WorldWideScience

Sample records for fidelis lead fracture

  1. Comparison of Sprint Fidelis and Riata defibrillator lead failure rates.

    Science.gov (United States)

    Fazal, Iftikhar A; Shepherd, Ewen J; Tynan, Margaret; Plummer, Christopher J; McComb, Janet M

    2013-09-30

    Sprint Fidelis and Riata defibrillator leads are prone to early failure. Few data exist on the comparative failure rates and mortality related to lead failure. The aims of this study were to determine the failure rate of Sprint Fidelis and Riata leads, and to compare failure rates and mortality rates in both groups. Patients implanted with Sprint Fidelis leads and Riata leads at a single centre were identified and in July 2012, records were reviewed to ascertain lead failures, deaths, and relationship to device/lead problems. 113 patients had Sprint Fidelis leads implanted between June 2005 and September 2007; Riata leads were implanted in 106 patients between January 2003 and February 2008. During 53.0 ± 22.3 months of follow-up there were 13 Sprint Fidelis lead failures (11.5%, 2.60% per year) and 25 deaths. Mean time to failure was 45.1 ± 15.5 months. In the Riata lead cohort there were 32 deaths, and 13 lead failures (11.3%, 2.71% per year) over 54.8 ± 26.3 months follow-up with a mean time to failure of 53.5 ± 24.5 months. There were no significant differences in the lead failure-free Kaplan-Meier survival curve (p=0.77), deaths overall (p=0.17), or deaths categorised as sudden/cause unknown (p=0.54). Sprint Fidelis and Riata leads have a significant but comparable failure rate at 2.60% per year and 2.71% per year of follow-up respectively. The number of deaths in both groups is similar and no deaths have been identified as being related to lead failure in either cohort. Copyright © 2012. Published by Elsevier Ireland Ltd.

  2. Generator exchange is associated with an increased rate of Sprint Fidelis lead failure.

    Science.gov (United States)

    Lovelock, Joshua D; Patel, Ayesha; Mengistu, Andenet; Hoskins, Michael; El-Chami, Mikhael; Lloyd, Michael S; Leon, Angel; DeLurgio, David; Langberg, Jonathan J

    2012-10-01

    The Medtronic Sprint Fidelis defibrillator lead is at an increased risk for failure and was recalled in October 2007. Approximately 268,000 leads were implanted, and more than 100,000 patients still have active Fidelis leads. A number of studies have examined the rate and clinical predictors of lead failure, but none has addressed the effect of an implantable cardioverter-defibrillator generator exchange on subsequent lead failure. Although the manufacturer asserts that "Sprint Fidelis performance after device change-out is similar to lead performance without device change-out," published data are lacking. To assess the effect of implantable cardioverter-defibrillator generator exchange on the rate of Fidelis lead failure. A chart review was conducted in patients who underwent implantation of a Fidelis lead. Patients with a functioning Fidelis lead at generator exchange were compared with controls with leads implanted for a comparable amount of time not undergoing ICD replacement. A total of 1366 patients received a Fidelis lead prior to the recall, of which 479 were still actively followed. Seventy-two patients with a functioning lead underwent generator exchange without lead replacement. Following generator replacement, 15 leads failed. Sixty percent of the Fidelis leads failed within 3 months. Generator exchange increased the rate of lead failure compared with matched controls (20.8% vs 2.54%; P exchange is associated with a higher than expected rate of Fidelis lead failure, often within 3 months. The risk-benefit ratio of Fidelis lead replacement at the time of generator exchange may be greater than appreciated. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  3. Management of functional Sprint Fidelis leads at cardiac resynchronization therapy-defibrillator generator replacement: a novel option for preventing inappropriate shocks from lead failure in fragile patients with high risk of sudden death.

    Science.gov (United States)

    Zhu, Dennis W X; Chu, Matthew M; House, Chad M

    2017-12-01

    In patients with a functional Sprint Fidelis lead at generator replacement, the manufacturer recommended to either continue to use the existing lead or replace it with a new lead. For those patients who continue to use a functional Fidelis lead, the risk of inappropriate shocks remains present if the lead fails in the future. We evaluated the feasibility of an alternative approach at the time of cardiac resynchronization therapy-defibrillator (CRT-D) generator replacement in patients with a functional bipolar left ventricular (LV) lead for prevention of inappropriate shocks from future Fidelis lead failure. During the procedure, the pace/sense IS-1 connection pin of the functional Fidelis lead was intentionally inserted into the LV port of the new CRT-D generator, while the existing bipolar LV lead IS-1 connection pin was inserted into the right ventricular (RV) pace/sense port. After such switching, the existing bipolar LV lead was used for functional LV pacing/sensing, while the Fidelis lead was used for functional RV pacing and high voltage shock only and could no longer be used for the purpose of sensing and detecting. This approach precluded oversensing and inappropriate shocks should the functional Fidelis lead fail in the future. Six fragile patients, who were not considered suitable candidates for lead replacement, underwent the alternative approach. During a follow-up of 35 ± 23 months, the CRT-D system functioned normally in five patients. The Fidelis lead fractured in one patient 7 months after generator replacement. The malfunction was detected promptly and the defected lead was replaced. No inappropriate detections or shock was triggered. In CRT-D patients with a functional Fidelis lead and a bipolar LV lead, switching of the Fidelis lead pace/sense IS-1 pin with the bipolar LV lead IS-1 pin at generator replacement did not affect normal system function. This novel approach may be valuable in fragile patients with high risk of sudden death for

  4. 19 CFR 10.152 - Bona-fide gifts.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Bona-fide gifts. 10.152 Section 10.152 Customs... and Bona Fide Gifts § 10.152 Bona-fide gifts. Subject to the conditions in § 10.153 of this part, the port director shall pass free of duty and tax any article sent as a bona-fide gift from a person in a...

  5. 19 CFR 145.32 - Bona-fide gifts.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Bona-fide gifts. 145.32 Section 145.32 Customs... (CONTINUED) MAIL IMPORTATIONS Special Classes of Merchandise § 145.32 Bona-fide gifts. The port director... as bona-fide gifts from persons in foreign countries to persons in the United States having an...

  6. 42 CFR 433.54 - Bona fide donations.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Bona fide donations. 433.54 Section 433.54 Public... Financial Participation § 433.54 Bona fide donations. (a) A bona fide donation means a provider-related donation, as defined in § 433.52, made to the State or unit of local government, that has no direct or...

  7. Pacemaker lead fracture without an increase in lead impedance caused by cardiac fibroma

    Directory of Open Access Journals (Sweden)

    Daisuke Sato

    2013-12-01

    Full Text Available We report the case of a 64-year-old man who had a permanent pacemaker with a unipolar silicone electrode positioned in the right ventricle in 1989 for sinus node dysfunction. On a routine checkup in June 2011, a 28-mm-diameter mass was discovered, which appeared to adhere to the tricuspid valve and the ventricular lead. The size of the mass did not change for the next 6 months, and the lead impedance was maintained at around 500–600 Ω. Because pacing failure was observed in January 2012, he underwent an urgent pacemaker check; however, the lead impedance was found not to have increased greatly (689 Ω. Nevertheless, the pacemaker lead was noted to be fractured at the tricuspid level. His echocardiogram showed new severe tricuspid regurgitation and a floating mass around the lead. We extracted the fractured lead, enucleated the tumor, replaced the tricuspid valve, and placed an epicardial lead. Macroscopic examination revealed that the tumor surrounded the fractured lead and covered the stump. Pathological examination revealed that the tumor was composed of fibrous connective tissue. We presumed that electric current continued to flow through the stump of the fractured unipolar lead to the generator, and this might have caused the limited increase in lead impedance.

  8. A cost-effectiveness analysis of a proactive management strategy for the Sprint Fidelis recall: a probabilistic decision analysis model.

    Science.gov (United States)

    Bashir, Jamil; Cowan, Simone; Raymakers, Adam; Yamashita, Michael; Danter, Matthew; Krahn, Andrew; Lynd, Larry D

    2013-12-01

    The management of the recall is complicated by the competing risks of lead failure and complications that can occur with lead revision. Many of these patients are currently undergoing an elective generator change--an ideal time to consider lead revision. To determine the cost-effectiveness of a proactive management strategy for the Sprint Fidelis recall. We obtained detailed clinical outcomes and costing data from a retrospective analysis of 341 patients who received the Sprint Fidelis lead in British Columbia, where patients younger than 60 years were offered lead extraction when undergoing generator replacement. These population-based data were used to construct and populate a probabilistic Markov model in which a proactive management strategy was compared to a conservative strategy to determine the incremental cost per lead failure avoided. In our population, elective lead revisions were half the cost of emergent revisions and had a lower complication rate. In the model, the incremental cost-effectiveness ratio of proactive lead revision versus a recommended monitoring strategy was $12,779 per lead failure avoided. The proactive strategy resulted in 21 fewer failures per 100 patients treated and reduced the chance of an additional complication from an unexpected surgery. Cost-effectiveness analysis suggests that prospective lead revision should be considered when patients with a Sprint Fidelis lead present for pulse generator change. Elective revision of the lead is justified even when 25% of the population is operated on per year, and in some scenarios, it is both less costly and provides a better outcome. © 2013 Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.

  9. Pacemaker lead fracture associated with weightlifting: a report of two cases.

    Science.gov (United States)

    Deering, J A; Pederson, D N

    1993-12-01

    Two cases of pacemaker lead fracture associated with weight-lifting are presented. This is a rare association which has only recently been described in the literature. In both cases, the pacemaker lead was fractured between the clavicle and the first rib, suggesting crush injury. The chest X-ray, pacemaker telemetry with measurement of lead impedance, and pacemaker reprogramming were all helpful in management.

  10. Exploring key considerations when determining bona fide inadvertent errors resulting in understatements

    Directory of Open Access Journals (Sweden)

    Chrizanne de Villiers

    2016-03-01

    Full Text Available Chapter 16 of the Tax Administration Act (28 of 2011 (the TA Act deals with understatement penalties. In the event of an ‘understatement’, in terms of Section 222 of the TA Act, a taxpayer must pay an understatement penalty, unless the understatement results from a bona fide inadvertent error. The determining of a bona fide inadvertent error on taxpayers’ returns is a totally new concept in the tax fraternity. It is of utmost importance that this section is applied correctly based on sound evaluation principles and not on professional judgement when determining if the error was indeed the result of a bona fide inadvertent error. This research study focuses on exploring key considerations when determining bona fide inadvertent errors resulting in understatements. The role and importance of tax penalty provisions is explored and the meaning of the different components in the term ‘bona fide inadvertent error’ critically analysed with the purpose to find a possible definition for the term ‘bona fide inadvertent error’. The study also compares the provisions of other tax jurisdictions with regards to errors made resulting in tax understatements in order to find possible guidelines on the application of bona fide inadvertent errors as contained in Section 222 of the TA Act. The findings of the research study revealed that the term ‘bona fide inadvertent error’ contained in Section 222 of the TA Act should be defined urgently and that guidelines must be provided by SARS on the application of the new amendment. SARS should also clarify the application of a bona fide inadvertent error in light of the behaviours contained in Section 223 of the TA Act to avoid any confusion.

  11. The influence of lead length on the fractures associated with leading corners and sidings

    CSIR Research Space (South Africa)

    Turner, PA

    1989-02-01

    Full Text Available leading and lagging panels was found generally to extend further into the lagging panel with increasing lead length. Curves fitted to the data seem to be asymptotic to a limiting fracture extent of about 15 to 20 m. More information is needed on the siding...

  12. Fracture mechanisms in lead zirconate titanate ceramics

    International Nuclear Information System (INIS)

    Freiman, S.W.; Chuck, L.; Mecholsky, J.J.; Shelleman, D.L.

    1986-01-01

    Lead Zirconate Titanate (PZT) ceramics can be formed over a wide range of PbTiO 3 /PbZrO 3 ratios and exist in a number of crystal structures. This study involved the use of various fracture mechanics techniques to determine critical fracture toughness, K /SUB IC/ , as a function of composition, microstructure, temperature, and electrical and thermal history. The results of these experiments indicate that variations in K /SUB IC/ are related to phase transformations in the material as well as to other toughening mechanisms such as twinning and microcracking. In addition, the strength and fracture toughness of selected PZT ceramics were determined using specimens in which a crack was introduced by a Vicker's hardness indentor. The variation of K /SUB IC/ with composition and microstructure was related to the extent of twin-crack interaction. Comparison of the plot of strength as a function of indentation load with that predicted from indentation fracture models indicates the presence of internal stresses which contribute to failure. The magnitude of these internal stresses has been correlated with electrical properties of the ceramic. Fractographic analysis was used to determine the magnitude of internal stresses in specimens failing from ''natural flaws.''

  13. Fiat or bona fide boundary--a matter of granular perspective.

    Directory of Open Access Journals (Sweden)

    Lars Vogt

    Full Text Available Distinguishing bona fide (i.e. natural and fiat (i.e. artificial physical boundaries plays a key role for distinguishing natural from artificial material entities and is thus relevant to any scientific formal foundational top-level ontology, as for instance the Basic Formal Ontology (BFO. In BFO, the distinction is essential for demarcating two foundational categories of material entity: object and fiat object part. The commonly used basis for demarcating bona fide from fiat boundary refers to two criteria: (i intrinsic qualities of the boundary bearers (i.e. spatial/physical discontinuity, qualitative heterogeneity and (ii mind-independent existence of the boundary. The resulting distinction of bona fide and fiat boundaries is considered to be categorial and exhaustive.By Referring to various examples from biology, we demonstrate that the hitherto used distinction of boundaries is not categorial: (i spatial/physical discontinuity is a matter of scale and the differentiation of bona fide and fiat boundaries is thus granularity-dependent, and (ii this differentiation is not absolute, but comes in degrees. By reducing the demarcation criteria to mind-independence and by also considering dispositions and historical relations of the bearers of boundaries, instead of only considering their spatio-structural properties, we demonstrate with various examples that spatio-structurally fiat boundaries can nevertheless be mind-independent and in this sense bona fide.We argue that the ontological status of a given boundary is perspective-dependent and that the strictly spatio-structural demarcation criteria follow a static perspective that is ignorant of causality and the dynamics of reality. Based on a distinction of several ontologically independent perspectives, we suggest different types of boundaries and corresponding material entities, including boundaries based on function (locomotion, physiology, ecology, development, reproduction and common history

  14. 7 CFR 27.96 - Quotations in bona fide spot markets.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Quotations in bona fide spot markets. 27.96 Section 27... Differences § 27.96 Quotations in bona fide spot markets. The price or value and differences between the price... determined by the sale of spot cotton in such spot market. Quotations shall be determined and maintained in...

  15. DMPD: NOD-like receptors (NLRs): bona fide intracellular microbial sensors. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 18585455 NOD-like receptors (NLRs): bona fide intracellular microbial sensors. Shaw...tml) (.csml) Show NOD-like receptors (NLRs): bona fide intracellular microbial sensors. PubmedID 18585455 Ti...tle NOD-like receptors (NLRs): bona fide intracellular microbial sensors. Authors

  16. 78 FR 9330 - Revision of Regulations Defining Bona Fide Cotton Spot Markets

    Science.gov (United States)

    2013-02-08

    ... Cotton Spot Markets AGENCY: Agricultural Marketing Service, USDA. ACTION: Proposed rule. SUMMARY: The... bona fide cotton spot markets in order to assure consistency with the revised Cotton Research and Promotion Act. Updated bona fide spot market definitions will allow for published spot quotes to consider...

  17. 7 CFR 15a.61 - Sex as a bona-fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Sex as a bona-fide occupational qualification. 15a.61... RECEIVING OR BENEFITTING FROM FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs and Activities Prohibited § 15a.61 Sex as a bona-fide occupational...

  18. Oportere ex fide bona. Una construcción decisiva de la jurisprudencia romana

    Directory of Open Access Journals (Sweden)

    Javier Humberto Facco

    2013-07-01

    Full Text Available Verificada la secularización de la antigua fides, asistimos al surgimiento de una construcción cuya valencia técnica parece concretarse en el específico ámbito del proceso. La fides resulta adjetivada con el calificativo de bona. A partir de entonces el sintagma bona fides significará una característica procesal, una cualidad de ciertas acciones que en la intentio de su fórmula se estructuraban en base al oportere ex fide bona. El núcleo de estas acciones estaba representado por los contratos sinalagmáticos, cuya fuerza obligatoria se fundaba en el consentimiento y pertenecían a la órbita del comercio internacional (ius gentium. Con todo, al margen de su aplicación pretoriana, la cláusula quidquid dare facere oportet ex fide bona fue una elaboración eminentemente jurisprudencial, producto del ingenio de los juristas romanos. Fueron ellos quienes idearon buena parte de las soluciones sobre cuestiones ligadas a la eficacia de los contratos consensuales que todavía hoy se consideran emanaciones de la buena fe-lealtad. Recuperar la trascendencia del rol de los juristas en la tarea de hacer que el derecho sea adherente a la realidad constituye la principal invitación que nace de este escrito.

  19. Do cadmium, lead, and aluminum in drinking water increase the risk of hip fractures? A NOREPOS study.

    Science.gov (United States)

    Dahl, Cecilie; Søgaard, Anne Johanne; Tell, Grethe S; Flaten, Trond Peder; Hongve, Dag; Omsland, Tone Kristin; Holvik, Kristin; Meyer, Haakon E; Aamodt, Geir

    2014-01-01

    The aim of this study was to investigate relations between cadmium, lead, and aluminum in municipality drinking water and the incidence of hip fractures in the Norwegian population. A trace metals survey in 566 waterworks was linked geographically to hip fractures from hospitals throughout the country (1994-2000). In all those supplied from these waterworks, 5,438 men and 13,629 women aged 50-85 years suffered a hip fracture. Poisson regression models were fitted, adjusting for age, region of residence, urbanization, and type of water source as well as other possibly bone-related water quality factors. Effect modification by background variables and interactions between water quality factors were examined (correcting for false discovery rate). Men exposed to a relatively high concentration of cadmium (IRR = 1.10; 95 % CI 1.01, 1.20) had an increased risk of fracture. The association between relatively high lead and hip fracture risk was significant in the oldest age group (66-85 years) for both men (IRR = 1.11; 95 % CI 1.02, 1.21) and women (IRR = 1.10; 95 % CI 1.04, 1.16). Effect modification by degree of urbanization on hip fracture risk in men was also found for all three metals: cadmium, lead, and aluminum. In summary, a relatively high concentration of cadmium, lead, and aluminum measured in drinking water increased the risk of hip fractures, but the associations depended on gender, age, and urbanization degree. This study could help in elucidating the complex effects on bone health by risk factors found in the environment.

  20. 7 CFR 27.93 - Bona fide spot markets.

    Science.gov (United States)

    2010-01-01

    ... Southwest Markets and the New Mexico counties of Union, Quay, Curry, Roosevelt and Lea. Desert Southwest The..., Hudspeth and El Paso, all New Mexico counties except those included in the West Texas market, all counties... 7 Agriculture 2 2010-01-01 2010-01-01 false Bona fide spot markets. 27.93 Section 27.93...

  1. Fracture Mechanics Analyses of the Slip-Side Joggle Regions of Wing-Leading-Edge Panels

    Science.gov (United States)

    Raju, Ivatury S.; Knight, Norman F., Jr.; Song, Kyongchan; Phillips, Dawn R.

    2011-01-01

    The Space Shuttle wing-leading edge consists of panels that are made of reinforced carbon-carbon. Coating spallation was observed near the slip-side region of the panels that experience extreme heating. To understand this phenomenon, a root-cause investigation was conducted. As part of that investigation, fracture mechanics analyses of the slip-side joggle regions of the hot panels were conducted. This paper presents an overview of the fracture mechanics analyses.

  2. Fracture Mechanics Analyses of Reinforced Carbon-Carbon Wing-Leading-Edge Panels

    Science.gov (United States)

    Raju, Ivatury S.; Phillips, Dawn R.; Knight, Norman F., Jr.; Song, Kyongchan

    2010-01-01

    Fracture mechanics analyses of subsurface defects within the joggle regions of the Space Shuttle wing-leading-edge RCC panels are performed. A 2D plane strain idealized joggle finite element model is developed to study the fracture behavior of the panels for three distinct loading conditions - lift-off and ascent, on-orbit, and entry. For lift-off and ascent, an estimated bounding aerodynamic pressure load is used for the analyses, while for on-orbit and entry, thermo-mechanical analyses are performed using the extreme cold and hot temperatures experienced by the panels. In addition, a best estimate for the material stress-free temperature is used in the thermo-mechanical analyses. In the finite element models, the substrate and coating are modeled separately as two distinct materials. Subsurface defects are introduced at the coating-substrate interface and within the substrate. The objective of the fracture mechanics analyses is to evaluate the defect driving forces, which are characterized by the strain energy release rates, and determine if defects can become unstable for each of the loading conditions.

  3. 24 CFR 3.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Sex as a bona fide occupational... and Urban Development NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education...

  4. 38 CFR 23.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Sex as a bona fide... VETERANS AFFAIRS (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education...

  5. Fides: Lightweight Authenticated Cipher with Side-Channel Resistance for Constrained Hardware

    DEFF Research Database (Denmark)

    Bilgin, Begul; Bogdanov, Andrey; Knezevic, Miroslav

    2013-01-01

    In this paper, we present a novel lightweight authenticated cipher optimized for hardware implementations called Fides. It is an online nonce-based authenticated encryption scheme with authenticated data whose area requirements are as low as 793 GE and 1001 GE for 80-bit and 96-bit security...

  6. 45 CFR 2555.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Sex as a bona fide occupational qualification. 2555.550 Section 2555.550 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION... to such action is essential to successful operation of the employment function concerned. A recipient...

  7. 44 CFR 19.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Sex as a bona fide... MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in...

  8. 10 CFR 5.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational qualification. 5.550 Section 5.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in...

  9. 45 CFR 618.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Sex as a bona fide occupational qualification. 618.550 Section 618.550 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE... successful operation of the employment function concerned. A recipient shall not take action pursuant to this...

  10. 34 CFR 106.61 - Sex as a bona-fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Sex as a bona-fide occupational qualification. 106.61..., DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or...

  11. Comparing bona fide psychotherapies of depression in adults with two meta-analytical approaches.

    Directory of Open Access Journals (Sweden)

    Sarah R Braun

    Full Text Available OBJECTIVE: Despite numerous investigations, the question whether all bona fide treatments of depression are equally efficacious in adults has not been sufficiently answered. METHOD: We applied two different meta-analytical techniques (conventional meta-analysis and mixed treatment comparisons. Overall, 53 studies with 3,965 patients, which directly compared two or more bona fide psychotherapies in a randomized trial, were included. Meta-analyses were conducted regarding five different types of outcome measures. Additionally, the influence of possible moderators was examined. RESULTS: Direct comparisons of cognitive behavior therapy, behavior activation therapy, psychodynamic therapy, interpersonal therapy, and supportive therapies versus all other respective treatments indicated that at the end of treatment all treatments but supportive therapies were equally efficacious whereas there was some evidence that supportive therapies were somewhat less efficacious than all other treatments according to patient self-ratings and clinical significance. At follow-up no significant differences were present. Age, gender, comorbid mental disorders, and length of therapy session were found to moderate efficacy. Cognitive behavior therapy was superior in studies where therapy sessions lasted 90 minutes or longer, behavior activation therapy was more efficacious when therapy sessions lasted less than 90 minutes. Mixed treatment comparisons indicated no statistically significant differences in treatment efficacy but some interesting trends. CONCLUSIONS: This study suggests that there might be differential effects of bona fide psychotherapies which should be examined in detail.

  12. 17 CFR 240.16b-5 - Bona fide gifts and inheritance.

    Science.gov (United States)

    2010-04-01

    ... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Bona fide gifts and inheritance. 240.16b-5 Section 240.16b-5 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION... gifts and inheritance. Both the acquisition and the disposition of equity securities shall be exempt...

  13. 49 CFR 25.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Sex as a bona fide occupational qualification. 25... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 25.550 Sex as a...

  14. 29 CFR 36.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Sex as a bona fide occupational qualification. 36.550 Section 36.550 Labor Office of the Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in...

  15. 28 CFR 54.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Sex as a bona fide occupational... ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 54.550 Sex as a...

  16. 40 CFR 5.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 5.550 Sex as a...

  17. 6 CFR 17.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational qualification... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 17.550 Sex as a...

  18. 43 CFR 41.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 41.550 Sex as a...

  19. 45 CFR 86.61 - Sex as a bona-fide occupational qualification.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Sex as a bona-fide occupational qualification. 86... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 86.61 Sex as a...

  20. 31 CFR 28.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 28.550 Sex as a...

  1. Factors leading to tracheobronchial self-expandable metallic stent fracture.

    Science.gov (United States)

    Chung, Fu-Tsai; Lin, Shu-Min; Chen, Hao-Cheng; Chou, Chun-Liang; Yu, Chih-Teng; Liu, Chien-Ying; Wang, Chun-Hua; Lin, Horng-Chyuan; Huang, Chien-Da; Kuo, Han-Pin

    2008-11-01

    This retrospective study was to determine factors that contribute to self-expandable metallic stent fracture in patients with tracheobronchial disease. From 2001 to 2006, 139 patients (age, 62.1 +/- 15.4 years; range, 23-87 years) with benign (n = 62) and malignant (n = 77) tracheobronchial disease received 192 Ultraflex (Boston Scientific, Natick, Mass) self-expandable metallic stents (98 in patients with benign disease and 94 in patients with malignant disease). Seventeen fractured self-expandable metallic stents were found; the incidence was 12.2% (17/139 patients) among patients with tracheobronchial disease. Tortuous airway (odds ratio, 4.06; 95% confidence interval, 1.04-18.34; P = .04) independently predicted self-expandable metallic stent fracture. Most self-expandable metallic stent fractures (64.7%, 11/17) were detected 500 to 1000 days after self-expandable metallic stent implantation. Clinical presentations for patients with fractured self-expandable metallic stents included dyspnea exacerbation (70.6%, 12/17) and cough (23.5%, 4/17). Self-expandable metallic stent fracture is not uncommon in patients with tracheobronchial disease. Tortuous airway is an independent predictor for it. Although management of the fractured self-expandable metallic stent in our study was feasible and safe, self-expandable metallic stents should be restricted to a more select population.

  2. Reconstruction of the Terminal of an Abandoned Fractured Unipolar Coronary Sinus Lead: a Feasible Solution to Restore Effective Cardiac Resynchronization Therapy

    Directory of Open Access Journals (Sweden)

    Armando Gardini, MD

    2013-05-01

    Full Text Available Complications related to coronary sinus lead are not infrequent in recipients of cardiac resynchronization devices. We describe the case of a patient with a biventricular implantable cardioverter defibrillator with persistent phrenic nerve stimulation, previous coronary sinus lead fracture, and severe left subclavian vein stenosis. The reimplantation of a new coronary sinus lead on the left side, ipsilateral to the original implant, was unsuccessful. In order to avoid more complex and risky procedures, we performed the repair of the fractured abandoned lead with the reconstruction of the unipolar lead terminal. Effective biventricular pacing was obtained with satisfactory electrical parameters and it was maintained at twelve months follow-up.

  3. Phenomenology of leading nucleon production in e p collisions at HERA in the framework of fracture functions

    Science.gov (United States)

    Shoeibi, Samira; Taghavi-Shahri, F.; Khanpour, Hamzeh; Javidan, Kurosh

    2018-04-01

    In recent years, several experiments at the e-p collider HERA have collected high precision deep-inelastic scattering (DIS) data on the spectrum of leading nucleon carrying a large fraction of the proton's energy. In this paper, we have analyzed recent experimental data on the production of forward protons and neutrons in DIS at HERA in the framework of a perturbative QCD. We propose a technique based on the fractures functions framework, and extract the nucleon fracture functions (FFs) M2(n /p )(x ,Q2;xL) from global QCD analysis of DIS data measured by the ZEUS Collaboration at HERA. We have shown that an approach based on the fracture functions formalism allows us to phenomenologically parametrize the nucleon FFs. Considering both leading neutron as well as leading proton production data at HERA, we present the results for the separate parton distributions for all parton species, including valence quark densities, the antiquark densities, the strange sea distribution, and the gluon distribution functions. We proposed several parametrizations for the nucleon FFs and open the possibility of these asymmetries. The obtained optimum set of nucleon FFs is accompanied by Hessian uncertainty sets which allow one to propagate uncertainties to other observables interest. The extracted results for the t -integrated leading neutron F2LN (3 )(x ,Q2;xL) and leading proton F2LP (3 )(x ,Q2;xL) structure functions are in good agreement with all data analyzed, for a wide range of fractional momentum variable x as well as the longitudinal momentum fraction xL.

  4. 15 CFR 8a.550 - Sex as a bona fide occupational qualification.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Sex as a bona fide occupational... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Employment in Education Programs or Activities Prohibited § 8a.550 Sex as a...

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

    Science.gov (United States)

    Zhou, Jing

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

  6. 29 CFR 1625.12 - Exemption for bona fide executive or high policymaking employees.

    Science.gov (United States)

    2010-07-01

    ... corporations [or other business organizations] are usually located at corporate or regional headquarters. With respect to employees whose duties are associated with corporate headquarters operations, such as finance..., would be covered by the term “bona fide executive.” Individuals at higher levels in the corporate...

  7. 29 CFR 516.3 - Bona fide executive, administrative, and professional employees (including academic...

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Bona fide executive, administrative, and professional... outside sales employees employed pursuant to section 13(a)(1) of the Act. 516.3 Section 516.3 Labor... professional employees (including academic administrative personnel and teachers in elementary or secondary...

  8. Law and culture: a theory of comparative variation in bona fide purchase rules

    NARCIS (Netherlands)

    Dari-Mattiacci, G.; Guerriero, C.

    2015-01-01

    A key question in comparative law is why different legal systems provide different legal solutions for the same problem. To answer this question, we use novel comparative evidence on how the conflict between the dispossessed original owner and the bona fide purchaser of a stolen good is resolved in

  9. Fracture mechanisms in ferroelectric-ferroelastic lead zirconate titanate (Zr:Ti = 0.54:0.46) ceramics

    International Nuclear Information System (INIS)

    Mehta, K.; Virkar, A.V.

    1990-01-01

    Fracture toughness, K IC , of a single-phase commercial lead zirconate titanate (PZT) ceramic of tetragonal structure was measured using the single edge notched beam method above and below the Curie temperature. Domain switching (poling) under electrical and mechanical loading was examined using x-ray diffraction. Surface grinding, electrical poling, and mechanical poling caused crystallographic texture. Similar texture, indicative of domain switching, was also observed on fracture surfaces of some samples fractured at room temperature. At room temperature, the highest K IC measured was 1.85 MPa · m 1/2 , while above the Curie temperature it was about 1.0 MPa · m 1/2 . Cracks emanating from Vickers indents in poled samples were different in the poling and the transverse directions. The difference in crack sizes is explained on the basis of domain switching during crack growth. These results indicate that ferroelastic domain switching (twinning) is a viable toughening mechanism in the PZT materials tested

  10. Fracture of the styloid process associated with the mandible fracture

    Directory of Open Access Journals (Sweden)

    K N Dubey

    2013-01-01

    Full Text Available Fracture of the styloid process (SP of temporal bone is an uncommon injuries. Fracture of the SP can be associated with the facial injuries including mandible fracture. However, injury to the SP may be concealed and missed diagnosis may lead to the improper or various unnecessary treatments. A rare case of SP fracture associated with the ipsilateral mandibular fracture and also the diagnostic and management considerations of the SP fracture are discussed.

  11. On Improving Density Estimators which are not Bona Fide Functions

    OpenAIRE

    Gajek, Leslaw

    1986-01-01

    In order to improve the rate of decrease of the IMSE for nonparametric kernel density estimators with nonrandom bandwidth beyond $O(n^{-4/5})$ all current methods must relax the constraint that the density estimate be a bona fide function, that is, be nonnegative and integrate to one. In this paper we show how to achieve similar improvement without relaxing any of these constraints. The method can also be applied for orthogonal series, adaptive orthogonal series, spline, jackknife, and other ...

  12. Facial Fractures.

    Science.gov (United States)

    Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy

    2018-06-01

    The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.

  13. Double segmental tibial fractures - an unusual fracture pattern

    Directory of Open Access Journals (Sweden)

    Bali Kamal

    2012-02-01

    Full Text Available 【Abstract】A case of a 50-year-old pedestrian who was hit by a bike and suffered fractures of both bones of his right leg was presented. Complete clinical and radiographic assessment showed double segmental fractures of the tibia and multisegmental fractures of the fibula. Review of the literature revealed that this fracture pattern was unique and only a single case was reported so far. Moreover, we discussed the possible mechanisms which can lead to such an injury. We also discussed the management of segmental tibial fracture and the difficulties encountered with them. This case was managed by modern osteosynthesis tech- nique with a pleasing outcome. Key words: Fracture, bone; Tibia; Fibula; Nails

  14. Fides et ratio: An early enlightenment defence of non-confessional religion by poiret and his circle

    NARCIS (Netherlands)

    H.A. Krop (Henri)

    2010-01-01

    textabstractIn 1707 an anonymous collection of treatises Fides et ratio was published in Amsterdam. The voluminous work of several authors contains a fierce critique of Locke's notion of faith and the moderate Enlightenment's conception of a reasonable Christianity. The sympathiser with mystic

  15. Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures.

    Science.gov (United States)

    Sabo, Alex; Hatgis, Jesse; Granville, Michelle; Jacobson, Robert E

    2017-12-19

    Osteoporotic patients can present with either single or multiple fractures secondary to repeated falls and progressive osteoporosis. Multiple fractures often lead to additional spinal deformity and are a sign of more severe osteoporosis. In the thoracic spine, multiple fractures are associated with the development of gradual thoracic kyphosis but neurologic deficits are uncommon. In the lumbar spine, patients with multiple lumbar fractures have more constant lumbar pain, may have symptoms related to concurrent lumbar stenosis or degenerative scoliosis, and may present with radiculopathy, especially with fractures at L4 and L5. In a review of a series of patients with recurrent multiple lumbar fractures or 'cascading' fractures, it was found that all the patients were female, had severe osteoporosis, often untreated, had a previous history of multiple previous thoracic and lumbar fractures, and all had associated scoliotic spinal deformities ranging from 6 o to 50 o . It was found that if the curve progressed and the greater the degree of curvature, the more frequently subsequent multiple fractures developed, leading to recurrent acute episodes of pain. Forty percent also had additional sacral insufficiency fractures, an unusually high percentage. Biomechanically, the lumbar spine is both more mobile and supports a larger portion of the spinal load compared to the thoracic spine. The existence or worsening of a lumbar spinal deformity from degenerative lumbar scoliosis shifts the mechanical forces more to one side on already weakened osteoporotic lumbar vertebrae and sacrum, leading to an increased incidence of these fractures. Because of the chronic and uneven lower lumbar spinal load with severe vertebral osteoporosis in certain patients with repeat lumbar fractures and worsening degenerative lumbar scoliosis, there may be a rationale to add preventive vertebroplasty at adjacent vertebral endplates when treating acute recurrent lumbar fractures to decrease the

  16. Mechanics of Hydraulic Fractures

    Science.gov (United States)

    Detournay, Emmanuel

    2016-01-01

    Hydraulic fractures represent a particular class of tensile fractures that propagate in solid media under pre-existing compressive stresses as a result of internal pressurization by an injected viscous fluid. The main application of engineered hydraulic fractures is the stimulation of oil and gas wells to increase production. Several physical processes affect the propagation of these fractures, including the flow of viscous fluid, creation of solid surfaces, and leak-off of fracturing fluid. The interplay and the competition between these processes lead to multiple length scales and timescales in the system, which reveal the shifting influence of the far-field stress, viscous dissipation, fracture energy, and leak-off as the fracture propagates.

  17. Unstable ductile fracture conditions in upper shelf region

    International Nuclear Information System (INIS)

    Nakano, Yoshifumi; Kubo, Takahiro

    1985-01-01

    The phenomenon of unstability of ductile fracture in the upper shelf region of a forged steel for nuclear reactor pressure vessels A508 Cl. 3 was studied with a large compliance apparatus, whose spring constants were 100, 170 and 230 kgf/mm, at the test temperatures of 100, 200 and 300 0 C and at the loading rates of 2, 20 and 200 mm/min in the crosshead speed. The main results obtained are as follows: (1) The fracture modes of the specimens consisted of (a) stable fracture, (b) unstable fracture which leads to a complete fracture rapidly and (c) quasiunstable fracture which does not lead to a complete fracture though a rapid extension of ductile crack takes place. (2) Side groove, high temperature or small spring constant made a ductile crack more unstable. (3) High temperature or large spring constant made the occurrence of quasiunstable fracture easier. (4) Quasiunstable ductile fracture took place before the maximum load, that is, at the J integral value of about 10 kgf/mm. The initiation of a microscopic ductile crack, therefore, seems to lead to quasiunstable fracture. (5) The concept that unstable ductile fracture takes place when Tsub(app) exceeds Tsub(mat) seems applicable only to the case in which unstable ductile fracture takes place after the maximum load has been exceeded. (author)

  18. Pregnancy Associated Osteoporosis Leading to Vertebral Compression Fracture

    Directory of Open Access Journals (Sweden)

    Berke Aras

    2016-08-01

    Full Text Available To describe a patient with low back pain developed in the postpartum period and diagnosed as having vertebral compression fracture due to pregnancy and lactation associated osteoporosis. A 28-year old woman presented with complaints of low back pain started two months after her first delivery. Laboratory tests including bone mineral density (BMD, biochemical evaluation and lomber spinal magnetic resonance imaging (MRI was evaluated. Lomber spine BMD was extremely decreased: L2-4: 0,685 g/cm2, T-score -3.9, Z-score -3.9. MRI revealed a compression fracture of T12 vertebra. The patient was investigated in terms of all possible risk factors and hormonal pathology causing osteoporosis and no abnormality was found. So she was diagnosed as having pregnancy and associated osteoporosis. Cease of the lactation and the treatment with teriparatide were recommended to the patient but she refused both of them. Clinicians should take into account of pregnancy and lactation associated osteoporosis, when evaluating patients with low back pain in early postpartum period.

  19. Imaging of insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

    Krestan, Christian [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)], E-mail: christian.krestan@meduniwien.ac.at; Hojreh, Azadeh [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)

    2009-09-15

    This review focuses on the occurrence, imaging and differential diagnosis of insufficiency fractures. Prevalence, the most common sites of insufficiency fractures and their clinical implications are discussed. Insufficiency fractures occur with normal stress exerted on weakened bone. Postmenopausal osteoporosis is the most common cause of insufficiency fractures. Other conditions which affect bone turnover include osteomalacia, hyperparathyroidism, chronic renal failure and high-dose glucocorticoid therapy. It is a challenge for the radiologist to detect and diagnose insufficiency fractures, and to differentiate them from other bone lesions. Radiographs are still the most widely used imaging method for identification of insufficiency fractures, but sensitivity is limited, depending on the location of the fractures. Magnetic resonance imaging (MRI) is a very sensitive tool to visualize bone marrow abnormalities associated with insufficiency fractures. Thin section, multi-detector computed tomography (MDCT) depicts subtle fracture lines allowing direct visualization of cortical and trabecular bone. Bone scintigraphy still plays a role in detecting fractures, with good sensitivity but limited specificity. The most important differential diagnosis is underlying malignant disease leading to pathologic fractures. Bone densitometry and clinical history may also be helpful in confirming the diagnosis of insufficiency fractures.

  20. Rib fracture following stereotactic body radiotherapy: a potential pitfall.

    Science.gov (United States)

    Stanic, Sinisa; Boike, Thomas P; Rule, William G; Timmerman, Robert D

    2011-11-01

    Although the incidence of rib fractures after conventional radiotherapy is generally low (rib fractures are a relatively common complication of stereotactic body radiotherapy. For malignancy adjacent to the chest wall, the incidence of rib fractures after stereotactic body radiotherapy is as high as 10%. Unrecognized bone fractures can mimic bone metastases on bone scintigraphy, can lead to extensive workup, and can even lead to consideration of unnecessary systemic chemotherapy, as treatment decisions can be based on imaging findings alone. Nuclear medicine physicians and diagnostic radiologists should always consider rib fracture in the differential diagnosis.

  1. Vitamin D and Calcium Supplementation to Prevent Fractures

    Science.gov (United States)

    ... Fractures, or breaking a bone, are common among women who have gone through menopause. These fractures often lead to pain and disability, less independence, and a reduced quality of life. Fractures, especially ...

  2. Influence of perforation erosion on multiple growing hydraulic fractures in multi-stage fracturing

    Directory of Open Access Journals (Sweden)

    Yongming Li

    2018-02-01

    Full Text Available In multi-stage hydraulic fracturing, the limited-entry method is widely used to promote uniform growth of multiple fractures. However, this method's effectiveness may be lost because the perforations will be eroded gradually during the fracturing period. In order to study the influence of perforation erosion on multiple growing hydraulic fractures, we combined the solid–fluid coupled model of hydraulic fracture growth with an empirical model of perforation erosion to implement numerical simulation. The simulations show clearly that the erosion of perforation will significantly deteriorate the non-uniform growth of multiple fractures. Based on the numerical model, we also studied the influences of proppant concentration and injection rates on perforation erosion in multi-stage hydraulic fracturing. The results indicate that the initial erosion rates become higher with the rising proppant concentration, but the growth of multiple hydraulic fractures is not sensitive to the varied proppant concentration. In addition, higher injection rates are beneficial significantly to the limited-entry design, leading to more uniform growth of fractures. Thus, in multi-stage hydraulic fracturing enough high injection rates are proposed to keep uniform growths. Keywords: Unconventional oil and gas reservoir, Horizontal well, Perforation friction, Perforation erosion, Multi-stage hydraulic fracturing, Numerical simulation, Mathematic model, Uniform growth of fractures

  3. XFEM modeling of hydraulic fracture in porous rocks with natural fractures

    Science.gov (United States)

    Wang, Tao; Liu, ZhanLi; Zeng, QingLei; Gao, Yue; Zhuang, Zhuo

    2017-08-01

    Hydraulic fracture (HF) in porous rocks is a complex multi-physics coupling process which involves fluid flow, diffusion and solid deformation. In this paper, the extended finite element method (XFEM) coupling with Biot theory is developed to study the HF in permeable rocks with natural fractures (NFs). In the recent XFEM based computational HF models, the fluid flow in fractures and interstitials of the porous media are mostly solved separately, which brings difficulties in dealing with complex fracture morphology. In our new model the fluid flow is solved in a unified framework by considering the fractures as a kind of special porous media and introducing Poiseuille-type flow inside them instead of Darcy-type flow. The most advantage is that it is very convenient to deal with fluid flow inside the complex fracture network, which is important in shale gas extraction. The weak formulation for the new coupled model is derived based on virtual work principle, which includes the XFEM formulation for multiple fractures and fractures intersection in porous media and finite element formulation for the unified fluid flow. Then the plane strain Kristianovic-Geertsma-de Klerk (KGD) model and the fluid flow inside the fracture network are simulated to validate the accuracy and applicability of this method. The numerical results show that large injection rate, low rock permeability and isotropic in-situ stresses tend to lead to a more uniform and productive fracture network.

  4. Fracturing process and effect of fracturing degree on wave velocity of a crystalline rock

    Directory of Open Access Journals (Sweden)

    Charalampos Saroglou

    2017-10-01

    Full Text Available The present paper investigates the effect of fracturing degree on P- and S-wave velocities in rock. The deformation of intact brittle rocks under loading conditions is characterized by a microcracking procedure, which occurs due to flaws in their microscopic structure and propagates through the intact rock, leading to shear fracture. This fracturing process is of fundamental significance as it affects the mechanical properties of the rock and hence the wave velocities. In order to determine the fracture mechanism and the effect of fracturing degree, samples were loaded at certain percentages of peak strength and ultrasonic wave velocity was recorded after every test. The fracturing degree was recorded on the outer surface of the sample and quantified by the use of the indices P10 (traces of joints/m, P20 (traces of joints/m2 and P21 (length of fractures/m2. It was concluded that the wave velocity decreases exponentially with increasing fracturing degree. Additionally, the fracturing degree is described adequately with the proposed indices. Finally, other parameters concerning the fracture characteristics, rock type and scale influence were found to contribute to the velocity decay and need to be investigated further.

  5. Quantifying Discrete Fracture Network Connectivity in Hydraulic Fracturing Stimulation

    Science.gov (United States)

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

    2017-12-01

    Hydraulic fracture stimulations generally result in microseismicity that is associated with the activation or extension of pre-existing microfractures and discontinuities. Microseismic events acquired under 3D downhole sensor coverage provide accurate event locations outlining hydraulic fracture growth. Combined with source characteristics, these events provide a high quality input for seismic moment tensor inversion and eventually constructing the representative discrete fracture network (DFN). In this study, we investigate the strain and stress state, identified fracture orientation, and DFN connectivity and performance for example stages in a multistage perf and plug completion in a North American shale play. We use topology, the familiar concept in many areas of structural geology, to further describe the relationships between the activated fractures and their effectiveness in enhancing permeability. We explore how local perturbations of stress state lead to the activation of different fractures sets and how that effects the DFN interaction and complexity. In particular, we observe that a more heterogeneous stress state shows a higher percentage of sub-horizontal fractures or bedding plane slips. Based on topology, the fractures are evenly distributed from the injection point, with decreasing numbers of connections by distance. The dimensionless measure of connection per branch and connection per line are used for quantifying the DFN connectivity. In order to connect the concept of connectivity back to productive volume and stimulation efficiency, the connectivity is compared with the character of deformation in the reservoir as deduced from the collective behavior of microseismicity using robustly determined source parameters.

  6. Comprehensive evaluation of fracture critical bridges.

    Science.gov (United States)

    2014-02-01

    Two-girder steel bridges are classified as fracture critical bridges based on the definition given in the AASHTO LRFD Bridge Design Specifications. In a fracture critical bridge a failure of a tension member leads to collapse of the bridge. However, ...

  7. Semper Fidelis: Some Values of The Marine Retiree Group

    Directory of Open Access Journals (Sweden)

    Virienia Puspita

    2016-01-01

    Full Text Available This research tried to reveal the group values of Marine retiree Depok, which has done by using symbolic convergence theory as the main theory. The aims of this research were to find and identify fantasy themes, rhetorical vision and group values of Marine retiree group in Depok. This study was based on a foundation of interpretative paradigm with qualitative research methods to find a fantasy theme that emerged in the group through the method of analysis of fantasy by Bormann. The results of the this study indicate the stories of Marine retiree in Depok are the bridge of experience of Marine retiree in the past with present time. Besides that, it is the formation of behavior in forms of values, culture and communication behavior of them. From the analysis theme shows that the group values of Marine retiree in Depok has manifested by universal's idealism value of Marines Semper Fidelis (loyalty, sacrifice, dedication, pride and self esteem. The group rhetorical visions are pride of the group, desire for being accepted and close to their group's identity. 

  8. Generating Bona Fide Mammalian Prions with Internal Deletions.

    Science.gov (United States)

    Munoz-Montesino, Carola; Sizun, Christina; Moudjou, Mohammed; Herzog, Laetitia; Reine, Fabienne; Chapuis, Jérôme; Ciric, Danica; Igel-Egalon, Angelique; Laude, Hubert; Béringue, Vincent; Rezaei, Human; Dron, Michel

    2016-08-01

    Mammalian prions are PrP proteins with altered structures causing transmissible fatal neurodegenerative diseases. They are self-perpetuating through formation of beta-sheet-rich assemblies that seed conformational change of cellular PrP. Pathological PrP usually forms an insoluble protease-resistant core exhibiting beta-sheet structures but no more alpha-helical content, loosing the three alpha-helices contained in the correctly folded PrP. The lack of a high-resolution prion structure makes it difficult to understand the dynamics of conversion and to identify elements of the protein involved in this process. To determine whether completeness of residues within the protease-resistant domain is required for prions, we performed serial deletions in the helix H2 C terminus of ovine PrP, since this region has previously shown some tolerance to sequence changes without preventing prion replication. Deletions of either four or five residues essentially preserved the overall PrP structure and mutant PrP expressed in RK13 cells were efficiently converted into bona fide prions upon challenge by three different prion strains. Remarkably, deletions in PrP facilitated the replication of two strains that otherwise do not replicate in this cellular context. Prions with internal deletion were self-propagating and de novo infectious for naive homologous and wild-type PrP-expressing cells. Moreover, they caused transmissible spongiform encephalopathies in mice, with similar biochemical signatures and neuropathologies other than the original strains. Prion convertibility and transfer of strain-specific information are thus preserved despite shortening of an alpha-helix in PrP and removal of residues within prions. These findings provide new insights into sequence/structure/infectivity relationship for prions. Prions are misfolded PrP proteins that convert the normal protein into a replicate of their own abnormal form. They are responsible for invariably fatal neurodegenerative

  9. Displaced trochanteric fragments lead to poor functional outcome in pertrochanteric fractures treated by cephalomedullary nails.

    Science.gov (United States)

    Studer, Patrick; Suhm, Norbert; Wang, Qing; Rosenthal, Rachel; Saleh, Hatem Al-Fadel; Jakob, Marcel

    2015-12-01

    The importance of the greater trochanter and its attached abductor muscles for physiological gait is well accepted. However the influence of a displaced greater trochanter fracture after a pertrochanteric fracture is unknown. The aim of this study is to determine if there is an association between the greater trochanter position and the level of patient mobility following internal fixation of pertrochanteric fractures. One hundred and thirty-three consecutive elderly patients with a median age of 85 (interquartile range [IQR] 79-91) years, who were treated for pertrochanteric fractures at a level I trauma centre, were recruited. AO 31 A3.1 and A3.2 fracture types were excluded from the statistical analysis. Patient mobility was prospectively assessed before the fracture and one year following fracture treatment using the Parker mobility score. In a multivariable analysis, the influence of a displaced greater trochanter on patient mobility at one-year follow-up was assessed. The analysis was adjusted for age, gender, body mass index, Charlson comorbidity index, AO fracture classification, varus-/valgus malposition of the neck-shaft fragments, and Parker mobility score before fracture. Post-operative X-rays were available in 125 patients, out of which 66 (53%) patients were identified with a displaced or migrated greater trochanter. One year mortality rate was 22% (n=27). In the 82 patients who had functional assessment one year post-operatively, the median Parker mobility score before fracture and at one-year follow-up was 7 (IQR 4-9) and 7 (IQR 3-9) in patients without, and 7 (IQR 4-9) and 3 (IQR 2-5) in patients with a displaced greater trochanter. In multivariable analysis, a displaced greater trochanter was significantly associated with a lower Parker mobility score (-1.74, 95% confidence interval -2.37, -1.12, pfractures with a cephalomedullary nail is associated with a poor functional outcome. Greater attention to achieve adequate reduction and stabilisation

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

    Science.gov (United States)

    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.

  11. A missed injury leading to delayed diagnosis and postoperative infection of an unstable thoracic spine fracture - case report of a potentially preventable complication

    Directory of Open Access Journals (Sweden)

    Stahel Philip F

    2011-10-01

    Full Text Available Abstract Background Patients suffering from polytrauma often present with altered mental status and have varying levels of examinability. This makes evaluation difficult. Physicians are often required to rely on advanced imaging techniques to make prompt and accurate diagnoses. Occasionally, injury detection on advanced imaging studies can be challenging given the subtle findings associated with certain conditions, such as diffuse idiopathic skeletal hyperostosis (DISH. Delayed or missed diagnoses in the setting of spinal fracture can lead to catastrophic neurological injury. Case presentation A man struck by a motor vehicle suffered multiple traumatic injuries including numerous rib fractures, a mechanically unstable pelvic fracture, and also had suspicion for an aortic injury. Unfortunately, the upper thoracic segment (T1-5 was only visualized with axial images based on the electronic data. Several days later, a contrast CT scan obtained to check the status of suspected aortic injury revealed T3-T4 subluxation indicative of an unstable extension-type fracture in the setting of DISH. Due to the missed injury and delay in diagnosis, surgery was not performed until eight days after the injury. At surgery, the patient was found to have left T3-T4 facet joint infection as well as infected hematoma surrounding a left T4 transverse process fracture and a traumatic T4 costo-transverse joint fracture-subluxation. Despite presence of infection, an instrumented posterior spinal fusion from T1-T6 was performed and the patient recovered well after antibiotic treatment. Conclusion A T3-T4 unstable DISH extension-type fracture was initially missed in a polytrauma patient due to inadequate imaging acquisition, which caused a delay in treatment and bacterial seeding of fracture hematoma. Complete imaging is especially needed in obtunded patients that cannot be thoroughly examined.

  12. La Graeca fides e la falsità moscovitanel discorso polacco premoderno. Storia di un topos ["Graeca fides and the Perfidy of the Muscovites in the Polish Early Modern Discourse. History of a Topos "

    Directory of Open Access Journals (Sweden)

    Roman Krzywy

    2015-12-01

    Full Text Available "The article discusses the usage of the classical topos Graeca fides to describe the citizens of the Grand Duchy of Moscow in early modern Polish literature (chronicles, diaries, journalistic writings, diplomatic reports etc.. This way of speaking was justified by the identification of the Eastern Orthodox Church with the Greek Byzantine Rite. The formula was used to deprecate Russians and became part of a negative stereotype. The author demonstrates, with diverse examples, how this formula became a constant topos in statements about a country considered hostile in Poland since the 16th century, and in which contexts it was developed."

  13. [Diagnosis and management of zygomaticomaxillary complex fractures].

    Science.gov (United States)

    Xu, Bing; Zheng, Jia-wei; Shi, Jun

    2006-12-01

    The zygornaticomaxillarx complex (ZMC) plays an important role in maintaining the structure and function of the face. The prominent convex shape of the ZMC makes it particularly vulnerable to trauma, resulting in a tetrapod fracture involving all four buttresses. ZMC fracture usually leads to local depressed deformities, even dysfunction such as limited mouth opening and diplopia. This article lescribes the etiology, clinical features, surgical approaches and postoperative complications of ZMC fractures based on our own clinical experiences and literature review. It is believed that lateral brow incision combined with intraoral incision can provide better access to ZMC fractures and avoid the disadvantages caused by coronal incision. This surgical approach leaves minimal scar and injury to the facial nerve, with better esthetic and functional outcomes. Supported by Shanghai Leading Academic Discipline Project (Grant No. Y0203).

  14. Atypical femoral fractures related to bisphosphonate therapy

    Directory of Open Access Journals (Sweden)

    Tarun Pankaj Jain

    2012-01-01

    Full Text Available Bisphosphonates (BP are a commonly prescribed class of drugs for the prevention of osteoporosis-related fractures. Paradoxically, however, they have recently been linked to atypical fractures in the shaft of the femur. Since many physicians including radiologists, are not aware of this entity, the incidence is likely underreported. These fractures usually occur in the sub-trochanteric region of the femur in the setting of low-energy trauma. It starts as a fracture line involving the lateral cortex and then progresses medially to give rise to a complete fracture. The fracture line is usually transverse, and there is a medial spike associated with a complete fracture. These fractures can be bilateral. Awareness of these atypical fractures and their radiological appearance should enable their early and accurate detection and thus lead to specific treatment.

  15. U-shaped sacral fractures: Surgical treatment and quality of life

    NARCIS (Netherlands)

    Gribnau, A. J. G.; Boele van Hensbroek, P.; Haverlag, R.; Ponsen, K. J.; Been, H. D.; Goslings, J. C.

    2009-01-01

    Background: U-shaped sacral fractures are rare and highly unstable pelvic ring fractures. They are not recognised in the standard classification systems of these fractures. The fracture pattern is associated with significant neurological injury and can lead to progressive deformity and chronic pain

  16. Management of Hip Fractures in Lateral Position without a Fracture Table

    Directory of Open Access Journals (Sweden)

    Hamid Pahlavanhosseini

    2014-09-01

    Full Text Available Background:  Hip fracture Management in supine position on a fracture table with biplane fluoroscopic views has some difficulties which leads to prolongation of surgery and increasing x- rays’ dosage. The purpose of this study was to report the results and complications of hip fracture management in lateral position on a conventional operating table with just anteroposterior fluoroscopic view.  Methods:  40 hip fractures (31 trochanteric and 9 femoral neck fractures were operated in lateral position between Feb 2006 and Oct 2012. Age, gender, fracture classification, operation time, intra-operation blood loss, reduction quality, and complications were extracted from patients’ medical records. The mean follow-up time was 30.78±22.73 months (range 4-83. Results: The mean operation time was 76.50 ± 16.88 min (range 50 – 120 min.The mean intra-operative blood loss was 628.75 ± 275.00 ml (range 250-1300ml. Anatomic and acceptable reduction was observed in 95%of cases. The most important complications were malunion (one case in trochanteric group, avascular necrosis of oral head and nonunion (each one case in femoral neck group.  Conclusions:  It sounds that reduction and fixation of hip fractures in lateral position with fluoroscopy in just anteroposterior view for small rural hospitals may be executable and probably safe.

  17. Ontology of fractures

    Science.gov (United States)

    Zhong, Jian; Aydina, Atilla; McGuinness, Deborah L.

    2009-03-01

    Fractures are fundamental structures in the Earth's crust and they can impact many societal and industrial activities including oil and gas exploration and production, aquifer management, CO 2 sequestration, waste isolation, the stabilization of engineering structures, and assessing natural hazards (earthquakes, volcanoes, and landslides). Therefore, an ontology which organizes the concepts of fractures could help facilitate a sound education within, and communication among, the highly diverse professional and academic community interested in the problems cited above. We developed a process-based ontology that makes explicit specifications about fractures, their properties, and the deformation mechanisms which lead to their formation and evolution. Our ontology emphasizes the relationships among concepts such as the factors that influence the mechanism(s) responsible for the formation and evolution of specific fracture types. Our ontology is a valuable resource with a potential to applications in a number of fields utilizing recent advances in Information Technology, specifically for digital data and information in computers, grids, and Web services.

  18. Discovery of a new Galactic bona fide luminous blue variable with Spitzer★

    Science.gov (United States)

    Gvaramadze, V. V.; Kniazev, A. Y.; Berdnikov, L. N.; Langer, N.; Grebel, E. K.; Bestenlehner, J. M.

    2014-11-01

    We report the discovery of a circular mid-infrared shell around the emission-line star Wray 16-137 using archival data of the Spitzer Space Telescope. Follow-up optical spectroscopy of Wray 16-137 with the Southern African Large Telescope revealed a rich emission spectrum typical of the classical luminous blue variables (LBVs) like P Cygni. Subsequent spectroscopic and photometric observations showed drastic changes in the spectrum and brightness during the last three years, meaning that Wray 16-137 currently undergoes an S Dor-like outburst. Namely, we found that the star has brightened by ≈1 mag in the V and Ic bands, while its spectrum became dominated by Fe II lines. Taken together, our observations unambiguously show that Wray 16-137 is a new member of the family of Galactic bona fide LBVs.

  19. WS1: one more new Galactic bona fide luminous blue variable★

    Science.gov (United States)

    Kniazev, A. Y.; Gvaramadze, V. V.; Berdnikov, L. N.

    2015-04-01

    In this Letter, we report the results of spectroscopic and photometric monitoring of the candidate luminous blue variable (LBV) WS1, which was discovered in 2011 through the detection of a mid-infrared circular shell and follow-up optical spectroscopy of its central star. Our monitoring showed that WS1 brightened in the B, V and I bands by more than 1 mag during the last three years, while its spectrum revealed dramatic changes during the same time period, indicating that the star became much cooler. The light curve of WS1 demonstrates that the brightness of this star has reached maximum in 2013 December and then starts to decline. These findings unambiguously proved the LBV nature of WS1 and added one more member to the class of Galactic bona fide LBVs, bringing their number to sixteen (an updated census of these objects is provided).

  20. OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

    OpenAIRE

    Lokesh; Dayanand; Deepak; Hemanth

    2016-01-01

    INTRODUCTION Most of these fractures except intra-articular fractures are treated with interlocking nail. 1,2 These nails are a boon for these fractures. But as the fracture nears to the joint stability the fracture fixation will be compromised due to malreduction and alignment, it leads to increased chances of delayed and nonunion. 3 Locking anatomical plates are evaluated for anatomical and relative stability fixation. Since then most intra and near intra-articul...

  1. Thrombotic thrombocytopenic purpura presenting with pathologic fracture: a case report.

    Science.gov (United States)

    Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Unlu, Serkan; Ertem, Kadir; Nizam, Ilknur

    2014-08-01

    Thrombotic thrombocytopenic purpura is an acute syndrome with abnormalities in multiple organ systems, which becomes manifest with microangiopathic hemolytic anemia and thrombocytopenia. The hereditary or acquired deficiency of ADAMTS-13 activity leads to an excess of high molecular weight von Willebrand factor multimers in plasma, leading to platelet aggregation and diffuse intravascular thrombus formation, resulting in thrombotic thrombocytopenic purpura. Thrombotic lesions occurring in TTP leads to ischemia and convulsion. Depending on the properties of the bony tissue, fractures are divided into three groups as traumatic, pathological, and stress fractures. A pathologic fracture is a broken bone caused by disease leading to weakness of the bone. This process is most commonly due to osteoporosis, but may also be due to other pathologies such as cancer, infections, inherited bone disorders, or a bone cyst. We herein report a case with a pathologic fracture due to convulsion secondary to thrombotic thrombocytopenic pupura. Thrombotic lesions occurring in TTP may lead to ischemia and convulsion, as in our patient and pathological fractures presented in our case report may occur as a result of severe muscle contractions associated with convulsive activity. Thrombotic thrombocytopenic pupura is a disease that involves many organ systems and thus may have a very wide spectrum of clinical presentations. Copyright © 2014. Published by Elsevier Ltd.

  2. Fractured Petroleum Reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Firoozabadi, Dr. Abbas

    2000-01-18

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

  3. Scaphoid Fracture

    Directory of Open Access Journals (Sweden)

    Esther Kim, BS

    2018-04-01

    Full Text Available History of present illness: A 25-year-old, right-handed male presented to the emergency department with left wrist pain after falling from a skateboard onto an outstretched hand two-weeks prior. He otherwise had no additional concerns, including no complaints of weakness or loss of sensation. On physical exam, there was tenderness to palpation within the anatomical snuff box. The neurovascular exam was intact. Plain films of the left wrist and hand were obtained. Significant findings: The anteroposterior (AP plain film of this patient demonstrates a full thickness fracture through the middle third of the scaphoid (red arrow, with some apparent displacement (yellow lines and subtle angulation of the fracture fragments (blue line. Discussion: The scaphoid bone is the most commonly fractured carpal bone accounting for 70%-80% of carpal fractures.1 Classically, it is sustained following a fall onto an outstretched hand (FOOSH. Patients should be evaluated for tenderness with palpation over the anatomical snuffbox, which has a sensitivity of 100% and specificity of 40%.2 Plain films are the initial diagnostic modality of choice and have a sensitivity of 70%, but are commonly falsely negative in the first two to six weeks of injury (false negative of 20%.3 The Mayo classification organizes scaphoid fractures as involving the proximal, mid, and distal portions of the scaphoid bone with mid-fractures being the most common.3 The proximal scaphoid is highly susceptible to vascular compromise because it depends on retrograde blood flow from the radial artery. Therefore, disruption can lead to serious sequelae including osteonecrosis, arthrosis, and functional impairment. Thus, a low threshold should be maintained for neurovascular evaluation and surgical referral. Patients with non-displaced scaphoid fractures should be placed in a thumb spica splint.3 Patients with even suspected scaphoid fractures should be placed in a thumb spica splint and re

  4. Patient-reported outcomes in Danish implantable cardioverter defibrillator patients with a Sprint Fidelis lead advisory notification

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Versteeg, Henneke; Nielsen, Jens Cosedis

    2011-01-01

    Few studies have investigated the association between implantable cardioverter defibrillators (ICDs) and lead advisory notifications and patient-reported outcomes (PROs). We examined (i) whether the mode used to inform patients about a device advisory is associated with PROs, and (ii) whether...... patients with a lead subject to a device advisory report poorer PROs than non-advisory controls....

  5. The Influence of Hydraulic Fracturing on Carbon Storage Performance

    Science.gov (United States)

    Fu, Pengcheng; Settgast, Randolph R.; Hao, Yue; Morris, Joseph P.; Ryerson, Frederick J.

    2017-12-01

    Conventional principles of the design and operation of geologic carbon storage (GCS) require injecting CO2 below the caprock fracturing pressure to ensure the integrity of the storage complex. In nonideal storage reservoirs with relatively low permeability, pressure buildup can lead to hydraulic fracturing of the reservoir and caprock. While the GCS community has generally viewed hydraulic fractures as a key risk to storage integrity, a carefully designed stimulation treatment under appropriate geologic conditions could provide improved injectivity while maintaining overall seal integrity. A vertically contained hydraulic fracture, either in the reservoir rock or extending a limited height into the caprock, provides an effective means to access reservoir volume far from the injection well. Employing a fully coupled numerical model of hydraulic fracturing, solid deformation, and matrix fluid flow, we study the enabling conditions, processes, and mechanisms of hydraulic fracturing during CO2 injection. A hydraulic fracture's pressure-limiting behavior dictates that the near-well fluid pressure is only slightly higher than the fracturing pressure of the rock and is insensitive to injection rate and mechanical properties of the formation. Although a fracture contained solely within the reservoir rock with no caprock penetration, would be an ideal scenario, poroelastic principles dictate that sustaining such a fracture could lead to continuously increasing pressure until the caprock fractures. We also investigate the propagation pattern and injection pressure responses of a hydraulic fracture propagating in a caprock subjected to heterogeneous in situ stress. The results have important implications for the use of hydraulic fracturing as a tool for managing storage performance.

  6. Fracture Mechanics Analyses of the Slip-Side Joggle Regions of Wing-Leading Edge Panels

    Science.gov (United States)

    Raju, Ivatury S.; Knight, Norman F., Jr.; Song, Kyongchan; Phillips, Dawn R.

    2010-01-01

    The Space Shuttle Orbiter wing comprises of 22 leading edge panels on each side of the wing. These panels are part of the thermal protection system that protects the Orbiter wings from extreme heating that take place on the reentry in to the earth atmosphere. On some panels that experience extreme heating, liberation of silicon carbon (SiC) coating was observed on the slip side regions of the panels. Global structural and local fracture mechanics analyses were performed on these panels as a part of the root cause investigation of this coating liberation anomaly. The wing-leading-edge reinforced carbon-carbon (RCC) panels, Panel 9, T-seal 10, and Panel 10, are shown in Figure 1 and the progression of the stress analysis models is presented in Figure 2. The global structural analyses showed minimal interaction between adjacent panels and the T-seal that bridges the gap between the panels. A bounding uniform temperature is applied to a representative panel and the resulting stress distribution is examined. For this loading condition, the interlaminar normal stresses showed negligible variation in the chord direction and increased values in the vicinity of the slip-side joggle shoulder. As such, a representative span wise slice on the panel can be taken and the cross section can be analyzed using plane strain analysis.

  7. Functional Treatment of a Child with Extracapsular Mandibular Fracture

    Directory of Open Access Journals (Sweden)

    Diana Cassi

    2017-01-01

    Full Text Available Condylar fractures are among the most frequent fractures in the context of traumatic lesions of the face. The management of condylar fractures is still controversial, especially when fractures occur in children: if overlooked or inappropriately treated, these lesions may lead to severe sequelae, both cosmetic and functional. The therapy must be careful because severe long-term complications can occur. In this case report, the authors present a case of mandibular fracture in which the decision between surgical therapy and functional therapeutic regimen may be controversial due to the particular anatomy of the fracture line and the age of the patient.

  8. A Resource for the Transcriptional Signature of Bona Fide Trophoblast Stem Cells and Analysis of Their Embryonic Persistence

    Directory of Open Access Journals (Sweden)

    Georg Kuales

    2015-01-01

    Full Text Available Trophoblast stem cells (TSCs represent the multipotent progenitors that give rise to the different cells of the embryonic portion of the placenta. Here, we analysed the expression of key TSC transcription factors Cdx2, Eomes, and Elf5 in the early developing placenta of mouse embryos and in cultured TSCs and reveal surprising heterogeneity in protein levels. We analysed persistence of TSCs in the early placenta and find that TSCs remain in the chorionic hinge until E9.5 and are lost shortly afterwards. To define the transcriptional signature of bona fide TSCs, we used inducible gain- and loss-of-function alleles of Eomes or Cdx2, and EomesGFP, to manipulate and monitor the core maintenance factors of TSCs, followed by genome-wide expression profiling. Combinatorial analysis of resulting expression profiles allowed for defining novel TSC marker genes that might functionally contribute to the maintenance of the TSC state. Analyses by qRT-PCR and in situ hybridisation validated novel TSC- and chorion-specific marker genes, such as Bok/Mtd, Cldn26, Duox2, Duoxa2, Nr0b1, and Sox21. Thus, these expression data provide a valuable resource for the transcriptional signature of bona fide and early differentiating TSCs and may contribute to an increased understanding of the transcriptional circuitries that maintain and/or establish stemness of TSCs.

  9. Functional outcome of intra-articular tibial plateau fractures: the impact of posterior column fractures.

    Science.gov (United States)

    van den Berg, Juriaan; Reul, Maike; Nunes Cardozo, Menno; Starovoyt, Anastasiya; Geusens, Eric; Nijs, Stefaan; Hoekstra, Harm

    2017-09-01

    INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies. A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted. All fractures were reclassified and applied treatment was assessed according to the updated three-column concept. Relevant demographic and clinical variables were studied. The patient reported outcome was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). Median follow-up was 45.5 (IQR 24.9-66.2) months. Significant outcome differences between operatively and non-operatively treated patients were found for all KOOS subscales. The incidence of posterior column fractures was 61.9%. Posterior column fractures, sagittal malalignment and an increased complication rate were associated with poor outcome. Patients treated according to the updated three-column concept, showed significantly better outcome scores than those patients who were not. We could not demonstrate the advantage of posterior column fracture fixation, due to a limited patient size. Our data indicates that implementation of the updated three-column classification concept may improve the surgical outcome of tibial plateau fractures. Failure to recognize posterior column fractures may lead to inappropriate utilization of treatment techniques. The current concept allows us to further substantiate the importance of reduction and fixation of posterior column fractures with restoration of the sagittal alignment. 3.

  10. Fracture size and transmissivity correlations: Implications for transport simulations in sparse three-dimensional discrete fracture networks following a truncated power law distribution of fracture size

    Science.gov (United States)

    Hyman, J.; Aldrich, G. A.; Viswanathan, H. S.; Makedonska, N.; Karra, S.

    2016-12-01

    We characterize how different fracture size-transmissivity relationships influence flow and transport simulations through sparse three-dimensional discrete fracture networks. Although it is generally accepted that there is a positive correlation between a fracture's size and its transmissivity/aperture, the functional form of that relationship remains a matter of debate. Relationships that assume perfect correlation, semi-correlation, and non-correlation between the two have been proposed. To study the impact that adopting one of these relationships has on transport properties, we generate multiple sparse fracture networks composed of circular fractures whose radii follow a truncated power law distribution. The distribution of transmissivities are selected so that the mean transmissivity of the fracture networks are the same and the distributions of aperture and transmissivity in models that include a stochastic term are also the same.We observe that adopting a correlation between a fracture size and its transmissivity leads to earlier breakthrough times and higher effective permeability when compared to networks where no correlation is used. While fracture network geometry plays the principal role in determining where transport occurs within the network, the relationship between size and transmissivity controls the flow speed. These observations indicate DFN modelers should be aware that breakthrough times and effective permeabilities can be strongly influenced by such a relationship in addition to fracture and network statistics.

  11. SUPRACONDYLAR FRACTURE FEMUR T REATED WITH INTRAMEDULLARY NAIL : A PROSPECTIVE STUDY

    OpenAIRE

    Venkateswara Rao; Chaitanya; Anvesh

    2015-01-01

    BACKGROUND: Supracondylar fractures are one of the commonest fractures encountered in high velocity trauma which are associated with high morbidity and mortality . 1 Isolated fracture can itself lead to complications such as ARDS and pulmonary embo lism 1 . This necessitates early stabilization of fractures. Internal fixation is the choice of treatment in supracondylar fractures (AO type – A) . 2 Retrograde supracondylar nail has shown to giv...

  12. Thoracolumbar spine fractures in the geriatric fracture center : early ambulation leads to good results on short term and is a successful and safe alternative compared to immobilization in elderly patients with two-column vertebral fractures

    NARCIS (Netherlands)

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

    INTRODUCTION: Thoracolumbar spine fractures are common osteoporotic fractures among elderly patients. Several studies suggest that these fractures can be treated successfully with a nonoperative management. The aim of this study is to evaluate the conservative treatment of elderly patients with a

  13. Mixing induced reactive transport in fractured crystalline rocks

    International Nuclear Information System (INIS)

    Martinez-Landa, Lurdes; Carrera, Jesus; Dentz, Marco; Fernàndez-Garcia, Daniel; Nardí, Albert; Saaltink, Maarten W.

    2012-01-01

    In this paper the solute retention properties of crystalline fractured rocks due to mixing-induced geochemical reactions are studied. While fractured media exhibit paths of fast flow and transport and thus short residence times for conservative solutes, at the same time they promote mixing and dilution due to strong heterogeneity, which leads to sharp concentration contrasts. Enhanced mixing and dilution have a double effect that favors crystalline fractured media as a possible host medium for nuclear waste disposal. Firstly, peak radionuclide concentrations are attenuated and, secondly, mixing-induced precipitation reactions are enhanced significantly, which leads to radionuclide immobilization. An integrated framework is presented for the effective modeling of these flow, transport and reaction phenomena, and the interaction between them. In a simple case study, the enhanced dilution and precipitation potential of fractured crystalline rocks are systematically studied and quantified and contrasted it to retention and attenuation in an equivalent homogeneous formation.

  14. Lower limb fractures associated with multiligament knee injury

    Science.gov (United States)

    Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

    2017-01-01

    Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of ligament injuries. Methods: A retrospective search was conducted from our hospital´s electronic database. We evaluated the initial diagnosis and acute surgical treatment, and management and functional outcomes after the ligament lesion was diagnosed. Results: Seven patients who presented a knee multiligament injury associated with a lower limb fracture were evaluated. The average age was 29 years. Primary diagnoses were: four tibial plateau fractures; one open fracture-dislocation of the knee; one open leg fracture and ipsilateral hip dislocation; and one bifocal femur fracture. Only three patients had an MRI during the initial management of trauma. Six out of seven patients had to be operated on for the multiligament knee injury. The period between the resolution of the fracture and the ligamentous repair was from 3 to 24 months. Conclusion: Poor functional outcomes are reported in patients with multiligament knee injuries associated with high-energy lower limb fractures. We consider an MRI during the initial management can lead to better outcomes. A trauma surgeon working alongside an arthroscopic surgeon might optimize the results for these lesions.

  15. Identification of fracture zones and its application in automatic bone fracture reduction.

    Science.gov (United States)

    Paulano-Godino, Félix; Jiménez-Delgado, Juan J

    2017-04-01

    The preoperative planning of bone fractures using information from CT scans increases the probability of obtaining satisfactory results, since specialists are provided with additional information before surgery. The reduction of complex bone fractures requires solving a 3D puzzle in order to place each fragment into its correct position. Computer-assisted solutions may aid in this process by identifying the number of fragments and their location, by calculating the fracture zones or even by computing the correct position of each fragment. The main goal of this paper is the development of an automatic method to calculate contact zones between fragments and thus to ease the computation of bone fracture reduction. In this paper, an automatic method to calculate the contact zone between two bone fragments is presented. In a previous step, bone fragments are segmented and labelled from CT images and a point cloud is generated for each bone fragment. The calculated contact zones enable the automatic reduction of complex fractures. To that end, an automatic method to match bone fragments in complex fractures is also presented. The proposed method has been successfully applied in the calculation of the contact zone of 4 different bones from the ankle area. The calculated fracture zones enabled the reduction of all the tested cases using the presented matching algorithm. The performed tests show that the reduction of these fractures using the proposed methods leaded to a small overlapping between fragments. The presented method makes the application of puzzle-solving strategies easier, since it does not obtain the entire fracture zone but the contact area between each pair of fragments. Therefore, it is not necessary to find correspondences between fracture zones and fragments may be aligned two by two. The developed algorithms have been successfully applied in different fracture cases in the ankle area. The small overlapping error obtained in the performed tests

  16. Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation.

    Science.gov (United States)

    Lujan, Trevor J; Henderson, Chris E; Madey, Steven M; Fitzpatrick, Dan C; Marsh, J Lawrence; Bottlang, Michael

    2010-03-01

    Locked plating constructs may be too stiff to reliably promote secondary bone healing. This study used a novel imaging technique to quantify periosteal callus formation of distal femur fractures stabilized with locking plates. It investigated the effects of cortex-to-plate distance, bridging span, and implant material on periosteal callus formation. Retrospective cohort study. One Level I and one Level II trauma center. Sixty-four consecutive patients with distal femur fractures (AO types 32A, 33A-C) stabilized with periarticular locking plates. Osteosynthesis using indirect reduction and bridge plating with periarticular locking plates. Periosteal callus size on lateral and anteroposterior radiographs. Callus size varied from 0 to 650 mm2. Deficient callus (20 mm2 or less) formed in 52%, 47%, and 37% of fractures at 6, 12, and 24 weeks postsurgery, respectively. Callus formation was asymmetric, whereby the medial cortex had on average 64% more callus (P=0.001) than the anterior or posterior cortices. A longer bridge span correlated minimally with an increased callus size at Week 6 (P=0.02), but no correlation was found at Weeks 12 and 24 postsurgery. Compared with stainless steel plates, titanium plates had 76%, 71%, and 56% more callus at Week 6 (P=0.04), Week 12 (P=0.03), and Week 24 (P=0.09), respectively. Stabilization of distal femur fractures with periarticular locking plates can cause inconsistent and asymmetric formation of periosteal callus. A larger bridge span only minimally improves callus formation. The more flexible titanium plates enhanced callus formation compared with stainless steel plates.

  17. Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women

    DEFF Research Database (Denmark)

    Rud, Bo; Greibe, Rasmus; Hyldstrup, Lars

    2005-01-01

    In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture t......, and it emphasizes the need to decide on a local level how to provide osteoporosis follow-up for women with fragility fractures. Udgivelsesdato: 2005 Spring......In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture...... to a Danish emergency department during a 1-yr period were followed up for osteoporosis. We performed a retrospective review of hospital records and we sent the women and their general practitioners (GPs) questionnaires regarding the follow-up undertaken in primary care. Finally, we invited the women...

  18. Hertel 7 fracture of the humeral head. Can two different fixation systems (Diphos/PHP) lead to different outcomes? A retrospective study.

    Science.gov (United States)

    Gumina, S; Baudi, P; Candela, V; Campochiaro, G

    2016-10-01

    To compare clinical outcomes and complication rates in the medium-to-long-term follow-up of Hertel 7 humeral head fractures treated with two different locking plates. A total of 52 patients with type 7 humeral head fracture (in accordance with Hertel classification) were enrolled retrospectively: 24 patients [4 male, 20 female; mean age (standard deviation [SD]): 68.9 (5.8) years] were treated with Diphos H plate (Group A) and 28 patients [6 male, 22 female; mean age (SD): 61.0 (7.5) years] with Proximal Humeral Plate (PHP; Group B). The mean follow-up periods were 25.6 and 18.9 months, respectively. Functional outcomes were assessed using the Constant score and Disabilities of the Arm, Shoulder and Hand (DASH) score; X-ray evaluation was also performed and complications were recorded. The mean Constant score in the Diphos and PHP groups at follow-up were 75.6 (SD 13.4) and 78.9 (SD 12.8), respectively (p>0.05). The DASH score was similar in both groups (Diphos: 18.6, range 0-51.5; PHP: 16.8, range 0-47.8) (p>0.05). In our series, 9.6% of patients had complications; these included a case of aseptic non-union and a case of avascular necrosis of the humeral head in each group, and a secondary screw perforation in a patient treated with Diphos. In patients with Hertel 7 proximal humeral fractures, Diphos and PHP lead to similar satisfactory functional outcomes and are associated with low complication rates; this confirms that both are useful implants for the treatment of this pattern of fracture. Copyright © 2016. Published by Elsevier Ltd.

  19. New C2 synchondrosal fracture classification system

    Energy Technology Data Exchange (ETDEWEB)

    Rusin, Jerome A.; Ruess, Lynne [Department of Radiology, Nationwide Children' s Hospital, Columbus, OH (United States); The Ohio State University College of Medicine and Public Health, Columbus, OH (United States); Daulton, Robert S. [Department of Radiology, Nationwide Children' s Hospital, Columbus, OH (United States)

    2015-06-15

    Excessive cervical flexion-extension accompanying mild to severe impact injuries can lead to C2 synchondrosal fractures in young children. To characterize and classify C2 synchondrosal fracture patterns. We retrospectively reviewed imaging and medical records of children who were treated for cervical spine fractures at our institution between 1995 and 2014. We reviewed all fractures involving the five central C2 synchondroses with regard to patient demographics, mechanism of injury, fracture pattern, associated fractures and other injuries, treatment plans and outcome. Fourteen children had fractures involving the central C2 synchondroses. There were nine boys and five girls, all younger than 6 years. We found four distinct fracture patterns. Eleven complete fractures were further divided into four subtypes (a, b, c and d) based on degree of anterior displacement of the odontoid segment and presence of distraction. Nine of these 11 children had fractures through both odontoneural synchondroses and the odontocentral synchondrosis; one had fractures involving both neurocentral synchondroses and the odontoneural synchondrosis; one had fractures through bilateral odontoneural and bilateral neurocentral synchondroses. Three children had incomplete fractures, defined as a fracture through a single odontoneural synchondrosis with or without partial extension into either the odontocentral or the adjacent neurocentral synchondroses. All complete fractures were displaced or angulated. Four had associated spinal cord injury, including two contusions (subtype c fractures) and two fatal transections (subtype d fractures). Most children were treated with primary halo stabilization. Subtype c fractures required surgical fixation. We describe four patterns of central C2 synchondrosal fractures, including two unique patterns that have not been reported. We propose a classification system to distinguish these fractures and aid in treatment planning. (orig.)

  20. Acidization of shales with calcite cemented fractures

    Science.gov (United States)

    Kwiatkowski, Kamil; Szymczak, Piotr; Jarosiński, Marek

    2017-04-01

    Investigation of cores drilled from shale formations reveals a relatively large number of calcite-cemented fractures. Usually such fractures are reactivated during fracking and can contribute considerably to the permeability of the resulting fracture network. However, calcite coating on their surfaces effectively excludes them from production. Dissolution of the calcite cement by acidic fluids is investigated numerically with focus on the evolution of fracture morphology. Available surface area, breakthrough time, and reactant penetration length are calculated. Natural fractures in cores from Pomeranian shale formation (northern Poland) were analyzed and classified. Representative fractures are relatively thin (0.1 mm), flat and completely sealed with calcite. Next, the morphology evolution of reactivated natural fractures treated with low-pH fluids has been simulated numerically under various operating conditions. Depth-averaged equations for fracture flow and reactant transport has been solved by finite-difference method coupled with sparse-matrix solver. Transport-limited dissolution has been considered, which corresponds to the treatment with strong acids, such as HCl. Calcite coating in reactivated natural fractures dissolves in a highly non-homogeneous manner - a positive feedback between fluid transport and calcite dissolution leads to the spontaneous formation of wormhole-like patterns, in which most of the flow is focused. The wormholes carry reactive fluids deeper inside the system, which dramatically increases the range of the treatment. Non-uniformity of the dissolution patterns provides a way of retaining the fracture permeability even in the absence of the proppant, since the less dissolved regions will act as supports to keep more dissolved regions open. Evolution of fracture morphology is shown to depend strongly on the thickness of calcite layer - the thicker the coating the more pronounced wormholes are observed. However the interaction between

  1. Acute ST-Elevation Myocardial Infarction after Coronary Stent Fracture.

    Science.gov (United States)

    Rafighdust, Abbasali; Eshraghi, Ali

    2015-10-27

    The invention of the drug-eluting stent (DES) has brought about revolutionary changes in the field of interventional cardiology. In the DES era, in-stent restenosis has declined but new issues such as stent thrombosis have emerged. One of the emerging paradigms in the DES era is stent fracture. There are reports about stent fracture leading to in-stent restenosis or stent thrombosis. Most of these reports concern the Sirolimus-eluting stent. The present case is a representation of a Biolimus-eluting stent fracture. We introduce a 64-year-old male patient, for whom the BioMatrix stent was deployed in the right coronary artery. Five months after the implantation, he experienced acute myocardial infarction, with stent fracture leading to stent thrombosis being the causative mechanism. Another DES (Cypher) was used to manage this situation, and the final result was good.

  2. acute compartment syndrome of the thigh without associated fracture

    African Journals Online (AJOL)

    FRACTURE: A CASE REPORT. C.K. Lakati, FCS ... fracture leading to failure to appreciate the severity of the injury. ... complaining of pain on the lower part of his right thigh, just above .... reported good recovery after non-operative treatment.

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

    Science.gov (United States)

    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.

  4. Tuning Fractures With Dynamic Data

    Science.gov (United States)

    Yao, Mengbi; Chang, Haibin; Li, Xiang; Zhang, Dongxiao

    2018-02-01

    Flow in fractured porous media is crucial for production of oil/gas reservoirs and exploitation of geothermal energy. Flow behaviors in such media are mainly dictated by the distribution of fractures. Measuring and inferring the distribution of fractures is subject to large uncertainty, which, in turn, leads to great uncertainty in the prediction of flow behaviors. Inverse modeling with dynamic data may assist to constrain fracture distributions, thus reducing the uncertainty of flow prediction. However, inverse modeling for flow in fractured reservoirs is challenging, owing to the discrete and non-Gaussian distribution of fractures, as well as strong nonlinearity in the relationship between flow responses and model parameters. In this work, building upon a series of recent advances, an inverse modeling approach is proposed to efficiently update the flow model to match the dynamic data while retaining geological realism in the distribution of fractures. In the approach, the Hough-transform method is employed to parameterize non-Gaussian fracture fields with continuous parameter fields, thus rendering desirable properties required by many inverse modeling methods. In addition, a recently developed forward simulation method, the embedded discrete fracture method (EDFM), is utilized to model the fractures. The EDFM maintains computational efficiency while preserving the ability to capture the geometrical details of fractures because the matrix is discretized as structured grid, while the fractures being handled as planes are inserted into the matrix grids. The combination of Hough representation of fractures with the EDFM makes it possible to tune the fractures (through updating their existence, location, orientation, length, and other properties) without requiring either unstructured grids or regridding during updating. Such a treatment is amenable to numerous inverse modeling approaches, such as the iterative inverse modeling method employed in this study, which is

  5. Fracture behaviour of the 14Cr ODS steel exposed to helium and liquid lead

    Science.gov (United States)

    Hojna, Anna; Di Gabriele, Fosca; Hadraba, Hynek; Husak, Roman; Kubena, Ivo; Rozumova, Lucia; Bublikova, Petra; Kalivodova, Jana; Matejicek, Jiri

    2017-07-01

    This work describes the fracture behaviour of the 14Cr ODS steel produced by mechanical alloying process, after high temperature exposures. Small specimens were exposed to helium gas in a furnace at 720 °C for 500 h. Another set of specimens was exposed to flowing liquid lead in the COLONRI II loop at 650 °C for 1000 h. All specimens were tested for the impact and tensile behaviour. The impact test results are compared to other sets of specimens in the as received state and after isothermal annealing at 650 °C for 1000 h. The impact curves of the exposed materials showed positive shifts on the transition temperature. While the upper shelf value did not change in the Pb exposed ODS steel, it significantly increased in the He exposed one. The differences are discussed in terms of surface and subsurface microscopy observation. The embrittlement can be explained as the effect of a slight change in the grain boundary and size distribution combined with the depletion of sub-surface region from alloying elements forming oxide scale on the surface.

  6. Stress generation and hierarchical fracturing in reactive systems

    Science.gov (United States)

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

    2007-12-01

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

  7. Circumstances leading to injurious falls in older men and women in the Netherlands.

    Science.gov (United States)

    Boyé, Nicole D A; Mattace-Raso, Francesco U S; Van der Velde, Nathalie; Van Lieshout, Esther M M; De Vries, Oscar J; Hartholt, Klaas A; Kerver, Albert J H; Bruijninckx, Milko M M; Van der Cammen, Tischa J M; Patka, Peter; Van Beeck, Ed F

    2014-08-01

    Fall-induced injuries in persons aged 65 years and older are a major public health problem. Data regarding circumstances leading to specific injuries, such as traumatic brain injury (TBI) and hip fractures in older adults are scarce. To investigate the activity distributions leading to indoor and outdoor falls requiring an emergency department (ED) visit, and those resulting in TBIs and hip fractures. 5880 older adults who visited the ED due to a fall. Data is descriptive and stratified by age and gender. Two-thirds of all falls occurred indoors. However, there were higher proportions of outdoor falls at ages 65-79 years (48%). Walking up or down stairs (51%) and housekeeping (17%) were the most common indoor activities leading to a TBIs. Walking (42%) and sitting or standing (16%) was the most common indoor activities leading to a hip fracture. The most common outdoor activities were walking (61% for TBIs and 57% for hip fractures) and cycling (10% for TBIs and 24% for hip fractures). In the present study we found that the indoor activities distribution leading to TBIs and hip fractures differed. Notably, about half of the traumatic brain injuries and hip fractures in men and women aged 65-79 years occurred outdoors. This study provides new insights into patterns leading to injurious falls by age, gender and injury type, and may guide the targeting of falls prevention at specific activities and risk groups, including highly functional older men and women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Gas-driven fracture propagation

    International Nuclear Information System (INIS)

    Nilson, R.H.

    1981-10-01

    A one-dimensional gas-flow drives a wedge-shaped fracture into a linearly elastic, impermeable half-space which is in uniform compression, sigma/sub infinity/, at infinity. Under a constant driving pressure, p 0 , the fracture/flow system accelerates through a sequence of three self-similar asymptotic regimes (laminar, turbulent, inviscid) in which the fracture grows like an elementary function of time (exponential, near-unity power, and linear; respectively). In each regime, the transport equations are reducible under a separation-of-variables transformation. The integro-differential equations which describe the viscous flows are solved by iterative shooting-methods using expansion techniques to accommodate a zero-pressure singularity at the leading edge of the flow. These numerical results are complemented by an asymptotic analysis for large pressure ratio (N = p 0 /sigma/sub infinity/ → infinity) which exploits the disparity between the fracture-length and penetration-length of the flow. The considered prototypic problem has geologic applications: containment evaluation of underground nuclear tests, explosive stimulation of oil and gas wells, and explosive permeability-enhancement prior to in-situ combustion of coal or oil-shale

  9. Guesstimation of posterior malleolar fractures on lateral plain radiographs

    NARCIS (Netherlands)

    Meijer, D. T.; Doornberg, J. N.; Sierevelt, I. N.; Mallee, W. H.; van Dijk, C. N.; Kerkhoffs, G. M.; Stufkens, S. A.; Palmanovich, Ezequiel; van Sterkenburg, Maayke; Engvall, Andreas; Arroyo, Ernesto; Golovakha, Maksym; Pereira, Ernesto; Josep Torrent, Eugene Toh; Haverkamp, Daniel; Bojanic, Ivan; Sousa, Manuel; Aragon, Oscar Castro; Russo, Alessandro; Cortes, Carlos; Pánics, Gergely; Vide, João; Spanos, Loannis; Carvalho, Manuel Santos; Maggi, Pablo; Thomas, Zach; Tanaka, Hirofumi; Dinato, Mauro; Fay, Jakob; Kimtys, Vytautas; Correia Moreira, António José; Hatziemmanuil, Dimitrios; Low, Tze-Choong; van der Plaat, Laurens Wessel; Mora, Allan David; van Rensen, Inge; del Vecchio, Javier; Ramos, James; Azevedo, Jorge; Bustamante, Carlos; Oliveira, Alexandre; Zaw, Htwe; Kurup, Harish; Yli-Kyyny, Tero; Baca, Emre; Haapasalo, Heidi; Bakhtamyan, Gurgen; Zbikowski, Piotr; van den Bekerom, Michel; de Muinck Keizer, Robert-Jan

    2015-01-01

    Accurate assessment of articular involvement of the posterior malleolar fracture fragments in ankle fractures is essential, as this is the leading argument for internal fixation. The purpose of this study is to assess diagnostic accuracy of measurements on plain lateral radiographs. Quantification

  10. Hydromechanical modeling of clay rock including fracture damage

    Science.gov (United States)

    Asahina, D.; Houseworth, J. E.; Birkholzer, J. T.

    2012-12-01

    Argillaceous rock typically acts as a flow barrier, but under certain conditions significant and potentially conductive fractures may be present. Fracture formation is well-known to occur in the vicinity of underground excavations in a region known as the excavation disturbed zone. Such problems are of particular importance for low-permeability, mechanically weak rock such as clays and shales because fractures can be relatively transient as a result of fracture self-sealing processes. Perhaps not as well appreciated is the fact that natural fractures can form in argillaceous rock as a result of hydraulic overpressure caused by phenomena such as disequlibrium compaction, changes in tectonic stress, and mineral dehydration. Overpressure conditions can cause hydraulic fracturing if the fluid pressure leads to tensile effective stresses that exceed the tensile strength of the material. Quantitative modeling of this type of process requires coupling between hydrogeologic processes and geomechanical processes including fracture initiation and propagation. Here we present a computational method for three-dimensional, hydromechanical coupled processes including fracture damage. Fractures are represented as discrete features in a fracture network that interact with a porous rock matrix. Fracture configurations are mapped onto an unstructured, three-dimensonal, Voronoi grid, which is based on a random set of spatial points. Discrete fracture networks (DFN) are represented by the connections of the edges of a Voronoi cells. This methodology has the advantage that fractures can be more easily introduced in response to coupled hydro-mechanical processes and generally eliminates several potential issues associated with the geometry of DFN and numerical gridding. A geomechanical and fracture-damage model is developed here using the Rigid-Body-Spring-Network (RBSN) numerical method. The hydrogelogic and geomechanical models share the same geometrical information from a 3D Voronoi

  11. Intelligent fracture creation for shale gas development

    KAUST Repository

    Douglas, Craig C.

    2011-05-14

    Shale gas represents a major fraction of the proven reserves of natural gas in the United States and a collection of other countries. Higher gas prices and the need for cleaner fuels provides motivation for commercializing shale gas deposits even though the cost is substantially higher than traditional gas deposits. Recent advances in horizontal drilling and multistage hydraulic fracturing, which dramatically lower costs of developing shale gas fields, are key to renewed interest in shale gas deposits. Hydraulically induced fractures are quite complex in shale gas reservoirs. Massive, multistage, multiple cluster treatments lead to fractures that interact with existing fractures (whether natural or induced earlier). A dynamic approach to the fracturing process so that the resulting network of reservoirs is known during the drilling and fracturing process is economically enticing. The process needs to be automatic and done in faster than real-time in order to be useful to the drilling crews.

  12. Stress fractures of the foot and ankle.

    Science.gov (United States)

    Welck, M J; Hayes, T; Pastides, P; Khan, W; Rudge, B

    2017-08-01

    Stress fractures occur as a result of microscopic injuries sustained when bone is subjected to repeated submaximal stresses. Overtime, with repeated cycles of loading, accumulation of such injuries can lead to macro-structural failure and frank fracture. There are numerous stress fractures about the foot and ankle of which a trauma and orthopaedic surgeon should be aware. These include: metatarsal, tibia, calcaneus, navicular, fibula, talus, medial malleolus, sesamoid, cuneiform and cuboid. Awareness of these fractures is important as the diagnosis is frequently missed and appropriate treatment delayed. Late identification can be associated with protracted pain and disability, and may predispose to non-union and therefore necessitate operative intervention. This article outlines the epidemiology and risk factors, aetiology, presentation and management of the range of stress fractures in the foot and ankle. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Stress fractures about the tibia, foot, and ankle.

    Science.gov (United States)

    Shindle, Michael K; Endo, Yoshimi; Warren, Russell F; Lane, Joseph M; Helfet, David L; Schwartz, Elliott N; Ellis, Scott J

    2012-03-01

    In competitive athletes, stress fractures of the tibia, foot, and ankle are common and lead to considerable delay in return to play. Factors such as bone vascularity, training regimen, and equipment can increase the risk of stress fracture. Management is based on the fracture site. In some athletes, metabolic workup and medication are warranted. High-risk fractures, including those of the anterior tibial diaphysis, navicular, proximal fifth metatarsal, and medial malleolus, present management challenges and may require surgery, especially in high-level athletes who need to return to play quickly. Noninvasive treatment modalities such as pulsed ultrasound and extracorporeal shock wave therapy may have some benefit but require additional research.

  14. Stress fractures and bone pain

    International Nuclear Information System (INIS)

    Groshar, D.; Even-Sapir, E.; Lam, M.; Israel, O.; Front, D.

    1984-01-01

    Stress fractures result from an unusual repetitive physical activity causing absorption of bone in excess of repair and bone formation. This leads to the weakening of the bone and subsequently to a fracture. It is a benign condition that if recognized in time does not need any treatment besides rest. However, if diagnosis is not made and physical activity continues it may result in severe injury to the bone and a frank fracture may result. Pain is the typical clinical feature and bone scintigraphy, being more sensitive than radiography, is done to establish early diagnosis. The presence of asymptomatic sites of abnormal bone uptake typical of stress fracture in which pain appeared only about 2 weeks after scintigraphy, drew the authors' attention to the question of how close is the relationship between stress fractures and bone pain. Sixty-four military recruits diagnosed as suffering from stress fracture were investigated in order to correlate sites with abnormal uptake of Tc-99m MDP on bone scintigraphy with sites of local pain. In 37 (58%) subjects multiple sites of abnormal uptake were recognised. Of 123 sites of abnormal uptake, 31 (25%) were asymptomatic. In three patients bone pain appeared at the site of the abnormal uptake two weeks after scintigraphy. Bone scintigraphy appears to be more sensitive than bone pain in the diagnosis of stress fractures. The osteoblastic activity which manifests itself by abnormal uptake appears in some cases earlier than the pain caused by the fracture. Present findings may suggest that under certain circumstances, in a population prone to stress fracture, bone scan should be considered as a screening method

  15. Fractures Due to Gunshot Wounds: Do Retained Bullet Fragments Affect Union?

    Science.gov (United States)

    Riehl, John T; Connolly, Keith; Haidukewych, George; Koval, Ken

    2015-01-01

    Many types of projectiles, including modern hollow point bullets, fragment into smaller pieces upon impact, particularly when striking bone. This study was performed to examine the effect on time to union with retained bullet material near a fracture site in cases of gunshot injury. All gunshot injuries operatively treated with internal fixation at a Level 1 Trauma Center between March 2008 and August 2011 were retrospectively reviewed. Retained bullet load near the fracture site was calculated based on percentage of material retained compared to the cortical diameter of the involved bone. Analyses were performed to assess the effect of the lead-cortical ratio and amount of comminution on time to fracture union. Thirty-two patients (34 fractures) met the inclusion criteria, with an equal number of comminuted (17) and non-comminuted fractures (17). Seventeen of 34 fractures (50%) united within 4 months, 16/34 (47%) developed a delayed union, and 1/34 (3%) developed a nonunion requiring revision surgery. Sixteen of 17 fractures (94%) that united by 4 months had a cumulative amount of bullet fragmentation retained near the fracture site of less than 20% of the cortical diameter. Nine out of 10 fractures (90%) with retained fragments near the fracture site was equal to or exceeding 20% of the cortical diameter had delayed or nonunion. Fracture comminution had no effect on time to union. The quantity of retained bullet material near the fracture site was more predictive of the rate of fracture union than was comminution. Fractures with bullet fragmentation equal to or exceeding 20% of the cortical width demonstrated a significantly higher rate of delayed union/nonunion compared to those fractures with less retained bullet material, which may indicate a local cytotoxic effect from lead on bone healing. These findings may influence decisions on timing of secondary surgeries. Level III.

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

    Science.gov (United States)

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

    2018-02-01

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

  17. Numerical methods for coupled fracture problems

    Science.gov (United States)

    Viesca, Robert C.; Garagash, Dmitry I.

    2018-04-01

    We consider numerical solutions in which the linear elastic response to an opening- or sliding-mode fracture couples with one or more processes. Classic examples of such problems include traction-free cracks leading to stress singularities or cracks with cohesive-zone strength requirements leading to non-singular stress distributions. These classical problems have characteristic square-root asymptotic behavior for stress, relative displacement, or their derivatives. Prior work has shown that such asymptotics lead to a natural quadrature of the singular integrals at roots of Chebyhsev polynomials of the first, second, third, or fourth kind. We show that such quadratures lead to convenient techniques for interpolation, differentiation, and integration, with the potential for spectral accuracy. We further show that these techniques, with slight amendment, may continue to be used for non-classical problems which lack the classical asymptotic behavior. We consider solutions to example problems of both the classical and non-classical variety (e.g., fluid-driven opening-mode fracture and fault shear rupture driven by thermal weakening), with comparisons to analytical solutions or asymptotes, where available.

  18. Analysis of nature of brazed joints fracture under operating conditions

    International Nuclear Information System (INIS)

    Orlov, A.V.; Gura, P.M.

    1985-01-01

    Technique establishing causes leading to brazed joint fracture in pressure boundary components, operating under heavy conditions of high temperature and corrosive medium is described. Some cases of tube brazed joint fractures in a superheater of 12Kh1MF and 08Kh18N10T steels are considered. The attention is paid on using metallography for determination of mechanical or corrosion fracture properties. The diagram is developed permitting to take into account the interrelation between the fracture area in the given zone and its strength

  19. Hydraulic conductivity of rock fractures

    International Nuclear Information System (INIS)

    Zimmerman, R.W.; Bodvarsson, G.S.

    1994-10-01

    Yucca Mountain, Nevada contains numerous geological units that are highly fractured. A clear understanding of the hydraulic conductivity of fractures has been identified as an important scientific problem that must be addressed during the site characterization process. The problem of the flow of a single-phase fluid through a rough-walled rock fracture is discussed within the context of rigorous fluid mechanics. The derivation of the cubic law is given as the solution to the Navier-Stokes equations for flow between smooth, parallel plates, the only fracture geometry that is amenable to exact treatment. The various geometric and kinetic conditions that are necessary in order for the Navier-Stokes equations to be replaced by the more tractable lubrication or Hele-Shaw equations are studied and quantified. Various analytical and numerical results are reviewed pertaining to the problem of relating the effective hydraulic aperture to the statistics of the aperture distribution. These studies all lead to the conclusion that the effective hydraulic aperture is always less than the mean aperture, by a factor that depends on the ratio of the mean value of the aperture to its standard deviation. The tortuosity effect caused by regions where the rock walls are in contact with each other is studied using the Hele-Shaw equations, leading to a simple correction factor that depends on the area fraction occupied by the contact regions. Finally, the predicted hydraulic apertures are compared to measured values for eight data sets from the literature for which aperture and conductivity data were available on the same fracture. It is found that reasonably accurate predictions of hydraulic conductivity can be made based solely on the first two moments of the aperture distribution function, and the proportion of contact area. 68 refs

  20. Role of MRI in hip fractures, including stress fractures, occult fractures, avulsion fractures

    International Nuclear Information System (INIS)

    Nachtrab, O.; Cassar-Pullicino, V.N.; Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J.

    2012-01-01

    MR imaging plays a vital role in the diagnosis and management of hip fractures in all age groups, in a large spectrum of patient groups spanning the elderly and sporting population. It allows a confident exclusion of fracture, differentiation of bony from soft tissue injury and an early confident detection of fractures. There is a spectrum of MR findings which in part is dictated by the type and cause of the fracture which the radiologist needs to be familiar with. Judicious but prompt utilisation of MR in patients with suspected hip fractures has a positive therapeutic impact with healthcare cost benefits as well as social care benefits.

  1. Paratrooper's ankle fracture: posterior malleolar fracture.

    Science.gov (United States)

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

    2015-03-01

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

  2. Bilateral femoral supracondylar stress fractures in a cross country runner.

    Science.gov (United States)

    Ross, Kate; Fahey, Mark

    2008-08-01

    Several high-risk factors lead to stress fractures. They include excessive training in athletes leading to overuse injuries, nutritional deficiencies, and endocrine disorders. While stress fractures are common, bilateral stress fractures are rarely seen. Few cases have been reported of bilateral femoral stress fractures in young athletes. This article presents a case of a 14-year-old cross country runner with a bilateral femoral supracondylar stress fracture. He presented with bilateral supracondylar stress fractures from running. The patient followed a strict vegan diet, but his parents stated that, to their knowledge, he was getting adequate protein and calcium. Treatment consisted of decreased activity to pain-free levels with acetaminophen for pain. Low-impact conditioning such as swimming and bicycling was allowed. Hamstring and quadricep stretching was suggested. Nutritional consultation was obtained to ensure appropriate nutrition on a vegan diet. At 1-month follow-up, he was pain free and allowed to proceed with a gradual return to running activities. In this case, the onset of a new workout routine was intolerable for this patient's low bone density, causing insufficiency fractures. Appropriate vegan diets were not associated with stress fracture in our literature review. He may have had an inadequate diet prior to this injury. As in this case, full recovery can be made after this rest period, and the patient may return to his or her original activity safely. In young athletes, diet and nutrition must be kept in mind.

  3. Stress fractures: definition, diagnosis and treatment ?

    OpenAIRE

    Astur, Diego Costa; Zanatta, Fernando; Arliani, Gustavo Gon?alves; Moraes, Eduardo Ramalho; Pochini, Alberto de Castro; Ejnisman, Benno

    2015-01-01

    ABSTRACT Stress fractures were first described in Prussian soldiers by Breithaupt in 1855. They occur as the result of repeatedly making the same movement in a specific region, which can lead to fatigue and imbalance between osteoblast and osteoclast activity, thus favoring bone breakage. In addition, when a particular region of the body is used in the wrong way, a stress fracture can occur even without the occurrence of an excessive number of functional cycles. The objective of this study wa...

  4. Predicting Hip Fracture Type With Cortical Bone Mapping (CBM) in the Osteoporotic Fractures in Men (MrOS) Study.

    Science.gov (United States)

    Treece, Graham M; Gee, Andrew H; Tonkin, Carol; Ewing, Susan K; Cawthon, Peggy M; Black, Dennis M; Poole, Kenneth E S

    2015-11-01

    Hip fracture risk is known to be related to material properties of the proximal femur, but fracture prediction studies adding richer quantitative computed tomography (QCT) measures to dual-energy X-ray (DXA)-based methods have shown limited improvement. Fracture types have distinct relationships to predictors, but few studies have subdivided fracture into types, because this necessitates regional measurements and more fracture cases. This work makes use of cortical bone mapping (CBM) to accurately assess, with no prior anatomical presumptions, the distribution of properties related to fracture type. CBM uses QCT data to measure the cortical and trabecular properties, accurate even for thin cortices below the imaging resolution. The Osteoporotic Fractures in Men (MrOS) study is a predictive case-cohort study of men over 65 years old: we analyze 99 fracture cases (44 trochanteric and 55 femoral neck) compared to a cohort of 308, randomly selected from 5994. To our knowledge, this is the largest QCT-based predictive hip fracture study to date, and the first to incorporate CBM analysis into fracture prediction. We show that both cortical mass surface density and endocortical trabecular BMD are significantly different in fracture cases versus cohort, in regions appropriate to fracture type. We incorporate these regions into predictive models using Cox proportional hazards regression to estimate hazard ratios, and logistic regression to estimate area under the receiver operating characteristic curve (AUC). Adding CBM to DXA-based BMD leads to a small but significant (p fracture, with AUC increasing from 0.78 to 0.79, assessed using leave-one-out cross-validation. For specific fracture types, the improvement is more significant (p trochanteric fractures and 0.76 to 0.82 for femoral neck fractures. In contrast, adding DXA-based BMD to a CBM-based predictive model does not result in any significant improvement. © 2015 The Authors. Journal of Bone and Mineral Research

  5. Visualization by X-ray tomography of void growth and coalescence leading to fracture in model materials

    International Nuclear Information System (INIS)

    Weck, A.; Wilkinson, D.S.; Maire, E.; Toda, H.

    2008-01-01

    The literature contains many models for the process of void nucleation, growth and coalescence leading to ductile fracture. However, these models lack in-depth experimental validation, in part because void coalescence is difficult to capture experimentally. In this paper, an embedded array of holes is obtained by diffusion bonding a sheet filled with laser-drilled holes between two intact sheets. The experiments have been performed with both pure copper and Glidcop. Using X-ray computed tomography, we show that void growth and coalescence (or linkage) are well captured in both materials. The Brown and Embury model for void coalescence underestimates coalescence strains due to constraining effects. However, both the Rice and Tracey model for void growth and the Thomason model for void coalescence give good predictions for copper samples when stress triaxiality is considered. The Thomason model, however, fails to predict coalescence for the Glidcop samples; this is primarily due to secondary void nucleation

  6. Subchondral insufficiency fractures of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

    2004-02-01

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  7. Fracture Mechanics

    International Nuclear Information System (INIS)

    Jang, Dong Il; Jeong, Gyeong Seop; Han, Min Gu

    1992-08-01

    This book introduces basic theory and analytical solution of fracture mechanics, linear fracture mechanics, non-linear fracture mechanics, dynamic fracture mechanics, environmental fracture and fatigue fracture, application on design fracture mechanics, application on analysis of structural safety, engineering approach method on fracture mechanics, stochastic fracture mechanics, numerical analysis code and fracture toughness test and fracture toughness data. It gives descriptions of fracture mechanics to theory and analysis from application of engineering.

  8. Comminuted intraarticular fractures of the tibial plateau lead to posttraumatic osteoarthritis of the knee: Current treatment review

    Directory of Open Access Journals (Sweden)

    Matthias Aurich

    2018-03-01

    Full Text Available Posttraumatic osteoarthritis (PTOA of the knee is a common complication after intra- and extra-articular fractures. Moreover, PTOA may also be a result of isolated cartilage defects, meniscus resections, and ligament injuries. There are various methods of treatment of knee joint fractures. However, in the final stage of a PTOA, when nonoperative treatment fails, endoprosthetic joint replacement is the method of choice. Primary total knee replacement (TKR for the treatment for a fracture of the knee joint is a rare indication, even at major treatment centers. It is performed in elderly patients with the inability to be mobilized with partial- or non-weight bearing; in cases with considerable bone destruction; in cases with symptomatic osteoarthritis (OA in the elderly; and, it is often associated with the primary use of a modular implant. However, TKR in the acute situation should always be an individual decision. Secondary TKR after knee joint fracture shows overall good functional results. However, the results are inferior when compared with TKR for primary OA. In addition, the complication rates of TKR for PTOA are much higher. Problems with the extensor mechanism after tibial plateau fractures are common. There are also problems caused by preexisting scars, nonunion (possibly due to a low grade infection, malalignment, restricted movement, or instability.

  9. RECENT ADVANCES IN NATURALLY FRACTURED RESERVOIR MODELING

    OpenAIRE

    ORDOÑEZ, A; PEÑUELA, G; IDROBO, E. A; MEDINA, C. E

    2001-01-01

    Large amounts of oil reserves are contained in naturally fractured reservoirs. Most of these hydrocarbon volumes have been left behind because of the poor knowledge and/or description methodology of those reservoirs. This lack of knowledge has lead to the nonexistence of good quantitative models for this complicated type of reservoirs. The complexity of naturally fractured reservoirs causes the need for integration of all existing information at all scales (drilling, well logging, seismic, we...

  10. Rockfall triggering by cyclic thermal stressing of exfoliation fractures

    Science.gov (United States)

    Collins, Brian D.; Stock, Greg M.

    2016-01-01

    Exfoliation of rock deteriorates cliffs through the formation and subsequent opening of fractures, which in turn can lead to potentially hazardous rockfalls. Although a number of mechanisms are known to trigger rockfalls, many rockfalls occur during periods when likely triggers such as precipitation, seismic activity and freezing conditions are absent. It has been suggested that these enigmatic rockfalls may occur due to solar heating of rock surfaces, which can cause outward expansion. Here we use data from 3.5 years of field monitoring of an exfoliating granite cliff in Yosemite National Park in California, USA, to assess the magnitude and temporal pattern of thermally induced rock deformation. From a thermodynamic analysis, we find that daily, seasonal and annual temperature variations are sufficient to drive cyclic and cumulative opening of fractures. Application of fracture theory suggests that these changes can lead to further fracture propagation and the consequent detachment of rock. Our data indicate that the warmest times of the day and year are particularly conducive to triggering rockfalls, and that cyclic thermal forcing may enhance the efficacy of other, more typical rockfall triggers.

  11. Connection between tectonic stresses and well fracturing data

    Energy Technology Data Exchange (ETDEWEB)

    Scheidegger, A E [Imperial Oil Res. Lab., Calgary, CA

    1961-01-01

    Theoretical considerations of hydraulic well fracturing normally utilize a model in which the borehole is assumed to be a cylinder of infinite length. This leads to treatment of the induced stress state in two dimensions. The two-dimensional model is obviously an oversimplification. Therefore, a three-dimensional model is proposed in which the well pressure is assumed to be equivalent to a spherical pressure center. The bottom hole pressure during fracturing is determined by 4 variables; i.e., the 3 principal geological stresses and the rock strength. The response to fracturing is determined primarily by the prevailing stress state and to a lesser degree by the rock strength. The fracture condition is formulated and the model is used in the calculation of geological stresses from well data.

  12. Diagnosis of scaphoid fracture: optimal imaging techniques

    Directory of Open Access Journals (Sweden)

    Geijer M

    2013-07-01

    Full Text Available Mats Geijer Center for Medical Imaging and Physiology, Skåne University Hospital and Lund University, Lund, Sweden Abstract: This review aims to provide an overview of modern imaging techniques for evaluation of scaphoid fracture, with emphasis on occult fractures and an outlook on the possible evolution of imaging; it also gives an overview of the pathologic and anatomic basis for selection of techniques. Displaced scaphoid fractures detected by wrist radiography, with or without special scaphoid views, pose no diagnostic problems. After wrist trauma with clinically suspected scaphoid fracture and normal scaphoid radiography, most patients will have no clinically important fracture. Between 5% and 19% of patients (on average 16% in meta-analyses will, however, have an occult scaphoid fracture which, untreated, may lead to later, potentially devastating, complications. Follow-up imaging may be done with repeat radiography, tomosynthesis, computed tomography, magnetic resonance imaging (MRI, or bone scintigraphy. However, no method is perfect, and choice of imaging may be based on availability, cost, perceived accuracy, or personal preference. Generally, MRI and bone scintigraphy are regarded as the most sensitive modalities, but both are flawed by false positive results at various rates. Keywords: occult fracture, wrist, radiography, computed tomography, magnetic resonance imaging, radionuclide imaging

  13. MRI of subchondral fractures: a review

    Energy Technology Data Exchange (ETDEWEB)

    Lopes Viana, Sergio [Hospital Ortopedico e Medicina Especializada (HOME) and Hospital da Crianca de Brasilia Jose Alencar, Brasilia, DF (Brazil); Beber Machado, Bruno [Clinica Radiologica Med Imagem, Unimed Sul Capixaba and Santa Casa de Misericordia de Cachoeiro de Itapemirim, Cachoeiro de Itapemirim (Brazil); Mendlovitz, Paulo Sergio [Hospital Universitario de Brasilia (Universidade de Brasilia) and Radiologia Anchieta, Brasilia (Brazil)

    2014-11-15

    Several authors have recently emphasized the role of magnetic resonance imaging (MRI) in the diagnosis of subchondral fractures. There is increasing interest about this type of fractures, mostly because they have been implicated in the genesis of some well-known destructive articular conditions whose cause was previously undetermined, such as distal clavicular osteolysis, rapidly progressive osteoarthritis of the hip, spontaneous osteonecrosis of the knee and adult-type Freiberg's infraction. Subchondral fractures may ultimately lead to bone collapse, secondary osteonecrosis and severe articular damage, and there may be rapid progression of joint destruction over a period of weeks to months. It has been suggested that timely diagnosis might potentially improve the outcome and avoid the onset of destructive joint disease, making MRI even more important in this setting. The fracture line usually appears as a band of low signal intensity in the subchondral bone plate, adjacent to the articular surface, most often surrounded by bone marrow edema. In this article the authors review the most relevant imaging features of subchondral fractures in several joints, stressing the importance of early recognition for a better outcome. (orig.)

  14. Quantifying voids effecting delamination in carbon/epoxy composites: static and fatigue fracture behavior

    Science.gov (United States)

    Hakim, I.; May, D.; Abo Ras, M.; Meyendorf, N.; Donaldson, S.

    2016-04-01

    On the present work, samples of carbon fiber/epoxy composites with different void levels were fabricated using hand layup vacuum bagging process by varying the pressure. Thermal nondestructive methods: thermal conductivity measurement, pulse thermography, pulse phase thermography and lock-in-thermography, and mechanical testing: modes I and II interlaminar fracture toughness were conducted. Comparing the parameters resulted from the thermal nondestructive testing revealed that voids lead to reductions in thermal properties in all directions of composites. The results of mode I and mode II interlaminar fracture toughness showed that voids lead to reductions in interlaminar fracture toughness. The parameters resulted from thermal nondestructive testing were correlated to the results of mode I and mode II interlaminar fracture toughness and voids were quantified.

  15. Effect of hydro mechanical coupling on natural fracture network formation in sedimentary basins

    Science.gov (United States)

    Ouraga, Zady; Guy, Nicolas; Pouya, Amade

    2018-05-01

    In sedimentary basin context, numerous phenomena, depending on the geological time span, can result in natural fracture network formation. In this paper, fracture network and dynamic fracture spacing triggered by significant sedimentation rate are studied considering mode I fracture propagation using a coupled hydro-mechanical numerical methods. The focus is put on synthetic geological structure under a constant sedimentation rate on its top. This model contains vertical fracture network initially closed and homogeneously distributed. The fractures are modelled with cohesive zone model undergoing damage and the flow is described by Poiseuille's law. The effect of the behaviour of the rock is studied and the analysis leads to a pattern of fracture network and fracture spacing in the geological layer.

  16. Fracture as a material sink

    Science.gov (United States)

    Volokh, K. Y.

    2017-12-01

    Cracks are created by massive breakage of molecular or atomic bonds. The latter, in its turn, leads to the highly localized loss of material, which is the reason why even closed cracks are visible by a naked eye. Thus, fracture can be interpreted as the local material sink. Mass conservation is violated locally in the area of material failure. We consider a theoretical formulation of the coupled mass and momenta balance equations for a description of fracture. Our focus is on brittle fracture and we propose a finite strain hyperelastic thermodynamic framework for the coupled mass-flow-elastic boundary value problem. The attractiveness of the proposed framework as compared to the traditional continuum damage theories is that no internal parameters (like damage variables, phase fields, etc.) are used while the regularization of the failure localization is provided by the physically sound law of mass balance.

  17. Model of T-Type Fracture in Coal Fracturing and Analysis of Influence Factors of Fracture Morphology

    Directory of Open Access Journals (Sweden)

    Yuwei Li

    2018-05-01

    Full Text Available Special T-type fractures can be formed when coal is hydraulically fractured and there is currently no relevant theoretical model to calculate and describe them. This paper first establishes the height calculation model of vertical fractures in multi-layered formations and deduces the stress intensity factor (SIF at the upper and lower sides of the fracture in the process of vertical fracture extension. Combined with the fracture tip stress analysis method of fracture mechanics theory, the horizontal bedding is taken into account for tensile and shear failure, and the critical mechanical conditions for the formation of horizontal fracture in coal are obtained. Finally, the model of T-type fracture in coal fracturing is established, and it is verified by fracturing simulation experiments. The model calculation result shows that the increase of vertical fracture height facilitates the increase of horizontal fracture length. The fracture toughness of coal has a significant influence on the length of horizontal fracture and there is a threshold. When the fracture toughness is less than the threshold, the length of horizontal fracture remains unchanged, otherwise, the length of horizontal fracture increases rapidly with the increase of fracture toughness. When the shear strength of the interface between the coalbed and the interlayer increases, the length of the horizontal fracture of the T-type fracture rapidly decreases.

  18. Fracture mechanics and parapsychology

    Science.gov (United States)

    Cherepanov, G. P.

    2010-08-01

    The problem of postcritical deformation of materials beyond the ultimate strength is considered a division of fracture mechanics. A simple example is used to show the relationship between this problem and parapsychology, which studies phenomena and processes where the causality principle fails. It is shown that the concept of postcritical deformation leads to problems with no solution

  19. Risk factors for stress fractures.

    Science.gov (United States)

    Bennell, K; Matheson, G; Meeuwisse, W; Brukner, P

    1999-08-01

    Preventing stress fractures requires knowledge of the risk factors that predispose to this injury. The aetiology of stress fractures is multifactorial, but methodological limitations and expediency often lead to research study designs that evaluate individual risk factors. Intrinsic risk factors include mechanical factors such as bone density, skeletal alignment and body size and composition, physiological factors such as bone turnover rate, flexibility, and muscular strength and endurance, as well as hormonal and nutritional factors. Extrinsic risk factors include mechanical factors such as surface, footwear and external loading as well as physical training parameters. Psychological traits may also play a role in increasing stress fracture risk. Equally important to these types of analyses of individual risk factors is the integration of information to produce a composite picture of risk. The purpose of this paper is to critically appraise the existing literature by evaluating study design and quality, in order to provide a current synopsis of the known scientific information related to stress fracture risk factors. The literature is not fully complete with well conducted studies on this topic, but a great deal of information has accumulated over the past 20 years. Although stress fractures result from repeated loading, the exact contribution of training factors (volume, intensity, surface) has not been clearly established. From what we do know, menstrual disturbances, caloric restriction, lower bone density, muscle weakness and leg length differences are risk factors for stress fracture. Other time-honoured risk factors such as lower extremity alignment have not been shown to be causative even though anecdotal evidence indicates they are likely to play an important role in stress fracture pathogenesis.

  20. Condyle and mandibular bone change after unilateral condylar neck fracture in growing rats.

    Science.gov (United States)

    Hu, Y; Yang, H-f; Li, S; Chen, J-z; Luo, Y-w; Yang, C

    2012-08-01

    Unilateral fracture of the condylar neck in immature subjects might lead to mandible asymmetry and condyle remodelling. A rat model was used to investigate mandibular deviation and condylar remodelling associated with condyle fracture. 72 4-week-old male rats were randomly divided into three groups: an experimental group (unilateral transverse condylar fracture induced surgically), a sham operation group (surgical exposure but no fracture), and a non-operative control group (no operation). The rats were killed at intervals up to 9weeks after surgery, and outcomes were assessed using various measures of mandible deviation, histological and X-ray observation, and immunohistochemical measures of expression levels of connective tissue growth factor (CTGF) and type II collagen (Col II). The fracture led to the degeneration of mandibular size, associated with atrophy of fractured condylar process. Progressive remodelling of cartilage and increasing expression levels of CTGF and Col II were found. The authors conclude that condylar fracture can lead to asymmetries in mandible and condyle remodelling and expression of CTGF and Col II in condylar cartilage on both the ipsilateral and the contralateral sides. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Osteoporosis and the risk of fracture | | South African Family Practice

    African Journals Online (AJOL)

    Osteoporosis is a skeletal disease characterised by low bone mass and a deterioration of the microarchitecture of bone tissue, leading to an increase in bone fragility and a greater risk of fracture. It is a life-threatening disease, with mortality following hip fracture exceeding mortality after myocardial infarction.1 For women, ...

  2. SCFJFK is a bona fide E3 ligase for ING4 and a potent promoter of the angiogenesis and metastasis of breast cancer

    Science.gov (United States)

    Yan, Ruorong; He, Lin; Li, Zhongwu; Han, Xiao; Liang, Jing; Si, Wenzhe; Chen, Zhe; Li, Lei; Xie, Guojia; Li, Wanjin; Wang, Peiyan; Lei, Liandi; Zhang, Hongquan; Pei, Fei; Cao, Dengfeng

    2015-01-01

    Loss of function/dysregulation of inhibitor of growth 4 (ING4) and hyperactivation of NF-κB are frequent events in many types of human malignancies. However, the molecular mechanisms underlying these remarkable aberrations are not understood. Here, we report that ING4 is physically associated with JFK. We demonstrated that JFK targets ING4 for ubiquitination and degradation through assembly of an Skp1–Cul1–F-box (SCF) complex. We showed that JFK-mediated ING4 destabilization leads to the hyperactivation of the canonical NF-κB pathway and promotes angiogenesis and metastasis of breast cancer. Significantly, the expression of JFK is markedly up-regulated in breast cancer, and the level of JFK is negatively correlated with that of ING4 and positively correlated with an aggressive clinical behavior of breast carcinomas. Our study identified SCFJFK as a bona fide E3 ligase for ING4 and unraveled the JFK–ING4–NF-κB axis as an important player in the development and progression of breast cancer, supporting the pursuit of JFK as a potential target for breast cancer intervention. PMID:25792601

  3. Fatigue fracture modes of a stainless steel

    International Nuclear Information System (INIS)

    Pacheco, D.J.; Souza e Silva, A.S. de; Monteiro, S.N.

    1977-01-01

    The influence of strain hardening and martensite phase transformation on the fatigue fracture regions (pulsative tension) of a Stainless Steel type AISI 316 was investigated. This lead to the conclusion that the greater austenite strain hardening level only favours the occurrence of a brittle fracture. Also, in as much as the static induced martensite is concerned, a direct influence on the failure process was not observed, whereas, apparently, the one transformed under cyclic loading has no contribution to the rupture mechanisms. (author) [pt

  4. Evaluation of WWER-1000 vessel materials fracture toughness

    International Nuclear Information System (INIS)

    Grinik, Eh.U.; Revka, V.N.; Chirko, L.I.; Chajkovskij, Yu.V.

    2007-01-01

    The lifetime of WWER-1000-type reactor vessels is finally conditioned by the fracture toughness (crack growth resistance) of RPV materials. Up to now in line with the regulations the fracture toughness is characterized by the critical temperature of brittleness determined by the results of the Charpy specimen impact testing. Such approach is typical for all countries operating the water pressure reactors. However, regulatory approach is known from the western specialists not always to characterize adequately the crack growth resistance of the vessel materials and in some cases to underestimate their characteristics in the reference state that leads to unreasonably high conservatism. Excessive conservatism may lead to the invalid restrictions in the operating modes and the service life of the reactor vessel. Therefore there appeared the necessity to apply another approaches based on the state-of-the-art experimental methods of the fracture mechanics and allowing evaluating the fracture toughness parameters sufficiently. The paper presents the results of the comparison of the regulatory approach and the Master curve approach from the point of view of the adequate determination of the vessel material crack growth resistance parameters. Analysis of the experimental data of the surveillance specimens illustrated the potential possibility of applying the new statistical method for the WWER-1000- type reactor vessel lifetime extension

  5. Minimizing the Fluid Used to Induce Fracturing

    Science.gov (United States)

    Boyle, E. J.

    2015-12-01

    The less fluid injected to induce fracturing means less fluid needing to be produced before gas is produced. One method is to inject as fast as possible until the desired fracture length is obtained. Presented is an alternative injection strategy derived by applying optimal system control theory to the macroscopic mass balance. The picture is that the fracture is constant in aperture, fluid is injected at a controlled rate at the near end, and the fracture unzips at the far end until the desired length is obtained. The velocity of the fluid is governed by Darcy's law with larger permeability for flow along the fracture length. Fracture growth is monitored through micro-seismicity. Since the fluid is assumed to be incompressible, the rate at which fluid is injected is balanced by rate of fracture growth and rate of loss to bounding rock. Minimizing injected fluid loss to the bounding rock is the same as minimizing total injected fluid How to change the injection rate so as to minimize the total injected fluid is a problem in optimal control. For a given total length, the variation of the injected rate is determined by variations in overall time needed to obtain the desired fracture length, the length at any time, and the rate at which the fracture is growing at that time. Optimal control theory leads to a boundary condition and an ordinary differential equation in time whose solution is an injection protocol that minimizes the fluid used under the stated assumptions. That method is to monitor the rate at which the square of the fracture length is growing and adjust the injection rate proportionately.

  6. Distinct Element Method modelling of fold-related fractures in a multilayer sequence

    Science.gov (United States)

    Kaserer, Klemens; Schöpfer, Martin P. J.; Grasemann, Bernhard

    2017-04-01

    Natural fractures have a significant impact on the performance of hydrocarbon systems/reservoirs. In a multilayer sequence, both the fracture density within the individual layers and the type of fracture intersection with bedding contacts are key parameters controlling fluid pathways. In the present study the influence of layer stacking and interlayer friction on fracture density and connectivity within a folded sequence is systematically investigated using 2D Distinct Element Method modelling. Our numerical approach permits forward modelling of both fracture nucleation/propagation/arrest and (contemporaneous) frictional slip along bedding planes in a robust and mechanically sound manner. Folding of the multilayer sequence is achieved by enforcing constant curvature folding by means of a velocity boundary condition at the model base, while a constant overburden pressure is maintained at the model top. The modelling reveals that with high bedding plane friction the multilayer stack behaves mechanically as a single layer so that the neutral surface develops in centre of the sequence and fracture spacing is controlled by the total thickness of the folded sequence. In contrast, low bedding plane friction leads to decoupling of the individual layers (flexural slip folding) so that a neutral surface develops in the centre of each layer and fracture spacing is controlled by the thickness of the individual layers. The low interfacial friction models illustrate that stepping of fractures across bedding planes is a common process, which can however have two contrasting origins: The mechanical properties of the interface cause fracture stepping during fracture propagation. Originally through-going fractures are later offset by interfacial slip during folding. A combination of these two different origins may lead to (apparently) inconsistent fracture offsets across bedding planes within a flexural slip fold.

  7. Talar Fractures and Dislocations: A Radiologist's Guide to Timely Diagnosis and Classification.

    Science.gov (United States)

    Melenevsky, Yulia; Mackey, Robert A; Abrahams, R Brad; Thomson, Norman B

    2015-01-01

    The talus, the second largest tarsal bone, has distinctive imaging characteristics and injury patterns. The predominantly extraosseous vascular supply of the talus predisposes it to significant injury in the setting of trauma. In addition, the lack of muscular attachments and absence of a secondary blood supply can lead to subsequent osteonecrosis. Although talar fractures account for less than 1% of all fractures, they commonly result from high-energy trauma and may lead to complications and long-term morbidity if not recognized and managed appropriately. While initial evaluation is with foot and ankle radiographs, computed tomography (CT) is often performed to evaluate the extent of the fracture, displacement, comminution, intra-articular extension, and associated injuries. Talar fractures are divided by anatomic region: head, neck, and body. Talar head fractures can be treated conservatively if nondisplaced, warranting careful radiographic and CT evaluation to assess rotation, displacement, and extension into the neck. The modified Hawkins-Canale classification of talar neck fractures is most commonly used due to its simplicity, usefulness in guiding treatment, and prognostic value, as it correlates associated malalignment with risk of subsequent osteonecrosis. Isolated talar body fractures may be more common than previously thought. The Sneppen classification further divides talar body fractures into osteochondral talar dome, lateral and posterior process, and shear and crush comminuted central body fractures. Crush comminuted central body fractures carry a poor prognosis due to nonanatomic reduction, bone loss, and subsequent osteonecrosis. Lateral process fractures can be radiographically occult and require a higher index of suspicion for successful diagnosis. Subtalar dislocations are often accompanied by fractures, necessitating postreduction CT. Familiarity with the unique talar anatomy and injury patterns is essential for radiologists to facilitate

  8. Nontraumatic Fracture of the Femoral Condylar Prosthesis in a Total Knee Arthroplasty Leading to Mechanical Failure

    Directory of Open Access Journals (Sweden)

    Girish N. Swamy

    2014-01-01

    Full Text Available This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA. A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before.

  9. Nontraumatic fracture of the femoral condylar prosthesis in a total knee arthroplasty leading to mechanical failure.

    Science.gov (United States)

    Swamy, Girish N; Quah, Conal; Bagouri, Elmunzar; Badhe, Nitin P

    2014-01-01

    This paper reports a case of fatigue fracture of the femoral component in a cruciate-retaining cemented total knee arthroplasty (TKA). A 64-year-old man had undergone a primary TKA for osteoarthritis 10 years previously at another institution using the PFC-Sigma prosthesis. The patient recovered fully and was back to his regular activities. He presented with a history of sudden onset pain and locking of the left knee since the preceding three months. There was no history of trauma, and the patient was mobilizing with difficulty using crutches. Radiographs revealed fracture of the posterior condyle of the femoral prosthesis. Revision surgery was performed as an elective procedure revealing the broken prosthesis. The TC3RP-PFC revision prosthesis was used with a medial parapatellar approach. The patient recovered fully without any squeal. Mechanical failure of the knee arthroplasty prosthesis is rare, and nontraumatic fracture of the femoral metallic component has not been reported before.

  10. Intergranular brittle fracture of a low alloy steel. Global and local approaches

    International Nuclear Information System (INIS)

    Kantidis, E.

    1993-08-01

    The intergranular brittle fracture of a low alloy steel (A533B.Cl1) is studied: an embrittlement heat treatment is used to develop two brittle 'states' that fail through an intergranular way at low temperatures. This mode of fracture leads to an important shift of the transition temperature (∼ 165 deg C) and a decrease in the fracture toughness. The local approach to fracture, developed for cleavage, is applied to the case of intergranular fracture. Modifications are proposed. The physical supports of these models are verified by biaxial (tension-torsion) tests. From the local approaches developed for intergranular fracture, the static and dynamic fracture toughness of the embrittled steel is predicted. The local approach applied to a structural steel, which presents mixed modes of fracture (cleavage and intergranular), showed that this mode of fracture seems to be controlled by intergranular loss of cohesion

  11. Discrimination-pregnancy leave-Pregnancy Discrimination Act not retroactive-bona fide seniority system. AT&T Corp. v. Hulteen, 2009 U.S. LEXIS 3470 (U.S. 5/18/2009).

    Science.gov (United States)

    2009-01-01

    A pension plan whose terms are those of a bona fide seniority system and which treats pregnancy leave, taken before the addition of the Pregnancy Discrimination Act (PDA) to Title VII, differently than other kinds of medical leave, does not amount to sex and pregnancy discrimination under Title VII because PDA does not apply retroactively.

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

    NARCIS (Netherlands)

    Kamphuis, S.J.; Meijs, C.M.E.M.; Kleinveld, S.; Diekerhof, C.H.; Heijden, F.H. van der

    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

  13. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  14. Modelisation of transport in fractured media with a smeared fractures modeling approach: special focus on matrix diffusion process.

    Science.gov (United States)

    Fourno, A.; Grenier, C.; Benabderrahmane, H.

    2003-04-01

    Modeling flow and transport in natural fractured media is a difficult issue due among others to the complexity of the system, the particularities of the geometrical features, the strong parameter value contrasts between the fracture zones (flow zones) and the matrix zones (no flow zones). This lead to the development of dedicated tools like for instance discrete fracture network models (DFN). We follow here another line applicable for classical continuous modeling codes. The fracture network is not meshed here but presence of fractures is taken into account by means of continuous heterogeneous fields (permeability, porosity, head, velocity, concentration ...). This line, followed by different authors, is referred as smeared fracture approach and presents the following advantages: the approach is very versatile because no dedicated spatial discretization effort is required (we use a basic regular mesh, simulations can be done on a rough mesh saving computer time). This makes this kind of approach very promising for taking heterogeneity of properties as well as uncertainties into account within a Monte Carlo framework for instance. Furthermore, the geometry of the matrix blocks where transfers proceed by diffusion is fully taken into account contrary to classical simplified 1D approach for instance. Nevertheless continuous heterogeneous field representation of a fractured medium requires a homogenization process at the scale of the mesh considered. Literature proves that this step of homogenization for transport is still a challenging task. Consequently, the level precision of the results has to be estimated. We precedently proposed a new approach dedicated to Mixed and Hybrid Finite Element approach. This numerical scheme is very interesting for such highly heterogeneous media and in particular guaranties exact conservation of mass flow for each mesh leading to good transport results. We developed a smeared fractures approach to model flow and transport limited to

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  17. Craniomaxillofacial fractures during recreational baseball and softball.

    Science.gov (United States)

    Bak, Matthew J; Doerr, Timothy D

    2004-10-01

    Baseball and softball are leading causes of sports-related facial trauma in the United States. We review our institutional experience (Strong Memorial Hospital, Rochester, NY) with these injuries and discuss measures to reduce their incidence. We review our institutions experience with facial fractures sustained during the course of a softball or baseball game over a 12-year period. A total of 38 patients were identified and medical records analyzed for patient demographics, type of impact, and fracture location. The male-to-female ratio was 3.2:1; mean age was 24.2 years, with 17 (45%) of the injuries occurring in the pediatric population. The majority of the injuries were caused by direct impact with the ball (68%), while player-player collisions (18%) and impact from a swung bat (13%) were responsible for the remaining injuries. There were a total of 39 fractures; 18 fractures (46%) involved the midface (level 2), skull (level 1) fractures accounted for 12 (31%), while 9 (23%) were mandibular (level 3) fractures. With 68% of the injuries resulting from a ball impact, we endorse the recommendations of the Consumer Product Safety Commission for the use of low-impact National Operating Committee on Standards for Athletic Equipment-approved baseballs and softballs for youth and recreational leagues.

  18. Numerical investigation and optimization of multiple fractures in tight gas reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Hou, M.Z. [Technische Univ. Clausthal, Clausthal-Zellerfeld (Germany). ITE; Energie-Forschungszentrum Niedersachsen, Goslar (Germany); Zhou, L. [Energie-Forschungszentrum Niedersachsen, Goslar (Germany)

    2013-08-01

    The main objective of the project DGMK-680 in phase 2 was to investigate the influence of fractures on each other in a multi-fracture system including their space optimization by using the numerical program FLAC3D with our own developments, which treats all fractures in one 3D geometric model under 3D stress state with fully hydro-mechanical coupling effect. The case study was conducted on a horizontal wellbore at location A, which was stimulated hydraulically with a total of eight transverse fractures in summer 2009. Transverse multiple fractures were simulated using the modified continuum method. In the simulation all fractures were generated in one single model, comprising 22 different rock layers. Each layer was assumed to be homogeneous with regard to its rock and hydromechanical parameters. Thus the influence of the individual fractures on each other can be investigated. The simulation procedure applied, which is a consecutive execution ofa hydraulic and a mechanical computation, is the same for all fractures. The only differences are the primary in-situ stresses, the initial pore pressure, the injection parameters (location, rate, volume, duration), which lead to different patterns of fracture propagations. But there are still some common points, such as irregular patterns of the fracture front, which represents the heterogeneity of the model. All fractures (1 to 8) have their fracture average half-length between 70 m to 115 m, height between 93 m to 114 m and average width between 18 mm to 31 mm. The percentage difference of fracture height for individual fractures is obviously smaller than that of the fracture half-lengths, because the fracture barriers at bottom and top limit the fracture propagation in z-direction. Incomparison with the analytical simulator (FracPro) most results match well. Simulation of multiple fractures at location A, with the newly developed algorithms, shows that individual transverse multiple fractures at distances between 100

  19. Fracture mechanics of ceramics. Vol. 8. Microstructure, methods, design, and fatigue

    International Nuclear Information System (INIS)

    Bradt, R.C.; Evans, A.G.; Hasselman, D.P.H.; Lange, F.F.

    1986-01-01

    This paper presents information on the following topics: fracture mechanics and microstructures; non-lubricated sliding wear of Al 2 O 3 , PSZ and SiC; mixed-mode fracture of ceramics; some fracture properties of alumina-containing electrical porcelains; transformation toughening in the Al 2 O 3 -Cr 2 O 3 /ZrO 2 -HfO 2 system; strength toughness relationships for transformation toughened ceramics; tensile strength and notch sensitivity of Mg-PSZ; fracture mechanisms in lead zirconate titanate ceramics; loading-unloading techniques for determining fracture parameters of brittle materials utilizing four-point bend, chevron-notched specimens; application of the potential drop technique to the fracture mechanics of ceramics; ceramics-to-metal bonding from a fracture mechanics perspective; observed changes in fracture strength following laser irradiation and ion beam mixing of Ni overlayers on sintered alpha-SiC; crack growth in single-crystal silicon; a fracture mechanics and non-destructive evaluation investigation of the subcritical-fracture process in rock; slow crack growth in sintered silicon nitride; uniaxial tensile fatigue testing of sintered silicon carbide under cyclic temperature change; and effect of surface corrosion on glass fracture

  20. Stress fractures: pathophysiology, clinical presentation, imaging features, and treatment options.

    Science.gov (United States)

    Matcuk, George R; Mahanty, Scott R; Skalski, Matthew R; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J

    2016-08-01

    Stress fracture, in its most inclusive description, includes both fatigue and insufficiency fracture. Fatigue fractures, sometimes equated with the term "stress fractures," are most common in runners and other athletes and typically occur in the lower extremities. These fractures are the result of abnormal, cyclical loading on normal bone leading to local cortical resorption and fracture. Insufficiency fractures are common in elderly populations, secondary to osteoporosis, and are typically located in and around the pelvis. They are a result of normal or traumatic loading on abnormal bone. Subchondral insufficiency fractures of the hip or knee may cause acute pain that may present in the emergency setting. Medial tibial stress syndrome is a type of stress injury of the tibia related to activity and is a clinical syndrome encompassing a range of injuries from stress edema to frank-displaced fracture. Atypical subtrochanteric femoral fracture associated with long-term bisphosphonate therapy is also a recently discovered entity that needs early recognition to prevent progression to a complete fracture. Imaging recommendations for evaluation of stress fractures include initial plain radiographs followed, if necessary, by magnetic resonance imaging (MRI), which is preferred over computed tomography (CT) and bone scintigraphy. Radiographs are the first-line modality and may reveal linear sclerosis and periosteal reaction prior to the development of a frank fracture. MRI is highly sensitive with findings ranging from periosteal edema to bone marrow and intracortical signal abnormality. Additionally, a brief description of relevant clinical management of stress fractures is included.

  1. Representative elements: A step to large-scale fracture system simulation

    International Nuclear Information System (INIS)

    Clemo, T.M.

    1987-01-01

    Large-scale simulation of flow and transport in fractured media requires the development of a technique to represent the effect of a large number of fractures. Representative elements are used as a tool to model a subset of a fracture system as a single distributed entity. Representative elements are part of a modeling concept called dual permeability. Dual permeability modeling combines discrete fracture simulation of the most important fractures with the distributed modeling of the less important fracture of a fracture system. This study investigates the use of stochastic analysis to determine properties of representative elements. Given an assumption of fully developed laminar flow, the net fracture conductivities and hence flow velocities can be determined from descriptive statistics of fracture spacing, orientation, aperture, and extent. The distribution of physical characteristics about their mean leads to a distribution of the associated conductivities. The variance of hydraulic conductivity induces dispersion into the transport process. Simple fracture systems are treated to demonstrate the usefulness of stochastic analysis. Explicit equations for conductivity of an element are developed and the dispersion characteristics are shown. Explicit formulation of the hydraulic conductivity and transport dispersion reveals the dependence of these important characteristics on the parameters used to describe the fracture system. Understanding these dependencies will help to focus efforts to identify the characteristics of fracture systems. Simulations of stochastically generated fracture sets do not provide this explicit functional dependence on the fracture system parameters. 12 refs., 6 figs

  2. Influence of fracture geometry on bone healing under locking plate fixations: A comparison between oblique and transverse tibial fractures.

    Science.gov (United States)

    Miramini, Saeed; Zhang, Lihai; Richardson, Martin; Mendis, Priyan; Ebeling, Peter R

    2016-10-01

    Mechano-regulation plays a crucial role in bone healing and involves complex cellular events. In this study, we investigate the change of mechanical microenvironment of stem cells within early fracture callus as a result of the change of fracture obliquity, gap size and fixation configuration using mechanical testing in conjunction with computational modelling. The research outcomes show that angle of obliquity (θ) has significant effects on interfragmentary movement (IFM) which influences mechanical microenvironment of the callus cells. Axial IFM at near cortex of fracture decreases with θ, while shear IFM significantly increases with θ. While a large θ can increase shear IFM by four-fold compared to transverse fracture, it also result in the tension-stress effect at near cortex of fracture callus. In addition, mechanical stimuli for cell differentiation within the callus are found to be strongly negatively correlated to angle of obliquity and gap size. It is also shown that a relatively flexible fixation could enhance callus formation in presence of a large gap but could lead to excessive callus strain and interstitial fluid flow when a small transverse fracture gap is present. In conclusion, there appears to be an optimal fixation configuration for a given angle of obliquity and gap size. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  3. Forearm diaphyseal fractures in the adolescent population: treatment and management.

    Science.gov (United States)

    Truntzer, Jeremy; Vopat, Matthew L; Kane, Patrick M; Christino, Melissa A; Katarincic, Julia; Vopat, Bryan G

    2015-02-01

    Pediatric both-bone diaphyseal forearm fractures are commonly treated in a variety of clinical settings. Most often, closed reduction followed by immobilization leads to satisfactory results. However, in the adolescent population (10-16 years of age), forearm fractures are more challenging due to less remodeling potential. The purpose of this review was to provide an overview of the anatomy, biomechanics, and treatment options relevant to adolescent patients. A systematic review of peer-reviewed publications and abstracts related to the treatment for pediatric both-bone diaphyseal forearm fractures in adolescents was carried out. Forearm fractures in the pediatric population are most common following indirect blows to the forearm. When treating these fractures using closed reduction, it is important to recognize the muscular attachments of the forearm. In roughly 70-90% of cases, closed reduction leads to adequate alignment. In all cases, return to function is the primary goal; however, exact alignment parameters remain controversial. In the adolescent population, surgical treatment has risen substantially in the last few decades. Intramedullary nailing and open reduction using plate fixation are the two most common operative techniques. Unfortunately, recent results have shown that nonunion, malunion, and overall complication rates are higher in older pediatric patients. Moreover, no consensus exists regarding one technique over another. Both-bone diaphyseal fractures in the adolescent population present unique challenges regarding optimal treatment, especially when considering surgical intervention. Further research is necessary to better understand indications for specific surgical treatment.

  4. Fractured tracheostomy tube presenting as a foreign body in a paediatric patient

    Science.gov (United States)

    Gupta, Suman Lata; Swaminathan, Srinivasan; Ramya, Ravivalar; Parida, Satyen

    2016-01-01

    Tracheostomy tube fracture and aspiration into the tracheobronchial tree leading to airway obstruction is a dangerous complication after tracheostomy. We report a case of a fractured tracheostomy tube in a 6-year-old child who had been maintained on a tracheostomy tube for the past 5 years. The tracheostomy tube got fractured at the junction of the tube and neck plate, and impacted in the trachea and right main bronchus. Rigid bronchoscopy performed through the tracheostomy stoma to retrieve the fractured tracheostomy tube and the anaesthetic management during the period are discussed. PMID:26957033

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

    Science.gov (United States)

    Reesink, Heidi L

    2017-08-01

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

  6. Hybrid-dimensional modelling of two-phase flow through fractured porous media with enhanced matrix fracture transmission conditions

    Science.gov (United States)

    Brenner, Konstantin; Hennicker, Julian; Masson, Roland; Samier, Pierre

    2018-03-01

    In this work, we extend, to two-phase flow, the single-phase Darcy flow model proposed in [26], [12] in which the (d - 1)-dimensional flow in the fractures is coupled with the d-dimensional flow in the matrix. Three types of so called hybrid-dimensional two-phase Darcy flow models are proposed. They all account for fractures acting either as drains or as barriers, since they allow pressure jumps at the matrix-fracture interfaces. The models also permit to treat gravity dominated flow as well as discontinuous capillary pressure at the material interfaces. The three models differ by their transmission conditions at matrix fracture interfaces: while the first model accounts for the nonlinear two-phase Darcy flux conservations, the second and third ones are based on the linear single phase Darcy flux conservations combined with different approximations of the mobilities. We adapt the Vertex Approximate Gradient (VAG) scheme to this problem, in order to account for anisotropy and heterogeneity aspects as well as for applicability on general meshes. Several test cases are presented to compare our hybrid-dimensional models to the generic equi-dimensional model, in which fractures have the same dimension as the matrix, leading to deep insight about the quality of the proposed reduced models.

  7. Lower limb fractures associated with multiligament knee injury

    OpenAIRE

    Stagnaro, Joaquin; Yacuzzi, Carlos; Barla, Jorge; Zicaro, Juan Pablo; Costa-Paz, Matias

    2017-01-01

    Objectives: Knee ligament injuries related to lower limb fractures are common and frequently unnoticed. Management of acute polytrauma is usually focused in the bone lesion and a complete physical examination might be really difficult. The purpose of this study was to analyze a series of patients who suffered multiligament knee injuries associated to a lower limb fracture. Hypothesis: The use of magnetic resonance imaging (MRI) during the initial management can lead to an early diagnosis of l...

  8. Preliminary experience with biodegradable implants for fracture fixation

    Directory of Open Access Journals (Sweden)

    Dhillon Mandeep

    2008-01-01

    Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

  9. SCF(JFK) is a bona fide E3 ligase for ING4 and a potent promoter of the angiogenesis and metastasis of breast cancer.

    Science.gov (United States)

    Yan, Ruorong; He, Lin; Li, Zhongwu; Han, Xiao; Liang, Jing; Si, Wenzhe; Chen, Zhe; Li, Lei; Xie, Guojia; Li, Wanjin; Wang, Peiyan; Lei, Liandi; Zhang, Hongquan; Pei, Fei; Cao, Dengfeng; Sun, Luyang; Shang, Yongfeng

    2015-03-15

    Loss of function/dysregulation of inhibitor of growth 4 (ING4) and hyperactivation of NF-κB are frequent events in many types of human malignancies. However, the molecular mechanisms underlying these remarkable aberrations are not understood. Here, we report that ING4 is physically associated with JFK. We demonstrated that JFK targets ING4 for ubiquitination and degradation through assembly of an Skp1-Cul1-F-box (SCF) complex. We showed that JFK-mediated ING4 destabilization leads to the hyperactivation of the canonical NF-κB pathway and promotes angiogenesis and metastasis of breast cancer. Significantly, the expression of JFK is markedly up-regulated in breast cancer, and the level of JFK is negatively correlated with that of ING4 and positively correlated with an aggressive clinical behavior of breast carcinomas. Our study identified SCF(JFK) as a bona fide E3 ligase for ING4 and unraveled the JFK-ING4-NF-κB axis as an important player in the development and progression of breast cancer, supporting the pursuit of JFK as a potential target for breast cancer intervention. © 2015 Yan et al.; Published by Cold Spring Harbor Laboratory Press.

  10. The Criteria for the Selection of Wells for Hydraulic Fracturing

    Directory of Open Access Journals (Sweden)

    O.V. Salimov

    2017-12-01

    Full Text Available Various methods of selection of wells for hydraulic fracturing are analyzed. It is established that all methods can be divided into three large groups: criteria in the table form of boundary values of parameters, statistical methods of pattern recognition, methods of engineering calculation. The complication or use of additional parameters only leads to a reduction in the number of wells at which hydraulic fracturing is possible. It is shown that the use of reservoir properties of rocks, which are already used by hydraulic fracturing simulators, is not practicable as selection criteria. It is required to include in the selection criteria only those additional factors on which the effectiveness of hydraulic fracturing depends directly.

  11. Diabetes mellitus and bone health: epidemiology, etiology and implications for fracture risk stratification.

    Science.gov (United States)

    Valderrábano, Rodrigo J; Linares, Maria I

    2018-01-01

    Skeletal fractures can result when there are co-morbid conditions that negatively impact bone strength. Fractures represent an important source of morbidity and mortality, especially in older populations. Diabetes mellitus is a metabolic disorder that has reached worldwide epidemic proportions and is increasingly being recognized as a risk factor for fracture. Type 1 and Type 2 diabetes have different effects on bone mineral density but share common pathways, which lead to bone fragility. In this review, we discuss the available data on diabetes and fractures, bone density and the clinical implications for fracture risk stratification in current practice.

  12. Improving consent in patients undergoing surgery for fractured neck of femur.

    Science.gov (United States)

    Thiruchandran, Gajendiran; McKean, Andrew R; Rudran, Branavan; Imam, Mohamed A; Yeong, Keefai; Hassan, Abdel

    2018-05-02

    Background Neck of femur fractures and their subsequent operative fixation are associated with high rates of perioperative morbidity and mortality. Consenting in this setting is suboptimal with the Montgomery court ruling changing the perspective of consent. This quality improvement project assessed the adequacy of consenting against British Orthopaedic Association-endorsed guidance and implemented a series of changes to improve the documentation of risks associated with surgery for fractured neck of femur. Methods Seventy consecutive patients who underwent any operative fixation of a neck of femur fracture were included over a 6-month period at a single centre. Patients unable to consent or without electronic notes were excluded. Consent forms were analysed and the documented potential risks or complications associated with surgery were compared to British Orthopaedic Association-endorsed guidance. A series of changes (using the plan, do study, act (PDSA) approach) was implemented to improve the adequacy of consent. Results Documentation of four out of 12 potential risks or complications was recorded in <50% of cases for patients with intracapsular fractures (n=35), and documentation of seven out of 12 potential risks or complications was recorded in <50% of cases for patients with extracapsular fractures (n=35). Re-audit following raising awareness and attaching consent guidance showed 100% documentation of potential risks or complications in patients with intracapsular and extracapsular fractures (n=70). A neck of femur fracture-specific consent form has been implemented which will hopefully lead to sustained improvement. Conclusions Consenting patients with fractured neck of femur for surgery in the authors' unit was suboptimal when compared to British Orthopaedic Association-endorsed consent guidance. This project has shown that ensuring such guidance is readily available has improved the adequacy of consent. The authors hope that introduction of a neck of

  13. Multiple fracture planes in deuteron irradiated metals

    International Nuclear Information System (INIS)

    Jones, W.R.; Johnson, P.B.

    1987-01-01

    Evidence has been found of multiple fracture planes in the blistering and flaking of metals observed at room temperature following irradiation at 120 K with 200 keV deuterons. In particular, two fracture planes are identified in copper, gold and stainless steel and three in aluminium. In nickel only one fracture plane is found. Qualitative models are proposed which explain the different fracture planes that are observed. In these models it is proposed that several mechanisms are important. (i) High levels of compressional stress in the implanted layer inhibits bubble nucleation and bubble growth in the depth region near the maxima in the damage and gas deposition profiles. (ii) The lateral stress varies from compression in the implant region to tension in the material below. In the region of tension bubble growth is enhanced. The vertical gradient in the lateral stress may also assist gas to move deeper into the target to further enhance bubble growth in this region. (iii) Shear resulting from differential expansion due to a combination of radiation induced swelling and localised heating is an important mechanism leading to fracture. (orig.)

  14. Fracture Toughness of Carbon Nanotube-Reinforced Metal- and Ceramic-Matrix Composites

    International Nuclear Information System (INIS)

    Chen, Y.L.; Liu, B.; Hwang, K.C.; Chen, Y.L.; Huang, Y.

    2011-01-01

    Hierarchical analysis of the fracture toughness enhancement of carbon nanotube- (CNT-) reinforced hard matrix composites is carried out on the basis of shear-lag theory and fracture mechanics. It is found that stronger CNT/matrix interfaces cannot definitely lead to the better fracture toughness of these composites, and the optimal interfacial chemical bond density is that making the failure mode just in the transition from CNT pull-out to CNT break. For hard matrix composites, the fracture toughness of composites with weak interfaces can be improved effectively by increasing the CNT length. However, for soft matrix composite, the fracture toughness improvement due to the reinforcing CNTs quickly becomes saturated with an increase in CNT length. The proposed theoretical model is also applicable to short fiber-reinforced composites.

  15. Posterior rib fractures in a young infant who received chiropractic care.

    Science.gov (United States)

    Wilson, Paria Majd; Greiner, Mary V; Duma, Elena M

    2012-11-01

    We report on a 21-day-old infant with healing posterior rib fractures that were noted after a chiropractic visit for colic. Chiropractors are the third largest group of health care professionals in the United States, and colic is the leading complaint for pediatric chiropractic care. Rib fractures, specifically when posterior, are traditionally considered to be secondary to nonaccidental trauma. Thorough investigation is necessary to rule out bone fragility and genetic disorders, but patient history is key when evaluating unexplained fractures.

  16. Acetabular Fracture

    Directory of Open Access Journals (Sweden)

    Chad Correa

    2017-09-01

    Full Text Available History of present illness: A 77-year-old female presented to her primary care physician (PCP with right hip pain after a mechanical fall. She did not lose consciousness or have any other traumatic injuries. She was unable to ambulate post-fall, so X-rays were ordered by her PCP. Her X-rays were concerning for a right acetabular fracture (see purple arrows, so the patient was referred to the emergency department where a computed tomography (CT scan was ordered. Significant findings: The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows, with associated obturator muscle hematoma (blue oval. Discussion: Acetabular fractures are quite rare. There are 37 pelvic fractures per 100,000 people in the United States annually, and only 10% of these involve the acetabulum. They occur more frequently in the elderly totaling an estimated 4,000 per year. High-energy trauma is the primary cause of acetabular fractures in younger individuals and these fractures are commonly associated with other fractures and pelvic ring disruptions. Fractures secondary to moderate or minimal trauma are increasingly of concern in patients of advanced age.1 Classification of acetabular fractures can be challenging. However, the approach can be simplified by remembering the three basic types of acetabular fractures (column, transverse, and wall and their corresponding radiologic views. First, column fractures should be evaluated with coronally oriented CT images. This type of fracture demonstrates a coronal fracture line running caudad to craniad, essentially breaking the acetabulum into two halves: a front half and a back half. Secondly, transverse fractures should be evaluated by sagittally oriented CT images. By definition, a transverse fracture separates the acetabulum into superior and inferior halves with the fracture line extending from anterior to posterior

  17. Fracture surface energy of the Punchbowl fault, San Andreas system.

    Science.gov (United States)

    Chester, Judith S; Chester, Frederick M; Kronenberg, Andreas K

    2005-09-01

    Fracture energy is a form of latent heat required to create an earthquake rupture surface and is related to parameters governing rupture propagation and processes of slip weakening. Fracture energy has been estimated from seismological and experimental rock deformation data, yet its magnitude, mechanisms of rupture surface formation and processes leading to slip weakening are not well defined. Here we quantify structural observations of the Punchbowl fault, a large-displacement exhumed fault in the San Andreas fault system, and show that the energy required to create the fracture surface area in the fault is about 300 times greater than seismological estimates would predict for a single large earthquake. If fracture energy is attributed entirely to the production of fracture surfaces, then all of the fracture surface area in the Punchbowl fault could have been produced by earthquake displacements totalling <1 km. But this would only account for a small fraction of the total energy budget, and therefore additional processes probably contributed to slip weakening during earthquake rupture.

  18. Discovery of a new bona fide luminous blue variable in Norma

    Science.gov (United States)

    Gvaramadze, V. V.; Kniazev, A. Y.; Berdnikov, L. N.

    2015-12-01

    We report the results of optical spectroscopy of the candidate evolved massive star MN44 revealed via detection of a circular shell with the Spitzer Space Telescope. First spectra taken in 2009 May-June showed the Balmer lines in emission as well as numerous emission lines of iron, which is typical of luminous blue variables (LBVs) near the visual maximum. New observations carried out in 2015 May-September detected significant changes in the spectrum, indicating that the star became hotter. We found that these changes are accompanied by significant brightness variability of MN44. In particular, the Ic-band brightness decreased by ≈ 1.6 mag during the last six years and after reaching its minimum in 2015 June has started to increase. Using archival data, we also found that the Ic-band brightness increased by ≈3 mag in ≈30 yr preceding our observations. MN44 therefore represents the 17th known example of the Galactic bona fide LBVs. We detected a nitrogen-rich knot to the north-west of the star, which might represent an interstellar cloudlet interacting with the circumstellar shell. We discuss a possible association between MN44 and the INTEGRAL transient source of hard X-ray emission IGR J16327-4940, implying that MN44 might be either a colliding-wind binary or a high-mass X-ray binary.

  19. Femoral neck fractures after removal of hardware in healed trochanteric fractures.

    Science.gov (United States)

    Barquet, Antonio; Giannoudis, Peter V; Gelink, Andrés

    2017-12-01

    Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention. A comprehensive review of the literature was undertaken using the PRISMA guidelines with no language restriction. Case reports of FNFARIHTF and series of TF with cases of FNFARIHTF due to pain or discomfort published between inception of journals to December 2016 were eligible for inclusion. Relevant information was divided in two parts. Part I included the analysis of cases of FNFARIHTF, with the objective of establishing the eventual risk factors, mechanisms and pathoanatomy, clinical presentation and diagnosis, treatment and prevention. Part II analyzed series of TF which included cases of FNFARIHTF for assessing the incidence of femoral neck fractures in this condition. Overall 24 publications with 45 cases of FNFARIHTF met the inclusion criteria. We found that the only prevalent factors for FNFARIHTF were: 1) preexisisting systemic osteoporosis, as most patients were older and elder females, with lower bone mineral density and bone mass; 2) local osteoporosis as a result of preloading by the fixation device in the femoral neck, leading to stress protection, reducing the strain at the neck, and increasing bone loss and weakness; and 3) the removal of hardware from the femoral neck, with reduction of the failure strength of the neck. The femoral neck fractures were spontaneous, i.e. not related to trauma or

  20. Fluid transport in reaction induced fractures

    Science.gov (United States)

    Ulven, Ole Ivar; Sun, WaiChing; Malthe-Sørenssen, Anders

    2015-04-01

    The process of fracture formation due to a volume increasing chemical reaction has been studied in a variety of different settings, e.g. weathering of dolerites by Røyne et al. te{royne}, serpentinization and carbonation of peridotite by Rudge et al. te{rudge} and replacement reactions in silica-poor igneous rocks by Jamtveit et al. te{jamtveit}. It is generally assumed that fracture formation will increase the net permeability of the rock, and thus increase the reactant transport rate and subsequently the total rate of material conversion, as summarised by Kelemen et al. te{kelemen}. Ulven et al. te{ulven_1} have shown that for fluid-mediated processes the ratio between chemical reaction rate and fluid transport rate in bulk rock controls the fracture pattern formed, and Ulven et al. te{ulven_2} have shown that instantaneous fluid transport in fractures lead to a significant increase in the total rate of the volume expanding process. However, instantaneous fluid transport in fractures is clearly an overestimate, and achievable fluid transport rates in fractures have apparently not been studied in any detail. Fractures cutting through an entire domain might experience relatively fast advective reactant transport, whereas dead-end fractures will be limited to diffusion of reactants in the fluid, internal fluid mixing in the fracture or capillary flow into newly formed fractures. Understanding the feedback process between fracture formation and permeability changes is essential in assessing industrial scale CO2 sequestration in ultramafic rock, but little is seemingly known about how large the permeability change will be in reaction-induced fracturing. In this work, we study the feedback between fracture formation during volume expansion and fluid transport in different fracture settings. We combine a discrete element model (DEM) describing a volume expanding process and the related fracture formation with different models that describe the fluid transport in the

  1. Self-perception of fracture risk: what can it tell us?

    Science.gov (United States)

    Litwic, A E; Compston, J E; Wyman, A; Siris, E S; Gehlbach, S H; Adachi, J D; Chapurlat, R; Díez-Pérez, A; LaCroix, A Z; Nieves, J W; Netelenbos, J C; Pfeilschifter, J; Rossini, M; Roux, C; Saag, K G; Silverman, S; Watts, N B; Greenspan, S L; March, L; Gregson, C L; Cooper, C; Dennison, E M

    2017-12-01

    In this study, we report that self-perception of fracture risk captures some aspect of fracture risk not currently measured using conventional fracture prediction tools and is associated with improved medication uptake. It suggests that adequate appreciation of fracture risk may be beneficial and lead to greater healthcare engagement and treatment. This study aimed to assess how well self-perception of fracture risk, and fracture risk as estimated by the fracture prediction tool FRAX, related to fracture incidence and uptake and persistence of anti-osteoporosis medication among women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). GLOW is an international cohort study involving 723 physician practices across 10 countries in Europe, North America and Australia. Aged ≥ 55 years, 60,393 women completed baseline questionnaires detailing medical history, including co-morbidities, fractures and self-perceived fracture risk (SPR). Annual follow-up included self-reported incident fractures and anti-osteoporosis medication (AOM) use. We calculated FRAX risk without bone mineral density measurement. Of the 39,241 women with at least 1 year of follow-up data, 2132 (5.4%) sustained an incident major osteoporotic fracture over 5 years of follow-up. Within each SPR category, risk of fracture increased as the FRAX categorisation of risk increased. In GLOW, only 11% of women with a lower baseline SPR were taking AOM at baseline, compared with 46% of women with a higher SPR. AOM use tended to increase in the years after a reported fracture. However, women with a lower SPR who were fractured still reported lower AOM rates than women with or without a fracture but had a higher SPR. These results suggest that SPR captures some aspect of fracture risk not currently measured using conventional fracture prediction tools and is also associated with improved medication uptake.

  2. Associations of early premenopausal fractures with subsequent fractures vary by sites and mechanisms of fractures.

    Science.gov (United States)

    Honkanen, R; Tuppurainen, M; Kroger, H; Alhava, E; Puntila, E

    1997-04-01

    In a retrospective population-based study we assessed whether and how self-reported former fractures sustained at the ages of 20-34 are associated with subsequent fractures sustained at the ages of 35-57. The 12,162 women who responded to fracture questions of the baseline postal enquiry (in 1989) of the Kuopio Osteoporosis Study, Finland formed the study population. They reported 589 former and 2092 subsequent fractures. The hazard ratio (HR), with 95% confidence interval (CI), of a subsequent fracture was 1.9 (1.6-2.3) in women with the history of a former fracture compared with women without such a history. A former low-energy wrist fracture was related to subsequent low-energy wrist [HR = 3.7 (2.0-6.8)] and high-energy nonwrist [HR = 2.4 (1.3-4.4)] fractures, whereas former high-energy nonwrist fractures were related only to subsequent high-energy nonwrist [HR = 2.8 (1.9-4.1)] but not to low-energy wrist [HR = 0.7 (0.3-1.8)] fractures. The analysis of bone mineral density (BMD) data of a subsample of premenopausal women who underwent dual x-ray absorptiometry (DXA) during 1989-91 revealed that those with a wrist fracture due to a fall on the same level at the age of 20-34 recorded 6.5% lower spinal (P = 0.140) and 10.5% lower femoral (P = 0.026) BMD than nonfractured women, whereas the corresponding differences for women with a former nonwrist fracture due to high-energy trauma were -1.8% (P = 0.721) and -2.4% (P = 0. 616), respectively. Our results suggest that an early premenopausal, low-energy wrist fracture is an indicator of low peak BMD which predisposes to subsequent fractures in general, whereas early high-energy fractures are mainly indicators of other and more specific extraskeletal factors which mainly predispose to same types of subsequent fractures only.

  3. Mineral Precipitation in Fractures: Multiscale Imaging and Geochemical Modeling

    Science.gov (United States)

    Hajirezaie, S.; Peters, C. A.; Swift, A.; Sheets, J. M.; Cole, D. R.; Crandall, D.; Cheshire, M.; Stack, A. G.; Anovitz, L. M.

    2017-12-01

    For subsurface energy technologies such as geologic carbon sequestration, fractures are potential pathways for fluid migration from target formations. Highly permeable fractures may become sealed by mineral precipitation. In this study, we examined shale specimens with existing cemented fractures as natural analogues, using an array of imaging methods to characterize mineralogy and porosity at several spatial scales. In addition, we used reactive transport modeling to investigate geochemical conditions that can lead to extensive mineral precipitation and to simulate the impacts on fracture hydraulic properties. The naturally-cemented fractured rock specimens were from the Upper Wolfcamp formation in Texas, at 10,000 ft depth. The specimens were scanned using x-ray computed tomography (xCT) at resolution of 13 microns. The xCT images revealed an original fracture aperture of 1.9 mm filled with several distinct mineral phases and vuggy void regions, and the mineral phase volumes and surface areas were quantified and mapped in 3D. Specimens were thin-sectioned and examined at micron- and submicron-scales using petrographic microscopy (PM), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and small angle X-ray scattering (SAXS). Collectively these methods revealed crystals of dolomite as large as 900 microns in length overlain with a heterogeneous mixture of carbonate minerals including calcite, dolomite, and Fe-rich dolomite, interspersed at spatial scales as small as 5 microns. In addition, secondary precipitation of SiO2 was found to fill some of the void space. This multiscale imaging was used to inform the reactive transport modeling employed to examine the conditions that can cause the observed mineral precipitation in fractures at a larger scale. Two brines containing solutions that when mixed would lead to precipitation of various carbonate minerals were simulated as injectants into a fracture domain. In particular, the competing

  4. Maxillofacial fracture experiences: a review of 152 cases.

    Science.gov (United States)

    Aydin, Osman Enver; Tan, Onder; Algan, Said; Kuduban, Selma Denktas; Barin, Ensar Zafer; Cinal, Hakan; Sarici, Murat; Avsar, Umit

    2012-12-01

    The fractures of facial structures lead to great morbidity. Cross-sectional studies are needed to evaluate the current state of maxillofacial traumas. Thus, this study aims to evaluate these experiences and to compare these results with the current literature. The medical records of the maxillofacial fracture cases hospitalized between January 2004 and November 2011 were examined. The age, sex, etiology, fracture localization and treatment method for each case were documented. The affected facial bones were grouped as mandible, maxilla, zygoma, naso-orbitoethmoid complex (NOEC) and blow-out. Nasal fractures were excluded. The cases were assigned to 3 groups with respect to age (below 16, above 65 and between 17 and 64). The chi Square test was used to assess the significance of the difference in mandibular fracture rates in the pediatric population compared to others. The total number of cases was 152. The total number of fractures was 185. Of the 152 cases, 117 were male and 35 were female. The average age was 31.4 (±18.3), ranging between 2 and 81. Thirty-one cases were 16 years old or less. Nine cases were 65 years old or more. Mandibular and zygomatic fractures were the most prevalent fractures in the adult group. Mandibular fractures were significantly more common in the pediatric age group compared to rest of the population (X(2), pOpen reduction and internal fixation was the most frequently conducted treatment modality in all age groups. Retrospective studies are important for the projection of future prospects. In summary, our results indicate that pediatric fractures are mostly in the lower face and usually affect the condylar region, which is consistent with the literature.

  5. Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism.

    Science.gov (United States)

    Barbosa, Ana Paula; Rui Mascarenhas, Mário; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; do Carmo, Isabel; de Oliveira, António Gouveia

    2015-02-01

    Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups. A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm(2)) at L1-L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used. The mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures. The results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment. © 2015 European Society of Endocrinology.

  6. Stress fractures: definition, diagnosis and treatment.

    Science.gov (United States)

    Astur, Diego Costa; Zanatta, Fernando; Arliani, Gustavo Gonçalves; Moraes, Eduardo Ramalho; Pochini, Alberto de Castro; Ejnisman, Benno

    2016-01-01

    Stress fractures were first described in Prussian soldiers by Breithaupt in 1855. They occur as the result of repeatedly making the same movement in a specific region, which can lead to fatigue and imbalance between osteoblast and osteoclast activity, thus favoring bone breakage. In addition, when a particular region of the body is used in the wrong way, a stress fracture can occur even without the occurrence of an excessive number of functional cycles. The objective of this study was to review the most relevant literature of recent years in order to add key information regarding this pathological condition, as an updating article on this topic.

  7. Fracture mechanics and microstructures

    International Nuclear Information System (INIS)

    Gee, M.G.; Morrell, R.

    1986-01-01

    The influence of microstructure on defects in ceramics, and the consequences of their presence for the application of fracture mechanics theories are reviewed. The complexities of microstructures, especially the multiphase nature, the crystallographic anisotropy and the resultant anisotropic physical properties, and the variation of microstructure and surface finish from point to point in real components, all lead to considerable uncertainties in the actual performance of any particular component. It is concluded that although the concepts of fracture mechanics have been and will continue to be most useful for the qualitative explanation of fracture phenomena, the usefulness as a predictive tool with respect to most existing types of material is limited by the interrelation between material microstructure and mechanical properties. At present, the only method of eliminating components with unsatisfactory mechanical properties is to proof-test them, despite the fact that proof-testing itself is limited in ability to cope with changes to the component in service. The aim of the manufacturer must be to improve quality and consistency within individual components, from component to component, and from batch to batch. The aim of the fracture specialist must be to study longer-term properties to improve the accuracy of behaviour predictions with a stronger data base. Materials development needs to concentrate on obtaining defect-free materials that can be translated into more-reliable products, using our present understanding of the influence of microstructure on strength and toughness

  8. Universal Linear Scaling of Permeability and Time for Heterogeneous Fracture Dissolution

    Science.gov (United States)

    Wang, L.; Cardenas, M. B.

    2017-12-01

    Fractures are dynamically changing over geological time scale due to mechanical deformation and chemical reactions. However, the latter mechanism remains poorly understood with respect to the expanding fracture, which leads to a positively coupled flow and reactive transport processes, i.e., as a fracture expands, so does its permeability (k) and thus flow and reactive transport processes. To unravel this coupling, we consider a self-enhancing process that leads to fracture expansion caused by acidic fluid, i.e., CO2-saturated brine dissolving calcite fracture. We rigorously derive a theory, for the first time, showing that fracture permeability increases linearly with time [Wang and Cardenas, 2017]. To validate this theory, we resort to the direct simulation that solves the Navier-Stokes and Advection-Diffusion equations with a moving mesh according to the dynamic dissolution process in two-dimensional (2D) fractures. We find that k slowly increases first until the dissolution front breakthrough the outbound when we observe a rapid k increase, i.e., the linear time-dependence of k occurs. The theory agrees well with numerical observations across a broad range of Peclet and Damkohler numbers through homogeneous and heterogeneous 2D fractures. Moreover, the theory of linear scaling relationship between k and time matches well with experimental observations of three-dimensional (3D) fractures' dissolution. To further attest to our theory's universality for 3D heterogeneous fractures across a broad range of roughness and correlation length of aperture field, we develop a depth-averaged model that simulates the process-based reactive transport. The simulation results show that, regardless of a wide variety of dissolution patterns such as the presence of dissolution fingers and preferential dissolution paths, the linear scaling relationship between k and time holds. Our theory sheds light on predicting permeability evolution in many geological settings when the self

  9. Numerical modeling of shear stimulation in naturally fractured geothermal reservoirs

    OpenAIRE

    Ucar, Eren

    2018-01-01

    Shear-dilation-based hydraulic stimulations are conducted to create enhanced geothermal systems (EGS) from low permeable geothermal reservoirs, which are initially not amenable to energy production. Reservoir stimulations are done by injecting low-pressurized fluid into the naturally fractured formations. The injection aims to activate critically stressed fractures by decreasing frictional strength and ultimately cause a shear failure. The shear failure leads to a permanent ...

  10. Experimental characterization and modelling of the alteration of fractured cement under CO2 storage conditions

    International Nuclear Information System (INIS)

    Abdoulghafour, Halidi

    2012-01-01

    The main purpose of this thesis was to characterize and to model the hydrodynamic and thermochemical processes leading to the alteration of the wellbore cement materials under borehole conditions. Percolation experiments were performed on fractured cement samples under CO 2 storage conditions (60 C and 10 MPa). Injection flow rate was dictated by the fracture aperture of each sample. CO 2 enriched brine was flowed along the fracture aperture, and permeability changes as well as chemical evolution of major cations were continuously acquired during the experiment time. Reaction paths developed by the alteration of the cement were characterized using microtomography and ESEM images. The experiments conducted using samples presenting large fracture apertures during 5 h showed that permeability was maintained constant during the experiment time. Three reacted layers were displaying by the alteration of portlandite and CSH. Long term experiment (26 h) conducted with large initial fracture aperture showed a decrease of the permeability after 15 hours of CO 2 exposure. Otherwise, experiments performed on samples presenting narrow apertures indicated the conversion of portlandite and CSH to calcite leading to the permeability reduction and the fracture clogging. Assemblages of phases and chemical changes were modelled using GEMS-PSI speciation code. We studied also using a coupled transport-reactive model the conditions leading to the cement alteration and the formation of associated layers. (author)

  11. Ballistic fractures: indirect fracture to bone.

    Science.gov (United States)

    Dougherty, Paul J; Sherman, Don; Dau, Nathan; Bir, Cynthia

    2011-11-01

    Two mechanisms of injury, the temporary cavity and the sonic wave, have been proposed to produce indirect fractures as a projectile passes nearby in tissue. The purpose of this study is to evaluate the temporal relationship of pressure waves using strain gauge technology and high-speed video to elucidate whether the sonic wave, the temporary cavity, or both are responsible for the formation of indirect fractures. Twenty-eight fresh frozen cadaveric diaphyseal tibia (2) and femurs (26) were implanted into ordnance gelatin blocks. Shots were fired using 9- and 5.56-mm bullets traversing through the gelatin only, passing close to the edge of the bone, but not touching, to produce an indirect fracture. High-speed video of the impact event was collected at 20,000 frames/s. Acquisition of the strain data were synchronized with the video at 20,000 Hz. The exact time of fracture was determined by analyzing and comparing the strain gauge output and video. Twenty-eight shots were fired, 2 with 9-mm bullets and 26 with 5.56-mm bullets. Eight indirect fractures that occurred were of a simple (oblique or wedge) pattern. Comparison of the average distance of the projectile from the bone was 9.68 mm (range, 3-20 mm) for fractured specimens and 15.15 mm (range, 7-28 mm) for nonfractured specimens (Student's t test, p = 0.036). In this study, indirect fractures were produced after passage of the projectile. Thus, the temporary cavity, not the sonic wave, was responsible for the indirect fractures.

  12. Cementless Stem for Femoral Neck Fractures in a Patient's 10th Decade of Life: High Rate of Periprosthetic Fractures.

    Science.gov (United States)

    Kabelitz, Method; Fritz, Yannick; Grueninger, Patrick; Meier, Christoph; Fries, Patrick; Dietrich, Michael

    2018-01-01

    Subsidence of cementless femoral stems in hemiarthroplasty (HA) and increased fracture rates are ongoing concerns of orthopedic surgeons when treating fractures in very old patients. Additionally, bone cement implantation syndrome may result in perioperative cardiac or pulmonary complications, especially in older patients, leading to morbidity and mortality. This study was performed to analyze possible subsidence and intraoperative fractures in a cohort of very old patients treated with cementless stems. We retrospectively analyzed a consecutive cohort of patients aged ≥90 years with femoral neck fractures treated by uncemented HA and an anterior minimally invasive approach. Immediate full-weight bearing was allowed postoperatively. Pelvic radiographs were examined for subsidence immediately postoperatively and 6 weeks later. We treated 109 patients (74% women; mean age, 93 years; range, 90-102 years) by HA from January 2010 to March 2016. The 30-day mortality rate was 16%, and the morbidity rate was 47%. There were 11 (12%) intraoperative fractures: 8 (Vancouver B 2 ) had to be addressed immediately during the primary operation, while 3 (1 Vancouver B 1 and 2 Vancouver A G ) were treated conservatively. One periprosthetic femoral fracture (Vancouver B 1 ) was documented during follow-up. In 17 patients, subsidence of >2.0 mm (median, 3.9 mm; range, 2.5-9.0 mm) was documented. Early subsidence was low in this very old cohort treated with an uncemented stem and not showing a periprosthetic fracture. The risk of intraoperative periprosthetic fractures was high. The use of uncemented implants in osteoporotic bone continues to be an intervention with high risk and should only be performed by experienced surgeons. Level III, Therapeutic study.

  13. Distinguishing stress fractures from pathologic fractures: a multimodality approach

    International Nuclear Information System (INIS)

    Fayad, Laura M.; Kamel, Ihab R.; Kawamoto, Satomi; Bluemke, David A.; Fishman, Elliot K.; Frassica, Frank J.

    2005-01-01

    Whereas stress fractures occur in normal or metabolically weakened bones, pathologic fractures occur at the site of a bone tumor. Unfortunately, stress fractures may share imaging features with pathologic fractures on plain radiography, and therefore other modalities are commonly utilized to distinguish these entities. Additional cross-sectional imaging with CT or MRI as well as scintigraphy and PET scanning is often performed for further evaluation. For the detailed assessment of a fracture site, CT offers a high-resolution view of the bone cortex and periosteum which aids the diagnosis of a pathologic fracture. The character of underlying bone marrow patterns of destruction can also be ascertained along with evidence of a soft tissue mass. MRI, however, is a more sensitive technique for the detection of underlying bone marrow lesions at a fracture site. In addition, the surrounding soft tissues, including possible involvement of adjacent muscle, can be well evaluated with MRI. While bone scintigraphy and FDG-PET are not specific, they offer a whole-body screen for metastases in the case of a suspected malignant pathologic fracture. In this review, we present select examples of fractures that underscore imaging features that help distinguish stress fractures from pathologic fractures, since accurate differentiation of these entities is paramount. (orig.)

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

    Science.gov (United States)

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

    2015-02-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

  16. Rib fractures in trauma patients: does operative fixation improve outcome?

    Science.gov (United States)

    Majak, Peter; Næss, Pål A

    2016-12-01

    Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively. Although patient selection and timing of the operation seem crucial for successful outcome, no consensus exists. Mortality reduction has only been shown in a few studies. Most studies are retrospective cohort and case-control studies. Only four randomized control trials exist. Conservative treatment, consisting of respiratory assistance and pain control, is still the treatment of choice in the vast majority of patients with multiple rib fractures. In selected patients, operative fixation of fractured ribs within 72 h postinjury may lead to better outcome. More randomized control trials are needed to further determine who benefits from surgical fixation of rib fractures.

  17. Hip fractures. Epidemiology, risk factors, falls, energy absorption, hip protectors, and prevention

    DEFF Research Database (Denmark)

    Lauritzen, J B

    1997-01-01

    have a high risk of hip fracture (annual rate of 5-6%), and the incidence of falls is about 1,500 falls/1,000 persons/year. Most hip fractures are a result of a direct trauma against the hip. The incidence of falls on the hip among nursing home residents is about 290 falls/1,000 persons/year and about......%, corresponding to 9 out of 247 residents saved from sustaining a hip fracture. The review points to the essentials of the development of hip fracture, which constitutes; risk of fall, type of fall, type of impact, energy absorption, and lastly bone strength, which is the ultimate and last permissive factor......The present review summarizes the pathogenic mechanisms leading to hip fracture based on epidemiological, experimental, and controlled studies. The estimated lifetime risk of hip fracture is about 14% in postmenopausal women and 6% in men. The incidence of hip fractures increases exponentially...

  18. Fracture mechanics based life assessment in petrochemical plants

    International Nuclear Information System (INIS)

    Norasiah Ab Kasim; Abd Nassir Ibrahim; Ab Razak Hamzah; Shukri Mohd

    2004-01-01

    The increasing use of thick walled pressure vessels in petrochemical plants operating at high pressure under severe service conditions could lead to catastrophic failure. In the Malaysian Institute for Nuclear Technology Research (MINT), initial efforts are underway to apply fracture mechanics approach for assessment of significance of defects detected during periodic in service inspection (ISI) of industrial plants. This paper outlines the integrity management strategy based on fracture mechanics and proposes a new procedure for life assessment of petrochemical plants based on ASME Boiler and Pressure Vessel Code, Section XI, BSI PD 6493:1991, BSI 6539:1994, BSI Standard 7910:1999 and API 579:2000. Essential relevant data required for the assessment is listed. Several methods available for determination of fracture toughness are reviewed with limitations in their application to petrochemical plants. A new non destructive method for determination of fracture toughness based on hardness testing and normalized key roughness curve is given. Results of fracture mechanics based life assessment conducted for 100 mm thick ammonia converter of Ni r o steel and 70 mm thick plat forming reactor vessel of ASTM A 38 7 grade B steel in operational fertilizer and petroleum refining plants are presented. (Author)

  19. Bilateral Stress Fractures of the Femoral Neck from Renal Osteomalacia: A Case Report

    Directory of Open Access Journals (Sweden)

    S Sengupta

    2008-04-01

    Full Text Available A rare case of spontaneous bilateral stress fractures of femoral neck leading to coxa vara in a young female with history of chronic renal disease and secondary osteomalacia is described. Once the underlying disease was controlled, the fracture was treated by valgus osteotomy with good result.

  20. The void nucleation mechanism within lead phase during spallation of leaded brass

    Science.gov (United States)

    Yang, Yang; Wang, Can; Chen, Xingzhi; Chen, Kaiguo; Hu, Haibo; Fu, Yanan

    2018-07-01

    The incipient spall behaviours of Cu-34%Zn-3%Pb leaded brass samples with annealed and cryogenic-treated conditions were loaded using one-stage light gas gun experiments. The effect of Pb-phase on dynamic damage nucleation in leaded brass specimens was investigated by means of optical microscopy, scanning electron microscopy and x-ray computer tomography. It was found that the voids of incipient spall were mainly nucleated in the interior of the lead (no tensile stress would be produced within lead according to the impact theory) instead of nucleated at the phase interface as expected by quasi-static damage fracture theory. A nucleation model is proposed in the present work that is the asymmetry high compression zones in the centre of the lead-phase were formed by the rarefaction wave convergence effects of matrix/quasi-spherical lead interface, which caused adiabatic temperature rise that exceeded melting point of lead due to severe plastic deformation, finally led to local melting and void nucleation. In addition, the spall strength and damage rate increased with the increase in the Pb-phase number.

  1. Flow characteristics through a single fracture of artificial fracture system

    International Nuclear Information System (INIS)

    Park, Byoung Yoon; Bae, Dae Seok; Kim, Chun Soo; Kim, Kyung Su; Koh, Young Kwon; Jeon, Seok Won

    2001-04-01

    Fracture flow in rock masses is one of the most important issues in petroleum engineering, geology, and hydrogeology. Especially, in case of the HLW disposal, groundwater flow in fractures is an important factor in the performance assessment of the repository because the radionuclides move along the flowing groundwater through fractures. Recently, the characterization of fractures and the modeling of fluid flow in fractures are studied by a great number of researchers. Among those studies, the hydraulic behavior in a single fracture is one of the basic issues for understanding of fracture flow in rockmass. In this study, a fluid flow test in the single fracture made of transparent epoxy replica was carried out to obtain the practical exponent values proposed from the Cubic law and to estimate the flow rates through a single fracture. Not only the relationship between flow rates and the geometry of fracture was studied, but also the various statistical parameters of fracture geometry were compared to the effective transmissivity data obtained from computer simulation.

  2. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol.

    Science.gov (United States)

    Witt, Cordelie E; Bulger, Eileen M

    2017-01-01

    Rib fractures are common among patients sustaining blunt trauma, and are markers of severe bodily and solid organ injury. They are associated with high morbidity and mortality, including multiple pulmonary complications, and can lead to chronic pain and disability. Clinical and radiographic scoring systems have been developed at several institutions to predict risk of complications. Clinical strategies to reduce morbidity have been studied, including multimodal pain management, catheter-based analgesia, pulmonary hygiene, and operative stabilization. In this article, we review risk factors for morbidity and complications, intervention strategies, and discuss experience with bundled clinical pathways for rib fractures. In addition, we introduce the multidisciplinary rib fracture management protocol used at our level I trauma center.

  3. A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

    Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.

  4. Anatomical reconstruction of unstable trochanteric fractures through posterior approach

    Directory of Open Access Journals (Sweden)

    Partha Saha

    2015-01-01

    Full Text Available Objective Unstable intertrochanteric fractures continue to be a challenge for orthopedic surgeons due to the functional limitations it results in the postoperative period. Anatomical reconstruction of the posteromedial fragment becomes difficult through conventional lateral approach, leading to excessive fracture collapse and limping. Materials and Methods: prospective, nonrandomized study was done with 40 patients. They were operated in prone position through posterior approach. Cancellous screws or SS-wires were used to fix the greater or lesser trochanteric fragments and dynamic hip screw (DHS or dynamic condylar screw (DCS for the main two fragments. Bone grafts were used to pack cavities at the posterior trochanteric regions. Results: Fracture healing occurred earlier compared to conventional lateral approach without excessive fracture collapse in majority of cases (average time to achieve union was 13.8 weeks; range: 10–18 weeks. Good functional recovery was noted with 75% 'Good' or 'Excellent' Harris Hip Scores at 24 weeks. Conclusion: Anatomical reconstruction of unstable trochanteric fractures becomes easier through posterior approach with earlier and better functional recovery.

  5. early functional outcome of distal femoral fractures at kenyatta

    African Journals Online (AJOL)

    The leading cause was RTA, followed by falls from a height. ... Distal femoral fractures cause considerable morbidity .... as means and standard deviations. .... Anaesthesia. Spinal. 37 (80). General Anaesthesia (GA). 9 (20). Transfusion.

  6. Multiple-point statistical prediction on fracture networks at Yucca Mountain

    International Nuclear Information System (INIS)

    Liu, X.Y; Zhang, C.Y.; Liu, Q.S.; Birkholzer, J.T.

    2009-01-01

    In many underground nuclear waste repository systems, such as at Yucca Mountain, water flow rate and amount of water seepage into the waste emplacement drifts are mainly determined by hydrological properties of fracture network in the surrounding rock mass. Natural fracture network system is not easy to describe, especially with respect to its connectivity which is critically important for simulating the water flow field. In this paper, we introduced a new method for fracture network description and prediction, termed multi-point-statistics (MPS). The process of the MPS method is to record multiple-point statistics concerning the connectivity patterns of a fracture network from a known fracture map, and to reproduce multiple-scale training fracture patterns in a stochastic manner, implicitly and directly. It is applied to fracture data to study flow field behavior at the Yucca Mountain waste repository system. First, the MPS method is used to create a fracture network with an original fracture training image from Yucca Mountain dataset. After we adopt a harmonic and arithmetic average method to upscale the permeability to a coarse grid, THM simulation is carried out to study near-field water flow in the surrounding waste emplacement drifts. Our study shows that connectivity or patterns of fracture networks can be grasped and reconstructed by MPS methods. In theory, it will lead to better prediction of fracture system characteristics and flow behavior. Meanwhile, we can obtain variance from flow field, which gives us a way to quantify model uncertainty even in complicated coupled THM simulations. It indicates that MPS can potentially characterize and reconstruct natural fracture networks in a fractured rock mass with advantages of quantifying connectivity of fracture system and its simulation uncertainty simultaneously.

  7. Cementless Stem for Femoral Neck Fractures in a Patient’s 10th Decade of Life: High Rate of Periprosthetic Fractures

    Science.gov (United States)

    Kabelitz, Method; Fritz, Yannick; Grueninger, Patrick; Meier, Christoph; Fries, Patrick

    2018-01-01

    Background: Subsidence of cementless femoral stems in hemiarthroplasty (HA) and increased fracture rates are ongoing concerns of orthopedic surgeons when treating fractures in very old patients. Additionally, bone cement implantation syndrome may result in perioperative cardiac or pulmonary complications, especially in older patients, leading to morbidity and mortality. This study was performed to analyze possible subsidence and intraoperative fractures in a cohort of very old patients treated with cementless stems. Methods: We retrospectively analyzed a consecutive cohort of patients aged ≥90 years with femoral neck fractures treated by uncemented HA and an anterior minimally invasive approach. Immediate full-weight bearing was allowed postoperatively. Pelvic radiographs were examined for subsidence immediately postoperatively and 6 weeks later. Results: We treated 109 patients (74% women; mean age, 93 years; range, 90-102 years) by HA from January 2010 to March 2016. The 30-day mortality rate was 16%, and the morbidity rate was 47%. There were 11 (12%) intraoperative fractures: 8 (Vancouver B2) had to be addressed immediately during the primary operation, while 3 (1 Vancouver B1 and 2 Vancouver AG) were treated conservatively. One periprosthetic femoral fracture (Vancouver B1) was documented during follow-up. In 17 patients, subsidence of >2.0 mm (median, 3.9 mm; range, 2.5-9.0 mm) was documented. Conclusion: Early subsidence was low in this very old cohort treated with an uncemented stem and not showing a periprosthetic fracture. The risk of intraoperative periprosthetic fractures was high. The use of uncemented implants in osteoporotic bone continues to be an intervention with high risk and should only be performed by experienced surgeons. Level of Evidence: Level III, Therapeutic study. PMID:29623237

  8. Fracture toughness of fibrous composite materials

    Science.gov (United States)

    Poe, C. C., Jr.

    1984-01-01

    Laminates with various proportions of 0 deg, 45 deg, and 90 deg plies were fabricated from T300/5208 and T300/BP-907 graphite/epoxy prepreg tape material. The fracture toughness of each laminate orientation or lay-up was determined by testing center-cracked specimens, and it was also predicted with the general fracture-toughness parameter. The predictions were good except when crack-tip splitting was large, at which time the toughness and strengths tended to be underpredicted. By using predictions, a parametric study was also made of factors that influence fracture toughness. Fiber and matrix properties as well as lay-up were investigated. Without crack-tip splitting, fracture toughness increases in proportion to fiber strength and fiber volume fraction, increases linearly with E(22)/E(11), is largest when the modulus for non-0 deg fibers is greater than that of 0 deg fibers, and is smallest for 0(m)/90(p)(s) lay-ups. (The E(11) and E(22) are Young's moduli of the lamina parallel to and normal to the direction of the fibers, respectively). For a given proportion of 0 deg plies, the most notch-sensitive lay-ups are 0(m)/90(p)(s) and the least sensitive are 0(m)/45(n)(s) and alpha(s). Notch sensitivity increases with the proportion of 0 deg plies and decreases with alpha. Strong, tough matrix materials, which inhibit crack-tip splitting, generally lead to minimum fracture toughness.

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

    International Nuclear Information System (INIS)

    Tsang, C.F.

    1986-12-01

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

  10. Chance Fracture Secondary to a Healed Kyphotic Compression Osteoporotic Fracture

    Directory of Open Access Journals (Sweden)

    Teh KK

    2009-11-01

    Full Text Available Chance fracture is an unstable vertebral fracture, which usually results from a high velocity injury. An elderly lady with a previously healed osteoporotic fracture of the T12 and L1 vertebra which resulted in a severe kyphotic deformity subsequently sustained a Chance fracture of the adjacent L2 vertebrae after a minor fall. The previously fracture left her with a deformity which resulted in significant sagittal imbalance therefore predisposing her to this fracture. This case highlights the importance of aggressive treatment of osteoporotic fractures in order to prevent significant sagittal imbalance from resultant (i.e. kyphotic deformity.

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

    Science.gov (United States)

    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.

  12. Hip Fracture

    Science.gov (United States)

    ... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...

  13. Ankle fractures have features of an osteoporotic fracture.

    Science.gov (United States)

    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 (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.

  14. Non traumatic fractures of the lumbar spine and seizures: case report

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2015-12-01

    Full Text Available Injury-induced seizures may appear clinically asymptomatic and can be easily monitored by the absence of trauma and post-ictal impairment of consciousness. Patients with epilepsy have a higher risk of compression fractures, leading to serious musculoskeletal injuries, this type of non-traumatic compression fractures of the spine secondary to seizures are rare lesions, and is produced by the severe contraction of the paraspinal muscles that can achieve the thoracic spine fracture. Seizures induced lesions may appear clinically asymptomatic and can be easily monitored by the absence of trauma and post-ictal impairment of consciousness. We present a case report.

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  17. The impact of thyroid diseases on bone metabolism and fracture risk.

    Science.gov (United States)

    Amashukeli, M; Giorgadze, E; Tsagareli, M; Nozadze, N; Jeiranashvili, N

    2010-01-01

    Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. One of the leading causes of secondary osteoporosis are thyroid diseases; this fact carries special importance for Georgia because of thyroid disease prevalence in Georgian population. In the present article we discuss the mechanisms, by which thyroid hormones and thyroid stimulating hormone (TSH) act on bone. We also present the data of meta-analysis of large studies, which demonstrate the complex relationship between the thyroid diseases and bone mineral density as well as the fracture risk; namely by overt and subclinical thyrotoxicosis, hypothyroidism and the treatment with the suppressive doses of levothyroxine. Beside that, we review the related data and the possible reasons, why different treatment regimens of Grave's disease: conservative, operative and radioiodine are related to different fracture risks. Finally, we discuss briefly the practical aspects of the treatment of secondary osteoporosis, related with thyroid diseases.

  18. Isolated Displaced Fracture of the Lesser Tuberosity

    African Journals Online (AJOL)

    publication of this report. The authors declare no competing interests. Discussion. A delay in diagnosis of a lesser tuberosity fracture may lead to significant future clinical disability (2). In one such case the patient presented with axillary nerve neuropraxia while another case reported displacement of the biceps tendon (4).

  19. Relationships between fractures

    Science.gov (United States)

    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.

  20. Costal cartilage fractures and disruptions in a rugby football player.

    Science.gov (United States)

    Lopez, Victor; Ma, Richard; Li, Xinning; Steele, John; Allen, Answorth A

    2013-05-01

    Costal cartilage fracture of the rib cage, or costochondral, is a rare sporting injury. For contact athletes, the instability of the rib cage may lead to potential serious complications, similar to rib fractures or thorax disruption. Most authors recommend initial conservative treatment with surgery reserved for only recalcitrant cases. We report a case of an amateur American male rugby football player who sustained a costal cartilage fracture and disruption involving the anterior left fifth and sixth rib costal cartilages. The case highlights the difficulty in establishing the diagnosis based on clinical examination and standard radiographs alone. Computed tomography was used to assist in diagnosing this destabilizing injury to the rib cage. Costal cartilage fractures and disruptions in athletes are rarely reported in the literature and can have serious implications for the athlete's ability to return to play if the rib cage is destabilized.

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

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

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

  2. Proximal femoral fractures.

    Science.gov (United States)

    Webb, Lawrence X

    2002-01-01

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

  3. Fracture mechanisms and fracture control in composite structures

    Science.gov (United States)

    Kim, Wone-Chul

    Four basic failure modes--delamination, delamination buckling of composite sandwich panels, first-ply failure in cross-ply laminates, and compression failure--are analyzed using linear elastic fracture mechanics (LEFM) and the J-integral method. Structural failures, including those at the micromechanical level, are investigated with the aid of the models developed, and the critical strains for crack propagation for each mode are obtained. In the structural fracture analyses area, the fracture control schemes for delamination in a composite rib stiffener and delamination buckling in composite sandwich panels subjected to in-plane compression are determined. The critical fracture strains were predicted with the aid of LEFM for delamination and the J-integral method for delamination buckling. The use of toughened matrix systems has been recommended for improved damage tolerant design for delamination crack propagation. An experimental study was conducted to determine the onset of delamination buckling in composite sandwich panel containing flaws. The critical fracture loads computed using the proposed theoretical model and a numerical computational scheme closely followed the experimental measurements made on sandwich panel specimens of graphite/epoxy faceskins and aluminum honeycomb core with varying faceskin thicknesses and core sizes. Micromechanical models of fracture in composites are explored to predict transverse cracking of cross-ply laminates and compression fracture of unidirectional composites. A modified shear lag model which takes into account the important role of interlaminar shear zones between the 0 degree and 90 degree piles in cross-ply laminate is proposed and criteria for transverse cracking have been developed. For compressive failure of unidirectional composites, pre-existing defects play an important role. Using anisotropic elasticity, the stress state around a defect under a remotely applied compressive load is obtained. The experimentally

  4. Avascular Necrosis of Trochlea After Supracondylar Humerus Fractures in Children.

    Science.gov (United States)

    Etier, Brian E; Doyle, J Scott; Gilbert, Shawn R

    2015-10-01

    Avascular necrosis (AVN) is a rare but important complication after supracondylar humerus fractures. Posttraumatic humerus deformity was first reported in 1948 and sporadically thereafter. AVN deformity has been classified as type A (AVN of the lateral ossification center) and type B (AVN of the entire medial crista and a metaphyseal portion). In this article, we present 5 cases of AVN after supracondylar humerus fracture, discuss the importance of late clinical findings, and postulate a mechanism of AVN in nondisplaced fractures. Five cases of AVN after supracondylar humerus fracture were reviewed from the Children's of Alabama database. Four of the 5 patients were female. Four patients sustained a Gartland type III fracture, and 1 patient sustained a nondisplaced Gartland type I fracture. Age at time of injury ranged from 5 years to 10 years. All patients had an asymptomatic clinical period after treatment and re-presented 6 months to 7 years later with elbow pain or loss of motion. All patients were treated symptomatically. AVN of the trochlea has a late clinical presentation. The cause of this complication is interruption of the trochlea blood supply. In displaced fractures, the medial and/or lateral vessels are injured, leading to type A or type B deformity. In nondisplaced fractures, the lateral vessels are interrupted by tamponade because of encased fracture hematoma; this presents as a type A deformity. Both type A and type B deformities can be clinically significant. AVN of the trochlea should be considered in patients with late presentation of pain or loss of motion after treatment of supracondylar humerus fractures.

  5. Time dependent fracture growth in intact crystalline rock: new laboratory procedures

    International Nuclear Information System (INIS)

    Backers, T.; Stephansson, O.

    2008-01-01

    Short term laboratory tests to determine the strength of rock material are commonly used to assess stability of rock excavations. However, loading the rock below its short term strength may lead to delayed failure due to slow stable fracture growth. This time-dependent phenomenon is called subcritical fracture growth. A fracture mechanics based approach is applied in this study to determine the parameters describing subcritical fracture growth under Mode Ⅰ (tensile) and Mode Ⅱ (in-plane shear) loading in terms of the stress intensity factors of saturated granodiorite from the) Aespoe HRL. A statistical method is applied to data from three-point bending (tension) and Punch-Through Shear with Confining Pressure, PTS/CP, (shear) experiments. One population of each set-up was subjected to rapid loading tests yielding a strength probability distribution. A second population was loaded up to a certain fraction of the statistical percentage for failure and the time-to-failure was determined. From these two populations the subcritical fracture growth parameters were determined successfully. Earlier studies demonstrated subcritical fracture growth under Mode I loading conditions, but this study shows that under a Mode Ⅱ load time-dependent fracture growth exists as well. (authors)

  6. Fracture behaviour of the 14Cr ODS steel exposed to helium and liquid lead

    Energy Technology Data Exchange (ETDEWEB)

    Hojna, Anna, E-mail: Anna.Hojna@cvrez.cz [Centrum Vyzkumu Rez s.r.o., UJV Group, Rez 130, 250 68 Husinec (Czech Republic); Di Gabriele, Fosca [Centrum Vyzkumu Rez s.r.o., UJV Group, Rez 130, 250 68 Husinec (Czech Republic); Hadraba, Hynek; Husak, Roman; Kubena, Ivo [CEITEC IPM, Institute of Physics of Materials, Academy of Sciences of the Czech Republic, Zizkova 22, 616 62 Brno (Czech Republic); Rozumova, Lucia; Bublikova, Petra; Kalivodova, Jana [Centrum Vyzkumu Rez s.r.o., UJV Group, Rez 130, 250 68 Husinec (Czech Republic); Matejicek, Jiri [Institute of Plasma Physics, Academy of Sciences of the Czech Republic, Za Slovankou 1782/3, 182 00 Praha (Czech Republic)

    2017-07-15

    This work describes the fracture behaviour of the 14Cr ODS steel produced by mechanical alloying process, after high temperature exposures. Small specimens were exposed to helium gas in a furnace at 720 °C for 500 h. Another set of specimens was exposed to flowing liquid lead in the COLONRI II loop at 650 °C for 1000 h. All specimens were tested for the impact and tensile behaviour. The impact test results are compared to other sets of specimens in the as received state and after isothermal annealing at 650 °C for 1000 h. The impact curves of the exposed materials showed positive shifts on the transition temperature. While the upper shelf value did not change in the Pb exposed ODS steel, it significantly increased in the He exposed one. The differences are discussed in terms of surface and subsurface microscopy observation. The embrittlement can be explained as the effect of a slight change in the grain boundary and size distribution combined with the depletion of sub-surface region from alloying elements forming oxide scale on the surface. - Highlights: •We compared the impact energy curves of as received, isothermally aged and He/Pb exposed ODS steel samples. •The highest transition temperature showed the ODS steel exposed to liquid Pb at 650 °C for 1000 h. •We observed the higher tendency of the He exposed samples to crack arrester delamination than the Pb exposed ones. •The crack arrested delamination induced apparent increase of impact energies.

  7. A Thermoelastic Hydraulic Fracture Design Tool for Geothermal Reservoir Development

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad Ghassemi

    2003-06-30

    Geothermal energy is recovered by circulating water through heat exchange areas within a hot rock mass. Geothermal reservoir rock masses generally consist of igneous and metamorphic rocks that have low matrix permeability. Therefore, cracks and fractures play a significant role in extraction of geothermal energy by providing the major pathways for fluid flow and heat exchange. Thus, knowledge of conditions leading to formation of fractures and fracture networks is of paramount importance. Furthermore, in the absence of natural fractures or adequate connectivity, artificial fracture are created in the reservoir using hydraulic fracturing. At times, the practice aims to create a number of parallel fractures connecting a pair of wells. Multiple fractures are preferred because of the large size necessary when using only a single fracture. Although the basic idea is rather simple, hydraulic fracturing is a complex process involving interactions of high pressure fluid injections with a stressed hot rock mass, mechanical interaction of induced fractures with existing natural fractures, and the spatial and temporal variations of in-situ stress. As a result it is necessary to develop tools that can be used to study these interactions as an integral part of a comprehensive approach to geothermal reservoir development, particularly enhanced geothermal systems. In response to this need we have set out to develop advanced thermo-mechanical models for design of artificial fractures and rock fracture research in geothermal reservoirs. These models consider the significant hydraulic and thermo-mechanical processes and their interaction with the in-situ stress state. Wellbore failure and fracture initiation is studied using a model that fully couples poro-mechanical and thermo-mechanical effects. The fracture propagation model is based on a complex variable and regular displacement discontinuity formulations. In the complex variable approach the displacement discontinuities are

  8. Catheter fracture of intravenous ports and its management.

    Science.gov (United States)

    Wu, Ching-Yang; Fu, Jui-Ying; Feng, Po-Hao; Kao, Tsung-Chi; Yu, Sheng-Yueh; Li, Hao-Jui; Ko, Po-Jen; Hsieh, Hung-Chang

    2011-11-01

    Intravenous ports are widely used for oncology patients. However, catheter fractures may lead to the need for re-intervention. We aimed to identify the risk factors associated with catheter fractures. Between January 1 and December 31, 2006, we retrospectively reviewed the clinical data and plain chest films of 1,505 patients implanted with an intravenous port at Chang Gung Memorial Hospital. Different vascular sites were compared using the chi-square or Fisher's exact test for categorical variables, and the t test was used for continuous variables with normal distribution; P port type Arrow French (Fr.) 8.1 (P port and catheter removal is recommended. Female gender, intravenous port implantation via the subclavian route, and the Arrow Fr. 8.1 port were found to be risk factors. Patients with these risk factors should be monitored closely to avoid catheter fractures.

  9. Strain-based fracture assessment of pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Olsoe, Erlend; Oestby, Erling; Nyhus, Baard [SINTEF, Trondheim (Norway); Skallerud, Bjoern; Holthe, Kjell [Norwegian University of Science and Technology (NTNU), Trondheim (Norway); Berg, Espen [LINKftr AS, Trondheim (Norway)

    2009-12-19

    The oil and gas industry moves into harsher regions and faces challenges with i.e. deep water, arctic conditions and seismic regions. Consequently, ensuring the integrity of pipelines becomes more challenging, and potential large deformation scenarios that can be attributed to the above mentioned areas have lead to a current strong focus on strain-based fracture assessment methods for pipelines. However, no widely established methods exist today. In this paper specific challenges related to development of such methods are discussed. Keywords are biaxial loading, crack driving force relations, ductile tearing resistance, and definition of strain capacity. The effect of the different features will be illustrated with both experimental and numerical simulation results. Experimental results presented will cover both large- and small-scale testing. A highly efficient and accurate line-spring based numerical fracture assessment method will be presented. A simplified scheme for a strain-based fracture assessment method will also be briefly outlined, and the extension of this method to also include partial safety factors is discussed. (author)

  10. Dating fractures and fracture movement in the Lac du Bonnet Batholith

    International Nuclear Information System (INIS)

    Gascoyne, M.; Brown, A.; Ejeckam, R.B.; Everitt, R.A.

    1997-04-01

    This report examines and summarizes all work that has been done from 1980 to the present in determining the age of rock crystallization, fracture initiation, fracture reactivation and rates of fracture movement in the Lac du Bonnet Batholith to provide information for Atomic Energy of Canada Limited's (AECL) Canadian Nuclear Fuel Waste Management Program. Geological and petrographical indicators of relative age (e.g. cross-cutting relationships, sequences of fracture infilling minerals, P-T characteristics of primary and secondary minerals) are calibrated with radiometric age determinations on minerals and whole rock samples, using 87 Rb- 87 Sr, 40 K- 39 Ar, 40 Ar- 39 Ar and fission track methods. Most fractures and fracture zones inclined at low angles are found to be ancient features, first formed in the Early Proterozoic under conditions of deuteric alteration. Following some movement on fractures in the Late Proterozoic and Early Paleozoic, reactivation of fractures during the Pleistocene is established from uranium-series dating methods and use of stable isotopic contents of fracture infilling minerals (mainly calcite). Some indication of movement on fracture zones during the Pleistocene is given by electron spin resonance dating techniques on fault gouge. The slow rate of propagation of fractures is indicated by mineral infillings, their P-T characteristics and U-series calcite ages in a fracture in sparsely fractured rock, accessible from AECL's Underground Research Laboratory. These results collectively indicate that deep fractures observed in the batholith are ancient features and the fracturing and jointing in the upper 200 m is relatively recent (< 1 Ma) and largely a result of stress release. (author)

  11. Fracture and Healing of Rock Salt Related to Salt Caverns

    International Nuclear Information System (INIS)

    Chan, K.S.; Fossum, A.F.; Munson, D.E.

    1999-01-01

    In recent years, serious investigations of potential extension of the useful life of older caverns or of the use of abandoned caverns for waste disposal have been of interest to the technical community. All of the potential applications depend upon understanding the reamer in which older caverns and sealing systems can fail. Such an understanding will require a more detailed knowledge of the fracture of salt than has been necessary to date. Fortunately, the knowledge of the fracture and healing of salt has made significant advances in the last decade, and is in a position to yield meaningful insights to older cavern behavior. In particular, micromechanical mechanisms of fracture and the concept of a fracture mechanism map have been essential guides, as has the utilization of continuum damage mechanics. The Multimechanism Deformation Coupled Fracture (MDCF) model, which is summarized extensively in this work was developed specifically to treat both the creep and fracture of salt, and was later extended to incorporate the fracture healing process known to occur in rock salt. Fracture in salt is based on the formation and evolution of microfractures, which may take the form of wing tip cracks, either in the body or the boundary of the grain. This type of crack deforms under shear to produce a strain, and furthermore, the opening of the wing cracks produce volume strain or dilatancy. In the presence of a confining pressure, microcrack formation may be suppressed, as is often the case for triaxial compression tests or natural underground stress situations. However, if the confining pressure is insufficient to suppress fracture, then the fractures will evolve with time to give the characteristic tertiary creep response. Two first order kinetics processes, closure of cracks and healing of cracks, control the healing process. Significantly, volume strain produced by microfractures may lead to changes in the permeability of the salt, which can become a major concern in

  12. Fracture toughness calculation using dynamic testing

    International Nuclear Information System (INIS)

    Perosanz, F. J.; Serrano, M.; Martinez, C.; Lapena, J.

    1998-01-01

    The most critical component of a Nuclear Power Station is the Reactor Pressure Vessel (RPV), due to safety and integrity requirements. The RPV is subjected to neutron radiation and this phenomenon lead to microstructural changes in the material and modifications in the mechanical properties. Due to this effects, it is necessary to assess the structural integrity of the RPV along the operational life through surveillance programs. The main objective of this surveillance programs is to determine the fracture toughness of the material. At present this objective is reached combining direct measures and prediction techniques. In this work, direct measures of fracture toughness using instrumented Charpy V impact testing are present using a CIEMAT development on analysis of results. (Author) 6 refs

  13. Swelling and fracturing of borides under neutron irradiation

    International Nuclear Information System (INIS)

    Krainy, A.G.; Ogorodnikov, V.V.; Grinik, E.U.; Chirko, L.I.; Shinakov, A.A.

    1994-01-01

    The neutron irradiation of high temperature borides, which are included in boron-containing reactor materials, results in high internal stresses, leading to considerable swelling and micro- and macro-fracturing. Experimental results over a large range of temperature and fluences, show a change of damage mechanism for borides within 400-530 C: the macro-cracking with formation of annular and radial cracks is observed below this temperature zone. The accumulation of micro-fractures and the process of gas swelling take place at irradiation temperatures above 530 C. The effect of the high internal stresses is compared to external pressure. 12 refs., 4 figs

  14. Thermo-hydro-mechanical behavior of fractured rock mass

    International Nuclear Information System (INIS)

    Coste, F.

    1997-12-01

    The purpose of this research is to model Thermo-Hydro-Mechanical behavior of fractured rock mass regarding a nuclear waste re-depository. For this, a methodology of modeling was proposed and was applied to a real underground site (EDF site at Nouvelle Romanche). This methodology consists, in a first step, to determine hydraulic and mechanical REV. Beyond the greatest of these REV, development of a finite element code allows to model all the fractures in an explicit manner. The homogenized mechanical properties are determined in drained and undrained boundary conditions by simulating triaxial tests that represent rock mass subject to loading. These simulations allow to study the evolution of hydraulic and mechanical properties as a function of stress state. Drained and undrained boundary conditions enable to discuss the validity of assimilation of a fractured rock mass to a porous medium. The simulations lead to a better understanding of the behavior of the fractured rock masses and allow to show the dominant role of the shear behavior of the fractures on the hydraulic and mechanical homogenized properties. From a thermal point of view, as long as conduction is dominant, thermal properties of the rock mass are almost the same as those the intact rock. (author)

  15. Pregnancy-associated osteoporosis presenting severe vertebral fractures.

    Science.gov (United States)

    Ozturk, Cihat; Atamaz, Funda Calis; Akkurt, Halil; Akkoc, Yesim

    2014-01-01

    The syndrome of pregnancy-associated osteoporosis (PAO) is a rare disorder which occurs either in late pregnancy or early post-partum period leading to fragility fracture(s), most commonly in the vertebral bodies. We presented two cases with PAO who had compression fractures at multiple levels involving five vertebrae in one case and 10 vertebrae in the other. Their spinal bone mineral density values were below -2.5 standard deviations. Anti-osteoporotic treatments with nasal calcitonin 400 IU/day, vitamin D 300.000 IU single dose, calcium 1000 mg/day, vitamin D 880 IU/day were initiated. In one case, kyphoplasty was performed by a spinal surgeon. In addition to a thoracolumbosacral orthosis, a rehabilitation program including muscle strengthening, range of motion, relaxation and weight-bearing exercises was started for both cases. These cases emphasize that all pregnant women with complaints of back/lumbar pain should be carefully evaluated. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  16. On fracture in finite strain gradient plasticity

    DEFF Research Database (Denmark)

    Martínez Pañeda, Emilio; Niordson, Christian Frithiof

    2016-01-01

    In this work a general framework for damage and fracture assessment including the effect of strain gradients is provided. Both mechanism-based and phenomenological strain gradient plasticity (SGP) theories are implemented numerically using finite deformation theory and crack tip fields are invest......In this work a general framework for damage and fracture assessment including the effect of strain gradients is provided. Both mechanism-based and phenomenological strain gradient plasticity (SGP) theories are implemented numerically using finite deformation theory and crack tip fields...... are investigated. Differences and similarities between the two approaches within continuum SGP modeling are highlighted and discussed. Local strain hardening promoted by geometrically necessary dislocations (GNDs) in the vicinity of the crack leads to much higher stresses, relative to classical plasticity...... in the multiple parameter version of the phenomenological SGP theory. Since this also dominates the mechanics of indentation testing, results suggest that length parameters characteristic of mode I fracture should be inferred from nanoindentation....

  17. Fracture studies of poly(propylene)/elastomer blend with β-form nucleating agent

    International Nuclear Information System (INIS)

    Bai Hongwei; Wang Yong; Zhang Danli; Xiao Chengquan; Song Bo; Li Yanli; Han Liang

    2009-01-01

    Poly(propylene)/elastomer blends with β-form nucleating agent (β-NA) aryl amides compound (TMB-5) were prepared. The effects of β-NA on crystallization, melting behaviors and elastomer morphologies of PP/elastomer blends were studied through polarization optical microscope (POM), differential scanning calorimetry (DSC) and scanning electronic microscope (SEM). The fracture behaviors, including notched Izod impact fracture and single-edge notched tensile (SENT) fracture, were comparatively studied to establish the role of NA in improving the fracture toughness of PP/elastomer blends. Our results showed that the presence of β-NA leads to determinable β-PP formation in the blends, and as a consequence the fracture toughness of the blend is improved dramatically. Compared with notched Izod impact testing, which can efficiently characterize the fracture toughness of the blends only at lower elastomer content, SENT testing provides more detail of fracture behavior in all the compositions. Furthermore, SENT test shows that the significant improvement in fracture toughness of PP/elastomer/β-NA is contributed to the simultaneous enhancement of crack initiation energy and crack propagation energy, but largely dominated by crack propagation stage.

  18. Atypical Femur Fractures in Patients Treated with Bisphosphonates: Identification, Management, and Prevention

    Directory of Open Access Journals (Sweden)

    Judith Sarah Bubbear

    2016-10-01

    Full Text Available Osteoporosis is a common condition with significant health care costs. First-line therapy is with bisphosphonates, which have proven anti-fracture efficacy. Around 10 years after the introduction of bisphosphonates reports began to be published of atypical femoral fractures (AFFs that may be associated with this therapy. These fractures are associated with significant morbidity although lower mortality than the more common osteoporotic neck-of-femur fractures. A case definition has been described to allow identification of this class of fracture. Further work has established a high relative risk of AFFs in patients treated with bisphosphonates, but a low absolute risk in comparison to that of osteoporotic fractures. Proposed pathological mechanisms include low bone turnover states leading to stress/insufficiency fractures. Clinicians should be aware of the risk of AFFs and in particular the high rate of prodromal thigh/groin pain that warrants investigation in a patient receiving a bisphosphonate. If an incomplete fracture is diagnosed then bisphosphonate therapy needs to be stopped and prophylactic surgery may be considered. Due to these rare side effects patients on bisphosphonates require regular review, and this is particularly advised after 5 years of oral or 3 years of intravenous therapy.

  19. Fracture Toughness of Carbon Nanotube-Reinforced Metal- and Ceramic-Matrix Composites

    Directory of Open Access Journals (Sweden)

    Y. L. Chen

    2011-01-01

    Full Text Available Hierarchical analysis of the fracture toughness enhancement of carbon nanotube- (CNT- reinforced hard matrix composites is carried out on the basis of shear-lag theory and facture mechanics. It is found that stronger CNT/matrix interfaces cannot definitely lead to the better fracture toughness of these composites, and the optimal interfacial chemical bond density is that making the failure mode just in the transition from CNT pull-out to CNT break. For hard matrix composites, the fracture toughness of composites with weak interfaces can be improved effectively by increasing the CNT length. However, for soft matrix composite, the fracture toughness improvement due to the reinforcing CNTs quickly becomes saturated with an increase in CNT length. The proposed theoretical model is also applicable to short fiber-reinforced composites.

  20. Mass transport in fracture media: impact of the random function model assumed for fractures conductivity

    International Nuclear Information System (INIS)

    Capilla, J. E.; Rodrigo, J.; Gomez Hernandez, J. J.

    2003-01-01

    Characterizing the uncertainty of flow and mass transport models requires the definition of stochastic models to describe hydrodynamic parameters. Porosity and hydraulic conductivity (K) are two of these parameters that exhibit a high degree of spatial variability. K is usually the parameter whose variability influence to a more extended degree solutes movement. In fracture media, it is critical to properly characterize K in the most altered zones where flow and solutes migration tends to be concentrated. However, K measurements use to be scarce and sparse. This fact calls to consider stochastic models that allow quantifying the uncertainty of flow and mass transport predictions. This paper presents a convective transport problem solved in a 3D block of fractured crystalline rock. the case study is defined based on data from a real geological formation. As the scarcity of K data in fractures does not allow supporting classical multi Gaussian assumptions for K in fractures, the non multi Gaussian hypothesis has been explored, comparing mass transport results for alternative Gaussian and non-Gaussian assumptions. The latter hypothesis allows reproducing high spatial connectivity for extreme values of K. This feature is present in nature, might lead to reproduce faster solute pathways, and therefore should be modeled in order to obtain reasonably safe prediction of contaminants migration in a geological formation. The results obtained for the two alternative hypotheses show a remarkable impact of the K random function model in solutes movement. (Author) 9 refs

  1. Is the permeability of naturally fractured rocks scale dependent?

    Science.gov (United States)

    Azizmohammadi, Siroos; Matthäi, Stephan K.

    2017-09-01

    The equivalent permeability, keq of stratified fractured porous rocks and its anisotropy is important for hydrocarbon reservoir engineering, groundwater hydrology, and subsurface contaminant transport. However, it is difficult to constrain this tensor property as it is strongly influenced by infrequent large fractures. Boreholes miss them and their directional sampling bias affects the collected geostatistical data. Samples taken at any scale smaller than that of interest truncate distributions and this bias leads to an incorrect characterization and property upscaling. To better understand this sampling problem, we have investigated a collection of outcrop-data-based Discrete Fracture and Matrix (DFM) models with mechanically constrained fracture aperture distributions, trying to establish a useful Representative Elementary Volume (REV). Finite-element analysis and flow-based upscaling have been used to determine keq eigenvalues and anisotropy. While our results indicate a convergence toward a scale-invariant keq REV with increasing sample size, keq magnitude can have multi-modal distributions. REV size relates to the length of dilated fracture segments as opposed to overall fracture length. Tensor orientation and degree of anisotropy also converge with sample size. However, the REV for keq anisotropy is larger than that for keq magnitude. Across scales, tensor orientation varies spatially, reflecting inhomogeneity of the fracture patterns. Inhomogeneity is particularly pronounced where the ambient stress selectively activates late- as opposed to early (through-going) fractures. While we cannot detect any increase of keq with sample size as postulated in some earlier studies, our results highlight a strong keq anisotropy that influences scale dependence.

  2. Physical fracture properties (fracture surfaces as information sources; crackgrowth and fracture mechanisms; exemples of cracks)

    International Nuclear Information System (INIS)

    Meny, Lucienne.

    1979-06-01

    Fracture surfaces are considered as a useful source of informations: an introduction to fractography is presented; the fracture surface may be observed through X ray microanalysis, and other physical methods such as Auger electron spectroscopy or secundary ion emission. The mechanisms of macroscopic and microscopic crackgrowth and fracture are described, in the case of unstable fracture (cleavage, ductile with shear, intergranular brittleness) and of progressive crack propagation (creep, fatigue). Exemples of cracks are presented in the last chapter [fr

  3. Age-specific incidence of hip fracture in the elderly: a healthy decline.

    LENUS (Irish Health Repository)

    Green, C

    2012-02-01

    Hip fractures in the elderly are an important source of morbidity and mortality. The predicted increase in the number of hip fractures due to the increasing elderly population has not been universally observed. The purpose of this study was to examine the incidence of hip fractures over a twenty year period to determine if this rise is occurring in our region. All hip fractures from the unit over 20 years were identified. Population data for those over 65 in the catchment area of our hospital was acquired. The rate of fractures occurring each year relative to the population was determined. The results were split into age groups. There was a strong correlation between the population rise and number of fractures (p = 0.77). But there was no significant difference in the rate of fracture over time (p = 0.41). However, the average age at which fracture occurred increased by two years. In addition we show the overall trend in the rate of fractures decreases in the younger age groups and increases in the older age groups. Therefore, the predicted rapid increase in rate is not occurring. This probably reflects the strengthening of the economy in Ireland from the 1930\\'s onwards, leading to a healthier population.

  4. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee

    2013-01-01

    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  5. Stabilization of multiple rib fractures in a canine model.

    Science.gov (United States)

    Huang, Ke-Nan; Xu, Zhi-Fei; Sun, Ju-Xian; Ding, Xin-Yu; Wu, Bin; Li, Wei; Qin, Xiong; Tang, Hua

    2014-12-01

    Operative stabilization is frequently used in the clinical treatment of multiple rib fractures (MRF); however, no ideal material exists for use in this fixation. This study investigates a newly developed biodegradable plate system for the stabilization of MRF. Silk fiber-reinforced polycaprolactone (SF/PCL) plates were developed for rib fracture stabilization and studied using a canine flail chest model. Adult mongrel dogs were divided into three groups: one group received the SF/PCL plates, one group received standard clinical steel plates, and the final group did not undergo operative fracture stabilization (n = 6 for each group). Radiographic, mechanical, and histologic examination was performed to evaluate the effectiveness of the biodegradable material for the stabilization of the rib fractures. No nonunion and no infections were found when using SF-PCL plates. The fracture sites collapsed in the untreated control group, leading to obvious chest wall deformity not encountered in the two groups that underwent operative stabilization. Our experimental study shows that the SF/PCL plate has the biocompatibility and mechanical strength suitable for fixation of MRF and is potentially ideal for the treatment of these injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Reconstruction of malunited diaphyseal fractures of the forearm

    OpenAIRE

    Jayakumar, Prakash; Jupiter, Jesse B

    2014-01-01

    The forearm is a complex anatomical and functional unit with unique osseous, soft tissue and articular relationships. Disruption of these important relations can have a significant impact, leading to pain, instability of the radio-ulnar articulation and reduced range of motion. The gold standard for treating forearm fractures in adults remains anatomic reduction, stable plate fixation and preservation of the surrounding blood supply. Failure to achieve these goals may lead to malunion, requir...

  7. Modeling fractures as interfaces for flow and transport in porous media

    International Nuclear Information System (INIS)

    Serres, Ch.; Alboin, C.; Jaffre, J.; Roberts, J.

    2002-05-01

    We are concerned with flow and transport in a fractured porous medium at a scale where the fractures can be modelled individually. The fractures themselves are porous media with large permeability in comparison with that in the surrounding rock. Contrarily to many studies in which the contrast in permeabilities is of such an order that the flow outside of the fracture is neglected, the purpose of this work is to consider the case where the exchange between the fractures and the surrounding rock is significant. Then it is necessary to take into account this interaction because it has a profound effect on the flow and the transport of a solute. The main idea for this work is to treat fractures as interfaces. Then it will not be necessary to use mesh refinements around the fractures, which is an important drawback of most models. Treating fractures as interfaces leads to non-overlapping domain decomposition methods, using the natural domain decomposition suggested by the fracture network. This paper is organized as follows. In Section 2, we present the model, and in Section 3, we show that the corresponding problem has a unique solution. In Section 4, we reduce the approximate problem to a problem with unknowns on the interface. Numerical results are given in Section 5 for the simple case of a domain divided into two sub-domains by one fracture. In Section 6 we extend the formulation to the case of intersecting fractures and in Section 7 to that of a solute transport. (authors)

  8. Emotional stress as a trigger of falls leading to hip or pelvic fracture. Results from the ToFa study - a case-crossover study among elderly people in Stockholm, Sweden.

    Science.gov (United States)

    Möller, Jette; Hallqvist, Johan; Laflamme, Lucie; Mattsson, Fredrik; Ponzer, Sari; Sadigh, Siv; Engström, Karin

    2009-02-09

    Sudden emotions may interfere with mechanisms for keeping balance among the elderly. The aim of this study is to analyse if emotional stress and specifically feelings of anger, sadness, worries, anxiety or stress, can trigger falls leading to hip or pelvic fracture among autonomous older people. The study applied the case-crossover design and was based on data gathered by face to face interviews carried out in Stockholm between November 2004 and January 2006 at the emergency wards of two hospitals. Cases (n = 137) were defined as persons aged 65 and older admitted for at least one night due to a fall-related hip or pelvic fracture (ICD10: S72 or S32) and meeting a series of selection criteria. Results are presented as relative risks with 95% confidence intervals. There was an increased risk for fall and subsequent hip or pelvic fracture for up to one hour after emotional stress. For anger there was an increased relative risk of 12.2 (95% CI 2.7-54.7), for sadness of 5.7 (95% CI 1.1-28.7), and for stress 20.6 (95% CI 4.5-93.5) compared to periods with no such feelings. Emotional stress seems to have the potential to trigger falls and subsequent hip or pelvic fracture among autonomous older people. Further studies are needed to clarify how robust the findings are - as the number of exposed cases is small - and the mechanisms behind them - presumably balance and vision impairment in stress situation.

  9. Thermal Effect on Fracture Integrity in Enhanced Geothermal Systems

    Science.gov (United States)

    Zeng, C.; Deng, W.; Wu, C.; Insall, M.

    2017-12-01

    In enhanced geothermal systems (EGS), cold fluid is injected to be heated up for electricity generation purpose, and pre-existing fractures are the major conduits for fluid transport. Due to the relative cold fluid injection, the rock-fluid temperature difference will induce thermal stress along the fracture wall. Such large thermal stress could cause the failure of self-propping asperities and therefore change the fracture integrity, which could affect the heat recovery efficiency and fluid recycling. To study the thermal effect on fracture integrity, two mechanisms pertinent to thermal stress are proposed to cause asperity contact failure: (1) the crushing between two pairing asperities leads to the failure at contact area, and (2) the thermal spalling expedites this process. Finite element modeling is utilized to investigate both failure mechanisms by idealizing the asperities as hemispheres. In the numerical analysis, we have implemented meso-scale damage model to investigate coupled failure mechanism induced by thermomechanical stress field and original overburden pressure at the vicinity of contact point. Our results have shown that both the overburden pressure and a critical temperature determine the threshold of asperity failure. Since the overburden pressure implies the depth of fractures in EGS and the critical temperature implies the distance of fractures to the injection well, our ultimate goal is to locate a region of EGS where the fracture integrity is vulnerable to such thermal effect and estimate the influences.

  10. Analysis of the pattern of maxillofacial fractures in north western of Iran: A retrospective study

    Directory of Open Access Journals (Sweden)

    Mesgarzadeh Ali

    2011-01-01

    Full Text Available Background : Maxillofacial fractures can lead to substantial long-term functional, esthetic and psychological complications. Aim : The aim of this study is to evaluate these injuries in a Turkish Iranian population. Materials and Methods : A retrospective study of 170 patients with 210 maxillofacial fractures admitted to the emergency department of a central referral emergency hospital in the area over a 5 year period is presented. Patients′ data included demographic information, etiology, site and associated injuries and complications. Results : Road traffic accident was the commonest cause (40% and the age group of 21-30 comprised the biggest group (30%. Mandibular fractures outnumbered midface fractures (150vs.60. Ramus (21.5% and zygoma (26.5% were the commonest fracture regions respectively in mandible and midface. Male: female ratio was 3.8:1 Almost half of patients (46% had sustained associated injuries most of which was soft tissue laceration of the face (17.5%. 22 patient (13% had associated complication and the hemorrhage was the commonest form of that (9%. Conclusion : It seems that road traffic accidents continue to be the leading cause of maxillofacial fractures and there is an urgent need to implement enhanced regulations and monitoring on motor vehicular traffic.

  11. Energy based methods for determining elastic plastic fracture

    International Nuclear Information System (INIS)

    Witt, F.J.

    1979-01-01

    Several methods are currently in use or under study for calculating various conditions of fracturing for varying degrees of plasticity. Among these are innovations on the J-integral concept, crack opening displacement or angle, the two parameter concept and the equivalent energy method. Methods involving crack arrest and ductile tearing also fall in this category. Each of these methods have many salient points and some efforts are underway to establish the underlying relationship between them. In this paper, the current research directions of J-integral and equivalent energy methodologies are reviewed with a broader discussion presented for the equivalent energy methodology. The fundamental basis of equivalent energy methodology rests with the volumetric energy ratio. For fractures governed by linear elastic fracture mechanics, the volumetric energy ratio is independent of flaw size and geometry and depends only on the scale factor between model and prototype and temperature. The behavioral aspects of the volumetric energy ratios have been investigated throughout the temperature range from brittle fracture to fully ductile fracture. For five different specimen and structural configurations it has been shown experimentally that the volumetric energy ratio retains its basic properties. That is, the volumetric energy ratio while changing in actual value, maintains its independence of geometry and flaw size while retaining a unique dependence on scale factor and temperature. This property interpreted in terms of fracture mechanics leads to the equivalent energy method. (orig.)

  12. Stress Fractures

    Science.gov (United States)

    Stress fractures Overview Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of ...

  13. Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2014-01-01

    Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up. This pattern is a new variant of scaphocapitate fracture as involves a fracture of the radial styloid as well.

  14. Scintigraphic diagnosis of stress-induced incomplete fractures of the proximal tibia

    International Nuclear Information System (INIS)

    Collier, B.D.; Johnson, R.P.; Carrera, G.F.; Akhtar, K.; Isitman, A.T.

    1984-01-01

    Incomplete stress fractures of the proximal tibial diaphysis can be diagnosed by bone scintigraphy. The scintigraphic appearance of incomplete rather than complete tibial stress fractures is apparently reported for the first time in this article. With no treatment other than restricted activity, this injury heals rapidly and completely in 4 to 6 weeks. The major threat to the patient's welfare is unfounded suspicion of tumor or infection which may lead to biopsy or inappropriate therapy

  15. Free flap reconstructions of tibial fractures complicated after internal fixation.

    Science.gov (United States)

    Nieminen, H; Kuokkanen, H; Tukiainen, E; Asko-Seljavaara, S

    1995-04-01

    The cases of 15 patients are presented where microvascular soft-tissue reconstructions became necessary after internal fixation of tibial fractures. Primarily, seven of the fractures were closed. Eleven fractures had originally been treated by open reduction and internal fixation using plates and screws, and four by intramedullary nailing. All of the patients suffered from postoperative complications leading to exposure of the bone or fixation material. The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases. Soft tissue reconstruction was performed using a free microvascular muscle flap (11 latissimus dorsi, three rectus abdominis, and one gracilis). In eight cases the nonunion of the fracture indicated external fixation. The microvascular reconstruction was successful in all 15 patients. In one case the recurrence of deep infection finally indicated a below-knee amputation. In another case, chronic infection with fistulation recurred postoperatively. After a mean follow-up of 26 months the soft tissue coverage was good in all the remaining 13 cases. All the fractures united. Microvascular free muscle flap reconstruction of the leg is regarded as a reliable method for salvaging legs with large soft-tissue defects or defects in the distal leg. If after internal fixation of the tibial fracture the osteosynthesis material or fracture is exposed, reconstruction of the soft-tissue can successfully be performed by free flap transfer. By radical revision, external fixation, bone grafting, and a free flap the healing of the fracture can be achieved.

  16. Risk of hip fracture after osteoporosis fractures. 451 women with fracture of lumbar spine, olecranon, knee or ankle

    DEFF Research Database (Denmark)

    Lauritzen, J B; Lund, B

    1993-01-01

    In a follow-up study during 1976-1984, the risk of a subsequent hip fracture was investigated in women aged 60-99 years, hospitalized for the following fractures: lumbar spine (n 70), olecranon (n 52), knee (n 129) and ankle (n 200). Follow-up ranged from 0 to 9 years. Observation time of the 4...... different fractures were 241, 180, 469, and 779, person-years, respectively. In women aged 60-79 years with one of the following fractures the relative risk of a subsequent hip fracture was increased by 4.8 (lumbar spine), 4.1 (olecranon), 3.5 (knee) and 1.5 (ankle). The relative risk of hip fracture showed...... a tendency to level off 3 years after the primary fracture....

  17. Atrophy of the brachialis muscle after a displaced clavicle fracture in an Ironman triathlete: case report

    Directory of Open Access Journals (Sweden)

    Knechtle Patrizia

    2011-10-01

    Full Text Available Abstract Clavicle fractures are frequent injuries in athletes and midshaft clavicle fractures in particular are well-known injuries in Ironman triathletes. In 2000, Auzou et al. described the mechanism leading to an isolated truncular paralysis of the musculocutaneous nerve after a shoulder trauma. It is well-known that nerve palsies can lead to an atrophy of the associated muscle if they persist for months or even longer. In this case report we describe a new case of an Ironman triathlete suffering from a persistent isolated atrophy of the brachialis muscle. The atrophy occurred following a displaced midshaft clavicle fracture acquiring while falling off his bike after hitting a duck during a competition.

  18. Operative management of ankle fractures during pregnancy: case ...

    African Journals Online (AJOL)

    Trauma affects approximately 5% of pregnancies and is the leading non-obstetric cause of maternal death. Ankle fractures occurring in pregnancy although minor, can nonetheless create diagnostic and therapeutic challenges for the patient and the surgeon. There is limited information on the operative management of ...

  19. Anomalous Transport in Natural Fracture Networks Induced by Tectonic Stress

    Science.gov (United States)

    Kang, P. K.; Lei, Q.; Lee, S.; Dentz, M.; Juanes, R.

    2017-12-01

    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 high uncertainty and large heterogeneity associated with 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 transportthrough fractured rock remains poorly understood. 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 geologic (tectonic) stress on flow and tracer transport through natural fracture networks. We model geomechanical effects in 2D fractured rock by means of a finite-discrete element method (FEMDEM) [2], which can capture the deformation of matrix blocks, reactivation of pre-existing fractures, and propagation of new cracks, upon changes in the stress field. We apply the model to a fracture network extracted from the geological map of an actual rock outcrop to obtain the aperture field at different stress conditions. 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 network, and show that the stress state is a powerful determinant of transport behavior: (1) An anisotropic stress state induces preferential flow paths through shear dilation; (2) An increase in geologic stress increases aperture heterogeneity that induces late-time tailing of particle breakthrough curves. Finally, we develop an effective transport model that captures the anomalous transport through the stressed fracture

  20. Simulation of non-isothermal gas-water processes in complex fracture-matrix systems

    International Nuclear Information System (INIS)

    Jakobs, H.

    2004-01-01

    Degassing effects may occur in fractures in the vicinity of deep radioactive-waste-disposal sites as a result of a pressure drop. These effects play an important role in the investigation of the hydraulic conditions in the near field of the disposal sites. The assumption of single-phase conditions may lead to the misinterpretation of experimental data as degassing leads to two-phase conditions and to a reduction of the effective permeability. The aim of this work is to contribute to the simulation of non-isothermal behaviour of water-gas systems in the near field of atomic waste disposal sites in fractured porous media. We distinguish between sub-REV effects within single fractures and effects due to super-REV heterogeneities which result from the fracture matrix system. We assume to have undisturbed physical conditions as report from the AespoeHard Rock Laboratory in Sweden, i.e.: - a fully water saturated system - a hydrostatic pressure of 5 million Pa. For the simulation on the laboratory scale we use a percolation model. To transfer the information from the laboratory scale to the field scale we use a renormalisation scheme. On the field scale we use a numerical simulator which solves the multiphase flow equations based on the extended form of Darcy's law. In order to investigate the limits of our models we analyse the importance of the forces taken into account, i.e., capillary forces, gravity forces, and viscous forces. This method allows us to quantify the constraints of our models. Furthermore, we investigate the influence of strong parameter heterogeneities caused by the fracture-matrix system on the flow behaviour of gas and water. We consider in particular the influence of the large difference between the entry pressures of matrix and fracture on the migration of the gas phase from the fracture system into the matrix system. (orig.)

  1. In-reactor deformation and fracture of austenitic stainless steels

    International Nuclear Information System (INIS)

    Bloom, E.E.; Wolfer, W.G.

    1978-01-01

    An experimental technique for determining in-reactor fracture strain was developed and demonstrated. Differential swelling between a sample holder and a test specimen with a lower swelling rate produced uniaxial deformation. In-reactor deformations of 0.7 to 2.1% were achieved in type 304 stainless steel previously irradiated to fluences up to 8.8 x 10 26 n/m 2 without fracture. These strains are significantly higher than found in postirradiation creep-rupture tests on similar samples. From the measured strain values and published irradiation creep data and correlations, the stress levels during the irradiation were calculated. On the basis of previous postirradiation creep-rupture results, many of the samples that did not fail would be predicted to fail. Thus we conclude that the in-reactor rupture life is longer than predicted by postirradiation tests. Strain in a fractured sample was estimated to be less than 3.8%, and the in-reactor fractures were intergranular--the same fracture mode as found in postirradiation tests. Irradiation creep may relax stresses at crack tips and sliding boundaries, thus retarding the initiation and/or growth of cracks and leading to longer rupture lives in-reactor. However, the very high ductility or superplastic behavior predicted by the strain rate sensitivity of irradiation creep is not achieved because of the eventual interruption of the deformation process by grain boundary fracture

  2. Atmospheric forcing of sea ice leads in the Beaufort Sea

    Science.gov (United States)

    Lewis, B. J.; Hutchings, J.; Mahoney, A. R.; Shapiro, L. H.

    2016-12-01

    Leads in sea ice play an important role in the polar marine environment where they allow heat and moisture transfer between the oceans and atmosphere and act as travel pathways for both marine mammals and ships. Examining AVHRR thermal imagery of the Beaufort Sea, collected between 1994 and 2010, sea ice leads appear in repeating patterns and locations (Eicken et al 2005). The leads, resolved by AVHRR, are at least 250m wide (Mahoney et al 2012), thus the patterns described are for lead systems that extend up to hundreds of kilometers across the Beaufort Sea. We describe how these patterns are associated with the location of weather systems relative to the coastline. Mean sea level pressure and 10m wind fields from ECMWF ERA-Interim reanalysis are used to identify if particular lead patterns can be uniquely forecast based on the location of weather systems. Ice drift data from the NSIDC's Polar Pathfinder Daily 25km EASE-Grid Sea Ice Motion Vectors indicates the role shear along leads has on the motion of ice in the Beaufort Gyre. Lead formation is driven by 4 main factors: (i) coastal features such as promontories and islands influence the origin of leads by concentrating stresses within the ice pack; (ii) direction of the wind forcing on the ice pack determines the type of fracture, (iii) the location of the anticyclone (or cyclone) center determines the length of the fracture for certain patterns; and (iv) duration of weather conditions affects the width of the ice fracture zones. Movement of the ice pack on the leeward side of leads originating at promontories and islands increases, creating shear zones that control ice transport along the Alaska coast in winter. . Understanding how atmospheric conditions influence the large-scale motion of the ice pack is needed to design models that predict variability of the gyre and export of multi-year ice to lower latitudes.

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

    Science.gov (United States)

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

    2017-02-01

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

  4. External fixation of tibial pilon fractures and fracture healing.

    Science.gov (United States)

    Ristiniemi, Jukka

    2007-06-01

    Distal tibial fractures are rare and difficult to treat because the bones are subcutaneous. External fixation is commonly used, but the method often results in delayed union. The aim of the present study was to find out the factors that affect fracture union in tibial pilon fractures. For this purpose, prospective data collection of tibial pilon fractures was carried out in 1998-2004, resulting in 159 fractures, of which 83 were treated with external fixation. Additionally, 23 open tibial fractures with significant > 3 cm bone defect that were treated with a staged method in 2000-2004 were retrospectively evaluated. The specific questions to be answered were: What are the risk factors for delayed union associated with two-ring hybrid external fixation? Does human recombinant BMP-7 accelerate healing? What is the role of temporary ankle-spanning external fixation? What is the healing potential of distal tibial bone loss treated with a staged method using antibiotic beads and subsequent autogenous cancellous grafting compared to other locations of the tibia? The following risk factors for delayed healing after external fixation were identified: post-reduction fracture gap of >3 mm and fixation of the associated fibula fracture. Fracture displacement could be better controlled with initial temporary external fixation than with early definitive fixation, but it had no significant effect on healing time, functional outcome or complication rate. Osteoinduction with rhBMP-7 was found to accelerate fracture healing and to shorten the sick leave. A staged method using antibiotic beads and subsequent autogenous cancellous grafting proved to be effective in the treatment of tibial bone loss. Healing potential of the bone loss in distal tibia was at least equally good as in other locations of the tibia.

  5. On the Processing of Spalling Experiments. Part II: Identification of Concrete Fracture Energy in Dynamic Tension

    Science.gov (United States)

    Lukić, Bratislav B.; Saletti, Dominique; Forquin, Pascal

    2017-12-01

    This paper presents a second part of the study aimed at investigating the fracture behavior of concrete under high strain rate tensile loading. The experimental method together with the identified stress-strain response of three tests conducted on ordinary concrete have been presented in the paper entitled Part I (Forquin and Lukić in Journal of Dynamic Behavior of Materials, 2017. https://doi.org/10.1007/s40870-017-0135-1). In the present paper, Part II, the investigation is extended towards directly determining the specific fracture energy of each observed fracture zone by visualizing the dynamic cracking process with a temporal resolution of 1 µs. Having access to temporal displacement fields of the sample surface, it is possible to identify the fracture opening displacement (FOD) and the fracture opening velocity of any principle (open) and secondary (closed) fracture at each measurement instance, that may or may not lead to complete physical failure of the sample. Finally, the local Stress-FOD curves were obtained for each observed fracture zone, opposed to previous works where indirect measurements were used. The obtained results indicated a much lower specific fracture energy compared to the results often found in the literature. Furthermore, numerical simulations were performed with a damage law to evaluate the validity of the proposed experimental data processing and compare it to the most often used one in the previous works. The results showed that the present method can reliably predict the specific fracture energy needed to open one macro-fracture and suggested that indirect measurement techniques can lead to an overestimate of specific fracture energy due to the stringent assumption of linear elasticity up-to the peak and the inability of having access to the real post-peak change of axial stress.

  6. Permeability evolution due to dissolution of natural shale fractures reactivated by fracking

    Science.gov (United States)

    Kwiatkowski, Kamil; Kwiatkowski, Tomasz; Szymczak, Piotr

    2015-04-01

    Investigation of cores drilled from gas-bearing shale formations reveals a relatively large number of calcite-cemented fractures. During fracking, some of these fractures will be reactivated [1-2] and may become important flow paths in the resulting fracture system. In this communication, we investigate numerically the effect of low-pH reactive fluid on such fractures. The low-pH fluids can either be pumped during the initial fracking stage (as suggested e.g. by Grieser et al., [3]) or injected later, as part of enhanced gas recovery (EGR) processes. In particular, it has been suggested that CO2 injection can be considered as a method of EGR [4], which is attractive as it can potentially be combined with simultaneous CO2 sequestration. However, when mixed with brine, CO2 becomes acidic and thus can be a dissolving agent for the carbonate cement in the fractures. The dissolution of the cement leads to the enhancement of permeability and interconnectivity of the fracture network and, as a result, increases the overall capacity of the reservoir. Importantly, we show that the dissolution of such fractures proceeds in a highly non-homogeneous manner - a positive feedback between fluid transport and mineral dissolution leads to the spontaneous formation of pronounced flow channels, frequently referred to as "wormholes". The wormholes carry the chemically active fluid deeper inside the system, which dramatically speeds up the overall permeability increase. If the low-pH fluids are used during fracking, then the non-uniform dissolution becomes important for retaining the fracture permeability, even in the absence of the proppant. Whereas a uniformly etched fracture will close tightly under the overburden once the fluid pressure is removed, the nonuniform etching will tend to maintain the permeability since the less dissolved regions will act as supports to keep more dissolved regions open. [1] Gale, J. F., Reed, R. M., Holder, J. (2007). Natural fractures in the Barnett

  7. Radiographic anatomy of the proximal femur: femoral neck fracture vs. transtrochanteric fracture

    Directory of Open Access Journals (Sweden)

    Ana Lecia Carneiro Leão de Araújo Lima

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the correlation between radiographic parameters of the proximal femur with femoral neck fractures or transtrochanteric fractures. METHODS: Cervicodiaphyseal angle (CDA, femoral neck width (FNW, hip axis length (HAL, and acetabular tear drop distance (ATD were analyzed in 30 pelvis anteroposterior view X-rays of patients with femoral neck fractures (n = 15 and transtrochanteric fractures (n = 15. The analysis was performed by comparing the results of the X-rays with femoral neck fractures and with transtrochanteric fractures. RESULTS: No statistically significant differences between samples were observed. CONCLUSION: There was no correlation between radiographic parameters evaluated and specific occurrence of femoral neck fractures or transtrochanteric fractures.

  8. Spall formation in solution mined storage caverns based on a creep and fracture analysis

    International Nuclear Information System (INIS)

    Munson, Darrell E.

    2000-01-01

    Because of limited direct observation, understanding of the interior conditions of the massive storage caverns constructed in Gulf Coast salt domes is realizable only through predictions of salt response. Determination of the potential for formation of salt spans, leading to eventual salt falls, is based on salt creep and fracture using the Multimechanism-Deformation Coupled Fracture (MCDF) model. This is a continuum model for creep, coupled to continuum damage evolution. The model has been successfully tested against underground results of damage around several test rooms at the Waste Isolation Pilot Plant (WIPP). Model simulations, here, evaluate observations made in the Strategic Petroleum Reserve (SPR) storage caverns, namely, the accumulation of material on cavern floors and evidence of salt falls. A simulation of a smooth cavern wall indicates damage is maximum at the surface but diminishes monotonically into the salt, which suggests the source of salt accumulation is surface sluffing. If a protuberance occurs on the wall, fracture damage can form beneath the protuberance, which will eventually cause fracture, and lead to a salt fall

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

    Science.gov (United States)

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

    2010-08-01

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

  10. Mandible Fractures.

    Science.gov (United States)

    Pickrell, Brent B; Serebrakian, Arman T; Maricevich, Renata S

    2017-05-01

    Mandible fractures account for a significant portion of maxillofacial injuries and the evaluation, diagnosis, and management of these fractures remain challenging despite improved imaging technology and fixation techniques. Understanding appropriate surgical management can prevent complications such as malocclusion, pain, and revision procedures. Depending on the type and location of the fractures, various open and closed surgical reduction techniques can be utilized. In this article, the authors review the diagnostic evaluation, treatment options, and common complications of mandible fractures. Special considerations are described for pediatric and atrophic mandibles.

  11. [Multiple fractures of the lower extremities (a propos of 50 patients)].

    Science.gov (United States)

    Touzard, R C; Kudela, I

    1975-04-01

    According to a study of 50 multiple fractures of the lower limbs, the frequency of associated lesions justifies the creation of new multiple injury units, well equipped in which may be found specialists of all branches of surgery. Although internal fixation in one stage as an emergency, is ideal in all fractures, one should in fact be circumspect for the danger of infection should lead one to avoid carrying out internal fixation if this is not absolutely necessary.

  12. Heart block and cardiac embolization of fractured inferior vena cava filter.

    Science.gov (United States)

    Abudayyeh, Islam; Takruri, Yessar; Weiner, Justin B

    2016-01-01

    A 66-year-old man underwent a placement of an inferior vena cava filter before a gastric surgery 9 years prior, presented to the emergency room with a complete atrioventricular block. Chest x-ray and transthoracic echocardiogram showed struts migrating to right ventricle with tricuspid regurgitation. Cardiothoracic surgery was consulted and declined an open surgical intervention due to the location of the embolized fragments and the patient's overall condition. It was also felt that the fragments had migrated chronically and were adhered to the cardiac structures. The patient underwent a dual-chamber permanent pacemaker implantation. Post-implant fluoroscopy showed no displacement of the inferior vena cava filter struts due to the pacemaker leads indicating that the filter fracture had likely been a chronic process. This case highlights a rare combination of complications related to inferior vena cava filter fractures and the importance of assessing for such fractures in chronic placements. Inferior vena cava filter placement for a duration greater than 1 month can be associated with filter fractures and strut migration which may lead to, although rare, serious or fatal complications such as complete atrioventricular conduction system disruption and valvular damage including significant tricuspid regurgitation. Assessing for inferior vena cava filter fractures in chronic filter placement is important to avoid such complications. When possible, retrieval of the filter should be considered in all patients outside the acute setting in order to avoid filter-related complications. Filter retrieval rates remain low even when a retrievable filter is in place and the patient no longer has a contraindication to anticoagulation.

  13. Continuum model for water movement in an unsaturated fractured rock mass

    International Nuclear Information System (INIS)

    Peters, R.R.; Klavetter, E.A.

    1988-01-01

    The movement of fluids in a fractured, porous medium has been the subject of considerable study. This paper presents a continuum model that may be used to evaluate the isothermal movement of water in an unsaturated, fractured, porous medium under slowly changing conditions. This continuum model was developed for use in evaluating the unsaturated zone at the Yucca Mountain site as a potential repository for high-level nuclear waste. Thus its development has been influenced by the conditions thought to be present at Yucca Mountain. A macroscopic approach and a microscopic approach are used to develop a continuum model to evaluate water movement in a fractured rock mass. Both approaches assume that the pressure head in the fractures and the matrix are identical in a plane perpendicular to flow. Both approaches lead to a single-flow equation for a fractured rock mass. The two approaches are used to calculate unsaturated hydrologic properties, i.e., relative permeability and saturation as a function of pressure head, for several types of tuff underlying Yucca Mountain, using the best available hydrologic data for the matrix and the fractures. Rock mass properties calculated by both approaches are similar

  14. Recognizing and reporting vertebral fractures: reducing the risk of future osteoporotic fractures

    International Nuclear Information System (INIS)

    Lentle, B.C.; Brown, J.P.; Khan, A.

    2007-01-01

    Given the increasing evidence that vertebral fractures are underdiagnosed and not acted on, Osteoporosis Canada and the Canadian Association of Radiologists initiated a project to develop and publish a set of recommendations to promote and facilitate the diagnosis and reporting of vertebral fractures. The identification of spinal fractures is not uniform. More than 65% of vertebral fractures cause no symptoms. It is also apparent that vertebral fractures are inadequately recognized when the opportunity for diagnosis arises fortuitously. It is to patients' benefit that radiologists report vertebral fractures evident on a chest or other radiograph, no matter how incidental to the immediate clinical indication for the examination. The present recommendations can help to close the gap in care in recognizing and treating vertebral fractures, to prevent future fractures and thus reduce the burden of osteoporosis-related morbidity and mortality, as well as fracture-related costs to the health care system. Several studies indicate that a gap exists in regard to the diagnosis of vertebral fractures and the clinical response following such diagnosis. All recommendations presented here are based on consensus. These recommendations were developed by a multidisciplinary working group under the auspices of the Scientific Advisory Council of Osteoporosis Canada and the Canadian Association of Radiologists. Prevalent vertebral fractures have important clinical implications in terms of future fracture risk. Recognizing and reporting fractures incidental to radiologic examinations done for other reasons has the potential to reduce health care costs by initiating further steps in osteoporosis diagnosis and appropriate therapy. Physicians should be aware of the importance of vertebral fracture diagnosis in assessing future osteoporotic fracture risk. Vertebral fractures incidental to radiologic examinations done for other reasons should be identified and reported. Vertebral fractures

  15. OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

    Directory of Open Access Journals (Sweden)

    Lokesh

    2016-05-01

    Full Text Available INTRODUCTION Most of these fractures except intra-articular fractures are treated with interlocking nail. 1,2 These nails are a boon for these fractures. But as the fracture nears to the joint stability the fracture fixation will be compromised due to malreduction and alignment, it leads to increased chances of delayed and nonunion. 3 Locking anatomical plates are evaluated for anatomical and relative stability fixation. Since then most intra and near intra-articular fractures are fixed with these plates with minimally invasive percutaneous plate osteosynthesis method, these plates have given excellent result 4 . But again these plates have some disadvantages 5 . This study is done to see the outcome of locking plates in distal tibia fracture. METHODS This study is done in the Department of Orthopaedics, Bangalore Medical College, Bangalore. This study is done from 2013 to 2015. 30 patients who came to outpatient department were treated with locking plates. All patients above 16 years having distal third tibia fracture are included. All open fractures except type 1 and elderly above 60 years and pathological fractures are excluded in our study. All patients were followed up for initial 5 months, thereafter, once in 3 months, for clinical and radiological evaluation of union status, knee range of motion, ankle range of motion and other complications. Assessment of the patient with functional recovery was done with American Orthopaedic Foot and Ankle Surgery(AOFAS 6 minimum 5 months after injury. RESULTS Majority of the patients are from age group 18-29 years (50%. Average age group was 30 years. Majority of the patients were males 80.6% (25. All fractures were closed fractures except 2 cases which are type 1. There were 12 cases of AO type A, 8 patients were AO type B and 10 patients were type C. Majority of the patients had fracture due to road traffic accidents, 74%. All fractures were united by the end of 20 weeks. There was delayed union in

  16. The role of strain localization in the fracture of irradiated pressure tube material

    International Nuclear Information System (INIS)

    Dutton, R.

    1989-04-01

    This report reviews those phenomena that lead to strain localization in zirconium alloys, with particular reference to the role played by the formation of shear bands in fracture processes. The important influence of plastic deformation, in general, on fracture mechanisms is emphasized. This is to be expected when elastic-plastic fracture mechanics is the chosen analytical technique. Intensely inhomogeneous characteristics of strain localization cause an abrupt bifurcation in the evolution of deformation strain and lead to plastic instability linked with intrinsic material behaviour (e.g., work softening) or of geometric origin (e.g., localized necking). Both of these effects are discussed in relation to measurable deformation parameters, such as the work hardening rate and strain rate sensitivity, which determine the degree of resistance to plastic instability. The modifying effect of irradiation on these quantities is given specific attention, the appropriate literature pertaining to Zircaloy and Zr-2.5% Nb being reviewed. Recommendations are made for a combined experimental and theoretical program to characterize strain localization and reduced ductility in irradiated cold-worked Zr-2.5% Nb pressure tube material. The relationship between the deformation properties and the fracture behaviour is discussed

  17. Emotional stress as a trigger of falls leading to hip or pelvic fracture. Results from the ToFa study – a case-crossover study among elderly people in Stockholm, Sweden

    Science.gov (United States)

    Möller, Jette; Hallqvist, Johan; Laflamme, Lucie; Mattsson, Fredrik; Ponzer, Sari; Sadigh, Siv; Engström, Karin

    2009-01-01

    Background Sudden emotions may interfere with mechanisms for keeping balance among the elderly. The aim of this study is to analyse if emotional stress and specifically feelings of anger, sadness, worries, anxiety or stress, can trigger falls leading to hip or pelvic fracture among autonomous older people. Methods The study applied the case-crossover design and was based on data gathered by face to face interviews carried out in Stockholm between November 2004 and January 2006 at the emergency wards of two hospitals. Cases (n = 137) were defined as persons aged 65 and older admitted for at least one night due to a fall-related hip or pelvic fracture (ICD10: S72 or S32) and meeting a series of selection criteria. Results are presented as relative risks with 95% confidence intervals. Results There was an increased risk for fall and subsequent hip or pelvic fracture for up to one hour after emotional stress. For anger there was an increased relative risk of 12.2 (95% CI 2.7–54.7), for sadness of 5.7 (95% CI 1.1–28.7), and for stress 20.6 (95% CI 4.5–93.5) compared to periods with no such feelings. Conclusion Emotional stress seems to have the potential to trigger falls and subsequent hip or pelvic fracture among autonomous older people. Further studies are needed to clarify how robust the findings are – as the number of exposed cases is small – and the mechanisms behind them – presumably balance and vision impairment in stress situation. PMID:19203356

  18. Hydraulic Fracturing and the Environment

    Science.gov (United States)

    Ayatollahy Tafti, T.; Aminzadeh, F.; Jafarpour, B.; de Barros, F.

    2013-12-01

    In this presentation, we highlight two key environmental concerns of hydraulic fracturing (HF), namely induced seismicity and groundwater contamination (GC). We examine the induced seismicity (IS) associated with different subsurface fluid injection and production (SFIP) operations and the key operational parameters of SFIP impacting it. In addition we review the key potential sources for possible water contamination. Both in the case of IS and GC we propose modeling and data analysis methods to quantify the risk factors to be used for monitoring and risk reduction. SFIP include presents a risk in hydraulic fracturing, waste water injection, enhanced oil recovery as well as geothermal energy operations. Although a recent report (NRC 2012) documents that HF is not responsible for most of the induced seismicities, we primarily focus on HF here. We look into vaious operational parameters such as volume and rate of water injection, the direction of the well versus the natural fracture network, the depth of the target and the local stress field and fault system, as well as other geological features. The latter would determine the potential for triggering tectonic related events by small induced seismicity events. We provide the building blocks for IS risk assessment and monitoring. The system we propose will involve adequate layers of complexity based on mapped seismic attributes as well as results from ANN and probabilistic predictive modeling workflows. This leads to a set of guidelines which further defines 'safe operating conditions' and 'safe operating zones' which will be a valuable reference for future SFIP operations. We also illustrate how HF can lead to groundwater aquifer contamination. The source of aquifer contamination can be the hydrocarbon gas or the chemicals used in the injected liquid in the formation. We explore possible pathways of contamination within and discuss the likelihood of contamination from each source. Many of the chemical compounds used

  19. Imaging basilar skull fractures in the horse: a review

    International Nuclear Information System (INIS)

    Ramirez, O. III; Jorgensen, J.S.; Thrall, D.E.

    1998-01-01

    Due to the complex nature of the anatomy of the equine head, superimposition of numerous structures, and poor soft tissue differentiation, radiography may be of limited value in the diagnosis of basilar skull fractures. However, in many horses radiographic changes such as soft tissue opacification of the guttural pouch region, irregular bone margination at the sphenooccipital line, attenuation of the nasopharynx, ventral displacement of the dorsal pharyngeal wall and the presence of irregularly shaped bone fragments in the region of the guttural pouches are suggestive of a fracture of the skull base. These findings in conjunction with physical examination findings and historical information may lead to a presumptive diagnosis of a fracture. When available and when the patient will accommodate the equipment, computed tomography may give a definitive diagnosis owing to its superior resolution and differentiation of soft tissue structures

  20. Simulation of complex fracture networks influenced by natural fractures in shale gas reservoir

    Directory of Open Access Journals (Sweden)

    Zhao Jinzhou

    2014-10-01

    Full Text Available When hydraulic fractures intersect with natural fractures, the geometry and complexity of a fracture network are determined by the initiation and propagation pattern which is affected by a number of factors. Based on the fracture mechanics, the criterion for initiation and propagation of a fracture was introduced to analyze the tendency of a propagating angle and factors affecting propagating pressure. On this basis, a mathematic model with a complex fracture network was established to investigate how the fracture network form changes with different parameters, including rock mechanics, in-situ stress distribution, fracture properties, and frac treatment parameters. The solving process of this model was accelerated by classifying the calculation nodes on the extending direction of the fracture by equal pressure gradients, and solving the geometrical parameters prior to the iteration fitting flow distribution. With the initiation and propagation criterion as the bases for the propagation of branch fractures, this method decreased the iteration times through eliminating the fitting of the fracture length in conventional 3D fracture simulation. The simulation results indicated that the formation with abundant natural fractures and smaller in-situ stress difference is sufficient conditions for fracture network development. If the pressure in the hydraulic fractures can be kept at a high level by temporary sealing or diversion, the branch fractures will propagate further with minor curvature radius, thus enlarging the reservoir stimulation area. The simulated shape of fracture network can be well matched with the field microseismic mapping in data point range and distribution density, validating the accuracy of this model.

  1. Risk factors for fractures in patients with rheumatoid arthritis (preliminary results of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment»

    Directory of Open Access Journals (Sweden)

    Marina Mikhailovna Podvorotova

    2013-01-01

    Full Text Available In patients with rheumatoid arthritis (RA, bone fractures occur 1.5-2 times more frequently than in the population. They often lead to reduced quality of life, to disability and death in the patients. It should be noted that risk factors (RFs for fractures have not been studied on a sufficient sample in Russia; there are no recommendations on the prevention of fractures in this category of patients. Objective: to compare groups of RA patients with and without a history of fractures to further identify possible RFs for fractures. Subjects and methods. The trial included 254 patients aged 18 to 85 years, diagnosed with RA, from the database of the multicenter program «Osteoporosis in rheumatoid arthritis: Diagnosis, risk factors, fractures, treatment», who had been followed up in 2010 to 2011. The patients were divided into two groups: 1 101 (39.8% patients with a history of low-trauma fractures and 2 153 (60.2% patients without a history of fractures. In Group 1, the patients were older than in Group 2 (mean age 59.8 and 56.1 years, respectively. Menopause was recorded in 88.1 and 77.8% of cases, respectively. The groups differed in the duration of RA an average of 15.5 and 11.5 years, respectively Results. The fractures in the history were associated with the use of glucocorticoids (GC, their higher cumulative dose and use duration. In Group 1 patients, the bone mineral density (BMD was lower in all study skeleton portions and more frequently corresponded to osteoporosis. RA complications, such as amyloidosis and osteonecrosis, were more common in the patients with a history of fractures. Conclusion. In RA patients, the most likely RFs of fractures are age, the long-term intake of large-dose GC, low BMD, the severe course of RA, and the presence of its complications.

  2. Nontraumatic tibial polyethylene insert cone fracture in mobile-bearing posterior-stabilized total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Yohei Tanikake

    2016-12-01

    Full Text Available A 72-year-old male patient underwent mobile-bearing posterior-stabilized total knee arthroplasty for osteoarthritis. He experienced a nontraumatic polyethylene tibial insert cone fracture 27 months after surgery. Scanning electron microscopy of the fracture surface of the tibial insert cone suggested progress of ductile breaking from the posterior toward the anterior of the cone due to repeated longitudinal bending stress, leading to fatigue breaking at the anterior side of the cone, followed by the tibial insert cone fracture at the anterior side of the cone, resulting in fracture at the base of the cone. This analysis shows the risk of tibial insert cone fracture due to longitudinal stress in mobile-bearing posterior-stabilized total knee arthroplasty in which an insert is designed to highly conform to the femoral component.

  3. Modeling flow and transport in fracture networks using graphs

    Science.gov (United States)

    Karra, S.; O'Malley, D.; Hyman, J. D.; Viswanathan, H. S.; Srinivasan, G.

    2018-03-01

    Fractures form the main pathways for flow in the subsurface within low-permeability rock. For this reason, accurately predicting flow and transport in fractured systems is vital for improving the performance of subsurface applications. Fracture sizes in these systems can range from millimeters to kilometers. Although modeling flow and transport using the discrete fracture network (DFN) approach is known to be more accurate due to incorporation of the detailed fracture network structure over continuum-based methods, capturing the flow and transport in such a wide range of scales is still computationally intractable. Furthermore, if one has to quantify uncertainty, hundreds of realizations of these DFN models have to be run. To reduce the computational burden, we solve flow and transport on a graph representation of a DFN. We study the accuracy of the graph approach by comparing breakthrough times and tracer particle statistical data between the graph-based and the high-fidelity DFN approaches, for fracture networks with varying number of fractures and degree of heterogeneity. Due to our recent developments in capabilities to perform DFN high-fidelity simulations on fracture networks with large number of fractures, we are in a unique position to perform such a comparison. We show that the graph approach shows a consistent bias with up to an order of magnitude slower breakthrough when compared to the DFN approach. We show that this is due to graph algorithm's underprediction of the pressure gradients across intersections on a given fracture, leading to slower tracer particle speeds between intersections and longer travel times. We present a bias correction methodology to the graph algorithm that reduces the discrepancy between the DFN and graph predictions. We show that with this bias correction, the graph algorithm predictions significantly improve and the results are very accurate. The good accuracy and the low computational cost, with O (104) times lower times than

  4. Radiotherapy of pathologic fractures and skeletal lesions bearing the risk of fracture

    International Nuclear Information System (INIS)

    Rieden, K.; Kober, B.; Mende, U.; Zum Winkel, K.

    1986-01-01

    Radiotherapy is of great importance in the treatment of pathologic fractures and skeletal lesions bearing the risk of fracture which are induced by malignomas, especially if these are in an advanced stage. In dependence on site and extent of skeletal destruction as well as on the general tumor dissemination, it can be distinguished between palliative radiotherapy and curative radiotherapy aiming at analgesia and remineralization. A retrospective analysis of 27 pathologic fractures and 56 skeletal lesions bearing the risk of fracture in malignoma patients showed an analgetic effect obtained by radiotherapy in 67% of pathological fractures and in 80% of skeletal lesions bearing the risk of fracture, whereas a remineralization could be demonstrated for 33% of pathological fractures and 50% of destructions bearing the risk of fracture. A stabilization of destructions progressing before therapy was found in 55% of pathological fractures and 40% of skeletal lesions bearing the risk of fracture. Thus a partial loading, supported by orthopedic prostheses, was possible for more than 50% of all patients. (orig.) [de

  5. Fracture Strength of Fused Silica From Photonic Signatures Around Collision Sites

    Science.gov (United States)

    Yost, William T.; Cramer, K Elliott

    2015-01-01

    Impact sites in glass affect its fracture strength. An analytical model that predicts fracture strength from grey-field polariscope (GFP) readings (photoelastic retardations) has been developed and reported in the literature. The model is suggestive that stress fields, resulting from impact damage, destablizes sites within the glass, which lead to pathways that cause strength degradation. Using data collected from fused silica specimens fabricated from outer window panes that were designed for the space shuttle, the model was tested against four categories of inflicted damage. The damage sites were cored from the window carcasses, examined with the GFP and broken using the ASTM Standard C1499-09 to measure the fracture strength. A correlation is made between the fracture strength and the photoelastic retardation measured at the damage site in each specimen. A least-squares fit is calculated. The results are compared with the predictions from the model. A plausible single-sided NDE damage site inspection method (a version of which is planned for glass inspection in the Orion Project) that relates photoelastic retardation in glass components to its fracture strength is presented.

  6. Fracture behaviour of the 14Cr ODS steel exposed to helium and liquid lead

    Czech Academy of Sciences Publication Activity Database

    Hojná, A.; Di Gabriele, F.; Hadraba, Hynek; Husák, Roman; Kuběna, Ivo; Rozumová, L.; Bublíková, P.; Kalivodová, J.; Matějíček, Jiří

    2017-01-01

    Roč. 490, JUL (2017), s. 143-154 ISSN 0022-3115 R&D Projects: GA ČR(CZ) GA14-25246S; GA ČR(CZ) GA14-12837S; GA MŠk(CZ) LQ1601 Institutional support: RVO:68081723 ; RVO:61389021 Keywords : Impact fracture * Microanalysis * Nanostructured steel * Oxidation * Thermal ageing Subject RIV: JG - Metallurgy; JG - Metallurgy (UFP-V) OBOR OECD: Materials engineering; Materials engineering (UFP-V); Materials engineering (UFM-A) Impact factor: 2.048, year: 2016

  7. Summary report on the up-scaling of the retention properties by matrix diffusion in fractured rock

    International Nuclear Information System (INIS)

    Poteri, A.

    2009-02-01

    Fractured rocks are composed of porous but almost impermeable rock matrix and water conducting fractures. The main characteristic of the fractured rock is the great heterogeneity in different scales that leads to preferential flow paths and channelling of the flow. Three distinct flow environments can be identified: channeling that causes variable flow in the individual fracture planes, transmissivity differences between fractures that leads to preferential flow paths and extensive fracture zones that provide highly transmissive connections over long distances. Large and transmissive fractures have an important role to the flow and transport properties of the fractured rock. Flow paths tend to accumulate on the large features that carry the majority of the flow. Modelling exercises have indicated persistence of the flow properties along the flow paths. This means that once a particle has entered a major flow path it tends to follow the high flow rate channel. The main challenge in spatial up-scaling of the retention properties is connected to the description of the flow characteristics in the fractured rock. The importance of individual fractures to the overall retention is proportional to the flow rate along the fracture. This means that simulations need to consider individual fractures. Fracture network modelling offers a suitable approach that is able to take into account the multiscale structure of the fractured rock and to determine retention properties of the flow paths. It also provides a straightforward way to up-scale transport properties along the preferential flow paths through the fracture network. However, the computational feasibility of the site scale applications in the performance assessment limits the range of different size fractures that can be taken into account in the fracture network simulations. Heterogeneity in the immobile zone properties may influence effective retention properties if the heterogeneity is coupled with a limited capacity

  8. The usefulness of sagittal reformation for diagnosis of sternal fracture

    Energy Technology Data Exchange (ETDEWEB)

    Im, Dong Jin; Hahn, Seok; Kim, Young Ju [Dept. of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    2014-01-15

    The purpose of our study was to evaluate the usefulness of sagittal reformation of chest computed tomography for the diagnosis of sternal fracture after trauma. We retrospectively reviewed medical records and chest computer tomography (CT) of 716 patients in the emergency department after trauma between January and December 2010. Two radiologists investigated chest CT images. We investigated numbers and locations of sternal fractures on axial images only and on both axial and sagittal images for each radiologist. First, radiologist found sternal fractures in 58 patients (70.7%) on only axial images, and 80 (97.5%) on both axial and sagittal images. Second, radiologist found fractures in 67 patients (81.7%) on axial image only and 81 (98.7%) on both axial and sagittal images. The sensitivity increased after adding sagittal reformation images for each radiologist (p < 0.05, respectively). On the axial images, the interobserver agreement was low (k 0.596) between the two radiologists. However, on both axial and sagittal images, the interobserver agreement increased (k = 0.872). Sagittal reformation of chest CT increases the chance of diagnosis for sternal fracture and leads to early diagnosis resulting in appropriate treatment.

  9. The usefulness of sagittal reformation for diagnosis of sternal fracture

    International Nuclear Information System (INIS)

    Im, Dong Jin; Hahn, Seok; Kim, Young Ju

    2014-01-01

    The purpose of our study was to evaluate the usefulness of sagittal reformation of chest computed tomography for the diagnosis of sternal fracture after trauma. We retrospectively reviewed medical records and chest computer tomography (CT) of 716 patients in the emergency department after trauma between January and December 2010. Two radiologists investigated chest CT images. We investigated numbers and locations of sternal fractures on axial images only and on both axial and sagittal images for each radiologist. First, radiologist found sternal fractures in 58 patients (70.7%) on only axial images, and 80 (97.5%) on both axial and sagittal images. Second, radiologist found fractures in 67 patients (81.7%) on axial image only and 81 (98.7%) on both axial and sagittal images. The sensitivity increased after adding sagittal reformation images for each radiologist (p < 0.05, respectively). On the axial images, the interobserver agreement was low (k 0.596) between the two radiologists. However, on both axial and sagittal images, the interobserver agreement increased (k = 0.872). Sagittal reformation of chest CT increases the chance of diagnosis for sternal fracture and leads to early diagnosis resulting in appropriate treatment.

  10. [Trochanteric femoral fractures].

    Science.gov (United States)

    Douša, P; Čech, O; Weissinger, M; Džupa, V

    2013-01-01

    At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. Our department serves as a trauma centre for half of Prague and part of the Central Bohemia Region with a population of 1 150 000. Prague in particular has a high number of elderly citizens. Our experience is based on extensive clinical data obtained from the Register of Proximal Femoral Fractures established in 1997. During 14 years, 4280 patients, 3112 women and 1168 men, were admitted to our department for treatment of proximal femoral fractures. All patients were followed up until healing or development of complications. In the group under study, 82% were patients older than 70 years; 72% of those requiring surgery were in their seventies and eighties. Men were significantly younger than women (pfractures were 2.3-times more frequent in women than in men. In the category under 60 years, men significantly outnumbered women (pfractures were, on the average, eight years older than the patients with intertrochanteric fractures, which is a significant difference (pTrochanteric fractures accounted for 54.7% and femoral neck fractures for 45.3% of all fractures. The inter-annual increase was 5.9%, with more trochanteric than femoral neck fractures. There was a non-significant decrease in intertrochanteric (AO 31-A3) fractures. On the other hand, the number of pertrochanteric (AO 31-A1+2) fractures increased significantly (pfractures were treated with a proximal femoral nail; a short nail was used in 1260 and a long nail in 134 of them. A dynamic hip screw (DHS) was employed to treat 947 fractures. Distinguishing between pertrochanteric (21-A1

  11. Jogger's fracture and other stress fractures of the lumbo-sacral spine

    International Nuclear Information System (INIS)

    Abel, M.S.

    1985-01-01

    The posterior rings of the lower lumbo-sacral vertebrae are subject to stress fractures at any part - pedicle, pars, or lamina. The site of fracture is apparently determined by the axis of weight bearing. The three illustrative clinical examples cited include a jogger with a laminar fracture, a ballet dancer with pedicle fractures, and a nine-year-old boy with fractures of pars and lamina. Chronic low back pain is the typical complaint with stress fractures of the lower lumbo-sacral spine. Special imaging techniques are usually needed to demonstrate these lesions, including vertebral arch views, multi-directional tomography, and computed tomography (CT). (orig.)

  12. A STUDY ON PROXIMAL HUMERAL FRACTURES STABILISED WITH PHILOS PLATE

    Directory of Open Access Journals (Sweden)

    Praveen Sivakumar K

    2017-02-01

    Full Text Available BACKGROUND Techniques for treating complex proximal humeral fractures vary and include fixations using tension bands, percutaneous pins, bone suture, T-plates, intramedullary nails, double tubular plates, hemiarthroplasty, plant tan humerus fixator plates, Polaris nails and blade plates. Complications of these techniques include cutout or back out of the screws and plates, avascular necrosis, nonunion, malunion, nail migration, rotator cuff impairment and impingement syndromes. Insufficient anchorage from conventional implants may lead to early loosening and failure, especially in osteoporotic bones. In general, nonoperative treatment of displaced three and four-part fractures of the proximal humerus leads to poor outcome due to intraarticular nature of injury and inherent instability of the fragments. Comminuted fractures of the proximal humerus are at risk of fixation failure, screw loosening and fracture displacement. Open reduction and internal fixation with conventional plate and screws has been associated with unacceptably high incidence of screw pull out. PHILOS (the proximal humeral internal locking system plate is an internal fixation system that enables angled stabilisation with multiple interlocking screws for fractures of the proximal humerus. MATERIALS AND METHODS 30 patients with proximal humerus fractures who were admitted in the Department of Orthopaedics, Government General Hospital, Kakinada, during the period November 2014 - November 2016 were taken up for study according to inclusion criteria. All patients were treated with PHILOS plate. These proximal humerus fractures were classified according to Neer’s classification. Patients were followed up at 6 weeks, 12 weeks and 6 months’ interval. Functional outcomes for pain, range of motion and muscle power and function were assessed using the Constant-Murley scoring system. Collected data analysed with independent t-test and ANNOVA test. RESULTS The outcome of the study was 1

  13. Laser induced damage and fracture in fused silica vacuum windows

    International Nuclear Information System (INIS)

    Campbell, J.H.; Hurst, P.A.; Heggins, D.D.; Steele, W.A.; Bumpas, S.E.

    1996-11-01

    Laser-induced damage, that initiates catastrophic fracture, has been observed in large (≤61 cm dia) fused silica lenses that also serve as vacuum barriers in Nova and Beamlet lasers. If the elastic stored energy in the lens is high enough, the lens will fracture into many pieces (implosion). Three parameters control the degree of fracture in the vacuum barrier window: elastic stored energy (tensile stress), ratio of window thickness to flaw depth, and secondary crack propagation. Fracture experiments were conducted on 15-cm dia fused silica windows that contain surface flaws caused by laser damage. Results, combined with window failure data on Beamlet and Nova, were used to develop design criteria for a ''fail-safe'' lens (that may catastrophically fracture but not implode). Specifically, the window must be made thick enough so that the peak tensile stress is less than 500 psi (3.4 MPa) and the thickness/critical flaw size is less than 6. The air leak through the window fracture and into the vacuum must be rapid enough to reduce the load on the window before secondary crack growth occurs. Finite element stress calculations of a window before and immediately following fracture into two pieces show that the elastic stored energy is redistributed if the fragments ''lock'' in place and thereby bridge the opening. In such cases, the peak stresses at the flaw site can increase, leading to further (i.e. secondary) crack growth

  14. Influence of structures on fracture and fracture toughness of cemented tungsten carbides

    International Nuclear Information System (INIS)

    Zhao, W.; Zhang, X.

    1987-01-01

    A study was made of the influence of structures on fracture and fracture toughness of cemented tungsten carbides with different compositions and grain sizes. The measurement of the fracture toughness of cemented tungsten carbide was carried out using single edge notched beam. The microstructural parameters and the proportion for each fracture mode on the fracture surface were obtained. The brittle fracture of the alloy is mainly due to the interfacial decohesion fracture following the interface of the carbide crystals. It has been observed that there are localized fractures region ahead of the crack tip. The morphology of the crack propagation path as well as the slip structure in the cobalt phase of the deformed region have been investigated. In addition, a study of the correlation between the plane strain fracture toughness and microstructural parameters, such as mean free path of the cobalt phase, tungsten carbide grain size and the contiguity of tungsten carbide crystals was also made

  15. [Direct osteosynthesis of instable Gehweiler Type III atlas fractures. Presentation of a dorsoventral osteosynthesis of instable atlas fractures while maintaining function].

    Science.gov (United States)

    Böhm, H; Kayser, R; El Saghir, H; Heyde, C-E

    2006-09-01

    This retrospective study evaluates eight patients with unstable fractures of the atlas vertebra, treated operatively in the Central Clinic Bad Berka between January 1995 and December 2001. In all cases, we were confronted with unstable and dislocated type III fractures according to Gehweiler, caused by an injured transverse ligament. Mean age was 34 years (range 20-49) in two women and six men. We introduce a new technique of direct reconstruction of the atlas vertebra. This technique leads to a stable ring construct that allows compression osteosynthesis of the fracture. Spinal fusion can be avoided, as can postoperative immobilization, since sufficient stability for functional postoperative treatment is achievable. The follow-up control 38 months (range 6-75) after surgery showed solid bony fusion in all cases, in one case after revision surgery. All patients showed good functional results, there was no need for analgesics and all patients could be reintegrated into their former occupation.

  16. Current concepts review: Fractures of the patella

    Science.gov (United States)

    Gwinner, Clemens; Märdian, Sven; Schwabe, Philipp; Schaser, Klaus-D.; Krapohl, Björn Dirk; Jung, Tobias M.

    2016-01-01

    Fractures of the patella account for about 1% of all skeletal injuries and can lead to profound impairment due to its crucial function in the extensor mechanism of the knee. Diagnosis is based on the injury mechanism, physical examination and radiological findings. While the clinical diagnosis is often distinct, there are numerous treatment options available. The type of treatment as well as the optimum timing of surgical intervention depends on the underlying fracture type, the associated soft tissue damage, patient factors (i.e. age, bone quality, activity level and compliance) and the stability of the extensor mechanism. Regardless of the treatment method an early rehabilitation is recommended in order to avoid contractures of the knee joint capsule and cartilage degeneration. For non-displaced and dislocated non-comminuted transverse patellar fractures (2-part) modified anterior tension band wiring is the treatment of choice and can be combined – due to its biomechanical superiority – with cannulated screw fixation. In severe comminuted fractures, open reduction and fixation with small fragment screws or new angular stable plates for anatomic restoration of the retropatellar surface and extension mechanism results in best outcome. Additional circular cerclage wiring using either typical metal cerclage wires or resorbable PDS/non-resorbable FiberWires increases fixation stability and decreases risk for re-dislocation. Distal avulsion fractures should be fixed with small fragment screws and should be protected by a transtibial McLaughlin cerclage. Partial or complete patellectomy should be regarded only as a very rare salvage operation due to its severe functional impairment. PMID:26816667

  17. Presentation and outcome of traumatic spinal fractures

    Directory of Open Access Journals (Sweden)

    Ahmed El-Faramawy

    2012-01-01

    Full Text Available Background: Motor vehicle crashes and falls account for most of the spine fractures with subsequent serious disability. Aim: To define the incidence, causes, and outcome of spinal fractures. Materials and Methods: Data were collected retrospectively from trauma registry database of all traumatic spinal injuries admitted to the section of trauma surgery in Qatar from November 2007 to December 2009. Results: Among 3712 patients who were admitted to the section of trauma surgery, 442 (12% injured patients had spinal fractures with a mean age of 33.2 ± 12 years. The male to female ratio was 11.6:1. Motor vehicle crashes (36.5% and falls from height (19.3% were the leading causes of cervical injury (P = 0.001. The injury severity score ranged between 4 and 75. Nineteen percent of cases with cervical injury had thoracic injury as well (P = 0.04. Lumber injury was associated with thoracic injury in 27% of cases (P < 0.001. Combined thoracic and lumber injuries were associated with cervical injury in 33% of cases (P < 0.001. The total percent of injuries associated with neurological deficit was 5.4%. Fifty-three cases were managed surgically for spine fractures; 14 of them had associated neurological deficits. Overall mortalityrate was 5%. Conclusions: Spine fractures are not uncommon in Qatar. Cervical and thoracic spine injuries carry the highest incidence of associated neurological deficit and injuries at other spinal levels. Young males are the most exposed population that deserves more emphasis on injury prevention programs in the working sites and in enforcement of traffic laws.

  18. Patellar Sleeve Fracture With Ossification of the Patellar Tendon.

    Science.gov (United States)

    Damrow, Derek S; Van Valin, Scott E

    2017-03-01

    Patellar sleeve fractures make up greater than 50% of all patellar fractures. They are essentially only seen in the pediatric population because of the thick periosteum and the distal patellar pole apophysis in this group. These fractures can lead to complications if not treated appropriately and in a timely fashion. Complications of missed or untreated patellar sleeve fractures include patella alta, anterior knee pain, and quadriceps atrophy. These can all result in severe limitations in activity. The authors describe a case of a 16-year-old boy who sustained a patellar sleeve fracture 3 years prior to presentation. On presentation, he had patella alta, diminished strength, 5° of extensor lag, and radiographs that revealed bone formation along the patellar tendon. Despite this, he was able to maintain a high level of activity. This case report explores how the patient could have maintained a high level of activity despite having a patellar sleeve fracture. Also, because of the delayed presentation, the patella was ossified and the quadriceps was retracted, which led to a novel approach to reconstructing his distal extensor mechanism. This approach included a V-Y advancement of the quadriceps tendon and patellar tendon reconstruction using the patient's hamstring tendon (semitendinosus). This technique, combined with physical therapy postoperatively, resulted in his return to varsity high school soccer. To the best of the authors' knowledge, this technique has not been reported for this rare condition. [Orthopedics. 2017; 40(2):e357-e359.]. Copyright 2016, SLACK Incorporated.

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

    Science.gov (United States)

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

    2006-01-01

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

  20. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  1. Fracture modes in human teeth.

    Science.gov (United States)

    Lee, J J-W; Kwon, J-Y; Chai, H; Lucas, P W; Thompson, V P; Lawn, B R

    2009-03-01

    The structural integrity of teeth under stress is vital to functional longevity. We tested the hypothesis that this integrity is limited by fracture of the enamel. Experiments were conducted on molar teeth, with a metal rod loaded onto individual cusps. Fracture during testing was tracked with a video camera. Two longitudinal modes of cracking were observed: median cracking from the contact zone, and margin cracking along side walls. Median cracks initiated from plastic damage at the contact site, at first growing slowly and then accelerating to the tooth margin. Margin cracks appeared to originate from the cemento-enamel junction, and traversed the tooth wall adjacent to the loaded cusp from the gingival to the occlusal surface. All cracks remained confined within the enamel shell up to about 550 N. At higher loads, additional crack modes--such as enamel chipping and delamination--began to manifest themselves, leading to more comprehensive failure of the tooth structure.

  2. Traumatic Fracture in a patient of Osteopoikilosis with review of literature

    Directory of Open Access Journals (Sweden)

    Rohan Bansal

    2013-04-01

    Full Text Available Introduction: Osteopoikilosis or osteopathia condensans disseminata is a rare hereditary autosomal dominant sclerosing bone dysplasia. Patients are usually asymptomatic and the diagnosis is usually made incidentally on radiographs which show presence of symmetric, multiple, well defined, small ovoid areas of increased radiodensity clustered in peri-articular osseous regions with propensity for epiphyseal and metaphyseal involvement. There are no increased risks of pathological fracture in a case of osteopoikilosis and traumatic fracture healing in a case of osteopoikilosis is similar to fracture occurring in other normal patients. Case Report: A 34 years male, electrician came with history of accidental fall from height while working in office leading to development of pain and swelling over left lower leg and ankle diagnosed with Ruedi-Allgower classification type I pilon fracture(without fibula fracture no distal neuro-vascular deficit. Patient was offered surgical treatment in form of open reduction and internal fixation of tibial fracture by plate osteosynthesis using antero-medial approach , showed complete union and was followed up for eight months. Conclusion: Osteopoikilosis has a benign course and it should always be kept as a possible differential diagnosis for osteoblastic metastasis to avoid diagnositic dilemma. Diagnosis can be settled by routine x-rays ( for type ,extent and site of lesions, bones affected, clinical features of patient , histopathology and other systemic or pre-existing conditions. Keywords: Fracture , Osteopoikilosis , union, Pilon, Osteoblastic metastasis

  3. Contribution to the research on fracture properties of metals in the elasto-plastic field

    International Nuclear Information System (INIS)

    Rousselier, G.; Electricite de France, 77 - Ecuelles. Dept. Etudes des Materiaux)

    1979-01-01

    Standard Fracture Mechanics theories proved unsuccessful for the treatment of ductile fracture in metals. We have shown the necessity of better knowledge and satisfactory modelling of the fracture process, prior to any application to cracked bodies. In that way we developed stress-strain laws which take into consideration the growth of voids during ductile fracture. The damage resulting from void growth is characterized by internal parameters. Finite strain analysis leads to material instability, corresponding to the stage of void coalescence and material decohesion. This latter result is only true in a finite strain analysis. In the infinitesimal strain finite element numerical analysis of three-point bend specimens, a local fracture criterion is used. The experimental determination of this criterion is performed with axisymmetrical notched tension specimens, which allow the investigation of various stress triaxialities at fracture. The numerical analysis proved effective in the modelling of stable crack growth and size effect, and was compared with experimental results [fr

  4. Fracture network growth for prediction of fracture characteristics and connectivity in tight reservoir rocks

    NARCIS (Netherlands)

    Barnhoorn, A.; Cox, S.F.

    2012-01-01

    Fracturing experiments on very low-porosity dolomite rocks shows a difference in growth of fracture networks by stress-driven fracturing and fluid-driven fracturing. Stress-driven fracture growth, in the absence of fluid pressure, initially forms fractures randomly throughout the rocks followed by

  5. Anterior tibial stress fractures treated with anterior tension band plating in high-performance athletes.

    Science.gov (United States)

    Cruz, Alexandre Santa; de Hollanda, João Paris Buarque; Duarte, Aires; Hungria Neto, José Soares

    2013-06-01

    The non-surgical treatment of anterior tibial cortex stress fractures requires long periods of abstention from sports activities and often results in non-union. Many different surgical techniques have already been previously described to treat these fractures, but there is no consensus on the best treatment. We describe the outcome of treatment using anterior tibial tension band plating in three high-performance athletes (4 legs) with anterior tibial cortex stress fractures. Tibial osteosynthesis with a 3.5-mm locking compression plate in the anterolateral aspect of the tibia was performed in all patients diagnosed with anterior tibial stress fracture after September 2010 at Santa Casa Hospital. All of the fractures were consolidated within a period of 3 months after surgery, allowing for an early return to pre-injury levels of competitive sports activity. There were no infection, non-union, malunion or anterior knee pain complications. Anterior tibial tension band plating leads to prompt fracture consolidation and is a good alternative for the treatment of anterior tibial cortex stress fractures. Bone grafts were shown to be unnecessary.

  6. Surrogate-based optimization of hydraulic fracturing in pre-existing fracture networks

    Science.gov (United States)

    Chen, Mingjie; Sun, Yunwei; Fu, Pengcheng; Carrigan, Charles R.; Lu, Zhiming; Tong, Charles H.; Buscheck, Thomas A.

    2013-08-01

    Hydraulic fracturing has been used widely to stimulate production of oil, natural gas, and geothermal energy in formations with low natural permeability. Numerical optimization of fracture stimulation often requires a large number of evaluations of objective functions and constraints from forward hydraulic fracturing models, which are computationally expensive and even prohibitive in some situations. Moreover, there are a variety of uncertainties associated with the pre-existing fracture distributions and rock mechanical properties, which affect the optimized decisions for hydraulic fracturing. In this study, a surrogate-based approach is developed for efficient optimization of hydraulic fracturing well design in the presence of natural-system uncertainties. The fractal dimension is derived from the simulated fracturing network as the objective for maximizing energy recovery sweep efficiency. The surrogate model, which is constructed using training data from high-fidelity fracturing models for mapping the relationship between uncertain input parameters and the fractal dimension, provides fast approximation of the objective functions and constraints. A suite of surrogate models constructed using different fitting methods is evaluated and validated for fast predictions. Global sensitivity analysis is conducted to gain insights into the impact of the input variables on the output of interest, and further used for parameter screening. The high efficiency of the surrogate-based approach is demonstrated for three optimization scenarios with different and uncertain ambient conditions. Our results suggest the critical importance of considering uncertain pre-existing fracture networks in optimization studies of hydraulic fracturing.

  7. Mortality Following Periprosthetic Proximal Femoral Fractures Versus Native Hip Fractures.

    Science.gov (United States)

    Boylan, Matthew R; Riesgo, Aldo M; Paulino, Carl B; Slover, James D; Zuckerman, Joseph D; Egol, Kenneth A

    2018-04-04

    The number of periprosthetic proximal femoral fractures is expected to increase with the increasing prevalence of hip arthroplasties. While native hip fractures have a well-known association with mortality, there are currently limited data on this outcome among the subset of patients with periprosthetic proximal femoral fractures. Using the New York Statewide Planning and Research Cooperative System, we identified patients from 60 to 99 years old who were admitted to a hospital in the state with a periprosthetic proximal femoral fracture (n = 1,655) or a native hip (femoral neck or intertrochanteric) fracture (n = 97,231) between 2006 and 2014. Within the periprosthetic fracture cohort, the indication for the existing implant was not available in the data set. We used mixed-effects regression models to compare mortality at 1 and 6 months and 1 year for periprosthetic compared with native hip fractures. The risk of mortality for patients who sustained a periprosthetic proximal femoral fracture was no different from that for patients who sustained a native hip fracture at 1 month after injury (3.2% versus 4.6%; odds ratio [OR], 0.90; 95% confidence interval [CI], 0.68 to 1.19; p = 0.446), but was lower at 6 months (3.8% versus 6.5%; OR, 0.74; 95% CI, 0.57 to 0.95; p = 0.020) and 1 year (9.7% versus 15.9%; OR, 0.71; 95% CI, 0.60 to 0.85; p accounting for age and comorbidities. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  8. An Efficient Two-Scale Hybrid Embedded Fracture Model for Shale Gas Simulation

    KAUST Repository

    Amir, Sahar Z.

    2016-12-27

    Natural and hydraulic fractures existence and state differs on a reservoir-by-reservoir or even on a well-by-well basis leading to the necessity of exploring the flow regimes variations with respect to the diverse fracture-network shapes forged. Conventional Dual-Porosity Dual-Permeability (DPDP) schemes are not adequate to model such complex fracture-network systems. To overcome this difficulty, in this paper, an iterative Hybrid Embedded multiscale (two-scale) Fracture model (HEF) is applied on a derived fit-for-purpose shale gas model. The HEF model involves splitting the fracture computations into two scales: 1) fine-scale solves for the flux exchange parameter within each grid cell; 2) coarse-scale solves for the pressure applied to the domain grid cells using the flux exchange parameter computed at each grid cell from the fine-scale. After that, the D dimensions matrix pressure and the (D-1) lower dimensional fracture pressure are solved as a system to apply the matrix-fracture coupling. HEF model combines the DPDP overlapping continua concept, the DFN lower dimensional fractures concept, the HFN hierarchical fracture concept, and the CCFD model simplicity. As for the fit-for-purpose shale gas model, various fit-for-purpose shale gas models can be derived using any set of selected properties plugged in one of the most popularly used proposed literature models as shown in the appendix. Also, this paper shows that shale extreme low permeability cause flow behavior to be dominated by the structure and magnitude of high permeability fractures.

  9. An Efficient Two-Scale Hybrid Embedded Fracture Model for Shale Gas Simulation

    KAUST Repository

    Amir, Sahar Z.; Sun, Shuyu

    2016-01-01

    Natural and hydraulic fractures existence and state differs on a reservoir-by-reservoir or even on a well-by-well basis leading to the necessity of exploring the flow regimes variations with respect to the diverse fracture-network shapes forged. Conventional Dual-Porosity Dual-Permeability (DPDP) schemes are not adequate to model such complex fracture-network systems. To overcome this difficulty, in this paper, an iterative Hybrid Embedded multiscale (two-scale) Fracture model (HEF) is applied on a derived fit-for-purpose shale gas model. The HEF model involves splitting the fracture computations into two scales: 1) fine-scale solves for the flux exchange parameter within each grid cell; 2) coarse-scale solves for the pressure applied to the domain grid cells using the flux exchange parameter computed at each grid cell from the fine-scale. After that, the D dimensions matrix pressure and the (D-1) lower dimensional fracture pressure are solved as a system to apply the matrix-fracture coupling. HEF model combines the DPDP overlapping continua concept, the DFN lower dimensional fractures concept, the HFN hierarchical fracture concept, and the CCFD model simplicity. As for the fit-for-purpose shale gas model, various fit-for-purpose shale gas models can be derived using any set of selected properties plugged in one of the most popularly used proposed literature models as shown in the appendix. Also, this paper shows that shale extreme low permeability cause flow behavior to be dominated by the structure and magnitude of high permeability fractures.

  10. Assessment of fracture risk

    International Nuclear Information System (INIS)

    Kanis, John A.; Johansson, Helena; Oden, Anders; McCloskey, Eugene V.

    2009-01-01

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  11. Rib fractures and death from deletion of osteoblast βcatenin in adult mice is rescued by corticosteroids.

    Science.gov (United States)

    Duan, JinZhu; Lee, Yueh; Jania, Corey; Gong, Jucheng; Rojas, Mauricio; Burk, Laurel; Willis, Monte; Homeister, Jonathon; Tilley, Stephen; Rubin, Janet; Deb, Arjun

    2013-01-01

    Ribs are primarily made of cortical bone and are necessary for chest expansion and ventilation. Rib fractures represent the most common type of non-traumatic fractures in the elderly yet few studies have focused on the biology of rib fragility. Here, we show that deletion of βcatenin in Col1a2 expressing osteoblasts of adult mice leads to aggressive osteoclastogenesis with increased serum levels of the osteoclastogenic cytokine RANKL, extensive rib resorption, multiple spontaneous rib fractures and chest wall deformities. Within days of osteoblast specific βcatenin deletion, animals die from respiratory failure with a vanishing rib cage that is unable to sustain ventilation. Increased bone resorption is also observed in the vertebrae and femur. Treatment with the bisphosphonate pamidronate delayed but did not prevent death or associated rib fractures. In contrast, administration of the glucocorticoid dexamethasone decreased serum RANKL and slowed osteoclastogenesis. Dexamethasone preserved rib structure, prevented respiratory compromise and strikingly increased survival. Our findings provide a novel model of accelerated osteoclastogenesis, where deletion of osteoblast βcatenin in adults leads to rapid development of destructive rib fractures. We demonstrate the role of βcatenin dependent mechanisms in rib fractures and suggest that glucocorticoids, by suppressing RANKL, may have a role in treating bone loss due to aggressive osteoclastogenesis.

  12. Fracture Behavior in Nylon 6 Fibers. Ph.D. Thesis

    Science.gov (United States)

    Lloyd, B. A.

    1972-01-01

    Electron paramagnetic resonance (EPR) techniques are used to determine the number of free radicals produced during deformation leading to fracture of nylon 6 fibers. A reaction rate molecular model is proposed to explain some of the deformation and bond rupture behavior leading to fracture. High-strength polymer fibers are assumed to consist of a sandwich structure of disordered and ordered regions along the fiber axis. In the disordered or critical flaw regions, tie chains connecting the ordered or crystalline block regions are assumed to have a statistical distribution in length. These chains are, therefore, subjected to different stresses. The effective length distribution was determined by EPR. The probability of bond rupture was assumed to be controlled by reaction-rate theory with a stress-aided activation energy and behavior of various loadings determined by numerical techniques. The model is successfully correlated with experimental stress, strain, and bond rupture results for creep, constant rate loadings, cyclic stress, stress relaxation and step strain tests at room temperature.

  13. Biological methods to enhance bone healing and fracture repair.

    Science.gov (United States)

    Verdonk, René; Goubau, Yannick; Almqvist, Fredrik K; Verdonk, Peter

    2015-04-01

    This article looks into normal physiological fracture healing with special emphasis on the diamond concept. A precise definition of nonunion of long bones is described. Most often inadequate fixation (too rigid or too loose) is the reason for nonunion in long bone fractures. Because a critical bone defect cannot be bridged, it may lead directly or indirectly (lack of fixation) to nonunion. Individual inadequate local biological characteristics are also often found to be the cause; poor soft tissue coverage as well as a lack of periosteum and muscle or fascia or skin defects can lead to compromised vascularity in situ. Systemic factors are now much more recognized, e.g., smoking, diabetes, and cachexia, as well as the limited impact of some medications, e.g., nonsteroidal anti-inflammatory drugs and steroids. Today's mode of treatment for nonunion is approached in this article, and suggestions for appropriate treatment of long bone nonunion is presented. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. The radiation swelling effect on fracture properties and fracture mechanisms of irradiated austenitic steels. Part I. Ductility and fracture toughness

    Energy Technology Data Exchange (ETDEWEB)

    Margolin, B., E-mail: mail@crism.ru; Sorokin, A.; Shvetsova, V.; Minkin, A.; Potapova, V.; Smirnov, V.

    2016-11-15

    The radiation swelling effect on the fracture properties of irradiated austenitic steels under static loading has been studied and analyzed from the mechanical and physical viewpoints. Experimental data on the stress-strain curves, fracture strain, fracture toughness and fracture mechanisms have been represented for austenitic steel of 18Cr-10Ni-Ti grade (Russian analog of AISI 321 steel) irradiated up to neutron dose of 150 dpa with various swelling. Some phenomena in mechanical behaviour of irradiated austenitic steels have been revealed and explained as follows: a sharp decrease of fracture toughness with swelling growth; untypical large increase of fracture toughness with decrease of the test temperature; some increase of fracture toughness after preliminary cyclic loading. Role of channel deformation and channel fracture has been clarified in the properties of irradiated austenitic steel and different tendencies to channel deformation have been shown and explained for the same austenitic steel irradiated at different temperatures and neutron doses.

  15. Experimental and Numerical Investigation of Preferential Flow in Fractured Network with Clogging Process

    Directory of Open Access Journals (Sweden)

    Xiaobing Chen

    2014-01-01

    Full Text Available In this study, physical experiments and numerical simulations are combined to provide a detailed understanding of flow dynamics in fracture network. Hydraulic parameters such as pressure head, velocity field, Reynolds number on certain monitoring cross points, and total flux rate are examined under various clogging conditions. Applying the COMSOL Multiphysics code to solve the Navier-Stokes equation instead of Reynolds equation and using the measured data to validate the model, the fluid flow in the horizontal 2D cross-sections of the fracture network was simulated. Results show that local clogging leads to a significant reshaping of the flow velocity field and a reduction of the transport capacity of the entire system. The flow rate distribution is highly influenced by the fractures connected to the dominant flow channels, although local disturbances in velocity field are unlikely to spread over the whole network. Also, modeling results indicate that water flow in a fracture network, compared with that in a single fracture, is likely to transit into turbulence earlier under the same hydraulic gradient due to the influence of fracture intersections.

  16. Simulation of counter-current imbibition in water-wet fractured reservoirs based on discrete-fracture model

    Directory of Open Access Journals (Sweden)

    Wang Yueying

    2017-08-01

    Full Text Available Isolated fractures usually exist in fractured media systems, where the capillary pressure in the fracture is lower than that of the matrix, causing the discrepancy in oil recoveries between fractured and non-fractured porous media. Experiments, analytical solutions and conventional simulation methods based on the continuum model approach are incompetent or insufficient in describing media containing isolated fractures. In this paper, the simulation of the counter-current imbibition in fractured media is based on the discrete-fracture model (DFM. The interlocking or arrangement of matrix and fracture system within the model resembles the traditional discrete fracture network model and the hybrid-mixed-finite-element method is employed to solve the associated equations. The Behbahani experimental data validates our simulation solution for consistency. The simulation results of the fractured media show that the isolated-fractures affect the imbibition in the matrix block. Moreover, the isolated fracture parameters such as fracture length and fracture location influence the trend of the recovery curves. Thus, the counter-current imbibition behavior of media with isolated fractures can be predicted using this method based on the discrete-fracture model.

  17. Fracture characteristics in Japanese rock

    International Nuclear Information System (INIS)

    Ijiri, Yuji; Sawada, Atsushi; Akahori, Kuniaki

    1999-11-01

    It is crucial for the performance assessment of geosphere to evaluate the characteristics of fractures that can be dominant radionuclide migration pathways from a repository to biosphere. This report summarizes the characteristics of fractures obtained from broad literature surveys and the fields surveys at the Kamaishi mine in northern Japan and at outcrops and galleries throughout the country. The characteristics of fractures described in this report are fracture orientation, fracture shape, fracture frequency, fracture distribution in space, transmissivity of fracture, fracture aperture, fracture fillings, alteration halo along fracture, flow-wetted surface area in fracture, and the correlation among these characteristics. Since granitic rock is considered the archetype fractured media, a large amount of fracture data is available in literature. In addition, granitic rock has been treated as a potential host rock in many overseas programs, and has JNC performed a number of field observations and experiments in granodiorite at the Kamaishi mine. Therefore, the characteristics of fractures in granitic rock are qualitatively and quantitatively clarified to some extent in this report, while the characteristics of fractures in another rock types are not clarified. (author)

  18. First-rib stress fracture in two adolescent swimmers: a case report.

    Science.gov (United States)

    Low, Sara; Kern, Michael; Atanda, Alfred

    2016-01-01

    First-rib stress fractures have been described in adolescent athletes in various sports, with only one prior case report of first-rib stress fractures in an adolescent female swimmer. There is a need for research on the cause, management, and prevention of these injuries as they lead to significant morbidity and critical time away from sport for these aspiring athletes. We aimed to describe first-rib stress fractures as a potential cause for non-specific atraumatic chronic shoulder pain in adolescent swimmers and to discuss the different presentations, unique risk factors, treatment, and potential injury prevention strategies of such fractures. We discussed two such cases which were successfully treated with activity modification with restriction of all overhead activity, gradually progressive physical therapy and a return to swimming protocol. First-rib stress fractures can vary in presentation and should be in the differential diagnosis in adolescent swimmers with chronic shoulder pain. These injuries can be successfully managed with rest from overhead activities and physical therapy. Gradual return to competitive swimming can be achieved even with non-union of a first-rib stress fracture. Emphasis on balanced strength training in different muscle groups and proper swimming technique is essential to prevent these injuries.

  19. Cough-induced rib fractures.

    Science.gov (United States)

    Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H

    2005-07-01

    To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.

  20. Mandible Fracture Complications and Infection: The Influence of Demographics and Modifiable Factors.

    Science.gov (United States)

    Odom, Elizabeth B; Snyder-Warwick, Alison K

    2016-08-01

    Mandible fractures account for 36 to 70 percent of all facial fractures. Despite their high prevalence, the literature lacks a comprehensive review of demographics, fracture patterns, timing of management, antibiotic selection, and outcomes, particularly when evaluating pediatric versus adult patients. The authors aim to determine the complication and infection rates after surgical treatment of mandibular fractures and the bacterial isolates and antibiotic sensitivities from mandible infections after open reduction and internal fixation at their institution. Data were collected retrospectively for all mandible fractures treated at the authors' institution between 2003 and 2013. Patients were divided into pediatric (younger than 16 years) and adult (16 years or older) subgroups. Demographics, fracture location, fracture cause, comorbidities, antibiotic choice, and subsequent complications and infections were analyzed. Data were evaluated using appropriate statistical tests for each variable. Three hundred ninety-five patients were evaluated. Demographics and fracture cause were similar to those reported in current literature. Of the 56 pediatric patients, complications occurred in 5.6 percent. Time from injury to operative intervention did not affect outcome. The complication rate was 17.5 percent and the infection rate was 9.4 percent in the adult subgroup. Time from injury to operative intervention, sex, and edentulism were not significant predictors of complication or infection. Tobacco use, number of fractures, number of fractures fixated, and surgical approach were predictors of complication and infection. Perioperative ampicillin-sulbactam had a significantly lower risk of infection. Certain demographic and operative factors lead to significantly higher risks of complications after surgical management of mandibular fractures. Ampicillin-sulbactam provides effective antibiotic prophylaxis. Risk factor modification may improve outcomes. Risk, IV.

  1. Characteristic fracture spacing in primary and secondary recovery for naturally fractured reservoirs

    NARCIS (Netherlands)

    Gong, J.; Rossen, W.R.

    2018-01-01

    If the aperture distribution is broad enough in a naturally fractured reservoir, even one where the fracture network is highly inter-connected, most fractures can be eliminated without significantly affecting the flow through the fracture network. During a waterflood or enhanced-oil-recovery

  2. Emotional stress as a trigger of falls leading to hip or pelvic fracture. Results from the ToFa study – a case-crossover study among elderly people in Stockholm, Sweden

    Directory of Open Access Journals (Sweden)

    Ponzer Sari

    2009-02-01

    Full Text Available Abstract Background Sudden emotions may interfere with mechanisms for keeping balance among the elderly. The aim of this study is to analyse if emotional stress and specifically feelings of anger, sadness, worries, anxiety or stress, can trigger falls leading to hip or pelvic fracture among autonomous older people. Methods The study applied the case-crossover design and was based on data gathered by face to face interviews carried out in Stockholm between November 2004 and January 2006 at the emergency wards of two hospitals. Cases (n = 137 were defined as persons aged 65 and older admitted for at least one night due to a fall-related hip or pelvic fracture (ICD10: S72 or S32 and meeting a series of selection criteria. Results are presented as relative risks with 95% confidence intervals. Results There was an increased risk for fall and subsequent hip or pelvic fracture for up to one hour after emotional stress. For anger there was an increased relative risk of 12.2 (95% CI 2.7–54.7, for sadness of 5.7 (95% CI 1.1–28.7, and for stress 20.6 (95% CI 4.5–93.5 compared to periods with no such feelings. Conclusion Emotional stress seems to have the potential to trigger falls and subsequent hip or pelvic fracture among autonomous older people. Further studies are needed to clarify how robust the findings are – as the number of exposed cases is small – and the mechanisms behind them – presumably balance and vision impairment in stress situation.

  3. Fracture mechanical materials characterisation

    International Nuclear Information System (INIS)

    Wallin, K.; Planman, T.; Nevalainen, M.

    1998-01-01

    The experimental fracture mechanics development has been focused on the determination of reliable lower-bound fracture toughness estimates from small and miniature specimens, in particular considering the statistical aspects and loading rate effects of fracture mechanical material properties. Additionally, materials aspects in fracture assessment of surface cracks, with emphasis on the transferability of fracture toughness data to structures with surface flaws have been investigated. Further a modified crack-arrest fracture toughness test method, to increase the effectiveness of testing, has been developed. (orig.)

  4. Getting the Message? Native Reactive Electrophiles Pass Two Out of Three Thresholds to be Bona Fide Signaling Mediators.

    Science.gov (United States)

    Poganik, Jesse R; Long, Marcus J C; Aye, Yimon

    2018-05-01

    Precision cell signaling activities of reactive electrophilic species (RES) are arguably among the most poorly-understood means to transmit biological messages. Latest research implicates native RES to be a chemically-distinct subset of endogenous redox signals that influence cell decision making through non-enzyme-assisted modifications of specific proteins. Yet, fundamental questions remain regarding the role of RES as bona fide second messengers. Here, we lay out three sets of criteria we feel need to be met for RES to be considered as true cellular signals that directly mediate information transfer by modifying "first-responding" sensor proteins. We critically assess the available evidence and define the extent to which each criterion has been fulfilled. Finally, we offer some ideas on the future trajectories of the electrophile signaling field taking inspiration from work that has been done to understand canonical signaling mediators. Also see the video abstract here: https://youtu.be/rG7o0clVP0c. © 2018 WILEY Periodicals, Inc.

  5. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

    Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering.  He teaches applied mechanics and his research t...

  6. Fractures and fracture infillings of the Eye-Dashwa Lakes pluton, Atikokan, Ontario

    International Nuclear Information System (INIS)

    Stone, Denver; Kamineni, D.C.

    1982-01-01

    Fractures in the Eye-Dashwa pluton near Atikokan, Ontario can be subdivided on the basis of their filling materials. These materials include aplite, epidote, chlorite, and gypsum-carbonate-clay, listed in order of decreasing age established from crosscutting relations. Textues indicate that infilling occurred during fracture growth. Continuous cooling of the pluton during fracturing is inferred from the expected crystallization temperatures of fillings. Fracturing began before the pluton was completely solidified (650-600 0 C) and continued to temperatures below 100 0 C. Many fractures appear to have been sealed by the filling materials after initiation but were subsequently sheared and filled by lower temperatue materials. Apparently the majority of fractures formed during or immediately after pluton solidification and new fractures became smaller and more restricted in location as cooling progressed. Fractures and filling materials are seen as important features in assessing the possibility of movement of radionuclides in aqueous solutions away from a nuclear fuel waste repository

  7. Computed tomograms of blowout fracture

    International Nuclear Information System (INIS)

    Ito, Haruhide; Hayashi, Minoru; Shoin, Katsuo; Hwang, Wen-Zern; Yamamoto, Shinjiro; Yonemura, Taizo.

    1985-01-01

    We studied 18 cases of orbital fractures, excluding optic canal fracture. There were 11 cases of pure blowout fracture and 3 of the impure type. The other 4 cases were orbital fractures without blowout fracture. The cardinal syndromes were diplopia, enophthalmos, and sensory disturbances of the trigeminal nerve in the pure type of blowout fracture. Many cases of the impure type of blowout fracture or of orbital fracture showed black eyes or a swelling of the eyelids which masked enophthalmos. Axial and coronal CT scans demonstrated: 1) the orbital fracture, 2) the degree of enophthalmos, 3) intraorbital soft tissue, such as incarcerated or prolapsed ocular muscles, 4) intraorbital hemorrhage, 5) the anatomical relation of the orbital fracture to the lacrimal canal, the trochlea, and the trigeminal nerve, and 6) the lesions of the paranasal sinus and the intracranial cavity. CT scans play an important role in determining what surgical procedures might best be employed. Pure blowout fractures were classified by CT scans into these four types: 1) incarcerating linear fracture, 2) trapdoor fracture, 3) punched-out fracture, and 4) broad fracture. Cases with severe head injury should be examined to see whether or not blowout fracture is present. If the patients are to hope to return to society, a blowout fracture should be treated as soon as possible. (author)

  8. Computed tomograms of blowout fracture

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Haruhide; Hayashi, Minoru; Shoin, Katsuo; Hwang, Wen-Zern; Yamamoto, Shinjiro; Yonemura, Taizo

    1985-02-01

    We studied 18 cases of orbital fractures, excluding optic canal fracture. There were 11 cases of pure blowout fracture and 3 of the impure type. The other 4 cases were orbital fractures without blowout fracture. The cardinal syndromes were diplopia, enophthalmos, and sensory disturbances of the trigeminal nerve in the pure type of blowout fracture. Many cases of the impure type of blowout fracture or of orbital fracture showed black eyes or a swelling of the eyelids which masked enophthalmos. Axial and coronal CT scans demonstrated: 1) the orbital fracture, 2) the degree of enophthalmos, 3) intraorbital soft tissue, such as incarcerated or prolapsed ocular muscles, 4) intraorbital hemorrhage, 5) the anatomical relation of the orbital fracture to the lacrimal canal, the trochlea, and the trigeminal nerve, and 6) the lesions of the paranasal sinus and the intracranial cavity. CT scans play an important role in determining what surgical procedures might best be employed. Pure blowout fractures were classified by CT scans into these four types: 1) incarcerating linear fracture, 2) trapdoor fracture, 3) punched-out fracture, and 4) broad fracture. Cases with severe head injury should be examined to see whether or not blowout fracture is present. If the patients are to hope to return to society, a blowout fracture should be treated as soon as possible. (author).

  9. Facial Fractures.

    Science.gov (United States)

    Ricketts, Sophie; Gill, Hameet S; Fialkov, Jeffery A; Matic, Damir B; Antonyshyn, Oleh M

    2016-02-01

    After reading this article, the participant should be able to: 1. Demonstrate an understanding of some of the changes in aspects of facial fracture management. 2. Assess a patient presenting with facial fractures. 3. Understand indications and timing of surgery. 4. Recognize exposures of the craniomaxillofacial skeleton. 5. Identify methods for repair of typical facial fracture patterns. 6. Discuss the common complications seen with facial fractures. Restoration of the facial skeleton and associated soft tissues after trauma involves accurate clinical and radiologic assessment to effectively plan a management approach for these injuries. When surgical intervention is necessary, timing, exposure, sequencing, and execution of repair are all integral to achieving the best long-term outcomes for these patients.

  10. Hip fracture epidemiological trends, outcomes, and risk factors, 1970–2009

    Directory of Open Access Journals (Sweden)

    Ray Marks

    2009-12-01

    Full Text Available Ray MarksCity University of New York and Columbia University, New York, NY, USAAbstract: Hip fractures – which commonly lead to premature death, high rates of morbidity, or reduced life quality – have been the target of a voluminous amount of research for many years. But has the lifetime risk of incurring a hip fracture decreased sufficiently over the last decade or are high numbers of incident cases continuing to prevail, despite a large body of knowledge and a variety of contemporary preventive and refined surgical approaches? This review examines the extensive hip fracture literature published in the English language between 1980 and 2009 concerning hip fracture prevalence trends, and injury mechanisms. It also highlights the contemporary data concerning the personal and economic impact of the injury, plus potentially remediable risk factors underpinning the injury and ensuing disability. The goal was to examine if there is a continuing need to elucidate upon intervention points that might minimize the risk of incurring a hip fracture and its attendant consequences. Based on this information, it appears hip fractures remain a serious global health issue, despite some declines in the incidence rate of hip fractures among some women. Research also shows widespread regional, ethnic and diagnostic variations in hip fracture incidence trends. Key determinants of hip fractures include age, osteoporosis, and falls, but some determinants such as socioeconomic status, have not been well explored. It is concluded that while more research is needed, well-designed primary, secondary, and tertiary preventive efforts applied in both affluent as well as developing countries are desirable to reduce the present and future burden associated with hip fracture injuries. In this context, and in recognition of the considerable variation in manifestation and distribution, as well as risk factors underpinning hip fractures, well-crafted comprehensive, rather

  11. Formulation of fracture gradient extension equations in the Sergipe Basin-Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Suzart, J. Walter P.; Moreto, Rodrigo [Halliburton, Rio de Janeiro, RJ (Brazil); Luduvice, Roberto; Gomes, Isaac Santana; Richard Junior, Emerson [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

    2008-07-01

    One of the challenges of drilling exploration wells is to accurately estimate fracture gradients. This may cause formation damage and lead to premature hydraulic fracturing and prevent an optimum hydraulic design during completion. To avoid this scenario, it is important to know the minimum pressure that causes fractures. This estimation may be based on density, overburden, Poisson's ratio, and minimum horizontal stress. It is now possible to monitor fracturing stimulation operations in real time, which allows real-time understanding of formation pressure response, including fracture extension behavior and screen out. It is possible to avoid risks related to unexpected high pressure applied on the formation while drilling and maintain well and equipment integrities. This may prevent non-productive time (NPT) caused by unplanned well-cleaning operations and material expenses. Real-time fracturing information is usually obtained from step-rate and/or mini-frac analyses. However, there are some scenarios where these tests and analyses may be uneconomical. This paper details an alternative solution. It uses modified Eaton's equations that are representative of the area of interest, which in the present case is the Sergipe Basin located in northeast Brazil. The modified Eaton's equations are used to estimate parameters of the minimum horizontal stress, fracture extension gradient, overburden, and Poisson's ratio. This is based on hydraulic fracturing jobs and density logs available from different locations within the Sergipe Basin. To validate the present method, the estimation results were compared with available step-rate test results for the area. (author)

  12. Fracture in Soft Materials

    DEFF Research Database (Denmark)

    Hassager, Ole

    Fracture is a phenomenon that is generally associated with solids. A key element in fracture theory is the so-called weakest link idea that fracture initiates from the largest pre-existing material imperfection. However, recent work has demonstrated that fracture can also happen in liquids, where...... surface tension will act to suppress such imperfections. Therefore, the weakest link idea does not seem immediately applicable to fracture in liquids. This presentation will review fracture in liquids and argue that fracture in soft liquids is a material property independent of pre-existing imperfections....... The following questions then emerge: What is the material description needed to predict crack initiation, crack speed and crack shape in soft materials and liquids....

  13. Exogenous PTHrP Repairs the Damaged Fracture Healing of PTHrP+/− Mice and Accelerates Fracture Healing of Wild Mice

    Science.gov (United States)

    Wang, Yinhe; Fang, Xin; Wang, Chun; Ding, Congzhu; Lin, Hua; Liu, Anlong; Wang, Lei; Cao, Yang

    2017-01-01

    Bone fracture healing is a complicated physiological regenerative process initiated in response to injury and is similar to bone development. To demonstrate whether an exogenous supply of parathyroid hormone–related protein (PTHrP) helps in bone fracture healing, closed mid-diaphyseal femur fractures were created and stabilized with intramedullary pins in eight-week-old wild-type (WT) PTHrP+/+ and PTHrP+/− mice. After administering PTHrP for two weeks, callus tissue properties were analyzed at one, two, and four weeks post-fracture (PF) by various methods. Bone formation–related genes and protein expression levels were evaluated by real-time reverse transcriptase–polymerase chain reaction and Western blots. At two weeks PF, mineral density of callus, bony callus areas, mRNA levels of alkaline phosphatase (ALP), type I collagen, Runt-related transcription factor 2 (Runx-2), and protein levels of Runx-2 and insulin-like growth factor-1 decreased in PTHrP+/− mice compared with WT mice. At four weeks PF, total collagen-positive bony callus areas, osteoblast number, ALP-positive areas, and type I collagen-positive areas all decreased in PTHrP+/− mice. At both two and four weeks PF, tartrate-resistant acid phosphatase–positive osteoclast number and surface decreased a little in PTHrP+/− mice. The study indicates that exogenous PTHrP provided by subcutaneous injection could redress impaired bone fracture healing, leading to mutation of activated PTHrP by influencing callus areas, endochondral bone formation, osteoblastic bone formation, and bone turnover. PMID:28178186

  14. Exogenous PTHrP Repairs the Damaged Fracture Healing of PTHrP+/− Mice and Accelerates Fracture Healing of Wild Mice

    Directory of Open Access Journals (Sweden)

    Yinhe Wang

    2017-02-01

    Full Text Available Bone fracture healing is a complicated physiological regenerative process initiated in response to injury and is similar to bone development. To demonstrate whether an exogenous supply of parathyroid hormone–related protein (PTHrP helps in bone fracture healing, closed mid-diaphyseal femur fractures were created and stabilized with intramedullary pins in eight-week-old wild-type (WT PTHrP+/+ and PTHrP+/− mice. After administering PTHrP for two weeks, callus tissue properties were analyzed at one, two, and four weeks post-fracture (PF by various methods. Bone formation–related genes and protein expression levels were evaluated by real-time reverse transcriptase–polymerase chain reaction and Western blots. At two weeks PF, mineral density of callus, bony callus areas, mRNA levels of alkaline phosphatase (ALP, type I collagen, Runt-related transcription factor 2 (Runx-2, and protein levels of Runx-2 and insulin-like growth factor-1 decreased in PTHrP+/− mice compared with WT mice. At four weeks PF, total collagen-positive bony callus areas, osteoblast number, ALP-positive areas, and type I collagen-positive areas all decreased in PTHrP+/− mice. At both two and four weeks PF, tartrate-resistant acid phosphatase–positive osteoclast number and surface decreased a little in PTHrP+/− mice. The study indicates that exogenous PTHrP provided by subcutaneous injection could redress impaired bone fracture healing, leading to mutation of activated PTHrP by influencing callus areas, endochondral bone formation, osteoblastic bone formation, and bone turnover.

  15. A PROSPECTIVE STUDY OF DISTAL TIBIAL FRACTURES BY MIPO (LCP

    Directory of Open Access Journals (Sweden)

    Chandra Sekharam Naidu

    2015-05-01

    Full Text Available INTRODUCTION: D istal tibial fractures represent a significant challenge to most of the surgeons even today. They constitute 1 - 10% of all lower extremity fractures . 1 The difficulty in treating the fractures of distal tibial end is exemplif ied by orthopedists, who in the first half of twentieth century, believed these injuries were so severe and fraught with so many complications, that these fractures were deemed not amenable for surgical reconstruction . 2 Conservative treatment by POP cast l ead to prolonged immobilization, leading to ankle and knee stiffness affecting quality of life of the patient . 3 Operative treatment is indicated for most tibial fractures caused by high energy trauma. Operative treatment allows early motion, and avoids sho rtening and other complications associated with prolonged immobilization . 4 The fundamental goal of treatment of distal tibial fractures is restoration of normal or near normal alignment and articular congruity and finally to obtain a well healed fracture; pain free weight bearing ; and functional ROM of ankle joint. For the past decade, plating has been successful in treating complex fractures of the lower extremity especially distal tibia . 5 Conventional ORIF have been associated with complications like infe ction and delayed or non - union due to devitalisation of bony fragments and additional damage to the soft tissues . 6 To improve fracture healing, more “biological” methods have been developed in the last decade to lessen the surgical dissection, preserving b lood supply to bony fragments and containing at least partially the fracture haematoma . 7 Recently, the trend is towards use of a Locking compression plate for treatment of fractures of the distal part of the tibia 8 . Compared with a conventional plate, a Lo cking compression plate imparts a higher degree of stability and provides better protection against primary and secondary losses of reduction and minimization of bone

  16. Continuum equivalent model for the fractured EDZ around underground galleries in clay-stone

    International Nuclear Information System (INIS)

    Pouya, A.; Bourgeois, E.; Larbi, B.; Poutrel, A.

    2010-01-01

    Document available in extended abstract form only. The Excavation Damaged Zone (EDZ) around the underground galleries excavated in clay-stone for the CMHM project, includes several zones showing different types of cracking and/or fracturing. In the vicinity of the wall, a fractured zone is observed that spreads out on a distance of about 1 m from the wall; at a larger distance from the wall one observes another zone with micro-cracks. The first zone, called 'fractured EDZ', includes different families of fractures with different geometries and origins. The main one consists of a family of shear fractures called 'chevron', that have approximately the shape of conical surfaces slightly flattened with respect to the horizontal plane. The 'chevrons' observed in the galleries at 490 m depth in LMSMH are regularly spaced of about 50 cm to 1 m along the gallery's axis, make an angle of about 45 deg. with this axis and extend to about 2 or 3 m beyond the wall depending of the size and orientation of the gallery. The fractures have a significant effect on the hydro-mechanical properties of the EDZ. The present work is focused on the effect of the 'chevron' fractures on the mechanical behaviour of the EDZ. Due to the large number of fractures, introducing them individually to the modelling leads to heavy and not easy to handle numerical models and to long calculations. One is led to find some Continuum Equivalent Material (CEM) for the EDZ including the fractures' effect. The EDZ is not very large compared to the fractures, so that it may not be fully justified to apply a homogenization approach; however, this is the approach we have used to define the behaviour of CEM. The geometry of the fractures is first simplified and assumed to correspond to conical surfaces with axial symmetry around the gallery's axis. The local behaviour of the CEM is deduced from the model of an infinite medium containing a family of planar

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

    Science.gov (United States)

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

    2014-12-01

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

  18. Similar Fracture Patterns in Human Nose and Gothic Cathedral.

    Science.gov (United States)

    Lee, Shu Jin; Tse, Kwong Ming; Lee, Heow Pueh

    2015-10-01

    This study proposes that the bony anatomy of the human nose and masonry structure of the Gothic cathedral are geometrically similar, and have common fracture patterns. We also aim to correlate the fracture patterns observed in patients' midface structures with those seen in the Gothic cathedral using computational approach. CT scans of 33 patients with facial fractures were examined and compared with computer simulations of both the Gothic cathedral and human nose. Three similar patterns were found: (1) Cracks of the nasal arch with crumpling of the vertical buttresses akin to the damage seen during minor earthquakes; (2) lateral deviation of the central nasal arch and collapse of the vertical buttresses akin to those due to lateral forces from wind and in major earthquakes; and (3) Central arch collapse seen as a result of collapse under excessive dead weight. Interestingly, the finding of occult nasal and septal fractures in the mandible fractures with absence of direct nasal trauma highlights the possibility of transmission of forces from the foundation to the arch leading to structural failure. It was also found that the structural buttresses of the Gothic cathedral delineate the vertical buttresses in the human midface structure. These morphologic similarities between the human nose and Gothic cathedral will serve as a basis to study the biomechanics of nasal fractures. Identification of structural buttresses in a skeletal structure has important implications for reconstruction as reestablishment of structural continuity restores normal anatomy and architectural stability of the human midface structure. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Double take--fracture fishing in accident and emergency practice.

    Science.gov (United States)

    Hyland-McGuire, P; Guly, H R; Hughes, P M

    1997-03-01

    To investigate conditions where, after initially negative plain x rays following trauma, there subsequently proves to be fracture, and to explore ways in which the management might be improved. A 16 month prospective study. Patient details were collected from accident and emergency (A&E) review clinics and returns, A&E ward admissions, correspondence from other services, and discussions at a weekly clinicoradiological conference. The inclusion criteria comprised A&E trauma patients with normal initial plain x rays and proven fractures on subsequent imaging for the same patient event. A large A&E department seeing 65,000 new attendances per annum with full back up services. 55 cases were identified: 41 fractures were identified on subsequent plain x ray, six on bone scan, six on CAT scan, and two on MRI scan. The commonest regions involved were the wrist, pelvis/hip, ankle/foot, and leg. Follow up had not been arranged at the initial attendance in 17 instances and between two and 135 days were required for definitive fracture recognition. All but nine patients required alteration in treatment because of fracture detection. Clinical suspicion of fracture at initial A&E attendance should prompt organised follow up even in the face of normal plain x rays. Consideration should be given to alternative imaging techniques which may have a higher resolution than plain x rays. Close corroboration between A&E and radiology departments has benefits in patient care in this group of patients and may lead to a reduction in functional disability and litigation.

  20. Statistical methodology for discrete fracture model - including fracture size, orientation uncertainty together with intensity uncertainty and variability

    Energy Technology Data Exchange (ETDEWEB)

    Darcel, C. (Itasca Consultants SAS (France)); Davy, P.; Le Goc, R.; Dreuzy, J.R. de; Bour, O. (Geosciences Rennes, UMR 6118 CNRS, Univ. def Rennes, Rennes (France))

    2009-11-15

    Investigations led for several years at Laxemar and Forsmark reveal the large heterogeneity of geological formations and associated fracturing. This project aims at reinforcing the statistical DFN modeling framework adapted to a site scale. This leads therefore to develop quantitative methods of characterization adapted to the nature of fracturing and data availability. We start with the hypothesis that the maximum likelihood DFN model is a power-law model with a density term depending on orientations. This is supported both by literature and specifically here by former analyses of the SKB data. This assumption is nevertheless thoroughly tested by analyzing the fracture trace and lineament maps. Fracture traces range roughly between 0.5 m and 10 m - i e the usual extension of the sample outcrops. Between the raw data and final data used to compute the fracture size distribution from which the size distribution model will arise, several steps are necessary, in order to correct data from finite-size, topographical and sampling effects. More precisely, a particular attention is paid to fracture segmentation status and fracture linkage consistent with the DFN model expected. The fracture scaling trend observed over both sites displays finally a shape parameter k{sub t} close to 1.2 with a density term (alpha{sub 2d}) between 1.4 and 1.8. Only two outcrops clearly display a different trend with k{sub t} close to 3 and a density term (alpha{sub 2d}) between 2 and 3.5. The fracture lineaments spread over the range between 100 meters and a few kilometers. When compared with fracture trace maps, these datasets are already interpreted and the linkage process developed previously has not to be done. Except for the subregional lineament map from Forsmark, lineaments display a clear power-law trend with a shape parameter k{sub t} equal to 3 and a density term between 2 and 4.5. The apparent variation in scaling exponent, from the outcrop scale (k{sub t} = 1.2) on one side, to

  1. Multi-Scale Modelling of Deformation and Fracture in a Biomimetic Apatite-Protein Composite: Molecular-Scale Processes Lead to Resilience at the μm-Scale.

    Directory of Open Access Journals (Sweden)

    Dirk Zahn

    Full Text Available Fracture mechanisms of an enamel-like hydroxyapatite-collagen composite model are elaborated by means of molecular and coarse-grained dynamics simulation. Using fully atomistic models, we uncover molecular-scale plastic deformation and fracture processes initiated at the organic-inorganic interface. Furthermore, coarse-grained models are developed to investigate fracture patterns at the μm-scale. At the meso-scale, micro-fractures are shown to reduce local stress and thus prevent material failure after loading beyond the elastic limit. On the basis of our multi-scale simulation approach, we provide a molecular scale rationalization of this phenomenon, which seems key to the resilience of hierarchical biominerals, including teeth and bone.

  2. Studies on postoperative enophthalmos in orbital fractures and zygomatic fractures. Measurements using CT images

    International Nuclear Information System (INIS)

    Abe, Yayoi; Hasumi, Toshiaki; Hosaka, Yoshiaki

    2010-01-01

    Enophthalmos is a common result of orbital fractures and zygomatic fractures. Reconstruction of the orbita is very important, because enophthalmos leads to not only functional but also cosmetic problems. We have experienced cases in which the eyeball became recessed following an operation or trauma. Even when we performed an overcorrective reconstruction surgical procedure, several patients showed tardive enophthalmos. The purpose of this study was to investigate the changes in eyeball position after operation or trauma. We measured the degree of eyeball displacement in 16 patients by using computed tomographic data collected immediately after operation and at one year. In 12 patients, enophthalmos was progressed, and the average change was 1.38 mm. We propose that the progression of enophthalmos was primarily caused by atrophy and cicatrisation of the soft tissue of the orbita. This change in the soft tissue is the result of traumatic hemorrhage, edema and the operative procedure. These findings suggest that we should perform an even more overcorrective reconstruction surgical procedure than in the past. (author)

  3. Alendronate for fracture prevention in postmenopause.

    Science.gov (United States)

    Holder, Kathryn K; Kerley, Sara Shelton

    2008-09-01

    Osteoporosis is an abnormal reduction in bone mass and bone deterioration leading to increased fracture risk. Alendronate (Fosamax) belongs to the bisphosphonate class of drugs, which act to inhibit bone resorption by interfering with the activity of osteoclasts. To assess the effectiveness of alendronate in the primary and secondary prevention of osteoporotic fractures in postmenopausal women. The authors searched Central, Medline, and EMBASE for relevant randomized controlled trials published from 1966 to 2007. The authors undertook study selection and data abstraction in duplicate. The authors performed meta-analysis of fracture outcomes using relative risks, and a relative change greater than 15 percent was considered clinically important. The authors assessed study quality through reporting of allocation concealment, blinding, and withdrawals. Eleven trials representing 12,068 women were included in the review. Relative and absolute risk reductions for the 10-mg dose were as follows. For vertebral fractures, a 45 percent relative risk reduction was found (relative risk [RR] = 0.55; 95% confidence interval [CI], 0.45 to 0.67). This was significant for primary prevention, with a 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.38 to 0.80) and 2 percent absolute risk reduction; and for secondary prevention, with 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.43 to 0.69) and 6 percent absolute risk reduction. For nonvertebral fractures, a 16 percent relative risk reduction was found (RR = 0.84; 95% CI, 0.74 to 0.94). This was significant for secondary prevention, with a 23 percent relative risk reduction (RR = 0.77; 95% CI, 0.64 to 0.92) and a 2 percent absolute risk reduction, but not for primary prevention (RR = 0.89; 95% CI, 0.76 to 1.04). There was a 40 percent relative risk reduction in hip fractures (RR = 0.60; 95% CI, 0.40 to 0.92), but only secondary prevention was significant, with a 53 percent relative risk reduction (RR = 0.47; 95% CI

  4. Pathological fractures in children

    Science.gov (United States)

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

    2012-01-01

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

  5. Coupled Fracture and Flow in Shale in Hydraulic Fracturing

    Science.gov (United States)

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

    2014-12-01

    Production of hydrocarbon from shale requires creation and maintenance of fracture permeability in an otherwise impermeable shale matrix. In this study, we use a combination of triaxial coreflood experiments and x-ray tomography characterization to investigate the fracture-permeability behavior of Utica shale at in situ reservoir conditions (25-50 oC and 35-120 bars). Initially impermeable shale core was placed between flat anvils (compression) or between split anvils (pure shear) and loaded until failure in the triaxial device. Permeability was monitored continuously during this process. Significant deformation (>1%) was required to generate a transmissive fracture system. Permeability generally peaked at the point of a distinct failure event and then dropped by a factor of 2-6 when the system returned to hydrostatic failure. Permeability was very small in compression experiments (fashion as pressure increased. We also observed that permeability decreased with increasing fluid flow rate indicating that flow did not follow Darcy's Law, possibly due to non-laminar flow conditions, and conformed to Forscheimer's law. The coupled deformation and flow behavior of Utica shale, particularly the large deformation required to initiate flow, indicates the probable importance of activation of existing fractures in hydraulic fracturing and that these fractures can have adequate permeability for the production of hydrocarbon.

  6. A study on management of extracapsular trochanteric fractures by proximal femoral nail

    Directory of Open Access Journals (Sweden)

    K Ramaprathap Reddy

    2016-01-01

    Full Text Available Background: Trochanteric fractures of femur like intertrochanteric and subtrochanteric fractures are a leading cause of hospital admissions in elderly people. Conservative methods of treatment results in malunion with shortening and limitation of hip movement as well as complications of prolonged immobilizations such as bed sores, deep vein thrombosis, and respiratory infections. This study is done to analyze the surgical management of trochanteric fractures of the femur using a proximal femoral nail (PFN. Methodology: This is a prospective study of 40 cases of trochanteric and subtrochanteric fractures admitted to Government General Hospital, Vijayawada, Andhra Pradesh. Cases were taken according to inclusion and exclusion criteria, i.e., patients with trochanteric fractures femur above the age of 20 years. Medically unsuitable, open fractures and patients not willing for surgery were excluded from the study. Results: Forty percentage of cases were admitted due to slip and fall and with a slight predominance of the right side. Out of 40 cases, 26 were trochanteric, and 14 were subtrochanteric. In trochanteric class, 37.5% were body and griffin Type 2, in subtrochanteric class 12.5% were sinsheimer Type 3a and 10% were 2b. Out of 30 remaining cases, 25 were trochanteric, and 05 were subtrochanteric. Good to excellent results are seen in 100% cases of trochanteric fractures and 90% cases in subtrochanteric fractures. Conclusion: From this sample study, we consider that PFN is an excellent implant for the treatment of pertrochanteric fractures. The terms of successful outcome include a good understanding of fracture biomechanics, proper patient selection, good preoperative planning, accurate instrumentation, good image intensifier, and exactly performed osteosynthesis.

  7. A Feasibility Study into the Use of Three-Dimensional Printer Modelling in Acetabular Fracture Surgery

    Directory of Open Access Journals (Sweden)

    A. W. Yu

    2015-01-01

    Full Text Available There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient’s unique anatomy can only lead to improved outcomes.

  8. Fluid-driven fracture propagation in heterogeneous media: Probability distributions of fracture trajectories.

    Science.gov (United States)

    Santillán, David; Mosquera, Juan-Carlos; Cueto-Felgueroso, Luis

    2017-11-01

    Hydraulic fracture trajectories in rocks and other materials are highly affected by spatial heterogeneity in their mechanical properties. Understanding the complexity and structure of fluid-driven fractures and their deviation from the predictions of homogenized theories is a practical problem in engineering and geoscience. We conduct a Monte Carlo simulation study to characterize the influence of heterogeneous mechanical properties on the trajectories of hydraulic fractures propagating in elastic media. We generate a large number of random fields of mechanical properties and simulate pressure-driven fracture propagation using a phase-field model. We model the mechanical response of the material as that of an elastic isotropic material with heterogeneous Young modulus and Griffith energy release rate, assuming that fractures propagate in the toughness-dominated regime. Our study shows that the variance and the spatial covariance of the mechanical properties are controlling factors in the tortuousness of the fracture paths. We characterize the deviation of fracture paths from the homogenous case statistically, and conclude that the maximum deviation grows linearly with the distance from the injection point. Additionally, fracture path deviations seem to be normally distributed, suggesting that fracture propagation in the toughness-dominated regime may be described as a random walk.

  9. Poromechanical response of naturally fractured sorbing media

    Science.gov (United States)

    Kumar, Hemant

    The injection of CO2 in coal seams has been utilized for enhanced gas recovery and potential CO2 sequestration in unmineable coal seams. It is advantageous because as it enhances the production and significant volumes of CO2 may be stored simultaneously. The key issues for enhanced gas recovery and geologic sequestration of CO2 include (1) Injectivity prediction: The chemical and physical processes initiated by the injection of CO2 in the coal seam leads to permeability/porosity changes (2) Up scaling: Development of full scale coupled reservoir model which may predict the enhanced production, associated permeability changes and quantity of sequestered CO2. (3) Reservoir Stimulation: The coalbeds are often fractured and proppants are placed into the fractures to prevent the permeability reduction but the permeability evolution in such cases is poorly understood. These issues are largely governed by dynamic coupling of adsorption, fluid exchange, transport, water content, stress regime, fracture geometry and physiomechanical changes in coals which are triggered by CO 2 injection. The understanding of complex interactions in coal has been investigated through laboratory experiments and full reservoir scale models are developed to answer key issues. (Abstract shortened by ProQuest.).

  10. Evidence for seismogenic fracture of silicic magma.

    Science.gov (United States)

    Tuffen, Hugh; Smith, Rosanna; Sammonds, Peter R

    2008-05-22

    It has long been assumed that seismogenic faulting is confined to cool, brittle rocks, with a temperature upper limit of approximately 600 degrees C (ref. 1). This thinking underpins our understanding of volcanic earthquakes, which are assumed to occur in cold rocks surrounding moving magma. However, the recent discovery of abundant brittle-ductile fault textures in silicic lavas has led to the counter-intuitive hypothesis that seismic events may be triggered by fracture and faulting within the erupting magma itself. This hypothesis is supported by recent observations of growing lava domes, where microearthquake swarms have coincided with the emplacement of gouge-covered lava spines, leading to models of seismogenic stick-slip along shallow shear zones in the magma. But can fracturing or faulting in high-temperature, eruptible magma really generate measurable seismic events? Here we deform high-temperature silica-rich magmas under simulated volcanic conditions in order to test the hypothesis that high-temperature magma fracture is seismogenic. The acoustic emissions recorded during experiments show that seismogenic rupture may occur in both crystal-rich and crystal-free silicic magmas at eruptive temperatures, extending the range of known conditions for seismogenic faulting.

  11. Traumatic thoracolumbar spine fractures

    NARCIS (Netherlands)

    J. Siebenga (Jan)

    2013-01-01

    textabstractTraumatic spinal fractures have the lowest functional outcomes and the lowest rates of return to work after injury of all major organ systems.1 This thesis will cover traumatic thoracolumbar spine fractures and not osteoporotic spine fractures because of the difference in fracture

  12. Fracture Patterns within the Shale Hills Critical Zone Observatory

    Science.gov (United States)

    Singha, K.; White, T.; Perron, J.; Chattopadhyay, P. B.; Duffy, C.

    2012-12-01

    Rock fractures are known to exist within the deep Critical Zone and are expected to influence groundwater flow, but there are limited data on their orientation and spatial arrangement and no general framework for systematically predicting their effects. Here, we explore fracture patterns within the Susquehanna-Shale Hills Critical Zone Observatory, and consider how they may be influenced by weathering, rock structure, and stress via field observations of variable fracture orientation within the site, with implications for the spatial variability of structural control on hydrologic processes. Based on field observations from 16-m deep boreholes and surface outcrop, we suggest that the appropriate structural model for the watershed is steeply dipping strata with meter- to decimeter-scale folds superimposed, including a superimposed fold at the mouth of the watershed that creates a short fold limb with gently dipping strata. These settings would produce an anisotropy in the hydraulic conductivity and perhaps also flow, especially within the context of the imposed stress field. Recently conducted 2-D numerical stress modeling indicates that the proxy for shear fracture declines more rapidly with depth beneath valleys than beneath ridgelines, which may produce or enhance the spatial variability in permeability. Even if topographic stresses do not cause new fractures, they could activate and cause displacement on old fractures, making the rocks easier to erode and increasing the permeability, and potentially driving a positive feedback that enhances the growth of valley relief. Calculated stress fields are consistent with field observations, which show a rapid decline in fracture abundance with increasing depth below the valley floor, and predict a more gradual trend beneath ridgetops, leading to a more consistent (and lower) hydraulic conductivity with depth on the ridgetops when compared to the valley, where values are higher but more variable with depth. Hydraulic

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

    Science.gov (United States)

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

    2010-03-15

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

  14. A study of mandibular fractures over a 5-year period of time: A retrospective study

    Directory of Open Access Journals (Sweden)

    Ashish Vyas

    2014-01-01

    Full Text Available Objective: This study aims to evaluate and compare with the existing literature on the etiology, pattern, gender, and anatomical distribution of mandibular fractures. Materials and Methods: The data of 225 cases were analyzed over a period of 5 years between March 2009 and November 2013. Of this 110 were unilateral, 23 bilateral, 18 symphysis and 74 multiple fractures. Results: Males are more affected than females.The peak incidence rate is occurring in 30-35 years of age group. The most common fracture site is parasymphysis and least common site is ramus of mandible. The most common etiological factor is road traffic accident (RTA (45.3% followed by falls (42.6%, assaults (8.9%, sport injuries (2.2%, and gunshot wounds (0.89%. Conclusion: Thus, we conclude that RTA is the leading cause of mandibular fractures and males are more affected. The most common site is parasymphysis fracture in association with angle fracture. We observed that gender was significantly associated with body and angle fracture (P = 0.04 and significant relationship between etiology with multiple site fracture such as (parasymphysis-angle, (body-condyle, (body-angle, and (symphysis-condyle was observed (P ≤ 0.05.

  15. Analysis of fracture patterns and local stress field variations in fractured reservoirs

    Science.gov (United States)

    Deckert, Hagen; Drews, Michael; Fremgen, Dominik; Wellmann, J. Florian

    2010-05-01

    A meaningful qualitative evaluation of permeabilities in fractured reservoirs in geothermal or hydrocarbon industry requires the spatial description of the existing discontinuity pattern within the area of interest and an analysis how these fractures might behave under given stress fields. This combined information can then be used for better estimating preferred fluid pathway directions within the reservoir, which is of particular interest for defining potential drilling sites. A description of the spatial fracture pattern mainly includes the orientation of rock discontinuities, spacing relationships between single fractures and their lateral extent. We have examined and quantified fracture patterns in several outcrops of granite at the Costa Brava, Spain, and in the Black Forest, Germany, for describing reservoir characteristics. For our analysis of fracture patterns we have used photogrammetric methods to create high-resolution georeferenced digital 3D images of outcrop walls. The advantage of this approach, compared to conventional methods for fracture analysis, is that it provides a better 3D description of the fracture geometry as the entity of position, extent and orientation of single fractures with respect to their surrounding neighbors is conserved. Hence for instance, the method allows generating fracture density maps, which can be used for a better description of the spatial distribution of discontinuities in a given outcrop. Using photogrammetric techniques also has the advantage to acquire very large data sets providing statistically sound results. To assess whether the recorded discontinuities might act as fluid pathways information on the stress field is needed. A 3D model of the regional tectonic structure was created and the geometry of the faults was put into a mechanical 3D Boundary Element (BE) Model. The model takes into account the elastic material properties of the geological units and the orientation of single fault segments. The

  16. Radiological classification of mandibular fractures

    International Nuclear Information System (INIS)

    Mihailova, H.

    2009-01-01

    Mandibular fractures present the biggest part (up to 97%) of the facial bone fractures. Method of choice for diagnosing of mandibular fractures is conventional radiography. The aim of the issue is to present an unified radiological classification of mandibular fractures for the clinical practice. This classification includes only those clinical symptoms of mandibular fracture which could be radiologically objectified: exact anatomical localization (F1-F6), teeth in fracture line (Ta,Tb), grade of dislocation (D I, D II), occlusal disturbances (O(+), O(-)). Radiological symptoms expressed by letter and number symbols are systematized in a formula - FTDO of mandibular fractures similar to TNM formula for tumours. FTDO formula expresses radiological diagnose of each mandibular fracture but it doesn't include neither the site (left or right) of the fracture, nor the kind and number of fractures. In order to express topography and number of fractures the radiological formula is transformed into a decimal fraction. The symbols (FTD) of right mandible fracture are written in the numerator and those of the left site - in the denominator. For double and multiple fractures between the symbols for each fracture we put '+'. Symbols for occlusal disturbances are put down opposite, the fractional line. So topographo-anatomical formula (FTD/FTD)xO is formed. In this way the whole radiological information for unilateral, bilateral, single or multiple fractures of the mandible is expressed. The information in the radiological topography anatomic formula, resp. from the unified topography-anatomic classification ensures a quick and exact X-ray diagnose of mandibular fracture. In this way contributes to get better, make easier and faster X-ray diagnostic process concerning mandibular fractures. And all these is a precondition for prevention of retardation of the diagnosis mandibular fracture. (author)

  17. MN48: a new Galactic bona fide luminous blue variable revealed by Spitzer and SALT

    Science.gov (United States)

    Kniazev, A. Y.; Gvaramadze, V. V.; Berdnikov, L. N.

    2016-07-01

    In this paper, we report the results of spectroscopic and photometric observations of the candidate evolved massive star MN48 disclosed via detection of a mid-infrared circular shell around it with the Spitzer Space Telescope. Follow-up optical spectroscopy of MN48 with the Southern African Large Telescope (SALT) carried out in 2011-2015 revealed significant changes in the spectrum of this star, which are typical of luminous blue variables (LBVs). The LBV status of MN48 was further supported by photometric monitoring which shows that in 2009-2011 this star has brightened by ≈0.9 and 1 mag in the V and Ic bands, respectively, then faded by ≈1.1 and 1.6 mag during the next four years, and apparently started to brighten again recently. The detected changes in the spectrum and brightness of MN48 make this star the 18th known Galactic bona fide LBV and increase the percentage of LBVs associated with circumstellar nebulae to more than 70 per cent. We discuss the possible birth place of MN48 and suggest that this star might have been ejected either from a putative star cluster embedded in the H II region IRAS 16455-4531 or the young massive star cluster Westerlund 1.

  18. An unusual stress fracture: Bilateral posterior longitudinal stress fracture of tibia.

    Science.gov (United States)

    Malkoc, Melih; Korkmaz, Ozgur; Ormeci, Tugrul; Oltulu, Ismail; Isyar, Mehmet; Mahirogulları, Mahir

    2014-01-01

    Stress fractures (SF) occur when healthy bone is subjected to cyclic loading, which the normal carrying range capacity is exceeded. Usually, stress fractures occur at the metatarsal bones, calcaneus, proximal or distal tibia and tends to be unilateral. This article presents a 58-year-old male patient with bilateral posterior longitudinal tibial stress fractures. A 58 years old male suffering for persistent left calf pain and decreased walking distance for last one month and after imaging studies posterior longitudinal tibial stress fracture was detected on his left tibia. After six months the patient was admitted to our clinic with the same type of complaints in his right leg. All imaging modalities and blood counts were performed and as a result longitudinal posterior tibial stress fractures were detected on his right tibia. Treatment of tibial stress fracture includes rest and modified activity, followed by a graded return to activity commensurate with bony healing. We have applied the same treatment protocol and our results were acceptable but our follow up time short for this reason our study is restricted for separate stress fractures of the posterior tibia. Although the main localization of tibial stress fractures were unilateral, anterior and transverse pattern, rarely, like in our case, the unusual bilateral posterior localization and longitudinal pattern can be seen. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Management of Hangman's Fractures: A Systematic Review.

    Science.gov (United States)

    Murphy, Hamadi; Schroeder, Gregory D; Shi, Weilong J; Kepler, Christopher K; Kurd, Mark F; Fleischman, Andrew N; Kandziora, Frank; Chapman, Jens R; Benneker, Lorin M; Vaccaro, Alexander R

    2017-09-01

    Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. The purpose of this review is to provide an evidence-based analysis of the literature and clinical outcomes associated with the surgical and nonsurgical management of hangman's fractures. A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE, MEDLINE, COMPENDEX) for all articles describing the treatment of hangman's fractures in 2 or more patients. Risk of nonunion, mortality, complications, and treatment failure (defined as the need for surgery in the nonsurgically managed patients and the need for revision surgery for any reason in the surgically managed patients) was compared for operative and nonoperative treatment methods using a generalized linear mixed model and odds ratio analysis. Overall, 25 studies met the inclusion criteria and were included in our quantitative analysis. Bony union was the principal outcome measure used to assess successful treatment. All studies included documented fracture union and were included in statistical analyses. The overall union rate for 131 fractures treated nonsurgically was 94.14% [95% confidence interval (CI), 76.15-98.78]. The overall union rate for 417 fractures treated surgically was 99.35% (95% CI, 96.81-99.87). Chance of nonunion was lower in those patients treated surgically (odds ratio, 0.12; 95% CI, 0.02-0.71). There was not a significant difference in mortality between patients treated surgically (0.16%; 95% CI, 0.01%-2.89%) and nonsurgically (1.04%; 95% CI, 0.08%-11.4%) (odds ratio, 0.15; 95% CI, 0.01-2.11). Treatment failure was less likely in the surgical treatment group (0.12%; 95% CI, 0.01%-2.45%) than the nonsurgical treatment group (0.71%; 95% CI, 0.28%-15.75%) (odds ratio 0.07; 95% CI, 0.01-0.56). Hangman's fractures are common injuries, and surgical treatment leads to an increase in the rate of

  20. Evaluation of Fibular Fracture Type vs Location of Tibial Fixation of Pilon Fractures.

    Science.gov (United States)

    Busel, Gennadiy A; Watson, J Tracy; Israel, Heidi

    2017-06-01

    Comminuted fibular fractures can occur with pilon fractures as a result of valgus stress. Transverse fibular fractures can occur with varus deformation. No definitive guide for determining the proper location of tibial fixation exists. The purpose of this study was to identify optimal plate location for fixation of pilon fractures based on the orientation of the fibular fracture. One hundred two patients with 103 pilon fractures were identified who were definitively treated at our institution from 2004 to 2013. Pilon fractures were classified using the AO/OTA classification and included 43-A through 43-C fractures. Inclusion criteria were age of at least 18 years, associated fibular fracture, and definitive tibial plating. Patients were grouped based on the fibular component fracture type (comminuted vs transverse), and the location of plate fixation (medial vs lateral) was noted. Radiographic outcomes were assessed for mechanical failures. Forty fractures were a result of varus force as evidenced by transverse fracture of the fibula and 63 were due to valgus force with a comminuted fibula. For the transverse fibula group, 14.3% mechanical complications were noted for medially placed plate vs 80% for lateral plating ( P = .006). For the comminuted fibular group, 36.4% of medially placed plates demonstrated mechanical complications vs 16.7% for laterally based plates ( P = .156). Time to weight bearing as tolerated was also noted to be significant between groups plated medially and laterally for the comminuted group ( P = .013). Correctly assessing the fibular component for pilon fractures provides valuable information regarding deforming forces. To limit mechanical complications, tibial plates should be applied in such a way as to resist the original deforming forces. Level of Evidence Level III, comparative study.

  1. Subtrochanteric Femur Fractures in an Irish Trauma Centre over 9 years: How the Impact of Hospital Coding on Diagnosis of Subtrochanteric Femur Fractures Leads to Inaccurate Occurrence Rates

    LENUS (Irish Health Repository)

    Coveney, EI

    2018-06-01

    Our aim was to assess the occurrence rates of subtrochanteric femur fractures in an orthopaedic tertiary referral centre and to assess the correlation of patient’s actual diagnosis with national hospital inpatient enquiry data.

  2. Influence of grain boundaries on the fracture toughness of tungsten alloys

    International Nuclear Information System (INIS)

    Gludovatz, B.; Faleschini, M.; Pippan, R.; Hoffmann, A.

    2007-01-01

    Full text of publication follows: Tungsten and tungsten alloys are possible candidates for future fusion reactors because of their high melting points, high thermal conductivity and their high erosion resistance. Since these materials have a body-centered cubic (bcc) structure, they show a typical change in fracture behaviour from brittle at low temperatures to ductile at high temperatures. For that reason the fracture behaviour of pure tungsten (W), potassium doped tungsten (AKS) and tungsten with 1 wt% La 2 O 3 (WL10) was studied, taking into account the influence of temperature and fabrication condition. Especially AKS has been studied to investigate the longitudinal splitting of the AKS-wires, the crack propagation direction with the lowest fracture toughness. This alloy subjected to intense deformation leads to a material with an elongated grain structure after recrystallization because of the potassium bubbles. Fracture toughness has been investigated by means of 3-point bending (3PB) specimens, double cantilever beam (DCB) specimens and compact tension (CT) specimens. Tests were performed in the range -196 deg. C to more than 1000 deg. C. Though all these materials show an expected increase in fracture toughness with increasing temperature, influences like texture, chemical composition, grain boundary segregation and dislocation density seem to have an extreme influence on the obtained results. These influences can especially be seen in the fracture behaviour and morphology, where two kinds of fracture can occur: on one hand the trans-crystalline and on the other hand the intercrystalline fracture. Therefore techniques like electron backscatter diffraction, auger electron spectroscopy and X-ray line profile analysis were used to determine the parameter influencing fracture toughness. Also new testing techniques have been devised and successfully applied. Additional tests like an 'in-situ EBSD' technique for investigating the formation of dislocations during

  3. Fractures in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1991-01-01

    In a cross-sectional study of 299 MS patients 22 have had fractures and of these 17 after onset of MS. The fractures most frequently involved the femoral neck and trochanter (41%). Three patients had had more than one fracture. Only 1 patient had osteoporosis. The percentage of fractures increase...

  4. Intrapartum sacral stress fracture due to pregnancy-related osteoporosis: a case report.

    Science.gov (United States)

    Oztürk, Gülcan; Külcü, Duygu Geler; Aydoğ, Ece

    2013-01-01

    Low back pain (LBP) and hip pain frequently occur during pregnancy and postpartum period. Although pelvic and mechanic lesions of the soft tissues are most responsible for the etiology, sacral fracture is also one of the rare causes. A 32-year-old primigravid patient presented with LBP and right hip pain which started 3 days after vaginal delivery. Although direct radiographic examination was normal, magnetic resonance imaging of the sacrum revealed sacral stress fracture. Lumbar spine and femoral bone mineral density showed osteoporosis as a risk factor. There were no other risk factors such as trauma, excessive weight gain, and strenuous physical activity. It is considered that the patient had sacral fatigue and insufficiency fracture in intrapartum period. The patient's symptoms subsided in 3 months after physical therapy and rest. In conclusion, sacral fractures during pregnancy and postpartum period, especially resulting from childbirth, are very rare. To date, there are two cases in the literature. In cases who even do not have risk factors related to vaginal delivery such as high birth weight infant and the use of forceps, exc., sacral fracture should be considered in the differential diagnosis of LBP and hip pain started soon after child birth. Pregnancy-related osteoporosis may lead to fracture during vaginal delivery.

  5. Application of fracture toughness scaling models to the ductile-to- brittle transition

    International Nuclear Information System (INIS)

    Link, R.E.; Joyce, J.A.

    1996-01-01

    An experimental investigation of fracture toughness in the ductile-brittle transition range was conducted. A large number of ASTM A533, Grade B steel, bend and tension specimens with varying crack lengths were tested throughout the transition region. Cleavage fracture toughness scaling models were utilized to correct the data for the loss of constraint in short crack specimens and tension geometries. The toughness scaling models were effective in reducing the scatter in the data, but tended to over-correct the results for the short crack bend specimens. A proposed ASTM Test Practice for Fracture Toughness in the Transition Range, which employs a master curve concept, was applied to the results. The proposed master curve over predicted the fracture toughness in the mid-transition and a modified master curve was developed that more accurately modeled the transition behavior of the material. Finally, the modified master curve and the fracture toughness scaling models were combined to predict the as-measured fracture toughness of the short crack bend and the tension specimens. It was shown that when the scaling models over correct the data for loss of constraint, they can also lead to non-conservative estimates of the increase in toughness for low constraint geometries

  6. TIBIAL SHAFT FRACTURES.

    Science.gov (United States)

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2011-01-01

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

  7. Treatment of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures.

    Science.gov (United States)

    Xu, Xiaofeng; Shi, Jun; Xu, Bing; Dai, Jiewen; Zhang, Shilei

    2015-03-01

    To evaluate the treatment methods of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures (MSF&DICF) and to compare the effect of different treatment methods of condylar fractures. Twenty-eight patients with MSF&DICF were included in this study. Twenty-two sites were treated by open reduction, and all the medial condylar fragments were fixed with titanium screws; whereas the other 22 sites underwent close treatment. The surgical effect between these 2 groups was compared based on clinical examination and radiographic examination results. Seventeen of 22 condyle fractures were repositioned in the surgery group, whereas 4 of 22 condyle fractures were repositioned in the close treatment group. Statistical difference was observed between these 2 groups (P condyle fractures should be treated by surgical reduction with the maintenance of the attachment of lateral pterygoid muscle, which is beneficial to repositioning the dislocated condyle to its original physiological position, to closure of the mandibular lingual gap, to restore the mandibular width.

  8. Classification of Porcine Cranial Fracture Patterns Using a Fracture Printing Interface,.

    Science.gov (United States)

    Wei, Feng; Bucak, Serhat Selçuk; Vollner, Jennifer M; Fenton, Todd W; Jain, Anil K; Haut, Roger C

    2017-01-01

    Distinguishing between accidental and abusive head trauma in children can be difficult, as there is a lack of baseline data for pediatric cranial fracture patterns. A porcine head model has recently been developed and utilized in a series of studies to investigate the effects of impact energy level, surface type, and constraint condition on cranial fracture patterns. In the current study, an automated pattern recognition method, or a fracture printing interface (FPI), was developed to classify cranial fracture patterns that were associated with different impact scenarios documented in previous experiments. The FPI accurately predicted the energy level when the impact surface type was rigid. Additionally, the FPI was exceedingly successful in determining fractures caused by skulls being dropped with a high-level energy (97% accuracy). The FPI, currently developed on the porcine data, may in the future be transformed to the task of cranial fracture pattern classification for human infant skulls. © 2016 American Academy of Forensic Sciences.

  9. Hydrajet fracturing: an effective method for placing many fractures in openhole horizontal wells

    Energy Technology Data Exchange (ETDEWEB)

    Surjaatmadja, J. B.; Grundmann, S. R.; McDaniel, B.; Deeg, W. F. J.; Brumley, J. L.; Swor, L. C.

    1998-12-31

    A new method for openhole horizontal well fracturing that combines hydrajetting and fracturing techniques, which was developed on the basis of Bernoulli`s theorem, is described. This theorem has been effectively proven in many applications such as jet pumps, additive injection systems and jet aircraft engines. By using this method, operators can position a jetting tool, without the use of sealing elements, at the exact point where fracture is required. The method also permits the use of multiple fractures in the same well, which can be spaced evenly or unevenly as prescribed by the fracturing program. Damage can be avoided by placing hundreds of small fractures in a long horizontal section, or operators can use acid and/or propped sand techniques to place a combination of two fracture types in the well. The paper describes the basic principles of horizontal hydrajet fracturing, and elements of a laboratory model which was developed to demonstrate the effectiveness of the method.

  10. Characterisation of hydraulically-active fractures in a fractured ...

    African Journals Online (AJOL)

    ... in the initial stage of a site investigation to select the optimal site location or to evaluate the hydrogeological properties of fractures in underground exploration studies, such as those related geothermal reservoir evaluation and radioactive waste disposal. Keywords: self-potential method, hydraulically-conductive fractures, ...

  11. Fracture propagation in sandstone and slate – Laboratory experiments, acoustic emissions and fracture mechanics

    Directory of Open Access Journals (Sweden)

    Ferdinand Stoeckhert

    2015-06-01

    Full Text Available Fracturing of highly anisotropic rocks is a problem often encountered in the stimulation of unconventional hydrocarbon or geothermal reservoirs by hydraulic fracturing. Fracture propagation in isotropic material is well understood but strictly isotropic rocks are rarely found in nature. This study aims at the examination of fracture initiation and propagation processes in a highly anisotropic rock, specifically slate. We performed a series of tensile fracturing laboratory experiments under uniaxial as well as triaxial loading. Cubic specimens with edge lengths of 150 mm and a central borehole with a diameter of 13 mm were prepared from Fredeburg slate. An experiment using the rather isotropic Bebertal sandstone as a rather isotropic rock was also performed for comparison. Tensile fractures were generated using the sleeve fracturing technique, in which a polymer tube placed inside the borehole is pressurized to generate tensile fractures emanating from the borehole. In the uniaxial test series, the loading was varied in order to observe the transition from strength-dominated fracture propagation at low loading magnitudes to stress-dominated fracture propagation at high loading magnitudes.

  12. Early Complications in Proximal Femoral Nailing Done for Treatment of Subtrochanteric Fractures

    Directory of Open Access Journals (Sweden)

    B Kanthimathi

    2012-03-01

    Full Text Available AIM: To analyse the early complications following the use of PFN in subtrochanteric fractures. Background: Osteosynthesis with PFN in subtrochanteric fracture features the advantages of high rotational stability of the head–neck fragment, an unreamed implantation technique and the possibility of static or dynamic distal locking. However, the use of the nail requires technical expertise and is accompanied by some risks of error which can lead to osteosynthesis failure. METHODS: Between May 2009 and May 2011, 50 consecutive patients with PFN fixations for subtrochanteric fractures were observed for intraoperative and postoperative complications. RESULTS: We identified intraoperative technical difficulties in four patients and six patients showed postoperative complications. CONCLUSION: When subtrochanteric fractures are to be stabilised with a PFN, the precise and expert technical performance of implantation is the basic surgical requirement. Good reduction with minimal dissection and the use of an appropriate implant is necessary to avoid treatment failure.

  13. Small Scale Yielding Correction of Constraint Loss in Small Sized Fracture Toughness Test Specimens

    International Nuclear Information System (INIS)

    Kim, Maan Won; Kim, Min Chul; Lee, Bong Sang; Hong, Jun Hwa

    2005-01-01

    Fracture toughness data in the ductile-brittle transition region of ferritic steels show scatter produced by local sampling effects and specimen geometry dependence which results from relaxation in crack tip constraint. The ASTM E1921 provides a standard test method to define the median toughness temperature curve, so called Master Curve, for the material corresponding to a 1T crack front length and also defines a reference temperature, T 0 , at which median toughness value is 100 MPam for a 1T size specimen. The ASTM E1921 procedures assume that high constraint, small scaling yielding (SSY) conditions prevail at fracture along the crack front. Violation of the SSY assumption occurs most often during tests of smaller specimens. Constraint loss in such cases leads to higher toughness values and thus lower T 0 values. When applied to a structure with low constraint geometry, the standard fracture toughness estimates may lead to strongly over-conservative estimates. A lot of efforts have been made to adjust the constraint effect. In this work, we applied a small-scale yielding correction (SSYC) to adjust the constraint loss of 1/3PCVN and PCVN specimens which are relatively smaller than 1T size specimen at the fracture toughness Master Curve test

  14. Rib Fractures

    Science.gov (United States)

    ... Video) Achilles Tendon Tear Additional Content Medical News Rib Fractures By Thomas G. Weiser, MD, MPH, Associate Professor, ... Tamponade Hemothorax Injury to the Aorta Pulmonary Contusion Rib Fractures Tension Pneumothorax Traumatic Pneumothorax (See also Introduction to ...

  15. Orbital fractures: a review

    Directory of Open Access Journals (Sweden)

    Jeffrey M Joseph

    2011-01-01

    Full Text Available Jeffrey M Joseph, Ioannis P GlavasDivision of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, School of Medicine, New York University, New York, NY, USA; Manhattan Eye, Ear, and Throat Hospital, New York, NY, USAAbstract: This review of orbital fractures has three goals: 1 to understand the clinically relevant orbital anatomy with regard to periorbital trauma and orbital fractures, 2 to explain how to assess and examine a patient after periorbital trauma, and 3 to understand the medical and surgical management of orbital fractures. The article aims to summarize the evaluation and management of commonly encountered orbital fractures from the ophthalmologic perspective and to provide an overview for all practicing ophthalmologists and ophthalmologists in training.Keywords: orbit, trauma, fracture, orbital floor, medial wall, zygomatic, zygomatic complex, zmc fracture, zygomaticomaxillary complex fractures 

  16. Phase field modelling of dynamic thermal fracture in the context of irradiation damage

    CERN Document Server

    Schlüter, Alexander; Müller, Ralf; Tomut, Marilena; Trautmann , Christina; Weick, Helmut; Plate, Carolin

    2015-01-01

    This work presents a continuum mechanics approach to model fracturing processes in brittle materials that are subjected to rapidly applied high-temperature gradients. Such a type of loading typically occurs when a solid is exposed to an intense high-energy particle beam that deposits a large amount of energy into a small sample volume. Given the rapid energy deposition leading to a fast temperature increase, dynamic effects have to be considered. Our existing phase field model for dynamic fracture is thus extended in a way that allows modelling of thermally induced fracture. A finite element scheme is employed to solve the governing partial differential equations numerically. Finally, the functionality of our model is illustrated by two examples.

  17. Brittle Fracture Behaviors of Large Die Holders Used in Hot Die Forging

    Directory of Open Access Journals (Sweden)

    Weifang Zhang

    2017-05-01

    Full Text Available Brittle fracture of large forging equipment usually leads to catastrophic consequences. To avoid this kind of accident, the brittle fracture behaviors of a large die holder were studied by simulating the practical application. The die holder is used on the large die forging press, and it is made of 55NiCrMoV7 hot-work tool steel. Detailed investigations including mechanical properties analysis, metallographic observation, fractography, transmission electron microscope (TEM analysis and selected area electron diffraction (SAED were conducted. The results reveal that the material generated a large quantity of large size polyhedral M23C6 (M: Fe and Cr mainly and elongated M3C (M: Fe mainly carbides along the martensitic lath boundaries when the die holder was recurrently tempered and water-cooled at 250 °C during the service. The large size carbides lead to the material embrittlement and impact toughness degradation, and further resulted in the brittle fracture of the die holder. Therefore, the operation specification must be emphasized to avoid the die holder being cooled by using water, which is aimed at accelerating the cooling.

  18. Transport of Particle Swarms Through Variable Aperture Fractures

    Science.gov (United States)

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

    2012-12-01

    Particle transport through fractured rock is a key concern with the increased use of micro- and nano-size particles in consumer products as well as from other activities in the sub- and near surface (e.g. mining, industrial waste, hydraulic fracturing, etc.). While particle transport is often studied as the transport of emulsions or dispersions, particles may also enter the subsurface from leaks or seepage that lead to particle swarms. Swarms are drop-like collections of millions of colloidal-sized particles that exhibit a number of unique characteristics when compared to dispersions and emulsions. Any contaminant or engineered particle that forms a swarm can be transported farther, faster, and more cohesively in fractures than would be expected from a traditional dispersion model. In this study, the effects of several variable aperture fractures on colloidal swarm cohesiveness and evolution were studied as a swarm fell under gravity and interacted with the fracture walls. Transparent acrylic was used to fabricate synthetic fracture samples with (1) a uniform aperture, (2) a converging region followed by a uniform region (funnel shaped), (3) a uniform region followed by a diverging region (inverted funnel), and (4) a cast of a an induced fracture from a carbonate rock. All of the samples consisted of two blocks that measured 100 x 100 x 50 mm. The minimum separation between these blocks determined the nominal aperture (0.5 mm to 20 mm). During experiments a fracture was fully submerged in water and swarms were released into it. The swarms consisted of a dilute suspension of 3 micron polystyrene fluorescent beads (1% by mass) with an initial volume of 5μL. The swarms were illuminated with a green (525 nm) LED array and imaged optically with a CCD camera. The variation in fracture aperture controlled swarm behavior. Diverging apertures caused a sudden loss of confinement that resulted in a rapid change in the swarm's shape as well as a sharp increase in its velocity

  19. Orbital wall fractures

    International Nuclear Information System (INIS)

    Iinuma, Toshitaka; Ishio, Ken-ichirou; Yoshinami, Hiroyoshi; Kuriyama, Jun-ichi; Hirota, Yoshiharu.

    1993-01-01

    A total of 59 cases of mild facial fractures (simple orbital wall fractures, 34 cases, other facial fractures, 25 cases) with the clinical suspects of orbital wall fractures were evaluated both by conventional views (Waters' and Caldwell views) and coronal CT scans. Conventional views were obtained, as an average, after 4 days and CT after 7 days of injuries. Both the medial wall and the floor were evaluated at two sites, i.e., anterior and posterior. The ethmoid-maxillary plate was also included in the study. The degree of fractures was classified as, no fractures, fractures of discontinuity, dislocation and fragmentation. The coronal CT images in bone window condition was used as reference and the findings were compared between conventional views and CT. The correct diagnosis was obtained as follows: orbital floor (anterior, 78%, posterior, 73%), medial orbital wall (anterior, 72%, posterior, 72%) and ethmoid-maxillary plate (64%). The false positive diagnosis was as follows: orbital floor (anterior only, 13%), medial orbital wall (anterior only, 7%) and ethmoid-maxillary plate (11%). The false negative diagnosis was as follows: orbital floor (anterior, 9%, posterior, 10%), medial orbital wall (anterior, 21%, posterior, 28%) and ethmoid-maxillary plate (21%). The results were compared with those of others in the past. (author)

  20. Linking advanced fracture models to structural analysis

    Energy Technology Data Exchange (ETDEWEB)

    Chiesa, Matteo

    2001-07-01

    Shell structures with defects occur in many situations. The defects are usually introduced during the welding process necessary for joining different parts of the structure. Higher utilization of structural materials leads to a need for accurate numerical tools for reliable prediction of structural response. The direct discretization of the cracked shell structure with solid finite elements in order to perform an integrity assessment of the structure in question leads to large size problems, and makes such analysis infeasible in structural application. In this study a link between local material models and structural analysis is outlined. An ''ad hoc'' element formulation is used in order to connect complex material models to the finite element framework used for structural analysis. An improved elasto-plastic line spring finite element formulation, used in order to take cracks into account, is linked to shell elements which are further linked to beam elements. In this way one obtain a global model of the shell structure that also accounts for local flexibilities and fractures due to defects. An important advantage with such an approach is a direct fracture mechanics assessment e.g. via computed J-integral or CTOD. A recent development in this approach is the notion of two-parameter fracture assessment. This means that the crack tip stress tri-axiality (constraint) is employed in determining the corresponding fracture toughness, giving a much more realistic capacity of cracked structures. The present thesis is organized in six research articles and an introductory chapter that reviews important background literature related to this work. Paper I and II address the performance of shell and line spring finite elements as a cost effective tool for performing the numerical calculation needed to perform a fracture assessment. In Paper II a failure assessment, based on the testing of a constraint-corrected fracture mechanics specimen under tension, is

  1. Multi-zone coupling productivity of horizontal well fracturing with complex fracture networks in shale gas reservoirs

    Directory of Open Access Journals (Sweden)

    Weiyao Zhu

    2018-02-01

    Full Text Available In this paper, a series of specific studies were carried out to investigate the complex form of fracture networks and figure out the multi-scale flowing laws of nano/micro pores–complex fracture networks–wellbore during the development of shale reservoirs by means of horizontal well fracturing. First, hydraulic fractures were induced by means of Brazilian splitting tests. Second, the forms of the hydraulic fractures inside the rock samples were observed by means of X-ray CT scanning to measure the opening of hydraulic fractures. Third, based on the multi-scale unified flowing model, morphological description of fractures and gas flowing mechanism in the matrix–complex fracture network–wellbore, the productivity equation of single-stage horizontal well fracturing which includes diffusion, slipping and desorption was established. And fourthly, a productivity prediction model of horizontal well multi-stage fracturing in the shale reservoir was established considering the interference between the multi-stage fracturing zones and the pressure drop in the horizontal wellbore. The following results were obtained. First, hydraulic fractures are in the form of a complex network. Second, the measured opening of hydraulic fractures is in the range of 4.25–453 μm, averaging 112 μm. Third, shale gas flowing in different shapes of fracture networks follows different nonlinear flowing laws. Forth, as the fracture density in the strongly stimulated zones rises and the distribution range of the hydraulic fractures in strongly/weakly stimulated zones enlarges, gas production increases gradually. As the interference occurs in the flowing zones of fracture networks between fractured sections, the increasing amplitude of gas production rates decreases. Fifth, when the length of a simulated horizontal well is 1500 m and the half length of a fracture network in the strongly stimulated zone is 100 m, the productivity effect of stage 10 fracturing is the

  2. Epidemiology of metatarsal stress fractures versus tibial and femoral stress fractures during elite training.

    Science.gov (United States)

    Finestone, Aharon; Milgrom, Charles; Wolf, Omer; Petrov, Kaloyan; Evans, Rachel; Moran, Daniel

    2011-01-01

    The training of elite infantry recruits takes a year or more. Stress fractures are known to be endemic in their basic training and the clinical presentation of tibial, femoral, and metatarsal stress fractures are different. Stress fracture incidence during the subsequent progressively more demanding training is not known. The study hypothesis was that after an adaptation period, the incidence of stress fractures during the course of 1 year of elite infantry training would fall in spite of the increasingly demanding training. Seventy-six male elite infantry recruits were followed for the development of stress fractures during a progressively more difficult training program composed of basic training (1 to 14 weeks), advanced training (14 to 26 weeks), and unit training (26 to 52 weeks). Subjects were reviewed regularly and those with clinical suspicion of stress fracture were assessed using bone scan and X-rays. The incidence of stress fractures was 20% during basic training, 14% during advanced training and 23% during unit training. There was a statistically significant difference in the incidence of tibial and femoral stress fractures versus metatarsal stress fractures before and after the completion of phase II training at week 26 (p=0.0001). Seventy-eight percent of the stress fractures during phases I and II training were either tibial or femoral, while 91% of the stress fractures in phase III training were metatarsal. Prior participation in ball sports (p=0.02) and greater tibial length (p=0.05) were protective factors for stress fracture. The study hypothesis that after a period of soldier adaptation, the incidence of stress fractures would decrease in spite of the increasingly demanding elite infantry training was found to be true for tibial and femoral fractures after 6 months of training but not for metatarsal stress fractures. Further studies are required to understand the mechanism of this difference but physicians and others treating stress fractures

  3. Reduction of femoral fractures in long-term care facilities: the Bavarian fracture prevention study.

    Directory of Open Access Journals (Sweden)

    Clemens Becker

    Full Text Available BACKGROUND: Hip fractures are a major public health burden. In industrialized countries about 20% of all femoral fractures occur in care dependent persons living in nursing care and assisted living facilities. Preventive strategies for these groups are needed as the access to medical services differs from independent home dwelling older persons at risk of osteoporotic fractures. It was the objective of the study to evaluate the effect of a fall and fracture prevention program on the incidence of femoral fracture in nursing homes in Bavaria, Germany. METHODS: In a translational intervention study a fall prevention program was introduced in 256 nursing homes with 13,653 residents. The control group consisted of 893 nursing homes with 31,668 residents. The intervention consisted of staff education on fall and fracture prevention strategies, progressive strength and balance training, and on institutional advice on environmental adaptations. Incident femoral fractures served as outcome measure. RESULTS: In the years before the intervention risk of a femoral fracture did not differ between the intervention group (IG and control group (CG. During the one-year intervention period femoral fracture rates were 33.6 (IG and 41.0/1000 person years (CG, respectively. The adjusted relative risk of a femoral fracture was 0.82 (95% CI 0.72-0.93 in residents exposed to the fall and fracture prevention program compared to residents from CG. CONCLUSIONS: The state-wide dissemination of a multi-factorial fall and fracture prevention program was able to reduce femoral fractures in residents of nursing homes.

  4. Pre-fracture individual characteristics associated with high total health care costs after hip fracture.

    Science.gov (United States)

    Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E

    2017-03-01

    Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.

  5. Scaling aspects of the sea-ice-drift dynamics and pack fracture

    Directory of Open Access Journals (Sweden)

    A. Chmel

    2007-05-01

    Full Text Available A study of the sea-ice dynamics in the periods of time prior to and during the cycles of basin-wide fragmentation of the ice cover in the Arctic Ocean is presented. The fractal geometry of the ice-sheets limited by leads and ridges was assessed using the satellite images, while the data on the correlated sea-ice motion were obtained in the research stations "North Pole 32" and "North Pole 33" established on the ice pack. The revealed decrease of the fractal dimension as a result of large-scale fragmentation is consistent with the localization of the fracture process (leads propagation. At the same time, the scaling properties of the distribution of amplitudes of ice-fields accelerations were insensitive to the event of sea-ice fragmentation. The temporal distribution of the accelerations was scale-invariant during "quiet" periods of sea-ice drift but disordered in the period of mechanical perturbation. The period of decorrelated (in time ice-field motion during the important fracture event was interpreted as an inter-level transition in the hierarchic dynamical system. The mechanism of the long-range correlations in the sea-ice cover, including the fracture process, is suggested to be in relation with the self-organized oscillation dynamics inherent in the ice pack.

  6. Age-related hip fractures in men: clinical spectrum and short-term outcomes.

    Science.gov (United States)

    Poór, G; Atkinson, E J; Lewallen, D G; O'Fallon, W M; Melton, L J

    1995-01-01

    Clinical spectrum, treatment and short-term outcomes were assessed among the 131 Rochester, Minnesota, men who contracted an initial hip fracture due to moderate trauma during 1978-89. Three-fourths of falls leading to hip fracture occurred indoors with little seasonality, and 91% of fractures were in men 65 years of age or older. The ratio of cervical to intertrochanteric femur fractures was 1.4:1, and there was a tendency toward more neurological conditions among the patients with cervical fractures. Hemiarthroplasty and total hip replacement were mostly performed for cervical fractures, while internal fixation was preferred for intertrochanteric fractures. In-hospital mortality was 11.5%, and the 30-day case fatality rate was 16.0%. Age and postoperative deterioration of mental status significantly increased the risk of early death, the latter even after adjustment in a multivariate model, while comorbidity had a suggestive but not statistically significant influence on mortality. More than half the men were discharged to nursing homes, and 79% of the patients who survived at 1 year resided in nursing homes or intermediate care facilities or were attended by home care. Only 41% of survivors recovered their prefracture level of functioning and nearly 60% of patients limped and required a cane or walker. After implementation of the prospective payment system in 1984, the length of hospital stay was reduced, but there was no change in early mortality rates, in the duration of physical therapy following fracture or in attendance at nursing homes. The results of this population-based study demonstrate the strong impact of hip fractures on short-term outcomes in men.

  7. Recombinant human bone morphogenetic protein-2 in the treatment of bone fractures

    Directory of Open Access Journals (Sweden)

    Neil Ghodadra

    2008-09-01

    Full Text Available Neil Ghodadra, Kern SinghDepartment of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USAAbstract: Over one million fractures occur per year in the US and are associated with impaired healing increasing patient morbidity, stress, and economic costs. Despite improvements in surgical technique, internal fixation, and understanding of biologics, fracture healing is delayed or impaired in up to 4% of all fractures. Complications due to impaired fracture healing present therapeutic challenges to the orthopedic surgeon and often lead to chronic functional and psychological disability for the patient. As a result, it has become clinically desirable to augment mechanical fixation with biologic strategies in order to accelerate osteogenesis and promote successful arthrodesis. The discovery of bone morphogenic protein (BMP has been pivotal in understanding the biology of fracture healing and has been a source of intense clinical research as an adjunct to fracture treatment. Multiple in vitro and in vivo studies in animals have elucidated the complex biologic interactions between BMPs and cellular receptors and have convincingly demonstrated rhBMP-2 to be a safe, effective treatment option to enhance bone healing. Multiple clinical trials in trauma surgery have provided level 1 evidence for the use of rhBMP-2 as a safe and effective treatment of fractures. Human clinical trials have provided further insight into BMP-2 dosage, time course, carriers, and efficacy in fracture healing of tibial defects. These promising results have provided hope that a new biologic field of technology has emerged as a useful adjunct in the treatment of skeletal injuries and conditions.Keywords: bone morphogenic protein-2, bone fracture, bone healing

  8. Statistical methodology for discrete fracture model - including fracture size, orientation uncertainty together with intensity uncertainty and variability

    International Nuclear Information System (INIS)

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

    2009-11-01

    Investigations led for several years at Laxemar and Forsmark reveal the large heterogeneity of geological formations and associated fracturing. This project aims at reinforcing the statistical DFN modeling framework adapted to a site scale. This leads therefore to develop quantitative methods of characterization adapted to the nature of fracturing and data availability. We start with the hypothesis that the maximum likelihood DFN model is a power-law model with a density term depending on orientations. This is supported both by literature and specifically here by former analyses of the SKB data. This assumption is nevertheless thoroughly tested by analyzing the fracture trace and lineament maps. Fracture traces range roughly between 0.5 m and 10 m - i e the usual extension of the sample outcrops. Between the raw data and final data used to compute the fracture size distribution from which the size distribution model will arise, several steps are necessary, in order to correct data from finite-size, topographical and sampling effects. More precisely, a particular attention is paid to fracture segmentation status and fracture linkage consistent with the DFN model expected. The fracture scaling trend observed over both sites displays finally a shape parameter k t close to 1.2 with a density term (α 2d ) between 1.4 and 1.8. Only two outcrops clearly display a different trend with k t close to 3 and a density term (α 2d ) between 2 and 3.5. The fracture lineaments spread over the range between 100 meters and a few kilometers. When compared with fracture trace maps, these datasets are already interpreted and the linkage process developed previously has not to be done. Except for the subregional lineament map from Forsmark, lineaments display a clear power-law trend with a shape parameter k t equal to 3 and a density term between 2 and 4.5. The apparent variation in scaling exponent, from the outcrop scale (k t = 1.2) on one side, to the lineament scale (k t = 2) on

  9. Determining the Role of Sost and Sostdc1 During Fracture Healing

    Energy Technology Data Exchange (ETDEWEB)

    Yee, Cristal Sook Ngei [Univ. of California, Merced, CA (United States)

    2016-01-01

    The bone is a dynamic organ, often changing throughout the course of the human lifespan with its continuous remodeling, laying down new bone and resorbing old bone. With age, the bone becomes increasingly porous and mechanically unstable, leading to the development of osteoporosis in some individuals. Elderly patients with osteoporosis are at an increased risk of fracturing their bones which contributes to a higher mortality rate. Recent studies have revealed that type 1 diabetic mellitus (T1DM) patients also have an osteoporotic bone phenotype and impaired fracture healing, independent of age. Currently, there is a lack of available treatments that can improve impaired healing and directly enhance bone formation. Therefore, there is a great need for developing new therapies that can not only aid type 1 diabetic patients with osteoporosis to improve bone phenotype, but that could also aid patients with difficult or impaired fracture healing. In this thesis, I will be discussing the role of Wnt signaling and Sclerostin, a Wnt antagonist that negatively regulates bone formation, in the content of fracture repair.

  10. Emergency ultrasound in the detection of pediatric long-bone fractures.

    Science.gov (United States)

    Barata, Isabel; Spencer, Robert; Suppiah, Ara; Raio, Christopher; Ward, Mary Frances; Sama, Andrew

    2012-11-01

    Long-bone fractures represent one of the most commonly sustained injuries following trauma and account for nearly 4% of emergency department visits in the United States each year. These fractures are associated with a significant risk of bleeding and neurovascular compromise. Delays in their identification and treatment can lead to loss of limb and even death. Although emergency physicians currently rely predominantly on radiography for the examination of long-bone injuries, emergency ultrasound has several advantages over radiography and may be useful in the identification of long-bone fractures. Ultrasound is rapid, noninvasive, and cost-effective. Unlike radiography, ultrasound does not expose children to ionizing radiation, which has been linked to cancer. The goal of this study was to assess the agreement between emergency physicians' and radiologists' final assessments of suspected long-bone fractures using emergency ultrasound and radiography, respectively, in the pediatric population. This is a prospective study involving a convenience sample of pediatric patients (fracture. Suspected fractures were characterized by swelling, erythema, and localized pain. Patients who had a history of fracture, extremity deformity, orthopedic hardware in the traumatized area, or an open fracture were excluded from this study. Each investigator received limited, focused training in the use of ultrasonography for fracture identification and localization. This training consisted of a brief didactic session and video review of normal and fractured long-bones. A total of 53 subjects (mean age, 10.2 [SD, 3.8] years; 56.6% were male) were enrolled, which corresponded to 98 ultrasound examinations. Sixty-nine scans (70.4%) involved bones of the upper extremity, and 29 (29.6%) the lower extremity. Radiography identified a total of 43 fractures. The sensitivity and specificity of ultrasound in the detection of long-bone fractures were 95.3% (95% confidence interval [CI], 82

  11. Nontraumatic tibial polyethylene insert cone fracture in mobile-bearing posterior-stabilized total knee arthroplasty

    OpenAIRE

    Tanikake, Yohei; Hayashi, Koji; Ogawa, Munehiro; Inagaki, Yusuke; Kawate, Kenji; Tomita, Tetsuya; Tanaka, Yasuhito

    2016-01-01

    A 72-year-old male patient underwent mobile-bearing posterior-stabilized total knee arthroplasty for osteoarthritis. He experienced a nontraumatic polyethylene tibial insert cone fracture 27 months after surgery. Scanning electron microscopy of the fracture surface of the tibial insert cone suggested progress of ductile breaking from the posterior toward the anterior of the cone due to repeated longitudinal bending stress, leading to fatigue breaking at the anterior side of the cone, followed...

  12. Fracture mechanics

    CERN Document Server

    Perez, Nestor

    2017-01-01

    The second edition of this textbook includes a refined presentation of concepts in each chapter, additional examples; new problems and sections, such as conformal mapping and mechanical behavior of wood; while retaining all the features of the original book. The material included in this book is based upon the development of analytical and numerical procedures pertinent to particular fields of linear elastic fracture mechanics (LEFM) and plastic fracture mechanics (PFM), including mixed-mode-loading interaction. The mathematical approach undertaken herein is coupled with a brief review of several fracture theories available in cited references, along with many color images and figures. Dynamic fracture mechanics is included through the field of fatigue and Charpy impact testing. Explains computational and engineering approaches for solving crack-related problems using straightforward mathematics that facilitate comprehension of the physical meaning of crack growth processes; Expands computational understandin...

  13. Coupled Effects of non-Newtonian Rheology and Aperture Variability on Flow in a Single Fracture

    Science.gov (United States)

    Di Federico, V.; Felisa, G.; Lauriola, I.; Longo, S.

    2017-12-01

    Modeling of non-Newtonian flow in fractured media is essential in hydraulic fracturing and drilling operations, EOR, environmental remediation, and to understand magma intrusions. An important step in the modeling effort is a detailed understanding of flow in a single fracture, as the fracture aperture is spatially variable. A large bibliography exists on Newtonian and non-Newtonian flow in variable aperture fractures. Ultimately, stochastic or deterministic modeling leads to the flowrate under a given pressure gradient as a function of the parameters describing the aperture variability and the fluid rheology. Typically, analytical or numerical studies are performed adopting a power-law (Oswald-de Waele) model. Yet the power-law model, routinely used e.g. for hydro-fracturing modeling, does not characterize real fluids at low and high shear rates. A more appropriate rheological model is provided by e.g. the four-parameter Carreau constitutive equation, which is in turn approximated by the more tractable truncated power-law model. Moreover, fluids of interest may exhibit yield stress, which requires the Bingham or Herschel-Bulkely model. This study employs different rheological models in the context of flow in variable aperture fractures, with the aim of understanding the coupled effect of rheology and aperture spatial variability with a simplified model. The aperture variation, modeled within a stochastic or deterministic framework, is taken to be one-dimensional and i) perpendicular; ii) parallel to the flow direction; for stochastic modeling, the influence of different distribution functions is examined. Results for the different rheological models are compared with those obtained for the pure power-law. The adoption of the latter model leads to overestimation of the flowrate, more so for large aperture variability. The presence of yield stress also induces significant changes in the resulting flowrate for assigned external pressure gradient.

  14. Algorithm of imaging modalities in cases of mandibular fractures

    International Nuclear Information System (INIS)

    Mihailova, H.

    2009-01-01

    Mandibular fracture is the most common bone fracture of maxillo-facial trauma. Up to now the main method for examination of the mandible is radiography. The aim of the issue is to present an algorithm of imaging modalities for investigation of patients in cases of mandibular trauma. It consists of series of X ray techniques and views of the facial skull named mandibulo-facial. This standardizes mandibulo-facial series includes exactly determined four projections done by conventional X ray techniques: posterior-anterior view of skull (PA or AP), oblique view of the left mandible; oblique view of the right mandible; occipito-mental view. Using these four planned radiograms is obligatory for each mandibular trauma. Panoramic X-ray is obligatory in cases of apparatus availability; this abolish only oblique views (left and right). Occipito-mental view of the skull gives anatomically better the coronoid process of the mandible, the zygoma complex, the orbital edges and maxillar sinus than Waters projection. So mandibulo-facial series of four planned radiograms is not only for diagnostic of mandibular fractures, but as a screening of mandibulo-facial trauma too. Thus using algorithm of imaging modalities in cases of mandibular fracture leads to optimization of diagnostic process in patients with mandibular trauma. (author)

  15. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  16. Artificial intelligence in fracture detection: transfer learning from deep convolutional neural networks.

    Science.gov (United States)

    Kim, D H; MacKinnon, T

    2018-05-01

    To identify the extent to which transfer learning from deep convolutional neural networks (CNNs), pre-trained on non-medical images, can be used for automated fracture detection on plain radiographs. The top layer of the Inception v3 network was re-trained using lateral wrist radiographs to produce a model for the classification of new studies as either "fracture" or "no fracture". The model was trained on a total of 11,112 images, after an eightfold data augmentation technique, from an initial set of 1,389 radiographs (695 "fracture" and 694 "no fracture"). The training data set was split 80:10:10 into training, validation, and test groups, respectively. An additional 100 wrist radiographs, comprising 50 "fracture" and 50 "no fracture" images, were used for final testing and statistical analysis. The area under the receiver operator characteristic curve (AUC) for this test was 0.954. Setting the diagnostic cut-off at a threshold designed to maximise both sensitivity and specificity resulted in values of 0.9 and 0.88, respectively. The AUC scores for this test were comparable to state-of-the-art providing proof of concept for transfer learning from CNNs in fracture detection on plain radiographs. This was achieved using only a moderate sample size. This technique is largely transferable, and therefore, has many potential applications in medical imaging, which may lead to significant improvements in workflow productivity and in clinical risk reduction. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  17. Fracture toughness of ultra high performance concrete by flexural performance

    Directory of Open Access Journals (Sweden)

    Manolova Emanuela

    2016-01-01

    Full Text Available This paper describes the fracture toughness of the innovative structural material - Ultra High Performance Concrete (UHPC, evaluated by flexural performance. For determination the material behaviour by static loading are used adapted standard test methods for flexural performance of fiber-reinforced concrete (ASTM C 1609 and ASTM C 1018. Fracture toughness is estimated by various deformation parameters derived from the load-deflection curve, obtained by testing simple supported beam under third-point loading, using servo-controlled testing system. This method is used to be estimated the contribution of the embedded fiber-reinforcement into improvement of the fractural behaviour of UHPC by changing the crack-resistant capacity, fracture toughness and energy absorption capacity with various mechanisms. The position of the first crack has been formulated based on P-δ (load- deflection response and P-ε (load - longitudinal deformation in the tensile zone response, which are used for calculation of the two toughness indices I5 and I10. The combination of steel fibres with different dimensions leads to a composite, having at the same time increased crack resistance, first crack formation, ductility and post-peak residual strength.

  18. Fracture toughness of irradiated Zr-2.5Nb pressure tube from Indian PHWR

    Science.gov (United States)

    Shah, Priti Kotak; Dubey, J. S.; Shriwastaw, R. S.; Dhotre, M. P.; Bhandekar, A.; Pandit, K. M.; Anantharaman, S.; Singh, R. N.; Chakravartty, J. K.

    2015-03-01

    Fracture toughness of irradiated Zr-2.5Nb alloy pressure tube, fabricated by the cold pilgering and stress relieving route, was evaluated using disk compact tension type specimens. These specimens were punched out from the irradiated pressure tube (S-07), which was in service for about 8 effective full power years of reactor operation in the Kakrapar Atomic Power Station-2 (KAPS-2). The tests were carried out remotely inside a lead shielded enclosure. Crack growth during the test was measured using the direct current potential drop technique. The irradiated pressure tube showed low fracture toughness at 25 °C. The fracture toughness increased with increase in temperature up to 250 °C but was practically unaffected with further increase in temperature up to 300 °C. This paper discusses the fracture behavior of irradiated Indian pressure tube material and compares it with other data available.

  19. ''Spinolaminar breach'': an important sign in cervical spinous process fractures

    International Nuclear Information System (INIS)

    Matar, L.D.; Helms, C.A.

    2000-01-01

    Objective. To report the sign of ''spinolaminar breach'' and its likely importance in fractures of the cervical spinous processes.Design. Six cases of spinous process fractures demonstrating disruption of the spinolaminar line or ''spinolaminar breach'' were analyzed. Lateral and anteroposterior radiographs (n=6), CT scans (n=3) and MRI scans (n=1) were reviewed together by the authors, with consensus being reached as to the radiographic findings. Clinical records were also reviewed.Results. The levels of injury were C6 (n=5) and C5 (n=2). Injuries were associated with delayed anterior subluxation (n=4) and neurological deficit (n=2). Five patients were male and one was female with a mean age of 31 years (range 8-59 years). Injuries resulted from motor vehicle accidents (n=4), a motor cycle accident (n=1) and a fall (n=1).Conclusion. ''Spinolaminar breach'', or disruption of the spinolaminar line, indicates a complex spinous process fracture with extension into the lamina and spinal canal. Spinous process fractures with spinolaminar breach may have associated posterior ligamentous injury with potential for delayed instability and neurological deficit. It is important that radiologists and physicians caring for the trauma patient be aware of this sign in order to avoid misdiagnosis as a ''clay shoveler's fracture'', which can lead to adverse outcome. (orig.)

  20. Proximal Tibial Epiphysis Fracture in a 13-Year-Old Male Athlete

    Directory of Open Access Journals (Sweden)

    Ioannis M. Stavrakakis

    2017-01-01

    Full Text Available Fractures of the proximal epiphysis of the tibia are rare, representing 0.5 to 3.0% of all epiphyseal injuries. These injuries can damage the popliteal vessels and their bifurcation, affecting the blood supply of the lower limb, as well as the nerves below the knee. Epiphyseal growth arrest is also a potential complication, leading to various angular deformities. We present a case of a 13-year-old male athlete with a posteriorly displaced Salter-Harris type II fracture of the proximal epiphysis of the left tibia who was treated conservatively with closed reduction and cast immobilization.

  1. Tibial Plateau Fractures

    DEFF Research Database (Denmark)

    Elsøe, Rasmus

    This PhD thesis reported an incidence of tibial plateau fractures of 10.3/100,000/year in a complete Danish regional population. The results reported that patients treated for a lateral tibial plateau fracture with bone tamp reduction and percutaneous screw fixation achieved a satisfactory level...... with only the subgroup Sport significantly below the age matched reference population. The thesis reports a level of health related quality of life (Eq5d) and disability (KOOS) significantly below established reference populations for patients with bicondylar tibial plateau fracture treated with a ring...... fixator, both during treatment and at 19 months following injury. In general, the thesis demonstrates that the treatment of tibial plateau fractures are challenging and that some disabilities following these fractures must be expected. Moreover, the need for further research in the area, both with regard...

  2. Leakage losses from a hydraulic fracture and fracture propagation

    International Nuclear Information System (INIS)

    Johnson, R.E.; Gustafson, C.W.

    1988-01-01

    The fluid mechanics of viscous fluid injection into a fracture embedded in a permeable rock formation is studied. Coupling between flow in the fracture and flow in the rock is retained. The analysis is based on a perturbation scheme that assumes the depth of penetration of the fluid into the rock is small compared to the characteristic length w 3 0 /k, where w 0 is the characteristic crack width and k is the permeability. This restriction, however, is shown to be minor. The spatial dependence of the leakage rate per unit length from the fracture is found to be linear, decreasing from the well bore to the fracture tip where it vanishes. The magnitude of the leakage rate per unit length is found to decay in time as t -1 /sup // 3 if the injection rate at the well bore is constant, and as t -1 /sup // 2 if the well bore pressure is held constant. The results cast considerable doubt on the validity of Carter's well-known leakage formula (Drilling Prod. Prac. API 1957, 261) derived from a one-dimensional theory. Using the simple fracture propagation model made popular by Carter, the present work also predicts that the fracture grows at a rate proportional to t 1 /sup // 3 for a fixed well bore injection rate and a rate proportional to t 1 /sup // 4 for a fixed well bore pressure

  3. Periprosthetic hip fractures: A review of the economic burden based on length of stay.

    Science.gov (United States)

    Lyons, Rebecca F; Piggott, Robert P; Curtin, William; Murphy, Colin G

    2018-03-01

    With the increasing rates of total hip replacements being performed worldwide, there is an increasing incidence of periprosthetic fractures. As our patients' demographics change to include older patients with multiple medical co-morbidities, there is a concurrent increase in morbidity and mortality rates. This leads to longer hospital stays and increasing hospital costs. In the current economic climate, the cost of treating periprosthetic fractures must be addressed and appropriate resource and funding allocation for future provision of services should be planned. All periprosthetic hip fractures that were admitted to a single trauma unit over a three-year period were reviewed. Independent chart review, haematological and radiological review was undertaken. All patients with a periprosthetic fracture associated with a total hip arthroplasty or hemiarthroplasty were included. Follow up data including complications were collated. Data from the hospital inpatient database and finance department was utilized for cost analysis. All statistical analysis was preformed using Minitab version 17. 48 patients were identified who met the inclusion criteria for review. The majority of participants were female with a mean age of 73.5 years. The mean time to fracture was 4.5 years (9 months-18.5 years). Periprosthetic fracture was associated with total hip arthroplasty in 24 cases and a Vancouver B2 classification was most common at n = 20. The majority of patients had revision arthroplasty, with a mean length of stay of 24 days for the whole cohort (9-42). Vancouver B3 fractures had the longest inpatient stay at a mean of 26 days. The mean cost of for a full revision of stem with additional plate and cable fixation was over €27000 compared to €14,600 for ORIF and cable fixation based on length of hospital stay. The prolonged length of stay associated with Vancouver B2 and B3 fractures leads to increased costs to the healthcare service. Accurately calculating

  4. Spontaneous rib fractures.

    Science.gov (United States)

    Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber

    2015-07-01

    Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.

  5. kISMET: Stress and fracture characterization in a deep mine

    Science.gov (United States)

    Oldenburg, C. M.; Dobson, P. F.; Daley, T. M.; Birkholzer, J. T.; Cook, P. J.; Ajo Franklin, J. B.; Rutqvist, J.; Siler, D.; Kneafsey, T. J.; Nakagawa, S.; Wu, Y.; Guglielmi, Y.; Ulrich, C.; Marchesini, P.; Wang, H. F.; Haimson, B. C.; Sone, H.; Vigilante, P.; Roggenthen, W.; Doe, T.; Lee, M.; Mattson, E.; Huang, H.; Johnson, T. C.; Morris, J.; White, J. A.; Johnson, P. A.; Coblentz, D. D.; Heise, J.

    2016-12-01

    We are developing a community facility called kISMET (permeability (k) and Induced Seismicity Management for Energy Technologies) at the Sanford Underground Research Facility (SURF) in Lead, SD. The purpose of kISMET is to investigate stress and the effects of rock fabric on hydraulic fracturing. Although findings from kISMET may have broad applications that inform stress and fracturing in anisotropic rock, results will be most applicable to improving control of hydraulic fracturing for enhanced geothermal systems (EGS) in crystalline rock. At the kISMET site on the 4850 ft (1480 m depth) level of SURF, we have drilled and cored an array of nearly vertical boreholes in Precambrian phyllite. The array consists of four 50-m deep monitoring boreholes surrounding one 100-m deep borehole forming a 6 m-wide five-spot pattern at a depth of 1530 m. Previous investigations of the stress field at SURF suggest that the principal stress s1 is nearly vertical. By aligning the kISMET boreholes approximately with σ1, fractures created in the center borehole should in theory be perpendicular to σ3, the least principal horizontal stress. But the phyllite at kISMET has a strong fabric (foliation) that could influence fracturing. Stress measurements and stimulation using hydraulic fracturing will be carried out in the center borehole using a straddle packer and high-pressure pump. We will use an impression packer and image logs after stress testing and stimulation to determine fracture orientation and extent at the center borehole. In order to study the control of stress, rock fabric, and stimulation approach on size, aperture, and orientation of hydraulic fractures, we will carefully monitor the stress measurements and stimulation. For example, we will use continuous active source seismic (CASSM) in two of the monitoring boreholes to measure changes in seismic-wave velocity as water fills the fracture. Second, near real-time electrical resistance tomography (ERT) will be used in

  6. Cough-induced rib fractures.

    Science.gov (United States)

    Sano, Atsushi; Tashiro, Ken; Fukuda, Tsutomu

    2015-10-01

    Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures. Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively. Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently. Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis. © The Author(s) 2015.

  7. Fracture Characterization of PVC Foam Core Sandwich Specimen Using the DCB-UBM Test Method

    DEFF Research Database (Denmark)

    Saseendran, Vishnu; Berggreen, Christian; Carlsson, Leif A.

    coupled with experimental validation is paramount to determine the fracture resistance of the face/core interface. In this paper, the test-rig exploiting the double cantilever beam with uneven bending moments (DCB-UBM) concept is used to determine the fracture toughness of PVC foam core sandwich......Face/core debond failure in sandwich composites is a critical failure mode. Lack of cohesion between face and core will lead to loss of structural integrity. The estimation of interface fracture toughness especially at the face/core interface is extremely challenging, provided the dissimilarity...... composites. The DCB-UBM test enables fracture testing over a large range of mode-mixities as expressed by a phase angle (ψ) which is a measure of the amount of shear loading at the crack tip. A desired phase angle may be achieved by changing the moment-ratio (MR = Md/Ms)....

  8. Mechanics of the Delayed Fracture of Viscoelastic Bodies with Cracks: Theory and Experiment (Review)

    Science.gov (United States)

    Kaminsky, A. A.

    2014-09-01

    Theoretical and experimental studies on the deformation and delayed fracture of viscoelastic bodies due to slow subcritical crack growth are reviewed. The focus of this review is on studies of subcritical growth of cracks with well-developed fracture process zones, the conditions that lead to their critical development, and all stages of slow crack growth from initiation to the onset of catastrophic growth. Models, criteria, and methods used to study the delayed fracture of viscoelastic bodies with through and internal cracks are analyzed. Experimental studies of the fracture process zones in polymers using physical and mechanical methods as well as theoretical studies of these zones using fracture mesomechanics models that take into account the structural and rheological features of polymers are reviewed. Particular attention is given to crack growth in anisotropic media, the effect of the aging of viscoelastic materials on their delayed fracture, safe external loads that do not cause cracks to propagate, the mechanism of multiple-flaw fracture of viscoelastic bodies with several cracks and, especially, processes causing cracks to coalesce into a main crack, which may result in a break of the body. Methods and results of solving two- and three-dimensional problems of the mechanics of delayed fracture of aging and non-aging viscoelastic bodies with cracks under constant and variable external loads, wedging, and biaxial loads are given

  9. Fracture analysis

    International Nuclear Information System (INIS)

    Ueng, Tzoushin; Towse, D.

    1991-01-01

    Fractures are not only the weak planes of a rock mass, but also the easy passages for the fluid flow. Their spacing, orientation, and aperture will affect the deformability, strength, heat transmittal, and fluid transporting properties of the rock mass. To understand the thermomechanical and hydrological behaviors of the rock surrounding the heater emplacement borehole, the location, orientation, and aperture of the fractures of the rock mass should be known. Borehole television and borescope surveys were performed to map the location, orientation, and aperture of the fractures intersecting the boreholes drilled in the Prototype Engineered Barrier System Field Tests (PEBSFT) at G-Tunnel. Core logging was also performed during drilling. However, because the core was not oriented and the depth of the fracture cannot be accurately determined, the results of the core logging were only used as reference and will not be discussed here

  10. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

    Full Text Available Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011. The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

  11. Investigation of the local fracture toughness and the elastic-plastic fracture behavior of NiAl and tungsten by means of micro-cantilever tests

    International Nuclear Information System (INIS)

    Ast, Johannes

    2016-01-01

    The objective of this work was to get an improved understanding of the size dependence of the fracture toughness. For this purpose notched micro-cantilevers were fabricated ranging in dimensions from the submicron regime up to some tens of microns by means of a focused ion beam. B2-NiAl and tungsten were chosen as model materials as their brittle to ductile transition temperatures are well above room temperature. In that way, fracture processes accompanied by limited plastic deformation around the crack tip could be studied at the micro scale. For this size regime, new methods to describe the local elastic-plastic fracture behavior and to measure the fracture toughness were elaborated. Particular focus was set on the J-integral concept which was adapted to the micro scale to derive crack growth from stiffness measurements. This allowed a precise analysis of the transition from crack tip blunting to stable crack growth which is necessary to accurately measure the fracture toughness. Experiments in single crystalline NiAl showed for the two investigated crack systems, namely the hard and the soft orientation, that the fracture toughness at the micro scale is the same as the one known from macroscopic testing. Thus, size effects were not found for the tested length scale. The addition of little amounts of iron did not affect the fracture toughness considerably. Yet, it influenced the crack growth in those samples and consequently the resistance curve behavior. Concerning experiments in single crystalline tungsten, the fracture toughness showed a clear dependency on sample size. The smallest cantilevers fractured purely by cleavage. Larger samples exhibited stable crack growth along with plastic deformation which was recognizable in SEM-micrographs and quantified by means of EBSD measurements. Just as in macroscopic testing, the investigated crack system {100} demonstrated a dependency on loading rate with higher loading rates leading to a more brittle behavior. This

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

    Science.gov (United States)

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

    2017-04-01

    The finding of considerable volumes of hydrocarbon resources within tight sedimentary rock formations in the UK led to focused attention on the fundamental fracture properties of low permeability rock types and hydraulic fracturing. Despite much research in these fields, there remains a scarcity of available experimental data concerning the fracture mechanics of fluid driven fracturing and the fracture properties of anisotropic, low permeability rock types. In this study, hydraulic fracturing is simulated in a controlled laboratory environment to track fracture nucleation (location) and propagation (velocity) in space and time and assess how environmental factors and rock properties influence the fracture process and the developing fracture network. Here we report data on employing fluid overpressure to generate a permeable network of micro tensile fractures in a highly anisotropic shale ( 50% P-wave velocity anisotropy). Experiments are carried out in a triaxial deformation apparatus using cylindrical samples. The bedding planes are orientated either parallel or normal to the major principal stress direction (σ1). A newly developed technique, using a steel guide arrangement to direct pressurised fluid into a sealed section of an axially drilled conduit, allows the pore fluid to contact the rock directly and to initiate tensile fractures from the pre-defined zone inside the sample. Acoustic Emission location is used to record and map the nucleation and development of the micro-fracture network. Indirect tensile strength measurements at atmospheric pressure show a high tensile strength anisotropy ( 60%) of the shale. Depending on the relative bedding orientation within the stress field, we find that fluid induced fractures in the sample propagate in two of the three principal fracture orientations: Divider and Short-Transverse. The fracture progresses parallel to the bedding plane (Short-Transverse orientation) if the bedding plane is aligned (parallel) with the

  13. Effects of local mechanical and fracture properties on LBB behavior of a dissimilar metal welded joint in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Du, L.Y.; Wang, G.Z., E-mail: gzwang@ecust.edu.cn; Xuan, F.Z.; Tu, S.T.

    2013-12-15

    Highlights: • Effect of local mechanical and fracture properties on LBB behavior were investigated. • Considering local mechanical properties leads to slightly high LBB curve. • Use of fracture resistance of base or weld will produce non-conservative LBB result. • Local fracture properties of interface region cannot be ignored in LBB analysis. - Abstract: In this paper, three-dimensional finite element models with and without considering local mechanical properties were built for a dissimilar metal welded joint (DMWJ) connected the safe end to pipe-nozzle of a reactor pressure vessel. The inner circumferential surface cracks were postulated at the interface of A508 steel and buttering Alloy52Mb. Based on the elastic–plastic fracture mechanics theory of J-integral, the crack growth stability was analyzed. The effects of the local mechanical and fracture resistance properties on LBB behavior were investigated. The results show that considering local mechanical properties leads to slightly high LBB curve. For the A508/Alloy52Mb interface region cracks in the DMWJ, if the fracture resistance curve of base metal A508 or the buttering Alloy52Mb is used, the non-conservative (unsafe) LBB assessment result will be produced. With increasing the applied bending moment, the degree of un-conservatism in LBB behavior becomes large. Therefore, to obtain accurate LBB assessment results, the local fracture resistance properties of the interface region should be used.

  14. An increased rate of falling leads to a rise in fracture risk in postmenopausal women with self-reported osteoarthritis: a prospective multinational cohort study (GLOW).

    Science.gov (United States)

    Prieto-Alhambra, Daniel; Nogues, Xavier; Javaid, M Kassim; Wyman, Allison; Arden, Nigel K; Azagra, Rafael; Cooper, Cyrus; Adachi, Jonathan D; Boonen, Steven; Chapurlat, Roland D; Compston, Juliet E; Gehlbach, Stephen H; Greenspan, Susan L; Hooven, Frederick H; Netelenbos, J Coen; Pfeilschifter, Johannes; Rossini, Maurizio; Sambrook, Philip N; Silverman, Stuart; Siris, Ethel S; Watts, Nelson B; Díez-Pérez, Adolfo

    2013-06-01

    Patients with osteoarthritis have increased bone mass but no decrease in fractures. The association between self-reported osteoarthritis and incident falls and fractures was studied in postmenopausal women. The Global Longitudinal Study of Osteoporosis in Women is a prospective multinational cohort of 60,393 non-institutionalised women aged ≥55 years who had visited primary care practices within the previous 2 years. Questionnaires were mailed at yearly intervals. Patients were classified as having osteoarthritis if they answered yes to the question, 'Has a doctor or other health provider ever said that you had osteoarthritis or degenerative joint disease?', and this was validated against primary care records in a subsample. Information on incident falls, fractures and covariates was self-reported. Cox and Poisson models were used for incident fractures and number of falls, respectively, to compute hazard ratios (HRs) and rate ratios (RRs) for baseline osteoarthritis status. Of 51 386 women followed for a median of 2.9 years (interquartile range 2.1-3.0), 20 409 (40%) reported osteoarthritis. The adjusted HR for osteoarthritis predicting fracture was 1.21 (95% CI 1.13 to 1.30; pfalls was 1.24 (95% CI 1.22 to 1.26; pfalls (HR 1.06 (95% CI 0.98 to 1.15; p=0.13)). Postmenopausal women with self-reported osteoarthritis have a 20% increased risk of fracture and experience 25% more falls than those without osteoarthritis. These data suggest that increased falls are the causal pathway of the association between osteoarthritis and fractures.

  15. Impact of surgical complications on length of stay after hip fracture surgery

    DEFF Research Database (Denmark)

    Foss, Nicolai Bang; Palm, Henrik; Krasheninnikoff, Michael

    2006-01-01

    BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact...... of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall...... showed that 64 complications (55%) were due to suboptimal surgery, 18 (16%) to infection, 6 (5%) to falls and 28 (24%) to no obvious cause. CONCLUSION: Surgical complications secondary to primary hip fracture surgery account for 27.1% of total hospital bed consumption within 6 months. Approximately, 50...

  16. Radiological study of the mandibular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun [Department of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju (Korea, Republic of)

    2009-06-15

    To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

  17. Radiological study of the mandibular fractures

    International Nuclear Information System (INIS)

    Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun

    2009-01-01

    To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

  18. Surface self-potential patterns related to transmissive fracture trends during a water injection test

    Science.gov (United States)

    DesRoches, A. J.; Butler, K. E.; MacQuarrie, K. TB

    2018-03-01

    Variations in self-potential (SP) signals were recorded over an electrode array during a constant head injection test in a fractured bedrock aquifer. Water was injected into a 2.2 m interval isolated between two inflatable packers at 44 m depth in a vertical well. Negative SP responses were recorded on surface corresponding to the start of the injection period with strongest magnitudes recorded in electrodes nearest the well. SP response decreased in magnitude at electrodes further from the well. Deflation of the packer system resulted in a strong reversal in the SP signal. Anomalous SP patterns observed at surface at steady state were found to be aligned with dominant fracture strike orientations found within the test interval. Numerical modelling of fluid and current flow within a simplified fracture network showed that azimuthal patterns in SP are mainly controlled by transmissive fracture orientations. The strongest SP gradients occur parallel to hydraulic gradients associated with water flowing out of the transmissive fractures into the tighter matrix and other less permeable cross-cutting fractures. Sensitivity studies indicate that increasing fracture frequency near the well increases the SP magnitude and enhances the SP anomaly parallel to the transmissive set. Decreasing the length of the transmissive fractures leads to more fluid flow into the matrix and into cross-cutting fractures proximal to the well, resulting in a more circular and higher magnitude SP anomaly. Results from the field experiment and modelling provide evidence that surface-based SP monitoring during constant head injection tests has the ability to identify groundwater flow pathways within a fractured bedrock aquifer.

  19. Estimation of the controlling stress in creep fracture

    International Nuclear Information System (INIS)

    Henderson, J.; Ferguson, F.R.

    1975-01-01

    The implementation of correct criterion in creep design, has been shown to be of fundamental significance in the assessment of component life. The present report considers the problem of the means whereby the criterion may be derived for a particular metal without the availability of sophisticated complex-stress testing equipment and procedures such as the combined tension and torsion tests on thin walled tubular specimens employed in the earlier fundamental researches on the subject. By investigating a wide spectrum of engineering metals it was established that for homogeneous stress conditions two criteria appeared to be sufficient to cover all the metals studied for complex-stress creep fracture, either the maximum principal stress or the octahedral shear stress criterion. Further, it was found that those metals which developed random and continuous cracking during creep were controlled with respect to fracture time by the maximum principal stress, while metals which showed virtually no cracking were governed by the octahedral shear stress or second order invariant. The physical nature of the final fracture (transcrystalline or inter-crystalline), contrary to considerable current concepts, was found to be unrelated to which criterion was operative. Having reduced the possible fracture criteria to two, it only remained to develop a simple test method exploiting this finding to achieve the precise identification for a particular metal. Seven metals including aluminium, copper, titanium, cast iron and three steels have been investigated in the present report at temperatures where creep conditions are operative. The results have shown that the method leads to sufficiently accurate prediction of the complex stress creep fracture criterion for the metals studied

  20. [Periprosthetic knee fractures].

    Science.gov (United States)

    Mittlmeier, T; Beck, M; Bosch, U; Wichelhaus, A

    2016-01-01

    The cumulative incidence of periprosthetic fractures around the knee is increasing further because of an extended indication for knee replacement, previous revision arthroplasty, rising life expectancy and comorbidities. The relevance of local parameters such as malalignment, osseous defects, neighbouring implants, aseptic loosening and low-grade infections may sometimes be hidden behind the manifestation of a traumatic fracture. A differentiated diagnostic approach before the treatment of a periprosthetic fracture is of paramount importance, while the physician in-charge should also have particular expertise in fracture treatment and in advanced techniques of revision endoprosthetics. The following work gives an overview of this topic. Valid classifications are available for categorising periprosthetic fractures of the femur, the tibia and the patella respectively, which are helpful for the selection of treatment. With the wide-ranging modern treatment portfolio bearing in mind the substantial rate of complications and the heterogeneous functional outcome, the adequate analysis of fracture aetiology and the corresponding transformation into an individualised treatment concept offer the chance of an acceptable functional restoration of the patient at early full weight-bearing and prolonged implant survival. The management of complications is crucial to the final outcome.

  1. Fracture sacrum.

    Directory of Open Access Journals (Sweden)

    Dogra A

    1995-04-01

    Full Text Available An extremely rare case of combined transverse and vertical fracture of sacrum with neurological deficit is reported here with a six month follow-up. The patient also had an L1 compression fracture. The patient has recovered significantly with conservative management.

  2. Surgical Management of Proximal Interphalangeal Joint Repetitive Stress Epiphyseal Fracture Nonunion in Elite Sport Climbers.

    Science.gov (United States)

    El-Sheikh, Yasser; Lutter, Chris; Schoeffl, Isabelle; Schoeffl, Volker; Flohe, Sascha

    2017-11-14

    Repetitive stress fracture of the middle phalanx epiphysis is an injury specific to elite adolescent sport climbers. As sport climbing becomes increasingly popular in younger age groups, an increased number of these injuries have been reported in recent years. To date, treatment of these fractures has been nonsurgical, with strict rest and physiotherapy prescribed until fracture union. However, when these patients present in a delayed fashion with an established nonunion, nonsurgical treatment may fail, leading to disabling chronic pain and/or digital deformity in some cases. In this article, we present 2 cases of surgical treatment for finger middle phalanx repetitive stress epiphyseal fracture nonunion, using a percutaneous spot drilling epiphysiodesis technique. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  3. Computed tomography in the evaluation of thoracic and lumbar spinal fracture

    International Nuclear Information System (INIS)

    Kim, Byung Tae; Cho, Chi Ja; Lee, Jeung Sik

    1983-01-01

    The accurate diagnosis of spine trauma is essential to its proper management, since therapeutic decisions depend on radiography and clinical data. Failure to recognize significant injury to the spine can lead to severe neurological deficit in the previously neulogically intact patient. The development of CT has open a new dimension in evaluation of spinal column. In our experience CT not only offer the accurate and thorough evaluation of spinal injury, but does so in a rapid and more efficient manner when compared with conventional radiography. CT has become the diagnostic procedure of choice when screening plain film and clinical examination indicate that a comprehensive radiographic evaluation is necessary. Eighteen patients with thoracic and lumber spinal fracture were studied with CT. Four had multiple level injuries. The results are summarized as follow; 1. Among the 18 patients, 4 had multiple level injuries and other 14 patients had single spinal injury. 2. 8 patients (11 spines) had simple compression fracture and 12 patients (13 spines) had burst fracture of vertebral body. 3. 15 spines among the 24 involved spines are located at T12 and L1 level. 4. Spinal canal narrowing and bony fragment in the canal are defined only 7 of 13 spines (53.8%) of burst fracture in conventional radiography. However CT showed in all spines of burst fracture. 5. Spinal posterior element involvement is suggested only one of 12 spines of burst fracture, but correctly interpretated by CT in 7 spines (11 anatomical position)

  4. Dynamic fracture characterization of material

    International Nuclear Information System (INIS)

    Kobayashi, A.S.; Emery, A.F.; Liaw, B.M.

    1981-01-01

    The influences of a wide range of material properties, i.e. of A533B steel, a silicon nitride ceramic and a Homalite-100 photoelastic polymer, as well as the influences of the specimen sizes on the dynamic fracture response of fracture specimens are presented in this paper. The results of a numerical study show that the dynamic fracture responses of these fracture specimens of proportional dimensions were indistinguishable provided the normalized dynamic fracture toughness versus normalized crack velocity relations of the three materials coincide. The limited results suggest that should the normalized dynamic fracture toughness versus normalized crack velocity relations between prototype and model materials coincide, then dynamic fracture experiments on scaled models can be used to infer the dynamic fracture response of the prototype. (orig./HP)

  5. [Hip Fracture--Epidemiology, Management and Liaison Service. Risk factor for hip fracture].

    Science.gov (United States)

    Fujiwara, Saeko

    2015-04-01

    Many risk factors have been identified for hip fracture, including female, advanced age, osteoporosis, previous fractures, low body weight or low body mass index, alcohol drinking, smoking, family history of fractures, use of glucocorticoid, factors related to falls, and bone strength. The factors related to falls are number of fall, frail, post stroke, paralysis, muscle weakness, anti-anxiety drugs, anti-depression drugs, and sedatives. Dementia and respiratory disease and others have been reported to be risk factors for secondary hip fracture.

  6. Experimental and theoretical fracture mechanics applied to volcanic conduits and domes

    Science.gov (United States)

    Sammonds, P.; Matthews, C.; Kilburn, C.; Smith, R.; Tuffen, H.; Meredith, P.

    2008-12-01

    We present an integrated modelling and experimental approach to magma deformation and fracture, which we attempt to validate against field observations of seismicity. The importance of fracture processes in magma ascent dynamics and lava dome growth and collapse are apparent from the associated seismicity. Our laboratory experiments have shown that brittle fracture of magma can occur at high temperature and stress conditions prevalent in the shallow volcanic system. Here, we use a fracture mechanics approach to model seismicity preceding volcanic eruptions. Starting with the fracture mechanics concept of a crack in an elastic body, we model crack growth around the volcanic conduit through the processes of crack interactions, leading either to the propagation and linkage of cracks, or crack avoidance and the inhibition of crack propagation. The nature of that interaction is governed by the temperature and plasticity of the magma. We find that fracture mechanics rules can account for the style of seismicity preceding eruptions. We have derived the changes in seismic b-value predicted by the model and interpret these in terms of the style of fracturing, fluid flow and heat transport. We compare our model with results from our laboratory experiments where we have deformed lava at high temperatures under triaxial stresses. These experiments were conducted in dry and water saturated conditions at effective pressures up to 10 MPa, temperatures up to 1000°C and strain rates from 10-4 s-1 to 10-6 s-1. The behaviour of these magmas was largely brittle under these conditions. We monitored the acoustic emission emitted and calculate the change in micro-seismic b-value with deformation. These we find are in accord with volcano seismicity and our fracture mechanics model.

  7. Frequency of extradural haematoma in patients with linear skull fracture

    International Nuclear Information System (INIS)

    Aurangzeb, A.; Afridi, E.A.K.; Khan, S.A.

    2015-01-01

    Apparently normal looking patients after traumatic brain injury can have serious neurological deterioration, and one of the common causes of such deterioration is extradural haematomas. This study was conducted to determine the frequency of extradural hematoma and common types of trauma leading to it among patients presenting with skull fracture due to head injury. Methods: This cross-sectional study was conducted in the department of Neurosurgery Ayub Medical College, Abbottabad from June 2011 to June 2012. All patients who were suspected to have Skull fracture on X-ray skull, during the study period, were included in study after informed consent and later on CT-Scan brain was done to see for extradural hematoma. Findings were recorded on a predesigned proforma including demographic data, radiological findings and the type of head trauma. Results: Out of 114 patients 85 (74.5%) were males and 29 (225.4%) were females. Age ranged from 2 to 70 years (18.23 ± 16.5 years). Among these patients the most important cause of head injury was fall from height in 65(57%), followed by road traffic accidents in 39 (34.2%), and assault in 10 (8.8%) patients. The most common site of fracture was parietal in 49 (43%) of patients, followed by frontal bone in 28 (24.6%) of patients, occipital bone in 24 (21.1%) of patients, and temporal bone in 23 (20.2%) of patients. Frequency of extradural hematoma among linear skull fracture was in 34 (29.8%) patients. Extradural hematoma was most common with parietotemporal linear skull fractures (73.5%). Conclusion: Extradural haematoma occurs commonly with linear skull fractures, so patients with linear skull fracture should be properly evaluated with CT brain. (author)

  8. Simulating Dynamic Fracture in Oxide Fuel Pellets Using Cohesive Zone Models

    Energy Technology Data Exchange (ETDEWEB)

    R. L. Williamson

    2009-08-01

    cracking) assumptions. A 3D model is then developed, permitting simultaneous radial and axial fractures. Although fuel cracking is clearly three-dimensional, 2D models are of interest since they are simpler to implement, are much less computationally intensive, and have potential application to existing 2D fuel performance codes. Numerical issues related to cohesive zone models, such as mesh dependency and viscous stabilization, are addressed. Model results indicate that for typical oxide fuel properties, both axial and radial cracking occurs during initial heat-up, well before steady-state thermal gradients are established in the pellet. Cracking results in local stress relief and a shift in peak stress locations, leading to the initiation of new cracks. Continued growth of existing cracks, plus the initiation and growth of additional fractures, is observed during steady operation and power ramping. 3D models provide considerable insight into the progressive interactions between radial and axial cracking. Parametric studies demonstrate the effects of temperature dependent material properties on crack initiation and progression. Increasing fracture strength and toughness with temperature, leads to crack arrest in high temperature regions near the pellet’s symmetry axis.

  9. Fractures (Broken Bones): First Aid

    Science.gov (United States)

    First aid Fractures (broken bones) Fractures (broken bones): First aid By Mayo Clinic Staff A fracture is a ... 10, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-fractures/basics/ART-20056641 . Mayo Clinic ...

  10. Stress fractures of the rib arising from the manufactory assembly line

    International Nuclear Information System (INIS)

    Arima, Toru; Iwasaki, Masayuki

    2007-01-01

    serratus anterior muscle, leading to a stress fracture of the rib. It was worthy of note that the 3D-CT revealed an avulsion of the said muscle in one case. To prevent stress fractures of the rib arising from the assembly line, such measures are considered as muscle training of the shoulder girdle, especially the serratus anterior, maintenance of physical condition, meticulous work orientation, innovation of the assembly line etc. (author)

  11. Image diagnosis of nasal bone fracture

    International Nuclear Information System (INIS)

    Hirota, Yoshiharu; Shimizu, Yayoi; Iinuma, Toshitaka.

    1988-01-01

    Twenty cases of nasal bone fractures were evaluated as to the types of fractures based upon HRCT findings. Conventional X-Ray films for nasal bones were analyzed and compared with HRCT findings. Nasal bone fractures were classified into lateral and frontal fractures. HRCT images were evaluated in three planes including upper, middle and lower portions of the nasal bone. Fractures favored males of teens. Lateral fracture gave rise to the fractures of the nasal bone opposite to the external force, loosening of the ipsilateral nasomaxillary sutures and fractures of the frontal process of the maxilla. Conventional X-Ray films were reevaluated after HRCT evaluation and indications of nasal bone fractures were determined. In addition to the discontinuity of the nasal dorsum, fracture lines parallel to and beneath the nasal dorsum and indistinct fracture lines along the nasomaxillary sutures are the indication of nasal bone fractures by conventional X-Ray films. (author)

  12. Polymer liquids fracture like solids

    DEFF Research Database (Denmark)

    Huang, Qian; Hassager, Ole

    2017-01-01

    While fracture in brittle solids has been studied for centuries until today, there are few studies on fracture in polymer liquids. Recent developments in experimental techniques, especially the combination of controlled filament stretching rheometry and high speed imaging, have opened new windows...... into the detailed study of fracture processes for polymer liquids. High speed imaging shows that polymer liquids fracture like solids with initiation and propagation of an edge fracture. However, remarkable features such as highly reproducible critical stress, independent appearance of multiple fractures...

  13. Traumatic subchondral fracture of the femoral head in a healed trochanteric fracture.

    Science.gov (United States)

    Lee, Sang Yang; Niikura, Takahiro; Iwakura, Takashi; Kurosaka, Masahiro

    2014-07-11

    An 82-year-old woman sustained a trochanteric fracture of the left femur after a fall. Fracture fixation was performed using proximal femoral nail antirotation (PFNA) II, and she was able to walk with a T-cane after 3 months. Eleven months following the operation, the patient presented with left hip pain after a fall. Radiographs showed a subchondral collapse of the femoral head located above the blade tip. The authors removed the PFNA-II and subsequently performed cemented bipolar hemiarthroplasty. Histological evaluation of the femoral head showed osteoporosis with no evidence of osteonecrosis. Repair tissue, granulation tissue and callus formation were seen at the collapsed subchondral area. Based on these findings, a traumatic subchondral fracture of the femoral head in a healed trochanteric fracture was diagnosed. A traumatic subchondral fracture of the femoral head may need to be considered as a possible diagnosis after internal fixation of the trochanteric fracture. 2014 BMJ Publishing Group Ltd.

  14. Evaluation of scale effects on hydraulic characteristics of fractured rock using fracture network model

    International Nuclear Information System (INIS)

    Ijiri, Yuji; Sawada, Atsushi; Uchida, Masahiro; Ishiguro, Katsuhiko; Umeki, Hiroyuki; Sakamoto, Kazuhiko; Ohnishi, Yuzo

    2001-01-01

    It is important to take into account scale effects on fracture geometry if the modeling scale is much larger than the in-situ observation scale. The scale effect on fracture trace length, which is the most scale dependent parameter, is investigated using fracture maps obtained at various scales in tunnel and dam sites. We found that the distribution of fracture trace length follows negative power law distribution in regardless of locations and rock types. The hydraulic characteristics of fractured rock is also investigated by numerical analysis of discrete fracture network (DFN) model where power law distribution of fracture radius is adopted. We found that as the exponent of power law distribution become larger, the hydraulic conductivity of DFN model increases and the travel time in DFN model decreases. (author)

  15. Dynamic Fracturing Behavior of Layered Rock with Different Inclination Angles in SHPB Tests

    Directory of Open Access Journals (Sweden)

    Jiadong Qiu

    2017-01-01

    Full Text Available The fracturing behavior of layered rocks is usually influenced by bedding planes. In this paper, five groups of bedded sandstones with different bedding inclination angles θ are used to carry out impact compression tests by split Hopkinson pressure bar. A high-speed camera is used to capture the fracturing process of specimens. Based on testing results, three failure patterns are identified and classified, including (A splitting along bedding planes; (B sliding failure along bedding planes; (C fracturing across bedding planes. The failure pattern (C can be further classified into three subcategories: (C1 fracturing oblique to loading direction; (C2 fracturing parallel to loading direction; (C3 mixed fracturing across bedding planes. Meanwhile, a numerical model of layered rock and SHPB system are established by particle flow code (PFC. The numerical results show that the shear stress is the main reason for inducing the damage along bedding plane at θ = 0°~75°. Both tensile stress and shear stress on bedding planes contribute to the splitting failure along bedding planes when the inclination angle is 90°. Besides, tensile stress is the main reason that leads to the damage in rock matrixes at θ = 0°~90°.

  16. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

    Full Text Available The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

  17. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

    Full Text Available The incidence of condylar fractures is high,but the management of fractures of the mandibularcondyle continues to be controversial. Historically, maxillomandibular fixation, externalfixation, and surgical splints with internal fixation systems were the techniques commonlyused in the treatment of the fractured mandible. Condylar fractures can be extracapsularor intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on theage of the patient, the co-existence of other mandibular or maxillary fractures, whether thecondylar fracture is unilateral or bilateral, the level and displacement of the fracture, thestate of dentition and dental occlusion, and the surgeonnds on the age of the patient, theco-existence of othefrom which it is difficult to recover aesthetically and functionally;anappropriate treatment is required to reconstruct the shape and achieve the function oftheuninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, andcomplication prevention are required. In particular, as mandibular condyle fracture may causelong-term complications such as malocclusion, particularly open bite, reduced posterior facialheight, and facial asymmetry in addition to chronic pain and mobility limitation, great cautionshould be taken. Accordingly, the authors review a general overview of condyle fracture.

  18. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    Science.gov (United States)

    Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

  19. 3-D description of fracture surfaces and stress-sensitivity analysis for naturally fractured reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, S.Q.; Jioa, D.; Meng, Y.F.; Fan, Y.

    1997-08-01

    Three kinds of reservoir cores (limestone, sandstone, and shale with natural fractures) were used to study the effect of morphology of fracture surfaces on stress sensitivity. The cores, obtained from the reservoirs with depths of 2170 to 2300 m, have fractures which are mated on a large scale, but unmated on a fine scale. A specially designed photoelectric scanner with a computer was used to describe the topography of the fracture surfaces. Then, theoretical analysis of the fracture closure was carried out based on the fracture topography generated. The scanning results show that the asperity has almost normal distributions for all three types of samples. For the tested samples, the fracture closure predicted by the elastic-contact theory is different from the laboratory measurements because plastic deformation of the aspirates plays an important role under the testing range of normal stresses. In this work, the traditionally used elastic-contact theory has been modified to better predict the stress sensitivity of reservoir fractures. Analysis shows that the standard deviation of the probability density function of asperity distribution has a great effect on the fracture closure rate.

  20. In-situ Investigation of the Fracture Behaviors of 2195-T8 Aluminum-Lithium alloy

    Directory of Open Access Journals (Sweden)

    Wang Liang

    2016-01-01

    Full Text Available In this paper, the tensile crack initiation and propagation behavior of 2195-T8 Aluminum-Lithium alloy was studied by in situ scanning electron microscope observation at room temperature. It was found that cracks initiated at second phases which propagated along the grain boundaries only as T1 phases could retard crack growth inside grains. With further increase of strain, within the grain a large number of slip bands were produced, resulting in the deflection of the grains, which leaded to transgranular fracture at last. SEM examination show both intergranular and transgranular fracture surface morphology indicating that the 2195-T8 alloy revealed a mix mechanism for the fracture.

  1. Why ductile fracture mechanics

    International Nuclear Information System (INIS)

    Ritchie, R.O.

    1983-01-01

    Until recently, the engineering application of fracture mechanics has been specific to a description of macroscopic fracture behavior in components and structural parts which remain nominally elastic under loading. While this approach, termed linear elastic fracture mechanics, has been found to be invaluable for the continuum analysis of crack growth in brittle and high strength materials, it is clearly inappropriate for characterizing failure in lower strength ductile alloys where extensive inelastic deformation precedes and accompanies crack initiation and subsequent propagation. Accordingly, much effort has been devoted in recent years toward the development of nonlinear or ductile fracture mechanics methodology to characterize fracture behavior under elastic/plastic conditions; an effort which has been principally motivated by problems in nuclear industry. In this paper, the concepts of ductile (elastic/plastic) fracture mechanics are introduced and applied to the problem of both stationary and nonstationary cracks. Specifically, the limitations inherent in this approach are defined, together with a description of the microstructural considerations and applications relevant to the failure of ductile materials by fracture, fatigue, and creep

  2. Dynamic fracture toughness and evaluation of fracture in a ferritic nodular cast iron for casks

    International Nuclear Information System (INIS)

    Yasunaka, T.; Nakano, K.

    1993-01-01

    The effect of loading rate and temperature on fracture toughness of a ferritic nodular cast iron obtained from a thick-walled cylindrical casting has been investigated. Based upon this result, the cast iron is evaluated as a material for casks. (1) In the ductile fracture region, fracture toughness increases with increases in loading rate. (2) Ductile-brittle transition temperature is linearly related to the logarithm of stress intensity rate. (3) In the ductile fracture region, converted plain strain fracture toughness divided by yield stress can be adopted as a material constant which is independent of loading rate and temperature. From the result of a static fracture toughness test, the evaluation of fracture in high loading rate can be made. (4) In the ductile fracture region of the material investigated, the maximum allowable flaw depth exceeded the minimum detectable flaw size by a nondestructive inspection. Ferritic nodular cast iron can be used as a material for casks in the ductile fracture region at least. (J.P.N.)

  3. Quasi-static analysis of elastic behavior for some systems having higher fracture densities.

    Energy Technology Data Exchange (ETDEWEB)

    Berryman, J.G.; Aydin, A.

    2009-10-15

    Elastic behavior of geomechanical systems with interacting (but not intersecting) fractures is treated using generalizations of the Backus and the Schoenberg-Muir methods for analyzing layered systems whose layers are intrinsically anisotropic due to locally aligned fractures. By permitting the axis of symmetry of the locally anisotropic compliance matrix for individual layers to differ from that of the layering direction, we derive analytical formulas for interacting fractured regions with arbitrary orientations to each other. This procedure provides a systematic tool for studying how contiguous, but not yet intersecting, fractured domains interact, and provides a direct (though approximate) means of predicting when and how such interactions lead to more dramatic weakening effects and ultimately to failure of these complicated systems. The method permits decomposition of the system elastic behavior into specific eigenmodes that can all be analyzed, and provides a better understanding about which of these specific modes are expected to be most important to the evolving failure process.

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

    Science.gov (United States)

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

    2013-01-01

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

  5. Fracture Characterization in Reactive Fluid-Fractured Rock Systems Using Tracer Transport Data

    Science.gov (United States)

    Mukhopadhyay, S.

    2014-12-01

    Fractures, whether natural or engineered, exert significant controls over resource exploitation from contemporary energy sources including enhanced geothermal systems and unconventional oil and gas reserves. Consequently, fracture characterization, i.e., estimating the permeability, connectivity, and spacing of the fractures is of critical importance for determining the viability of any energy recovery program. While some progress has recently been made towards estimating these critical fracture parameters, significant uncertainties still remain. A review of tracer technology, which has a long history in fracture characterization, reveals that uncertainties exist in the estimated parameters not only because of paucity of scale-specific data but also because of knowledge gaps in the interpretation methods, particularly in interpretation of tracer data in reactive fluid-rock systems. We have recently demonstrated that the transient tracer evolution signatures in reactive fluid-rock systems are significantly different from those in non-reactive systems (Mukhopadhyay et al., 2013, 2014). For example, the tracer breakthrough curves in reactive fluid-fractured rock systems are expected to exhibit a long pseudo-state condition, during which tracer concentration does not change by any appreciable amount with passage of time. Such a pseudo-steady state condition is not observed in a non-reactive system. In this paper, we show that the presence of this pseudo-steady state condition in tracer breakthrough patterns in reactive fluid-rock systems can have important connotations for fracture characterization. We show that the time of onset of the pseudo-steady state condition and the value of tracer concentration in the pseudo-state condition can be used to reliably estimate fracture spacing and fracture-matrix interface areas.

  6. Osteoporotic fractures in older adults

    OpenAIRE

    Colón-Emeric, Cathleen S.; Saag, Kenneth G.

    2006-01-01

    Osteoporotic fractures are emerging as a major public health problem in the aging population. Fractures result in increased morbidity, mortality and health expenditures. This article reviews current evidence for the management of common issues following osteoporotic fractures in older adults including: (1) thromboembolism prevention; (2) delirium prevention; (3) pain management; (4) rehabilitation; (5) assessing the cause of fracture; and (6) prevention of subsequent fractures. Areas for prac...

  7. Fracture Propagation and Permeability Change under Poro-thermoelastic Loads & Silica Reactivity in Enhanced Geothermal Systems

    Energy Technology Data Exchange (ETDEWEB)

    Ahmad Ghassemi

    2009-10-01

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

  8. Dependence of fracture mechanical and fluid flow properties on fracture roughness and sample size

    International Nuclear Information System (INIS)

    Tsang, Y.W.; Witherspoon, P.A.

    1983-01-01

    A parameter study has been carried out to investigate the interdependence of mechanical and fluid flow properties of fractures with fracture roughness and sample size. A rough fracture can be defined mathematically in terms of its aperture density distribution. Correlations were found between the shapes of the aperture density distribution function and the specific fractures of the stress-strain behavior and fluid flow characteristics. Well-matched fractures had peaked aperture distributions that resulted in very nonlinear stress-strain behavior. With an increasing degree of mismatching between the top and bottom of a fracture, the aperture density distribution broadened and the nonlinearity of the stress-strain behavior became less accentuated. The different aperture density distributions also gave rise to qualitatively different fluid flow behavior. Findings from this investigation make it possible to estimate the stress-strain and fluid flow behavior when the roughness characteristics of the fracture are known and, conversely, to estimate the fracture roughness from an examination of the hydraulic and mechanical data. Results from this study showed that both the mechanical and hydraulic properties of the fracture are controlled by the large-scale roughness of the joint surface. This suggests that when the stress-flow behavior of a fracture is being investigated, the size of the rock sample should be larger than the typical wave length of the roughness undulations

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

    Science.gov (United States)

    Langenhan, R; Reimers, N; Probst, A

    2014-12-01

    both sides. The DASH, Constant-Murley, Oxford shoulder and clavicular scores (Jubel) were calculated. Patients documented contentedness of outcome by VAS between 0 (absolute discontented) and 10 (very contented). Complications were recorded. Operatively treated displaced midshaft clavicular fractures. in comparison to the healthy side in group A had an average shortening of 5 (0-20) mm and in group B of 10 (3-25) mm, with a statistical significance between both groups. Patients of both groups were very contented with the results (VAS group A: 9.6; B: 9.5). DASH score (group A: 28; B: 3.1), Constant-Murley score (group A: 95.0; B: 93.8), Oxford shoulder score (group A: 46.2; B: 45.9) and the clavicula score (Jubel) (group A: 1.2; B: 2.1) were comparable between both groups without significance. In 4 patients (11%) complications occurred. Once (group B) an infection was seen, three times (group B) the ESIN had to be shortened on the medial side because of telescoping. Open ESIN of simple and complex displaced midshaft clavicular fractures leads after an average of 27 months to good or even excellent results. Healing of the clavicle in a modestly shortened position does not impair the patient. Georg Thieme Verlag KG Stuttgart · New York.

  10. Epidemiology of racing injuries in Thoroughbred racehorses with special reference to bone fractures: Japanese experience from the 1980s to 2000s

    OpenAIRE

    MAEDA, Yousuke; HANADA, Michiko; OIKAWA, Masa-aki

    2016-01-01

    ABSTRACT This report describes the descriptive epidemiology of racing fractures that occurred from the 1980s to 2000s on racetracks of the Japan Racing Association (JRA). The incidence of racehorse fractures during flat racing was approximately 1?2%. Fractures occurring during a race are more likely to occur in a forelimb. Fractures mostly occur at the third and fourth corners of oval tracks and on the home stretch. They also occur more frequently at the time of changing the leading limb. Com...

  11. Effects of fracture distribution and length scale on the equivalent continuum elastic compliance of fractured rock masses

    Directory of Open Access Journals (Sweden)

    Marte Gutierrez

    2015-12-01

    Full Text Available Fracture systems have strong influence on the overall mechanical behavior of fractured rock masses due to their relatively lower stiffness and shear strength than those of the rock matrix. Understanding the effects of fracture geometrical distribution, such as length, spacing, persistence and orientation, is important for quantifying the mechanical behavior of fractured rock masses. The relation between fracture geometry and the mechanical characteristics of the fractured rock mass is complicated due to the fact that the fracture geometry and mechanical behaviors of fractured rock mass are strongly dependent on the length scale. In this paper, a comprehensive study was conducted to determine the effects of fracture distribution on the equivalent continuum elastic compliance of fractured rock masses over a wide range of fracture lengths. To account for the stochastic nature of fracture distributions, three different simulation techniques involving Oda's elastic compliance tensor, Monte Carlo simulation (MCS, and suitable probability density functions (PDFs were employed to represent the elastic compliance of fractured rock masses. To yield geologically realistic results, parameters for defining fracture distributions were obtained from different geological fields. The influence of the key fracture parameters and their relations to the overall elastic behavior of the fractured rock mass were studied and discussed. A detailed study was also carried out to investigate the validity of the use of a representative element volume (REV in the equivalent continuum representation of fractured rock masses. A criterion was also proposed to determine the appropriate REV given the fracture distribution of the rock mass.

  12. Mathematical and computational analyses of cracking formation fracture morphology and its evolution in engineering materials and structures

    CERN Document Server

    Sumi, Yoichi

    2014-01-01

    This book is about the pattern formation and the evolution of crack propagation in engineering materials and structures, bridging mathematical analyses of cracks based on singular integral equations, to computational simulation of engineering design. The first two parts of this book focus on elasticity and fracture and provide the basis for discussions on fracture morphology and its numerical simulation, which may lead to a simulation-based fracture control in engineering structures. Several design concepts are discussed for the prevention of fatigue and fracture in engineering structures, including safe-life design, fail-safe design, damage tolerant design. After starting with basic elasticity and fracture theories in parts one and two, this book focuses on the fracture morphology that develops due to the propagation of brittle cracks or fatigue cracks.   In part three, the mathematical analysis of a curved crack is precisely described, based on the perturbation method. The stability theory of interactive ...

  13. Basic principles of fracture treatment in children.

    Science.gov (United States)

    Ömeroğlu, Hakan

    2018-04-01

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

  14. Plain film analysis of acetabular fracture

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan [Inje Medical College Paik Hospital, Pusan (Korea, Republic of)

    1986-02-15

    Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%)

  15. Plain film analysis of acetabular fracture

    International Nuclear Information System (INIS)

    Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan

    1986-01-01

    Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%).

  16. Modelling of Fracture Initiation, Propagation and Creep of a KBS-3V and KBS-3H Repository in Sparsely Fractured Rock with Application to the Design at Forsmark Candidate Site

    International Nuclear Information System (INIS)

    Backers, Tobias; Stephansson, Ove

    2008-01-01

    influences the stability of the KBS-3 repository. With an acting swelling pressure no additional fracturing may be expected due to the ice load. If the swelling pressure is reduced for whatever reason, only the KBS-3H concept with the deposition hole axis parallel SH remained stable. Neighbouring excavations at spacing of 6m, as is currently planned by SKB, do not influence each other and therefore do not introduce additional risk for fracturing. It is concluded that the KBS-3H concept with the deposition hole axis parallel SH is the most favourable concept assuming rock properties and stress state according to SDM 1.2 at Forsmark. The impact of the stress changes due to excavation, swelling pressure and temperature are predicted to be minimal on this layout. Repository deposition holes at a depth of -450m are most favourable. In case of KBS-3 concept with deposition holes in a rock mass with discrete fracture network DFN according to SDM 1.2 at Forsmark the following conclusions are drawn: (i) In some regions of the fractured rock mass the original fracture network is not much affected by the excavation of the deposition holes, in other regions the fractures are significantly propagated and sometimes also leading to a connection between neighbouring deposition holes. (j) Due to presence of the pre-existing fractures, the initiation of new fractures in the vicinity of the deposition holes is reduced. (k) For some configurations of deposition holes and DFN, pre-existing fractures are propagating due to the increased stress field around the excavations that leads to interconnected fractures linking up neighbouring deposition holes. These connected fractures may act as potential pathways for fluid flow and transport, not only between the deposition holes, but also between deposition holes and the deposition tunnel. Time-dependent fracture growth is of minor importance at relevant in-situ stresses, swelling pressures and temperature conditions. The fracturing in case of the KBS

  17. Paediatric talus fracture.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria

    2012-01-01

    Paediatric talus fractures are rare injuries resulting from axial loading of the talus against the anterior tibia with the foot in dorsiflexion. Skeletally immature bone is less brittle, with higher elastic resistance than adult bone, thus the paediatric talus can sustain higher forces before fractures occur. However, displaced paediatric talus fractures and those associated with high-energy trauma have been associated with complications including avascular necrosis, arthrosis, delayed union, neurapraxia and the need for revision surgery. The authors present the rare case of a talar neck fracture in a skeletally immature young girl, initially missed on radiological review. However, clinical suspicion on the part of the emergency physician, repeat examination and further radiographic imaging revealed this rare paediatric injury.

  18. Comparison of surgical techniques of 111 medial malleolar fractures classified by fracture geometry.

    Science.gov (United States)

    Ebraheim, Nabil A; Ludwig, Todd; Weston, John T; Carroll, Trevor; Liu, Jiayong

    2014-05-01

    Evaluation of operative techniques used for medial malleolar fractures by classifying fracture geometry has not been well documented. One hundred eleven patients with medial malleolar fractures (transverse n = 63, oblique n = 29, vertical n = 7, comminuted n = 12) were included in this study. Seventy-two patients had complicating comorbidities. All patients were treated with buttress plate, lag screw, tension band, or K-wire fixation. Treatment outcomes were evaluated on the basis of radiological outcome (union, malunion, delayed union, or nonunion), need for operative revision, presence of postoperative complications, and AOFAS Ankle-Hindfoot score. For transverse fractures, tension band fixation showed the highest rate of union (79%), highest average AOFAS score (86), lowest revision rate (5%), and lowest complication rate (16%). For oblique fractures, lag screws showed the highest rate of union (71%), highest average AOFAS score (80), lowest revision rate (19%), and lowest complication rate (33%) of the commonly used fixation techniques. For vertical fractures, buttress plating was used in every case but 1, achieving union (whether normal or delayed) in all cases with an average AOFAS score of 84, no revisions, and a 17% complication rate. Comminuted fractures had relatively poor outcomes regardless of fixation method. The results of this study suggest that both tension bands and lag screws result in similar rates of union for transverse fractures of the medial malleolus, but that tension band constructs are associated with less need for revision surgery and fewer complications. In addition, our data demonstrate that oblique fractures were most effectively treated with lag screws and that vertical fractures attained superior outcomes with buttress plating. Level III, retrospective comparative series.

  19. Effect of Nb on hydrogen-induced delayed fracture in high strength hot stamping steels

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Shiqi [School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083 (China); College of Mechanical Engineering, Yangtze University, Jingzhou 434023 (China); Huang, Yunhua, E-mail: huangyh@mater.ustb.edu.cn [School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083 (China); Sun, Bintang, E-mail: bingtangsun@ustb.edu.cn [School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083 (China); Liao, Qingliang [School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083 (China); Lu, Hongzhou [CITIC Metal Co. Ltd., Room 1901, Capital Mansion 6, Xin Yuan Nanlu, Chaoyang District, Beijing 100004 (China); The School of Resources and Environmental Engineering, East China University of Science and Technology, Meilong road 130, Xujiahui District, Shanghai 200237 (China); Jian, Bian [Niobium Tech Asia, 068898 Singapore (Singapore); Mohrbacher, Hardy [NiobelCon bvba, 2970 Schilde (Belgium); Zhang, Wei; Guo, Aimin [CITIC Metal Co. Ltd., Room 1901, Capital Mansion 6, Xin Yuan Nanlu, Chaoyang District, Beijing 100004 (China); Zhang, Yue [School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing 100083 (China); The State Key Laboratory for Advanced Metals and Materials, University of Science and Technology Beijing, Beijing 100083 (China)

    2015-02-25

    The effect of Nb addition (0.022, 0.053, 0.078 wt%) on the hydrogen-induced delayed fracture resistance of 22MnB5 was studied by constant load test and electrochemical hydrogen permeation method. It is shown that the appropriate addition of Nb is beneficial to the improvement of the delayed fracture resistance of tested steel, especially when the steel contains high concentration of hydrogen, and the maximum delayed fracture resistance is obtained at a Nb content of 0.053%.The result of hydrogen permeation test shows that the diffusion coefficient of hydrogen in the steel containing niobium is lower than that in steel without niobium, which indicates that it is harder for hydrogen in the steels containing niobium to diffuse and aggregate. In addition, the reason for Nb improving the delayed fracture resistance of steels is discussed from two aspects: hydrogen trap effect and grain refinement effect. The analysis shows that the main reason leading to the improvement of the delayed fracture resistance is the hydrogen trapping effect of NbC while the grain refinement effect of Nb(C,N) secondary.

  20. Effect of Nb on hydrogen-induced delayed fracture in high strength hot stamping steels

    International Nuclear Information System (INIS)

    Zhang, Shiqi; Huang, Yunhua; Sun, Bintang; Liao, Qingliang; Lu, Hongzhou; Jian, Bian; Mohrbacher, Hardy; Zhang, Wei; Guo, Aimin; Zhang, Yue

    2015-01-01

    The effect of Nb addition (0.022, 0.053, 0.078 wt%) on the hydrogen-induced delayed fracture resistance of 22MnB5 was studied by constant load test and electrochemical hydrogen permeation method. It is shown that the appropriate addition of Nb is beneficial to the improvement of the delayed fracture resistance of tested steel, especially when the steel contains high concentration of hydrogen, and the maximum delayed fracture resistance is obtained at a Nb content of 0.053%.The result of hydrogen permeation test shows that the diffusion coefficient of hydrogen in the steel containing niobium is lower than that in steel without niobium, which indicates that it is harder for hydrogen in the steels containing niobium to diffuse and aggregate. In addition, the reason for Nb improving the delayed fracture resistance of steels is discussed from two aspects: hydrogen trap effect and grain refinement effect. The analysis shows that the main reason leading to the improvement of the delayed fracture resistance is the hydrogen trapping effect of NbC while the grain refinement effect of Nb(C,N) secondary

  1. Streaming potential modeling in fractured rock: Insights into the identification of hydraulically active fractures

    Science.gov (United States)

    Roubinet, D.; Linde, N.; Jougnot, D.; Irving, J.

    2016-05-01

    Numerous field experiments suggest that the self-potential (SP) geophysical method may allow for the detection of hydraulically active fractures and provide information about fracture properties. However, a lack of suitable numerical tools for modeling streaming potentials in fractured media prevents quantitative interpretation and limits our understanding of how the SP method can be used in this regard. To address this issue, we present a highly efficient two-dimensional discrete-dual-porosity approach for solving the fluid flow and associated self-potential problems in fractured rock. Our approach is specifically designed for complex fracture networks that cannot be investigated using standard numerical methods. We then simulate SP signals associated with pumping conditions for a number of examples to show that (i) accounting for matrix fluid flow is essential for accurate SP modeling and (ii) the sensitivity of SP to hydraulically active fractures is intimately linked with fracture-matrix fluid interactions. This implies that fractures associated with strong SP amplitudes are likely to be hydraulically conductive, attracting fluid flow from the surrounding matrix.

  2. Mixed-mode fracture of ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Petrovic, J.J.

    1985-01-01

    The mixed-mode fracture behavior of ceramic materials is of importance for monolithic ceramics in order to predict the onset of fracture under generalized loading conditions and for ceramic composites to describe crack deflection toughening mechanisms. Experimental data on surface flaw mixed-mode fracture in various ceramics indicate that the flaw-plane normal stress at fracture decreases with increasing in-flaw-plane shear stress, although present data exhibit a fairly wide range in details of this sigma - tau relationship. Fracture from large cracks suggests that Mode II has a greater effect on Mode I fracture than Mode III. A comparison of surface flaw and large crack mixed-mode I-II fracture responses indicated that surface flaw behavior is influenced by shear resistance effects.

  3. Hydrologic behavior of fracture networks

    International Nuclear Information System (INIS)

    Long, J.C.S.; Endo, H.K.; Karasaki, K.; Pyrak, L.; MacLean, P.; Witherspoon, P.A.

    1985-01-01

    This paper reviews recent research on the nature of flow and transport in discontinuous fracture networks. The hydrologic behavior of these networks has been examined using two- and three-dimensional numerical models. The numerical models represent random realizations of fracture networks based on statistical field measurements of fracture geometry and equivalent hydraulic aperture. The authors have compared the flux and mechanical transported behavior of these networks to the behavior of equivalent continua. In this way they were able to determine whether a given fracture network could be modeled as an equivalent porous media in both flux and advective transport studies. They have examined departures from porous media behavior both as a function of interconnectivity and heterogeneity. Parameter studies have revealed behavior patterns such as: given a fracture frequency that can be measured in the field, porous media like behavior and the magnitude of permeability are both enhanced if the fractures are longer and the standard deviation of fracture permeabilities is smaller. The behavior of well tests in fractured networks has been modeled and compared to a new analytical well test solution which accounts for the early time dominance of the fractures intersecting the well. Finally, a three-dimensional fracture flow model has been constructed which assumes fractures are randomly located discs. This model has been constructed which assumes fractures are randomly located discs. This model uses a semi-analytical solution for flow such that it is relatively easy to use the model as a tool for stochastic analysis. 13 references, 12 figures

  4. Metatarsal stress fractures - aftercare

    Science.gov (United States)

    ... Metatarsal stress fracture. In: Safran MR, Zachazewski J, Stone DA, eds. Instructions for Sports Medicine Patients . 2nd ed. Elsevier Saunders; 2012:648-652. Smith MS. Metatarsal fractures. In: Eiff PM, Hatch R, eds. Fracture Management for Primary Care . 3rd ed. ...

  5. Acetabular fractures: anatomic and clinical considerations.

    Science.gov (United States)

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

    2013-09-01

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

  6. Subtrochanteric femoral fracture during trochanteric nailing for the treatment of femoral shaft fracture.

    Science.gov (United States)

    Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

    2013-09-01

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

  7. Multi-Site Application of the Geomechanical Approach for Natural Fracture Exploration

    Energy Technology Data Exchange (ETDEWEB)

    R. L. Billingsley; V. Kuuskraa

    2006-03-31

    of geomechanical tools. Thus, the outcome of this project is a set of predictive tools with broad applicability across low permeability gas basins where natural fractures play an important role in reservoir permeability. Potential uses for these learnings and tools range from rank exploration to field-development portfolio management. Early incorporation of the permeability development concepts presented here can improve basin assessment and direct focus to the high potential areas within basins. Insight into production variability inherent in tight naturally fractured reservoirs leads to improved wellbore evaluation and reduces the incidence of premature exits from high potential plays. A significant conclusion of this project is that natural fractures, while often an important, overlooked aspect of reservoir geology, represent only one aspect of the overall reservoir fabric. A balanced perspective encompassing all aspects of reservoir geology will have the greatest impact on exploration and development in the low permeability gas setting.

  8. Growth Kinematics of Opening-Mode Fractures

    Science.gov (United States)

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

    2014-12-01

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

  9. Rare stress fracture: longitudinal fracture of the femur.

    Science.gov (United States)

    Pérez González, M; Velázquez Fragua, P; López Miralles, E; Abad Moretón, M M

    42-year-old man with pain in the posterolateral region of the right knee that began while he was running. Initially, it was diagnosed by magnetic resonance (MR) as a possible aggressive process (osteosarcoma or Ewing's sarcoma) but with computed tomography it was noted a cortical hypodense linear longitudinal image with a continuous, homogeneous and solid periosteal reaction without clear soft tissue mass that in this patient suggest a longitudinal distal femoral fatigue stress fracture. This type of fracture at this location is very rare. Stress fractures are entities that can be confused with an agressive process. MR iscurrently the most sensitive and specific imaging method for its diagnosis. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Clinical and radiological results 6 years after treatment of traumatic thoracolumbar burst fractures with pedicle screw instrumentation and balloon assisted endplate reduction

    NARCIS (Netherlands)

    Verlaan, Jorrit Jan; Somers, Inne; Dhert, Wouter J A; Oner, F. Cumhur

    2015-01-01

    Background context  When used to fixate traumatic thoracolumbar burst fractures, pedicle screw constructs may fail in the presence of severe vertebral body comminution as the intervertebral disc can creep through the fractured endplates leading to insufficient anterior column support.

  11. Fracturing formations in wells

    Energy Technology Data Exchange (ETDEWEB)

    Daroza, R A

    1964-05-15

    This well stimulation method comprises introducing through the well bore a low-penetrating, dilatant fluid, and subjecting the fluid to sufficient pressure to produce fractures in the formation. The fluid is permitted to remain in contact with the formation so as to become diluted by the formation fluids, and thereby lose its properties of dilatancy. Also, a penetrating fluid, containing a propping agent suspended therein, in introduced into contact with the fractures at a pressure substantially reduced with respect to that pressure which would have been required, prior to the fracturing operation performed using the low-penetrating dilatant fluid. The propping agent is deposited within the fractures, and thereafter, fluid production is resumed from the fractured formation. (2 claims)

  12. Research on fracture analysis, groundwater flow and sorption processes in fractured rocks

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dae Ha [Korea Institute of Geology Mining and Materials, Taejon (Korea)

    1998-12-01

    Due to increasing demand for numerous industrial facilities including nuclear power plants and waste repositories, the feasibility of rocks masses as sites for the facilities has been a geological issue of concern. Rock masses, in general, comprises systems of fractures which can provide pathways for groundwater flow and may also affect the stability of engineered structures. such properties of fractures stimulate a synthetic study on (1) analyses of fracture systems, and (2) characterization of groundwater flow and sorption processes in fractured rocks to establish a preliminary model for assessing suitable sites for industrial facilities. The analyses of fracture systems cover (1) reconstruction of the Cenozoic tectonic movements and estimation of frequency indices for the Holocene tectonic movements, (2) determination of distributions and block movements of the Quaternary marine terraces, (3) investigation of lithologic and geotechnical nature of study area, and (4) examination of the Cenozoic volcanic activities and determination of age of the dike swarms. Using data obtained from above mentioned analyses along with data related to earthquakes and active faults, probabilistic approach is performed to determine various potential hazards which may result from the Quaternary or the Holocene tectonic movements. In addition, stepwise and careful integration of various data obtained from field works and laboratory experiments are carried out to analyze groundwater flow in fractures rocks as follows; (1) investigation of geological feature of the site, (2) identification and characterization of fracture systems using core and televiewer logs, (3) determination of conductive fractures using electrical conductivity, temperature, and flow logs, (4) identification of hydraulic connections between fractures using televiewer logs with tracer tests within specific zones. The results obtained from these processes allow a qualitative interpretation of groundwater flow patterns

  13. Displaced proximal humeral fractures: an Indian experience with locking plates

    Directory of Open Access Journals (Sweden)

    Aggarwal Sameer

    2010-08-01

    Full Text Available Abstract Background The treatment of displaced proximal humerus fractures, especially in elderly, remains controversial. The objective of this study was to evaluate functional outcome of locking plate used for fixation of these fractures after open reduction. We also attempted to evaluate the complications and predictors of loss of fixation for such an implant. Methods Over two and a half years, 56 patients with an acute proximal humerus fracture were managed with locking plate osteosynthesis. 47 of these patients who completed a minimum follow up of 1 year were evaluated using Constant score calculation. Statistical analysis was done using SPSS 16 and a p value of less than 0.05 was taken as statistically significant. Results The average follow up period was around 21.5 months. Outcomes were excellent in 17%, good in 38.5%, moderate in 34% while poor in 10.5%. The Constant score was poorer for AO-OTA type 3 fractures as compared to other types. The scores were also inferior for older patients (> 65 years old. Complications included screw perforation of head, AVN, subacromial impingement, loss of fixation, axillary nerve palsy and infection. A varus malalignment was found to be a strong predictor of loss of fixation. Conclusion Locking plate osteosynthesis leads to satisfactory functional outcomes in all the patients. Results are better than non locking plates in osteoporotic fractures of the elderly. However the surgery has steep learning curve and various complications could be associated with its use. Nevertheless we believe that a strict adherence to the principles of locking plate use can ensure good result in such challenging fractures.

  14. Fracture Phenomena in Amorphous Selenium

    DEFF Research Database (Denmark)

    Lindegaard-Andersen, Asger; Dahle, Birgit

    1966-01-01

    Fracture surfaces of amorphous selenium broken in flexure at room temperature have been studied. The fracture velocity was found to vary in different regions of the fracture surface. Peculiar features were observed in a transition zone between fast and slower fracture. In this zone cleavage steps...

  15. Hydraulic Properties of Closely Spaced Dipping Open Fractures Intersecting a Fluid-Filled Borehole Derived From Tube Wave Generation and Scattering

    Science.gov (United States)

    Minato, Shohei; Ghose, Ranajit; Tsuji, Takeshi; Ikeda, Michiharu; Onishi, Kozo

    2017-10-01

    Fluid-filled fractures and fissures often determine the pathways and volume of fluid movement. They are critically important in crustal seismology and in the exploration of geothermal and hydrocarbon reservoirs. We introduce a model for tube wave scattering and generation at dipping, parallel-wall fractures intersecting a fluid-filled borehole. A new equation reveals the interaction of tube wavefield with multiple, closely spaced fractures, showing that the fracture dip significantly affects the tube waves. Numerical modeling demonstrates the possibility of imaging these fractures using a focusing analysis. The focused traces correspond well with the known fracture density, aperture, and dip angles. Testing the method on a VSP data set obtained at a fault-damaged zone in the Median Tectonic Line, Japan, presents evidences of tube waves being generated and scattered at open fractures and thin cataclasite layers. This finding leads to a new possibility for imaging, characterizing, and monitoring in situ hydraulic properties of dipping fractures using the tube wavefield.

  16. Laryngeal Fracture after Blunt Cervical Trauma in Motorcycle Accident and Its Management

    Directory of Open Access Journals (Sweden)

    Nuno Ribeiro-Costa

    2017-01-01

    Full Text Available Laryngeal fracture is a rare traumatic injury, potentially fatal, with an estimated incidence of 1 in 30,000 patients admitted to severe trauma centers. Because of the rarity of this injury, physician may be not aware of its existence, leading to a late diagnosis of this entity. We report a case of a 59-year-old woman admitted to the emergency room after a motorcycle accident with cervical trauma. The patient presented with dysphonia, hemoptysis, cervical subcutaneous emphysema, and increasing respiratory distress that led to the intubation of the patient. CT-scan demonstrated displaced fracture of the cricoid and thyroid cartilage. The patient was submitted to tracheostomy and the fracture was surgically repaired. Tracheostomy was removed in third postoperative month. The patient presented a good recovery, reporting only hoarseness but without swallowing or breathing problems at 6-month follow-up.

  17. A New Method for Fracturing Wells Reservoir Evaluation in Fractured Gas Reservoir

    Directory of Open Access Journals (Sweden)

    Jianchun Guo

    2014-01-01

    Full Text Available Natural fracture is a geological phenomenon widely distributed in tight formation, and fractured gas reservoir stimulation effect mainly depends on the communication of natural fractures. Therefore it is necessary to carry out the evaluation of this reservoir and to find out the optimal natural fractures development wells. By analyzing the interactions and nonlinear relationships of the parameters, it establishes three-level index system of reservoir evaluation and proposes a new method for gas well reservoir evaluation model in fractured gas reservoir on the basis of fuzzy logic theory and multilevel gray correlation. For this method, the Gaussian membership functions to quantify the degree of every factor in the decision-making system and the multilevel gray relation to determine the weight of each parameter on stimulation effect. Finally through fuzzy arithmetic operator between multilevel weights and fuzzy evaluation matrix, score, rank, the reservoir quality, and predicted production will be gotten. Result of this new method shows that the evaluation of the production coincidence rate reaches 80%, which provides a new way for fractured gas reservoir evaluation.

  18. Fracture surfaces of granular pastes.

    Science.gov (United States)

    Mohamed Abdelhaye, Y O; Chaouche, M; Van Damme, H

    2013-11-01

    Granular pastes are dense dispersions of non-colloidal grains in a simple or a complex fluid. Typical examples are the coating, gluing or sealing mortars used in building applications. We study the cohesive rupture of thick mortar layers in a simple pulling test where the paste is initially confined between two flat surfaces. After hardening, the morphology of the fracture surfaces was investigated, using either the box counting method to analyze fracture profiles perpendicular to the mean fracture plane, or the slit-island method to analyze the islands obtained by cutting the fracture surfaces at different heights, parallel to the mean fracture plane. The fracture surfaces were shown to exhibit scaling properties over several decades. However, contrary to what has been observed in the brittle or ductile fracture of solid materials, the islands were shown to be mass fractals. This was related to the extensive plastic flow involved in the fracture process.

  19. Change in fracture risk and fracture pattern after bariatric surgery: nested case-control study.

    Science.gov (United States)

    Rousseau, Catherine; Jean, Sonia; Gamache, Philippe; Lebel, Stéfane; Mac-Way, Fabrice; Biertho, Laurent; Michou, Laëtitia; Gagnon, Claudia

    2016-07-27

     To investigate whether bariatric surgery increases the risk of fracture.  Retrospective nested case-control study.  Patients who underwent bariatric surgery in the province of Quebec, Canada, between 2001 and 2014, selected using healthcare administrative databases.  12 676 patients who underwent bariatric surgery, age and sex matched with 38 028 obese and 126 760 non-obese controls.  Incidence and sites of fracture in patients who had undergone bariatric surgery compared with obese and non-obese controls. Fracture risk was also compared before and after surgery (index date) within each group and by type of surgery from 2006 to 2014. Multivariate conditional Poisson regression models were adjusted for fracture history, number of comorbidities, sociomaterial deprivation, and area of residence.  Before surgery, patients undergoing bariatric surgery (9169 (72.3%) women; mean age 42 (SD 11) years) were more likely to fracture (1326; 10.5%) than were obese (3065; 8.1%) or non-obese (8329; 6.6%) controls. A mean of 4.4 years after surgery, bariatric patients were more susceptible to fracture (514; 4.1%) than were obese (1013; 2.7%) and non-obese (3008; 2.4%) controls. Postoperative adjusted fracture risk was higher in the bariatric group than in the obese (relative risk 1.38, 95% confidence interval 1.23 to 1.55) and non-obese (1.44, 1.29 to 1.59) groups. Before surgery, the risk of distal lower limb fracture was higher, upper limb fracture risk was lower, and risk of clinical spine, hip, femur, or pelvic fractures was similar in the bariatric and obese groups compared with the non-obese group. After surgery, risk of distal lower limb fracture decreased (relative risk 0.66, 0.56 to 0.78), whereas risk of upper limb (1.64, 1.40 to 1.93), clinical spine (1.78, 1.08 to 2.93), pelvic, hip, or femur (2.52, 1.78 to 3.59) fractures increased. The increase in risk of fracture reached significance only for biliopancreatic diversion.  Patients undergoing bariatric

  20. Pubic insufficiency fracture: MRI findings

    International Nuclear Information System (INIS)

    Min, Tae Kyu; Lee, Yeon Soo; Park, Jeong Mi; Kim, Jee Young; Chung, Hong Jun; Lee, Eun Hee; Lee, Eun Ja; Kang, So Won; Han Tae Il

    2000-01-01

    To evaluate the characteristic MRI findings of pubic insufficiency fracture. In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium

  1. Effects of simplifying fracture network representation on inert chemical migration in fracture-controlled aquifers

    Science.gov (United States)

    Wellman, Tristan; Shapiro, Allen M.; Hill, Mary C.

    2009-01-01

    While it is widely recognized that highly permeable 'large-scale' fractures dominate chemical migration in many fractured aquifers, recent studies suggest that the pervasive 'small-scale' fracturing once considered of less significance can be equally important for characterizing the spatial extent and residence time associated with transport processes. A detailed examination of chemical migration through fracture-controlled aquifers is used to advance this conceptual understanding. The influence of fracture structure is evaluated by quantifying the effects to transport caused by a systematic removal of fractures from three-dimensional discrete fracture models whose attributes are derived from geologic and hydrologic conditions at multiple field sites. Results indicate that the effects to transport caused by network simplification are sensitive to the fracture network characteristics, degree of network simplification, and plume travel distance, but primarily in an indirect sense since correlation to individual attributes is limited. Transport processes can be 'enhanced' or 'restricted' from network simplification meaning that the elimination of fractures may increase or decrease mass migration, mean travel time, dispersion, and tailing of the concentration plume. The results demonstrate why, for instance, chemical migration may not follow the classic advection-dispersion equation where dispersion approximates the effect of the ignored geologic structure as a strictly additive process to the mean flow. The analyses further reveal that the prediction error caused by fracture network simplification is reduced by at least 50% using the median estimate from an ensemble of simplified fracture network models, and that the error from network simplification is at least 70% less than the stochastic variability from multiple realizations. Copyright 2009 by the American Geophysical Union.

  2. Radiological diagnosis of fractures

    International Nuclear Information System (INIS)

    Finlay, D.B.L.; Allen, M.J.

    1984-01-01

    This book is about radiology of fractures. While it contains sections of clinical features it is not intended that readers should rely entirely upon these for the diagnosis and management of the injured patient. As in the diagnosis and treatment of all medical problems, fracture management must be carried out in a logical step-by-step fashion - namely, history, examination, investigation, differential diagnosis, diagnosis and then treatment. Each section deals with a specific anatomical area and begins with line drawings of the normal radiographs demonstrating the anatomy. Accessory views that may be requested, and the indications for these, are included. Any radiological pitfalls for the area in general are then described. The fractures in adults are then examined in turn, their radiological features described, and any pitfalls in their diagnosis discussed. A brief note of important clinical findings is included. A brief mention is made of pediatric fractures which are of significance and their differences to the adult pattern indicated. Although fractures can be classified into types with different characteristics, in life every fracture is individual. Fractures by and large follow common patterns, but many have variations

  3. Distinct hip and rearfoot kinematics in female runners with a history of tibial stress fracture.

    Science.gov (United States)

    Milner, Clare E; Hamill, Joseph; Davis, Irene S

    2010-02-01

    Cross-sectional controlled laboratory study. To investigate the kinematics of the hip, knee, and rearfoot in the frontal and transverse planes in female distance runners with a history of tibial stress fracture. Tibial stress fractures are a common overuse injury in runners, accounting for up to half of all stress fractures. Abnormal kinematics of the lower extremity may contribute to abnormal musculoskeletal load distributions, leading to an increased risk of stress fractures. Thirty female runners with a history of tibial stress fracture were compared to 30 age-matched and weekly-running-distance-matched control subjects with no previous lower extremity bony injuries. Kinematic and kinetic data were collected using a motion capture system and a force platform, respectively, as subjects ran in the laboratory. Selected variables of interest were compared between the groups using a multivariate analysis of variance (MANOVA). Peak hip adduction and peak rearfoot eversion angles were greater in the stress fracture group compared to the control group. Peak knee adduction and knee internal rotation angles and all joint angles at impact peak were similar between the groups. Runners with a previous tibial stress fracture exhibited greater peak hip adduction and rearfoot eversion angles during the stance phase of running compared to healthy controls. A consequence of these mechanics may be altered load distribution within the lower extremity, predisposing individuals to stress fracture.

  4. Atraumatic First Rib Fracture

    OpenAIRE

    Koray Aydogdu

    2014-01-01

    Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  5. Association between cervical spine and skull-base fractures and blunt cerebrovascular injury

    Energy Technology Data Exchange (ETDEWEB)

    Buch, Karen; Nguyen, Thanh; Norbash, Alex; Mian, Asim [Boston University School of Medicine, Department of Radiology, Boston Medical Center, Boston, MA (United States); Mahoney, Eric; Burke, Peter [Boston University School of Medicine, Department of Surgery, Boston Medical Center, Boston, MA (United States); Libby, Brandon; Calner, Paul [Boston University School of Medicine, Department of Emergency Medicine, Boston Medical Center, Boston, MA (United States)

    2016-02-15

    Blunt cerebrovascular injuries (BCVI) are associated with high morbidity and mortality and can lead to neurological deficits. The established criteria for patients undergoing CT angiography (CTA) for BCVI are broad, and can expose patients to radiation unnecessarily. This study aimed to examine the prevalence of BCVI in patients on CTA and determine presentations associated with the highest rates of BCVI. With IRB approval, patients were selected for CTA screening for BCVI according to a predefined set of criteria at our hospital between 2007 and 2010. Patients were identified from our institution's trauma database. CTAs were retrospectively reviewed for BCVI including vasospasm and dissection. Electronic medical records were reviewed for clinical presentation and hospital course. Of 432 patients, vasospasm (n = 10) and/or dissection (n = 36) were found in 46 patients (10.6 %). BCVI was associated with cervical spine and/or skull-base fracture in 40/46 patients (87 %, P < 0.0001). Significant correlations were seen between dissection and fracture in 31/36 patients (86.2 %, p < 0.0001) and between BCVI and both neurological deficits and fractures (27/44, P < 0.0001). BCVI was significantly associated with cervical and/or skullbase fractures and neurological deficits with coexistent fractures. Patients with these injuries should be prioritized for rapid CTA evaluation for BCVI. (orig.)

  6. Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.

    Science.gov (United States)

    Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang

    2017-12-01

    Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  7. The incidence of associated fractures of the upper limb in fractures of the radial head

    NARCIS (Netherlands)

    Kaas, Laurens; van Riet, Roger P.; Vroemen, Jos P. A. M.; Eygendaal, Denise

    2008-01-01

    Radial head fractures are common injuries. In American publications, one-third of the patients with these fractures have been shown to have associated injuries. The aim of this retrospective study is to describe the epidemiology of radial head fractures and associated fractures of the ipsilateral

  8. Fracture heuristics: surgical decision for approaches to distal radius fractures. A surgeon's perspective.

    Science.gov (United States)

    Wichlas, Florian; Tsitsilonis, Serafim; Kopf, Sebastian; Krapohl, Björn Dirk; Manegold, Sebastian

    2017-01-01

    Introduction: The aim of the present study is to develop a heuristic that could replace the surgeon's analysis for the decision on the operative approach of distal radius fractures based on simple fracture characteristics. Patients and methods: Five hundred distal radius fractures operated between 2011 and 2014 were analyzed for the surgeon's decision on the approach used. The 500 distal radius fractures were treated with open reduction and internal fixation through palmar, dorsal, and dorsopalmar approaches with 2.4 mm locking plates or underwent percutaneous fixation. The parameters that should replace the surgeon's analysis were the fractured palmar cortex, and the frontal and the sagittal split of the articular surface of the distal radius. Results: The palmar approach was used for 422 (84.4%) fractures, the dorsal approach for 39 (7.8%), and the combined dorsopalmar approach for 30 (6.0%). Nine (1.8%) fractures were treated percutaneously. The correlation between the fractured palmar cortex and the used palmar approach was moderate (r=0.464; p<0.0001). The correlation between the frontal split and the dorsal approach, including the dorsopalmar approach, was strong (r=0.715; p<0.0001). The sagittal split had only a weak correlation for the dorsal and dorsopalmar approach (r=0.300; p<0.0001). Discussion: The study shows that the surgical decision on the preferred approach is dictated through two simple factors, even in the case of complex fractures. Conclusion: When the palmar cortex is displaced in distal radius fractures, a palmar approach should be used. When there is a displaced frontal split of the articular surface, a dorsal approach should be used. When both are present, a dorsopalmar approach should be used. These two simple parameters could replace the surgeon's analysis for the surgical approach.

  9. Reduced Fracture Finite Element Model Analysis of an Efficient Two-Scale Hybrid Embedded Fracture Model

    KAUST Repository

    Amir, Sahar Z.

    2017-06-09

    A Hybrid Embedded Fracture (HEF) model was developed to reduce various computational costs while maintaining physical accuracy (Amir and Sun, 2016). HEF splits the computations into fine scale and coarse scale. Fine scale solves analytically for the matrix-fracture flux exchange parameter. Coarse scale solves for the properties of the entire system. In literature, fractures were assumed to be either vertical or horizontal for simplification (Warren and Root, 1963). Matrix-fracture flux exchange parameter was given few equations built on that assumption (Kazemi, 1968; Lemonnier and Bourbiaux, 2010). However, such simplified cases do not apply directly for actual random fracture shapes, directions, orientations …etc. This paper shows that the HEF fine scale analytic solution (Amir and Sun, 2016) generates the flux exchange parameter found in literature for vertical and horizontal fracture cases. For other fracture cases, the flux exchange parameter changes according to the angle, slop, direction, … etc. This conclusion rises from the analysis of both: the Discrete Fracture Network (DFN) and the HEF schemes. The behavior of both schemes is analyzed with exactly similar fracture conditions and the results are shown and discussed. Then, a generalization is illustrated for any slightly compressible single-phase fluid within fractured porous media and its results are discussed.

  10. Reduced Fracture Finite Element Model Analysis of an Efficient Two-Scale Hybrid Embedded Fracture Model

    KAUST Repository

    Amir, Sahar Z.; Chen, Huangxin; Sun, Shuyu

    2017-01-01

    A Hybrid Embedded Fracture (HEF) model was developed to reduce various computational costs while maintaining physical accuracy (Amir and Sun, 2016). HEF splits the computations into fine scale and coarse scale. Fine scale solves analytically for the matrix-fracture flux exchange parameter. Coarse scale solves for the properties of the entire system. In literature, fractures were assumed to be either vertical or horizontal for simplification (Warren and Root, 1963). Matrix-fracture flux exchange parameter was given few equations built on that assumption (Kazemi, 1968; Lemonnier and Bourbiaux, 2010). However, such simplified cases do not apply directly for actual random fracture shapes, directions, orientations …etc. This paper shows that the HEF fine scale analytic solution (Amir and Sun, 2016) generates the flux exchange parameter found in literature for vertical and horizontal fracture cases. For other fracture cases, the flux exchange parameter changes according to the angle, slop, direction, … etc. This conclusion rises from the analysis of both: the Discrete Fracture Network (DFN) and the HEF schemes. The behavior of both schemes is analyzed with exactly similar fracture conditions and the results are shown and discussed. Then, a generalization is illustrated for any slightly compressible single-phase fluid within fractured porous media and its results are discussed.

  11. Management of civilian ballistic fractures.

    Science.gov (United States)

    Seng, V S; Masquelet, A C

    2013-12-01

    The management of ballistic fractures, which are open fractures, has often been studied in wartime and has benefited from the principles of military surgery with debridement and lavage, and the use of external fixation for bone stabilization. In civilian practice, bone stabilization of these fractures is different and is not performed by external fixation. Fifteen civilian ballistic fractures, Gustilo II or IIIa, two associated with nerve damage and none with vascular damage, were reviewed. After debridement and lavage, ten internal fixations and five conservative treatments were used. No superficial or deep surgical site infection was noted. Fourteen of the 15 fractures (93%) healed without reoperation. Eleven of the 15 patients (73%) regained normal function. Ballistic fractures have a bad reputation due to their many complications, including infections. In civilian practice, the use of internal fixation is not responsible for excessive morbidity, provided debridement and lavage are performed. Civilian ballistic fractures, when they are caused by low-velocity firearms, differ from military ballistic fractures. Although the principle of surgical debridement and lavage remains the same, bone stabilization is different and is similar to conventional open fractures. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. Bilateral stress fractures of femoral neck in non-athletes: a report of four cases

    Directory of Open Access Journals (Sweden)

    Naik Monappa A

    2013-04-01

    Full Text Available 【Abstract】Femoral neck stress fractures (FNSFs are rare, constituting only 5% of all stress fractures in young adults. These fractures are usually seen in athletes, military recruits and patients with underlying metabolic diseases. The treatment of FNSFs is still controversial because of the inherent complications associated with the treatment procedure. We came across 4 cases of bilateral FNSFs in non-athletic individuals who were manual labourers with-out underlying bony disorders. Two patients with FNSFs and coxa vara deformity on both sides were managed by subtrochanteric valgus osteotomy and dynamic hip screw fixation. One of the remaining two patients was treated by cannulated cancellous screw fixation on one side and sub-trochanteric valgus osteotomy on the other side. The fourth patient received subtrochanteric valgus osteotomy on one side and bipolar hemiarthroplasty on the other side after failed cannulated screw fixation. All the fractures healed without any complications. No evidence of avascular ne-crosis or arthritis was noted in our series. Subtrochanteric valgus osteotomy restores normal neck-shaft angle in pa-tients suffering from FNSFs combined with coxa vara deformity. Moreover, it helps to bring the forces acting around the hip to normal biomechanical levels, leading to fracture union and better results. Replacement arthroplasty is recommended to patients who fail to achieve bony union after fixation. Key words: Fractures, stress; Femoral neck fractures; Coxa vara; Osteotomy

  13. On the temperature independence of statistical model parameters for cleavage fracture in ferritic steels

    Science.gov (United States)

    Qian, Guian; Lei, Wei-Sheng; Niffenegger, M.; González-Albuixech, V. F.

    2018-04-01

    The work relates to the effect of temperature on the model parameters in local approaches (LAs) to cleavage fracture. According to a recently developed LA model, the physical consensus of plastic deformation being a prerequisite to cleavage fracture enforces any LA model of cleavage fracture to observe initial yielding of a volume element as its threshold stress state to incur cleavage fracture in addition to the conventional practice of confining the fracture process zone within the plastic deformation zone. The physical consistency of the new LA model to the basic LA methodology and the differences between the new LA model and other existing models are interpreted. Then this new LA model is adopted to investigate the temperature dependence of LA model parameters using circumferentially notched round tensile specimens. With the published strength data as input, finite element (FE) calculation is conducted for elastic-perfectly plastic deformation and the realistic elastic-plastic hardening, respectively, to provide stress distributions for model calibration. The calibration results in temperature independent model parameters. This leads to the establishment of a 'master curve' characteristic to synchronise the correlation between the nominal strength and the corresponding cleavage fracture probability at different temperatures. This 'master curve' behaviour is verified by strength data from three different steels, providing a new path to calculate cleavage fracture probability with significantly reduced FE efforts.

  14. The Role of BMI in Hip Fracture Surgery.

    Science.gov (United States)

    Akinleye, Sheriff D; Garofolo, Garret; Culbertson, Maya Deza; Homel, Peter; Erez, Orry

    2018-01-01

    Obesity is an oft-cited cause of surgical morbidity and many institutions require extensive supplementary screening for obese patients prior to surgical intervention. However, in the elderly patients, obesity has been described as a protective factor. This article set out to examine the effect of body mass index (BMI) on outcomes and morbidity after hip fracture surgery. The National Surgical Quality Improvement Program database was queried for all patients undergoing 1 of 4 surgical procedures to manage hip fracture between 2008 and 2012. Patient demographics, BMI, and known factors that lead to poor surgical outcomes were included as putative predictors for complications that included infectious, cardiac, pulmonary, renal, and neurovascular events. Using χ 2 tests, 30-day postoperative complication rates were compared between 4 patient groups stratified by BMI as low weight (BMI BMI = 20-30), obese (BMI = 30-40), and morbidly obese (BMI > 40). A total of 15 108 patients underwent surgery for hip fracture over the examined 5-year period. Of these, 18% were low weight (BMI BMI = 20-30), 13% were obese (BMI = 30-40), and 2% were morbidly obese (BMI > 40). The low-weight and morbidly obese patients had both the highest mortality rates and the lowest superficial infection rates. There was a significant increase in blood transfusion rates that decreased linearly with increasing BMI. Deep surgical site infection and renal failure increased linearly with increasing BMI, however, these outcomes were confounded by comorbidities. This study demonstrates that patients at either extreme of the BMI spectrum, rather than solely the obese, are at greatest risk of major adverse events following hip fracture surgery. This runs contrary to the notion that obese hip fracture patients automatically require additional preoperative screening and perioperative services, as currently implemented in many institutions.

  15. Vitamin D and fractures: a sistematic review

    Directory of Open Access Journals (Sweden)

    L. Idolazzi

    2011-09-01

    Full Text Available Vitamin D deficiency is a relevant problem particularly in south Europe and in over 65 year old subjects, that is often underestimated. Vitamin D deficiency represents a real medical emergency also for its role in the patho-physiology of muscular-skeletal diseases. Chronic vitamin D deficiency leads to severe bone and muscular outcomes including: osteoporosis, osteomalacia and proximal limb myopathy. These increase the risk of falling and fractures. The efficacy of vitamin D treatment in decreasing the fracture risk has been reporting in several studies. The negative results of some recent studies questioned the clinical vitamin D efficacy. However these studies have a number of methodological problems and even the interpretation of the results is questionable. In this paper we review all these aspects. This analysis permits to confirm that vitamin D treatment can be extremely cost-effective when given to people at high risk of deficiency. An acceptable compliance is obviously of critical importance.

  16. An unusual stress fracture: Bilateral posterior longitudinal stress fracture of tibia

    OpenAIRE

    Malkoc, Melih; Korkmaz, Ozgur; Ormeci, Tugrul; Oltulu, Ismail; Isyar, Mehmet; Mahirogulları, Mahir

    2014-01-01

    INTRODUCTION Stress fractures (SF) occur when healthy bone is subjected to cyclic loading, which the normal carrying range capacity is exceeded. Usually, stress fractures occur at the metatarsal bones, calcaneus, proximal or distal tibia and tends to be unilateral. PRESENTATION OF CASE This article presents a 58-year-old male patient with bilateral posterior longitudinal tibial stress fractures. A 58 years old male suffering for persistent left calf pain and decreased walking distance for las...

  17. Computer model for ductile fracture

    International Nuclear Information System (INIS)

    Moran, B.; Reaugh, J. E.

    1979-01-01

    A computer model is described for predicting ductile fracture initiation and propagation. The computer fracture model is calibrated by simple and notched round-bar tension tests and a precracked compact tension test. The model is used to predict fracture initiation and propagation in a Charpy specimen and compare the results with experiments. The calibrated model provides a correlation between Charpy V-notch (CVN) fracture energy and any measure of fracture toughness, such as J/sub Ic/. A second simpler empirical correlation was obtained using the energy to initiate fracture in the Charpy specimen rather than total energy CVN, and compared the results with the empirical correlation of Rolfe and Novak

  18. Hybrid external fixation in the treatment of tibial pilon fractures: A retrospective analysis of 162 fractures.

    Science.gov (United States)

    Galante, Vito N; Vicenti, Giovanni; Corina, Gianfranco; Mori, Claudio; Abate, Antonella; Picca, Girolamo; Conserva, Vito; Speciale, Domenico; Scialpi, Lorenzo; Tartaglia, Nicola; Caiaffa, Vincenzo; Moretti, Biagio

    2016-10-01

    To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. Retrospective, multicentre study. Adult patients with tibial pilon fractures treated with hybrid external fixation. Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. Fracture union, complications, functional outcome (Mazur Ankle Score). Union was obtained in 159 fractures at an average of 125days; there were three delayed unions and three non-unions. The most frequent complication was superficial pin-track infections (48), all of which responded to local wound care and antibiotics. There were no deep infections and no DVT. Only one fracture had loss of reduction that required frame revision. The overall functional scores were 91 (excellent) for AO/OTA type A fractures, 89 (good) for type B fractures, and 75 (satisfactory) for type C fractures. Hybrid external fixation is an effective method of stabilising tibial pilon fractures, particularly those with marked comminution. The minimally-invasive technique and stable fixation enable early mobilisation, with good functional results and minimal complications. Level IV Case series. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Multi-Attribute Seismic/Rock Physics Approach to Characterizing Fractured Reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Gary Mavko

    2004-11-30

    fracturing is likely to be more intense near faults--sometimes referred to as the damaged zone. Yet another constraint, based on world-wide observations, is that the maximum likely fracture density increases with depth in a well-defined way. Defining these prior constrains has several benefits: they lead to a priori probability distributions of fractures, that are important for objective statistical integration; they limit the number of geologic hypotheses that need to be theoretically modeled; they provide plausible models for fracture distributions below the seismic resolution. The second element was theoretical rock physics modeling of optimal seismic attributes, including offset and azimuth dependence of traveltime, amplitude, and impedance signatures of anisotropic fractured rocks. The suggested workflow is to begin with an elastic earth model, based on well logs, theoretically add fractures to the likely facies as defined by the geologic prior information, and then compute synthetic seismic traces and attributes, including variations in P and S-wave velocities, Poisson's ratio, reflectivity, travel time, attenuation, and anisotropies of these parameters. This workflow is done in a Monte-Carlo fashion, yielding ranges of expected fracture signatures, and allowing realistic assessments of uncertainty to be honored. The third element was statistical integration of the geophysical data and prior constraints to map fracture intensity and orientations, along with uncertainties. A Bayesian framework was developed that allowed systematic integration of the prior constraints, the theoretical relations between fractures and their seismic signatures, and the various observed seismic observations. The integration scheme was successfully applied on an East Texas field site. The primary benefit from the study was the optimization and refinement of practical workflows for improved geophysical characterization of natural fractures and for quantifying the uncertainty of these

  20. Correlation between high resolution sequence stratigraphy and mechanical stratigraphy for enhanced fracture characteristic prediction

    Science.gov (United States)

    Al Kharusi, Laiyyan M.

    correlation to fracture spacing. Furthermore, bed thickness is found to be only one factor in determining fracture density but with increasing strain, internal bedforms and rock petrophysical heterogeneities influence fracture density patterns. This study illustrates how integrating sedimentologic and sequence stratigraphic interpretations with data on structural kinematics can lead to refined predictive understanding of fracture attributes.