block arthrodesis has made remarkable progress in the treatment of calcaneus fracture malunion, but it has the disadvantages of postoperative nonunion and absorption of bone block, so further study is needed.

[APPLICATION OF COMPRESSION MINI-SCREWS IN TREATMENT OF PATIENTS WITH INJURY OF ELBOW JOINT BONES].

PubMed

Neverov, V A; Egorov, K S

2015-01-01

A case report presents the experience of application of compression pileateless mini-screws (Gerbert's screws) in treatment of intra-articular fractures, which formed the elbow joint (44 cases). There were performed 32 operations concerning fracture of head of radius, 10 operations on the occasion of fractures of distal section of the humerus and 2 operations on the coronoid process. Long-term treatment results were followed-up in 31 patients during more than 6 months. On basis of analysis of treatment results the authors made a conclusion that the application of mini-screws in case of bone fractures, which formed the elbow joint, allowed realization of stable osteosynthesis after anatomic reposition of articular surfaces, obtaining good anatomical and functional result and shortened the terms of patient's treatment.

The development and nature of femoral head cam lesions following acetabular fractures.

PubMed

Berber, Onur; Foote, Julian; Sabharwal, Sanjeeve; Datta, Gorav; Bircher, Martin D

2014-01-01

The aim of acetabular fracture fixation is to restore joint congruity with restoration of the articular surface. Poor outcomes are seen where this has not been achieved. Letournel reported a collarette osteophyte seen postoperatively in a proportion of patients, which he suggested was an early precursor to the development of osteoarthritis. This is a retrospective study of patients treated at a tertiary referral unit who developed this lesion. The triangular index was measured in 48 of these patients and then correlated with their clinical findings, Oxford Hip Score and the presence of osteoarthritis. Length of follow-up, fracture classification, and joint congruency were also recorded. Results showed a statistically significant relationship between cam lesion size and the development of osteoarthritis (P = 0.008), cam lesion size and length of follow-up (P = 0.01), and between groin pain and postoperative joint congruency (LR = 0.035). These findings suggest that the appearance of a cam lesion is a poor long-term prognostic marker for the development of osteoarthritis in patients with an acetabular fracture.

Subtalar distraction osteogenesis for posttraumatic arthritis following intra-articular calcaneal fractures.

PubMed

Fan, Wei-Li; Sun, Hong-Zhen; Wu, Si-Yu; Wang, Ai-Min

2013-03-01

The most common treatment for old calcaneal fractures accompanied by subtalar joint injury is the use of subtalar in situ arthrodesis and subtalar distraction bone-block arthrodesis or osteotomy. This article describes the introduction of a novel surgical treatment, gradual subtalar distraction with external fixation and restoration of the calcaneal height, and presents an assessment of its efficacy. The protruding lateral calcaneus and the articular surfaces and subchondral bone of the posterior facet of the subtalar joint were surgically removed. An external fixator, attached with 2 pins in the subcutaneous tibia and 2 pins in the posterolateral calcaneus, was used to fix the subtalar joint for 7 to 10 days followed by gradual subtalar distraction at 1 mm/d. The lengthening procedure was stopped when the calcaneal height was restored according to radiography. The external fixator was removed after bone fusion. Seven cases of old calcaneal fractures accompanied by severe subtalar joint injury (8 feet) were treated using this method. Average follow-up was 14.3 months (range, 7-36 months). In all 7 cases (1 case of both feet), the postoperative wound healed primarily. The calcaneal heights of all 8 feet were partially restored. Subtalar joint bone fusion was completed within 4 to 6 months after the operation. The average preoperative American Orthopedic Foot & Ankle Society (AOFAS) hindfoot score was 25.3, and the average postoperative AOFAS score was 76.3. Subtalar distraction osteogenesis with external fixation was a novel and effective method for the treatment of old calcaneal fractures accompanied by severe subtalar joint injury in this small group of patients. Level IV, retrospective case series.

A Comparison of Sacroiliac and Pubic Rami Fracture Occurrences in Oblique Side Impact Tests on Nine Post Mortem Human Subjects.

PubMed

Petit, Philippe; Trosseille, Xavier; Lebarbé, Mathieu; Baudrit, Pascal; Potier, Pascal; Compigne, Sabine; Masuda, Mitsutoshi; Yamaoka, Akira; Yasuki, Tsuyoshi; Douard, Richard

2015-11-01

The WorldSID dummy can be equipped with both a pubic and a sacroiliac joint (S-I joint) loadcell. Although a pubic force criterion and the associated injury risk curve are currently available and used in regulation (ECE95, FMVSS214), as of today injury mechanisms, injury criteria, and injury assessment reference values are not available for the sacroiliac joint itself. The aim of this study was to investigate the sacroiliac joint injury mechanism. Three configurations were identified from full-scale car crashes conducted with the WorldSID 50th percentile male where the force passing through the pubis in all three tests was approximately 1500 N while the sacroiliac Fy/Mx peak values were 4500 N/50 Nm, 2400 N/130 Nm, and 5300 N/150 Nm, respectively. These tests were reproduced using a 150 kg guided probe impacting Post Mortem Human Subjects (PMHS) at 8 m/s, 5.4 m/s and 7.5 m/s. The shape and the orientation of the impacting face of the probe were selected to match the WorldSID pubic Fy and sacroiliac Fy/Mx loads of the three vehicle test configurations. Three PMHS were tested in each of the three configurations (nine PMHS in total). In the first PMHS configuration, one specimen sustained an AIS 3 injury and one sustained an AIS 4 injury (an unstable pelvis with complete disruption of the posterior arch, a sacroiliac joint disruption associated with an iliac fracture, and a pubic symphysis separation). In the second configuration, all specimens sustained a fracture of the superior lateral iliac wing (AIS 2). In the third configuration, one specimen sustained a partial disruption of the anterior arch (AIS 2). Based on the data from strain gauges located on the pubic rami and near the sacroiliac joint, the pubic rami fractures were identified as occurring prior to the sacroiliac fractures. Out of nine impactor tests performed, the PMHS S-I joint injuries were observed to consistently be associated with pelvic anterior arch fractures. In addition, from the injury

Long-Wavelength Elastic Wave Propagation Across Naturally Fractured Rock Masses

NASA Astrophysics Data System (ADS)

Mohd-Nordin, Mohd Mustaqim; Song, Ki-Il; Cho, Gye-Chun; Mohamed, Zainab

2014-03-01

Geophysical site investigation techniques based on elastic waves have been widely used to characterize rock masses. However, characterizing jointed rock masses by using such techniques remains challenging because of a lack of knowledge about elastic wave propagation in multi-jointed rock masses. In this paper, the roughness of naturally fractured rock joint surfaces is estimated by using a three-dimensional (3D) image-processing technique. The classification of the joint roughness coefficient (JRC) is enhanced by introducing the scan line technique. The peak-to-valley height is selected as a key indicator for JRC classification. Long-wavelength P-wave and torsional S-wave propagation across rock masses containing naturally fractured joints are simulated through the quasi-static resonant column (QSRC) test. In general, as the JRC increases, the S-wave velocity increases within the range of stress levels considered in this paper, whereas the P-wave velocity and the damping ratio of the shear wave decrease. In particular, the two-dimensional joint specimen underestimates the S-wave velocity while overestimating the P-wave velocity. This suggests that 3D joint surfaces should be implicated to obtain the reliable elastic wave velocity in jointed rock masses. The contact characteristic and degree of roughness and waviness of the joint surface are identified as a factor influencing P-wave and S-wave propagation in multi-jointed rock masses. The results indicate a need for a better understanding of the sensitivity of contact area alterations to the elastic wave velocity induced by changes in normal stress. This paper's framework can be a reference for future research on elastic wave propagation in naturally multi-jointed rock masses.

Chromium content in the human hip joint tissues.

PubMed

Brodziak-Dopierała, Barbara; Kwapuliński, Jerzy; Sobczyk, Krzysztof; Wiechuła, Danuta

2015-02-01

Chromium has many important functions in the human body. For the osseous tissue, its role has not been clearly defined. This study was aimed at determining chromium content in hip joint tissues. A total of 91 hip joint samples were taken in this study, including 66 from females and 25 from males. The sample tissues were separated according to their anatomical parts. The chromium content was determined by the AAS method. The statistical analysis was performed with U Mann-Whitney's non-parametric test, P≤0.05. The overall chromium content in tissues of the hip joint in the study subjects was as follows: 5.73 µg/g in the articular cartilage, 5.33 µg/g in the cortical bone, 17.86 µg/g in the cancellous bone, 5.95 µg/g in the fragment of the cancellous bone from the intertrochanteric region, and 1.28 µg/g in the joint capsule. The chromium contents were observed in 2 group patients, it was 7.04 µg/g in people with osteoarthritis and 12.59 µg/g in people with fractures. The observed chromium content was highest in the cancellous bone and the lowest in the joint capsule. Chromium content was significantly different between the people with hip joint osteoarthritis and the people with femoral neck fractures. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

[Treatment of Schatzker IV tibial plateau fractures with arthroscopy combined with MIPPO technique].

PubMed

Li, Jian-Wen; Ye, Feng; Bi, Da-Wei; Zheng, Xiao-Dong; Chen, Jian-Liang

2018-02-25

To discusses the clinical effects of arthroscopy combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) technology in treating Schatzker IV tibial plateau fractures. From January 2012 to January 2016, 19 patients with Schatzker type IV tibial plateau fractures were treated with arthroscopy combined with minimally invasive technique including 12 males and 7 females with an average age of 46.5 years old ranging from 19 to 78 years old. Patients were suffering knee pain, swelling, flexion and extension limited, and other symptoms preoperative. Patients were followed up and assessed by Rasmussen knee function score. No infection, traumatic arthritis, and knee joint valgus occurred after operation. Nineteen cases were followed up for 12 to 24 months with an average of 18.6 months. Fracture healing time was 3 to 5 months with an average of 3.8 months. The knee pain and limited mobility improved significantly. The range of autonomic movement of joints was from 90 to 136 degrees. According to Rasmussen functional score criteria, the total score was 27.00±2.49, the result was excellent in 16 cases, good in 2 cases, fair in 1 case. Arthroscopic treatment for Schatzker type IV tibial plateau fractures combined with MIPPO can simultaneously treat internal structural injuries such as meniscus and other knee joints, with less trauma, fewer complications, and faster joint function recovery, but we must strictly grasp surgical indications and avoid expanding injuries. Copyright© 2018 by the China Journal of Orthopaedics and Traumatology Press.

Microstructure of friction stir welded joints of 2017A aluminium alloy sheets.

PubMed

Mroczka, K; Dutkiewicz, J; Pietras, A

2010-03-01

The present study examines a friction stir welded 2017A aluminium alloy. Transmission electron microscope investigations of the weld nugget revealed the average grain size of 5 microm, moderate density of dislocations as well as the presence of nanometric precipitates located mostly in grains interiors. Scanning electron microscope observations of fractures showed the presence of ductile fracture in the region of the weld nugget with brittle precipitates in the lower part. The microhardness analysis performed on the cross-section of the joints showed fairly small changes; however, after the artificial ageing process an increase in hardness was observed. The change of the joint hardness subject to the ageing process indicates partial supersaturation in the material during friction stir welding and higher precipitation hardening of the joint.

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

PubMed

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

1989-01-01

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

Pathogenesis of Fifth Metatarsal Fractures in College Soccer Players

PubMed Central

Fujitaka, Kohei; Taniguchi, Akira; Isomoto, Shinji; Kumai, Tsukasa; Otuki, Shingo; Okubo, Mamoru; Tanaka, Yasuhito

2015-01-01

Background: The pathogenesis of fifth metatarsal stress fractures remains uncertain. Hypothesis: Physical characteristics and environmental factors, which have received limited attention in the literature thus far, might be involved in the development of fifth metatarsal stress fractures. Study Design: Case-control study; Level of evidence, 3. Methods: To test the study hypothesis, a medical examination and survey of the living environment of collegiate soccer players was conducted and correlated with the existence of fifth metatarsal stress fractures. The survey and measurements were conducted in 273 male athletes from the same college soccer team between 2005 and 2013. A medical examination comprising assessment of stature, body weight, body mass index, foot–arch height ratio, toe-grip strength, quadriceps angle, leg-heel angle, functional reach test, single-leg standing time with eyes closed, straight-leg raise angle, finger-floor distance, heel-buttock distance, ankle joint range of motion, and a general joint laxity test were performed once a year, along with a questionnaire survey. The survey was also repeated when a fifth metatarsal stress fracture was diagnosed. The study participants were separated into a fifth metatarsal stress fracture injury group and a noninjury group. The measurement items and survey items were compared, and the association between the factors and the presence or absence of injuries was analyzed. Results: Toe-grip strength was significantly weaker in the injury group compared with the noninjury group, suggesting that weak toe-grip is associated with fifth metatarsal stress fracture (P < .05). In addition, fifth metatarsal stress fractures were more common in the nondominant leg (P < .05). Between-group comparisons of the other items showed no statistically significant differences. Conclusion: The association between weak toe-grip strength and fifth metatarsal fracture suggests that weak toe-grip may lead to an increase in the load

[Dislocation of the PIP-Joint - Treatment of a common (ball)sports injury].

PubMed

Müller-Seubert, Wibke; Bührer, Gregor; Horch, Raymund E

2017-09-01

Background  Fractures or fracture dislocations of the proximal interphalangeal joint often occur during sports or accidents. Dislocations of the PIP-joint are the most common ligamentary injuries of the hand. As this kind of injury is so frequent, hand surgeons and other physicians should be aware of the correct treatment. Objectives  This paper summarises the most common injury patterns and the correct treatment of PIP-joint dislocations. Materials and Methods  This paper reviews the current literature and describes the standardised treatment of PIP-joint dislocations. Results  What is most important is that reposition is anatomically correct, and this should be controlled by X-ray examination. Depending on the instability and possible combination with other injuries (e. g. injury to the palmar plate), early functional physiotherapy of the joint or a short immobilisation period is indicated. Conclusions  Early functional treatment of the injured PIP-joint, initially using buddy taping, is important to restore PIP-joint movement and function. Depending on the injury, joint immobilisation using a K-wire may be indicated. Detailed informed consent is necessary to explain to the patient the severity of the injury and possible complications, such as chronic functional disorders or development of arthrosis. © Georg Thieme Verlag KG Stuttgart · New York.

Fracture-Correlated Lineaments at Great Bay, Southeastern New Hampshire

DTIC Science & Technology

2002-01-01

U.S. Department of the Interior U.S. Geological Survey By James R. Degnan and Stewart F. Clark, Jr. Pembroke, New Hampshire 2002 In Cooperation with...Lineaments at Great Bay, Southeastern New Hampshire By James R. Degnan and Stewart F. Clark, Jr. 2 Fracture-Correlated Lineaments at Great Bay...and Mabee and others (1994). Walsh found that 24 percent of lineaments near outcrops correlate with brittle structures including joints, fracture

Fracture Systems - Digital Field Data Capture

NASA Astrophysics Data System (ADS)

Haslam, Richard

2017-04-01

Fracture systems play a key role in subsurface resources and developments including groundwater and nuclear waste repositories. There is increasing recognition that there is a need to record and quantify fracture systems to better understand the potential risks and opportunities. With the advent of smart phones and digital field geology there have been numerous systems designed for field data collection. Digital field data collection allows for rapid data collection and interpretations. However, many of the current systems have principally been designed to cover the full range of field mapping and data needs, making them large and complex, plus many do not offer the tools necessary for the collection of fracture specific data. A new multiplatform data recording app has been developed for the collection of field data on faults and joint/fracture systems and a relational database designed for storage and retrieval. The app has been developed to collect fault data and joint/fracture data based on an open source platform. Data is captured in a form-based approach including validity checks to ensure data is collected systematically. In addition to typical structural data collection, the International Society of Rock Mechanics' (ISRM) "Suggested Methods for the Quantitative Description of Discontinuities in Rock Masses" is included allowing for industry standards to be followed and opening up the tools to industry as well as research. All data is uploaded automatically to a secure server and users can view their data and open access data as required. Users can decide if the data they produce should remain private or be open access. A series of automatic reports can be produced and/or the data downloaded. The database will hold a national archive and data retrieval will be made through a web interface.

Return to sport following clavicle fractures: a systematic review.

PubMed

Robertson, G A J; Wood, A M

2016-09-01

This review aims to provide information on the return rates and return times to sport following clavicle fractures. A systematic search of Medline, EMBASE, CINAHAL, Cochrane, Web of Science, PEDro, SPORTDiscus, Scopus and Google Scholar was performed using the keywords 'clavicle', 'clavicular', 'fractures', 'athletes', 'sports', 'non-operative', 'conservative', 'operative', 'return to sport'. Twenty-three studies were included: 10 reported on mid-shaft fractures, 14 on lateral fractures. The management principles for athletic patients were to attempt non-operative management for undisplaced fractures to undertake operative intervention for displaced lateral fractures and to recommend operative intervention for displaced mid-shaft fractures. The optimal surgical modality for mid-shaft and lateral clavicle fractures. Operative management of displaced mid-shaft fractures offers improved return rates and times to sport compared to non-operative management. Suture fixation and non-acromio-clavicular joint (ACJ)-spanning plate fixation of displaced lateral fractures show promising results. Future prospective studies should aim to establish the optimal treatment modalities for clavicle fractures. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sleeve fracture of the adult patella

PubMed Central

Xie, Linjun; Xu, Hong; Zhang, Lizhi; Xu, Rong; Guo, Yingkun

2017-01-01

Abstract Rationale: The patellar fractures are common in adults, but rare in children. As a particular type of patellar fracture, however, sleeve fractures are almost always limited to children in the under 16's group. Patient concerns: Herein, we report a rare case of a 19-year-old healthy adult female who presented sleeve fracture at the superior pole of the left patella. The clinical and radiological features are found including joint effusion, anterior tilt of the patella and a shell of bone lying proximally to the patella. Diagnoses: Computed tomography and magnetic resonance imaging examination have been performed to further confirm the diagnosis of sleeve fracture, rupture of the quadriceps tendon and the cartilaginous injury. Interventions: Under general anaesthesia, she underwent open surgical procedures for reconstituting anatomically the fracture and repairing the rupture of the quadriceps tendon. Outcomes: Six months after the operation, she could fully use her left knee without any pain and disability. Lessons: Sleeve fractures of the patellar in adults are extremely rare, and our case is of interest for the first time occurring in healthy female adults. Our case report and literature review was aim to describe the clinic and imaging characteristics of superior pole sleeve fractures in adults, and highlight that physicians must be aware of this entity in adults so as to reduce misdiagnosis due to unfamiliarity. PMID:28796028

In Situ SEM Observations of Fracture Behavior of Laser Welded-Brazed Al/Steel Dissimilar Joint

NASA Astrophysics Data System (ADS)

Xia, Hongbo; Tan, Caiwang; Li, Liqun; Ma, Ninshu

2018-03-01

Laser welding-brazing of 6061-T6 aluminum alloy to DP590 dual-phase steel with Al-Si12 flux-cored filler wire was performed. The microstructure at the brazing interface was characterized. Fracture behavior was observed and analyzed by in situ scanning electron microscope. The microstructure of the brazing interface showed that inhomogeneous intermetallic compounds formed along the thickness direction, which had a great influence on the crack initiation and propagation. In the top region, the reaction layer at the interface consisted of scattered needle-like Fe(Al,Si)3 and serration-shaped Fe1.8Al7.2Si. In the middle region, the compound at the interface was only serration-shaped Fe1.8Al7.2Si. In the bottom region, the interface was composed of lamellar-shaped Fe1.8Al7.2Si. The cracks were first detected in the bottom region and propagated from bottom to top along the interface. At the bottom region, the crack initiated and propagated along the Fe1.8Al7.2Si/weld seam interface during the in situ tensile test. When the crack propagated into the middle region, a deflection of crack propagation appeared. The crack first propagated along the steel/Fe1.8Al7.2Si interface and then moved along the weld seam until the failure of the joint. The tensile strength of the joint was 146.5 MPa. Some micro-cracks were detected at Fe(Al,Si)3 and the interface between the steel substrate and Fe(Al,Si)3 in the top region while the interface was still connected.

Ankle fusion for definitive management of non-reconstructable pilon fractures.

PubMed

Bozic, Vladimir; Thordarson, David B; Hertz, Jennifer

2008-09-01

Highly comminuted pilon fractures, especially with a compromised soft tissue envelope, present a challenging treatment scenario. This study presents our results for patients managed with ankle fusion rather than ORIF. Fourteen patients with ankle joint incongruence after non-reconstructable tibia pilon fractures were treated with primary tibiotalar arthrodesis using a fixed-angle cannulated blade plate. Delayed metaphyseal unions due to bone defects were treated concurrently. The subtalar joint was preserved in all cases. Metaphyseal healing and stable arthrodesis was obtained in each case. There was one case of blade plate breakage in a patient who still achieved successful arthrodesis without reoperation. Union was achieved at an average of 15 weeks. No secondary procedures were required to obtain union. All 14 patients were ambulatory at last followup. Average followup was 39 weeks. Primary ankle arthrodesis can be achieved using a cannulated blade plate to address a non-reconstructable articular surface and metaphyseal bone defects in complex tibia pilon fractures.

Fracture network of the Ferron Sandstone Member of the Mancos Shale, east-central Utah, USA

USGS Publications Warehouse

Condon, S.M.

2003-01-01

The fracture network at the outcrop of the Ferron Sandstone Member of the Mancos Shale was studied to gain an understanding of the tectonic history of the region and to contribute data to studies of gas and water transmissivity related to the occurrence and production of coal-bed methane. About 1900 fracture readings were made at 40 coal outcrops and 62 sandstone outcrops in the area from Willow Springs Wash in the south to Farnham dome in the north of the study area in east-central Utah.Two sets of regional, vertical to nearly vertical, systematic face cleats were identified in Ferron coals. A northwest-striking set trends at a mean azimuth of 321??, and a northeast-striking set has a mean azimuth of 55??. Cleats were observed in all coal outcrops examined and are closely spaced and commonly coated with thin films of iron oxide.Two sets of regional, systematic joint sets in sandstone were also identified and have mean azimuths of 321?? and 34??. The joints of each set are planar, long, and extend vertically to nearly vertically through multiple beds; the northeast-striking set is more prevalent than the northwest-striking set. In some places, joints of the northeast-striking set occur in closely spaced clusters, or joint zones, flanked by unjointed rock. Both sets are mineralized with iron oxide and calcite, and the northwest-striking set is commonly tightly cemented, which allowed the northeast-striking set to propagate across it. All cleats and joints of these sets are interpreted as opening-mode (mode I) fractures. Abutting relations indicate that the northwest-striking cleats and joints formed first and were later overprinted by the northeast-striking cleats and joints. Burial curves constructed for the Ferron indicate rapid initial burial after deposition. The Ferron reached a depth of 3000 ft (1000 m) within 5.2 million years (m.y.), and this is considered a minimum depth and time for development of cleats and joints. The Sevier orogeny produced southeast

Modeling of the fracture behavior of spot welds using advanced micro-mechanical damage models

NASA Astrophysics Data System (ADS)

Sommer, Silke

2010-06-01

This paper presents the modeling of deformation and fracture behavior of resistance spot welded joints in DP600 steel sheets. Spot welding is still the most commonly used joining technique in automotive engineering. In overloading situations like crash joints are often the weakest link in a structure. For those reasons, crash simulations need reliable and applicable tools to predict the load bearing capacity of spot welded components. Two series of component tests with different spot weld diameters have shown that the diameter of the weld nugget is the main influencing factor affecting fracture mode (interfacial or pull-out fracture), load bearing capacity and energy absorption. In order to find a correlation between nugget diameter, load bearing capacity and fracture mode, the spot welds are simulated with detailed finite element models containing base metal, heat affected zone and weld metal in lap-shear loading conditions. The change in fracture mode from interfacial to pull-out or peel-out fracture with growing nugget diameter under lap-shear loading was successfully modeled using the Gologanu-Leblond model in combination with the fracture criteria of Thomason and Embury. A small nugget diameter is identified to be the main cause for interfacial fracture. In good agreement with experimental observations, the calculated pull-out fracture initiates in the base metal at the boundary to the heat affected zone.

Imaging in traumatic mandibular fractures

PubMed Central

Gemal, Hugo; Reed, Duncan

2017-01-01

A fracture of the mandible is a common trauma presentation amongst young males and represents one of the most frequently encountered fractured bones within the viscerocranium. Historically, assault was the dominant contributing factor but now due to the increased number of vehicles used per capita, motor vehicle accidents are the primary cause. Mandibular fractures can be classified anatomically, by dentition, by muscle group and by severity. The fracture may also be closed, open, comminuted, displaced or pathological. It is important that the imaging modality used identifies the classification as this will decide definitive treatment. X-ray projections have typically been used to detect a mandibular fracture, but are limited to an anteroposterior (AP), lateral and oblique view in an unstable trauma patient. These views are inadequate to detail the level of fracture displacement and show poor detail of the condylar region. Computer tomography (CT) is the imaging modality of choice when assessing a traumatic mandibular injury and can demonstrate a 100% sensitivity in detecting a fracture. This is through use of a multidetector-row CT, which reduces motion blur and therefore produces accurate coronal and sagittal reconstructions. Furthermore, reconstructive three-dimensional CT images gained from planar views, allows a better understanding of the spatial relationship of the fracture with other anatomical landmarks. This ensures a better appreciation of the severity and classification of a mandibular fracture, which therefore influences operative planning. Ultrasound is another useful modality in detecting a mandibular fracture when the patient is too unstable to be transferred to a CT scanner. The sensitivity however is less in comparison to a CT series of images and provides limited detail on the fracture pattern. Magnetic resonance imaging demonstrates use in assessing soft tissue injury of the temporomandibular joint but this is unlikely to be of priority when

Modified Essex-Lopresti / Westheus reduction for displaced intra-articular fractures of the calcaneus. Description of surgical technique and early outcomes.

PubMed

Pillai, Anand; Basappa, Prabhudeva; Ehrendorfer, Stefan

2007-02-01

We describe a modification of the classical Essex-Lopresti manoeuvre for the indirect reduction and stabilisation of displaced intra-articular fractures of the calcaneus. The radiological and functional results achieved using this technique in 15 patients is presented. Ten tongue-shaped and 8 joint depression type fractures were treated by the new method, incorporating the use of an additional traction pin. The pre and postoperative Böhler angles as well as the correction achieved were documented. Functional assessment was carried out using the Maryland Foot Score. The mean pre-operative Böhler angle in the joint depression group was 5.5 degrees, and in the tongue shaped fracture group 5 degrees. The mean postoperative Böhler angle in the joint depression group was 15.8 degrees, and in the tongue shape group was 23.25 degrees. At a mean follow-up of 28 months the joint depression group scored 51/100 on the foot score, and the tongue shaped fracture group 77/100. The mean correction achieved as well as the mean overall functional scores were significantly better in the tongue shaped group. The technique described has much promise in the management of selected displaced intra-articular fractures of the calcaneus (true tongue shaped / Sanders II), and may also have a limited role in other fracture types in patients with significant co-morbidities, soft tissue compromise and poor healing potential.

A likely-universal model of fracture density and scaling justified by both data and theory. Consequences for crustal hydro-mechanics

NASA Astrophysics Data System (ADS)

Davy, P.; Darcel, C.; Le Goc, R.; Bour, O.

2011-12-01

We discuss the parameters that control fracture density on the Earth. We argue that most of fracture systems are spatially organized according to two main regimes. The smallest fractures can grow independently of each others, defining a "dilute" regime controlled by nuclei occurrence rate and individual fracture growth law. Above a certain length, fractures stop growing due to mechanical interactions between fractures. For this "dense" regime, we derive the fracture density distribution by acknowledging that, statistically, fractures do not cross a larger one. This very crude rule, which expresses the inhibiting role of large fractures against smaller ones but not the reverse, actually appears be a very strong control on the eventual fracture density distribution since it results in a self-similar distribution whose exponents and density term are fully determined by the fractal dimension D and a dimensionless parameter γ that encompasses the details of fracture correlations and orientations. The range of values for D and γ appears to be extremely limited, which makes this model quite universal. This theory is supported by quantitative data on either fault or joint networks. The transition between the dilute and dense regimes occurs at about a few tenths of kilometers for faults systems, and a few meters for joints. This remarkable difference between both processes is likely due to a large-scale control (localization) of the fracture growth for faulting that does not exist for jointing. Finally, we discuss the consequences of this model on both flow and mechanical properties. In the dense regime, networks appears to be very close to a critical state.

Lunate fractures and associated radiocarpal and midcarpal instabilities: a systematic review.

PubMed

Shunmugam, Meenalochani; Phadnis, Joideep; Watts, Amy; Bain, Gregory I

2018-01-01

The aim of this study was to analyse lunate fractures and any associated osseo-ligamentous injuries. A systematic review identified 34 cases. We identified carpal instabilities at the radiocarpal and midcarpal joints in volar and dorsal directions. Radiocarpal instabilities (10/34) were usually dorsoradial (8/10), with a transverse lunate fracture, best seen on a coronal image. Midcarpal instabilities (24/34) were usually volar (14/18), with a volar lunate shear fracture, best seen on a sagittal image. Instabilities were sub-classified into non-displaced, subluxated and dislocated. Associated fractures of the scaphoid and the radial and ulnar styloid processes were common. Lunate fractures without subluxation or dislocation had good outcomes with cast immobilization or fixation of associated fractures. Lunate fracture-subluxations are unstable injuries that are best managed with fixation of the carpal fractures. Lunate fracture-dislocations are complex injuries, requiring stabilization of the lunate, associated fractures and ligament injuries; complications are common and acute or delayed salvage procedures may be required.

Rock Fracture Toughness Study Under Mixed Mode I/III Loading

NASA Astrophysics Data System (ADS)

Aliha, M. R. M.; Bahmani, A.

2017-07-01

Fracture growth in underground rock structures occurs under complex stress states, which typically include the in- and out-of-plane sliding deformation of jointed rock masses before catastrophic failure. However, the lack of a comprehensive theoretical and experimental fracture toughness study for rocks under contributions of out-of plane deformations (i.e. mode III) is one of the shortcomings of this field. Therefore, in this research the mixed mode I/III fracture toughness of a typical rock material is investigated experimentally by means of a novel cracked disc specimen subjected to bend loading. It was shown that the specimen can provide full combinations of modes I and III and consequently a complete set of mixed mode I/III fracture toughness data were determined for the tested marble rock. By moving from pure mode I towards pure mode III, fracture load was increased; however, the corresponding fracture toughness value became smaller. The obtained experimental fracture toughness results were finally predicted using theoretical and empirical fracture models.

Fracture network evaluation program (FraNEP): A software for analyzing 2D fracture trace-line maps

NASA Astrophysics Data System (ADS)

Zeeb, Conny; Gomez-Rivas, Enrique; Bons, Paul D.; Virgo, Simon; Blum, Philipp

2013-10-01

Fractures, such as joints, faults and veins, strongly influence the transport of fluids through rocks by either enhancing or inhibiting flow. Techniques used for the automatic detection of lineaments from satellite images and aerial photographs, LIDAR technologies and borehole televiewers significantly enhanced data acquisition. The analysis of such data is often performed manually or with different analysis software. Here we present a novel program for the analysis of 2D fracture networks called FraNEP (Fracture Network Evaluation Program). The program was developed using Visual Basic for Applications in Microsoft Excel™ and combines features from different existing software and characterization techniques. The main novelty of FraNEP is the possibility to analyse trace-line maps of fracture networks applying the (1) scanline sampling, (2) window sampling or (3) circular scanline and window method, without the need of switching programs. Additionally, binning problems are avoided by using cumulative distributions, rather than probability density functions. FraNEP is a time-efficient tool for the characterisation of fracture network parameters, such as density, intensity and mean length. Furthermore, fracture strikes can be visualized using rose diagrams and a fitting routine evaluates the distribution of fracture lengths. As an example of its application, we use FraNEP to analyse a case study of lineament data from a satellite image of the Oman Mountains.

Pure Varus Injury to the Knee Joint.

PubMed

Yoo, Jae Ho; Lee, Jung Ha; Chang, Chong Bum

2015-06-01

A 30-year-old male was involved in a car accident. Radiographs revealed a depressed marginal fracture of the medial tibial plateau and an avulsion fracture of the fibular head. Magnetic resonance imaging showed avulsion fracture of Gerdy's tubercle, injury to the posterior cruciate ligament (PCL), posterior horn of the medial meniscus, and the attachments of the lateral collateral ligament and the biceps femoris tendon. The depressed fracture of the medial tibial plateau was elevated and stabilized using a cannulated screw and washer. The injured lateral and posterolateral corner (PLC) structures were repaired and augmented by PLC reconstruction. However, the avulsion fracture of Gerdy's tubercle was not fixed because it was minimally displaced and the torn PCL was also not repaired or reconstructed. We present a unique case of pure varus injury to the knee joint. This case contributes to our understanding of the mechanism of knee injury and provides insight regarding appropriate treatment plans for this type of injury.

Effect of Isothermal Aging and Thermal Cycling on Interfacial IMC Growth and Fracture Behavior of SnAgCu/Cu Joints

NASA Astrophysics Data System (ADS)

Li, Xiaoyan; Li, Fenghui; Guo, Fu; Shi, Yaowu

2011-01-01

The growth behavior of interfacial intermetallic compounds (IMCs) of SnAgCu/Cu soldered joints was investigated during the reflow process, isothermal aging, and thermal cycling with a focus on the influence of these parameters on growth kinetics. The SnAgCu/Cu soldered joints were isothermally aged at 125°C, 150°C, and 175°C while the thermal cycling was performed within the temperature ranges from -25°C to 125°C and -40°C to 125°C. It was observed that a Cu6Sn5 layer formed, followed by rapid coarsening at the solder/Cu interface during reflowing. The grain size of the interfacial Cu6Sn5 was found to increase with aging time, and the morphology evolved from scallop-like to needle-like to rod-like and finally to particles. The rod-like Ag3Sn phase was formed on the solder side in front of the previously formed Cu6Sn5 layer. However, when subject to an increase of the aging time, the Cu3Sn phase was formed at the interface of the Cu6Sn5 layer and Cu substrate. The IMC growth rate increased with aging temperature for isothermally aged joints. During thermal cycling, the thickness of the IMC layer was found to increase with the number of thermal cycles, although the growth rate was slower than that for isothermal aging. The dwell time at the high-temperature end of the thermal cycles was found to significantly influence the growth rate of the IMCs. The growth of the IMCs, for both isothermal aging and thermal cycling, was found to be Arrhenius with aging temperature, and the corresponding diffusion factor and activation energy were obtained by data fitting. The tensile strength of the soldered joints decreased with increasing aging time. Consequently, the fracture site of the soldered joints migrated from the solder matrix to the interfacial Cu6Sn5 layer. Finally, the shear strength of the joints was found to decrease with both an increase in the number of thermal cycles and a decrease in the dwell temperature at the low end of the thermal cycle.

Fault and joint geometry at Raft River Geothermal Area, Idaho

NASA Astrophysics Data System (ADS)

Guth, L. R.; Bruhn, R. L.; Beck, S. L.

1981-07-01

Raft River geothermal reservoir is formed by fractures in sedimentary strata of the Miocene and Pliocene salt lake formation. The fracturing is most intense at the base of the salt lake formation, along a decollement that dips eastward at less than 50 on top of metamorphosed precambrian and lower paleozoic rocks. Core taken from less than 200 m above the decollement contains two sets of normal faults. The major set of faults dips between 500 and 700. These faults occur as conjugate pairs that are bisected by vertical extension fractures. The second set of faults dips 100 to 200 and may parallel part of the basal decollement or reflect the presence of listric normal faults in the upper plate. Surface joints form two suborthogonal sets that dip vertically. East-northeast-striking joints are most frequent on the limbs of the Jim Sage anticline, a large fold that is associated with the geothermal field.

Inpatient Rehabilitation Volume and Functional Outcomes in Stroke, Lower Extremity Fracture, and Lower Extremity Joint Replacement

PubMed Central

Graham, James E.; Deutsch, Anne; O’Connell, Ann A.; Karmarkar, Amol M.; Granger, Carl V.; Ottenbacher, Kenneth J.

2013-01-01

Background It is unclear if volume-outcome relationships exist in inpatient rehabilitation. Objectives Assess associations between facility volumes and two patient-centered outcomes in the three most common diagnostic groups in inpatient rehabilitation. Research Design We used hierarchical linear and generalized linear models to analyze administrative assessment data from patients receiving inpatient rehabilitation services for stroke (n=202,423), lower extremity fracture (n=132,194), or lower extremity joint replacement (n=148,068) between 2006 and 2008 in 717 rehabilitation facilities across the U.S. Facilities were assigned to quintiles based on average annual diagnosis-specific patient volumes. Measures Discharge functional status (FIM instrument) and probability of home discharge. Results Facility-level factors accounted for 6–15% of the variance in discharge FIM total scores and 3–5% of the variance in home discharge probability across the 3 diagnostic groups. We used the middle volume quintile (Q3) as the reference group for all analyses and detected small, but statistically significant (p < .01) associations with discharge functional status in all three diagnosis groups. Only the highest volume quintile (Q5) reached statistical significance, displaying higher functional status ratings than Q3 each time. The largest effect was observed in FIM total scores among fracture patients, with only a 3.6-point difference in Q5 and Q3 group means. Volume was not independently related to home discharge. Conclusions Outcome-specific volume effects ranged from small (functional status) to none (home discharge) in all three diagnostic groups. Patients with these conditions can be treated locally rather than at higher-volume regional centers. Further regionalization of inpatient rehabilitation services is not needed for these conditions. PMID:23579350

Inpatient rehabilitation volume and functional outcomes in stroke, lower extremity fracture, and lower extremity joint replacement.

PubMed

Graham, James E; Deutsch, Anne; O'Connell, Ann A; Karmarkar, Amol M; Granger, Carl V; Ottenbacher, Kenneth J

2013-05-01

It is unclear if volume-outcome relationships exist in inpatient rehabilitation. Assess associations between facility volumes and 2 patient-centered outcomes in the 3 most common diagnostic groups in inpatient rehabilitation. We used hierarchical linear and generalized linear models to analyze administrative assessment data from patients receiving inpatient rehabilitation services for stroke (n=202,423), lower extremity fracture (n=132,194), or lower extremity joint replacement (n=148,068) between 2006 and 2008 in 717 rehabilitation facilities across the United States. Facilities were assigned to quintiles based on average annual diagnosis-specific patient volumes. Discharge functional status (FIM instrument) and probability of home discharge. Facility-level factors accounted for 6%-15% of the variance in discharge FIM total scores and 3%-5% of the variance in home discharge probability across the 3 diagnostic groups. We used the middle volume quintile (Q3) as the reference group for all analyses and detected small, but statistically significant (P<0.01) associations with discharge functional status in all 3 diagnosis groups. Only the highest volume quintile (Q5) reached statistical significance, displaying higher functional status ratings than Q3 each time. The largest effect was observed in FIM total scores among fracture patients, with only a 3.6-point difference in Q5 and Q3 group means. Volume was not independently related to home discharge. Outcome-specific volume effects ranged from small (functional status) to none (home discharge) in all 3 diagnostic groups. Patients with these conditions can be treated locally rather than at higher volume regional centers. Further regionalization of inpatient rehabilitation services is not needed for these conditions.

Simultaneous avulsion fracture of the posterior medial and posterior lateral meniscus root: a case report and review of the literature.

PubMed

Feucht, Matthias J; Salzmann, Gian M; Pestka, Jan M; Südkamp, Norbert P; Niemeyer, Philipp

2014-04-01

Injuries of the meniscus roots are increasingly recognized as a serious knee joint pathology. An avulsion fracture of the meniscus root is a rare variant of this injury pattern. In this article, a case of a traumatic simultaneous avulsion fracture of both the posterior medial and posterior lateral meniscus root associated with a tear of the anterior cruciate ligament is presented. Both avulsion fractures were treated by indirect arthroscopic transtibial pullout fixation of the bony fragment. Based on the findings of our literature review, root avulsion fractures seem to be more common in young male patients after an acute trauma to the knee joint.

[Operative treatment for complex tibial plateau fractures].

PubMed

Song, Qi-Zhi; Li, Tao

2012-03-01

To explore the surgical methods and clinical evaluation of complex tibial plateau fractures resulted from high-energy injuries. From March 2006 to May 2009,48 cases with complex tibial plateau fractures were treated with open reduction and plate fixation, including 37 males and 11 females, with an average age of 37 years (ranged from 18 to 63 years). According to Schatzker classification, 16 cases were type IV, 20 cases type V and 12 cases type VI. All patients were examined by X-ray flim and CT scan. The function of knee joint were evaluated according to postoperative follow-up X-ray and Knee Merchant Rating. Forty-eight patients were followed up with a mean time of 14 months. According to Knee Merchant Rating, 24 cases got excellent results, 16 cases good, 6 cases fair and 2 cases poor. Appropriate operation time, anatomical reduction, suitable bone graft and reasonable rehabilitation exercises can maximally recovery the function of knee joint.

Effect of Nd:YAG laser beam welding on weld morphology and mechanical properties of Ti-6Al-4V butt joints and T-joints

NASA Astrophysics Data System (ADS)

Kashaev, Nikolai; Ventzke, Volker; Fomichev, Vadim; Fomin, Fedor; Riekehr, Stefan

2016-11-01

A Nd:YAG single-sided laser beam welding process study for Ti-6Al-4V butt joints and T-joints was performed to investigate joining techniques with regard to the process-weld morphology relationship. An alloy compatible filler wire was used to avoid underfills and undercuts. The quality of the butt joints and T-joints was characterized in terms of weld morphology, microstructure and mechanical properties. Joints with regular shapes, without visible cracks, pores, and geometrical defects were achieved. Tensile tests revealed high joint integrity in terms of strength and ductility for both the butt joint and T-joint geometries. Both the butt joints and T-joints showed base material levels of strength. The mechanical performance of T-joints was also investigated using pull-out tests. The performance of the T-joints in such tests was sensitive to the shape and morphology of the welds. Fracture always occurred in the weld without any plastic deformation in the base material outside the weld.

Fracture-fault network characterization of pavement imagery of the Whitby Mudstone, Yorkshire

NASA Astrophysics Data System (ADS)

Boersma, Quinten; Hardebol, Nico; Houben, Maartje; Barnhoorn, Auke; Drury, Martyn

2015-04-01

Natural fractures play an important role in the hydrocarbon production from tight reservoirs. The need for fracture network pathways by fraccing matters particularly for shale gas prospects, due to their micro- to nano-darcies matrix permeabilities. The study of natural fractures from outcrops helps to better understand network connectivity and possibility of reactivating pre-existing planes of weakness, induced by hydraulic stimulation. Microseismicity also show that natural fractures are reactivated during fraccing in tight gas reservoirs and influence the success of the stimulation. An accurate understanding of natural fracture networks can help in predicting the development of fracture networks. In this research we analyze an outcrop analogue, the Whitby Mustone Formation (WMF), in terms of its horizontal fracture network. The WMF is the time equivalent of the Posidonia Shale Formation (PSF), which on itself is the main shale gas prospect in the Dutch subsurface. The fracture network of the WMF is characterized by a system of steep dipping joints with two dominant directions with N-S and E-W strike. The network was digitized from bird-view imagery of the pavement with a spatial extent of ~100 m at sub-cm resolution. The imagery is interpreted in terms of orientation and length distributions, intensity and fractal dimensions. Samples from the field were analyzed for rock strength and sample mineralogy. The results indicate that the fracture networks greatly differ per bed. Observed differences are for example; the geometry of the fracture network, its cumulative length distribution law, the fracture intensity, the fracture length vs its orientation and the fractal dimension. All these parameters greatly influence fracture network connectivity, the probability that longer fractures exist within the pavement and whether the network is more prone to clustering or scattering. Apart from the differences, the networks display a fairly similar orthogonal arrangement

Update on mandibular condylar fracture management.

PubMed

Weiss, Joshua P; Sawhney, Raja

2016-08-01

Fractures of the mandibular condyle have provided a lasting source of controversy in the field of facial trauma. Concerns regarding facial nerve injury as well as reasonable functional outcomes with closed management led to a reluctance to treat with an open operative intervention. This article reviews how incorporating new technologies and surgical methods have changed the treatment paradigm. Multiple large studies and meta-analyses continue to demonstrate superior outcomes for condylar fractures when managed surgically. Innovations, including endoscopic techniques, three-dimensional miniplates, and angled drills provide increased options in the treatment of condylar fractures. The literature on pediatric condylar fractures is limited and continues to favor a more conservative approach. There continues to be mounting evidence in radiographic, quality of life, and functional outcome studies to support open reduction with internal fixation for the treatment of condylar fractures in patients with malocclusion, significant displacement, or dislocation of the temporomandibular joint. The utilization of three-dimensional trapezoidal miniplates has shown improved outcomes and theoretically enhanced biomechanical properties when compared with traditional fixation with single or double miniplates. Endoscopic-assisted techniques can decrease surgical morbidity, but are technically challenging, require skilled assistants, and utilize specialized equipment.

Gunshot-induced fractures of the extremities: a review of antibiotic and debridement practices.

PubMed

Sathiyakumar, Vasanth; Thakore, Rachel V; Stinner, Daniel J; Obremskey, William T; Ficke, James R; Sethi, Manish K

2015-09-01

The use of antibiotic prophylaxis and debridement is controversial when treating low- and high-velocity gunshot-induced fractures, and established treatment guidelines are currently unavailable. The purpose of this review was to evaluate the literature for the prophylactic antibiotic and debridement policies for (1) low-velocity gunshot fractures of the extremities, joints, and pelvis and (2) high-velocity gunshot fractures of the extremities. Low-velocity gunshot fractures of the extremities were subcategorized into operative and non-operative cases, whereas low-velocity gunshot fractures of the joints and pelvis were evaluated based on the presence or absence of concomitant bowel injury. In the absence of surgical necessity for fracture care such as concomitant absence of gross wound contamination, vascular injury, large soft-tissue defect, or associated compartment syndrome, the literature suggests that superficial debridement for low-velocity ballistic fractures with administration of antibiotics is a satisfactory alternative to extensive operative irrigation and debridement. In operative cases or those involving bowel injuries secondary to pelvic fractures, the literature provides support for and against extensive debridement but does suggest the use of intravenous antibiotics. For high-velocity ballistic injuries, the literature points towards the practice of extensive immediate debridement with prophylactic intravenous antibiotics. Our systematic review demonstrates weak evidence for superficial debridement of low-velocity ballistic fractures, extensive debridement for high-velocity ballistic injuries, and antibiotic use for both types of injury. Intra-articular fractures seem to warrant debridement, while pelvic fractures with bowel injury have conflicting evidence for debridement but stronger evidence for antibiotic use. Given a relatively low number of studies on this subject, we recommend that further high-quality research on the debridement and

Minimal internal fixation augmented by small wire transfixion frames for high-energy tibial plateau fractures.

PubMed

Katsenis, Dimitris; Athanasiou, Vasilis; Vasilis, Athanasiou; Megas, Panayiotis; Panayiotis, Megas; Tyllianakis, Minos; Minos, Tillianakis; Lambiris, Elias

2005-04-01

To evaluate the outcome of bicondylar tibial plateau fractures treated with minimal internal fixation augmented by small wire external fixation frames and to assess the necessity of bridging the knee joint by extending the external fixation to the distal femur. This is a retrospective study of 48 tibial plateau fractures. There were 40 (83.5%) Schatzker type VI fractures, 8 Schatzker type V fractures, and 18 (37.5%) fractures were open. A complex injury according to the Tscherne-Lobenhoffer classification was recorded in 30 (62.5%) patients. All fractures were treated with combined minimally invasive internal and external fixation. Closed reduction was achieved in 32 (66.6%) of the fractures. Extension of the external fixation to the distal femur was done in 30 (62.5%) fractures. Results were assessed according to the criteria of Honkonen-Jarvinen. Follow-up ranged from 28 to 60 months with an average of 38 months. All fractures but 1 united at an average of 13.5 weeks (range 11-18 weeks). One patient developed an infected nonunion of the diaphyseal segment of his fracture. Thirty-nine (81%) patients achieved an excellent or good radiologic result. An excellent or good final clinical result was recorded in 36 patients (76%). Bridging the knee joint did not affect significantly the result (P < 0.418). No significant correlation was found between the type of fracture and the final score (P < 0.458). Hybrid internal and external fixation combined with tibiofemoral extension of the fixation is an attractive treatment option for complex tibial plateau fractures.

[Treatment of pediatric distal femur fractures by external fixator combined with limited internal fixation].

PubMed

Wei, Sheng-wang; Shi, Zhan-ying; Hu, Ju-zheng; Wu, Hao

2016-03-01

To discuss the clinical effects of external fixator combined with limited internal fixation in the treatment of pediatric distal femur fractures. From January 2008 to June 2014, 17 children of distal femur fractures were treated by external fixator combined with limited internal fixation. There were 12 males and 5 females, aged from 6 to 13 years old with an average of 10.2 years, ranged in the course of disease from 1 h to 2 d. Preoperative diagnoses were confirmed by X-ray films in all children. There were 11 patients with supracondylar fracture , and 6 patients with intercondylar comminuted fracture. According to AO/ASIF classification, 9 fractures were type A1, 5 cases were type A2,and 3 cases were type C1. The intraoperative and postoperative complications, postoperative radiological examination, lower limbs length and motion of knee joints were observed. Knee joint function was assessed by KSS score. All the patients were followed up from 6 to 38 months with an average of 24.4 months. No nerve or blood vessel injury was found. One case complicated with the external fixation loosening, 2 cases with the infection of pin hole and 3 cases with the leg length discrepancy. Knee joint mobility and length measurement (compared with the contralateral), the average limited inflexion was 10 degrees (0 degrees to 20 degrees), the average limited straight was 4 degrees (0 degrees to 10), the average varus or valgus angle was 3 degrees (0 degrees to 5 degrees). KSS of the injured side was (96.4 +/- 5.0) points at final follow-up, 16 cases got excellent results and 1 good. All fractures obtained healing and no epiphyseal closed early was found. External fixator combined with limited internal fixation has advantages of simple operation, reliable fixation, early functional exercise in treating pediatric distal femurs fractures.

[Treatment strategy and planning for pilon fractures].

PubMed

Mittlmeier, Thomas; Wichelhaus, Alice

2017-08-01

Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms. The aim of the present analysis was to display the strategy variations for the treatment of pilon fractures taking into account the advantages and disadvantages of the corresponding treatment concepts. A staged procedure including primary closed reduction employing ligamentotaxis and fixation of the joints of the hindfoot via tibiocalcaneal metatarsal fixation offers a safe basis for consecutive imaging and the selection of specific approaches for definitive reconstruction. A simultaneous reconstruction and fixation of the fibula during the primary intervention are generally not recommended in order to avoid any limitations for subsequent reconstructive procedures. A time frame for definitive reconstruction covers a period of up to 3 weeks after trauma and allows a detailed planning considering the individual dynamics of the soft tissue situation and any logistic requirements. For the choice of the definitive treatment concept a wide range of procedures and implants are available. There are also valid concepts for primary treatment of defined fracture constellations while primary arthrodesis represents a solution in cases of major destruction of the joint surface. Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture.

The treatment options for posterior malleolar fractures in tibial spiral fractures.

PubMed

Guo, Jialiang; Liu, Lei; Yang, Zongyou; Hou, Zhiyong; Chen, Wei; Zhang, Yingze

2017-09-01

The posterior malleolar fracture (PMF) in tibial spiral fractures are a common type of complication that occurs in tibial fractures. However, the indication of fixation for posterior fractures is still under debate and varies between different surgeons'. It is not unusual to find the smaller PMF (<25%), which could be treated conservatively within guidelines, treated with internal fixation in clinic. The aim of this study is to evaluate the clinical outcomes of tibial spiral fractures with PMF and provide proper guidance for the treatment of this special fracture. A total of 284 cases of spiral fractures combined with PMF were collected and analyzed. Demographic data, fragment size (classified by 25% involvement of ankle joint), time to weight-bearing and functional scores post-operatively were recorded. The ankle-hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS), a visual analogue scale (VAS) pain score, assessment of dorsiflexion restriction and arthritis scale were used as the main evaluations. Forty patients with a larger PMF (≥25%) and 72 with smaller ones (<25%) were fixed and categorized as the fixation group (FG). In the nonfixation group (NG), the corresponding numbers were four and 168 patients respectively. A total of 279 PMF were classified as large posterolateral triangular fragment carrying the posterior half of the fibular notch and intra-incisural posterolateral fragment involving one-fourth to one-third of the fibular notch. However, no obvious differences were observed in terms of the clinical outcomes in PMF involving one-fourth to one-third of the fibular notch. In the treatment of smaller PMF (<25%) of this type, there were no obvious differences in the functional outcomes between fixed (SF) and nonfixed PMF (SN). Many patients with smaller PMFs were fixated, but functional outcomes of SF were not better than those of SN. There is no need to emphasize other factors guiding the treatment of PMF involving one-fourth to

Open reduction-internal fixation of a navicular body fracture with dorsal displacement of the first and second cuneiforms: a case report.

PubMed

Andersen, Robert C; Neiderer, Katherine; Martin, Billy; Dancho, James

2013-01-01

Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He underwent open reduction internal fixation of the navicular body fracture successfully but failed adequate reduction of the navicular cuneiform joint after ligamentous reconstruction. After revisional surgery, he also failed 6 weeks of percutanous pinning with Kirschner-wire fixation. When comparing the literature of a similar injury, the Lisfranc fracture disclocation, the same principles may apply. One should consider rigid open reduction internal fixation or even primary fusion to treat disclocation of the naviculocuneiform joint following a navicular body fracture.

[Clinical application of artificial condylar process for reconstructing temporomandibular joint].

PubMed

Huang, Xiangdao; Shao, Zhanying; Wang, Fasheng; Duan, Yi

2012-01-01

To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.

Employing Eigenvalue Ratios to Generate Prior Fracture-like Features for Stochastic Hydrogeophysical Characterization of a Fractured Aquifer System

NASA Astrophysics Data System (ADS)

Brewster, J.; Oware, E. K.

2017-12-01

Groundwater hosted in fractured rocks constitutes almost 65% of the principal aquifers in the US. The exploitation and contaminant management of fractured aquifers require fracture flow and transport modeling, which in turn requires a detailed understanding of the structure of the aquifer. The widely used equivalent porous medium approach to modeling fractured aquifer systems is inadequate to accurately predict fracture transport processes due to the averaging of the sharp lithological contrast between the matrix and the fractures. The potential of geophysical imaging (GI) to estimate spatially continuous subsurface profiles in a minimally invasive fashion is well proven. Conventional deterministic GI strategies, however, produce geologically unrealistic, smoothed-out results due to commonly enforced smoothing constraints. Stochastic GI of fractured aquifers is becoming increasing appealing due to its ability to recover realistic fracture features while providing multiple likely realizations that enable uncertainty assessment. Generating prior spatial features consistent with the expected target structures is crucial in stochastic imaging. We propose to utilize eigenvalue ratios to resolve the elongated fracture features expected in a fractured aquifer system. Eigenvalues capture the major and minor directions of variability in a region, which can be employed to evaluate shape descriptors, such as eccentricity (elongation) and orientation of features in the region. Eccentricity ranges from zero to one, representing a circularly sharped to a line feature, respectively. Here, we apply eigenvalue ratios to define a joint objective parameter consisting of eccentricity (shape) and direction terms to guide the generation of prior fracture-like features in some predefined principal directions for stochastic GI. Preliminary unconditional, synthetic experiments reveal the potential of the algorithm to simulate prior fracture-like features. We illustrate the strategy with a

Flat H Redundant Frangible Joint Development

NASA Technical Reports Server (NTRS)

Brown, Chris

2016-01-01

Orion and Commercial Crew Program (CCP) Partners have chosen to use frangible joints for certain separation events. The joints currently available are zero failure tolerant and will be used in mission safety applications. The goal is to further develop a NASA designed redundant frangible joint that will lower flight risk and increase reliability. FY16 testing revealed a successful design in subscale straight test specimens that gained efficiency and supports Orion load requirements. Approach / Innovation A design constraint is that the redundant joint must fit within the current Orion architecture, without the need for additional vehicle modification. This limitation required a design that changed the orientation of the expanding tube assemblies (XTAs), by rotating them 90deg from the standard joint configuration. The change is not trivial and affects the fracture mechanism and structural load paths. To address these changes, the design incorporates cantilevered arms on the break plate. The shock transmission and expansion of the XTA applies force to these arms and creates a prying motion to push the plate walls outward to the point of structural failure at the notched section. The 2014 test design revealed that parts could slip during functioning wasting valuable energy needed to separate the structure with only a single XTA functioning. Dual XTA functioning fully separated the assembly showing a discrepancy can be backed up with redundancy. Work on other fully redundant systems outside NASA is limited to a few patents that have not been subjected to functionality testing Design changes to prevent unwanted slippage (with ICA funding in 2015) showed success with a single XTA. The main goal for FY 2016 was to send the new Flat H RFJ to WSTF where single XTA test failures occurred back in 2014. The plan was to gain efficiency in this design by separating the Flat H RFJ with thicker ligaments with dimensions baselined in 2014. Other modifications included geometry

Intra-articular fractures of the distal tibia

PubMed Central

Sitnik, Alexandre; Beletsky, Aleksander; Schelkun, Steven

2017-01-01

Results of the treatment of intra-articular fractures of the distal tibia have improved significantly during the last two decades. Recognition of the role of soft tissues has led to the development of a staged treatment strategy. At the first stage, joint-bridging external fixation and fibular fixation are performed. This leads to partial reduction of the distal tibial fracture and allows time for the healing of soft tissues and detailed surgical planning. Definitive open reduction and internal fixation of the tibial fracture is performed at a second stage, when the condition of the soft tissues is safe. The preferred surgical approach(es) is chosen based on the fracture morphology as determined from standard radiographic views and computed tomography. Meticulous atraumatic soft-tissue handling and the use of modern fixation techniques for the metaphyseal component such as minimally invasive plate osteosynthesis further facilitate healing. Cite this article: EFORT Open Rev 2017;2:352-361. DOI: 10.1302/2058-5241.2.150047 PMID:28932487

Facilitation of bone resorption activities in synovial lavage fluid patients with mandibular condyle fractures.

PubMed

Takano, H; Takahashi, T; Nakata, A; Nogami, S; Yusa, K; Kuwajima, S; Yamazaki, M; Fukuda, M

2016-05-01

The aim of this study was to investigate the bone resorption effect of the mediators delivered in joint cavity of patients with mandibular condyle fractures by detecting osteoclast markers using cellular biochemistry methods, and by analysing bone resorption activities via inducing osteoclast differentiation of the infiltrated cells from arthrocentesis. Sixteen joints in 10 patients with mandibular condyle fractures were evaluated. The control group consisted of synovial fluid (SF) samples from seven joints of four volunteers who had no clinical signs or symptoms involving the temporomandibular joint (TMJ) or disc displacement. We collected SF cells from all patients during therapeutic arthrocentesis. The infiltrating cells from TMJ SF were cultured, differentiated into tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and examined bone resorption activities. We also investigated factors related to osteoclast induction of SF, using ELISA procedures. Osteoclast-like cells were induced from the SF cells obtained from all patients with condylar fractures. These multinucleated giant cells were positive for TRAP and actin, and had the ability to absorb dentin slices. The levels of macrophage colony-stimulating factor (M-CSF), prostaglandin E2 (PGE2), soluble form of receptor activator of nuclear factor kappa-B ligand (sRANKL) and osteoprotegerin (OPG), in SF samples from the patients, were significantly higher than in the controls. These findings indicate that bone resorption activities in SF from patients with mandibular condyle fractures were upregulated and may participate in the pathogenesis and wound healing. © 2016 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.

The structure and functioning of Dynastab DK - K fixator (knee joint) and its usefullness in clinical use.

PubMed

Deszczyński, J; Karpiński, J; Deszczyńska, H

1999-12-30

The autor describes following stages of research on external fixator Dynastab DK - K (knee joint) with in - built artificial joint enabling physiological range of movement of the knee and the use of the device in functional treatment of articular fractures of the knee. The final clinical prototype of the device was developed according to the results of the experiments with anatomical preparations of knee joints in which the trajectory of the physiological movement of the knee was stated. These observations were used to construct mechanical joint with the range of movement adequate to this of the healthy knee. The positive and negative aspects in DK - K fixator are also described. The fixator was appled in 6 difficult cases of articular fractures of knee with good results.

Investigation of the Fracture Behavior of Scaled HY-130 Weldments

DTIC Science & Technology

1990-06-01

RESULTS OF EPFM ANALYSIS OF TFREE-POINT BEND SPECIMENS OF DIFFERENT SIZES ........... D-48 xi NAVSWC TR 90-360 TABLES 1 RESULTS OF DYNAMIC FRACTURE...characterize the critical loading needed to cause fracture of the welded joint. An example of such a measure of severity applicable to structures with...weldments. Application of the approach to two titanium alloys and the results of that hwvestigation will be presented in another report. The next four

Peroneal tendon displacement accompanying intra-articular calcaneal fractures.

PubMed

Toussaint, Rull James; Lin, Darius; Ehrlichman, Lauren K; Ellington, J Kent; Strasser, Nicholas; Kwon, John Y

2014-02-19

Peroneal tendon displacement (subluxation or dislocation) accompanying an intra-articular calcaneal fracture is often undetected and under-treated. The goals of this study were to determine (1) the prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures, (2) the association of tendon displacement with fracture classifications, (3) the association of tendon displacement with heel width, and (4) the rate of missed diagnosis of the tendon displacement on radiographs and computed tomography (CT) scans and the resulting treatment rate. A retrospective radiographic review of all calcaneal fractures presenting at three institutions from June 30, 2006, to June 30, 2011, was performed. CT imaging of 421 intra-articular calcaneal fractures involving the posterior facet was available for review. The prevalence of peroneal tendon displacement was noted and its associations with fracture classification and heel width were evaluated. Peroneal tendon displacement was identified in 118 (28.0%) of the 421 calcaneal fracture cases. The presence of tendon displacement was significantly associated with joint-depression fractures compared with tongue-type fractures (p < 0.001). Only twelve (10.2%) of the 118 cases of peroneal tendon displacement had been identified in the radiology reports. Although sixty-five (55.1%) of the fractures with tendon displacement had been treated with internal fixation, the tendon displacement was treated surgically in only seven (10.8%) of these cases. Analysis of CT images showed a 28% prevalence of peroneal tendon displacement accompanying intra-articular calcaneal fractures. Surgeons and radiologists are encouraged to consider this association.

Investigation of Super*Zip separation joint

NASA Technical Reports Server (NTRS)

Bement, Laurence J.; Schimmel, Morry L.

1988-01-01

An investigation to determine the most likely cause of two failures of five tests on 79 inch diameter Lockheed Super*Zip spacecraft separation joints being used for the development of a Shuttle/Centaur propulsion system. This joint utilizes an explosively expanded tube to fracture surrounding prenotched aluminum plates to achieve planar separation. A test method was developed and more than 300 tests firings were made to provide an understanding of severance mechanisms and the functional performance effects of system variables. An approach for defining functional margin was developed, and specific recommendations were made for improving existing and future systems.

Experimental and failure analysis of the prosthetic finger joint implants

NASA Astrophysics Data System (ADS)

Naidu, Sanjiv H.

Small joint replacement arthroplasty of the hand is a well accepted surgical procedure to restore function and cosmesis in an individual with a crippled hand. Silicone elastomers have been used as prosthetic material in various small hand joints for well over three decades. Although the clinical science aspects of silicone elastomer failure are well known, the physical science aspects of prosthetic failure are scant and vague. In the following thesis, using both an animal model, and actual retrieved specimens which have failed in human service, experimental and failure analysis of silicone finger joints are presented. Fractured surfaces of retrieved silicone trapezial implants, and silicone finger joint implants were studied with both FESEM and SEM; the mode of failure for silicone trapezium is by wear polishing, whereas the finger joint implants failed either by fatigue fracture or tearing of the elastomer, or a combination of both. Thermal analysis revealed that the retrieved elastomer implants maintained its viscoelastic properties throughout the service period. In order to provide for a more functional and physiologic arthroplasty a novel finger joint (Rolamite prosthesis) is proposed using more recently developed thermoplastic polymers. The following thesis also addresses the outcome of the experimental studies of the Rolamite prosthesis in a rabbit animal model, in addition to the failure analysis of the thermoplastic polymers while in service in an in vivo synovial environment. Results of retrieved Rolamite specimens suggest that the use for thermoplastic elastomers such as block copolymer based elastomers in a synovial environment such as a mammalian joint may very well be limited.

[Concomitant injuries after upper ankle joint dislocations].

PubMed

Dann, K; Wahler, G; Neubauer, N; Steiner, R; Titze, W; Wagner, M

1996-09-01

Functional treatment with the Air Stirrup Ankle Brace recommended by C. N. Stover in 1979 can reduce pathological inversion of the ankle joint. In our retrospective study of 109 patients treated by this kind of ankle brace we found 96 patients (88%) with excellent results. Only 13 patients (12%) reported moderate to good results. To detect and characterize their painful conditions of ankles we did a clinical, radiological and MRI-Investigation. In only 2 cases we found a moderate instability after clinical investigation, anterior stress roentgenogram and talar tilt. By using the MRI-investigation 1.0 Tesla with a 512 x 360 Matrix we could find 10 cases with osteochondral lesions of the ankle. In 7 cases there was separated ossicle in the fibulotalar joint, in 1 case we detected a fracture of the processus anterior tali, in another case we could see a posttraumatic lesion of the talus and calcaneus with bone bruise and at least one osteochondral fracture of the distal tibia. The capability of the MRI to detect particularly osteo-chondral lesions of the talus and the tibiofibular joint was shown in 10 of 13 cases. Therefore we recommend to do an MRI-investigation on all patients after ankle sprain if there are painful conditions within the ankle after conservative treatment.

Clinic research on the treatment for humeral shaft fracture with minimal invasive plate osteosynthesis: a retrospective study of 128 cases.

PubMed

Chen, H; Hu, X; Yang, G; Xiang, M

2017-04-01

Minimal invasive plate osteosynthesis (MIPO) is one of the most important techniques in the treatment for humeral shaft fractures. This study was performed to evaluate the efficacy of MIPO technique for the treatment for humeral shaft fractures. We retrospectively evaluated 128 cases with humeral shaft fractures that were treated with MIPO technique from March 2005 to August 2008. All the patients were followed up by routine radiological imaging and clinical examinations. Constant-Murley score and HSS elbow joint score were used to evaluate the treatment outcome. The average duration of the surgery was 60 min (range 40-95 min) without blood transfusion. All fractures healed without infection. All cases recovered carrying angle except four cases with 10°-15° cubitus varus. After the average follow-up of 23 (13-38) months, satisfactory function was achieved according to Constant-Murley score and HSS elbow joint score. Constant-Murley score was 80 on average (range 68-91). According to HSS elbow joint score, there were 123 cases of excellent clinical outcome and five cases of effective outcome. It seems to be a safe and effective method for managing humeral shaft fractures with MIPO technique.

Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture Dislocation of the Elbow in an Adult

PubMed Central

Hassan, Youssef G.; Joukhadar, Nabih I.

2018-01-01

Medial epicondyle entrapment after an acute fracture dislocation of the elbow is a common finding in the pediatric population, but a rare finding in adults. We present a case of an adult patient diagnosed with a traumatic fracture dislocation of the elbow joint with intra-articular entrapment of the medial epicondyle. After initial evaluation, closed reduction was done. Stability testing after reduction showed an unstable joint; thus, open reduction and internal fixation was decided. PMID:29666736

Low-dose CT of postoperative pelvic fractures: a comparison with radiography.

PubMed

Eriksson, Thomas; Berg, Per; Olerud, Claes; Shalabi, Adel; Hänni, Mari

2018-01-01

Background Computed tomography (CT) is superior to conventional radiography (CR) for assessing internal fixation of pelvic fractures, but with a higher radiation exposure. Low-dose CT (LDCT) could possibly have a sufficient diagnostic accuracy but with a lower radiation dose. Purpose To compare postoperative diagnostic accuracy of LDCT and CR after open reduction and internal fixation of pelvic fracture. Material and Methods Twenty-one patients were examined with LDCT and CR 0-9 days after surgery. The examinations were reviewed by two musculoskeletal radiologists. Hardware, degree of fracture reduction, image quality, and reviewing time were assessed, and effective radiation dose was calculated. Inter-reader agreement was calculated. Results LDCT was significantly better than CR in determining whether hardware positioning was assessable ( P < 0.001). Acetabular congruence was assessable in all fractured patients with LDCT. In 12 of the 32 assessments with CR of patients with an acetabular fracture, joint congruence was not assessable due to overlapping hardware ( P = 0.001). Image quality was significantly higher for LDCT. Median time to review was 240 s for LDCT compared to 180 s for CR. Effective dose was 0.79 mSv for LDCT compared to 0.32 mSv for CR ( P < 0.001). Conclusion LDCT is more reliable than CR in assessing hardware position and fracture reduction. Joint congruency is sometimes not possible to assess with CR, due to overlapping hardware. The image quality is higher, but also the effective dose, with LDCT than with CR.

Numerical Model for the Study of the Strength and Failure Modes of Rock Containing Non-Persistent Joints

NASA Astrophysics Data System (ADS)

Vergara, Maximiliano R.; Van Sint Jan, Michel; Lorig, Loren

2016-04-01

The mechanical behavior of rock containing parallel non-persistent joint sets was studied using a numerical model. The numerical analysis was performed using the discrete element software UDEC. The use of fictitious joints allowed the inclusion of non-persistent joints in the model domain and simulating the progressive failure due to propagation of existing fractures. The material and joint mechanical parameters used in the model were obtained from experimental results. The results of the numerical model showed good agreement with the strength and failure modes observed in the laboratory. The results showed the large anisotropy in the strength resulting from variation of the joint orientation. Lower strength of the specimens was caused by the coalescence of fractures belonging to parallel joint sets. A correlation was found between geometrical parameters of the joint sets and the contribution of the joint sets strength in the global strength of the specimen. The results suggest that for the same dip angle with respect to the principal stresses; the uniaxial strength depends primarily on the joint spacing and the angle between joints tips and less on the length of the rock bridges (persistency). A relation between joint geometrical parameters was found from which the resulting failure mode can be predicted.

Upper ankle joint space detection on low contrast intraoperative fluoroscopic C-arm projections

NASA Astrophysics Data System (ADS)

Thomas, Sarina; Schnetzke, Marc; Brehler, Michael; Swartman, Benedict; Vetter, Sven; Franke, Jochen; Grützner, Paul A.; Meinzer, Hans-Peter; Nolden, Marco

2017-03-01

Intraoperative mobile C-arm fluoroscopy is widely used for interventional verification in trauma surgery, high flexibility combined with low cost being the main advantages of the method. However, the lack of global device-to- patient orientation is challenging, when comparing the acquired data to other intrapatient datasets. In upper ankle joint fracture reduction accompanied with an unstable syndesmosis, a comparison to the unfractured contralateral site is helpful for verification of the reduction result. To reduce dose and operation time, our approach aims at the comparison of single projections of the unfractured ankle with volumetric images of the reduced fracture. For precise assessment, a pre-alignment of both datasets is a crucial step. We propose a contour extraction pipeline to estimate the joint space location for a prealignment of fluoroscopic C-arm projections containing the upper ankle joint. A quadtree-based hierarchical variance comparison extracts potential feature points and a Hough transform is applied to identify bone shaft lines together with the tibiotalar joint space. By using this information we can define the coarse orientation of the projections independent from the ankle pose during acquisition in order to align those images to the volume of the fractured ankle. The proposed method was evaluated on thirteen cadaveric datasets consisting of 100 projections each with manually adjusted image planes by three trauma surgeons. The results show that the method can be used to detect the joint space orientation. The correlation between angle deviation and anatomical projection direction gives valuable input on the acquisition direction for future clinical experiments.

[Intraoperative virtual implant planning for volar plate osteosynthesis of distal radius fractures].

PubMed

Franke, J; Vetter, S Y; Reising, K; Herrmann, S; Südkamp, N P; Grützner, P A; von Recum, J

2016-01-01

Digital planning of implants is in most cases conducted prior to surgery. The virtual implant planning system (VIPS) is an application developed for mobile C-arms, which assists the virtual planning of screws close to the joint line during surgery for treatment of distal radius fractures with volar plate osteosynthesis. The aim of this prospective randomized study was to acquire initial clinical experiences and to compare the VIPS method with the conventional technique. The study included 10 patients for primary testing and 30 patients with distal radius fractures of types A3, C1 and C2, divided in 2 groups. In the VIPS group, after placement of the plate and fracture reduction, a virtual 3D model of the plate was matched with the image of the plate from the fluoroscopic acquisition. Next, the length and position of the screws close to the joint line were planned on the virtual plate. The control group was treated with the same implant in the conventional way. Data were collected regarding screw replacement, fluoroscopy and operating room (OR) times. The VIPS group included six A3, one C1 and eight C2 fractures, while the control group consisted of six A3 and nine C2 fractures. Three screws were replaced in the VIPS group and two in the control group (p = 0.24). The mean intraoperative fluoroscopy time of the VIPS group amounted to 2.58 ± 1.38 min, whereas it was 2.12 ± 0.73 min in the control group (p = 0.26). The mean OR time in the VIPS group was 53.3 ± 34.5 minutes and 42.3 ± 8.8 min (p = 0.23) in the control group. The VIPS enables a precise positioning of screws close to joint line in the treatment of distal radius fractures; however, for routine use, further development of the system is necessary.

[Effect factors analysis of knee function recovery after distal femoral fracture operation].

PubMed

Bei, Chaoyong; Wang, Ruiying; Tang, Jicun; Li, Qiang

2009-09-01

an excellent and good rate of 72.83%. Single factor analysis showed that age, preoperative ASA classification, fracture type, reduction quality, whether or not CPM functional exercise, and postoperative complications were significantly in knee function recovery (P < 0.05). logistic regression analysis showed that the fracture type, quality of reduction, whether or not CPM functional exercise, and age were major factors in the knee joint function recovery. Age, preoperative ASA classification, fracture type, reduction quality, and whether or not CPM functional training, postoperative complications factors may affect the knee joint function recovery. Adjustment to the patient's preoperative physical status, fractures anatomic reduction and firm fixation, early postoperative active and passive functional exercises, less postoperative complications can maximize the restoration of knee joint function.

Effects of different brazing and welding methods on the fracture load of various orthodontic joining configurations.

PubMed

Bock, Jens J; Bailly, Jacqueline; Fuhrmann, Robert A

2009-06-01

The aim of this study was to compare the fracture load of different joints made by conventional brazing, tungston inert gas (TIG) and laser welding. Six standardized joining configurations of spring hard quality orthodontic wire were investigated: end-to-end, round, cross, 3 mm length, 9 mm length and 6.5 mm to orthodontic band. The joints were made by five different methods: brazing with universal silver solder, two TIG and two laser welding devices. The fracture loads were measured with a universal testing machine (Zwick 005). Data were analysed with the Mann-Whitney-Wilcoxon and Kruskal-Wallis tests. The significance level was set at P<0.05). In all cases brazed joints were ruptured at a low level of fracture load (186-407 N). Significant differences between brazing and TIG or laser welding (P<0.05) were found. The highest mean fracture loads were observed for laser welding (826 N). No differences between the various TIG or laser welding devices were demonstrated, although it was not possible to join an orthodontic wire to an orthodontic band using TIG welding. For orthodontic purposes laser and TIG welding are solder free alternatives. TIG welding and laser welding showed similar results. The laser technique is an expensive, but sophisticated and simple method.

Proximal tibial fractures: early experience using polyaxial locking-plate technology.

PubMed

Nikolaou, Vassilios S; Tan, Hiang Boon; Haidukewych, George; Kanakaris, Nikolaos; Giannoudis, Peter V

2011-08-01

Between 2004 and 2009, 60 patients with proximal tibial fractures were included in this prospective study. All fractures were treated with the polyaxial locked-plate fixation system (DePuy, Warsaw, IN, USA). Clinical and radiographic data, including fracture pattern, changes in alignment, local and systemic complications, hardware failure and fracture union were analysed. The mean follow-up was 14 (12-36) months. According to the Orthopaedic Trauma Association (OTA) classification, there were five 41-A, 28 41-B and 27 41-C fractures. Fractures were treated percutaneously in 30% of cases. Double-plating was used in 11 cases. All but three fractures progressed to union at a mean of 3.2 (2.5-5) months. There was no evidence of varus collapse as a result of polyaxial screw failure. No plate fractured, and no screw cut out was noted. There was one case of lateral joint collapse (>10°) in a patient with open bicondylar plateau fracture. The mean Knee Society Score at the time of final follow-up was 91 points, and the mean functional score was 89 points. The polyaxial locking-plate system provided stable fixation of extra-articular and intra-articular proximal tibial fractures and good functional outcomes with a low complication rate.

Risk of Osteoporotic Fracture After Steroid Injections in Patients With Medicare.

PubMed

Carreon, Leah Y; Ong, Kevin L; Lau, Edmund; Kurtz, Steven M; Glassman, Steven D

To further evaluate the relationship between steroid injections and osteoporotic fracture risk, we analyzed Medicare administrative claims data on both large-joint steroid injections (LJSIs) into knee and hip and transforaminal steroid injections (TSIs), as well as osteoporotic hip and wrist fractures. Our hypothesis was that a systemic effect of steroid injections would increase fracture risk in all skeletal locations regardless of injection site, whereas a local effect would produce a disproportionate increased risk of spine fracture with spine injection. Patients treated with an LJSI, a TSI, or an epidural steroid injection (ESI) were identified from 5% Medicare claims data. Patients under age 65 years and patients with prior osteoporotic fracture were excluded. Analyses were performed to determine fracture risk (adjusted hazard ratio) for each type of injection. Analysis of the Medicare data revealed that ESIs were associated with decreased osteoporotic spine fracture risk, but the effect was small and might not be clinically relevant. ESIs did not influence osteoporotic hip or wrist fracture risk, but LJSIs reduced the risk.

Progressive Damage Analysis of Bonded Composite Joints

NASA Technical Reports Server (NTRS)

Leone, Frank A., Jr.; Girolamo, Donato; Davila, Carlos G.

2012-01-01

The present work is related to the development and application of progressive damage modeling techniques to bonded joint technology. The joint designs studied in this work include a conventional composite splice joint and a NASA-patented durable redundant joint. Both designs involve honeycomb sandwich structures with carbon/epoxy facesheets joined using adhesively bonded doublers.Progressive damage modeling allows for the prediction of the initiation and evolution of damage within a structure. For structures that include multiple material systems, such as the joint designs under consideration, the number of potential failure mechanisms that must be accounted for drastically increases the complexity of the analyses. Potential failure mechanisms include fiber fracture, intraply matrix cracking, delamination, core crushing, adhesive failure, and their interactions. The bonded joints were modeled using highly parametric, explicitly solved finite element models, with damage modeling implemented via custom user-written subroutines. Each ply was discretely meshed using three-dimensional solid elements. Layers of cohesive elements were included between each ply to account for the possibility of delaminations and were used to model the adhesive layers forming the joint. Good correlation with experimental results was achieved both in terms of load-displacement history and the predicted failure mechanism(s).

Percutaneous Distraction Pinning for Metacarpophalangeal Joint Stabilization After Blast or Crush Injuries of the Hand.

PubMed

Langford, Matthew A; Cheung, Kevin; Li, Zhongyu

2015-09-01

Unstable, severely comminuted fractures of the metacarpophalangeal (MCP) joint are difficult to treat. Closed treatment and casting of these fractures often fail to maintain proper alignment and impede wound care where concomitant open injuries such as gunshot wounds are present. Conventional pinning or plating techniques are not feasible if extensive bone loss and comminution are present. A distraction pinning technique represents a potential alternative, but results with this approach, to our knowledge, have not been reported. The purposes of this study were (1) to evaluate the effectiveness (defined as osseous union and joint stability) of distraction pinning for comminuted fractures involving MCP joints after gunshot or crush injuries; (2) to report the short-term results in terms of pain and function in a small group of patients who underwent MCP distraction pinning; and (3) to evaluate complications and return to work status of these patients in the short term. We reviewed 10 patients with comminuted pilon-type fractures of the base of the proximal phalanx or metacarpal head treated with wire distraction fixation from 2005 and 2014. During that period, we used this technique to treat all patients whose fractures were deemed too comminuted for plating or pinning, and during that period, no other techniques (such as simple external fixation) were used for patients meeting those indications. The minimum followup was 6 months; eight of the 10 patients were accounted at a median of 10 months (range, 6-89 months). The median age was 47 years (range, 28-57 years), and seven of the eight were male. Kirschner wire fixation frames were removed 3.5 to 6 weeks after the index surgery when fracture consolidation was confirmed on radiography by the treating surgeon. Stability and range of motion of the MCP joint were assessed using physical examination, radiographs, and goniometer by the treating surgeon. Patients completed the Quick Disabilities of the Arm, Shoulder and

Celiac disease is not increased in women with hip fractures and low vitamin D levels.

PubMed

Leboff, M S; Cobb, H; Gao, L Y; Hawkes, W; Yu-Yahiro, J; Kolatkar, N S; Magaziner, J

2013-01-01

Celiac disease is associated with decreased bone density; however, the risk of fractures in celiac disease patients is unclear. We compared the prevalence of celiac disease between a group of women with hip fractures and a group of women undergoing elective joint replacement surgery and the association between celiac disease and vitamin D levels. Two hundred eight community dwelling and postmenopausal women were recruited from Boston, MA (n=81) and Baltimore, MD (n=127). We measured tissue transglutaminase IgA by ELISA to diagnose celiac disease and 25-hydroxyvitamin D (25(OH)D) levels by radioimmunoassay in both women with hip fractures (n=157) and a control group (n=51) of total hip replacement subjects from Boston. Subjects were excluded if they took any medications or had medical conditions that might affect bone. Median serum 25(OH)D levels were significantly lower (p< 0.0001) in the hip fracture cohorts compared to the elective joint replacement cohort (14.1 ng/ml vs. 21.3 ng/ml, respectively). There were no differences in the percentage of subjects with a positive tissue transglutaminase in the women with hip fractures versus the control group (1.91% vs. 1.96%, respectively). Vitamin D levels are markedly reduced in women with hip fractures, however hip fracture patients did not show a higher percentage of positive tissue transglutaminase levels compared with controls. These data suggest that routine testing for celiac disease among hip fracture patients may not be necessary in the absence of clinical signs and symptoms, although data from larger studies among hip fracture subjects are needed.

Steeply-dipping extension fractures in the Newark basin, New Jersey

USGS Publications Warehouse

Herman, G.C.

2009-01-01

Late Triassic and Early Jurassic bedrock in the Newark basin is pervasively fractured as a result of Mesozoic rifting of the east-central North American continental margin. Tectonic rifting imparted systematic sets of steeply-dipping, en ??chelon, Mode I, extension fractures in basin strata including ordinary joints and veins. These fractures are arranged in transitional-tensional arrays resembling normal dip-slip shear zones. They contributed to crustal stretching, sagging, and eventual faulting of basin rift deposits. Extension fractures display progressive linkage and spatial clustering that probably controlled incipient fault growth. They cluster into three prominent strike groups correlated to early, intermediate, and late-stage tectonic events reflecting about 50- 60?? of counterclockwise rotation of incremental stretching directions. Finite strain analyses show that extension fractures allowed the stretching of basin strata by a few percent, and these fractures impart stratigraphic dips up to a few degrees in directions opposing fracture dips. Fracture groups display three-dimensional spatial variability but consistent geometric relations. Younger fractures locally cut across and terminate against older fractures having more complex vein-cement morphologies and bed-normal folds from stratigraphic compaction. A fourth, youngest group of extension fractures occur sporadically and strike about E-W in obliquely inverted crustal blocks. A geometric analysis of overlapping fracture sets shows how fracture groups result from incremental rotation of an extending tectonic plate, and that old fractures can reactivate with oblique slip components in the contemporary, compressive stress regime. ?? 2008 Elsevier Ltd. All rights reserved.

[Progress on treatment and research of quadrilateral plate fractures of acetabular].

PubMed

Peng, Ye; Zhang, Li-hai; Tang, Pei-fu

2015-05-01

Acetabular is an important human joint for weight bearing. Quadrilateral plate is a crucial structure of medial acetabulum with special morphology and important function. Quadrilateral plate fractures are common fracture in acetabulum. Quadrilateral plate fracture is hard to expose and reduction because it is in the medial of acetabulum. At the same time,the bone in the quadrilateral plate is not easy to fixed for thinning bones and adjacent to the articular cavity. The operator should know well about the anatomy and choose the suitable internal fixation. After quadrilateral plate fractures, the femur head maybe displace medially even break into pelvis. That make reduction and treatment always be a challenge. With different kinds of fractures,the efficacy of treatment is not the same. This paper intend to review the relation of anatomic features,approaches, internal fixations, key point of treatment and efficacy.

The role of a small posterior malleolar fragment in trimalleolar fractures: a biomechanical study.

PubMed

Evers, J; Fischer, M; Zderic, I; Wähnert, D; Richards, R G; Gueorguiev, B; Raschke, M J; Ochman, S

2018-01-01

The aim of this study was to investigate the effect of a posterior malleolar fragment (PMF), with < 25% ankle joint surface, on pressure distribution and joint-stability. There is still little scientific evidence available to advise on the size of PMF, which is essential to provide treatment. To date, studies show inconsistent results and recommendations for surgical treatment date from 1940. A total of 12 cadaveric ankles were assigned to two study groups. A trimalleolar fracture was created, followed by open reduction and internal fixation. PMF was fixed in Group I, but not in Group II. Intra-articular pressure was measured and cyclic loading was performed. Contact area decreased following each fracture, while anatomical fixation restored it nearly to its intact level. Contact pressure decreased significantly with fixation of the PMF. In plantarflexion, the centre of force shifted significantly posteriorly in Group II and anteriorly in Group I. Load to failure testing showed no difference between the groups. Surgical reduction of a small PMF with less than 25% ankle joint surface improves pressure distribution but does not affect ankle joint stability. Cite this article: Bone Joint J 2018;100-B:95-100. ©2018 The British Editorial Society of Bone & Joint Surgery.

Effect of Thermal Aging on the Mechanical Properties of Sn3.0Ag0.5Cu/Cu Solder Joints Under High Strain Rate Conditions

NASA Astrophysics Data System (ADS)

Nguyen, Van Luong; Kim, Ho-Kyung

2015-07-01

Shear tests with velocities between 0.5 m/s and 2.5 m/s were conducted to investigate the deformation characteristics of 0.76 mm lead-free Sn-3Ag-0.5Cu solder ball joints after thermal aging at 373 K up to 1000 h. A scanning electron microscope equipped with energy dispersive spectroscopy was then used to examine the fracture surfaces and microstructures of the solder joints. The results showed that the main failure mode of the solder joints was the brittle interfacial fracture mode with cleavage failure in the intermetallic compound (IMC). The maximum shear strength and the fracture toughness ( K C) of the solder joint decreased substantially after aging for the initial aging time, after which they decreased gradually with further aging or an increase in the strain rate. The evolution of the IMC layer when it was thicker and had coarser nodules due to thermal aging was the primary cause of the reduction in the shear strength and fracture toughness in this study.

Targeting pro-inflammatory cytokines following joint injury: acute intra-articular inhibition of interleukin-1 following knee injury prevents post-traumatic arthritis

PubMed Central

2014-01-01

Introduction Post-traumatic arthritis (PTA) is a progressive, degenerative response to joint injury, such as articular fracture. The pro-inflammatory cytokines, interleukin 1(IL-1) and tumor necrosis factor alpha (TNF-α), are acutely elevated following joint injury and remain elevated for prolonged periods post-injury. To investigate the role of local and systemic inflammation in the development of post-traumatic arthritis, we targeted both the initial acute local inflammatory response and a prolonged 4 week systemic inflammatory response by inhibiting IL-1 or TNF-α following articular fracture in the mouse knee. Methods Anti-cytokine agents, IL-1 receptor antagonist (IL-1Ra) or soluble TNF receptor II (sTNFRII), were administered either locally via an acute intra-articular injection or systemically for a prolonged 4 week period following articular fracture of the knee in C57BL/6 mice. The severity of arthritis was then assessed at 8 weeks post-injury in joint tissues via histology and micro computed tomography, and systemic and local biomarkers were assessed in serum and synovial fluid. Results Intra-articular inhibition of IL-1 significantly reduced cartilage degeneration, synovial inflammation, and did not alter bone morphology following articular fracture. However, systemic inhibition of IL-1, and local or systemic inhibition of TNF provided no benefit or conversely led to increased arthritic changes in the joint tissues. Conclusion These results show that intra-articular IL-1, rather than TNF-α, plays a critical role in the acute inflammatory phase of joint injury and can be inhibited locally to reduce post-traumatic arthritis following a closed articular fracture. Targeted local inhibition of IL-1 following joint injury may represent a novel treatment option for PTA. PMID:24964765

Hybrid external fixation in high-energy elbow fractures: a modular system with a promising future.

PubMed

Lerner, A; Stahl, S; Stein, H

2000-12-01

Severe, high-energy, periarticular elbow injuries producing a "floating joint" are a major surgical challenge. Their reconstruction and rehabilitation are not well documented. Therefore, the following reports our experience with treating such injuries caused by war wounds. Seven adults with compound open peri- and intra-articular elbow fractures were treated in hybrid ring tubular fixation frames. After debridement, bone stabilization, and neurovascular reconstructions, early controlled daily movements were started in the affected joint. These seven patients had together seven humeral, five radial, and six ulnar fractures. All fractures united at a median time of 180 days. No deep infection developed. The functional end results assessed by the Khalfayan functional score were excellent in two, good in one, and fair in four of these severely mangled upper extremities. None was amputated. The Mangled Extremity Severity Score has been shown to be unable to provide a reliable assessment for severe high-energy limb injuries surgically managed with the modular hybrid thin wire tubular external fixation system. This hybrid system is a very useful addition to the surgical armamentarium of orthopedic trauma surgeons. It both allows complex surgical reconstructions and reduces the incidence of deep infections in these heavily contaminated injuries. The hybrid circular (thin wire) external fixation system is very modular and may provide secure skeletal stabilization even in cases of severely comminuted juxta-articular fractures on both sides of the elbow joint (floating elbow) with severe damage to soft tissues. This fixation system allows individual fixation of forearm bone fractures, thus allowing the preservation of pronation-supination movements.

Assessment of Biomarkers Associated with Joint Injury and Subsequent Post-Traumatic Arthritis

DTIC Science & Technology

2015-10-01

osteoarthritis, articular fracture, joint injury, trauma, biomarker, inflammation, MRI , knee, mouse model, translational research. 3. OVERALL PROJECT...intervention. MRI imaging of the injured knee will be obtained to assess the articular cartilage. Degenerative changes in the cartilage and joint space...successfully enrolled patients, collected and stored biosamples, obtained all post-operative MRI scans and are continuing to obtain 18- month MRI scans for

Experimental Investigation into the Fatigue Life of Hybrid Joints Under Fully Reversed Flexure Loading

DTIC Science & Technology

2008-06-01

joint classification 3 b. Hot spot-stress approach c. Notch-stress approach * d. Mesh-insensitive approach 2. Fracture mechanics (used for crack... classification approach, which is an adaptation of the nominal stress approach just discussed, with the welded joint fatigue curves as given in Table...used. More detail is provided on the joint classifications , and -- 19 I graphic representations are also included. It is explained that the stress

(Un)importance of physical therapy in treatment of displaced supracondylar humerus fractures in children.

PubMed

Ducic, Sinisa; Bumbasirevic, Marko; Radlovic, Vladimir; Bukumiric, Zoran; Bukva, Bojan; Abramovic, Dusan

2015-09-01

Elbow joint stiffness is a common complication following supracondylar humerus fractures. In prospective study, dynamics of establishing a full range of motion in the elbow joint following the treatment of supracondylar humerus fractures were assessed, together with the effects of physical therapy on improvement in the range of motion. Two groups of patients were observed. Physical therapy was administered to the first group, comprised of 25 patients. The second group, comprised of 28 patients, underwent no physical therapy. In the first few months following treatment, the range of motion was significantly greater in the patients who had undergone physical therapy, but after 12 months, the range of motion was almost equal in the two groups. This study has shown that it takes about 12 months to establish a full range of motion after the injury, and that it is not necessary to apply physical therapy in patients with elbow fractures.

[Comparison of LCP and locked intramedullary nailing fixation in treatment of tibial diaphysis fractures].

PubMed

Huang, Peng; Tang, Peifu; Yao, Qi

2007-11-01

To evaluate the treatment results of LCP and locked intramedullary nailing for tibial diaphysis fractures. From October 2003 to April 2006, 55 patients with tibial diaphysis fractures (58 fractures) were treated. Of them there were 39 males and 16 females with an average of 39 years years ( 14 to 62 years). The fractures were on the left side in 27 patients and on the right side in 31 patients (3 patients had bilateral involvement). Thirty-four fractures were treated by intramedullary nailing (intramedullary nailing group) and 24 fractures by LCP fixation (LCP group). The average disease course was 3 days (intramedullary nailing group) and 3.1 days (LCP group). The operation time, the range of motion of knee and ankle joints, fracture healing time, and complications were evaluated. The patients were followed up 8-26 months (13 months on average). The operation time was 84.0+/-9.2 min (intramedullary nailing group) and 69.0+/-8.4 min (LCP group); the average cost in hospital was yen 19,297.78 in the intramedullary nailing group and yen 14,116.55 in the LCP group respectively, showing significant differences (P < 0.05). The flexion and extension of knee joint was 139.0 +/- 3.7 degrees and 4.0 +/- 0.7 degrees in intramedullary nailing group and 149.0+/-4.2 degrees and 0+/-0.4 degrees in LCP group, showing no significant difference (P>0.05). The doral flexion and plantar flexion of ankle joint were 13.0+/-1.7 degrees and 41.0+/-2.6 degrees in intramedullary nailing group, and 10.0+/-1.4 degrees and 44.0+/-2.3 degrees in LCP group, showing no significant differences (P>0.05). The mean healing time was 3.3 months in intramedullary nailing group, and 3. 1 months in LCP group. Length discrepancy occurred in 1 case (2.5 cm), delayed union in 1 case and nailing end trouble in 3 cases in intramedullary nailing group; moreover rotation deformity occurred 1 case and anterior knee pain occurred in 6 cases (17.1%). One angulation and open fracture developed osteomyelitis in 1

Rotary self-locking intramedullary nail for long tubular bone fractures.

PubMed

Huang, Zhong-lian; Yang, Hai-long; Xu, Jian-kun; Xia, Xue; Wang, Xin-jia; Song, Jian-xin; Hu, Jun

2013-10-01

Intramedullary nails had been widely used in the treatment of long-bone fractures because of less interference of fractures and center bearing biomechanical advantage. However, it had been also found many shortcomings such as broken nails, delayed healing and was modified in order to achieve better efficacy and reduce complications. The aim of the present study is to compare the efficacy of rotary self-locking intramedullary nails (RSIN) with that of interlocking intramedullary nails (IIN) in the treatment of long-bone fractures. A retrospective study investigated 129 cases with long-bone fractures (36 with femoral fracture, 81 with tibial fracture, and 12 with humeral fracture). The fractures were fixed using either an RSIN or IIN. All patients underwent followup for 12-30 months. All patients in both groups achieved a clinical fracture healing standard and the postoperative affected limb muscle strength and joint function were well restored. The RSIN group required a shorter operative time and the fracture healed faster. There was no significant difference in the hospital stay, intraoperative blood loss or postoperative complications between the two groups. RSIN is used to treat long-bone fractures. Its healing efficacy is equivalent to the IIN. Moreover, the RSIN method is simpler and causes less tissue damage than the IIN, therefore having the advantage of accelerated healing.

Uncertainty Analysis of Simulated Hydraulic Fracturing

NASA Astrophysics Data System (ADS)

Chen, M.; Sun, Y.; Fu, P.; Carrigan, C. R.; Lu, Z.

2012-12-01

Artificial hydraulic fracturing is being used widely to stimulate production of oil, natural gas, and geothermal reservoirs with low natural permeability. Optimization of field design and operation is limited by the incomplete characterization of the reservoir, as well as the complexity of hydrological and geomechanical processes that control the fracturing. Thus, there are a variety of uncertainties associated with the pre-existing fracture distribution, rock mechanics, and hydraulic-fracture engineering that require evaluation of their impact on the optimized design. In this study, a multiple-stage scheme was employed to evaluate the uncertainty. We first define the ranges and distributions of 11 input parameters that characterize the natural fracture topology, in situ stress, geomechanical behavior of the rock matrix and joint interfaces, and pumping operation, to cover a wide spectrum of potential conditions expected for a natural reservoir. These parameters were then sampled 1,000 times in an 11-dimensional parameter space constrained by the specified ranges using the Latin-hypercube method. These 1,000 parameter sets were fed into the fracture simulators, and the outputs were used to construct three designed objective functions, i.e. fracture density, opened fracture length and area density. Using PSUADE, three response surfaces (11-dimensional) of the objective functions were developed and global sensitivity was analyzed to identify the most sensitive parameters for the objective functions representing fracture connectivity, which are critical for sweep efficiency of the recovery process. The second-stage high resolution response surfaces were constructed with dimension reduced to the number of the most sensitive parameters. An additional response surface with respect to the objective function of the fractal dimension for fracture distributions was constructed in this stage. Based on these response surfaces, comprehensive uncertainty analyses were conducted

[Principles of management of periprosthetic fractures].

PubMed

Röderer, G; Gebhard, F; Scola, A

2016-03-01

The increasing numbers of primary total hip and knee replacements have subsequently led to growing rates of periprosthetic fractures. In many cases geriatric patients with osteopenia or osteoporotic bone quality are affected. The goal of treatment is the retention or reconstruction of joint function using open reduction and internal fixation or a revision prosthesis. The aim of this article is a description of the basic principles of treatment of periprosthetic fractures of the lower extremities. An exact description of the fracture using current classification systems with imaging diagnostics is mandatory. This also includes an assessment of the stability of the prosthesis. In the case of a stable prosthesis and a good bone stock open reduction and internal fixation should be performed. In these cases locking plates are standard procedure. If fracture reduction is possible minimally invasive procedures can be performed which help to reduce the surgical trauma and accelerate rehabilitation. If the prosthesis is loose it has to be exchanged for a revision implant. If vast bony defects result they can be augmented using wedges. Conservative treatment plays only a subordinate role in selected cases. Periprosthetic fractures show an increasing incidence and occur more frequently in the geriatric patient population. Due to comorbidities and poor bone quality surgical treatment is a challenge. The fracture must be exactly classified using the appropriate classification system in order to clarify if the prosthesis can be retained or if it has to be exchanged.

Motor function and activities of daily living capacity of patients with fractures sustained during the Wenchuan earthquake.

PubMed

Zhang, Jin-Long; He, Hong-Chen; Lin, Hai-Dan; Luo, Qing-Lu; Xia, Lu; Li, Sha-Sha; He, Cheng-Qi

2011-05-01

On the afternoon of May 12, 2008, a 8.0-magnitude earthquake hit Sichuan Province, a mountainous region in Western China, killing about 70 000 people and leaving over 18 000 missing. What about the survivors motor functions and activities of daily living (ADL) capacity, especially for fractures? We need the data to guide the rehabilitation for the seismic wounded and it's important to collect the data for the future. We study the survivors to understand the motor functions and ADL capacity of patients with fractures sustained in the Wenchuan earthquake, to provide a basis for rehabilitation and treatment. We used the Manual Muscle Testing method to evaluate muscle strength, the joint angle scale to measure joint range of motion (ROM), and the Barthel index to evaluate the activities of daily living status. SPSS 13.0 software was used to analyze the data and the results were tested using one-way analysis of variance (ANOVA). The number of seismic wounded amounted to 487; 81.1% of patients had fractures. Most of the injured had fractures in multiple regions (53.9% of all fracture patients), followed by fractures of the upper limb (34.0% of patients); cranial fractures were rare (2.3%). Totally 82.0% had restricted range of motion, 23.5% had decreased muscle force, and 72.2% of the patients had restricted activities of daily living capacities. With time the activities of daily living capacity of female increased (P < 0.05), compared with the male fracture patients who did not show any relative improvement (P > 0.05). The difference between the patients' ages and ADL capacities did not reach statistical significance (P > 0.05), nor was there a significant difference between their ages and the numbers of days in hospital (P > 0.05). Fractures were the main issue in the seismic wounded, many of them had reductions in the ROM, muscle force and ADL capacities. The physicians involved in rehabilitation should pay greater attention to muscle force exercises, joint

Land-Surface Subsidence and Open Bedrock Fractures in the Tully Valley, Onondaga County, New York

USGS Publications Warehouse

Hackett, William R.; Gleason, Gayle C.; Kappel, William M.

2009-01-01

Open bedrock fractures were mapped in and near two brine field areas in Tully Valley, New York. More than 400 open fractures and closed joints were mapped for dimension, orientation, and distribution along the east and west valley walls adjacent to two former brine fields. The bedrock fractures are as much as 2 feet wide and over 50 feet deep, while linear depressions in the soil, which are 3 to 10 feet wide and 3 to 6 feet deep, indicate the presence of open bedrock fractures below the soil. The fractures are probably the result of solution mining of halite deposits about 1,200 feet below the land surface.

A close examination of healthcare expenditures related to fractures.

PubMed

Kilgore, Meredith L; Curtis, Jeffrey R; Delzell, Elizabeth; Becker, David J; Arora, Tarun; Saag, Kenneth G; Morrisey, Michael A

2013-04-01

This study evaluated reasons for healthcare expenditures both before and after the occurrence of fractures among Medicare beneficiaries. In a previous study we examined healthcare expenditures in the 6 months before and after fractures. The difference-"incremental" expenditures-provides one estimate of the potentially avoidable costs associated with fractures. We constructed a second estimate of the cost burden-"attributable" expenditures-using only those costs recorded in claims with fracture diagnosis codes. Attributable expenditures accounted for only 24% to 60% of incremental expenditures, depending on the fracture site. We examined health care expenditures between 1999 and 2005 among Medicare beneficiaries who experienced fractures (cases) and among beneficiaries who did not experience fractures (controls), matched to cases on age, race, and sex. We also examined healthcare expenditures for cases and controls for 24 months prior to the fracture index date. When expenditures associated with diagnoses for aftercare, joint pain, and osteoporosis, other musculoskeletal diagnoses, pneumonia, and pressure ulcers were included, the proportion of incremental costs directly attributable to fracture care rose to 72% to 88%. Expenditures prior to fracture were higher for cases than controls, and the rate of increase accelerated over the 12 months prior to the hip fracture. Our findings confirm that the original incremental cost analysis constituted a satisfactory method for estimating avoidable costs associated with fractures. We also conclude that those with fractures had much higher and growing healthcare expenditures in the 12 months prior to the event, compared with age-, race-, and sex-matched controls. This suggests that patterns of healthcare services utilization may provide a means to improve fracture prediction rules. Copyright © 2013 American Society for Bone and Mineral Research.

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

PubMed

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

2013-01-01

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

Microstructure and Fatigue Properties of Laser Welded DP590 Dual-Phase Steel Joints

NASA Astrophysics Data System (ADS)

Xie, Chaojie; Yang, Shanglei; Liu, Haobo; Zhang, Qi; Cao, Yaming; Wang, Yuan

2017-08-01

In this paper, cold-rolled DP590 dual-phase steel sheets with 1.5 mm thickness were butt-welded by a fiber laser, and the evolution and effect on microhardness, tensile property and fatigue property of the welded joint microstructure were studied. The results showed that the base metal is composed of ferrite and martensite, with the martensite dispersed in the ferrite matrix in an island manner. The microstructure of the weld zone was lath-shaped martensite that can be refined further by increasing the welding speed, while the heat-affected zone was composed of ferrite and tempered martensite. The microhardness increased with increasing welding speed, and the hardness reached its highest value—393.8 HV—when the welding speed was 5 m/min. Static tensile fracture of the welded joints always occurred in the base metal, and the elongation at break was more than 16%. The conditional fatigue limits of the base metal and the weld joints were 354.2 and 233.6 MPa, respectively, under tension-tension fatigue tests with a stress rate of 0.1. After observation of the fatigue fracture morphology, it was evident that the fatigue crack of the base metal had sprouted into the surface pits and that its expansion would be accelerated under the action of a secondary crack. The fatigue source of the welded joint was generated in the weld zone and expanded along the martensite, forming a large number of fatigue striations. Transient breaking, which occurred in the heat-affected zone of the joint as a result of the formation of a large number of dimples, reflected the obvious characteristics of ductile fracture.

The Characteristics of Fatigue Damage in the Fuselage Riveted Lap Splice Joint

NASA Technical Reports Server (NTRS)

Piascik, Robert S.; Willard, Scott A.

1997-01-01

An extensive data base has been developed to form the physical basis for new analytical methodology to predict the onset of widespread fatigue damage in the fuselage lap splice joint. The results of detailed destructive examinations have been cataloged to describe the physical nature of MSD in the lap splice joint. ne catalog includes a detailed description, e.g., crack initiation, growth rates, size, location, and fracture morphology, of fatigue damage in the fuselage lap splice joint structure. Detailed examinations were conducted on a lap splice joint panel removed from a full scale fuselage test article after completing a 60,000 cycle pressure test. The panel contained a four bay region that exhibited visible outer skin cracks and regions of crack link-up along the upper rivet row. Destructive examinations revealed undetected fatigue damage in the outer skin, inner skin, and tear strap regions. Outer skin fatigue cracks were found to initiate by fretting damage along the faying surface. The cracks grew along the faying surface to a length equivalent to two to three skin thicknesses before penetrating the outboard surface of the outer skin. Analysis of fracture surface marker bands produced during full scale testing revealed that all upper rivet row fatigue cracks contained in a dim bay region grow at similar rates; this important result suggests that fracture mechanics based methods can be used to predict the growth of outer skin fatigue cracks in lap splice structure. Results are presented showing the affects of MSD and out-of-plane pressure loads on outer skin crack link-up.

Interfacial microstructure and mechanical properties of brazed aluminum / stainless steel - joints

NASA Astrophysics Data System (ADS)

Fedorov, V.; Elßner, M.; Uhlig, T.; Wagner, G.

2017-03-01

Due to the demand of mass and cost reduction, joints based on dissimilar metals become more and more interesting. Especially there is a high interest for joints between stainless steel and aluminum, often necessary for example for automotive heat exchangers. Brazing offers the possibilities to manufacture several joints in one step at, in comparison to fusion welding, lower temperatures. In the recent work, aluminum / stainless steel - joints are produced by induction brazing using an AlSi10 filler and a non-corrosive flux. The mechanical properties are determined by tensile shear tests as well as fatigue tests at ambient and elevated temperatures. The microstructure of the brazed joints and the fracture surfaces of the tested samples are investigated by SEM.

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

PubMed

Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible

[Clinical application of continuous douche and vacuum sealing drainage in refractory tissue, bone and joint infections after debridement].

PubMed

Yang, Ping-lin; He, Xi-jing; Li, Hao-peng; Wang, Guo-yu; Zang, Quan-jin

2010-01-01

To explore effect and the application value of continuous douche and vacuum sealing drainage (VSD) in refractory tissue, and joint infections after complete debridement. As retrospective analysis of treatment time and restoration or recurrence, from Jan. 2006 to Dec. 2007, 61 cases of refractory tissue, bone and joint infections underwent continuous douche and VSD combined with the treatment of anti-inflammatory and rehabilitation training after debridement in our hospital. The 61 patients included 39 males and 22 females with age ranging from 10 to 58 years with an average of (35 +/- 12) years, among whom 61 identified to have ankle ulcers combined with infections,open fracture combined with infections, sacrococcygeal pressure ulcers combined with infections, infections after hip replacement, infections after open fracture, and infections after skin avulsion postoperation were 11, 15, 9, 3, 5 and 18 cases respectively. The course was from 2 weeks to 11 months with an average of 4 months. In all 61 patients,the mean healing time was 17, 36, 42, 24, 32, 29 and 28 days in ankle ulcers and infections, tibia and fibula open fracture and infections, femoral shaft fracture and infections, sacrococcygeal pressure ulcers and infections, infections after hip replacement, infections after open fracture, and infections after skin avulsion postoperation respectively. The replacement of VSD was 1, 2-4, 3-5, 1-3, 2-4, 2-3 and 1-3 times in each group respectively. There was no wound recurrence except for 2 cases with recurrent in 61 cases with external fixation nail hole semi-pathological fracture in 1 case of femoral shaft fracture and infection and 1 case of tibia and fibula fracture and infection after follow-up at least one year. Application of continuous douche and VSD can effectively decrease incidence of complications and promote the refractory tissue, bone and joint infections wound growth, healing and considerably shorten the healing time.

[APPLICATION OF COMPUTER-ASSISTED SURGICAL PLANNING IN SURGICAL TREATMENT OF ANKLE FRACTURES].

PubMed

Xia, Shengli; Wang, Xiuhui; Fu, Beigang; Lu, Yaogang; Wang, Minghui

2015-12-01

To explore the clinical value of computer-assisted surgical planning in the treatment of ankle fractures. Between January 2012 and January 2014, open reduction and internal fixation were performed on 42 patients with ankle fractures. There were 22 males and 20 females with an average age of 52 years (range, 19-72 years). The causes were spraining injury (20 cases), traffic accident injury (14 cases), and falling from height injury (8 cases). The time from injury to operation was 5 hours to 12 days (mean, 2.5 days). All fractures were closed trimalleolar fractures. According to Lauge-Hansen classification, 25 cases were rated as supination extorsion type IV, 13 as pronation extorsion type IV, and 4 as pronation abduction type III. The preoperative planning was made by virtual reduction and internal fixation using Superimage software. The mean operation time was 93.7 minutes (range, 76-120 minutes). Delayed wound healing occurred in 1 case, and secondary healing was obtained after treatment; primary healing of incision was achieved in the other patients. Postoperative X-ray films and CT images showed anatomic reduction of fracture and good position of internal fixation. All patients were followed up 14.6 months on average (range, 9-27 months). The range of motion of the affected ankle was close to the normal side at 6-8 weeks. The mean fracture healing time was 13.1 weeks (range, 11-17 weeks). Degenerative change of the ankle joint was observed in 3 cases (7.1%) with manifestation of mild narrowing of joint space on the X-ray films at last follow-up. According to Baird-Jackson score system, the results were excellent in 24 cases, good in 13 cases, and fair in 5 cases, with an excellent and good rate of 88%. Computer-assisted surgical planning for ankle fractures can help surgeons identify type of ankle fractures and improve surgical scheme for guiding fracture reduction and selecting and placing implants, so good effectiveness can be obtained.

Immediate effects of modified landing pattern on a probabilistic tibial stress fracture model in runners.

PubMed

Chen, T L; An, W W; Chan, Z Y S; Au, I P H; Zhang, Z H; Cheung, R T H

2016-03-01

Tibial stress fracture is a common injury in runners. This condition has been associated with increased impact loading. Since vertical loading rates are related to the landing pattern, many heelstrike runners attempt to modify their footfalls for a lower risk of tibial stress fracture. Such effect of modified landing pattern remains unknown. This study examined the immediate effects of landing pattern modification on the probability of tibial stress fracture. Fourteen experienced heelstrike runners ran on an instrumented treadmill and they were given augmented feedback for landing pattern switch. We measured their running kinematics and kinetics during different landing patterns. Ankle joint contact force and peak tibial strains were estimated using computational models. We used an established mathematical model to determine the effect of landing pattern on stress fracture probability. Heelstrike runners experienced greater impact loading immediately after landing pattern switch (P<0.004). There was an increase in the longitudinal ankle joint contact force when they landed with forefoot (P=0.003). However, there was no significant difference in both peak tibial strains and the risk of tibial stress fracture in runners with different landing patterns (P>0.986). Immediate transitioning of the landing pattern in heelstrike runners may not offer timely protection against tibial stress fracture, despite a reduction of impact loading. Long-term effects of landing pattern switch remains unknown. Copyright © 2016 Elsevier Ltd. All rights reserved.

Biofilm development in a hotspot of mixing between shallow and deep groundwater in a fractured aquifer: field evidence from joint flow, chemical and microbiological characterization

NASA Astrophysics Data System (ADS)

Bochet, Olivier; Le Borgne, Tanguy; Pédrot, Mathieu; Labasque, Thierry; Lavenant, Nicolas; Petton, Christophe; Dufresne, Alexis; Ben Maamar, Sarah; Chatton, Eliot; De la Bernardie, Jérôme; Aquilina, Luc

2015-04-01

Biofilm development in a hotspot of mixing between shallow and deep groundwater in a fractured aquifer: field evidence from joint flow, chemical and microbiological characterization Olivier Bochet1, Tanguy Le Borgne1, Mathieu Pédrot1, Thierry Labasque1, Nicolas Lavenant1, Christophe Petton1, Alexis Dufresne2,Sarah Ben Maamar1-2, Eliot Chatton1, Jérôme de la Bernardie1, Luc Aquilina1 1: Géosciences Rennes, CNRS UMR 6118, Université de Rennes 1, Campus de Beaulieu bât 14B, Rennes, France 2: Ecobio, CNRS UMR 6553, Université de Rennes 1, Campus de Beaulieu, bât 14, Rennes, France Biofilms play a major role in controlling the fluxes and reactivity of chemical species transported in hydrological systems. Their development can have either positive impacts on groundwater quality (e.g. attenuation of contaminants under natural or stimulated conditions), or possible negative effects on subsurface operations (e.g. bio-clogging of geothermal dipoles or artificial recharge systems). Micro-organisms require both electron donors and electron acceptors for cellular growth, proliferation and maintenance of their metabolic functions. The mechanisms controlling these reactions derive from the interactions occurring at the micro-scale that depend on mineral compositions, the biota of subsurface environment, but also fluid mixing, which determines the local concentrations of nutriments, electron donors and electron acceptors. Hence, mixing zones between oxygen and nutriment rich shallow groundwater and mineralized deep groundwater are often considered as potential hotspots of microbial activity, although relatively few field data document flow distributions, transport properties, chemical gradients and micro-organisms distributions across these mixing interfaces. Here we investigate the origin of a localized biofilm development observed in the fractured granite aquifer at the Ploemeur observatory (H+ network hplus.ore.fr).This biofilm composed of ferro-oxidizing bacteria is

Characterization of fracture aperture for groundwater flow and transport

NASA Astrophysics Data System (ADS)

Sawada, A.; Sato, H.; Tetsu, K.; Sakamoto, K.

2007-12-01

This paper presents experiments and numerical analyses of flow and transport carried out on natural fractures and transparent replica of fractures. The purpose of this study was to improve the understanding of the role of heterogeneous aperture patterns on channelization of groundwater flow and dispersion in solute transport. The research proceeded as follows: First, a precision plane grinder was applied perpendicular to the fracture plane to characterize the aperture distribution on a natural fracture with 1 mm of increment size. Although both time and labor were intensive, this approach provided a detailed, three dimensional picture of the pattern of fracture aperture. This information was analyzed to provide quantitative measures for the fracture aperture distribution, including JRC (Joint Roughness Coefficient) and fracture contact area ratio. These parameters were used to develop numerical models with corresponding synthetic aperture patterns. The transparent fracture replica and numerical models were then used to study how transport is affected by the aperture spatial pattern. In the transparent replica, transmitted light intensity measured by a CCD camera was used to image channeling and dispersion due to the fracture aperture spatial pattern. The CCD image data was analyzed to obtain the quantitative fracture aperture and tracer concentration data according to Lambert-Beer's law. The experimental results were analyzed using the numerical models. Comparison of the numerical models to the transparent replica provided information about the nature of channeling and dispersion due to aperture spatial patterns. These results support to develop a methodology for defining representative fracture aperture of a simplified parallel fracture model for flow and transport in heterogeneous fractures for contaminant transport analysis.

Geostatistical analysis of fault and joint measurements in Austin Chalk, Superconducting Super Collider Site, Texas

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

Mace, R.E.; Nance, H.S.; Laubach, S.E.

1995-06-01

Faults and joints are conduits for ground-water flow and targets for horizontal drilling in the petroleum industry. Spacing and size distribution are rarely predicted accurately by current structural models or documented adequately by conventional borehole or outcrop samples. Tunnel excavations present opportunities to measure fracture attributes in continuous subsurface exposures. These fracture measurements ran be used to improve structural models, guide interpretation of conventional borehole and outcrop data, and geostatistically quantify spatial and spacing characteristics for comparison to outcrop data or for generating distributions of fracture for numerical flow and transport modeling. Structure maps of over 9 mi of nearlymore » continuous tunnel excavations in Austin Chalk at the Superconducting Super Collider (SSC) site in Ellis County, Texas, provide a unique database of fault and joint populations for geostatistical analysis. Observationally, small faults (<10 ft. throw) occur in clusters or swarms that have as many as 24 faults, fault swarms are as much as 2,000 ft. wide and appear to be on average 1,000 ft. apart, and joints are in swarms spaced 500 to more than 2l,000 ft. apart. Semi-variograms show varying degrees of spatial correlation. These variograms have structured sills that correlate directly to highs and lows in fracture frequency observed in the tunnel. Semi-variograms generated with respect to fracture spacing and number also have structured sills, but tend to not show any near-field correlation. The distribution of fault spacing can be described with a negative exponential, which suggests a random distribution. However, there is clearly some structure and clustering in the spacing data as shown by running average and variograms, which implies that a number of different methods should be utilized to characterize fracture spacing.« less

Fatigue Properties of Butt Welded Aluminum Alloy and Carbon Steel Joints by Friction Stirring

NASA Astrophysics Data System (ADS)

Okane, M.; Shitaka, T.; Ishida, M.; Chaki, T.; Yasui, T.; Fukumoto, M.

2017-05-01

The butt dissimilar joints of Al-Mg-Si alloy JIS A6063 and carbon steel JIS S45C by means of friction stir welding were prepared for investigating fatigue properties of the joints. The joining tool used has cemented carbide thread probe and a shoulder made of alloy tool steel. All the fatigue tests were carried out under a load-controlled condition with a load ratio R=0.1 in air at room temperature. From the experimental results, it was found that hardness near the interface in A6063 was lower than that of base material. Three types of fatigue fracture occurred even in case of same welding condition. The first one was fracture at boundary between the lower hardness region and base material in A6063, the second type was initiated in the stir zone by FSW process and the last one was fracture at interface. Fatigue strength in case of the second one was lower than others. Furthermore, to investigate the effect of heat treatment on fatigue properties of the dissimilar joints, fatigue tests were also carried out with using the specimens which were heat treated under the same condition to aging process in T6 treatment. Fatigue fracture was initiated at interface between A6063 and S45C in case of the heat treated specimen, but fatigue strength was improved approximately 25% as compared with that of the non-heat treated specimen.

Improvements in hip fracture incidence counterbalanced by the rise of other fracture types: data from Spain 2000-2010.

PubMed

Cirera, Eva; Pérez, Katherine; Santamariña-Rubio, Elena; Novoa, Ana M; Olabarria, Marta

2014-12-01

In recent years, the incidence of injury in older people has increased. The aim of this study is to address the hypothesis that this increase is due to an increase in the incidence of some injuries that, while less common than hip fractures, are sufficient jointly to counteract the decrease or stabilisation in hip fracture rates observed in most countries. We performed a descriptive study of trends using data from the National Hospital Discharge Register. We included individuals 65 years and older who were discharged from a Spanish hospital during the period 2000-2010 with at least one injury diagnosis in the primary diagnosis field on the discharge form. The dependent variables were the following injury groups, classified using the Barell Matrix: hip fracture, shoulder and upper arm fractures, forearm and elbow fractures, thoracic fractures, lower leg and ankle fractures, and TBI type 1 internal injury. Incidence rates were calculated per 100,000 inhabitants (data from National Statistics Institute) and stratified by sex and age group. Trends, in terms of Annual Percent Change (APC), were assessed using Poisson Regression with discharge year as the independent variable. Hip fracture continues to be the most important injury type in older people. Thoracic fractures and TBI internal injuries are more common in men, while fractures in the upper extremities are more common in women. All injuries increased in frequency with age, except lower leg and ankle fractures, which decreased. While a secular decreasing trend in hip fracture was noted, the incidences of fractures of the shoulder and upper arm, forearm and elbow, and lower leg and ankle, as well as of TBI type 1 internal injuries have increased steadily. Although hip fracture continue to be the most common type of injury in older people, this study has allowed identifying other types of injury that are becoming increasingly common. These trends are driving paradigm changes in the burden of injuries requiring

Anatomical evidence for the anterior plate fixation of sacroiliac joint.

PubMed

Bai, Zhibiao; Gao, Shichang; Liu, Jia; Liang, Anlin; Yu, Weihua

2018-01-01

The iatrogenic injuries to the lumbar nerves during the fixation the sacroiliac (SI) joint fractures with anterior plates were often reported. No specific method had been reported to avoid it. This study was done to find a safer way of placing the anterior plates and screws for treating the sacroiliac (SI) joint fracture and/or dislocation. The research was performed using 8 male and 7 female normal corpse pelvic specimens preserved by 10% formalin solution. Try by measuring the horizontal distance from L4, L5 nerve roots to the sacroiliac joint and perpendicular distance from L4, L5 nerve roots to the ala sacralis, the length of L4, L5 nerve roots from intervertebral foramen to the edge of true pelvis, the diameter of L4, L5 nerve roots. The angles between the sacroiliac joint and sagittal plane were measured on the CT images. The horizontal distance between the lateral side of the anterior branches of L4, L5 nerve roots and the sacroiliac joint decreased gradually from the top to the bottom. The widest distances for L4,5 were 2.1 cm (range, 1.74-2.40) and 2.7 cm (range, 2.34-3.02 cm), respectively. The smallest distances for L4, 5 were 1.2 cm (range, 0.82-1.48 cm) and 1.5 cm (range, 1.08-1.74 cm), respectively. On CT images, the angle between the sacroiliac joint and sagittal plane was about 30°. If we use two anterior plates to fix the sacroiliac joint, It is recommended to place one plate on the superior one third part of the joint, with exposing medially no more than 2.5 cm and the other in the middle one third part of the joint, with elevating periosteum medially no more than 1.5 cm. The screws in the sacrum are advised to incline medially about 30° directing to the true pelvis. Copyright © 2017. Published by Elsevier B.V.

Negative pressure wound therapy for Gustilo Anderson grade IIIb open tibial fractures.

PubMed

Park, Chul Hyun; Shon, Oog Jin; Kim, Gi Beom

2016-09-01

Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study. The clinical results were assessed using a Puno scoring system for severe open fractures of the tibia at the last followup. The range of motion (ROM) of the knee and ankle joints and postoperative complication were evaluated at the last followup. The radiographic results were assessed using time to bone union, coronal and sagittal angulations and a shortening at the last followup. The mean score of Puno scoring system was 87.4 (range 67-94). The mean ROM of the knee and ankle joints was 121.3° (range 90°-130°) and 37.7° (range 15°-50°), respectively. Bone union developed in all patients and the mean time to union was 25.3 weeks (range 16-42 weeks). The mean coronal angulation was 2.1° (range 0-4°) and sagittal was 2.7° (range 1-4°). The mean shortening was 4.1 mm (range 0-8 mm). Three patients had partial flap necrosis and 1 patient had total flap necrosis. There was no superficial and deep wound infection. Staged treatment using NPWT decreased the risks of infection and requirement of flap surgeries in Gustilo Anderson grade IIIb open tibial fractures. Therefore, staged treatment using NPWT could be a useful treatment option for Gustilo Anderson grade IIIb open tibial fractures.

Hip Fractures and the Bundle: A Cost Analysis of Patients Undergoing Hip Arthroplasty for Femoral Neck Fracture vs Degenerative Joint Disease.

PubMed

Grace, Trevor R; Patterson, Joseph T; Tangtiphaiboontana, Jennifer; Krogue, Justin D; Vail, Thomas P; Ward, Derek T

2018-06-01

The purpose of this study is to determine whether episode Target Prices in the Bundled Payment for Care Improvement (BPCI) initiative sufficiently match the complexities and expenses expected for patients undergoing hip arthroplasty for femoral neck fracture (FNF) as compared to hip degenerative joint disease (DJD). Claims data under BPCI Model 2 were collected for patients undergoing hip arthroplasty at a single institution over a 2-year period. Payments from the index hospitalization to 90 days postoperatively were aggregated by Medicare Severity Diagnosis-Related Group (469 or 470), indication (DJD vs FNF), and categorized as index procedure, postacute services, and related hospital readmissions. Actual episode costs and Target Prices were compared in both the FNF and DJD cohorts undergoing hip arthroplasty to gauge the cost discrepancy in each group. A total of 183 patients were analyzed (31 with FNFs, 152 with DJD). In total, the FNF cohort incurred a $415,950 loss under the current episode Target Prices, whereas the DJD cohort incurred a $172,448 gain. Episode Target Prices were significantly higher than actual episode prices for the DJD cohort ($32,573 vs $24,776, P < .001). However, Target Prices were significantly lower than actual episode prices for the FNF cohort ($32,672 vs $49,755, P = .021). Episode Target Prices in the current BPCI model fall dramatically short of the actual expenses incurred by FNF patients undergoing hip arthroplasty. Better risk-adjusting Target Prices for this fragile population should be considered to avoid disincentives and delays in care. Copyright © 2018 Elsevier Inc. All rights reserved.

Triangulation Based 3D Laser Imaging for Fracture Orientation Analysis

NASA Astrophysics Data System (ADS)

Mah, J.; Claire, S.; Steve, M.

2009-05-01

Laser imaging has recently been identified as a potential tool for rock mass characterization. This contribution focuses on the application of triangulation based, short-range laser imaging to determine fracture orientation and surface texture. This technology measures the distance to the target by triangulating the projected and reflected laser beams, and also records the reflection intensity. In this study, we acquired 3D laser images of rock faces using the Laser Camera System (LCS), a portable instrument developed by Neptec Design Group (Ottawa, Canada). The LCS uses an infrared laser beam and is immune to the lighting conditions. The maximum image resolution is 1024 x 1024 volumetric image elements. Depth resolution is 0.5 mm at 5 m. An above ground field trial was conducted at a blocky road cut with well defined joint sets (Kingston, Ontario). An underground field trial was conducted at the Inco 175 Ore body (Sudbury, Ontario) where images were acquired in the dark and the joint set features were more subtle. At each site, from a distance of 3 m away from the rock face, a grid of six images (approximately 1.6 m by 1.6 m) was acquired at maximum resolution with 20% overlap between adjacent images. This corresponds to a density of 40 image elements per square centimeter. Polyworks, a high density 3D visualization software tool, was used to align and merge the images into a single digital triangular mesh. The conventional method of determining fracture orientations is by manual measurement using a compass. In order to be accepted as a substitute for this method, the LCS should be capable of performing at least to the capabilities of manual measurements. To compare fracture orientation estimates derived from the 3D laser images to manual measurements, 160 inclinometer readings were taken at the above ground site. Three prominent joint sets (strike/dip: 236/09, 321/89, 325/01) were identified by plotting the joint poles on a stereonet. Underground, two main joint

Texture, microstructure, and fractal features of the low-cycle fatigue failure of the metal in pipeline welded joints

NASA Astrophysics Data System (ADS)

Usov, V. V.; Gopkalo, E. E.; Shkatulyak, N. M.; Gopkalo, A. P.; Cherneva, T. S.

2015-09-01

Crystallographic texture and fracture features are studied after low-cycle fatigue tests of laboratory specimens cut from the base metal and the characteristic zones of a welded joint in a pipeline after its longterm operation. The fractal dimensions of fracture surfaces are determined. The fractal dimension is shown to increase during the transition from ductile to quasi-brittle fracture, and a relation between the fractal dimension of a fracture surface and the fatigue life of the specimen is found.

Effects of joint configuration for the arc welding of cast Ti-6Al-4V alloy rods in argon.

PubMed

Taylor, J C; Hondrum, S O; Prasad, A; Brodersen, C A

1998-03-01

Titanium and its alloys are more commonly used in prosthodontics and welding has become the most common modality for their joining. Studies on the welding of titanium and its alloys have not quantified this value, though its importance has been suggested. This study compared the strength and properties of the joint achieved at various butt joint gaps by the arc-welding of cast Ti-6Al-4V alloy tensile bars in an argon atmosphere. Forty of 50 specimens were sectioned and welded at four gaps. All specimens underwent tensile testing to determine ultimate tensile strength and percentage elongation, then oxygen analysis and scanning electron microscopy. As no more than 3 samples in any group of 10 actually fractured in the weld itself, a secondary analysis that involved fracture location was initiated. There were no differences in ultimate tensile strength or percentage elongation between specimens with weld gaps of 0.25, 0.50, 0.75, and 1.00 mm and the as-cast specimens. There were no differences in ultimate tensile strength between specimens fracturing in the weld and those fracturing in the gauge in welded specimens; however, as-cast specimens demonstrated a higher ultimate tensile strength than welded specimens that fractured in the weld. Specimens that fractured in the weld site demonstrated less ductility than those that fractured in the gauge in both welded and as-cast specimens, as confirmed by scanning electron microscopy examination. The weld wire showed an oxygen scavenging effect from the as-cast parent alloy. The effects of the joint gap were not significant, whereas the characteristics of the joint itself were, which displayed slightly lower strength and significantly lower ductility (and thus decreased toughness). The arc-welding of cast titanium alloy in argon atmosphere appears to be a reliable and efficient prosthodontic laboratory modality producing predictable results, although titanium casting and joining procedures must be closely controlled to

Extra-articular osteotomy for malunited unicondylar fractures of the proximal phalanx.

PubMed

Harness, Neil G; Chen, Alvin; Jupiter, Jesse B

2005-05-01

To evaluate an extra-articular osteotomy rather than an intra-articular osteotomy in the treatment of malunited unicondylar fractures of the proximal phalanx. An extra-articular osteotomy was used to correct the deformity resulting from a malunion of a unicondylar fracture of the proximal phalanx in 5 patients. A closing wedge osteotomy that was stabilized with tension band fixation accomplished realignment of the joint. Each patient was evaluated at a minimum of 1 year after surgery for radiographic healing, correction of angulation, digital motion, postoperative complications, current level of pain with motion, and overall satisfaction with the procedure. All of the osteotomies healed by 10 to 12 weeks after surgery with an average angular correction from 25 degrees to 1 degrees . The average proximal interphalangeal joint motion improved to 86 degrees from the preoperative average of 40 degrees , whereas the average total digital motion improved from 154 degrees before surgery to 204 degrees at follow-up evaluation. This method of extra-articular osteotomy for malunited unicondylar fractures of the proximal phalanx is highly reproducible, avoids the risks of intra-articular surgery, and leads to a predictable outcome.

Tectonic context of the penetrative fracture system origin in the Early Paleozoic shale complex (Baltic Basin, Poland/Sweden).

NASA Astrophysics Data System (ADS)

Jarosiński, Marek; Gluszynski, Andrzej; Bobek, Kinga; Dyrka, Ireneusz

2017-04-01

Characterization of natural fracture and fault pattern play significant role for reservoir stimulation design and evaluation of its results. Having structural observations limited to immediate borehole surrounding it is a common need to build up a fracture model of reservoir in a range of stimulation reservoir volume or even beyond. To do this we need both a 3D seismic model and a consistent concept of the regional tectonic evolution. We present the result of integrated tectonic study in several deep boreholes target the Lower Paleozoic shale complex of Baltic Basin (BB), combined with analysis of 3D seismic survey and outcrop screening in Scania (Swedish part of the BB). During deposition of shale complex in the Ordovician and Silurian the research area was located 200-300 km away from the continental margin of Baltica involved in the Caledonian collision with the Eastern Avalonia. This distance allowed the shale complex to avoid significant tectonic deformation. Regional seismic cross section reveals the general pattern of the BB infill characteristic for the foreland basin underwent post-collisional isostatic rebound. Due to stress changes in collisional context the shale complex was cross-cut by steep, mostly inverse faults trending NW-SE and NE-SW. The fault zones oriented NW-SE are associated with an array of en echelon faults characteristic for strike-slip displacement. In our interpretation, these faults of Silurian (Wenlock) age create pattern of the regional pop-up structure, which is simultaneously involved in the plate flexure extension. Seismic attributes (e.g. curvature or ant tracking) highlight lineaments which mostly mimic the faults orientation. However, attributes show also some artefacts that come from regular array of seismic sources and receivers, which mimic the orthogonal joint system. Structural observations on borehole core lead us to conclusion that regular, orthogonal fracture system developed after maximum burial of the complex

Management of tibial fractures using a circular external fixator in two calves.

PubMed

Aithal, Hari Prasad; Kinjavdekar, Prakash; Amarpal; Pawde, Abhijit Motiram; Singh, Gaj Raj; Setia, Harish Chandra

2010-07-01

To report the repair of tibial diaphyseal fractures in 2 calves using a circular external skeletal fixator (CEF). Clinical report. Crossbred calves (n=2; age: 6 months; weight: 55 and 60 kg). Mid-diaphyseal tibial fractures were repaired by the use of a 4-ring CEF (made of aluminum rings with 2 mm K-wires) alone in 1 calf and in combination with hemicerclage wiring in 1 calf. Both calves had good weight bearing with moderate lameness postoperatively. Fracture healing occurred by day 60 in 1 calf and by day 30 in calf 2. The CEF was well maintained and tolerated by both calves through fracture healing. Joint mobility and limb usage improved gradually after CEF removal. CEF provided a stable fixation of tibial fractures and healing within 60 days and functional recovery within 90 days. CEF can be safely and successfully used for the management of selected tibial fractures in calves.

[High complication rate after surgical treatment of ankle fractures].

PubMed

Bjørslev, Naja; Ebskov, Lars; Lind, Marianne; Mersø, Camilla

2014-08-04

The purpose of this study was to determine the quality and re-operation rate of the surgical treatment of ankle fractures at a large university hospital. X-rays and patient records of 137 patients surgically treated for ankle fractures were analyzed for: 1) correct classification according to Lauge-Hansen, 2) if congruity of the ankle joint was achieved, 3) selection and placement of the hardware, and 4) the surgeon's level of education. Totally 32 of 137 did not receive an optimal treatment, 11 were re-operated. There was no clear correlation between incorrect operation and the surgeon's level of education.

[Comparison of external fixation with or without limited internal fixation for open knee fractures].

PubMed

Li, K N; Lan, H; He, Z Y; Wang, X J; Yuan, J; Zhao, P; Mu, J S

2018-03-01

Objective: To explore the characteristics and methods of different fixation methods and prevention of open knee joint fracture. Methods: The data of 86 cases of open knee joint fracture admitted from January 2002 to December 2015 in Department of Orthopaedics, Affiliated Hospital of Chengdu University were analyzed retrospectively.There were 65 males and 21 females aged of 38.6 years. There were 38 cases treated with trans articular external fixation alone, 48 cases were in the trans articular external fixation plus auxiliary limited internal fixation group. All the patients were treated according to the same three stages except for different fixation methods. Observation of external fixation and fracture fixation, fracture healing, wound healing and treatment, treatment and related factors of infection control and knee function recovery. χ(2) test was used to analyze data. Results: Eleven patients had primary wound healing, accounting for 12.8%. Seventy-five patients had two wounds healed, accounting for 87.2%. Only 38 cases of trans articular external fixator group had 31 cases of articular surface reduction, accounting for 81.6%; Five cases of trans articular external fixator assisted limited internal fixation group had 5 cases of poor reduction, accounting for 10.4%; There was significant difference between the two groups (χ(2)=44.132, P <0.05). Take a single cross joint external fixation group, a total of 23 cases of patients with infection, accounted for 60.5% of external fixation group; trans articular external fixation assisted limited internal fixation group there were 30 cases of patients with infection, accounting for the assistance of external fixator and limited internal fixation group 62.5%; There was significant difference between the two groups(χ(2)=0.035, P >0.05). Five cases of fracture nonunion cases of serious infection, patients voluntarily underwent amputation. The Lysholm Knee Scale: In the external fixation group, 23 cases were less than

Artificial atlanto-odontoid joint replacement through a transoral approach.

PubMed

Lu, Bin; He, Xi Jing; Zhao, Chen Guang; Li, Hao Peng; Wang, Dong

2009-01-01

. This artificial atlanto-odontoid joint may be useful in cases of odontoid resection due to malunion or nonunion of odontoid fracture, atraumatic odontoid fracture, irreducible atlas dislocation, posterior atlantoaxial subluxation, or congenital skull base abnormalities.

Artificial atlanto-odontoid joint replacement through a transoral approach

PubMed Central

Lu, Bin; Zhao, Chen Guang; Li, Hao Peng; Wang, Dong

2008-01-01

tear after the fatigue test. This artificial atlanto-odontoid joint may be useful in cases of odontoid resection due to malunion or nonunion of odontoid fracture, atraumatic odontoid fracture, irreducible atlas dislocation, posterior atlantoaxial subluxation, or congenital skull base abnormalities. PMID:19043745

Primary ankle arthrodesis for neglected open Weber B ankle fracture dislocation.

PubMed

Thomason, Katherine; Ramesh, Ashwanth; McGoldrick, Niall; Cove, Richard; Walsh, James C; Stephens, Michael M

2014-01-01

Primary ankle arthrodesis used to treat a neglected open ankle fracture dislocation is a unique decision. A 63-year-old man presented to the emergency department with a 5-day-old open fracture dislocation of his right ankle. After thorough soft tissue debridement, primary arthrodesis of the tibiotalar joint was performed using initial Kirschner wire fixation and an external fixator. Definitive soft tissue coverage was later achieved using a latissimus dorsi free flap. The fusion was consolidated to salvage the limb from amputation. The use of primary arthrodesis to treat a compound ankle fracture dislocation has not been previously described. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

[MINIMALLY INVASIVE TREATMENT OF POSTERIOR CRUCIATE LIGAMENT AVULSION FRACTURE IN A FLOPPY LATERAL POSITION].

PubMed

Zhao, Junchao; Wang, Hao

2016-09-08

To conclude the effectiveness of arthroscopy combined with Burks and SchaVer's approach in the treatment of posterior cruciate ligament (PCL) avulsion fractures in a floppy lateral position. Between May 2010 and March 2014, 21 patients with PCL avulsion fractures were treated. There were 13 males and 8 females, aged 21 to 62 years (mean, 39.1 years). The causes included traffic accident injury in 10 cases, sports injury in 5 cases, and falling injury from height in 6 cases. The time from injury to hospital was 1-6 days (mean, 2.5 days). The results of posterior drawer test were all positive, and the results of anterior drawer test and lateral stress test were all negative. The Lysholm score was 28.0±5.5 before operation. And the American Orthopaedic Foot and Ankle Society (IKDC) score was 46.2±7.6 before operation. According to Meyer standards for fractures classification, 11 cases were rated as type II and 10 cases as type III. Arthroscopy was used to inspect and treat the intra-articular lesions, then avulsion fracture was fixed by Burks and SchaVer's approach in lateral position. Postoperative functional exercises were performed. Primary healing of incision was obtained, without nerve and vascular injury or joint infection. All patients were followed up 18-36 months (mean, 27.2 months). The X-ray films of the knee joint showed good fractures reduction and healing at 3 months after operation. The results of posterior drawer test and reverse Lachman test were negative. The knee range of motion was recovered to normal level. At last follow-up, the Lysholm score of the knee joint was significantly improved to 90.9±1.4 from preoperative one ( t =54.584, P =0.000), and the IKDC score was significantly increased to 90.5±5.3 from preoperative one ( t =15.638, P =0.000), including 19 cases of grade A and 2 cases of grade B. A combination of arthroscopy and Burks and SchaVer's approach for the treatment of PCL avulsion fractures in a floppy lateral position has the

Muscle Fiber Orientation Angle Dependence of the Tensile Fracture Behavior of Frozen Fish Muscle

NASA Astrophysics Data System (ADS)

Hagura, Yoshio; Okamoto, Kiyoshi; Suzuki, Kanichi; Kubota, Kiyoshi

We have proposed a new cutting method for frozen fish named "cryo-cutting". This method applied tensile fracture force or bending fracture force to the frozen fish at appropriate low temperatures. In this paper, to clarify cryo-cutting mechanism, we analyzed tensile fracture behavior of the frozen fish muscle. In the analysis, the frozen fish muscle was considered unidirectionally fiber-reinforced composite material which consisted of fiber (muscle fiber) and matrix (connective tissue). Fracture criteria (maximum stress criterion, Tsai-Hill criterion) for the unidirectionally fiber-reinforced composite material were used. The following results were obtained: (1) By using Tsai-Hill criterion, muscle fiber orientation angle dependence of the tensile fracture stress could be calculated. (2) By using the maximum stress theory jointly with Tsai-Hill criterion, muscle fiber orientation angle dependence of the fracture mode of the frozen fish muscle could be estimated.

Timing of Surgical Reduction and Stabilization of Talus Fracture-Dislocations.

PubMed

Buckwalter V, Joseph A; Westermann, Robert; Mooers, Brian; Karam, Matthew; Wolf, Brian

Talus fractures with associated dislocations are rare but have high rates of complications, including avascular necrosis (AVN). Management of these injuries involves urgent surgical reduction and fixation, although there are no definitive data defining an operative time frame for preserving the blood supply and preventing complications. To determine the effect of time to surgical reduction of talus fractures and talus fracture-dislocations on rates of AVN and posttraumatic osteoarthritis (PTOA), we retrospectively reviewed talus fractures surgically managed at a level I trauma center during the 10-year period 2003 to 2013. Operative reports were obtained and reviewed, and 3 independent reviewers, using the Hawkins and AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) systems, classified the injuries on plain radiographs. Analysis of AO/OTA 81 fractures with associated tibiotalar, subtalar, or talonavicular dislocations was performed. Primary outcomes were presence of AVN/PTOA and subsequent arthrodesis of tibiotalar or subtalar joints. We identified 106 surgically managed talus fractures. Rates of AVN/PTOA were 41% for all talus fractures and 50% for talus fracture-dislocations. Mean time to surgical reduction was not significant for development of AVN/PTOA for all talus fractures (P = .45) or talus fracture-dislocations (P = .29). There was no difference in age (P = .20), body mass index (P = .45), or polytrauma (P = .79) between patients who developed AVN and those who did not. Open fractures were significantly correlated with the development of AVN/PTOA (P = .009). Talar fracture-dislocations are devastating injuries with high rates of complications. Our data suggest there is no effect of time from injury to surgical reduction of talus fractures or talus fracture-dislocations on rates of AVN and PTOA.

Coupled Flow and Mechanics in Porous and Fractured Media*

NASA Astrophysics Data System (ADS)

Martinez, M. J.; Newell, P.; Bishop, J.

2012-12-01

Numerical models describing subsurface flow through deformable porous materials are important for understanding and enabling energy security and climate security. Some applications of current interest come from such diverse areas as geologic sequestration of anthropogenic CO2, hydro-fracturing for stimulation of hydrocarbon reservoirs, and modeling electrochemistry-induced swelling of fluid-filled porous electrodes. Induced stress fields in any of these applications can lead to structural failure and fracture. The ultimate goal of this research is to model evolving faults and fracture networks and flow within the networks while coupling to flow and mechanics within the intact porous structure. We report here on a new computational capability for coupling of multiphase porous flow with geomechanics including assessment of over-pressure-induced structural damage. The geomechanics is coupled to the flow via the variation in the fluid pore pressures, whereas the flow problem is coupled to mechanics by the concomitant material strains which alter the pore volume (porosity field) and hence the permeability field. For linear elastic solid mechanics a monolithic coupling strategy is utilized. For nonlinear elastic/plastic and fractured media, a segregated coupling is presented. To facilitate coupling with disparate flow and mechanics time scales, the coupling strategy allows for different time steps in the flow solve compared to the mechanics solve. If time steps are synchronized, the controller allows user-specified intra-time-step iterations. The iterative coupling is dynamically controlled based on a norm measuring the degree of variation in the deformed porosity. The model is applied for evaluation of the integrity of jointed caprock systems during CO2 sequestration operations. Creation or reactivation of joints can lead to enhanced pathways for leakage. Similarly, over-pressures can induce flow along faults. Fluid flow rates in fractures are strongly dependent on the

The fracture criticality of crustal rocks

NASA Astrophysics Data System (ADS)

Crampin, Stuart

1994-08-01

The shear-wave splitting observed along almost all shear-wave ray paths in the Earth's crust is interpreted as the effects of stress-aligned fluid-filled cracks, microcracks, and preferentially oriented pore space. Once away from the free surface, where open joints and fractures may lead to strong anisotropy of 10 per cent or greater, intact ostensibly unfractured crustal rock exhibits a limited range of shear-wave splitting from about 1.5 to 4.5 per cent differential shear-wave velocity anisotropy. Interpreting this velocity anisotropy as normalized crack densities, a factor of less than two in crack radius covers the range from the minimum 1.5 per cent anisotropy observed in intact rock to the 10 per cent observed in heavily cracked almost disaggregated near-surface rocks. This narrow range of crack dimensions and the pronounced effect on rock cohesion suggests that there is a state of fracture criticality at some level of anisotropy between 4.5 and 10 per cent marking the boundary between essentially intact, and heavily fractured rock. When the level of fracture criticality is exceeded, cracking is so severe that there is a breakdown in shear strength, the likelihood of progressive fracturing and the dispersal of pore fluids through enhanced permeability. The range of normalized crack dimensions below fracture criticality is so small in intact rock, that any modification to the crack geometry by even minor changes of conditions or minor deformation (particularly in the presence of high pore-fluid pressures) may change rock from being essentially intact (below fracture criticality) to heavily fractured (above fracture criticality). This recognition of the essential compliance of most crustal rocks, and its effect on shear-wave splitting, has implications for monitoring changes in any conditions affecting the rock mass. These include monitoring changes in reservoir evolution during hydrocarbon production and enhanced oil recovery, and in monitoring changes before

Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct.

PubMed

Chiu, Chih-Hao; Cheng, Chun-Ying; Tsai, Min-Chain; Chang, Shih-Sheng; Chen, Alvin Chao-Yu; Chen, Yeung-Jen; Chan, Yi-Sheng

2013-08-01

To present the radiologic and clinical results of posteromedial fractures treated with arthroscopy-assisted reduction and buttress plate and cannulated screw fixation. Twenty-five patients with posteromedial tibial plateau fractures treated by the described technique were included in this study. According to the Schatzker classification, there were 5 type IV fractures (20%), 2 type V fractures (8%), and 18 type VI fractures (72%). The mean age at operation was 46 years (range, 21 to 79 years). The mean follow-up period was 86 months (range, 60 to 108 months). Clinical and radiologic outcomes were scored by the Rasmussen system. Subjective data were collected to assess swelling, difficulty climbing stairs, joint stability, ability to work and participate in sports, and overall patient satisfaction with recovery. Secondary osteoarthritis was diagnosed when radiographs showed a narrowed joint space in the injured knee at follow-up in comparison with the films taken at the time of injury. The mean postoperative Rasmussen clinical score was 25.9 (range, 18 to 29), and the mean radiologic score was 15.8 (range, 10 to 18). All 25 fractures achieved successful union, and 92% had good or excellent clinical and radiologic results. The 3 fracture types did not significantly differ in Rasmussen scores or rates of satisfactory results (P > .05). Secondary osteoarthritis was noted in 6 injured knees (24%). Arthroscopy-assisted reduction with buttress plate and cannulated screw fixation can restore posteromedial tibial plateau fractures of the knee with well-documented radiographic healing, good clinical outcomes, and low complication rates. Level IV, therapeutic case series. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Characterization of Joint Sets Through UAV Photogrammetry on Sedimentary Rock Sea Cliffs and Abrasion Platforms in Northern Taiwan

NASA Astrophysics Data System (ADS)

Hsieh, P. C.; LU, A.; Yeh, C. H.; Huang, W. K.; Lin, H. H.; Lin, M. L.

2017-12-01

Rockfall hazards are very common in obsequent slope and oblique slope. In the coastal area of northern Taiwan, many sea cliffs are formed by obsequent slope and oblique slope. A famous case of rockfall failure happened on Aug. 31, 2013, a 150-ton rock block fell on the highway in Badouzi, Keelung, during a high intensity rainfall event which was caused by Typhoon No.15 (Kong-rey). To reduce this kind of rockfall hazard, it is important to characterize discontinuous planes in the bedrock because rock blocks are mainly divided from bedrock by two or more sets of discontinuous planes including joint planes and the bedding plane. For doing characterization of those fracture patterns of joint sets, it is necessary to do detailed field investigations. However, the survey of discontinuous planes, especially joint sets, are usually difficult and cannot get enough characterization data about joint sets. The first reason is that doing field investigations on the surface of sea cliffs is very dangerous and difficult for engineers or geologists to approach the upper part of outcrop. The second reason is the complexity of joint sets. In Badouzi area, each cliff is constituted by many different layers such as sandstone, shale, or alternations of sandstone and shale, and each layer has different fracture pattern of joint sets. In this study, we use UAV photogrammetry as a solution of these difficulties. UAV photogrammetry can produce a high-resolution digital surface model (DSM), orthophoto, and anaglyph of sea cliffs and abrasion platforms. Than we use self-developed geoprocessing toolsets to auto-trace joint planes with DSM data and produce fracture pattern of joint sets semi-automatically and systematically. Our method can provide basic information for rock mass rating on rock slope stability and rockfall hazards evaluation.

J-integral fracture toughness and tearing modulus measurement of radiation cross-linked UHMWPE.

PubMed

Gomoll, A; Wanich, T; Bellare, A

2002-11-01

Radiation and chemical cross-linking of medical grade ultrahigh molecular weight polyethylene (UHMWPE) has recently been utilized in an effort to improve wear performance of total joint replacement components. However, reductions in mechanical properties with cross-linking are cause for concern regarding the use of cross-linked UHMWPE for high-stress applications such as in total knee replacement prostheses. In this study, the fracture behavior of radiation cross-linked UHMWPE was compared to that of uncross-linked UHMWPE. The Rice and Sorensen model that utilizes mechanical parameters obtained from uniaxial tensile and compact tension tests was used to calculate the steady state J-integral fracture toughness, Jss, for radiation cross-linked UHMWPE. Jss decreased monotonically with increase in radiation dose. UHMWPE exhibited tough, ductile tearing behavior with stable crack growth when it was cross-linked using a gamma radiation dose of 0-50 kGy. However, in cross-linked UHMWPE irradiated to a dose of 100 and 200 kGy, unstable fracture occurred spontaneously upon attaining the initial crack driving force, J1c. This indicates that a high degree of cross-linking is less desirable for high-stress applications in orthopaedic implants. However, a substantial increase in J1c, even at a low degree of cross-linking, suggests that a low degree of cross-linking may be beneficial for resistance to delamination and catastrophic failure, both of which require an initiation step for the fracture to propagate in the material. This mechanical test should, however, be considered along with fatigue tests and joint simulator testing before determination of an appropriate amount of cross-linking for total joint replacement prostheses that experience high stresses.

The Applications of Finite Element Analysis in Proximal Humeral Fractures.

PubMed

Ye, Yongyu; You, Wei; Zhu, Weimin; Cui, Jiaming; Chen, Kang; Wang, Daping

2017-01-01

Proximal humeral fractures are common and most challenging, due to the complexity of the glenohumeral joint, especially in the geriatric population with impacted fractures, that the development of implants continues because currently the problems with their fixation are not solved. Pre-, intra-, and postoperative assessments are crucial in management of those patients. Finite element analysis, as one of the valuable tools, has been implemented as an effective and noninvasive method to analyze proximal humeral fractures, providing solid evidence for management of troublesome patients. However, no review article about the applications and effects of finite element analysis in assessing proximal humeral fractures has been reported yet. This review article summarized the applications, contribution, and clinical significance of finite element analysis in assessing proximal humeral fractures. Furthermore, the limitations of finite element analysis, the difficulties of more realistic simulation, and the validation and also the creation of validated FE models were discussed. We concluded that although some advancements in proximal humeral fractures researches have been made by using finite element analysis, utility of this powerful tool for routine clinical management and adequate simulation requires more state-of-the-art studies to provide evidence and bases.

[Intramedullary stabilisation of displaced midshaft clavicular fractures: does the fracture pattern (simple vs. complex) influence the anatomic and functional result].

PubMed

Langenhan, R; Reimers, N; Probst, A

2014-12-01

Displaced midshaft clavicular fractures are often treated operatively. The most common way of treatment is plating. Elastic stable intramedullary nailing (ESIN) is an alternative, but seldom used. Studies showed comparable or even better results for intramedullary nailing than for plating in simple 2- or 3-fragment midshaft fractures. The indication of ESIN for multifragmentary clavicular fractures is discussed critically in the literature because of reduced primary stability and danger of secondary shortening. Until now only few studies report functional results after fracture healing depending on the fracture type. To the best of our knowledge there is no study showing significantly worse functional scores for ESIN in complex displaced midshaft fractures. The objective of this study was to examine anatomic and functional results of simple (2 or 3 fragments, OTA type 15B1 and 15B2) and complex (multifragmentary, OTA type 15B3) displaced midshaft clavicula fractures after internal fixation. Between 2009 and 2012, 40 patients (female/male 10/30; mean age 33 [16-60] years) with closed displaced midshaft clavicular fractures were treated by open reduction and ESIN (Titanium Elastic Nail [TEN], Synthes, Umkirch, Germany). Thirty-seven patients were retrospectively analysed after a mean of 27 (12-43) months. Twenty patients (group A) had simple fractures (OTA type 15B1 and 15B2), 17 patients (group B) had complex fractures (OTA type 15B3). All shoulder joints were postoperatively treated functionally for six weeks without weight limited to 90° abduction/flexion. Both groups were comparable in gender, age, body mass index, months until metal removal, number of physiotherapy sessions and time until follow-up examination. Joint function (neutral zero method) and strength (standing patient with arm in 90° abduction, holding 1-12 kg for 5 sec) in both shoulders were documented. The distance between the centre of the jugulum and the lateral acromial border was measured for

Spatial and layer-controlled variability in fracture networks

NASA Astrophysics Data System (ADS)

Procter, Andrew; Sanderson, David J.

2018-03-01

Topological sampling, based on 1) node counting and 2) circular sampling areas, is used to measure fracture intensity in surface exposures of a layered limestone/shale sequence in north Somerset, UK. This method provides similar levels of precision as more traditional line samples, but is about 10 times quicker and allows characterization of the network topology. Georeferencing of photographs of the sample sites allows later analysis of trace lengths and orientations, and identification of joint set development. ANOVA tests support a complex interaction of within-layer, between-layer and between-location variability in fracture intensity, with the different layers showing anomalous intensity at different locations. This variation is not simply due to bed thickness, nor can it be related to any obvious compositional or textural variation between the limestone beds. These results are used to assess approaches to the spatial mapping of fracture intensity.

Microstructure and Mechanical Properties of Stainless Steel/Brass Joints Brazed by Sn-Electroplated Ag Brazing Filler Metals

NASA Astrophysics Data System (ADS)

Wang, Xingxing; Peng, Jin; Cui, Datian

2018-05-01

To develop a high-Sn-content AgCuZnSn brazing filler metal, the BAg50CuZn was used as the base filler metal and a Sn layer was electroplated upon it. Then, the 304 stainless steel and the H62 brass were induction-brazed with the Sn-plated brazing filler metals. The microstructures of the joints were examined with an optical microscope, a scanning electron microscope and an x-ray diffractometer. The corresponding mechanical properties were obtained with a universal tensile testing machine. The results indicated that the induction brazed joints consisted of the Ag phase, the Cu phase and the CuZn phase. When the content of Sn in the Sn-plated Ag brazing filler metal was 6.0 or 7.2 wt.%, the Cu5Zn8, the Cu41Sn11 and the Ag3Sn phases appeared in the brazed joint. The tensile strength of the joints brazed with the Sn-plated filler metal was higher compared to the joints with the base filler metal. When the content of Sn was 6.0 wt.%, the highest tensile strength of the joint reached to 395 MPa. The joint fractures presented a brittle mode, mixed with a low amount of ductile fracture, when the content of Sn exceeded 6.0 wt.%.

Treatment of segmental tibial fractures with supercutaneous plating.

PubMed

He, Xianfeng; Zhang, Jingwei; Li, Ming; Yu, Yihui; Zhu, Limei

2014-08-01

Segmental tibial fractures usually follow a high-energy trauma and are often associated with many complications. The purpose of this report is to describe the authors' results in the treatment of segmental tibial fractures with supercutaneous locking plates used as external fixators. Between January 2009 and March 2012, a total of 20 patients underwent external plating (supercutaneous plating) of the segmental tibial fractures using a less-invasive stabilization system locking plate (Synthes, Paoli, Pennsylvania). Six fractures were closed and 14 were open (6 grade IIIa, 2 grade IIIb, 4 grade II, and 2 grade I, according to the Gustilo classification). When imaging studies confirmed bone union, the plates and screws were removed in the outpatient clinic. Average time of follow-up was 23 months (range, 12-47 months). All fractures achieved union. Median time to union was 19 weeks (range, 12-40 weeks) for the proximal fractures and 22 weeks (range, 12-42 weeks) for the distal fractures. Functional results were excellent in 17 patients and good in 3. Delayed union of the fracture occurred in 2 patients. All patients' radiographs showed normal alignment. No rotational deformities and leg shortening were seen. No incidences of deep infection or implant failures occurred. Minor screw tract infection occurred in 2 patients. A new 1-stage protocol using supercutaneous plating as a definitive fixator for segmental tibial fractures is less invasive, has a lower cost, and has a shorter hospitalization time. Surgeons can achieve good reduction, soft tissue reconstruction, stable fixation, and high union rates using supercutaneous plating. The current patients obtained excellent knee and ankle joint motion and good functional outcomes and had a comfortable clinical course. Copyright 2014, SLACK Incorporated.

Microstructure and mechanical properties of China low activation martensitic steel joint by TIG multi-pass welding with a new filler wire

NASA Astrophysics Data System (ADS)

Huang, Bo; Zhang, Junyu; Wu, Qingsheng

2017-07-01

Tungsten Inner Gas (TIG) welding is employed for joining of China low activation martensitic (CLAM) steel. A new filler wire was proposed, and the investigation on welding with various heat input and welding passes were conducted to lower the tendency towards the residual of δ ferrite in the joint. With the optimized welding parameters, a butt joint by multi-pass welding with the new filler wire was prepared to investigate the microstructure and mechanical properties. The microstructure of the joint was observed by optical microscope (OM) and scanning electron microscope (SEM). The hardness, Charpy impact and tensile tests of the joint were implemented at room temperature (25 °C). The results revealed that almost full martensite free from ferrite in the joints were obtained by multipass welding with the heat input of 2.26 kJ/mm. A certain degree of softening occurred at the heat affected zone of the joint according to the results of tensile and hardness tests. The as welded joints showed brittle fracture in the impact tests. However, the joints showed toughness fracture after tempering and relatively better comprehensive performance were achieved when the joints were tempered at 740 °C for 2 h.

[EFFECTIVENESS OF SHARP TEETH HOOK PLATE FOR TREATMENT OF OLECRANON FRACTURES].

PubMed

Yin, Qudong; Gu, Sanjun; Liu, Jun; Wu, Yongwei; Lu, Yao; Ma, Yunhong; Sheng, Youyin

2016-09-08

To investigate the effectiveness of sharp teeth hook plate by cutting for the treatment of olecranon fractures by comparison with Kirschner wire tension belt and locking plate. Between January 2011 and April 2015, 32 cases of olecranon fractures were treated. Fracture was fixed with sharp teeth hook plate by cutting in 12 cases (trial group) and with Kirschner wire tension belt or locking plate in 20 cases (control group). There was no significant difference in gender, age, side and type of fracture, and time from injury to operation between 2 groups ( P >0.05). The healing time of fractures and complications were recorded. At 1 year after operation, the subjective function results were evaluated according to Disability of Arm, Shoulder, and Hand (DASH) score, and objective function results by Mayo Elbow Score (MEPS); visual analogue scale (VAS) was used for elbow joint pain, and range of motion of flexion and extension of elbow joint was measured. All incisions healed by first intention, with no vascular and nerve injuries. All patients were followed up 12-36 months with an average of 18 months. All fractures healed, and there was no significant difference in the healing time between 2 groups ( P >0.05). Loosening of Kirschner wire occurred in 2 cases of control group, but no loosening of internal fixation was observed in trial group after operation. There was no significant difference in the incidence of complications between 2 groups ( P >0.05). The DASH, MEPS, VAS score, and range of motion of flexion in trial group were superior to those in control group, showing significant differences ( P <0.05) at 1 year after operation. There was no significant difference in range of motion of extension between 2 groups ( P >0.05). Sharp teeth hook plate for treatment of olecranon fractures overcomes the shortcomings that Kirschner wire tension is easy to slide and locking plate has a compression effect on triceps tendon, so it has good effectiveness.

Fracture dislocation of the mandibular condyle; a report of a case

PubMed Central

Mierau, Dale; Cassidy, J. David; Nykoliation, Jim

1985-01-01

A case report is presented in which discussion centers about a 26 year old male who complained of left sided neck and facial pain, mid-dorsal pain and right jaw pain associated with headaches. Investigation revealed a fracture dislocation of his right temporomandibular joint. The need for the chiropractor to x-ray patients with similar complaints is highlighted and the natural history of temporomandibular joint pain dysfunction syndrome (TMJ-PDS) is reviewed with attention to assessment. ImagesFigure 1Figure 2

Surgical treatment of open pilon fractures.

PubMed

Zeng, Xian-tie; Pang, Gui-gen; Ma, Bao-tong; Mei, Xiao-long; Sun, Xiang; Wang, Jia; Jia, Peng

2011-02-01

To discuss the methods, timing and clinical outcomes of surgical treatment for open pilon fractures. From April 2003 to July 2008, 28 patients with open pilon fractures were treated. All had type C fractures according to the Arbeitsgemeinschaft für osteosynthesefragen-Association for the Study of Internal Fixation (AO/ASIF) classification. Three operative methods were applied, the methods being determined by the types of fracture, soft tissue damage and time interval after injury. Seven cases were treated by debridement and internal fixation with plate; 19 by limited internal fixation combined with external fixation; and 2 by delayed surgery. The clinical outcomes were evaluated by the Burwell-Charnley score. All cases were followed up for from 6 to 48 months (average 24 months). The Burwell-Charnley score of clinical outcomes: anatomic reduction achieved in 12 cases, functional reduction in 15, and unsatisfactory reduction in 1. The healing time was from 2.5 to 11 months (average 4.7 months). Two cases had delayed union. According to the American Orthopaedic Foot and Ankle Society (AOFAS) scale for the ankle joint, there were excellent results in 8 cases, good in 14, fair in 5 and poor in 1. Complications included four cases of skin superficial sloughing, two of superficial infection, one of deep infection, two of delayed fracture union and ten of post-traumatic arthritis. It is important to perform appropriate surgeries for open pilon fracture according to fracture classification, different damage to skin and tissue and time interval after injury. Thorough debridement, proper use of anti-infective medication, appropriate bone grafting, and postoperative ankle function exercise can reduce the occurrence of complications. © 2011 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

[Osteosynthesis of Weber B ankle fractures using the one-third tubular plate and refixation of the syndesmosis].

PubMed

Spering, C; Lesche, V; Dresing, K

2015-08-01

Anatomical reconstruction and recovery to complete range of function of the upper ankle joint. Therefore, the most stable but least invasive osteosynthesis is required to enable the patient early functional mobilization. Supination and pronation fracture with luxation mechanism of the upper ankle joint with or without rupture of the syndesmosis. Open fracture of the distal fibula including displaced and instable fractures. Severe peripheral arterial occlusive disease; contaminated open fractures (≥ 2nd degree); pediatric fractures with open epiphyseal plate. Supine position with ipsilateral slightly elevated hip and knee. Incision of about 8 cm length along the dorsal edge of the distal fibula. When reaching the lateral malleolus, a slight ventral angulation is necessary. Open reduction through this posterolateral approach. Secure the reposition using an interfragmentary lag screw and anatomically adjusted third tubular plate. Followed by a revision of the syndesmosis and transfixation using a tricortical position screw. Mobilization on day 1 after surgery with reduced weight-bearing when position screw is not applied; when position screw is implanted with ground contact for 6 weeks. Removal of position screw under local anesthesia after 6 weeks and pain-controlled full weight-bearing. Removal of metal after 1.5 years. Open reduction using the third tubular plate and an interfragmentary lag screw through a dorsolateral approach used in 90 % of all Weber B fractures in our clinic. Additional revision of a ruptured syndesmosis performed in 70 % and transfixation through a position screw in 40 %. Persisting instability in the upper ankle joint significantly reduced after surgical treatment compared to a conservative approach. Revisions necessary in 3.7 % of patients and pseudarthrosis diagnosed in 0.9 %. It has been shown that the preoperative x-ray and clinical examination is limited in detecting a ruptured syndesmosis.

[The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

PubMed

Bi, Hong-zheng; Yang, Mao-qing; Tan, Yuan-chao; Fu, Song

2008-07-01

To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture. All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups. After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (P<0.05). Rotatory manual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

PATIENT-SPECIFIC FINITE ELEMENT ANALYSIS OF CHRONIC CONTACT STRESS EXPOSURE AFTER INTRA-ARTICULAR FRACTURE OF THE TIBIAL PLAFOND

PubMed Central

Li, Wendy; Anderson, Donald D.; Goldsworthy, Jane K.; Marsh, J. Lawrence; Brown, Thomas D.

2008-01-01

SUMMARY The role of altered contact mechanics in the pathogenesis of post-traumatic osteoarthritis (PTOA) following intra-articular fracture remains poorly understood. One proposed etiology is that residual incongruities lead to altered joint contact stresses that, over time, predispose to PTOA. Prevailing joint contact stresses following surgical fracture reduction were quantified in this study using patient-specific contact finite element (FE) analysis. FE models were created for 11 ankle pairs from tibial plafond fracture patients. Both (reduced) fractured ankles and their intact contralaterals were modeled. A sequence of 13 loading instances was used to simulate the stance phase of gait. Contact stresses were summed across loadings in the simulation, weighted by resident time in the gait cycle. This chronic exposure measure, a metric of degeneration propensity, was then compared between intact and fractured ankle pairs. Intact ankles had lower peak contact stress exposures that were more uniform, and centrally located. The series-average peak contact stress elevation for fractured ankles was 38% (p=0.0015; peak elevation was 82%). Fractured ankles had less area with low contact stress exposure than intacts, and a greater area with high exposure. Chronic contact stress overexposures (stresses exceeding a damage threshold) ranged from near zero to a high of 18 times the matched intact value. The patient-specific FE models utilized in this study represent substantial progress towards elucidating the relationship between altered contact stresses and the outcome of patients treated for intra-articular fractures. PMID:18404662

Relative Dating Via Fractures

NASA Technical Reports Server (NTRS)

2005-01-01

[figure removed for brevity, see original site]

This VIS image of the eastern part of the Tharsis region illustrates how fractures can be used in relative dating of a surface. The fractured materials on the right side of the image are embayed by younger volcanic flows originating to the west of the image. Note how the younger flows cover the ends of the fractures, and are not at all fractured themselves.

Image information: VIS instrument. Latitude 43.2, Longitude 269.4 East (90.6 West). 19 meter/pixel resolution.

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

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

Microstructural Evolution and Fracture Behavior of Friction-Stir-Welded Al-Cu Laminated Composites

NASA Astrophysics Data System (ADS)

Beygi, R.; Kazeminezhad, Mohsen; Kokabi, A. H.

2014-01-01

In this study, we attempt to characterize the microstructural evolution during friction stir butt welding of Al-Cu-laminated composites and its effect on the fracture behavior of the joint. Emphasis is on the material flow and particle distribution in the stir zone. For this purpose, optical microscopy and scanning electron microscopy (SEM) images, energy-dispersive spectroscopy EDS and XRD analyses, hardness measurements, and tensile tests are carried out on the joints. It is shown that intermetallic compounds exist in lamellas of banding structure formed in the advancing side of the welds. In samples welded from the Cu side, the banding structure in the advancing side and the hook formation in the retreating side determine the fracture behavior of the joint. In samples welded from the Al side, a defect is formed in the advancing side of the weld, which is attributed to insufficient material flow. It is concluded that the contact surface of the laminate (Al or Cu) with the shoulder of the FSW tool influences the material flow and microstructure of welds.

Improvement in Fatigue Performance of Aluminium Alloy Welded Joints by Laser Shock Peening in a Dynamic Strain Aging Temperature Regime.

PubMed

Su, Chun; Zhou, Jianzhong; Meng, Xiankai; Huang, Shu

2016-09-26

As a new treatment process after welding, the process parameters of laser shock peening (LSP) in dynamic strain aging (DSA) temperature regimes can be precisely controlled, and the process is a non-contact one. The effects of LSP at elevated temperatures on the distribution of the surface residual stress of AA6061-T6 welded joints were investigated by using X-ray diffraction technology with the sin² ϕ method and Abaqus software. The fatigue life of the welded joints was estimated by performing tensile fatigue tests. The microstructural evolution in surface and fatigue fractures of the welded joints was presented by means of surface integrity and fracture surface testing. In the DSA temperature regime of AA6061-T6 welded joints, the residual compressive stress was distributed more stably than that of LSP at room temperature. The thermal corrosion resistance and fatigue properties of the welded joints were also improved. The experimental results and numerical analysis were in mutual agreement.

Improvement in Fatigue Performance of Aluminium Alloy Welded Joints by Laser Shock Peening in a Dynamic Strain Aging Temperature Regime

PubMed Central

Su, Chun; Zhou, Jianzhong; Meng, Xiankai; Huang, Shu

2016-01-01

As a new treatment process after welding, the process parameters of laser shock peening (LSP) in dynamic strain aging (DSA) temperature regimes can be precisely controlled, and the process is a non-contact one. The effects of LSP at elevated temperatures on the distribution of the surface residual stress of AA6061-T6 welded joints were investigated by using X-ray diffraction technology with the sin2ϕ method and Abaqus software. The fatigue life of the welded joints was estimated by performing tensile fatigue tests. The microstructural evolution in surface and fatigue fractures of the welded joints was presented by means of surface integrity and fracture surface testing. In the DSA temperature regime of AA6061-T6 welded joints, the residual compressive stress was distributed more stably than that of LSP at room temperature. The thermal corrosion resistance and fatigue properties of the welded joints were also improved. The experimental results and numerical analysis were in mutual agreement. PMID:28773920

[Forensic Analysis of the Characteristics of Pelvic Fracture in 65 Road Traffic Accident Death Cases].

PubMed

Zhang, W

2016-12-01

To analyze the characteristics and mechanisms of pelvic fractures in the cases of road traffic accident deaths. Total 65 cases of road traffic accident deaths with pelvic fracture were collected, and the sites, characteristics and injury mechanisms of pelvic fracture were statistically analyzed. Among the 65 cases of pelvic fracture, 38 cases of dislocation of sacroiliac joint were found, and most combined with pubis symphysis separation or fracture of pubis. In the fractures of pubis, ischium and acetabulum, linear fractures were most common, while comminuted fractures were most common in sacrum and coccyx fractures. There were 54 cases combined with pelvic soft tissue injury, and 8 cases with pelvic organ injury and 44 cases with abdominal organ injury. In the types of pelvic ring injury, 32 cases were separation, 49.32%, followed by compression, 26.15% and only one case was verticality, 1.54%. Detailed and comprehensive examination of the body and determination of the pelvic fracture type contribute to analyze the mechanisms of injury. Copyright© by the Editorial Department of Journal of Forensic Medicine

Temporary Percutaneous Instrumentation and Selective Anterior Fusion for Thoracolumbar Fractures.

PubMed

Charles, Yann Philippe; Walter, Axel; Schuller, Sébastien; Steib, Jean-Paul

2017-05-01

Prospective clinical trial in thoracolumbar trauma with 5-year follow-up. To analyze clinical and radiographic outcomes of minimal invasive surgery, and the rational of circumferential fracture treatment with regard to age, degenerative changes, bone mineral density, and global sagittal balance. Non-neurologic fractures with anterior column defect can be treated by posterior percutaneous instrumentation and selective anterior fusion. After consolidation, instrumentation can be removed at 1 year to provide mobility in non-fused segments. Fifty-one patients, 47 (18-75) years, were operated for A2, A3, or B-type fractures. Visual analog scale (VAS) for back pain and Oswestry Disability Index (ODI) were assessed. Radiographic measurements were: sagittal index, regional kyphosis, T4-T12 kyphosis, L1-S1 lordosis, pelvic incidence, pelvic tilt, sacral slope, and T9 tilt. Anterior fusion and facet joints were analyzed on computed tomography (CT) at 1 year. The ODI was 8.8 before accident, 35.4 at 3 months, 17.8 at 2 years, 14.4 at 5 years. The VAS was 2.0 at 3 months and 1.0 at 5 years. The sagittal index was 18.0° preoperatively and 1.0° at 3 months (P < 0.0001). A loss of reduction of 1.1° occurred after implant removal (P = 0.009). Global sagittal balance remained unchanged. Ten patients with osteopenia or osteoporosis had a worse ODI: 24.7 versus 11.9 (P = 0.016), and a greater loss of correction: 4.9° versus 1.3° (P = 0.007). Cages filled with cancellous bone from the fractured vertebra fused regularly. Spontaneous facet joint fusions were observed in two patients at the fracture level in B-type injuries. Percutaneous instrumentation and selective anterior fusion using autologous bone and mesh cages lead to high fusion rates, which provided good long-term clinical results in younger patients with thoracolumbar fractures. Sagittal alignment was maintained after instrumentation removal without damaging paravertebral muscles. Outcomes were worse in

Improving joint pain and function in osteoarthritis.

PubMed

Owens, Claire; Conaghan, Philip G

2016-12-01

Osteoarthritis has become a major chronic pain condition. It affects more than 10% of adults and accounts for almost 10% of health service resources. The impact of osteoarthritis is amplified by underuse of effective muscle strengthening exercises and a focus on often less effective and poorly tolerated analgesic therapies. Although traditionally considered to be primarily a disease of cartilage, there is now ample evidence that typical clinical osteoarthritis involves multiple tissue pathologies. Increased BMI is associated with a higher incidence of knee osteoarthritis. Anatomical abnormalities such as valgus alignment or previous joint trauma including meniscectomy, anterior cruciate ligament rupture and fracture through the joint are also associated with increased incidence of osteoarthritis. Pain is the main presenting symptom. However, we still have a poor understanding of the causes of pain in osteoarthritis. In patients aged 45 or over the diagnosis should be made clinically without investigations if the patient has activity-related joint pain in addition to early morning joint stiffness lasting less than 30 minutes. Muscle strengthening and aerobic exercise have been shown to improve joint pain and function. Weight loss not only improves joint pain and function but has a myriad of other health benefits, reducing the incidence of lifestyle associated diseases such as cardiovascular disease and type 2 diabetes, and mechanical stress on the joints.

Development and application of rail defect fracture models to assess remedial actions

DOT National Transportation Integrated Search

1993-08-01

The fracture mechanics models were refined for two types of rail defects - the bolt hole crack and the vertical split head. Beam-type finite element analysis was conducted to determine the effects of joint bar looseness, rail height mismatch and trai...

Fracture analysis of an Eocene reservoir in Eastern Tunisia by coupling Terrestrial Laser Scanning with GigaPan Technology and seismic attribute

NASA Astrophysics Data System (ADS)

Mastouri, Raja; Guerin, Antoine; Marchant, Robin; Derron, Marc-Henri; Boulares, Achref; Lazzez, Marzouk; Marillier, François; Jaboyedoff, Michel; Bouaziz, Samir

2015-04-01

It is usually not possible to study in situ fractures and faults of oil reservoirs. Then outcropping reservoir analogues are used instead. For this purpose, Terrestrial Laser Scanning (TLS) has been increasingly used for some years in the petroleum sector. The formations El Garia and Reineche make the Eocene oil reservoir of Eastern Tunisia. The fracturing of these formations has been analyzed on the surface by TLS on a reservoir analogue outcrop and in the depth by 3D seismic data. TLS datasets provide clear information on fracture geometry distribution (spacing and persistence), connectivity and joint orientation. These results were then compared to structures observed in depth with seismic data. The reservoir analogues are the Ousselat cliff (formation El Garia) and the Damous quarry (formation Reineche). Those two sites are made of marine limestone rich in large foraminifers, gastropods and nummulites. Fieldwork, TLS acquisitions and high-resolution GigaPan panoramas were put together to create digital outcrop models. A total of 9 scans at 3 different survey positions were carried out. Firstly, the data processing (cleaning, alignment and georeferencing of the raw point clouds) was carried out using the Polyworks software. Secondly, we draped Gigapixel pictures on the triangular mesh generated with 3DReshaper to produce relief shading. This process produces a photorealistic model that gives a 3D representation of the outcrop. Finally, Coltop3D was used to identify the different sets of discontinuities and to measure their orientations. Furthermore, we used some 3D seismic attribute data to interpret approximately 60 fractures and faults at the top of the Eocene reservoir. The Coltop3D analysis of the Ousselat cliff shows 5 sets of joints and fractures, with different dips and dip directions. They all strike in directions NW-SE, NNE-SSW, NE-SW and ENE-WSW. Using the photorealistic model, we measured approximately 120 fracture spacings ranging from 1.75m to 10m

Intramedullary Percutaneous Fixation of Extra-Articular Proximal and Middle Phalanx Fractures.

PubMed

Jovanovic, Nebojsa; Aldlyami, Ehab; Saraj, Basem; Fm Seidam, Mohamed; Badawi, Hamed; Shaat, Ahmed; Alawadi, Khalid; Dodakundi, Chaitanya

2018-06-01

Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications.

The effect of methotrexate on the bone healing of mandibular condylar process fracture: an experimental study in rats.

PubMed

Cavalcanti, Samantha Cristine Santos X B; Corrêa, Luciana; Mello, Suzana Beatriz Veríssimo; Luz, João Gualberto C

2014-10-01

Methotrexate (MTX) is an anti-metabolite used in rheumatology and oncology. High doses are indicated for oncological treatment, whereas low doses are indicated for chronic inflammatory diseases. This study evaluated the effect of two MTX treatment schedules on the bone healing of the temporomandibular joint fracture in rats. Seventy-five adult male Wistar rats were used to generate an experimental unilateral medially rotated condylar fracture model that allows an evaluation of bone healing and the articular structures. The animals were subdivided into three groups that each received one of the following treatments intraperitoneally: saline (1 mL/week), low-dose MTX (3 mg/kg/week) and high-dose MTX (30 mg/kg). The histological study comprised fracture site and temporomandibular joint evaluations and bone neoformation was evaluated by histomorphometric analysis. A biochemical parameter of bone formation was also assessed. When compared with saline, high-dose MTX delayed bone fracture repairs. In this latter group, after 90 days, the histological analysis revealed atrophy of the fibrocartilage and the presence of fibrous tissue in the joint space. The histomorphometric analysis revealed diminished bone neoformation. The alkaline phosphatase levels also decreased after MTX treatment. It was concluded that high-dose MTX impaired mandibular condyle repair and induced degenerative articular changes. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

Patient-accident-fracture (PAF) classification of acute distal radius fractures in adults.

PubMed

Herzberg, G; Galissard, T; Burnier, M

2018-05-19

There is not enough evidence in the literature to support the use of any classification system for distal radius fractures (DRF) in adults. However, there is a need for identification of more homogeneous groups of patients with DRF so that the extent of preoperative workup and sophistication of treatment would best match the needs of the patient. The authors propose an innovative method to analyse and stratify acute DRF in adults. A one-page chart includes criteria related to the patient (P), the energy of the accident (A) and the pathology of the fracture (F). Analysis of the pathology includes not only the distal radius itself but also the associated ulnar and carpal lesions. Radiological suspicion of associated carpal of distal radio-ulnar joint ligamentous injuries is included in the analysis. The preliminary results of the use of this chart in 1610 consecutive adult patients (16-102 years) with unilateral acute DRF are presented. A total of six homogeneous groups of patients are described, and the relevance of this classification regarding the therapeutic options is discussed.

Fractures and the increased risk of suicide.

PubMed

Chang, C-F; Lai, E C-C; Yeh, M-K

2018-06-01

Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients' demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of suicide. In addition, we found that patients who had a lower income, had never married, had lower levels of educational attainment, or had coexistent physical and mental conditions such as anxiety, mood disorders, and psychosis-related disorders had a higher risk of suicide. Conclusion Fractures, specifically those of the hip and spine, were associated with an increased risk of suicide. The findings suggest that greater clinical attention should be given to this risk in patients with fractures, especially for those with additional risk factors. Cite this article: Bone Joint J 2018;100-B:780-6.

Intramedullary reduction and stabilisation of adult radial neck fractures.

PubMed

Keller, H W; Rehm, K E; Helling, J

1994-05-01

We report the treatment of six adult patients with displaced fractures of the radial neck by intramedullary reduction and stabilisation. Nine months after operation all the patients had good joint function, little or no pain, complete healing and no significant periarticular calcification. This simple semi-closed procedure may help to avoid resection of the radial head in some cases.

Expedited CT-Based Methods for Evaluating Fracture Severity to Assess Risk of Post-Traumatic Osteoarthritis After Articular Fractures.

PubMed

Anderson, Donald D; Kilburg, Anthony T; Thomas, Thaddeus P; Marsh, J Lawrence

2016-01-01

included in the CT scan. The described methods provide surgeons an objective, quantitative representation of the severity of a fracture. Obtained prior to the surgery, it provides a reasonable alternative to current subjective classification systems. The expedited severity metric offers surgeons an objective means for factoring severity of joint insult into treatment decision-making.

Advantages of the Ilizarov external fixation in the management of intra-articular fractures of the distal tibia

PubMed Central

Vasiliadis, Elias S; Grivas, Theodoros B; Psarakis, Spyridon A; Papavasileiou, Evangelos; Kaspiris, Angelos; Triantafyllopoulos, Georgios

2009-01-01

Background Treatment of distal tibial intra-articular fractures is challenging due to the difficulties in achieving anatomical reduction of the articular surface and the instability which may occur due to ligamentous and soft tissue injury. The purpose of this study is to present an algorithm in the application of external fixation in the management of intra-articular fractures of the distal tibia either from axial compression or from torsional forces. Materials and methods Thirty two patients with intra-articular fractures of the distal tibia have been studied. Based on the mechanism of injury they were divided into two groups. Group I includes 17 fractures due to axial compression and group II 15 fractures due to torsional force. An Ilizarov external fixation was used in 15 patients (11 of group I and 4 of group II). In 17 cases (6 of group I and 11 of group II) a unilateral hinged external fixator was used. In 7 out of 17 fractures of group I an additional fixation of the fibula was performed. Results All fractures were healed. The mean time of removal of the external fixator was 11 weeks for group I and 10 weeks for group II. In group I, 5 patients had radiological osteoarthritic lesions (grade III and IV) but only 2 were symptomatic. Delayed union occurred in 3 patients of group I with fixed fibula. Other complications included one patient of group II with subluxation of the ankle joint after removal of the hinged external fixator, in 2 patients reduction found to be insufficient during the postoperative follow up and were revised and 6 patients had a residual pain. The range of ankle joint motion was larger in group II. Conclusion Intra-articular fractures of the distal tibia due to axial compression are usually complicated with cartilaginous problems and are requiring anatomical reduction of the articular surface. Fractures due to torsional forces are complicated with ankle instability and reduction should be augmented with ligament repair, in order to

Computed tomography of calcaneal fractures: anatomy, pathology, dosimetry, and clinical relevance

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

Guyer, B.H.; Levinsohn, E.M.; Fredrickson, B.E.

1985-11-01

Eighteen CT examinations were performed in 10 patients for the evaluation of acute intraarticular fractures and their follow-up. Fractures comparable to those in the patients were created in cadavers. The normal anatomy and the traumatically altered anatomy of the calcaneus in the axial, coronal, and sagittal planes are demonstrated by CT and corresponding anatomic sections. Scanning was performed in the axial plane, with subsequent reconstruction in the coronal and sagittal planes. The axial scans show disruption of the inferior part of the posterior facet, calcaneocuboid joint involvement, and widening of the calcaneus. The coronal scans show disruption of the superiormore » part of the posterior facet, sustentaculum tali depression (involvement of middle and anterior facets), peroneal and flexor hallucis longus tendon impingement, and widening and height loss of the calcaneus. The sagittal scans show disruption of the posterior facet, calcaneocuboid joint involvement, and height loss of the calcaneus and allow the evaluation of Boehler's and Gissane's angles. All three planes show the position of major fracture fragments. Radiation dose to the foot was measured to be 0.1 rad (0.001 Gy) for plain film radiography (five exposures), 18 rad (0.18 Gy) for conventional tomography (20 cuts), and 2.6 rad (0.026 Gy) for axial CT examination.« less

Characterization of Nitinol Laser-Weld Joints by Nondestructive Testing

NASA Astrophysics Data System (ADS)

Wohlschlögel, Markus; Gläßel, Gunter; Sanchez, Daniela; Schüßler, Andreas; Dillenz, Alexander; Saal, David; Mayr, Peter

2015-12-01

Joining technology is an integral part of today's Nitinol medical device manufacturing. Besides crimping and riveting, laser welding is often applied to join components made from Nitinol to Nitinol, as well as Nitinol components to dissimilar materials. Other Nitinol joining techniques include adhesive bonding, soldering, and brazing. Typically, the performance of joints is assessed by destructive mechanical testing, on a process validation base. In this study, a nondestructive testing method—photothermal radiometry—is applied to characterize small Nitinol laser-weld joints used to connect two wire ends via a sleeve. Two different wire diameters are investigated. Effective joint connection cross sections are visualized using metallography techniques. Results of the nondestructive testing are correlated to data from destructive torsion testing, where the maximum torque at fracture is evaluated for the same joints and criteria for the differentiation of good and poor laser-welding quality by nondestructive testing are established.

Modeling the effect of preexisting joints on normal fault geometries using a brittle and cohesive material

NASA Astrophysics Data System (ADS)

Kettermann, M.; van Gent, H. W.; Urai, J. L.

2012-04-01

Brittle rocks, such as for example those hosting many carbonate or sandstone reservoirs, are often affected by different kinds of fractures that influence each other. Understanding the effects of these interactions on fault geometries and the formation of cavities and potential fluid pathways might be useful for reservoir quality prediction and production. Analogue modeling has proven to be a useful tool to study faulting processes, although usually the used materials do not provide cohesion and tensile strength, which are essential to create open fractures. Therefore, very fine-grained, cohesive, hemihydrate powder was used for our experiments. The mechanical properties of the material are scaling well for natural prototypes. Due to the fine grain size structures are preserved in in great detail. The used deformation box allows the formation of a half-graben and has initial dimensions of 30 cm width, 28 cm length and 20 cm height. The maximum dip-slip along the 60° dipping predefined basement fault is 4.5 cm and was fully used in all experiments. To setup open joints prior to faulting, sheets of paper placed vertically within the box to a depth of about 5 cm from top. The powder was then sieved into the box, embedding the paper almost entirely. Finally strings were used to remove the paper carefully, leaving open voids. Using this method allows the creation of cohesionless open joints while ensuring a minimum impact on the sensitive surrounding material. The presented series of experiments aims to investigate the effect of different angles between the strike of a rigid basement fault and a distinct joint set. All experiments were performed with a joint spacing of 2.5 cm and the fault-joint angles incrementally covered 0°, 4°, 8°, 12°, 16°, 20° and 25°. During the deformation time lapse photography from the top and side captured every structural change and provided data for post-processing analysis using particle imaging velocimetry (PIV). Additionally

Dikes, joints, and faults in the upper mantle

NASA Astrophysics Data System (ADS)

Wilshire, H. G.; Kirby, S. H.

1989-04-01

Three different types of macroscopic fractures are recognized in upper-mantle and lower-crustal xenoliths in volcanic rocks from around the world: (1) joints that are tensile fractures not occupied by crystallized magma products (2) dikes that are tensile fractures occupied by mafic magmas crystallized to pyroxenites, gabbros or hydrous-mineral-rich rocks, (3) faults that are unfilled shear fractures with surface markings indicative of shear displacement. In addition to intra-xenolith fractures, xenoliths commonly have polygonal or faceted shapes that represent fractures exploited during incorporation of the xenoliths into the host magma that brought them to the surface. The various types of fractures are considered to have formed in response to the pressures associated with magmatic fluids and to the ambient tectonic stress field. The presence of fracture sets and crosscutting relations indicate that both magma-filled and unfilled fractures can be contemporaneous and that the local stress field can change with time, leading to repeated episodes of fracture. These observations give insight into the nature of deep fracture processes and the importance of fluid-peridotite interactions in the mantle. We suggest that unfilled fractures were opened by volatile fluids exsolved from ascending magmas to the tops of growing dikes. These volatile fluids are important because they are of low viscosity and can rapidly transmit fluid pressure to dike and fault tips and because they lower the energy and tectonic stresses required to extend macroscopic cracks and to allow sliding on pre-existing fractures. Mantle seismicity at depths of 20-65 km beneath active volcanic centers in Hawaii corresponds to the depth interval where CO 2-rich fluids are expected to be liberated from ascending basaltic magmas, suggesting that such fluids play an important role in facilitating earthquake instabilities in the presence of tectonic stresses. Other phenomena related to the fractures include

The effects of welded joint characteristics on its properties in HDPE thermal fusion welding

NASA Astrophysics Data System (ADS)

Dai, Hongbin; Peng, Jun

2017-05-01

In this paper, PE100 pipes with the diameter of 200 mm and the thickness of 11.9 mm were used as material. The welded joints were obtained in different welding pressures with the optimal welding temperature of 220∘C. Reheating process on the welded joints with the temperature of 130∘C was carried out. The joints exhibited X-type, and the cause of X-type joints was discussed. The temperature field in the forming process of welded joints was measured, and tensile and bending tests on welded joints were carried out. The fracture surface of welded joints was observed by scanning electron microscopy (SEM), and crystallinity calculation was taken by X-ray diffraction (XRD). The mechanism of X-type weld profile effects on welded joints properties was analyzed. It was concluded that the mechanical properties of welded joints decrease with the reduced X distance between lines.

Mapping Inherited Fractures in the Critical Zone Using Seismic Anisotropy From Circular Surveys

NASA Astrophysics Data System (ADS)

Novitsky, Christopher G.; Holbrook, W. Steven; Carr, Bradley J.; Pasquet, Sylvain; Okaya, David; Flinchum, Brady A.

2018-04-01

Weathering and hydrological processes in Earth's shallow subsurface are influenced by inherited bedrock structures, such as bedding planes, faults, joints, and fractures. However, these structures are difficult to observe in soil-mantled landscapes. Steeply dipping structures with a dominant orientation are detectable by seismic anisotropy, with fast wave speeds along the strike of structures. We measured shallow ( 2-4 m) seismic anisotropy using "circle shots," geophones deployed in a circle around a central shot point, in a weathered granite terrain in the Laramie Range of Wyoming. The inferred remnant fracture orientations agree with brittle fracture orientations measured at tens of meters depth in boreholes, demonstrating that bedrock fractures persist through the weathering process into the shallow critical zone. Seismic anisotropy positively correlates with saprolite thickness, suggesting that inherited bedrock fractures may control saprolite thickness by providing preferential pathways for corrosive meteoric waters to access the deep critical zone.

[Treatment of fractures of proximal phalanx of fingers by Eiffel Tower percutaneous pinning method. A review of 45 cases].

PubMed

Chbani, B; Amar, M F; Loudyi, D; Boutayeb, F

2010-04-01

The authors report in the treatment of fractures of the proximal phalanx of the fingers, the use of Eiffel Tower pinning, a relatively simple method, fast and stable, associated to a protection and early rehabilitation. The objective of this method is to offer to the patient a pollici-digital grip. Our study is a retrospective study of 45 patients treated for fractures of the proximal phalanx of the fingers by percutaneous pinning according to Eiffel Tower method. We detail this simple and economic technique and examine the functional and radiological results of this series of patients. The amplitude of the active total motion of the proximal interphalangeal joint is on average 94.16 degrees (78.5 % of the normal active mobility of the proximal interphalangeal joint), and the amplitude of the active total motion of the metacarpo-phalangeal joint is on average 90.05 degrees (75 % of the normal active mobility of the metacarpo-phalangeal joint). Copyright 2010 Elsevier Masson SAS. All rights reserved.

Short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx: Description of the injury and a technique for repair.

PubMed

Wright, I M; Minshall, G J

2018-01-01

Chip fractures of the dorsoproximal articular margin of the proximal phalanx are common injuries in racehorses. Large fractures can extend distal to the joint capsule insertion and have been described as dorsal frontal fractures. To report the location and morphology of short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx and describe a technique for repair under arthroscopic and radiographic guidance. Single centre retrospective case study. Case records of horses with frontal plane fractures restricted to the dorsoproximal epiphysis and metaphysis of the proximal phalanx referred to Newmarket Equine Hospital were retrieved, images reviewed and lesion morphology described. A technique for repair and the results obtained are reported. A total of 22 fractures in 21 horses commencing at the proximal articular surface exited the dorsal cortex of the proximal phalanx distal to the metacarpophalangeal/metatarsophalangeal joint capsule in 17 hind- and five forelimbs. All were in Thoroughbred racehorses. In 16 cases these were acute racing or training injuries; 20 fractures were medial, one lateral and one was midline. All were repaired with a single lag screw using arthroscopic and radiographically determined landmarks. A total of 16 horses raced after surgery with performance data similar to their preinjury levels. The study demonstrates substantial morphological similarities between individual lesions supporting a common pathophysiology, but does not identify precise causation. There are no cases managed differently that might permit assessment of the comparative efficacy of the treatment described. Short frontal plane fractures involving the dorsoproximal margin of the proximal phalanx that exit the bone distal to the metacarpophalangeal/metatarsophalangeal joint capsule have substantial morphological similarities, are amenable to minimally invasive repair and carry a good prognosis for return to training and racing. �

Joint Inversion of Source Location and Source Mechanism of Induced Microseismics

NASA Astrophysics Data System (ADS)

Liang, C.

2014-12-01

Seismic source mechanism is a useful property to indicate the source physics and stress and strain distribution in regional, local and micro scales. In this study we jointly invert source mechanisms and locations for microseismics induced in fluid fracturing treatment in the oil and gas industry. For the events that are big enough to see waveforms, there are quite a few techniques can be applied to invert the source mechanism including waveform inversion, first polarity inversion and many other methods and variants based on these methods. However, for events that are too small to identify in seismic traces such as the microseismics induced by the fluid fracturing in the Oil and Gas industry, a source scanning algorithms (SSA for short) with waveform stacking are usually applied. At the same time, a joint inversion of location and source mechanism are possible but at a cost of high computation budget. The algorithm is thereby called Source Location and Mechanism Scanning Algorithm, SLMSA for short. In this case, for given velocity structure, all possible combinations of source locations (X,Y and Z) and source mechanism (Strike, Dip and Rake) are used to compute travel-times and polarities of waveforms. Correcting Normal moveout times and polarities, and stacking all waveforms, the (X, Y, Z , strike, dip, rake) combination that gives the strongest stacking waveform is identified as the solution. To solve the problem of high computation problem, CPU-GPU programing is applied. Numerical datasets are used to test the algorithm. The SLMSA has also been applied to a fluid fracturing datasets and reveal several advantages against the location only method: (1) for shear sources, the source only program can hardly locate them because of the canceling out of positive and negative polarized traces, but the SLMSA method can successfully pick up those events; (2) microseismic locations alone may not be enough to indicate the directionality of micro-fractures. The statistics of

[Effects of Surgically Treated Pelvic Ring and Acetabular Fractures on Postural Control].

PubMed

Lang, P; Schnegelberger, A; Riesner, H-J; Stuby, F; Friemert, B; Palm, H-G

2016-04-01

The aim of surgical treatment of pelvic ring and acetabular fractures is to allow rapid mobilisation of patients in order to restore stance and gait stability (postural control), as this significantly correlates with a positive outcome. The regulation of postural stability is mainly controlled by transmission of proprioceptive stimuli. In addition, the pelvis serves as a connection between the legs and the spine and thus is also of great importance for mechanical stabilisation. It remains unclear whether surgical treatment of pelvic ring and acetabular fractures affects the regulation of postural control. Therefore, the aim of this study was to examine the impact of surgically treated pelvic ring and acetabular fractures on postural stability by means of computerised dynamic posturography (CDP) after a mean of 35 months and to compare the results with a healthy control group. A retrospective case control study of 38 patients with surgically treated pelvic ring and acetabular fractures and 38 healthy volunteers was carried out using CDP. The average time of follow-up was 35 (12-78) months. The most important outcome parameter in this investigation was the overall stability index (OSI). Hip joint mobility, the health-related quality of life (SF-12) and pain were supplementary outcome parameters. It was found that surgically treated pelvic ring and acetabular fractures had no influence on postural stability. The OSI was 2.1 ° in the patient group and 1.9 ° in the control group. There was no significant difference between the groups in hip joint mobility. A total of 52 % of patients showed no or only mild pain. Mean health-related quality of life was the same as in the total population. Surgically treated pelvic ring and acetabular fractures do not lead to deterioration in postural control in the mid term. This is of high prognostic importance for rapid mobilisation of the patients. Therefore no increase in the risk of falling is expected after successfully

Investigation of Stimulation-Response Relationships for Complex Fracture Systems in Enhanced Geothermal Reservoirs

DOE Data Explorer

Fu, Pengcheng; Johnson, Scott M.; Carrigan, Charles R.

2011-01-01

Hydraulic fracturing is currently the primary method for stimulating low-permeability geothermal reservoirs and creating Enhanced (or Engineered) Geothermal Systems (EGS) with improved permeability and heat production efficiency. Complex natural fracture systems usually exist in the formations to be stimulated and it is therefore critical to understand the interactions between existing fractures and newly created fractures before optimal stimulation strategies can be developed. Our study aims to improve the understanding of EGS stimulation-response relationships by developing and applying computer-based models that can effectively reflect the key mechanisms governing interactions between complex existing fracture networks and newly created hydraulic fractures. In this paper, we first briefly describe the key modules of our methodology, namely a geomechanics solver, a discrete fracture flow solver, a rock joint response model, an adaptive remeshing module, and most importantly their effective coupling. After verifying the numerical model against classical closed-form solutions, we investigate responses of reservoirs with different preexisting natural fractures to a variety of stimulation strategies. The factors investigated include: the in situ stress states (orientation of the principal stresses and the degree of stress anisotropy), pumping pressure, and stimulation sequences of multiple wells.

Post-Traumatic Periprosthetic Tibial and Fibular Fracture After Total Ankle Arthroplasty: A Case Report.

PubMed

Brock, Amanda K; Tan, Eric W; Shafiq, Babar

Periprosthetic fractures after total ankle arthroplasty are uncommon, with most cases occurring intraoperatively. We describe a post-traumatic periprosthetic fracture of the distal tibia and fibula after total ankle arthroplasty that was treated with minimally invasive plate osteosynthesis. It is important for orthopedic surgeons not only to recognize the risk factors for postoperative periprosthetic total ankle arthroplasty fractures, but also to be familiar with the treatment options available to maximize function and minimize complications. The design of the tibial prosthesis and surgical techniques required to prepare the ankle joint for implantation are important areas of future research to limit the risk of periprosthetic fractures. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Retroauricular transmeatal approach to manage mandibular condylar head fractures.

PubMed

Benech, Arnaldo; Arcuri, Francesco; Baragiotta, Nicola; Nicolotti, Matteo; Brucoli, Matteo

2011-03-01

There is a multitude of reported surgical approaches and technical variants with some unresolved technical problems to gain direct access to mandibular condylar head fractures; they can be divided into 2 groups: intraoral and extraoral. In 2005, Neff et al (Mund Kiefer Gesichtschir 2005;9:80), supported by a previous experimental work, reported a successful clinical study of condylar head fractures treated by a retroauricular approach; this article is in German, and the later English-language literature does not mention about this approach to open reduction and internal fixation of mandibular condylar fractures. The retroauricular transmeatal access, selected and performed by the senior author to treat 14 patients affected by highly located condylar head fracture, is illustrated in details. We collected data of 14 consecutive adult patients who, after the discussion about all options, had consented to have 16 mandibular condylar head fractures treated with open reduction and internal fixation by miniplates and screws via a retroauricular transmeatal approach. We exposed the temporomandibular joint area easily and better by dissecting via a retroauricular route with identification, ligation, and transection of the retromandibular vein; because of the posterior access, the frontal branch of the facial nerve and the auriculotemporal nerve are located and protected within the substance of the anteriorly retracted flap, superficial to the retromandibular vein. The follow-up clinical examination showed temporary weakness of the frontal branch of the facial nerve in 1 case with a recovery to normal function of 1.6 months; no patients had permanent weakness of the facial nerve or injury of the auriculotemporal nerve. There was absence of any salivary fistula, sialocele, and Frey syndrome; hearing was preserved in all cases, without any auditory stenosis or aesthetic deformity, and there was absence of any infections, hematoma, or scarring. Retroauricular approach provides

[Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].

PubMed

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

2016-04-01

Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup. Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation. Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening. Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition. Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups. Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.

[Intramedullary nailing combined with cannulated screw in treating femoral condyles fractures].

PubMed

Shen, Guo-Qing; Zhang, Hao; Long, Da-Fu; Li, Zheng-Wen; Tan, Ying-Dong

2017-07-25

To observe the clinical effects of retrograde intramedullary nailing and cannulated screws in the treatment of femoral condylar fracture. From June 2009 to June 2015, 13 patients with femoral condyles fracture were treated by retrograde intramedullary nailing and cannulated screws including 6 males and 7 females with an average age of 46.1 years old ranging from 16 to 76 years old. There were 10 cases of closed fractures, 3 cases of open fraetures. According to AO classification criteriam, 4 cases were type C1, 7 cases were type C2, 2 cases were type C3. Postoperative reduction of fracture and the knee joint function recovery were observed. All patients were followed up for 12 to 36 months with a mean of 24 months. X-ray examination showed that the union time of fracture was 18 to 24 weeks, 21 weeks on average. There were no cases of loosening, breakage of internal fixators and re-fracture. Hospital for Special Surgery(HSS) knee score was 90.07±4.99 at 1 year after the operation. The clinical efficacy for retrograde intramedullary nailing and cannulated screw for the treatment of femoral condyles fracture was excellent. It can improve the anatomical reattachment rate and reduce the complications and promote the knee functional recovery.

Impact of Stress on Anomalous Transport in Fractured Rock

NASA Astrophysics Data System (ADS)

Kang, P. K.; Lei, Q.; Lee, S.; Dentz, M.; Juanes, R.

2016-12-01

Fluid flow and transport in fractured rock controls many natural and engineered processes in the subsurface. However, characterizing flow and transport through fractured media is challenging due to the large heterogeneity of fractured rock properties. In addition to these "static" challenges, geologic fractures are always under significant overburden stress, and changes in the stress state can lead to changes in the fracture's ability to conduct fluids. While confining stress has been shown to impact fluid flow through fractures in a fundamental way, the impact of confining stress on transport through fractured rock remains largely unexplored. The link between anomalous (non-Fickian) transport and confining stress has been shown only recently, at the level of a single rough fracture [1]. Here, we investigate the impact of confining stress on flow and transport through discrete fracture networks. We model geomechanical effects in 2D fractured rock by means of a finite-discrete element method (FEMDEM), which can capture the deformation of matrix blocks, reactivation and propagation of cracks. We implement a joint constitutive model within the FEMDEM framework to simulate the effect of fracture roughness. We apply the model to a fracture network extracted from the geological map of an actual outcrop to obtain the aperture field at different stress conditions (Figure 1). We then simulate fluid flow and particle transport through the stressed fracture networks. We observe that anomalous transport emerges in response to confining stress on the fracture networks, and show that this anomalous behavior can be linked to the stress state of the rock. Finally, we develop an effective transport model that captures the anomalous transport through stressed fractures. Our results point to a heretofore unrecognized link between geomechanics and anomalous transport in discrete fractured networks. [1] P. K. Kang, S. Brown, and R. Juanes, Emergence of anomalous transport in stressed

Pediatric fractures through the eyes of parents: an observational study.

PubMed

Sofu, Hakan; Gursu, Sarper; Kockara, Nizamettin; Issin, Ahmet; Oner, Ali; Camurcu, Yalkin

2015-01-01

The present study is an observational cross-sectional study. The main purpose of this research was to analyze the perception and behaviors of parents in a series of pediatric upper extremity fracture cases. Hundred and seventeen patients younger than 12 years who were conservatively treated for the upper extremity fracture were included in our study. Parents of the patients were requested to answer a family-centered questionnaire related to their child's fracture and its treatment. When the parents were asked whether they believe casting would be sufficient or not as the treatment of their child's fracture, 84.6% answered 'yes', 13.7% answered 'I am not sure,' and 1.7% answered 'no.' Sixty-four of the parents were not worried about any residual defect in joint or extremity functions related to fracture, whereas 21 were worried and 32 were not sure on this. The rate of searching further information about the child's fracture was 34.2% and the mostly used source was the Internet. Twenty-eight of the 117 respondents (23.9%) emphasized that they would reduce the time their child spend outside the home at least for a while after the removal of cast. When conservatively treating a child's fracture, physicians dealing with traumatology should always consider the parents' perception and behaviors as critically important.

Crack-jump mechanism of microvein formation and its implications for stress cyclicity during extension fracturing

NASA Astrophysics Data System (ADS)

Caputo, Riccardo; Hancock, Paul L.

1998-11-01

It is well accepted and documented that faulting is produced by the cyclic behaviour of a stress field. Some extension fractures, such as veins characterised by the crack-seal mechanism, have also been presumed to result from repeated stress cycles. In the present note, some commonly observed field phenomena and relationships such as hackle marks and vein and joint spacing, are employed to argue that a stress field can also display cyclic behaviour during extensional fracturing. Indeed, the requirement of critical stress conditions for the occurrence of extensional failure events does not accord with the presence of contemporaneously open nearby parallel fractures. Therefore, because after each fracture event there is stress release within the surrounding volume of rock, high density sets of parallel extensional fractures also strongly support the idea that rocks undergo stress cyclicity during jointing and veining. A comparison with seismological data from earthquakes with dipole mechanical solutions, confirms that this process presently occurs at depth in the Earth crust. Furthermore, in order to explain dense sets of hair-like closely spaced microveins, a crack-jump mechanism is introduced here as an alternative to the crack-seal mechanism. We also propose that as a consequence of medium-scale stress cyclicity during brittle deformation, the re-fracturing of a rock mass occurs in either one or the other of these two possible ways depending on the ratio between the elastic parameters of the sealing material and those of the host rock. The crack-jump mechanism occurs when the former is stronger.

Articular congruity is associated with short-term clinical outcomes of operatively treated SER IV ankle fractures.

PubMed

Berkes, Marschall B; Little, Milton T M; Lazaro, Lionel E; Pardee, Nadine C; Schottel, Patrick C; Helfet, David L; Lorich, Dean G

2013-10-02

With regard to supination-external rotation type-IV (SER IV) ankle fractures, there is no consensus regarding which patient, injury, and treatment variables most strongly influence clinical outcome. The purpose of this investigation was to examine the impact of articular surface congruity on the functional outcomes of operatively treatment of SER IV ankle fractures. A prospectively generated database consisting of operatively treated SER IV ankle fractures was reviewed. Postoperative computed tomography (CT) scans were used to assess ankle joint congruity. Ankles were considered incongruent in the presence of >2 mm of articular step-off, intra-articular loose bodies, or an articular surface gap of >2 mm (despite an otherwise anatomic reduction) due to joint impaction and comminution. Patients with at least one year of clinical follow-up were eligible for analysis. The primary and secondary outcome measures were the Foot and Ankle Outcome Score (FAOS) and ankle motion. One hundred and eight SER IV fractures met our inclusion criteria. The average duration of follow-up was twenty-one months. Seventy-two patients (67%) had a congruent ankle joint, and thirty-six (33%) had elements of articular surface incongruity on postoperative CT scanning. These two groups were similar with regard to comorbidities and injury and treatment variables. At the time of the final follow-up, the group with articular incongruity had a significantly worse FAOS with regard to symptoms (p = 0.012), pain (p = 0.004), and activities of daily living (p = 0.038). Those with articular incongruity had worse average scores in the FAOS sport domain as well. No significant differences in ankle motion were found between the two groups. In this population of patients with an operatively treated SER IV ankle fracture, the presence of postoperative articular incongruity correlated with inferior early clinical outcomes. Orthopaedic surgeons should scrutinize ankle fracture reductions and strive for

[Midterm follow-up results on Asian femoral intramedullary nail for the treatment of segmental and comminuted femoral fractures].

PubMed

Li, Lang; Gao, Feng; Huang, Qi; Li, Qiang; Xie, Lin; Zhang, Bin

2016-06-01

To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures. Between June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9.1 d. There were 6 cases were type C1,2 cases were type C2 and 8 cases were type C3 according to AO classification. X-ray of femoral segment at 3,6 and 12 months after operation were applied for evaluating fracture healing. Harris score of hip joint and HSS score of knee joint were used to evaluate postoperative function. All patients were followed up from 24 to 36 months with an average of 28.4 months. Operative time was from 88 to 112 min with an average of 90.7 min; blood loss ranged from 150 to 200 ml with an average of 188.75 ml; the time of fracture healing was from 5 to 9 months with an average of 5.4 months. All incision were healed at stage I. No loosening, breakage of internal fixation and displacement of fracture were occurred. There were no significant differences in Harris score of hip joint at 3, 6 and 12 months after operation (F = 0.07, P = 0.893 > 0.05), 10 cases obtained excellent results, 5 good and 1 moderate. There was no obvious meaning in HSS score of knee joint (F = 0.08,P = 0.876 > 0.05), 9 cases obtained excellent results, 6 good and 1 poor. Asian femoral intramedullary nail could treat segmental and comminuted femoral fractures by using variety of less invasive ways,which has advantages of less trauma, quick recovery of function and satisfied midterm following-up results. But long term following-up effects remains to be seen.

Probabilistic and Possibilistic Analyses of the Strength of a Bonded Joint

NASA Technical Reports Server (NTRS)

Stroud, W. Jefferson; Krishnamurthy, T.; Smith, Steven A.

2001-01-01

The effects of uncertainties on the strength of a single lap shear joint are explained. Probabilistic and possibilistic methods are used to account for uncertainties. Linear and geometrically nonlinear finite element analyses are used in the studies. To evaluate the strength of the joint, fracture in the adhesive and material strength failure in the strap are considered. The study shows that linear analyses yield conservative predictions for failure loads. The possibilistic approach for treating uncertainties appears to be viable for preliminary design, but with several qualifications.

Multi-scale fracture networks within layered shallow water tight carbonates

NASA Astrophysics Data System (ADS)

Panza, Elisa; Agosta, Fabrizio; Rustichelli, Andrea; Vinciguerra, Sergio; Zambrano, Miller; Prosser, Giacomo; Tondi, Emanuele

2015-04-01

The work is aimed at deciphering the contribution of background deformation and persistent fracture zones on the fluid flow properties of tight platform carbonates. Taking advantage of 3D exposures present in the Murge area of southern Italy, the fracture networks crosscutting at different scales the layered Cretaceous limestone of the Altamura Fm. were analyzed. The rock multi-layer is characterized by 10's of cm-thick, sub-horizontal, laterally continuous carbonate beds. Each bed commonly represents a shallowing-upward peritidal cycle made up of homogeneous micritic limestones grading upward to cm-thick stromatolitic limestones and/or fenestral limestones. The bed interfaces are formed by sharp maximum flooding surfaces. Porosity measurements carried out on 40 limestone samples collected from a single carbonate bed show values ranging between 0,5% and 5,5%. Background deformation includes both stratabound and non-stratabound fractures. The former elements consist of bed-perpendicular joints and sheared joints, which are confined within a single bed and often displace small, bed-parallel stylolites. Non-stratabound fractures consist of incipient, cm offset, sub-vertical strike-slip faults, which crosscut the bed interfaces. The aforementioned elements are often confined within individual bed-packages, which are identified by presence of pronounced surfaces locally marked by veneers of reddish clayey paleosoils. Persistent fracture zones consist of 10's of m-high, 10's of cm-offset strike-slip faults that offset the bed-package interfaces and are confined within individual bed-packages association. Laterally discontinuous, cm- to a few m-thick paleokarstic breccia levels separate the different bed-packages associations. Persistent fracture zones include asymmetric fractured damage zones and mm-thick veneers of discontinuous fault rocks. The fracture networks that pervasively crosscut the study limestone multi-layer are investigated by mean of scanline and scanarea

The state of stress in the limb of the Split Mountain anticline, Utah: constraints placed by transected joints

NASA Astrophysics Data System (ADS)

Silliphant, Laura J.; Engelder, Terry; Gross, Michael R.

2002-01-01

Transected joints (i.e. systematic joints that strike at an angle to the present fold axis trend) occur on the flanks of Split Mountain, a Laramide anticline near the eastern end of the Uinta Mountains, Utah. The common orientation on both flanks for these WNW-striking joints is inconsistent with joints driven by a syn-folding stretch normal to the direction of highest curvature. A smaller dispersion of the poles to these transected joints occurs when they are rotated with bedding to their 'pre-fold' orientation. This dispersion of poles is inconsistent with a post-fold genesis in a regional stress field but permits the possibility that these WNW joints propagated as a systematic set prior to Laramide folding. A pre-fold interpretation is substantiated by a regional WNW-striking joint set within Cretaceous and older rocks in the surrounding Piceance, Uinta, and southeastern Sand Wash basins. During tilting accompanying the upfolding of Split Mountain, most joints of this WNW-striking regional set remain locked without slipping under a shear stress. Fracture toughness and frictional strength are two rock properties that serve to lock a joint until a critical resolved shear stress is achieved. A gravity load caused down-dip slip on some joints that were tilted to a dip of about 62°. This suggests that a local principal stress remained roughly vertical during bedding rotation. Assuming fracture strength and friction prevented slip on most joints during tilting, the ratio of least horizontal, Sh, to vertical stress, Sv, at the critical tilt angle was approximately 0.55.

Characteristics of solder joints under fatigue loads using piezomechanical actuation

NASA Astrophysics Data System (ADS)

Shim, Dong-Jin; Spearing, S. Mark

2003-07-01

Crack initiation and growth characteristics of solder joints under fatigue loads are investigated using piezomechanical actuation. Cracks in solder joints, which can cause failure in microelectronics components, are induced via piezoelectricity in piezo-ceramic bonded joints. Lead-zirconate-titanate ceramic plates and eutectic Sn-Pb solder bonded in a double-lap shear configuration are used in the investigation. Electric field across each piezo-ceramic plate is applied such that shear stresses/strains are induced in the solder joints. The experiments show that cracks initiate in the solder joints around defects such as voids and grow in length until they coalesce with other cracks from adjacent voids. These observations are compared with the similar thermal cycling tests from the literature to show feasibility and validity of the current method in investigating the fatigue characteristics of solder joints. In some specimens, cracks in the piezo-ceramic plates are observed, and failure in the specimens generally occurred due to piezo-ceramic plate fracture. The issues encountered in implementing this methodology such as low actuation and high processing temperatures are further discussed.

[APPLICATION OF BUTTERFLY SHAPED LOCKING COMPRESSION PLATE IN COMPLEX DISTAL RADIUS FRACTURES].

PubMed

Jiang, Zongyuan; Ma, Tao; Xia, Jiang; Hu, Caizhi; Xu, Lei

2014-06-01

To investigate the effectiveness of butterfly shaped locking compression plate for the treatment of complex distal radius fractures. Between June 2011 and January 2013, 20 cases of complex distal radius fractures were treated with butterfly shaped locking compression plate fixation. There were 11 males and 9 females with an average age of 54 years (range, 25-75 years). Injury was caused by falling in 10 cases, by traffic accident in 7 cases, and by falling from height in 3 cases. All of fractures were closed. According to AO classification system, there were 8 cases of type C1, 8 cases of type C2, and 4 cases of type C3. Of them, 9 cases had radial styloid process fracture, 4 cases had sigmoid notch fracture, and 7 cases had both radial styloid process fracture and sigmoid notch fracture. The mean interval between injury and operation was 5.2 days (range, 3-15 days). All incisions healed by first intention; no complications of infection and necrosis occurred. All cases were followed up 14 months on average (range, 10-22 months). All factures healed after 9.3 weeks on average (range, 6-11 weeks). No complications such as displacement of fracture, joint surface subsidence, shortening of the radius, and carpal tunnel syndrome were found during follow-up. At last follow-up, the mean palmar tilt angle was 10.2° (range, 7-15°), and the mean ulnar deviation angle was 21.8° (range, 17-24°). The mean range of motion of the wrist was 45.3° (range, 35-68°) in dorsal extension, 53.5° (range, 40-78°) in palmar flexion, 19.8° (range, 12-27°) in radial inclination, 26.6° (range, 18-31°) in ulnar inclination, 70.2° (range, 45-90°) in pronation, and 68.4° (range, 25-88°) in supination. According to the Dienst scoring system, the results were excellent in 8 cases, good in 10 cases, and fair in 2 cases, and the excellent and good rate was 90%. Treatment of complex distal radius fractures with butterfly shaped locking compression plate can reconstruct normal anatomic

[Treatment of complex scapular body fractures by locking reconstructive plates].

PubMed

Zhang, Jun-wei; Hou, Jin-yong; Yang, Mao-qing

2011-03-01

To investigate the method and effect of treatment of complex scapular body fractures by locking reconstructive plate through modified posterior approach. From August 2005 to November 2009, 27 patients with complex scapula body fractures were treated by locking reconstruction bone plate fixation,including 19 males and 8 females with an average age of 36 years old ranging from 16 to 64 years. The time after injury was 0.5 hours to 11 days (averaged 3 days). Of all the patients, 9 cases were associated with ipsilateral clavicle fracture, 2 cases were associated with acromioclavicular joint dislocation,16 cases were associated with multiple rib fractures, 1 case were associated with humeral shaft fractures, 5 cases were associated with pleural effusion, atelectasis, lung contusion etc. After operating,shoulder functional recovery were followed up. Twenty-four patients were followed up from 2 to 35 months with an average of 19 months. According to Hardegger shoulder function,the results were excellent in 15 cases, good in 7 cases, general in 2 cases. This method had the advantage of less trauma and clear exposure, firm and reliable fixation, and early activities.

The conservative treatment of pediatric mandibular fracture with prefabricated surgical splint: a case report.

PubMed

Kocabay, Ceyda; Ataç, Mustafa Sancar; Oner, Burak; Güngör, Nadir

2007-08-01

The use of rigid fixation in children is controversial and may cause growth retardation along cranial suture lines. Intermaxillary fixation for mandibular fractures should be used cautiously as bony ankylosis in the temporomandibular joint (TMJ) and trismus may develop. The high osteogenic potential of the pediatric mandible allows non-surgical management to be successful in younger patients with conservative approaches. In this case, successful conservative treatment of mandibular fracture of a 3-year-old patient is presented.

Check radiography after fixation of hip fractures: is it necessary?

PubMed

Mohanty, K; Gupta, S K; Evans, R M

2000-12-01

Technological advances in radiography in the form of image intensification has not only made internal fixation of femoral neck fracture much easier but these high resolution films can be saved as hard copies and can also be reversed into 'positives' at a later date. However, requesting routine post-operative check radiographs for these fractures are still a common practice. A retrospective study was carried out to compare the quality of image intensifier films with conventional post-operative radiographs. 79 sets of films were reviewed with particular reference to adequacy of fixation and possible joint penetration by the screws. No significant difference was noted between the two sets of films. We suggest that routine post-operative radiographs after femoral neck fracture fixation are unnecessary unless there is some clinical indication. This has significant implications in relation to patient discomfort, radiation exposure and cost-effectiveness.

Interfacial Microstructure and Mechanical Strength of 93W/Ta Diffusion-Bonded Joints with Ni Interlayer

NASA Astrophysics Data System (ADS)

Luo, Guoqiang; Zhang, Jian; Li, Meijuan; Wei, Qinqin; Shen, Qiang; Zhang, Lianmeng

2013-02-01

93W alloy and Ta metal were successfully diffusion bonded using a Ni interlayer. Ni4W was found at the W-Ni interface, and Ni3Ta and Ni2Ta were formed at the Ni-Ta interface. The shear strength of the joints increases with increasing holding time, reaching a value of 202 MPa for a joint prepared using a 90-minute holding time at 1103 K (830 °C) and 20 MPa. The fracture of this joint occurred within the Ni/Ta interface.

Joint Use of ERT, Tracer, and Numerical Techniques to Image Preferential Flow Paths in a Fractured Granite Aquifer

NASA Astrophysics Data System (ADS)

Sanaga, S.; Vijay, S.; Kbvn, P.; Peddinti, S. R.; P S L, S.

2017-12-01

Fractured geologic media poses formidable challenges to hydrogeologists due of the strenuous mapping of fracture-matrix system and quantification of flow and transport processes. In this research, we demonstrated the efficacy of tracer-ERT studies coupled with numerical simulations to delineate preferential flow paths in a fractured granite aquifer of Deccan traps in India. A series of natural gradient saline tracer experiments were conducted from a depth window of 18 to 22 m in an injection well located inside the IIT Hyderabad campus. Tracer migration was monitored in a time-lapse mode using two cross-sectional surface ERT profiles placed in the direction of flow gradient. Dynamic changes in sub-surface electrical properties inferred via resistivity anomalies were used to highlight preferential flow paths of the study area. ERT-derived tracer breakthrough curves were in agreement with geochemical sample measurements (R2=0.74). Fracture geometry and hydraulic properties derived from ERT and pumping tests were then used to evaluate two mathematical conceptualizations that are relevant to fractured aquifers. Results of numerical analysis conclude that a dual continuum model that combines matrix and fracture systems through a flow exchange term has outperformed equivalent continuum model in reproducing tracer concentrations at the monitoring wells (evident by decrease in RMSE from 199 mg/l to 65 mg/l). A sensitivity analysis of the model parameters reveals that spatial variability in hydraulic conductivity, local-scale dispersion, and flow exchange at fracture-matrix interface have a profound effect on model simulations. Keywords: saline tracer, ERT, fractured granite, groundwater, preferential flow, numerical simulation

Salvage of tibial pilon fractures using fusion of the ankle with a 90 degrees cannulated blade-plate: a preliminary report.

PubMed

Morgan, S J; Thordarson, D B; Shepherd, L E

1999-06-01

Six patients with ankle joint destruction and delayed metaphyseal union after tibial plafond fracture were surgically treated with tibiotalar arthrodesis and metaphyseal reconstruction, using a fixed-angle cannulated blade-plate. The procedure was performed through a posterior approach in five cases and a lateral approach in one case. The subtalar joint was preserved in all cases. Metaphyseal union and a stable arthrodesis were obtained in all cases without loss of fixation and with no mechanical failure of the blade-plate. Union was obtained in an average of 26 weeks. No secondary procedures were required to obtain union. All six patients were ambulatory at last follow-up. Stable internal fixation for simultaneous tibiotalar fusion and metaphyseal reconstruction can be achieved with a cannulated blade-plate while preserving the subtalar joint in complex plafond fractures.

The Development of a new Numerical Modelling Approach for Naturally Fractured Rock Masses

NASA Astrophysics Data System (ADS)

Pine, R. J.; Coggan, J. S.; Flynn, Z. N.; Elmo, D.

2006-11-01

An approach for modelling fractured rock masses has been developed which has two main objectives: to maximise the quality of representation of the geometry of existing rock jointing and to use this within a loading model which takes full account of this style of jointing. Initially the work has been applied to the modelling of mine pillars and data from the Middleton Mine in the UK has been used as a case example. However, the general approach is applicable to all aspects of rock mass behaviour including the stress conditions found in hangingwalls, tunnels, block caving, and slopes. The rock mass fracture representation was based on a combination of explicit mapping of rock faces and the synthesis of this data into a three-dimensional model, based on the use of the FracMan computer model suite. Two-dimensional cross sections from this model were imported into the finite element computer model, ELFEN, for loading simulation. The ELFEN constitutive model for fracture simulation includes the Rotating Crack, and Rankine material models, in which fracturing is controlled by tensile strength and fracture energy parameters. For tension/compression stress states, the model is complemented with a capped Mohr-Coulomb criterion in which the softening response is coupled to the tensile model. Fracturing due to dilation is accommodated by introducing an explicit coupling between the inelastic strain accrued by the Mohr-Coulomb yield surface and the anisotropic degradation of the mutually orthogonal tensile yield surfaces of the rotating crack model. Pillars have been simulated with widths of 2.8, 7 and 14 m and a height of 7 m (the Middleton Mine pillars are typically 14 m wide and 7 m high). The evolution of the pillar failure under progressive loading through fracture extension and creation of new fractures is presented, and pillar capacities and stiffnesses are compared with empirical models. The agreement between the models is promising and the new model provides useful

Progressive Damage Modeling of Durable Bonded Joint Technology

NASA Technical Reports Server (NTRS)

Leone, Frank A.; Davila, Carlos G.; Lin, Shih-Yung; Smeltzer, Stan; Girolamo, Donato; Ghose, Sayata; Guzman, Juan C.; McCarville, Duglas A.

2013-01-01

The development of durable bonded joint technology for assembling composite structures for launch vehicles is being pursued for the U.S. Space Launch System. The present work is related to the development and application of progressive damage modeling techniques to bonded joint technology applicable to a wide range of sandwich structures for a Heavy Lift Launch Vehicle. The joint designs studied in this work include a conventional composite splice joint and a NASA-patented Durable Redundant Joint. Both designs involve a honeycomb sandwich with carbon/epoxy facesheets joined with adhesively bonded doublers. Progressive damage modeling allows for the prediction of the initiation and evolution of damage. For structures that include multiple materials, the number of potential failure mechanisms that must be considered increases the complexity of the analyses. Potential failure mechanisms include fiber fracture, matrix cracking, delamination, core crushing, adhesive failure, and their interactions. The joints were modeled using Abaqus parametric finite element models, in which damage was modeled with user-written subroutines. Each ply was meshed discretely, and layers of cohesive elements were used to account for delaminations and to model the adhesive layers. Good correlation with experimental results was achieved both in terms of load-displacement history and predicted failure mechanisms.

Butt Welding of 2205/X65 Bimetallic Sheet and Study on the Inhomogeneity of the Properties of the Welded Joint

NASA Astrophysics Data System (ADS)

Gou, Ning-Nian; Zhang, Jian-Xun; Wang, Jian-Long; Bi, Zong-Yue

2017-04-01

The explosively welded 2205 duplex stainless steel/X65 pipe steel bimetallic sheets were butt jointed by multilayer and multi-pass welding (gas tungsten arc welding for the flyer and gas metal arc welding for the transition and parent layers of the bimetallic sheets). The microstructure and mechanical properties of the welded joint were investigated. The results showed that in the thickness direction, microstructure and mechanical properties of the welded joint exhibited obvious inhomogeneity. The microstructures of parent filler layers consisted of acicular ferrite, widmanstatten ferrite, and a small amount of blocky ferrite. The microstructure of the transition layer and flyer layer consisted of both austenite and ferrite structures; however, the transition layer of weld had a higher volume fraction of austenite. The results of the microhardness test showed that in both weld metal (WM) and heat-affected zone (HAZ) of the parent filler layers, the average hardness decreased with the increasing (from parent filler layer 1 to parent filler layer 3) welding heat input. The results of hardness test also indicated that the hardness of the WM and the HAZ for the flyer and transition layers was equivalent. The tensile test combined with Digital Specklegram Processing Technology demonstrated that the fracturing of the welded joint started at the HAZ of the flyer, and then the fracture grew toward the base metal of the parent flyer near the parent HAZ. The stratified impact test at -5 °C showed that the WM and HAZ of the flyer exhibited lower impact toughness, and the fracture mode was ductile and brittle mixed fracture.

Intensity of joints associated with an extensional fault zone: an estimation by poly3d .

NASA Astrophysics Data System (ADS)

Minelli, G.

2003-04-01

The presence and frequency of joints in sedimentary rocks strongly affects the mechanical and fluid flow properties of the host layers. Joints intensity is evaluated by spacing, S, the distance between neighbouring fractures, or by density, D = 1/S. Joint spacing in layered rocks is often linearly related to layer thickness T, with typical values of 0.5 T < S < 2.0 T . On the other hand, some field cases display very tight joints with S << T and nonlinear relations between spacing and thickness , most of these cases are related to joint system “genetically” related to a nearby fault zone. The present study by using the code Poly3D (Rock Fracture Project at Stanford), numerically explores the effect of the stress distribution in the neighbour of an extensional fault zone with respect to the mapped intensity of joints both in the hanging wall and in the foot wall of it (WILLEMSE, E. J. M., 1997; MARTEL, S. J, AND BOGER, W. A,; 1998). Poly3D is a C language computer program that calculates the displacements, strains and stresses induced in an elastic whole or half-space by planar, polygonal-shaped elements of displacement discontinuity (WILLEMSE, E. J. M., POLLARD, D. D., 2000) Dislocations of varying shapes may be combined to yield complex three-dimensional surfaces well-suited for modeling fractures, faults, and cavities in the earth's crust. The algebraic expressions for the elastic fields around a polygonal element are derived by superposing the solution for an angular dislocation in an elastic half-space. The field data have been collected in a quarry located close to Noci town (Puglia) by using the scan line methodology. In this quarry a platform limestone with a regular bedding with very few shale or marly intercalations displaced by a normal fault are exposed. The comparison between the mapped joints intensity and the calculated stress around the fault displays a good agreement. Nevertheless the intrinsic limitations (isotropic medium and elastic behaviour

Modeling Anisotropic Elastic Wave Propagation in Jointed Rock Masses

NASA Astrophysics Data System (ADS)

Hurley, R.; Vorobiev, O.; Ezzedine, S. M.; Antoun, T.

2016-12-01

We present a numerical approach for determining the anisotropic stiffness of materials with nonlinearly-compliant joints capable of sliding. The proposed method extends existing ones for upscaling the behavior of a medium with open cracks and inclusions to cases relevant to natural fractured and jointed rocks, where nonlinearly-compliant joints can undergo plastic slip. The method deviates from existing techniques by incorporating the friction and closure states of the joints, and recovers an anisotropic elastic form in the small-strain limit when joints are not sliding. We present the mathematical formulation of our method and use Representative Volume Element (RVE) simulations to evaluate its accuracy for joint sets with varying complexity. We then apply the formulation to determine anisotropic elastic constants of jointed granite found at the Nevada Nuclear Security Site (NNSS) where the Source Physics Experiments (SPE), a campaign of underground chemical explosions, are performed. Finally, we discuss the implementation of our numerical approach in a massively parallel Lagrangian code Geodyn-L and its use for studying wave propagation from underground explosions. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

An Impact of Zirconium Doping of Zn-Al Braze on the Aluminum-Stainless Steel Joints Integrity During Aging

NASA Astrophysics Data System (ADS)

Yang, Jinlong; Xue, Songbai; Sekulic, Dusan P.

2017-01-01

This work offers an analysis of the microstructure and the growth rate of an intermetallic compound within the aged AA 6061 aluminum alloy-304 stainless steel joint brazed with Zn-15Al and Zn-15Al-0.2Zr filler metals. The effect of zirconium addition on mechanical integrity of the brazed joint was studied. The experimental results confirm that the thickness of the Fe-Al intermetallic layer formed at the brazed seam/stainless steel interface increases with the increase of the aging time. Furthermore, it is established that the growth rate of the intermetallic layer for the Zn-15Al-0.2Zr brazed joint was lower than that for Zn-15Al. The results also indicate that the shear strength of both Zn-15Al and Zn-15Al-0.2Zr brazed joints decreases monotonously during aging. The value of the strength after aging lasting for 800 h for Zn-15Al and Zn-15Al-0.2Zr has decreased by 20 and 17%, respectively. The fracture of joints occurred at the interface between the brazed seam and the Fe4Al13 intermetallic layer. The morphology of the surfaces exhibits a cleavage fracture.

Broken Pieces of Circlage Wire Lying in Soft Tissue Envelope Around Knee Joint: A Case Report and Review of Literature

PubMed Central

Kalia, Anoop; Khatri, Kavin; Singh, Jagdeep; Bansal, Kapil; Sagy, Mohammed

2016-01-01

Introduction: The migration of circlage wires used in tension band wiring construct of patella fractures in the posterior soft tissue envelope surrounding the knee joint has been rarely reported. Case Presentation: A 60-year-old woman presented to us with pain over medial aspect of right knee joint. She underwent open reduction and internal fixation for a patellar fracture which she sustained 4 years back and subsequently underwent kirschner wire(k wire) removal for the same around 2 years back. X-rays of the knee joint shows that the circlage wire used in tension band construct which was left in place had broken into multiple pieces and was lying in the soft tissue envelope surrounding the knee joint and one piece migrate to the popliteal fossa. On examination patient did not had distal neuro-vascular deficit. The pain of the patient was due to the osteo-arthritic changes in her medial side of knee joint rather than broken wire pieces. Patient was advised to undergo total knee replacement along with subsequent removal of broken wires but patient refused for any type of surgery and is kept on regular follow up Conclusion: This case report summarizes a rare complication resulting from hardware failure used for fixing patella fractures and throws a light on potential unwarned complications due to broken wires along with early recogonition and removal of broken hardware by surgeons. PMID:28116277

Microstructure and Shear Strength in Brazing Joint of Mo-Cu Composite with 304 Stainless Steel by Ni-Cr-P Filler Metal

NASA Astrophysics Data System (ADS)

Wang, Juan; Wang, Jiteng; Li, Yajiang; Zheng, Deshuang

2015-07-01

The brazing of Mo-Cu composite and 304 stainless steel was carried out in vacuum with Ni-Cr-P filler metal at 980 °C for 20 min. Microstructure in Mo-Cu/304 stainless steel joint was investigated by field-emission scanning electron microscope (FE-SEM) with energy dispersive spectrometer (EDS) and shear strength was measured by shearing test. The results indicate that shear strength of the Mo-Cu/304 stainless steel joint is about 155 MPa. There forms eutectic structure of γ-Ni solid solution with Ni3P in the braze seam. Ni-Cu(Mo) and Ni-Fe solid solution are at the interface beside Mo-Cu composite and 304 stainless steel, respectively. Shear fracture exhibits mixed ductile-brittle fracture feature with trans-granular fracture, ductile dimples and tearing edges. Fracture originates from the interface between brazing seam and Mo-Cu composite and it propagates to the braze seam due to the formation of brittle Ni5P2 and Cr3P precipitation.

Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures.

PubMed

Lian, Kejian; Wang, Lei; Lin, Dasheng; Chen, Zhiwen

2013-08-01

Mid-distal third humeral shaft fractures can be effectively treated with minimally invasive plating osteosynthesis and intramedullary nailing (IMN). However, these 2 treatments have not been adequately compared. Forty-seven patients (47 fractures) with mid-distal third humeral shaft fractures were randomly allocated to undergo either minimally invasive plating osteosynthesis (n=24) or IMN (n=23). The 2 groups were similar in terms of fracture patterns, fracture location, age, and associated injuries. Intraoperative measurements included blood loss and operative time. Clinical outcome measurements included fracture healing, radial nerve recovery, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Functional outcome was satisfactory in both groups. Mean American Shoulder and Elbow Surgeons score and Mayo score were both better for the minimally invasive plating osteosynthesis group than for the IMN group (98.2 vs 97.6, respectively, and 93.5 vs 94.1, respectively; P<.001). Operative time was shorter and less intraoperative blood loss occurred in the minimally invasive plating osteosynthesis group than in the IMN group. Average time to union was similar in both groups. Primary union was achieved in 23 of 24 patients in the minimally invasive plating osteosynthesis group and in 22 of 23 in the IMN group. Minimally invasive plating osteosynthesis may have outcomes comparable with IMN for the management of mid-distal third humeral shaft fractures. Minimally invasive plating osteosynthesis is more suitable for complex fractures, especially for radial protection and motion recovery of adjacent joints, compared with IMN for simple fractures. Copyright 2013, SLACK Incorporated.

Talocrural Dislocation With Associated Weber Type C Fibular Fracture in a Collegiate Football Player: A Case Report

PubMed Central

Ricci, R Daniel; Cerullo, James; Blanc, Robert O; McMahon, Patrick J; Buoncritiani, Anthony M; Stone, David A; Fu, Freddie H

2008-01-01

Objective: To present the case of a talocrural dislocation with a Weber type C fibular fracture in a National Collegiate Athletic Association Division I football athlete. Background: The athlete, while attempting to make a tackle during a game, collided with an opponent, who in turn stepped on the lateral aspect of the athlete's ankle, resulting in forced ankle eversion and external rotation. On-field evaluation showed a laterally displaced talocrural dislocation. Immediate reduction was performed in the athletic training room to maintain skin integrity. Post-reduction radiographs revealed a Weber type C fibular fracture and increased medial joint clear space. A below-knee, fiberglass splint was applied to stabilize the ankle joint complex. Differential Diagnosis: Subtalar dislocation, Maisonneuve fracture, malleolar fracture, deltoid ligament rupture, syndesmosis disruption. Treatment: The sports medicine staff immediately splinted and transported the athlete to the athletic training room to reduce the dislocation. The athlete then underwent an open reduction and internal fixation procedure to stabilize the injury: 2 syndesmosis screws and a fibular plate were placed to keep the ankle joint in an anatomically reduced position. With the guidance of the athletic training staff, the athlete underwent an accelerated physical rehabilitation protocol in an effort to return to sport as quickly and safely as possible. Uniqueness: Most talocrural dislocations and associated Weber type C fibular fractures are due to motor vehicle accidents or falls. We are the first to describe this injury in a Division I football player and to present a general rehabilitation protocol for a high-level athlete. Conclusions: Sports medicine practitioners must recognize that this injury can occur in the athletic environment. Prompt reduction, early surgical intervention, sufficient resources, and an accelerated rehabilitation protocol all contributed to a successful outcome in the patient

Fracture overprinting history using Markov chain analysis: Windsor-Kennetcook subbasin, Maritimes Basin, Canada

NASA Astrophysics Data System (ADS)

Snyder, Morgan E.; Waldron, John W. F.

2018-03-01

The deformation history of the Upper Paleozoic Maritimes Basin, Atlantic Canada, can be partially unraveled by examining fractures (joints, veins, and faults) that are well exposed on the shorelines of the macrotidal Bay of Fundy, in subsurface core, and on image logs. Data were collected from coastal outcrops and well core across the Windsor-Kennetcook subbasin, a subbasin in the Maritimes Basin, using the circular scan-line and vertical scan-line methods in outcrop, and FMI Image log analysis of core. We use cross-cutting and abutting relationships between fractures to understand relative timing of fracturing, followed by a statistical test (Markov chain analysis) to separate groups of fractures. This analysis, previously used in sedimentology, was modified to statistically test the randomness of fracture timing relationships. The results of the Markov chain analysis suggest that fracture initiation can be attributed to movement along the Minas Fault Zone, an E-W fault system that bounds the Windsor-Kennetcook subbasin to the north. Four sets of fractures are related to dextral strike slip along the Minas Fault Zone in the late Paleozoic, and four sets are related to sinistral reactivation of the same boundary in the Mesozoic.

Size effects in tin-based lead-free solder joints: Kinetics of bond formation and mechanical characteristics

NASA Astrophysics Data System (ADS)

Abdelhadi, Ousama Mohamed Omer

Continuous miniaturization of microelectronic interconnects demands smaller joints with comparable microstructural and structural sizes. As the size of joints become smaller, the volume of intermetallics (IMCs) becomes comparable with the joint size. As a result, the kinetics of bond formation changes and the types and thicknesses of IMC phases that form within the constrained region of the bond varies. This dissertation focuses on investigating combination effects of process parameters and size on kinetics of bond formation, resulting microstructure and the mechanical properties of joints that are formed under structurally constrained conditions. An experiment is designed where several process parameters such as time of bonding, temperature, and pressure, and bond thickness as structural chracteristic, are varied at multiple levels. The experiment is then implemented on the process. Scanning electron microscope (SEM) is then utilized to determine the bond thickness, IMC phases and their thicknesses, and morphology of the bonds. Electron backscatter diffraction (EBSD) is used to determine the grain size in different regions, including the bulk solder, and different IMC phases. Physics-based analytical models have been developed for growth kinetics of IMC compounds and are verified using the experimental results. Nanoindentation is used to determine the mechanical behavior of IMC phases in joints in different scales. Four-point bending notched multilayer specimen and four-point bending technique were used to determine fracture toughness of the bonds containing IMCs. Analytical modeling of peeling and shear stresses and fracture toughness in tri-layer four-point bend specimen containing intermetallic layer was developed and was verified and validated using finite element simulation and experimental results. The experiment is used in conjunction with the model to calculate and verify the fracture toughness of Cu6Sn5 IMC materials. As expected two different IMC phases

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

NASA Astrophysics Data System (ADS)

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

2016-12-01

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

The Efficacy of Transverse Fixation and Early Exercise in the Treatment of Fourth Metacarpal Bone Fractures

PubMed Central

Moon, Suk-Ho; Kim, Hak-Soo; Jung, Sung-No

2016-01-01

Background Several techniques have been designed to treat fifth metacarpal fractures reported to be effective. However, these methods cannot be easily applied to the fourth metacarpal due to its central anatomical position. In this study, we sought to analyze the functional outcomes of patients who underwent transverse pinning for a fourth metacarpal bone fracture. Methods A total of 21 patients were selected and their charts were retrospectively reviewed. After fracture reduction, two transverse Kirchner wires were first inserted from the fifth metacarpal to the third metacarpal transversely at the distal part of the fractured bone, and then another two wires were inserted at the proximal part of the fractured bone. The splint was removed approximately one week postoperatively and the Kirchner wires were removed four to five weeks postoperatively. Patients started active and passive exercise one week after the operation. Pain visual analog scores, total active and passive motion, and the active and passive range of motion of the metacarpophalangeal joint and grip strength were evaluated. Results Dorsal angulation improved from a preoperative value of 44.2° to a postoperative value of 5.9°. Six weeks after surgery, functional recovery parameters, such as range of motion and grip strength, had improved to 98% of the function of the normal side. No major complication was observed. Conclusions We suggest that the transverse pinning of fourth metacarpal bone fractures is an effective treatment option that is less invasive than other procedures, easy to perform, requires no secondary surgery, minimizes joint and soft tissue injury, and allows early mobilization. PMID:27019812

Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method.