Midterm Follow-up of Treating Volar Marginal Rim Fractures with Variable Angle Lcp Volar Rim Distal Radius Plates.

Science.gov (United States)

Goorens, Chul Ki; Geeurickx, Stijn; Wernaers, Pascal; Staelens, Barbara; Scheerlinck, Thierry; Goubau, Jean

2017-06-01

Specific treatment of the volar marginal rim fragment of distal radius fractures avoids occurance of volar radiocarpal dislocation. Although several fixation systems are available to capture this fragment, adequately maintaining internal fixation is difficult. We present our experience of the first 10 cases using the 2.4 mm variable angle LCP volar rim distal radius plate (Depuy Synthes®, West Chester, US), a low-profile volar rim-contouring plate designed for distal plate positioning and stable buttressing of the volar marginal fragment. Follow-up patient satisfaction, range of motion, grips strength, functional scoring with the QuickDASH and residual pain with a numeric rating scale were assessed. Radiological evaluation consisted in evaluating fracture consolidation, ulnar variance, volar angulation and maintenance of the volar rim fixation. The female to male ratio was 5:5 and the mean age was 52.2 (range, 17-80) years. The mean follow-up period was 11 (range, 5-19) months postoperatively. Patient satisfaction was high. The mean total flexion/extension range was 144° (range, 100-180°) compared to the contralateral uninjured side 160° (range, 95-180°). The mean total pronation/supination range was 153° (range, 140-180°) compared to the contralateral uninjured side 170° (range, 155-180°). Mean grip strength was 14 kg (range, 9-22), compared to the contralateral uninjured side 20 kg (range, 12-25 kg). Mean pre-injury level activity QuickDASH was 23 (range, 0-34.1), while post-recovery QuickDASH was 25 (range 0-43.2). Residual pain was 1.5 on the visual numerical pain rating scale. Radiological evaluation revealed in all cases fracture consolidation, satisfactory reconstruction of ulnar variance, volar angulation and volar rim. We encountered no flexor tendon complications, although plate removal was systematically performed after fracture consolidation. The 2.4 mm variable angle LCP volar rim distal radius plates is a valid treatment option for treating

Fracture resistance and failure modes of polymer infiltrated ceramic endocrown restorations with variations in margin design and occlusal thickness.

Science.gov (United States)

Taha, Doaa; Spintzyk, Sebastian; Schille, Christine; Sabet, Ahmed; Wahsh, Marwa; Salah, Tarek; Geis-Gerstorfer, Jürgen

2017-12-11

The purpose of this in vitro study was to assess the effect of varying the margin designs and the occlusal thicknesses on the fracture resistance and mode of failures of endodontically treated teeth restored with polymer infiltrated ceramic endocrown restorations. Root canal treated mandibular molars were divided into four groups (n=8) and were prepared to receive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) fabricated polymer infiltrated ceramic endocrowns (ENAMIC blocks). Group B2 represents teeth prepared with a butt joint design receiving endocrowns with 2mm occlusal thickness and the same for group B3.5 but with 3.5mm occlusal thickness. Group S2 represents teeth prepared with 1mm shoulder finish line receiving endocrowns with 2mm occlusal thickness and the same for group S3.5 but with 3.5mm occlusal thickness. After cementation and thermal aging, fracture resistance test was performed and failure modes were observed. Group S3.5 showed the highest mean fracture load value (1.27±0.31kN). Endocrowns with shoulder finish line had significantly higher mean fracture resistance values than endocrowns with butt margin (p<0.05). However, the results were not statistically significant regarding the restoration thickness. Evaluation of the fracture modes revealed no statistically significant difference between the modes of failure of tested groups. For the restoration of endodontically treated teeth, adding a short axial wall and shoulder finish line can increase the fracture resistance. However, further investigations, especially the fatigue behavior, are needed to ensure this effect applies with small increases of restoration thickness. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Quaternary redox transitions in deep crystalline rock fractures at the western margin of the Greenland ice sheet

International Nuclear Information System (INIS)

Drake, Henrik; Suksi, Juhani; Tullborg, Eva-Lena; Lahaye, Yann

2017-01-01

When planning for long term deep geological repositories for spent nuclear fuel knowledge of processes that will influence and change the sub-surface environment is crucial. For repositories in northern Europe and similar areas, influence from advancing and retreating continental ice sheets must be planned for. Rapid transport of meltwater into the bedrock may introduce oxic conditions at great depth, which may affect the copper canisters planned to encapsulate the spent fuel. The lack of direct observations has led to simplified modelling assumptions not reflecting the complexity of natural systems. As part of a unique field and modelling study, The Greenland Analogue Project, of a continental ice sheet and related sub-surface conditions, we here present mineralogical and U-series data unravelling the Quaternary redox history in the deep bedrock fracture system close to the margin of the Greenland ice sheet. The aim was to increase the understanding of circulation of potentially oxygenated glacial meltwater from the surface down to 650 m depth. Secondary mineral coatings were sampled from open fractures in cored boreholes down to 650 m, within and below the current permafrost. Despite continental ice sheet coverage and/or prevailing permafrost during large parts of the last 1 Ma, measured disequilibrium in the 238 U- 234 U- 230 Th system shows that water has circulated in the bedrock fracture system at various occasions during this time span. In fractures of the upper 60 m, infiltration of oxygenated surface water has resulted in a prominent near-surface ”oxidised zone” with abundant FeOOH precipitation. However, this zone must be relict because it is currently within permafrost and the U-series disequilibrium signatures of most fracture coatings show evidence of deposition of U prior to the Holocene and even prior to the last glaciation maximum which occurred less than 100 ka ago. This U deposition is found both within and below the near surface �

Fracture behavior of human molars.

Science.gov (United States)

Keown, Amanda J; Lee, James J-W; Bush, Mark B

2012-12-01

Despite the durability of human teeth, which are able to withstand repeated loading while maintaining form and function, they are still susceptible to fracture. We focus here on longitudinal fracture in molar teeth-channel-like cracks that run along the enamel sidewall of the tooth between the gum line (cemento-enamel junction-CEJ) and the occlusal surface. Such fractures can often be painful and necessitate costly restorative work. The following study describes fracture experiments made on molar teeth of humans in which the molars are placed under axial compressive load using a hard indenting plate in order to induce longitudinal cracks in the enamel. Observed damage modes include fractures originating in the occlusal region ('radial-median cracks') and fractures emanating from the margin of the enamel in the region of the CEJ ('margin cracks'), as well as 'spalling' of enamel (the linking of longitudinal cracks). The loading conditions that govern fracture behavior in enamel are reported and observations made of the evolution of fracture as the load is increased. Relatively low loads were required to induce observable crack initiation-approximately 100 N for radial-median cracks and 200 N for margin cracks-both of which are less than the reported maximum biting force on a single molar tooth of several hundred Newtons. Unstable crack growth was observed to take place soon after and occurred at loads lower than those calculated by the current fracture models. Multiple cracks were observed on a single cusp, their interactions influencing crack growth behavior. The majority of the teeth tested in this study were noted to exhibit margin cracks prior to compression testing, which were apparently formed during the functional lifetime of the tooth. Such teeth were still able to withstand additional loading prior to catastrophic fracture, highlighting the remarkable damage containment capabilities of the natural tooth structure.

Pedicular stress fracture in the lumbar spine

International Nuclear Information System (INIS)

Chong, V.F.H.; Htoo, M.M.

1997-01-01

Spondylolisthesis with or without spondylolysis is common in the lumbar spine. Associated fracture in the pedicle ('pediculolysis') is unusual. The margins of pedicular stress fractures, like spondylolysis, usually appear sclerotic. A patient with a pedicular stress fracture with minimal marginal sclerosis suggesting an injury of recent onset is presented here. There was associated bilateral spondylolysis. The findings in this patient suggest that established pediculolysis probably represents a stress fracture that has failed to heal. (authors)

Diagnosis of an isolated occult fracture of the posterior margin of the tibia with the SPECT/CT; Diagnostic d'une fracture occulte isolee de la marge posterieure du tibia par la TEMP-TDM

Energy Technology Data Exchange (ETDEWEB)

Bourdon, A.; Granier, P.; Mourad, M. [Centre Hospitalier de Carcassonne Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)

2007-12-15

We report the case of a 56-year-old woman, investigated for pains of the right ankle related to a trauma of an unspecified mechanism. The radiographic assessment was negative. The {sup 99m}Tc-HDP 3-phase bone scintigraphy highlighted, on the blood pool and the delayed images, a located lesion on the right ankle. The single photon emission computerized tomography guided by computerized tomography (SPECT-CT) showed a focused uptake on the posterior margin of the right tibia and a sharp lucent line within the tomo-scintigraphy spot of uptake. The diagnosis accepted was an isolated occult fracture of the posterior margin of the right tibia. The contribution of the {sup 99m}Tc-HDP 3-phase bone scintigraphy combined with the SPECT-CT in the diagnosis of the occult fractures is discussed. (N.C.)

Pedicular stress fracture in the lumbar spine

Energy Technology Data Exchange (ETDEWEB)

Chong, V.F.H.; Htoo, M.M. [Singapore General Hospital, Singapore, (Singapore). Department of Diagnostic Radiology

1997-08-01

Spondylolisthesis with or without spondylolysis is common in the lumbar spine. Associated fracture in the pedicle (`pediculolysis`) is unusual. The margins of pedicular stress fractures, like spondylolysis, usually appear sclerotic. A patient with a pedicular stress fracture with minimal marginal sclerosis suggesting an injury of recent onset is presented here. There was associated bilateral spondylolysis. The findings in this patient suggest that established pediculolysis probably represents a stress fracture that has failed to heal. (authors). 10 refs., 2 figs.

Percutaneous clamping of spiral and oblique fractures of the tibial shaft: a safe and effective reduction aid during intramedullary nailing.

Science.gov (United States)

Collinge, Cory A; Beltran, Michael J; Dollahite, Henry A; Huber, Florian G

2015-06-01

The reduction of tibial shaft fractures during intramedullary nailing is important if limb alignment is to be restored and successful clinical outcomes are expected. We have used a percutaneously applied (or open) clamp or clamps to achieve and maintain reduction during nailing of all amendable tibial shaft fractures. In this article, we describe the technique and preliminary results comparing closed, simple spiral and oblique tibial shaft fractures (OTA 42-A1 and A2) managed with percutaneous clamp-assisted nailing (CAN) versus nailing using manual reduction (MRN) held by the surgical team. In the MRN group, there were an increased fracture gap (P = 0.04) and trends toward malalignment (P = 0.07) and healing time (P = 0.06) compared with the CAN group. There were also trends in clinical; no wound complications occurred in either group. We have found that percutaneous CAN of closed, simple spiral and oblique tibial shaft fractures seems safe and allows for early predictable union with reproducible alignment compared with nailing using MRN.

The inclusion of weld residual stress in fracture margin assessments of embrittled nuclear reactor pressure vessels

International Nuclear Information System (INIS)

Dickson, T.L.; Bass, B.R.; McAfee, W.J.

1998-01-01

Analyses were performed to determine the impact of weld residual stresses in a reactor pressure vessel (RPV) on (1) the generation of pressure temperature (P-T) curves required for maintaining specified fracture prevention margins during nuclear plant startup and shutdown, and (2) the conditional probability of vessel failure due to pressurized thermal shock (PTS) loading. The through wall residual stress distribution in an axially oriented weld was derived using measurements taken from a shell segment of a canceled RPV and finite element thermal stress analyses. The P-T curve derived from the best estimate load analysis and a t / 8 deep flaw, based on K Ic , was less limiting than the one derived from the current methodology prescribed in the ASME Boiler and Pressure Vessel Code. The inclusion of the weld residual stresses increased the conditional probability of cleavage fracture due to PTS loading by a factor ranging from 2 to 4

Clinical implications of determination of safe surgical margins by using a combination of CT and 18FDG-positron emission tomography in soft tissue sarcoma

Directory of Open Access Journals (Sweden)

Yoshioka Takako

2011-07-01

Full Text Available Abstract Background To determine safe surgical margins for soft tissue sarcoma, it is essential to perform a general evaluation of the extent of tumor, responses to auxiliary therapy, and other factors preoperatively using multiple types of diagnostic imaging. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT is a tool for diagnostic imaging that has recently spread rapidly in clinical use. At present, the roles played by FDG-PET/CT in determination of margins for surgical resection of sarcoma are unclear. The present study was undertaken to explore the roles of FDG-PET/CT in determination of surgical margins for soft tissue sarcoma and to examine whether PET can serve as a standard means for setting the margins of surgical resection during reduced surgery. Methods The study involved 7 patients with sarcoma who underwent surgery in our department and in whom evaluation with FDG-PET/CT was possible. Sarcoma was histologically rated as MFH in 6 cases and leiomyosarcoma in 1 case. In all cases, sarcoma was superficial (T1a or T2a. The tumor border was defined by contrast-enhanced MRI, and SUVs were measured at intervals of 1 cm over a 5-cm long area from the tumor border. Mapping of viable tumor cells was carried out on whole-mount sections of resected tissue, and SUVs were compared with histopathological findings. Results Preoperative maximum SUVs (SUV-max of the tumor averaged 11.7 (range: 3.8-22.1. Mean SUV-max was 2.2 (range: 0.3-3.8 at 1 cm from the tumor border, 1.1 (0.85-1.47 at 2 cm, 0.83 (0.65-1.15 at 3 cm, 0.7 (0.42-0.95 at 4 cm, and 0.64 (0.45-0.82 at 5 cm. When resected tissue was mapped, tumor cells were absent in the areas where SUV-max was below 1.0. Conclusions Our findings suggest that a safe surgical margin free of viable tumor cells can be ensured if the SUV cut-off level is set at 1.0. FDG-PET/CT is promising as a diagnostic imaging technique for setting of safe minimal margins for surgical

Modified Risdon approach using periangular incision in surgical treatment of subcondylar mandibular fractures

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Nikolić Živorad S.

2016-01-01

Full Text Available Introduction. No consensus has been reached yet on the surgical approach for treatment of condylar fractures. Objective. The aim of this study was to present modified Risdon approach (without facial nerve identification in the treatment of subcondylar mandibular fractures. Method. This is a retrospective study of a period 2005-2012. During this seven-year period, 25 condylar mandibular fractures in 22 men and three women (19-68 years old were treated by modified Risdon approach without identifying the facial nerve. The main inclusion criterion was subcondylar fracture according to Lindahl classification. Results. No additional morbidity related to postoperative complications, such as infection or salivary fistula, was observed in this series. Only two (8% patients developed temporary weakness of the marginal branch of the facial nerve, which resolved six weeks postoperatively. Each patient achieved good mouth opening postoperatively. Scar was camouflaged in the first cervical wrinkle. Two patients developed temporomandibular joint dysfunction. No patient had postoperative occlusal disturbance. In all of the patients good aesthetic result was achieved in a two-year follow-up. Conclusion. In comparison with techniques described in the literature, the main advantages of the modified Risdon approach are the following: no need for facial vessels identification; direct, fast, and safe approach to mandibular angle and subcondylar region; relatively simple surgical technique and good cosmetic result - due to aesthetically placed incision. This approach could be recommended for subcondylar fracture as a simplified and safe procedure. [Projekat Ministarstva nauke Republike Srbije, br. 175075

Seismic Margin of 500MWe PFBR Beyond Safe Shutdown Earthquake

International Nuclear Information System (INIS)

Sajish, S.D.; Chellapandi, P.; Chetal, S.C.

2012-01-01

Summary: • Seismic design aspects of safety related systems and components of PFBR is discussed with a focus on reactor assembly components. • PFBR is situated in a low seismic area with a peak ground acceleration value of 0.156 g. • The design basis ground motion parameters for the seismic design are evaluated by deterministic method and confirmed by probabilistic seismic hazard analysis. • Review of the seismic design of various safety related systems and components indicate that margin is available to meet any demand due to an earthquake beyond SSE. • Reactor assembly vessels are the most critical components w.r.t seismic loading. • Minimum safety margin is 1.41 for plastic deformation and 1.46 against buckling. • From the preliminary investigation we come to the conclusion that PFBR can withstand an earthquake up to 0.22 g without violating any safety limits. • Additional margin can be estimated by detailed fragility analysis and seismic margin assessment methods

A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study

Directory of Open Access Journals (Sweden)

Vaishali Kalburge

2013-01-01

Full Text Available Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance. Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites. Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10. Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed. Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01 Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored

Compressive fracture resistance of the marginal ridge in large Class II tunnels restored with cermet and composite resin.

Science.gov (United States)

Ehrnford, L E; Fransson, H

1994-01-01

Compressive fracture resistance of the marginal ridge was studied in large tunnel preparations, before and after restoration with cermet (Ketac Silver, ESPE), a universal hybrid composite (Superlux, DMG) and an experimental composite. Each group was represented by six tunnels in extracted upper premolars. The tunnels were prepared by the use of round burs up to size #6. Remaining ridge width was 1.5 mm and ridge height 1.7 mm in the contact area. The ridge was loaded to fracture by a rod placed perpendicular to the ridge. Generally this resulted in a shear fracture of the restoration. There was no significant reinforcement of the ridge by the cermet whereas the composites both reinforced by the same magnitude, averaging 62%. It was concluded that the ridge could be considered a "megafiller" where contact need to be preserved and contour protected against proximal and occlusal wear of the restoration. Clinically there would therefore be good reasons to save even ridge areas with very low inherent strength. Based on the present study composite resin might therefore be the filling material of choice for such tunnel preparations.

Patients with eating disorders. A high-risk group for fractures

DEFF Research Database (Denmark)

Vestergaard, Peter; Emborg, C.; Stoving, R.K.

2003-01-01

PURPOSE: To analyze fracture risk and bone mineral density in patients with eating disorders (anorexia nervosa, bulimia nervosa, and other eating disorders). DESIGN: Clinical overview. FINDINGS: Bone mineral density is decreased and fracture risk increased in patients with anorexia nervosa....... In patients with bulimia nervosa, bone mineral is only marginally decreased and fracture risk marginally increased. In patients with other eating disorders (eating disorders not otherwise specified), bone mineral density is decreased and fracture risk increased. CONCLUSIONS: Fracture risk is increased...

Interrater reliability of sonographic examinations of orbital fractures

International Nuclear Information System (INIS)

Siegfried, Jank; Martina, Deibl; Heinrich, Strobl; Andreas, Oberrauch; Alessandro, Nicasi; Martin, Missmann; Gerd, Bodner

2005-01-01

Objective: The purpose of this study is to determine whether there are statistically significant variations among different observers when examining fractures of the orbital walls. Material and methods: From December 2003 to April 2004, 28 patients with clinically suspected orbital fractures were examined by ultrasound prospectively. The US images of the infra-orbital margins, the orbital floors, the medial and lateral orbital walls of each patient were reexamined by two independent investigators. Results: Computed tomography revealed fractures of the orbital floor in 28 out of 31 patients (90.3%). The infra-orbital margins showed fractures of 14 of 31 patients (45.2%). The ultrasound examinations of the orbits by the three examiners presented satisfactory correlation regarding sensitivity and specificity. There were no significant differences between investigators. There was good agreement among the ultrasound examiners regarding the infra-orbital margins. This was not the case for the orbital floors. Conclusions: If there are clear cut clinical findings ultrasound examination could represent an alternative to computed tomography. If the clinical findings were indeterminate, computed tomography was essential as implicated by this study. Accordingly, further evaluation of ultrasound examinations of fractures of the orbital margins and floors are necessary

Fracture mechanics aspects in the safe design of ductile iron shipping and storage containers

International Nuclear Information System (INIS)

Sappok, M.; Bounin, D.

1996-01-01

Containers made of ductile cast iron provide a safe method for transport of radioactive material. Contrary to widespread opinion ductile cast iron is a very tough material and can be manufactured in heavy sections. The containers are designed to withstand the very high impact loads of accidents like free drops onto unyielding targets. The design is based on postulated undetected crack-like flaws at the highest stressed location. Design must show that applied stress intensities are smaller than fracture toughness and no crack initiation and therefore also no crack propagation can occur. The design procedure followed in this paper is given in a new guideline still being drafted by the International Atomic Energy Agency

A comparison between three different pit and fissure sealants with regard to marginal integrity.

Science.gov (United States)

Fernandes, Kristlee Sabrin; Chalakkal, Paul; de Ataide, Ida de Noronha; Pavaskar, Rajdeep; Fernandes, Precylia Philo; Soni, Harleen

2012-04-01

THE AIM OF THIS STUDY IS TO COMPARE THE OCCURRENCE OF ENAMEL FRACTURES, SEALANT FRACTURES AND MARGINAL FISSURES AFTER PLACEMENT OF THREE SEALANTS: Helioseal F, Conseal F and Clinpro. Thirty individuals between 13 and 15 years of age, diagnosed with pit and fissure caries by visual and DIAGNOdent examination, were chosen for sealant placement on their mandibular molars. The sealants were placed at random, after which, impressions were made with polyvinyl siloxane and casts were fabricated. Dies were prepared, each of which were sputter coated with gold in order to be examined under a scanning electron microscope. The following morphologies were analyzed from dies from each of the sealant groups: Continuous margins, sealant fractures, marginal fissures and enamel fractures. After six months, they were recalled for impression making. Dies were prepared and microscopically analyzed as mentioned. Based on the time of evaluation, there were two groups: Initial group (soon after placement) and final group (after six months). Statistical analysis was done using the paired 't' test and One-way analysis of variance (ANOVA). Clinpro had the greatest fracture resistance, followed by Conseal F and Helioseal F. The occurrence of marginal fissure was found to be least with Clinpro.

Comparative Evaluation of Marginal Adaptation and Fracture Strength of Different Ceramic Inlays Produced by CEREC Omnicam and Heat-Pressed Technique

OpenAIRE

Oz, F. D.; Bolay, S.

2018-01-01

Objective. The aim of this in vitro study was to evaluate marginal adaptation and fracture strength of inlays produced by CEREC Omnicam using different types of blocs and heat-pressed technique. Methods: Seventy-five extracted human mandibular molars were divided randomly into 5 groups (n=15). 60 molars in four groups received MOD inlay preparations. Experimental groups were CO: Intact teeth, EC: IPS e.max CAD and CEREC, LU: Lava Ultimate and CEREC, EL: IPS Empress CAD and CEREC, EP: IPS Empr...

Evidence of stratabound liquefaction in the formation of fractured topographic margins, cone chains and pit catenas along the Martian Dichotomy Boundary and in Isidis Planitia, Mars.

Science.gov (United States)

Gallagher, C.; Balme, M. R.

2012-04-01

On the low-lying plains along much of the Martian Dichotomy Boundary (MDB) and in the Isidis impact basin, cones and curving chains of cones, referred to as thumbprint terrain (TPT), are common. In the same settings, pit chains (catenas) occur in orthogonal to curving and conchoidal fracture sets between mesa-like crustal blocks, generally at or near topographic margins. Many of the fractures consist of linked pits rather than simple propagated cracks. These assemblages are often associated with the more disaggregated populations of blocks comprising chaos terrain. We show that the local planimetric arrangement of the cone chains, fractures and pit catenas is strikingly similar in both shape and scale, including lateral separation, length, longitudinal slope and radius of curvature. The summits of cones tend to be closely accordant along individual cone chains. Neighbouring cone chains tend to be mutually accordant on low gradient basin surfaces but generally stepped en echelon closer to the fractured basin margins. Similarly, the crustal blocks (including very isolated block sets) are often mutually stepped, and fractures between these en echelon blocks tend to be very close to horizontal. Hence, many cone chains, fractures and pit catenas in fractures share the property of being arranged along strike. They diverge morphologically by the cone chains being positive forms separated by narrow gulfs but the pit catenas being negative forms separated by planar blocks. All of these characteristics point to the possibility that the arcuate cone chains and the arcuate pit catenas have a common origin. In particular, we hypothesise that the cone chains characteristic of TPT along the MDB and in Isidis are filled, indurated and then exhumed pit catenas revealed by the stripping-away of intervening blocks [cf. 1]. Many other surfaces on Mars are pervaded by pits and pit catenas, with evidence of former water flow through the catenas suggesting that ground-ice thaw played a

The initial safe range of motion of the ankle joint after three methods of internal fixation of simulated fractures of the medial malleolus.

Science.gov (United States)

Shimamura, Yoshio; Kaneko, Kazuo; Kume, Kazuhiko; Maeda, Mutsuhiro; Iwase, Hideaki

2006-07-01

Previous studies have demonstrated the safe passive range of ankle motion for inter-bone stiffness after internal fixation under load but there is a lack of information about the safe range of ankle motion for early rehabilitation in the absence of loading. The present study was designed to assess the effect of ankle movement on inter-bone displacement characteristics of medial malleolus fractures following three types of internal fixation to determine the safe range of motion. Five lower legs obtained during autopsy were used to assess three types of internal fixation (two with Kirschner-wires alone; two with Kirschner-wires plus tension band wiring; and, one with an AO/ASIF malleolar screw alone). Following a simulated fracture by sawing through the medial malleolus the displacement between the fractured bone ends was measured during a passive range of movement with continuous monitoring using omega (Omega) shaped transducers and a biaxial flexible goniometer. Statistical analysis was performed with repeated measures analysis of variance. Inter-bone displacement was not proportional to the magnitude of movement throughout the range of ankle motion as, when separation exceeded 25 microm, there was increasingly wide separation as plantar-flexion or dorsal-flexion was increased. There was no statistical significant difference between the small amount of inter-bone displacement observed with three types of fixation within the safe range of dorsal-flexion and plantar-flexion for early rehabilitation. However the inter-bone separation when fixation utilized two Kirschner-wires alone tended to be greater than when using the other two types of fixation during dorsal-flexion and eversion. The present study revealed a reproducible range of ankle motion for early rehabilitation which was estimated to be within the range of 20 degrees of dorsal-flexion and 10 degrees of plantar-flexion without eversion. Also, internal fixation with two Kirschner-wires alone does not seem to

MANAGEMENT OF EXTRIMITY FRACTURE IN EMERGENCY DEPARTMENT

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Putu Sukma Parahita

2013-09-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Fracture injuries in the extremities are accounted for 40% of the incidence of fractures in the United States and causes high morbidity (physical suffering, lost time, and mental stress. High-energy fractures of the lower limbs can also cause life threatening condition like major vascular injury, crush syndrome, and compartment syndrome. Initial treatment in the emergency room is essential to save lives and to save the fractured extremities. Primary survey (securing the airway, breathing and circulation and the secondary survey will be able to quickly and accurately identify dangerous early complication of fractures, such as major arterial injury, crush syndrome and compartment syndrome. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Better well control through safe drilling margin identification, influx analysis and direct bottom hole pressure control method for deep water

Energy Technology Data Exchange (ETDEWEB)

Veeningen, Daan [National Oilwell Varco IntelliServ (NOV), Houston, TX (United States)

2012-07-01

Currently, well control events are almost exclusively detected by using surface measurements. Measuring a volume increase in the 'closed loop' mud circulation system; a standpipe pressure decrease; or changes in a variety of drilling parameters provide indicators of a kick. Especially in deep water, where the riser comprises a substantial section of the well bore, early kick detection is paramount for limiting the severity of a well bore influx and improve the ability to regain well control. While downhole data is presently available from downhole tools nearby the bit, available data rates are sparse as mud pulse telemetry bandwidth is limited and well bore measurements compete with transmission of other subsurface data. Further, data transfer is one-directional, latency is significant and conditions along the string are unknown. High-bandwidth downhole data transmission system, via a wired or networked drill string system, has the unique capability to acquire real-time pressure and temperature measurement at a number of locations along the drill string. This system provides high-resolution downhole data available at very high speed, eliminating latency and restrictions that typically limit the availability of downhole data. The paper describes well control opportunities for deep water operations through the use of downhole data independent from surface measurements. First, the networked drill string provides efficient ways to identify pore pressure, fracture gradient, and true mud weight that comprise the safe drilling margin. Second, the independent measurement capability provides early kick detection and improved ability to analyze an influx even with a heterogeneous mud column through distributed along-string annular pressure measurements. Third, a methodology is proposed for a direct measurement method using downhole real-time pressure for maintaining constant bottom hole pressure during well kills in deep water. (author)

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.

Risk Informed Safety Margin Characterization Case Study: Selection of Electrical Equipment To Be Subjected to Environmental Qualification

Energy Technology Data Exchange (ETDEWEB)

D. Blanchard; R. Youngblood

2012-04-01

In general, the margins-based safety case helps the decision-maker manage plant margins most effectively. It tells the plant decision-maker such things as what margin is present (at the plant level, at the functional level, at the barrier level, at the component level), and where margin is thin or perhaps just degrading. If the plant is safe, it tells the decision-maker why the plant is safe and where margin needs to be maintained, and perhaps where the plant can afford to relax.

Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function.

Science.gov (United States)

Oilo, Marit; Hardang, Anne D; Ulsund, Amanda H; Gjerdet, Nils R

2014-06-01

Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation. © 2014 Eur J Oral Sci.

Bone tumors with an associated pathologic fracture: Differentiation between benign and malignant status using radiologic findings

International Nuclear Information System (INIS)

Bae, Ji Hyun; Lee, In Sook; Song, You Seon; Kim, Jeung Il; Lee, Moon Sung; Lee, Young Hwan; Song, Jong Woon

2015-01-01

To determine whether benign and malignant bone tumors with associated pathologic fractures can be differentiated using radiologic findings. Seventy-eight patients (47 men and 31 women, age range: 1-93 years) with a bone tumor and an associated pathologic fracture from 2004 to 2013 constituted the retrospective study cohort. The tumor size, margin, and enhancement patterns; the presence of sclerotic margin, the peritumoral bone marrow, soft tissue edema, extra-osseous soft tissue mass, intratumoral cystic/hemorrhagic/necrotic regions, mineralization/sclerotic regions, periosteal reaction and its appearance; and cortical change and its appearance were evaluated on all images. Differences between the imaging characteristics of malignant and benign pathologic fractures were compared using Pearson's chi-square test and the 2-sample t-test. There were 22 benign and 56 malignant bone tumors. Some factors were found to significantly differentiate between benign and malignant tumors; specifically, ill-defined tumor margin, the presence of sclerotic tumor margin and an extra-osseous soft tissue mass, the absence of cystic/necrotic/hemorrhagic portions in a mass, the homogeneous enhancement pattern, and the presence of a displaced fracture and of underlying cortical change were suggestive of malignant pathologic fractures. Some imaging findings were helpful for differentiating between benign and malignant pathologic fractures

Bone tumors with an associated pathologic fracture: Differentiation between benign and malignant status using radiologic findings

Energy Technology Data Exchange (ETDEWEB)

Bae, Ji Hyun; Lee, In Sook; Song, You Seon [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Kim, Jeung Il [Dept. of Radiology, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu (Korea, Republic of); Lee, Moon Sung [Dept. of Radiology, Keimyung University College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Lee, Young Hwan [Dept. of Radiology, Catholic University of Daegu College of Medicine, Daegu Catholic University Hospital, Daegu (Korea, Republic of); Song, Jong Woon [Dept. of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan (Korea, Republic of)

2015-10-15

To determine whether benign and malignant bone tumors with associated pathologic fractures can be differentiated using radiologic findings. Seventy-eight patients (47 men and 31 women, age range: 1-93 years) with a bone tumor and an associated pathologic fracture from 2004 to 2013 constituted the retrospective study cohort. The tumor size, margin, and enhancement patterns; the presence of sclerotic margin, the peritumoral bone marrow, soft tissue edema, extra-osseous soft tissue mass, intratumoral cystic/hemorrhagic/necrotic regions, mineralization/sclerotic regions, periosteal reaction and its appearance; and cortical change and its appearance were evaluated on all images. Differences between the imaging characteristics of malignant and benign pathologic fractures were compared using Pearson's chi-square test and the 2-sample t-test. There were 22 benign and 56 malignant bone tumors. Some factors were found to significantly differentiate between benign and malignant tumors; specifically, ill-defined tumor margin, the presence of sclerotic tumor margin and an extra-osseous soft tissue mass, the absence of cystic/necrotic/hemorrhagic portions in a mass, the homogeneous enhancement pattern, and the presence of a displaced fracture and of underlying cortical change were suggestive of malignant pathologic fractures. Some imaging findings were helpful for differentiating between benign and malignant pathologic fractures.

Problems in the diagnosis of metaphyseal fractures

International Nuclear Information System (INIS)

Kleinman, Paul K.

The radiographic projection influences the appearance of the metaphyseal fragment. If the long axis of the metaphysis and the radiographic projection are at right angles, the thicker peripheral margin of the metaphyseal fragment will be viewed end-on as a relatively discrete triangular bony fragment. A caudally or cranially angulated radiographic projection results in a curvilinear bony density that represents the dense peripheral margin of the fracture fragment that has been separated from the metaphysis. Thus, in one projection a fragment may appear as a corner fracture, and in another view, as a bucket-handle lesion. From autopsy and clinical studies it is evident that bruising overlying CMLs is often absent. (orig.)

NRC Seismic Design Margins Program Plan

International Nuclear Information System (INIS)

Cummings, G.E.; Johnson, J.J.; Budnitz, R.J.

1985-08-01

Recent studies estimate that seismically induced core melt comes mainly from earthquakes in the peak ground acceleration range from 2 to 4 times the safe shutdown earthquake (SSE) acceleration used in plant design. However, from the licensing perspective of the US Nuclear Regulatory Commission, there is a continuing need for consideration of the inherent quantitative seismic margins because of, among other things, the changing perceptions of the seismic hazard. This paper discusses a Seismic Design Margins Program Plan, developed under the auspices of the US NRC, that provides the technical basis for assessing the significance of design margins in terms of overall plant safety. The Plan will also identify potential weaknesses that might have to be addressed, and will recommend technical methods for assessing margins at existing plants. For the purposes of this program, a general definition of seismic design margin is expressed in terms of how much larger that the design basis earthquake an earthquake must be to compromise plant safety. In this context, margin needs to be determined at the plant, system/function, structure, and component levels. 14 refs., 1 fig

Clinical features and MRI findings of blow-out fracture

Energy Technology Data Exchange (ETDEWEB)

Yamanouchi, Yasuo; Yasuda, Takasumi; Kawamoto, Keiji [Kansai Medical Univ., Moriguchi, Osaka (Japan); Inagaki, Takayuki; Someda, Kuniyuki

1996-06-01

Precise anatomical understanding of orbital blow-out fracture lesions is necessary for the treatment of patients. Retrospectively, MRI findings were compared with the clinical features of pure type blow-out fractures and the efficacy of MRI in influencing a decision for surgical intervention was evaluated. Eighteen child (15 boys, 3 girls) cases were evaluated and compared with adult cases. The patients were classified into three categories (Fig.1) and two types (Fig.2) in accordance with the degree of protrusion of fat tissue. The degree of muscle protrusion also was divided into three categories (Fig. 3). Both muscle and fat tissue were protruding from the fracture site in 14 cases. Fat tissue protrusion alone was found in 3 cases. In contrast, no protrusion was seen in one case. The incarcerated type of fat prolapse was found in 40% of cases, while muscle tissue prolapse was found in 75% of patients. Marginal irregularity or swelling of muscle was observed in 11 patients. There was good correlation of ocular motor disturbance and MRI findings. Disturbance of eyeball movement was observed in all patients with either incarcerated fat tissue or marginal irregularity or swelling of muscle. In contrast, restriction of eyeball movement was rare in cases of no incarceration, even if the fracture was wide. Deformity or marginal irregularity of the ocular muscle demonstrated in MRI may suggest damage an adhesion to the muscle wall. When MRI reveals incarceration or severe prolapse of fat tissue, or deformity and marginal irregularity of the ocular muscle, surgical intervention should be considered. (author)

Clinical features and MRI findings of blow-out fracture

International Nuclear Information System (INIS)

Yamanouchi, Yasuo; Yasuda, Takasumi; Kawamoto, Keiji; Inagaki, Takayuki; Someda, Kuniyuki.

1996-01-01

Precise anatomical understanding of orbital blow-out fracture lesions is necessary for the treatment of patients. Retrospectively, MRI findings were compared with the clinical features of pure type blow-out fractures and the efficacy of MRI in influencing a decision for surgical intervention was evaluated. Eighteen child (15 boys, 3 girls) cases were evaluated and compared with adult cases. The patients were classified into three categories (Fig.1) and two types (Fig.2) in accordance with the degree of protrusion of fat tissue. The degree of muscle protrusion also was divided into three categories (Fig. 3). Both muscle and fat tissue were protruding from the fracture site in 14 cases. Fat tissue protrusion alone was found in 3 cases. In contrast, no protrusion was seen in one case. The incarcerated type of fat prolapse was found in 40% of cases, while muscle tissue prolapse was found in 75% of patients. Marginal irregularity or swelling of muscle was observed in 11 patients. There was good correlation of ocular motor disturbance and MRI findings. Disturbance of eyeball movement was observed in all patients with either incarcerated fat tissue or marginal irregularity or swelling of muscle. In contrast, restriction of eyeball movement was rare in cases of no incarceration, even if the fracture was wide. Deformity or marginal irregularity of the ocular muscle demonstrated in MRI may suggest damage an adhesion to the muscle wall. When MRI reveals incarceration or severe prolapse of fat tissue, or deformity and marginal irregularity of the ocular muscle, surgical intervention should be considered. (author)

Study Suggests Smaller Melanoma Excision Margins May Be Option for Some Patients

Science.gov (United States)

A randomized controlled trial of patients with stage IIA–C cutaneous melanoma thicker than 2-mm found that a 2-cm surgical resection margin is sufficient and is as safe for patients as a 4-cm margin.

Distal phalanx fractures in horses: a survey of 274 horses with radiographic assessment of healing in 36 horses

International Nuclear Information System (INIS)

Honnas, C.M.; O'Brien, T.R.; Linford, R.L.

1988-01-01

The case records of 274 horses with fractures of the distal phalanx were reviewed. Fifty-two horses had bilateral forelimb fractures, for a total of 326 distal phalanx fractures. The fractures were classified into one of five previously described types, based on the radiographic anatomic configuration of the fracture. Solar margin fractures, which have been briefly described in other reports and previously classified as type V fractures, were identified in 132 horses. This type of fracture is distinct from other distal phalanx fractures. Due to the high incidence of solar margin fractures, these fractures were classified as a separate type (type VI). Follow-up radiographic examinations to assess fracture healing were available for 36 horses. Twenty-two horses with distal phalanx fractures (three type I, nine type II, two type III, one type IV, one type V, and six type VI) had radiographic evidence of complete bony union of the fracture at a mean of 11 months after injury. Eight horses with conplete type II fractures involving the articular surface had bony union of the body and solar margin, but not the subchondral bone at the articular surface, a mean of 11 months after injury. Six horses (four type II and two type IV) had little radiographic evidence of bony healing during the follow-up period. All fractures that eventually healed had evidence of progression toward bony union by 6 months after injury

Improving safety margin of LWRs by rethinking the emergency core cooling system criteria and safety system capacity

Energy Technology Data Exchange (ETDEWEB)

Lee, Youho, E-mail: euo@kaist.ac.kr; Kim, Bokyung, E-mail: bkkim2@kaist.ac.kr; NO, Hee Cheon, E-mail: hcno@kaist.ac.kr

2016-10-15

Highlights: • Zircaloy embrittlement criteria can increase to 1370 °C for CP-ECR lower than 13%. • The draft ECCS criteria of U.S. NRC allow less than 5% in power margin. • The Japanese fracture-based criteria allow around 5% in power margin. • Increasing SIT inventory is effective in assuring safety margin for power uprates. - Abstract: This study investigates the engineering compatibility between emergency core cooling system criteria and safety water injection systems, in the pursuit of safety margin increase of light water reactors. This study proposes an acceptable temperature increase to 1370 °C as long as equivalent cladding reacted calculated by the Cathcart–Pawel equation is below 13%, after an extensive literature review. The influence of different ECCS criteria on the safety margin during large break loss of coolant accident is investigated for OPR-1000 by the system code MARS-KS, implemented with the KINS-REM method. The fracture-based emergency core cooling system (ECCS) criteria proposed in this study are shown to enable power margins up to 10%. In the meantime, the draft U.S. NRC’s embrittlement criteria (burnup-sensitive) and Japanese fracture-based criteria are shown to allow less than 5%, and around 5% of power margins, respectively. Increasing safety injection tank (SIT) water inventory is the key, yet convenient, way of assuring safety margin for power increase. More than 20% increase in the SIT water inventory is required to allow 15% power margins, for the U.S. NRC’s burnup-dependent embrittlement criteria. Controlling SIT water inventory would be a useful option that could allow the industrial desire to pursue power margins even under the recent atmosphere of imposing stricter ECCS criteria for the considerable burnup effects.

A geometrically based method for predicting stress-induced fracture aperture and flow in discrete fracture networks

DEFF Research Database (Denmark)

Bisdom, Kevin; Bertotti, Giovanni; Nick, Hamid

2016-01-01

networks, digitized from outcropping pavements. These networks cover a wide range of possible geometries and spatial distributions. The geometrically based method predicts the average hydraulic aperture and equivalent permeability of fractured porous media with error margins of less than 5%....

Managing sub-gingival fracture by multi-disciplinary approach: Endodontics-forced orthodontic extrusion and prosthetic rehabilitation

Directory of Open Access Journals (Sweden)

Rakesh Mittal

2013-01-01

Full Text Available Traumatized anterior teeth with sub-gingival crown fractures are a challenge to treat. The management of sub-gingival fractures includes exposing the cervical margin followed by appropriate coronal restoration. The treatment modalities, which involve exposing the cervical margin, are surgical crown lengthening and orthodontic extrusion. This paper reports a case of fractured maxillary anterior tooth at the sub-gingival level that was managed by forced orthodontic extrusion after endodontic treatment followed by esthetic rehabilitation, a much forgotten technique not utilized routinely yet conservative and cost-effective.

RISK-INFORMED SAFETY MARGIN CHARACTERIZATION

International Nuclear Information System (INIS)

Dinh, Nam; Szilard, Ronaldo

2009-01-01

The concept of safety margins has served as a fundamental principle in the design and operation of commercial nuclear power plants (NPPs). Defined as the minimum distance between a system's 'loading' and its 'capacity', plant design and operation is predicated on ensuring an adequate safety margin for safety-significant parameters (e.g., fuel cladding temperature, containment pressure, etc.) is provided over the spectrum of anticipated plant operating, transient and accident conditions. To meet the anticipated challenges associated with extending the operational lifetimes of the current fleet of operating NPPs, the United States Department of Energy (USDOE), the Idaho National Laboratory (INL) and the Electric Power Research Institute (EPRI) have developed a collaboration to conduct coordinated research to identify and address the technological challenges and opportunities that likely would affect the safe and economic operation of the existing NPP fleet over the postulated long-term time horizons. In this paper we describe a framework for developing and implementing a Risk-Informed Safety Margin Characterization (RISMC) approach to evaluate and manage changes in plant safety margins over long time horizons

Minimally invasive locked plating of distal tibia fractures is safe and effective.

Science.gov (United States)

Ronga, Mario; Longo, Umile Giuseppe; Maffulli, Nicola

2010-04-01

Distal tibial fractures are difficult to manage. Limited soft tissue and poor vascularity impose limitations for traditional plating techniques that require large exposures. The nature of the limitations for traditional plating techniques is intrinsic to the large exposure required to approach distal tibia, a bone characterized by limited soft tissue coverage and poor vascularity. The locking plate (LP) is a new device for treatment of fractures. We assessed the bone union rate, deformity, leg-length discrepancy, ankle range of motion, return to preinjury activities, infection, and complication rate in 21 selected patients who underwent minimally invasive osteosynthesis of closed distal tibia fractures with an LP. According to the AO classification, there were 12 Type A, 5 Type B, and 4 Type C fractures. The minimum followup was 2 years (average, 2.8 years; range, 2-4 years). Two patients were lost to followup. Union was achieved in all but one patient by the 24th postoperative week. Four patients had angular deformity less than 7 degrees . No patient had a leg-length discrepancy more than 1.1 cm. Five patients had ankle range of motion less than 20 degrees compared with the contralateral side. Sixteen patients had not returned to their preinjury sporting or leisure activities. Three patients developed a delayed infection. We judge the LP a reasonable device for treating distal tibia fractures. The level of physical activities appears permanently reduced in most patients. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Catastrophic scapular fractures in Californian racehorses: pathology, morphometry and bone density.

Science.gov (United States)

Vallance, S A; Spriet, M; Stover, S M

2011-11-01

To enhance understanding of the nature and pathogenesis of scapular fractures in racehorses. Scapular fractures in racehorses have a consistent configuration related to sites of pre-existing stress modelling and remodelling. Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Scapular fracture configuration, bone modelling changes and standardised CT morphometry and density measurements were recorded. Statistical comparisons were made between fractured, nonfractured contralateral and control scapulae. Thirty-nine scapulae from 10 Thoroughbred (TB) and 10 Quarter Horse (QH) racehorses were obtained. All 14 fractured scapulae (from 12 horses) had a consistent comminuted fracture configuration. A complete fracture coursed transversely through the neck of the scapula at the level of the distal aspect of the spine (8.9 ± 0.9 cm proximal to the lateral articular margin of the glenoid cavity). The distal fragment of 13 fractured scapulae was split into 2 major fragments by a fracture in the frontal plane that entered the glenoid cavity (2.8 ± 0.4 cm caudal to the cranial articular margin). Focal areas of periosteal proliferation and/or radiolucency were present in the distal aspect of the scapular spine of all fractured and intact contralateral scapulae, but less commonly (Phorses without a scapular fracture. Fractured scapulae had 7-10% lower mean density and 46-104% greater density heterogeneity in the spine adjacent to the transverse fracture compared to control scapulae (Pfracture configuration that is associated with pre-existing pathology of the distal aspect of the spine. This location is consistent with scapular stress fractures diagnosed in lame TB racehorses. Catastrophic fracture is the acute manifestation of a more chronic process. Consequently, there are opportunities for early detection and prevention of fatalities. © 2010 EVJ Ltd.

[Treatment of Pilon fractures complicated with fractures of fibula with titanic elastic nailing].

Science.gov (United States)

Liu, Yi-jun; Lin, Fu-qing; Guo, Yu-xiang

2010-02-01

To explore the effect of titanic elastic nailing (TEN) fixing for Pilon fractures complicated with fractures of fibula. From March 2007 to March 2009, 20 patients with Pilon fractures complicated with fractures of fibula were surgically treated with TEN. There were 14 males and 7 females with an average age of 42.6 years ranging from 35 to 70 years. Among them, 12 cases were on the left, 8 cases were on the right. All patients were followed-up for from 6 to 23 months (averaged 11.6 months). The symptoms of all patients had primarily relieved and the patients coulde ambulate at 2 to 3 months after treatment. According to Johner-Wruhs critera, the therapeutic results were excellent in 10 cases, good in 8 cases, fair in 2 cases. No case had skin infection and skin necrosis. Treatment of Pilon fractures complicated with fractures of fibula with TEN has the advantages such as less invasion, high rate of bone union and less soft tissue complication, it is a safe and effective procedure.

Surface analogue outcrops of deep fractured basement reservoirs in extensional geological settings. Examples within active rift system (Uganda) and proximal passive margin (Morocco).

Science.gov (United States)

Walter, Bastien; Géraud, Yves; Diraison, Marc

2014-05-01

structures). Two field cases, located in Morocco and Uganda, allow us to investigate basement complexes at different stages of an extension process and give us analog geological data of similar fractured basement reservoirs. Border faults and associated fracture networks of an active rifting system propagated in Proterozoic basement rocks are analyzed in the Albertine rift system in Uganda. Brittle structures developed along a proximal passive margin of the Atlantic domain are analyzed in Proterozoic basements rocks in Western Anti-Atlas in Morocco.

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.

Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study.

NARCIS (Netherlands)

Groen, B.E.; Smulders, E.; Duysens, J.E.J.; Lankveld, W.G.J.M. van; Weerdesteijn, V.G.M.

2010-01-01

ABSTRACT: BACKGROUND: Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA) fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This

Flexible intramedullary nailing for femoral diaphyseal fractures in children

Directory of Open Access Journals (Sweden)

Rojan Tamrakar

2017-12-01

Full Text Available Background & Objectives: Although various treatment options are available for the treatment of femoral diaphyesal fractures in children, the titanium flexible nailing has gained popularity because it is safe, easy procedure with rapid recovery and high success rate. The aim of this study was to evaluate the outcome of titanium elastic nails in treating paediatric femoral diaphyesal fractures at Patan Hospital.Materials & Methods: There were 35 cases which were all fixed with titanium flexible intramedullary nail under image intensifier at the Patan hospital from January 2013 and December 2015. Patients were evaluated in follow-ups to observe the alignment of fracture, infection, delayed union, nonunion, limb length discrepancy, implant failure, range of movement of hip and knee joints, and time to unite the fracture. The final results were evaluated using criteria of titanium elastic nail (TEN outcome score described by Flynn et al.Results: The mean age of the patients was 8.51 years. Among 35 patients (22 boys and 13 girls, there were 19 mid-shaft fractures, nine proximal third fractures and seven distal third fractures. Fracture patterns were transverse (22, oblique (10, spiral (2, and comminuted (2. The mean time for fracture union was 8.17 weeks radiologically whereas 9.83 weeks clinically. According to TEN outcome score, excellent and good results were in 28 cases (80% and seven cases (20% respectively.Conclusion: Flexible titanium nailing is a safe and satisfactory treatment for diaphyseal femoral fractures in children, because it provides rapid recovery, short rehabilitation and immobilization as well as very high union rate with few complications.

Frontal plane fractures of the accessory carpal bone and implications for the carpal sheath of the digital flexor tendons.

Science.gov (United States)

Minshall, G J; Wright, I M

2014-09-01

Accurate radiological and ultrasonographic descriptions of frontal plane fractures of the accessory carpal bone (ACB) are lacking, and implications of these fractures for the carpal sheath and its contents have not previously been reported. Aims were as follows: 1) to describe the location and radiological features of frontal plane fractures of the ACB; 2) to document communication of displaced fractures with the carpal sheath and consequent injury to the deep digital flexor tendon (DDFT); 3) to describe ultrasonographic identification of lesions; and 4) to report tenoscopic evaluation and treatment. Retrospective case series. Analysis of frontal plane fractures of the ACB referred to a single hospital between 2006 and 2012, including review of radiographic, ultrasonographic and tenoscopic images. Nine fractures were identified, of which 8 displaced fractures all communicated with the carpal sheath. Comminuted fragments and/or protruding fracture margins lacerated the lateral margin of the enclosed DDFT. This was identifiable ultrasonographically and confirmed at tenoscopy in 7 cases. Treatment in these horses consisted of removal of torn tendon tissue together with fragmentation and protuberant fracture edges, and 7 of 7 cases returned to work. One horse with a nondisplaced fracture was managed with immobilisation; the fracture healed, and the horse returned to work. One horse with a displaced fracture was retired to stud. Frontal plane fractures of the ACB occur palmar to the groove in its lateral margin for the tendon of insertion of ulnaris lateralis. Comminuted fragments can displace distally within the carpal sheath to a mid-metacarpal level or abaxially to lie extrathecally, lateral to the parent bone. Displaced fractures communicate with the carpal sheath and traumatise the DDFT. © 2013 EVJ Ltd.

Computational evaluation of the constraint loss on the fracture toughness of reactor pressure vessel steels

International Nuclear Information System (INIS)

Serrano Garcia, M.

2007-01-01

The Master Curve approach is included on the ASME Code through some Code Cases to assess the reactor pressure vessel integrity. However, the margin definition to be added is not defined as is the margin to be added when the Master Curve reference temperature T 0 is obtained by testing pre-cracked Charpy specimens. The reason is that the T 0 value obtained with this specimen geometry is less conservative than the value obtained by testing compact tension specimens possible due to a loss of constraint. The two parameter fracture mechanics, considered as an extension of the classical fracture mechanics, coupled to a micromechanical fracture models is a valuable tool to assess the effect of constraint loss on fracture toughness. The definition of a parameter able to connect the fracture toughens value to the constraint level on the crack tip will allow to quantify margin to be added to the T 0 value when this value is obtained testing the pre-cracked Charpy specimens included in the surveillance capsule of the reactor pressure vessel. The Nuclear Regulatory Commission (NRC) define on the To value obtained by testing compact tension specimens and ben specimens (as pre-cracked Charpy are) bias. the NRC do not approved any of the direct applications of the Master Curve the reactor pressure vessel integrity assessment until this bias will be quantified in a reliable way. the inclusion of the bias on the integrity assessment is done through a margin to be added. In this thesis the bias is demonstrated an quantified empirical and numerically and a generic value is suggested for reactor pressure vessel materials, so that it can be used as a margin to be added to the T 0 value obtained by testing the Charpy specimens included in the surveillance capsules. (Author) 111 ref

Stress and gas hydrate-filled fracture distribution, Krishna-Godavari Basin, India

Energy Technology Data Exchange (ETDEWEB)

Cook, A.; Goldberg, D. [Lamont-Doherty Earth Observatory of Columbia Univ., Palisades, NY (United States)

2008-07-01

The first expedition of the Indian National Gas Hydrate Program (NGHP) was launched in the summer of 2006 to characterize the presence of gas hydrates on the continental margins of India. This paper presented a study from the NGHP expedition that found high resistivity fractures in unconsolidated clay sediments on logging-while-drilling (LWD) borehole resistivity images. Gas hydrate-filled and conductive fractures appearing on LWD resistivity images in holes 5A, 5B, 6A, 7A and 10 were analysed and discussed. Fracture orientation and shallow sediment stress orientations were determined for each hole. The paper described how to determine which sections of a log are hydrate bearing as well as how to calculate the predicted water saturated resistivity. It was concluded that holes 5A, 5B, 6A and 7A contained well-ordered, high-angle fractures, from which horizontal stress directions could be accurately resolved. However, these stress directions, contradicted the orientations normally seen on a passive margin, and may be the result of local bathymetry variations. 6 refs., 1 tab., 11 figs.

FRACTURING FLUID CHARACTERIZATION FACILITY

Energy Technology Data Exchange (ETDEWEB)

Subhash Shah

2000-08-01

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

Internal fixation of proximal fractures of the 2nd and 4th metacarpal and metatarsal bones using bioabsorbable screws.

Science.gov (United States)

Mageed, M; Steinberg, T; Drumm, N; Stubbs, N; Wegert, J; Koene, M

2018-03-01

Fractures involving the proximal one-third of the splint bone are relatively rare and are challenging to treat. A variety of management techniques have been reported in the literature. The aim of this retrospective case series was to describe the clinical presentation and evaluate the efficacy of bioabsorbable polylactic acid screws in internal fixation of proximal fractures of the 2nd and 4th metacarpal and metatarsal bones in horses. The medical records, diagnostic images and outcome of all horses diagnosed with a proximal fracture of the splint bones and treated with partial resection and internal fixation of the proximal stump using bioabsorbable polylactic acid screws between 2014 and 2015 were reviewed. Eight horses met the inclusion criteria. The results showed that there were no complications encountered during screw placement or postoperatively. Six horses returned to full work 3 months after the operation and two horses remained mildly lame. On follow-up radiographs 12 months postoperatively (n = 2) the screws were not completely absorbed. The screws resulted in a cone-shaped radiolucency, which was progressively replaced from the outer margins by bone sclerosis. The use of bioabsorbable screws for fixation of proximal fractures of the splint bone appears to be a safe and feasible technique and may offer several advantages over the use of traditional metallic implants. © 2018 Australian Veterinary Association.

Fracture mechanisms and fracture control in composite structures

Science.gov (United States)

Kim, Wone-Chul

observed complex compressive failure modes, such as shear crippling and pure compressive fiber failure of fibers are explained by the predicted stress distributions calculated in this work. These fracture analyses can be damage tolerant design methodology for composite structures. The proposed fracture criteria and the corresponding critical fracture strains provide the designer with quantitative guidelines for safe-life design. These have been incorporated into a fracture control plan for composite structures, which is also described. Currently, fracture control plans do not exist for composite structures; the proposed plan is a first step towards establishing fracture control and damage tolerant design methodology for this important class of materials.

Generic analyses for evaluation of low Charpy upper-shelf energy effects on safety margins against fracture of reactor pressure vessel materials

International Nuclear Information System (INIS)

Dickson, T.L.

1993-07-01

Appendix G to 10 CFR Part 50 requires that reactor pressure vessel beltline material maintain Charpy upper-shelf energies of no less than 50 ft-lb during the plant operating life, unless it is demonstrated in a manner approved by the Nuclear Regulatory Commission (NRC), that lower values of Charpy upper-shelf energy provide margins of safety against fracture equivalent to those in Appendix G to Section XI of the ASME Code. Analyses based on acceptance criteria and analysis methods adopted in the ASME Code Case N-512 are described herein. Additional information on material properties was provided by the NRC, Office of Nuclear Regulatory Research, Materials Engineering Branch. These cases, specified by the NRC, represent generic applications to boiling water reactor and pressurized water reactor vessels. This report is designated as HSST Report No. 140

Definition of a safe zone for antegrade lag screw fixation of fracture of posterior column of the acetabulum by 3D technology.

Science.gov (United States)

Feng, Xiaoreng; Zhang, Sheng; Luo, Qiang; Fang, Jintao; Lin, Chaowen; Leung, Frankie; Chen, Bin

2016-03-01

The objective of this study was to define a safe zone for antegrade lag screw fixation of fracture of posterior column of the acetabulum using a novel 3D technology. Pelvic CT data of 59 human subjects were obtained to reconstruct three-dimensional (3D) models. The transparency of 3D models was then downgraded along the axial perspective (the view perpendicular to the cross section of the posterior column axis) to find the largest translucent area. The outline of the largest translucent area was drawn on the iliac fossa. The line segments of OA, AB, OC, CD, the angles of OAB and OCD that delineate the safe zone (ABDC) were precisely measured. The resultant line segments OA, AB, OC, CD, and angles OAB and OCD were 28.46mm(13.15-44.97mm), 45.89mm (34.21-62.85mm), 36.34mm (18.68-55.56mm), 53.08mm (38.72-75.79mm), 37.44° (24.32-54.96°) and 55.78° (43.97-79.35°) respectively. This study demonstrates that computer-assisted 3D modelling techniques can aid in the precise definition of the safe zone for antegrade insertion of posterior column lag screws. A full-length lag screw can be inserted into the zone (ABDC), permitting a larger operational error. Copyright © 2016 Elsevier Ltd. All rights reserved.

Outcrossings of safe regions by generalized hyperbolic processes

DEFF Research Database (Denmark)

Klüppelberg, Claudia; Rasmussen, Morten Grud

2013-01-01

We present a simple Gaussian mixture model in space and time with generalized hyperbolic marginals. Starting with Rice’s celebrated formula for level upcrossings and outcrossings of safe regions we investigate the consequences of the mean-variance mixture model on such quantities. We obtain...

Fracture criteria of reactor graphite under multiaxial stresses

International Nuclear Information System (INIS)

Sato, S.; Kawamata, K.; Kurumada, A.; Oku, T.

1987-01-01

New fracture criteria for graphite under multiaxial stresses are presented for designing core and support materials of a high temperature gas cooled reactor. Different kinds of fracture strength tests are carried out for a near isotropic graphite IG-11. Results show that, under the stress state in which tensile stresses are predominant, the maximum principal stress theory is seen as applicable for brittle fracture. Under the stress state in which compressive stresses are predominant there may be two fracture modes for brittle fracture, namely, slipping fracture and mode II fracture. For the former fracture mode the maximum shear stress criterion is suitable, but for the latter fracture mode a new mode II fracture criterion including a restraint effect for cracks is verified to be applicable. Also a statistical correction for brittle fracture criteria under multiaxial stresses is discussed. By considering the allowable stress values for safe design, the specified minimum ultimate strengths corresponding to a survival probability of 99% at the 95% confidence level are presented. (orig./HP)

The Safe Area in the Parieto-Occipital Lobe in the Human Brain: Diffusion Tensor Tractography.

Science.gov (United States)

Jang, Sung Ho; Kim, Seong Ho; Kwon, Hyeok Gyu

2015-06-01

A recent study reported on the relatively safe area in the frontal lobe for performance of neurological interventions; however, no study on the posterior safe area has been reported. In this study, using diffusion tensor tractography, we attempted to identify the safe area in the parieto-occipital lobe in healthy subjects. A total of 47 healthy subjects were recruited for this study. Eleven neural tracts were reconstructed in and around the parieto-occipital area of the brain using diffusion tensor tractography. The safe area, which is free from any trajectory of 10 neural tracts, was measured anteriorly and medially from the line of the most posterior and lateral margin of the brain at 5 axial levels (from the cerebral cortex to the corona radiata). The anterior boundaries of the safe area in the upper cerebral cortex, lower cerebral cortex, centrum semiovale, upper corona radiata, and lower corona radiata levels were located at 31.0, 32.6, 32.7, 35.1, and 35.2 mm anteriorly from the line of the most posterior margin of the brain, respectively, and the medial boundaries were located at an average of 34.7, 38.1, 39.2, 36.1, and 33.6 mm medially from the line of the most lateral margin of the brain, respectively. According to our findings, the safe area was located in the posterolateral portion of the parieto-occipital lobe in the shape of a triangle. However, we found no safe area in the deep white matter around the lateral ventricle. Copyright © 2015 Elsevier Inc. All rights reserved.

[Fracture resistance of Procera Allceram depending on the framework design--an in vitro study].

Science.gov (United States)

Hagmann, Edgar; Marinello, Carlo P; Zitzmann, Nicola U

2006-01-01

Procera AllCeram is one of the all-ceramic systems with an aluminium-oxide core employing CAD/CAM technology. The aim of the current study was to investigate the fracture resistance of Procera AllCeram full-ceramic crowns with a reduced core design compared to the conventional method. In addition, a possible influence of the preparation form (molars or premolars) and the cementation material (glas-ionomer or composite) was analyzed. For both preparation forms, 30 ceramic cores with reduced margins (collarless cores, test) and 30 cores with extended cores (control) were veneered with porcelain in a standardized procedure (total 120 crowns). For the test group, Procera-AllCeram-margin ceramic material was used for the porcelain collar. 40 crowns each were cemented on stainless steel dies with either Ketac-Cem Aplicap or Panavia F. The additional 40 crowns were set on polyurethane dies without cementation and occlusally loaded until fracture occurred. Among the molar crowns, no differences were observed in fracture resistance neither for the different core designs (test or control) nor for the cementation materials. For the premolar form, fusing of a porcelain margin was associated with a reduction in fracture resistance, while the use of composite cement was accompanied with an increase. The present in vitro results indicate that for Procera AllCeram crowns with a highly undulating preparation margin, a conventional core design combined with adhesive cementation is preferable, especially in the posterior region due to higher chewing forces; this assumption needs to be proven in clinical studies.

A survey on orbital fractures in an educational center

Directory of Open Access Journals (Sweden)

Farahvash MR

2009-06-01

Full Text Available "n Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Trauma is the 2nd cause of mortality in Iran, after cardiovascular diseases. In traumatic patients, head and neck and face skeletal fracture is common. The most common facial fracture is mandible fracture and the least common is frontal fracture. Complications due to orbital fracture are more devasting than the other fractures in face."n"nMethods: These descriptive cross sectional studies are designed on 92 patients with orbital fractures in a referral educational trauma center, Imam Khomeini hospital, Tehran, Iran. Sample size was the patients who referred to this hospital with orbital fracture during the ten years period (1986-2000."n"nResults: In this study 74 patients were male and 18 patients were female. Mean age of patients was 30 years. The most common cause of orbital fracture was motor vehicle accident which was seen in 38 patients.46 patients had fracture in left orbit and 44 patients in right. Isolated orbital fracture was seen in 38 patients and 54 patients had concomitant trauma and fracture in the other organs. Management of orbital fracture was reduction of displaced bone fragment and fixation for osteosynthesis. The most common methods for osteosynthesis was

Glacitectonic deformation around the retreating margin of the last Irish ice sheet

Science.gov (United States)

Knight, J.

2008-12-01

Evidence for ice-marginal glacitectonic shunting and deformation of bedrock slabs is described from three sites around the west coast of Ireland. These sites (Brandon Bay, County Kerry; Pigeon Point, County Mayo; Inishcrone, County Sligo) are all locations where the late Devensian ice margin retreated on land and was confined to within limestone bedrock embayments. At these sites, flat-lying bedrock slabs (bedrock slabs have been variously stacked, rotated, deformed into open folds, and brecciated. Separating the bedrock slabs is either a thin layer (bedrock that shows internal folding; or a thicker (bedrock fractures and bedding planes and away from the ice margin, and that bedrock slabs were moved in part by hydraulic lift as well as thrust-style ice-marginal tectonics. The presence of a mosaic of warm and frozen ice-bed patches, in combination with strong geologic control and meltwater generation from behind the ice margin, can help explain formation of these unusual bedrock slab features.

Rapid Geriatric Assessment of Hip Fracture.

Science.gov (United States)

Zanker, Jesse; Duque, Gustavo

2017-08-01

A comprehensive geriatric assessment, combined with a battery of imaging and blood tests, should be able to identify those hip fracture patients who are at higher risk of short- and long-term complications. This comprehensive assessment should be followed by the implementation of a comprehensive multidimensional care plan aimed to prevent negative outcomes in the postoperative period (short and long term), thus assuring a safe and prompt functional recovery while also preventing future falls and fractures. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of Chamfer and Deep Chamfer Preparation Designs on the Fracture Resistance of Zirconia Core Restorations

Directory of Open Access Journals (Sweden)

Ezatollah Jalalian

2011-06-01

Full Text Available Background and aims. One of the major problems of all-ceramic restorations is their probable fracture under occlusal force. The aim of the present in vitro study was to compare the effect of two marginal designs (chamfer and deep chamfer on the fracture resistance of all-ceramic restorations, CERCON. Materials and methods. This in vitro study was carried out with single-blind experimental technique. One stainless steel die with 50’ chamfer finish line design (0.8 mm deep was prepared using a milling machine. Ten epoxy resin dies were prepared. The same die was retrieved and 50' chamfer was converted into a deep chamfer design (1 mm. Again ten epoxy resin dies were prepared from the deep chamfer die. Zirconia cores with 0.4 mm thickness and 35 µm cement space were fabricated on the epoxy resin dies (10 chamfer and 10 deep chamfer samples. The zirconia cores were cemented on the epoxy resin dies and underwent a fracture test with a universal testing machine and the samples were investigated from the point of view of the origin of the failure. Results. The mean values of fracture resistance for deep chamfer and chamfer samples were 1426.10±182.60 and 991.75±112.00 N, respectively. Student’s t-test revealed statistically significant differences between the groups. Conclusion. The results indicated a relationship between the marginal design of zirconia cores and their fracture resistance. A deep chamfer margin improved the biomechanical performance of posterior single zirconia crown restorations, which might be attributed to greater thickness and rounded internal angles in deep chamfer margins.

Medical abortion: understanding perspectives of rural and marginalized women from rural South India.

Science.gov (United States)

Sri, B Subha; Ravindran, T K Sundari

2012-09-01

To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.

Fundamental Solution For The Self-healing Fracture Pulse

Science.gov (United States)

Nielsen, S.; Madariaga, R.

We find the analytical solution for a fundamental fracture mode in the form of a self- similar, self-healing pulse. The existence of such a fracture mode was strongly sug- gested by recent numerical findings but, to our knwledge, no formal proof had been proposed up to date. We present a two dimensional, anti-plane solution for fixed rup- ture and healing velocities, that satisfies both wave equation and stress conditions; we argue that such a solution is plausible even in the absence of rate-weakening in the friction, as an alternative to the classic crack solution. In practice, the impulsive mode rather than the expanding crack mode is selected depending on details of fracture initiation, and is therafter self-maintained. We discuss stress concentration, fracture energy, rupture velocity and compare them to the case of a crack. The analytical study is complemented by various numerical examples and comparisons. On more general grounds, we argue that an infinity of marginally stable fracture modes may exist other than the crack solution or the impulseive fracture described here.

Miniplating of metacarpal fractures: an outcome study

Directory of Open Access Journals (Sweden)

Fallah E

2011-05-01

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Trauma to the hand is very common and consequently, metacarpal fractures are not rare entities. Some of these fractures need surgery. Considering the diversity of surgical methods available for these kinds of fractures and also the importance of achieving full function and speedy return to work for patients that are mainly young workers or athletes, this study was undertaken to investigate the outcome of treating these fractures by mini-plates."n"nMethods : Eighteen patients with open or comminuted fractures of metacarpal bones who were admitted to the emergency department of Sina Hospital between the years 2007 and 2010 underwent fixation surgery using mini-plates. Fourteen patients with 17 metacarpal fractures completed the study."n"nResults : Thirteen out of 14 patients had complete fracture union. The patient with non-union underwent revision surgery and bone graft. Four individuals developed an extensor lag of 15 degrees without functional impairment. Two patients had joint stiffness that was relieved after a period of physiotherapy and one developed wound dehiscence and discharge that improved with debridement and use of antibiotics without plate removal. Six patients had

Diagnostic Accuracy of 2-Dimensional Computed Tomography for Articular Involvement and Fracture Pattern of Posterior Malleolar Fractures.

Science.gov (United States)

Meijer, Diederik T; de Muinck Keizer, Robert-Jan O; Doornberg, Job N; Sierevelt, Inger N; Stufkens, Sjoerd A; Kerkhoffs, Gino M M J; van Dijk, C Niek

2016-01-01

Up to 44% of ankle fractures have involvement of the posterior tibial margin. Fracture size and morphology are important factors to guide treatment of these fragments, but reliability of plain radiography in estimating size is low. The aim of the current study was to evaluate the accuracy of 2-dimensional computed tomography (2DCT) in the assessment of posterior malleolar fractures. Additionally, the diagnostic accuracy of 2DCT and its value in preoperative planning was evaluated. Thirty-one patients with 31 ankle fractures including a posterior malleolar fragment were selected. Preoperative CT scans were analyzed by 50 observers from 23 countries. Quantitative 3-dimensional CT (Q3DCT) reconstructions were used as a reference standard. Articular involvement of the posterior fragment was overestimated on 2DCT by factors 1.6, 1.4, and 2.2 for Haraguchi types I, II, and III, respectively. Interobserver agreement on operative management ("to fix, or not to fix?") was substantial (κ = 0.69) for Haraguchi type I fractures, fair (κ = 0.23) for type II fractures, and poor (κ = 0.09) for type III fractures. 2DCT images led to a change in treatment of the posterior malleolus in 23% of all fractures. Surgeons would operatively treat type I fractures in 63%, type II fractures in 67%, and type III fractures in 22%. Surgeons overestimated true articular involvement of posterior malleolar fractures on 2DCT scans. 2DCT showed some additional value in estimating the involved articular surface when compared to plain radiographs; however, this seemed not yet sufficient to accurately read the fractures. Analysis of the CT images showed a significant influence on choice of treatment in 23% with a shift toward operative treatment in 12% of cases compared to evaluating plain lateral radiographs alone. Level III, comparative study. © The Author(s) 2015.

MR imaging findings of ring apophyseal fractures in lumbar vertebrae

Energy Technology Data Exchange (ETDEWEB)

Kang, Yong Soo; Kwon, Soon Tae; Song, Chang Joon; Lee, Young Hwan; Kim, Hyoung Seob; Lee, Hwan Do; Cho, June Sik; Ahn, Jae Sung; Lee, June Kyu [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

1997-07-01

To assess the location and associated findings of fractures of the posterior lumbar vertebral ring apophysis as seen on MRI We retrospectively evaluated MR findings in 77 patients (86 lesions) with lumbar apophyseal ring fractures. Their age ranged from ten to 67 (mean 33-1) years. To confirm the presence of verterbral ring fractures, CT was performed in 29 patients (31 lesions) within two weeks of MR imaging. Open laminectomy was performed in ten patients, percutaneous automated nucleotomy in three, and LASER operation in four. The most common location of fractures was the superior margin of L5 (36 lesions 41.9%), next was superior margin of S1 (21 lesions, 24.4%). On CT, a bony fragment was seen in 28 patients (30 lesions); the positive predictive value of MR was 99.7%. Multiple lesions were seen in nine patients. Associated disc herniation and bulging were noted in 64 (74.4%) and 15 lesions (17.4%), respectively, and a high signal intensity rim aound the bony fragment on T1 weighted image was noted in 33 (38.4%). Other associated findings were spondylolysis in eight patients, retrolisthesis in five, and spondylolisthesis in three. Operative outcomes were variable. The results of open laminectomy were better than those of percutaneous automated laminectomy or LASER operation. In patients with lumbar apophyseal ring fractures, their exact location and associated findings could be evalvated by MRI, which was therefore useful in the planning of appropriate surgery.

MR imaging findings of ring apophyseal fractures in lumbar vertebrae

International Nuclear Information System (INIS)

Kang, Yong Soo; Kwon, Soon Tae; Song, Chang Joon; Lee, Young Hwan; Kim, Hyoung Seob; Lee, Hwan Do; Cho, June Sik; Ahn, Jae Sung; Lee, June Kyu

1997-01-01

To assess the location and associated findings of fractures of the posterior lumbar vertebral ring apophysis as seen on MRI We retrospectively evaluated MR findings in 77 patients (86 lesions) with lumbar apophyseal ring fractures. Their age ranged from ten to 67 (mean 33-1) years. To confirm the presence of verterbral ring fractures, CT was performed in 29 patients (31 lesions) within two weeks of MR imaging. Open laminectomy was performed in ten patients, percutaneous automated nucleotomy in three, and LASER operation in four. The most common location of fractures was the superior margin of L5 (36 lesions 41.9%), next was superior margin of S1 (21 lesions, 24.4%). On CT, a bony fragment was seen in 28 patients (30 lesions); the positive predictive value of MR was 99.7%. Multiple lesions were seen in nine patients. Associated disc herniation and bulging were noted in 64 (74.4%) and 15 lesions (17.4%), respectively, and a high signal intensity rim aound the bony fragment on T1 weighted image was noted in 33 (38.4%). Other associated findings were spondylolysis in eight patients, retrolisthesis in five, and spondylolisthesis in three. Operative outcomes were variable. The results of open laminectomy were better than those of percutaneous automated laminectomy or LASER operation. In patients with lumbar apophyseal ring fractures, their exact location and associated findings could be evalvated by MRI, which was therefore useful in the planning of appropriate surgery

[Balloon osteoplasty as reduction technique in the treatment of tibial head fractures].

Science.gov (United States)

Freude, T; Kraus, T M; Sandmann, G H

2015-10-01

Tibial plateau fractures requiring surgery are severe injuries of the lower extremities. Depending on the fracture pattern, the age of the patient, the range of activity and the bone quality there is a broad variation in adequate treatment.  This article reports on an innovative treatment concept to address split depression fractures (Schatzker type II) and depression fractures (Schatzker type III) of the tibial head using the balloon osteoplasty technique for fracture reduction. Using the balloon technique achieves a precise and safe fracture reduction. This internal osteoplasty combines a minimal invasive percutaneous approach with a gently rise of the depressed area and the associated protection of the stratum regenerativum below the articular cartilage surface. This article lights up the surgical procedure using the balloon technique in tibia depression fractures. Using the balloon technique a precise and safe fracture reduction can be achieved. This internal osteoplasty combines a minimally invasive percutaneous approach with a gentle raising of the depressed area and the associated protection of the regenerative layer below the articular cartilage surface. Fracture reduction by use of a tamper results in high peak forces over small areas, whereas by using the balloon the forces are distributed over a larger area causing less secondary stress to the cartilage tissue. This less invasive approach might help to achieve a better long-term outcome with decreased secondary osteoarthritis due to the precise and chondroprotective reduction technique.

Twenty-degree-tilt radiography for evaluation of lateral humeral condylar fracture in children

International Nuclear Information System (INIS)

Imada, Hideaki; Tanaka, Ryuji; Itoh, Yohei; Kishi, Kazuhiko

2010-01-01

To investigate the efficacy of '20 -tilt anteroposterior (A-P) radiography' in the assessment of lateral condylar fractures of the distal humerus. Eighteen children with lateral humeral condylar fractures were studied. Every child underwent conventional A-P and lateral radiography, and six children underwent multi-detector computed tomography (MDCT). For the investigation of 20 -tilt radiography, ten children with lateral humeral condylar fractures had conventional and 20 -tilt A-P and lateral radiography both preoperatively and postoperatively. Fragment dislocation was measured at the lateral and medial margins of the fracture on both the conventional A-P and 20 -tilt A-P radiographs. The lateral condylar fragment was triangular and was most prominent posteriorly. The fracture line was typically tilted approximately 20 to a reference line perpendicular to the long axis of the humerus in the lateral view. The extent of dislocation at the lateral and medial margins of the fracture site by 20 -tilt A-P radiography (9.3 ± 3.6 mm and 5.6 ± 2.5 mm) was significantly wider than that measured by the conventional method (6.8 ± 4.1 mm and 2.0 ± 1.5 mm), which may influence treatment. Twenty-degree-tilt A-P radiography may more precisely demonstrate fragment dislocation than standard radiographs and may influence patient treatment. (orig.)

Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture

DEFF Research Database (Denmark)

Lauridsen, Eva; Gerds, Thomas; Andreasen, Jens Ove

2016-01-01

AIM: To analyze the risk of pulp canal obliteration (PCO), pulp necrosis (PN), repair-related resorption (RRR), infection-related resorption (IRR), ankylosis-related resorption (ARR), marginal bone loss (MBL), and tooth loss (TL) for teeth involved in an alveolar process fracture and to identify ...

ADVANCED FRACTURING TECHNOLOGY FOR TIGHT GAS: AN EAST TEXAS FIELD DEMONSTRATION

Energy Technology Data Exchange (ETDEWEB)

Mukul M. Sharma

2005-03-01

The primary objective of this research was to improve completion and fracturing practices in gas reservoirs in marginal plays in the continental United States. The Bossier Play in East Texas, a very active tight gas play, was chosen as the site to develop and test the new strategies for completion and fracturing. Figure 1 provides a general location map for the Dowdy Ranch Field, where the wells involved in this study are located. The Bossier and other tight gas formations in the continental Unites States are marginal plays in that they become uneconomical at gas prices below $2.00 MCF. It was, therefore, imperative that completion and fracturing practices be optimized so that these gas wells remain economically attractive. The economic viability of this play is strongly dependent on the cost and effectiveness of the hydraulic fracturing used in its well completions. Water-fracs consisting of proppant pumped with un-gelled fluid is the type of stimulation used in many low permeability reservoirs in East Texas and throughout the United States. The use of low viscosity Newtonian fluids allows the creation of long narrow fractures in the reservoir, without the excessive height growth that is often seen with cross-linked fluids. These low viscosity fluids have poor proppant transport properties. Pressure transient tests run on several wells that have been water-fractured indicate a long effective fracture length with very low fracture conductivity even when large amounts of proppant are placed in the formation. A modification to the water-frac stimulation design was needed to transport proppant farther out into the fracture. This requires suspending the proppant until the fracture closes without generating excessive fracture height. A review of fracture diagnostic data collected from various wells in different areas (for conventional gel and water-fracs) suggests that effective propped lengths for the fracture treatments are sometimes significantly shorter than those

Fatigue and fracture mechanics in pressure vessels and piping. PVP-Volume 304

International Nuclear Information System (INIS)

Mehta, H.S.; Wilkowski, G.; Takezono, S.; Bloom, J.; Yoon, K.; Aoki, S.; Rahman, S.; Nakamura, T.; Brust, F.; Yoshimura, S.

1995-01-01

Fracture mechanics and fatigue evaluations are an important part of the structural integrity analyses to assure safe operation of pressure vessels and piping components during their service life. The paper presented in this volume illustrate the application of fatigue and fracture mechanics techniques to assess the structural integrity of a wide variety of Pressure Vessels and Piping components. The papers are organized in six sections: (1) fatigue and fracture--vessels; (2) fatigue and fracture--piping; (3) fatigue and fracture--material property evaluations; (4) constraint effects in fracture mechanics; (5) probabilistic fracture mechanics analyses; and (6) user's experience with failure assessment diagrams. Separate abstracts were prepared for most of the papers in this book

An evaluation of fracture toughness of bituminous coal

International Nuclear Information System (INIS)

Pathan, A.G.

2005-01-01

The role of fracture mechanics in the design of rock structures is vitally important. However, because of the complexities of rock structures and lack of understanding of the fundamentals of the failure mechanism, it has become customary to use the engineering properties approach in the design of stable rock structures. Recently considerable attention has been given and attempts are being made to apply the fracture mechanics approach to the design of safe mining structures. In mining engineering the fracture mechanics may be applied to calculate the formation of fracture zones around mine opening, thus estimating support requirements and formulating guide lines for the selection of mine roadway support system. The research work presented here is concerned with the evaluation of fracture toughness of coal under laboratory conditions. Diametral compression test method is used to determine the fracture toughness parameter of coal in the opening model failure. The effect of crack length and dimensionless crack length on the fracture toughness was studied also. A laboratory investigation of fracture toughness of coal in tensile mode failure has led to the conclusion that fracture toughness could be treated as a material property. (author)

Maxillary fractures: a review of 56 cases in a university affiliated hospital

Directory of Open Access Journals (Sweden)

Farahvash MR

2009-07-01

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The aim of this study was to describe the prevalence of different types of maxillary fractures, concurrent fractures and accompanying signs and symptoms. Trauma is the second cause of mortality in Iran, after cardiovascular diseases. In traumatic patients, head, neck and facial bones fractures are common. The maxillary fractures are seen much less commonly than the fractures of the mandible, zygoma, or nose. Maxillary fractures include: (Le fort I, II, III fractures- alveolar process fracture and Sagittal fracture. The most common cause of maxillary fracture is motor vehicle accidents. "n"n Methods: This descriptive cross sectional study designed on 56 patients with maxillary fractures in a referral educational trauma center of Tehran. Sample size was the patients who referred to this hospital with maxillary fracture during past seven years. "n"nResults: Forty eight (86% patients were male and 8(14% were female. Male to female ratio was 6/1. Mean age of patients was 30 years. The most common type of maxillary fracture was infra orbital rim and floor fracture. Among Le fort fracture; Le fort type II was the most common. Paresthesia of infra orbital nerve and malocclusion were

The application of the Risdon approach for mandibular condyle fractures.

Science.gov (United States)

Nam, Seung Min; Lee, Jang Hyun; Kim, Jun Hyuk

2013-07-06

Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures. All of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1-2 months. The Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized.

[Osteosynthesis by tension band wiring of displaced fractures of the olecranon].

Science.gov (United States)

Doursounian, L; Prevot, O; Touzard, R C

1994-01-01

Fifty-two displaced olecranon fractures in adults were treated over a 5-year period. Minimum follow-up was 6 months. Forty-eight fractures were operated and 38 were treated by tension band wiring technique. This technique, applied for all types of fractures, gave good functional results in 33 cases (87%) and fair functional results in 5 cases. Complications include 1 pseudarthrosis, 2 loss of reduction, 2 transient tourniquet palsy and 13 skin problems due to wire protrusion. Tension band wiring is a simple safe and effective technique for displaced olecranon fractures but often requires K-wire removal.

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 ...

In Vitro Evaluation of the Effect of Tooth Structure Loss on Fracture Resistance of Endodontically Treated Teeth

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Shirinzad M

2017-06-01

Full Text Available Introduction: Since preserving the structure of treated teeth is a critical success factor, studying the effects of tooth structure loss on fracture resistance of the tooth tissue appears necessary. The aim of this study was to evaluate the consequences of the loss of different tissues regarding fracture resistance of teeth undergoing root canal treatment without the use of indirect restorations. Methods :In this experimental study, 70 healthy maxillary first premolar teeth were randomly divided into 7 groups of 10 members, including control group, endodontic access preparation only, MOD cavity preparation, cutting buccal cusp, cutting palatal cusp, cutting buccal cusp and marginal ridge, and cutting the palatal cusp and marginal ridge. The coronal section of teeth was restored incrementally with light cure composite. Finally, samples underwent compressive load with 45˚ angle from each cusp slope in the middle of cusp with an instant speed of 1 mm per min in the Instron machine. Fracture resistance was measured and samples were examined under stereo-microscope to evaluate the mode of failure. Results: The resistance to fracture in root canal treated teeth in different groups in order from first to seventh was 797.13 ± 52.92, 722.50 ± 131.40, 432.15 ± 203.20, 592.66 ± 195.86 124.53 ± 33.09, 85.17 ± 18.45, and 26.03 ± 5.21 Newton. ANOVA test showed statistically significant differences between the groups in terms of their fracture resistance (P = 0.000. Conclusions: The results showed that fracture resistance levels of teeth were significantly affected by amount of their tissue loss. In this study, removal of teeth palatal cusp and marginal ridge had a significant effect on decreasing the fracture resistance, while removing the buccal cusps alone cannot have a significant effect.

Uplift history of a transform continental margin revealed by the stratigraphic record: The case of the Agulhas transform margin along the Southern African Plateau

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Baby, Guillaume; Guillocheau, François; Boulogne, Carl; Robin, Cécile; Dall'Asta, Massimo

2018-04-01

The south and southeast coast of southern Africa (from 28°S to 33°S) forms a high-elevated transform passive margin bounded to the east by the Agulhas-Falkland Fracture Zone (AFFZ). We analysed the stratigraphic record of the Outeniqua and Durban (Thekwini) Basins, located on the African side of the AFFZ, to determine the evolution of these margins from the rifting stage to present-day. The goal was to reconstruct the strike-slip evolution of the Agulhas Margin and the uplift of the inland high-elevation South African Plateau. The Agulhas transform passive margin results from four successive stages: Rifting stage, from Late Triassic to Early Cretaceous ( 200?-134 Ma), punctuated by three successive rifting episodes related to the Gondwana breakup; Wrench stage (134-131 Ma), evidenced by strike- and dip-slip deformations increasing toward the AFFZ; Active transform margin stage (131-92 Ma), during which the Falkland/Malvinas Plateau drifts away along the AFFZ, with an uplift of the northeastern part of the Outeniqua Basin progressively migrating toward the west; Thermal subsidence stage (92-0 Ma), marked by a major change in the configuration of the margin (onset of the shelf-break passive margin morphology). Two main periods of uplift were documented during the thermal subsidence stage of the Agulhas Margin: (1) a 92 Ma short-lived margin-scale uplift, followed by a second one at 76 Ma located along the Outeniqua Basin and; (2) a long-lasting uplift from 40 to 15 Ma limited to the Durban (Thekwini) Basin. This suggests that the South African Plateau is an old Upper Cretaceous relief (90-70 Ma) reactivated during Late Eocene to Early Miocene times (40-15 Ma).

Is the cervical spine clear? Undetected cervical fractures diagnosed only at autopsy.

Science.gov (United States)

Sweeney, J F; Rosemurgy, A S; Gill, S; Albrink, M H

1992-10-01

Undetected cervical-spine injuries are a nemesis to both trauma surgeons and emergency physicians. Radiographic protocols have been developed to avoid missing cervical-spine fractures but are not fail-safe. Three case reports of occult cervical fractures documented at autopsy in the face of normal cervical-spine radiographs and computerized tomography scans are presented.

Finnie's notes on fracture mechanics fundamental and practical lessons

CERN Document Server

Dharan, C K H; Finnie, Iain

2016-01-01

This textbook consists primarily of notes by Iain Finnie who taught a popular course on fracture mechanics at the University of California at Berkeley. It presents a comprehensive and detailed exposition of fracture, the fundamentals of fracture mechanics and procedures for the safe design of engineering components made from metal alloys, brittle materials like glasses and ceramics, and composites. Interesting and practical problems are listed at the end of most chapters to give the student practice in applying the theory. A solutions manual is provided to the instructor. The text presents a unified perspective of fracture with a strong fundamental foundation and practical applications. In addition to its role as a text, this reference would be invaluable for the practicing engineer who is involved in the design and evaluation of components that are fracture critical. This book also: Presents details of derivations of the basic equations of fracture mechanics and the historical context of the development of f...

Probabilistic fracture mechanics analysis of reactor vessels with low upper-shelf fracture toughness

International Nuclear Information System (INIS)

Yoon, K.K.

1993-01-01

A class of submerged-arc welds used in fabricating early reactor vessels has relatively high copper contents. Studies have shown that when such vessels are irradiated, the copper contributes to lowering the Charpy upper-shelf energy level. To address this concern, 10CFR50, Appendix G requires a fracture mechanics analysis to demonstrate an adequate margin of safety for continued service. The B and W Owners Group (B and WOG) has been accumulating J-resistance fracture toughness data for these weld metals. Based on a mathematical model derived from this B and WOG data base, the first Appendix G analysis was performed. Another important issue affecting reactor vessel integrity is pressurized thermal shock (PIS) transients. In the early 1980s, probabilistic fracture mechanics analyses were performed on a reactor vessel to determine the probability of failure under postulated accident scenarios. Results of such analyses were used by the Nuclear Regulatory Commission (NRC) to establish the screening criteria for assessing reactor vessel integrity under PTS transient loads. This paper addresses the effect of low upper-shelf toughness on the probability of failure of reactor vessels under PTS loads. Probabilistic fracture mechanics codes were modified to include the low upper-shelf toughness model used in a reference and a series of analyses was performed using plant-specific material conditions and realistic PTS scenarios. The results indicate that low upper-shelf toughness has an insignificant effect on the probability of reactor vessel failures. This is mostly due to PTS transients being susceptible to crack initiation at low temperatures and not affected by upper-shelf fracture toughness

A QI Initiative to Reduce Hospitalization for Children With Isolated Skull Fractures.

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Lyons, Todd W; Stack, Anne M; Monuteaux, Michael C; Parver, Stephanie L; Gordon, Catherine R; Gordon, Caroline D; Proctor, Mark R; Nigrovic, Lise E

2016-06-01

Although children with isolated skull fractures rarely require acute interventions, most are hospitalized. Our aim was to safely decrease the hospitalization rate for children with isolated skull fractures. We designed and executed this multifaceted quality improvement (QI) initiative between January 2008 and July 2015 to reduce hospitalization rates for children ≤21 years old with isolated skull fractures at a single tertiary care pediatric institution. We defined an isolated skull fracture as a skull fracture without intracranial injury. The QI intervention consisted of 2 steps: (1) development and implementation of an evidence-based guideline, and (2) dissemination of a provider survey designed to reinforce guideline awareness and adherence. Our primary outcome was hospitalization rate and our balancing measure was hospital readmission within 72 hours. We used standard statistical process control methodology to assess change over time. To assess for secular trends, we examined admission rates for children with an isolated skull fracture in the Pediatric Health Information System administrative database. We identified 321 children with an isolated skull fracture with a median age of 11 months (interquartile range 5-16 months). The baseline admission rate was 71% (179/249, 95% confidence interval, 66%-77%) and decreased to 46% (34/72, 95% confidence interval, 35%-60%) after implementation of our QI initiative. No child was readmitted after discharge. The admission rate in our secular trend control group remained unchanged at 78%. We safely reduced the hospitalization rate for children with isolated skull fractures without an increase in the readmissions. Copyright © 2016 by the American Academy of Pediatrics.

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

Assessment of fracture toughness of structural steels

Energy Technology Data Exchange (ETDEWEB)

Gomes Junyor, José Onésimo; Faria, Stéfanno Bruno; Rocha, Nirlando Antônio; Reis, Emil; Vilela, Jefferson José, E-mail: ze_onezo@hotmail.com, E-mail: sbrunofaria@gmail.com, E-mail: nar@cdtn.br, E-mail: emilr@cdtn.br, E-mail: jjv@cdtn.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Centro Universitário de Belo Horizonte (UNIBH), MG (Brazil); Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2017-11-01

The fracture toughness parameters are applied to estimate the lifetime of mechanical components and define the criteria of safe failure and tolerable damages. This information allows equipment to be used longer with a high degree of safety. These techniques are applied in the Leak-Before-Break (LBB) concept that is accepted for designing the piping system of the primary circuit of the pressurized water reactor (PWR). In this work, fracture toughness tests such as J{sub IC} and CTOD were performed on some structural steels. The fracture toughness parameters were determined using SE(B) and C(T) test specimens. The fracture toughness values for the same material varied according to the type specimen. The parameter δ{sub 1c} showed different values when it was calculated using the ASTM E1820 standard and using the BS 7448: Part 1 standard. These results indicate that procedures of these standards need to be improved. Two systems with different sensitivity in the force measurement were used that showed similar results for toughness fracture but the dispersion was different. (author)

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

Parametric investigation of fracture of EBR-II ducts

International Nuclear Information System (INIS)

Chopra, P.S.; Moustakakis, B.

1977-01-01

Results of preliminary static and dynamic finite element fracture mechanics analyses that were conducted to analytically simulate the dynamic fracture behavior of EBR-II ducts are presented. The loads considered are those that may arise because of rapid release of fission gases from a failed fuel element inside a duct, obtained from some previous tests and a recent analytical model. In spite of the motivation for the present work, the analytical procedures described may have a wider general application in the fail-safe design of structures

CT of the acetabular fracture

International Nuclear Information System (INIS)

Magu, N.K.; Moda, S.K.; Magu, Sarita; Airon, R.K.

1993-01-01

Nine patients with 10 injured hips, in whom acetabular fractures with posterior dislocation of the femoral heads were demonstrated on initial radiography, underwent CT. CT was found superior in detecting the presence of intra-articular bony fragments in Group A patients (40%), where conventional radiography exhibited congruous manipulative reduction of the joint surfaces. The spatial position of the intra-articular fragments could not be ascertained on conventional radiography in 40% of the patients in Group B, in whom congruous manipulative reduction could not be achieved and subluxation of the femoral heads was observed. On conventional radiography, it was also difficult to appreciate the presence of intra-articular fragments in 60% of the patients in Group B, in whom either the dislocation could not be reduced (40%) or the femoral head redislocated after close manipulative reduction (20%). CT proved its superiority in detecting the extent of the fractures of the acetabular roof, posterior and anterior acetabular margins, the quadrilateral plate along with rotation of the acetabular columns and displacements of the major fractured fragments. Associated fractures of the sacrum (20%), and traumatic lesions of the sacro-iliac joint (20%), not apparent on conventional radiography were well demonstrated by CT. As a result of CT, the treatment was changed in 60% of the patients in Group A, and 40% in Group B. In addition, CT permitted a better choice of surgical technique in the management of acetabular fractures. (author). 9 refs., 3 figs., 2 tabs

Correction factors for safe performance of API X65 pipeline steel

International Nuclear Information System (INIS)

Hashemi, Sayyed H.

2009-01-01

Prediction of required Charpy energy for fracture arrest is vital for safe performance of gas transportation pipelines. This is commonly estimated through failure models calibrated in the past on fracture data from combined Charpy tests and full-thickness burst experiments. Unfortunately, such pipeline failure models are unable to correctly predict the minimum arrest toughness of thermo-mechanical controlled rolled (TMCR) steels. To refine the existing failure models, different empirical adjustments have been proposed in recent years. In this paper, similar correction factors were derived from fracture information of instrumented Charpy impact tests on API X65 steel. The contribution of different fracture mechanisms of impact test specimens was determined through energy partitioning analysis. Parts of the energy contribution were correlated then to the source of uncertainty observed in similar experiments. The applied technique was similar to that of previous studies on X70 and X100 steels, and proved to be encouraging in giving consistent results compared to available test data.

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

Science.gov (United States)

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

2014-01-01

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

Safe Spaces in Online Places: Social Media and LGBTQ Youth

Science.gov (United States)

Lucero, Leanna

2017-01-01

This study responds to a need for research in a fast-growing and significant area of study, that of exploring, understanding and documenting the numerous ways that multiply marginalized LGBTQ youth use social media as part of their everyday experiences in an attempt to safely navigate their lives through learning, participating, engaging,…

Virtual stress testing of fracture stability in soldiers with severely comminuted tibial fractures.

Science.gov (United States)

Petfield, Joseph L; Hayeck, Garry T; Kopperdahl, David L; Nesti, Leon J; Keaveny, Tony M; Hsu, Joseph R

2017-04-01

Virtual stress testing (VST) provides a non-invasive estimate of the strength of a healing bone through a biomechanical analysis of a patient's computed tomography (CT) scan. We asked whether VST could improve management of patients who had a tibia fracture treated with external fixation. In a retrospective case-control study of 65 soldier-patients who had tibia fractures treated with an external fixator, we performed VST utilizing CT scans acquired prior to fixator removal. The strength of the healing bone and the amount of tissue damage after application of an overload were computed for various virtual loading cases. Logistic regression identified computed outcomes with the strongest association to clinical events related to nonunion within 2 months after fixator removal. Clinical events (n = 9) were associated with a low tibial strength for compression loading (p fracture patients who can safely resume weight bearing. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:805-811, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Multidisciplinary treatment of a fractured maxillary central incisor

Directory of Open Access Journals (Sweden)

Praveen Kumar Neela

2017-01-01

Full Text Available Subgingivally fractured incisors are still a challenge to treat. Restoration of severely damaged teeth requires careful attention and comprehensive preplanned treatment. Here, a patient who had traumatic injury to the upper left central incisor which led to an oblique fracture involving enamel, dental and extending into the root below the gingival margin was saved from extraction by accelerated forced eruption of a root portion, allowing placement of crown, and eliminating the need for a fixed partial denture. A tooth otherwise would have gone for extraction routinely was thus saved and restored through a multidisciplinary approach by a combined orthodontic, periodontal and endodontic treatment.

MRI of occult sacral insufficiency fractures following radiotherapy

International Nuclear Information System (INIS)

Mammone, J.F.; Schweitzer, M.E.

1995-01-01

Following radiation therapy, marrow abnormalities noted on magnetic resonance imaging (MRI) are frequent and may mimic metastases. Specific radiotherapy changes are usually easily identifiable; however, traumatic lesions cause more interpretive difficulties. We assessed the incidence and MRI characteristics of insufficiency fractures in this population. During a 5-year span (1987-1991), 546 patients received pelvic radiotherapy for primary malignancies. MRI was performed in 25 of these patients at least 3 months after treatment. The mean dose in this group was 53 Gy. These MRI scans were retrospectively reviewed for the appearance of the sacrum with particular attention to the presence of insufficiency fractures. This was correlated with clinical course and scintigraphic findings. Presumed insufficiency fractures on MRI paralleled the sacral side of the sacroiliac joint, enhanced with Gd-DTPA, were most prominent or initially seen anteriorly, and had ill-defined margins on all imaging sequences. The incidence of occult sacral insufficiency fractures was at least 20%. Insufficiency fractures of the sacrum in the post-radiotherapy patient are a relatively frequent occurrence which can mimic metastases. Consideration of this phenomenon and knowledge of differential features may avoid overdiagnosis of osseous metastases. (orig.)

Fracture assessment of Savannah River Reactor carbon steel piping

International Nuclear Information System (INIS)

Mertz, G.E.; Stoner, K.J.; Caskey, G.R.; Begley, J.A.

1991-01-01

The Savannah River Site (SRS) production reactors have been in operation since the mid-1950's. One postulated failure mechanism for the reactor piping is brittle fracture of the original A285 and A53 carbon steel piping. Material testing of archival piping determined (1) the static and dynamic tensile properties; (2) Charpy impact toughness; and (3) the static and dynamic compact tension fracture toughness properties. The nil-ductility transition temperature (NDTT), determined by Charpy impact test, is above the minimum operating temperature for some of the piping materials. A fracture assessment was performed to demonstrate that potential flaws are stable under upset loading conditions and minimum operating temperatures. A review of potential degradation mechanisms and plant operating history identified weld defects as the most likely crack initiation site for brittle fracture. Piping weld defects, as characterized by radiographic and metallographic examination, and low fracture toughness material properties were postulated at high stress locations in the piping. Normal operating loads, upset loads, and residual stresses were assumed to act on the postulated flaws. Calculated allowable flaw lengths exceed the size of observed weld defects, indicating adequate margins of safety against brittle fracture. Thus, a detailed fracture assessment was able to demonstrate that the piping systems will not fail by brittle fracture, even though the NDTT for some of the piping is above the minimum system operating temperature

Probabilistic pipe fracture evaluations for leak-rate-detection applications

International Nuclear Information System (INIS)

Rahman, S.; Ghadiali, N.; Paul, D.; Wilkowski, G.

1995-04-01

Regulatory Guide 1.45, open-quotes Reactor Coolant Pressure Boundary Leakage Detection Systems,close quotes was published by the U.S. Nuclear Regulatory Commission (NRC) in May 1973, and provides guidance on leak detection methods and system requirements for Light Water Reactors. Additionally, leak detection limits are specified in plant Technical Specifications and are different for Boiling Water Reactors (BWRs) and Pressurized Water Reactors (PWRs). These leak detection limits are also used in leak-before-break evaluations performed in accordance with Draft Standard Review Plan, Section 3.6.3, open-quotes Leak Before Break Evaluation Proceduresclose quotes where a margin of 10 on the leak detection limit is used in determining the crack size considered in subsequent fracture analyses. This study was requested by the NRC to: (1) evaluate the conditional failure probability for BWR and PWR piping for pipes that were leaking at the allowable leak detection limit, and (2) evaluate the margin of 10 to determine if it was unnecessarily large. A probabilistic approach was undertaken to conduct fracture evaluations of circumferentially cracked pipes for leak-rate-detection applications. Sixteen nuclear piping systems in BWR and PWR plants were analyzed to evaluate conditional failure probability and effects of crack-morphology variability on the current margins used in leak rate detection for leak-before-break

Am I Safe Here? LGBTQ Teens and Bullying in Schools

Science.gov (United States)

Short, Donn

2017-01-01

"Am I safe here?" LGBTQ students ask this question every day within the school system. This book shines a light on the marginalization and bullying faced by LGBTQ youth, offering a new conceptualization of school safety. Donn Short treats students as the experts on what happens in their schools, giving them a chance to speak for…

Methodology for plastic fracture - a progress report

International Nuclear Information System (INIS)

Wilkinson, J.P.D.; Smith, R.E.E.

1977-01-01

This paper describes the progress of a study to develop a methodology for plastic fracture. Such a fracture mechanics methodology, having application in the plastic region, is required to assess the margin of safety inherent in nuclear reactor pressure vessels. The initiation and growth of flaws in pressure vessels under overload conditions is distinguished by a number of unique features, such as large scale yielding, three-dimensional structural and flaw configurations, and failure instabilities that may be controlled by either toughness or plastic flow. In order to develop a broadly applicable methodology of plastic fracture, these features require the following analytical and experimental studies: development of criteria for crack initiation and growth under large scale yielding; the use of the finite element method to describe elastic-plastic behaviour of both the structure and the crack tip region; and extensive experimental studies on laboratory scale and large scale specimens, which attempt to reproduce the pertinent plastic flow and crack growth phenomena. This discussion centers on progress to date on the selection, through analysis and laboratory experiments, of viable criteria for crack initiation and growth during plastic fracture. (Auth.)

Marginal bone-level alterations of loaded zirconia and titanium dental implants: an experimental study in the dog mandible.

Science.gov (United States)

Thoma, Daniel S; Benic, Goran I; Muñoz, Fernando; Kohal, Ralf; Sanz Martin, Ignacio; Cantalapiedra, Antonio G; Hämmerle, Christoph H F; Jung, Ronald E

2016-04-01

The aim was to test whether or not the marginal bone-level alterations of loaded zirconia implants are similar to the bone-level alterations of a grade 4 titanium one-piece dental implant. In six dogs, all premolars and the first molars were extracted in the mandible. Four months later, three zirconia implants (BPI, VC, ZD) and a control titanium one-piece (STM) implant were randomly placed in each hemimandible and left for transmucosal healing (baseline). Six months later, CAD/CAM crowns were cemented. Sacrifice was scheduled at 6-month postloading. Digital X-rays were taken at implant placement, crowns insertion, and sacrifice. Marginal bone-level alterations were calculated, and intra- and intergroup comparisons performed adjusted by confounding factors. Implants were successfully placed. Until crown insertion, two implants were fractured (one VC, one ZD). At sacrifice, 5 more implants were (partly) fractured (one BPI, four ZD), and one lost osseointegration (VC). No decementation of crowns occurred. All implant systems demonstrated a statistically significant (except VC) loss of marginal bone between baseline and crown insertion ranging from 0.29 mm (VC; P = 0.116) to 0.80 mm (ZD; P = 0.013). The estimated marginal bone loss between baseline and 6 months of loading ranged between 0.19 mm (BPI) and 1.11 mm (VC), being statistically significant for STM and VC only (P implants and control implants (STM vs. BPI P = 0.007; vs. VC P = 0.001; vs. ZD P = 0.011). Zirconia implants were more prone to fracture prior to and after loading with implant-supported crowns compared to titanium implants. Individual differences and variability in the extent of the bone-level changes during the 12-month study period were found between the different implant types and materials. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Systems considerations in seismic margin evaluations

International Nuclear Information System (INIS)

Buttermer, D.R.

1987-01-01

Increasing knowledge in the geoscience field has led to the understanding that, although highly unlikely, it is possible for a nuclear power plant to be subjected to earthquake ground motion greater than that for which the plant was designed. While it is recognized that there are conservatisms inherent in current design practices, interest has developed in evaluating the seismic risk of operating plants. Several plant-specific seismic probabilistic risk assessments (SPRA) have been completed to address questions related to the seismic risk of a plant. The results from such SPRAs are quite informative, but such studies may entail a considerable amount of expensive analysis of large portions of the plant. As an alternative to an SPRA, it may be more practical to select an earthquake level above the design basis for which plant survivability is to be demonstrated. The principal question to be addressed in a seismic margin evaluation is: At what ground motion levels does one have a high confidence that the probability of seismically induced core damage is sufficiently low? In a seismic margin evaluation, an earthquake level is selected (based on site-specific geoscience considerations) for which a stable, long-term safe shutdown condition is to be demonstrated. This prespecified earthquake level is commonly referred to as the seismic margin earthquake (SME). The Electric Power Research Institute is currently supporting a research project to develop procedures for use by the utilities to allow them to perform nuclear plant seismic margin evaluations. This paper describes the systems-related aspects of these procedures

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

Inferring biological evolution from fracture patterns in teeth.

Science.gov (United States)

Lawn, Brian R; Bush, Mark B; Barani, Amir; Constantino, Paul J; Wroe, Stephen

2013-12-07

It is hypothesised that specific tooth forms are adapted to resist fracture, in order to accommodate the high bite forces needed to secure, break down and consume food. Three distinct modes of tooth fracture are identified: longitudinal fracture, where cracks run vertically between the occlusal contact and the crown margin (or vice versa) within the enamel side wall; chipping fracture, where cracks run from near the edge of the occlusal surface to form a spall in the enamel at the side wall; and transverse fracture, where a crack runs horizontally through the entire section of the tooth to break off a fragment and expose the inner pulp. Explicit equations are presented expressing critical bite force for each fracture mode in terms of characteristic tooth dimensions. Distinctive transitions between modes occur depending on tooth form and size, and loading location and direction. Attention is focussed on the relatively flat, low-crowned molars of omnivorous mammals, including humans and other hominins and the elongate canines of living carnivores. At the same time, allusion to other tooth forms - the canines of the extinct sabre-tooth (Smilodon fatalis), the conical dentition of reptiles, and the columnar teeth of herbivores - is made to highlight the generality of the methodology. How these considerations impact on dietary behaviour in fossil and living taxa is discussed. © 2013 Elsevier Ltd. All rights reserved.

Seismic margin analysis for Kashiwazaki Kariwa ABWR plant considering the Niigataken Chuetsu-oki earthquake

International Nuclear Information System (INIS)

Matsuo, Toshihiro; Nagasawa, Kazuyuki; Kawamura, Shinichi; Ueki, Takashi; Higuchi, Tomokazu; Sakaki, Isao

2009-01-01

Seismic Margin Analysis (SMA) study was conducted for Kashiwazaki Kariwa (KK) ABWR representative plant (unit 6). Considering that the installation behaved in a safe manner during and after the Niigataken Chuetsu-oki (NCO) Earthquake which significantly exceeded the level of the seismic input taken into account in the design of the plant, the study to find out how much margin the ABWR plant had toward the same seismic motion was conducted. In this study fragility analyses were conducted for SSCs that were included in the accident sequences and that were considered to have relatively small margin taking EPRI margin analysis method into consideration. In order to calculate plant level seismic margin Min-Max method was adopted. As the result of this study, the plant level High Confidence Low Probability of Failure (HCLPF) acceleration for unit 6 was calculated more than tripled NCO earthquake motion. (author)

Concepts and possibilities of fracture mechanics for fracture safety assessment

International Nuclear Information System (INIS)

Blauel, J.

1980-01-01

In very tough materials for pressure vessels and pipelines of nuclear plants, cracking begins in a stable manner and only after macroscopic plastic deformations and crack blunting. It is possible to describe this elasto-plastic fracture behaviour and to quantify the safety margin compared to the assessment criteria based on linear elastic stressing and initiation by the concept of the J integral, the crack peak width and the crack resistance Jsub(R) curve. The numerous problems of details still open and the partly very limited validity range should not prevent the further investigation into the great possibilities of this concept and making greater use of the interpretation of large scale tests. (orig./RW) [de

Accurate, safe, and rapid method of intraoperative tumor identification for totally laparoscopic distal gastrectomy: injection of mixed fluid of sodium hyaluronate and patent blue.

Science.gov (United States)

Nakagawa, Masatoshi; Ehara, Kazuhisa; Ueno, Masaki; Tanaka, Tsuyoshi; Kaida, Sachiko; Udagawa, Harushi

2014-04-01

In totally laparoscopic distal gastrectomy, determining the resection line with safe proximal margins is often difficult, particularly for tumors located in a relatively upper area. This is because, in contrast to open surgery, identifying lesions by palpating or opening the stomach is essentially impossible. This study introduces a useful method of tumor identification that is accurate, safe, and rapid. On the operation day, after inducing general anesthesia, a mixture of sodium hyaluronate and patent blue is injected into the submucosal layer of the proximal margin. When resecting stomach, all marker spots should be on the resected side. In all cases, the proximal margin is examined histologically by using frozen sections during the operation. From October 2009 to September 2011, a prospective study that evaluated this method was performed. A total of 34 patients who underwent totally laparoscopic distal gastrectomy were enrolled in this study. Approximately 5 min was required to complete the procedure. Proximal margins were negative in all cases, and the mean ± standard deviation length of the proximal margin was 23.5 ± 12.8 mm. No side effects, such as allergy, were encountered. As a method of tumor identification for totally laparoscopic distal gastrectomy, this procedure appears accurate, safe, and rapid.

How safe is safe?

International Nuclear Information System (INIS)

Hughes, C.F.; Flood, M.

1996-01-01

60 and 70 degree convexo-concave valve. Nine hundred and one valves were implanted in Australia. Twelve strut fractures were reported. Two other patients have been explanted and have demonstrated 'single leg separation'. This particular problem was only investigated when two patients died of a fractured valve in the same hospital on the same day. A retrospective study of all known patients in Australia has shown poor follow up, lack of knowledge and indeed lack of interest in device failure modes. Consequently, the Australian and New Zealand Heart Valve Registry was established to track all implanted valves and to notify physicians of any new information. This is perhaps the first device-specific register in Australia. The safety of individual devices is often not known by manufacturers, regulators and clinicians alike. No follow up is available and large volume long term studies are yet to be implemented for the majority of devices. Without such studies and without mandatory problem reporting, the relative safety of medical devices will continue to be measured by banner headlines, sensational TV 'grabs' and protracted law suits. At present, only schemes such as the Problem Reporting Scheme can tell us (albeit vaguely) 'how safe is safe'

Minimally invasive surgery under fluoro-navigation for anterior pelvic ring fractures

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Kai-Hua Zhou

2016-01-01

Conclusions: Fluoro-navigation technique could become a safe, accurate, and fairly quick method for the treatment of anterior pelvic ring fractures. Standardization of the operative procedure and training are mandatory for the success of this procedure.

Once-yearly zoledronic acid in hip fracture prevention

Science.gov (United States)

Demontiero, Oddom; Duque, Gustavo

2009-01-01

Osteoporosis is an escalating global problem. Hip fractures, the most catastrophic complication of osteoporosis, continue to cause significant mortality and morbidity despite increasing availability of effective preventative agents. Among these agents, oral bisphosphonates have been the first choice for the treatment and prevention of osteoporotic fractures. However, the use of oral bisphosphonates, especially in the older population, has been limited by their side effects and method of administration thus compromising their persistent use. The resultant low adherence by patients has undermined their full potential and has been associated with an increase in the incidence of fragility fractures. Recently, annual intravenous zoledronic acid (ZOL) has been approved for osteoporosis. Randomized controlled trials have demonstrated ZOL to be safe, have good tolerability and produce significant effect on bone mass and microarchitecture. Adherence has also been shown to be better with ZOL. Furthermore two large trials firmly demonstrated significant anti-osteoporotic effect (∼59% relative risk reduction of hip fractures) and mortality benefit (28% reduction in mortality) of ZOL in older persons with recent hip fractures. In this review, we report the current evidence on the use of ZOL for the prevention of hip fractures in the elderly. We also report the pharmacological characteristics and the advantages and disadvantages of ZOL in this particular group. PMID:19503777

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

Science.gov (United States)

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

2016-10-01

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

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.

Assessment of margins with respect to pressurized thermal shock for the 3 loop plants of the French program

International Nuclear Information System (INIS)

Buchalet, C.; Haussaire, P.; Houssin, B.; Vagner, J.

1983-08-01

Presentation of the FRAMATOME and EDF program on pressurized thermal shock which objectives are to demonstrate that present and older French reactor vessels have adequate safety margins and to provide recommendations of feasible plant specific modifications, both technically and economically. Phase I consists in a thorough analysis of pressure and temperature transients that the R.P.V. beltine could undergo during plant operations; phase II is the fracture mechanics analysis; phase III estimates the safety margins available during normal, upset, emergency and faulted conditions

Prevention of Fractures in Older People with Calcium and Vitamin D

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Caryl A. Nowson

2010-09-01

Full Text Available The greatest cause of fracture in older people is osteoporosis which contributes to increased morbidity and mortality in older people. A number of meta-analyses have been performed assessing the effectiveness of calcium supplementation alone, vitamin D supplementation alone and the combined therapy on bone loss and fracture reduction in older people. The results of these meta-analyses indicate that vitamin D supplementation alone is unlikely to reduce fracture risk, calcium supplementation alone has a modest effect in reducing total fracture risk, but compliance with calcium supplements is poor in the long term. The combination of calcium supplementation with vitamin D supplementation, particularly in those at risk of marginal and low vitamin D status reduces total fractures, including hip fractures. Therefore older people would be recommended to consume adequate dietary calcium (>1100 mg/day together with maintaining adequate vitamin D status (>60 nmol/L 25(OHD to reduce risk of fracture. It is a challenge to consume sufficient dietary calcium from dietary sources, but the increasing range of calcium fortified foods could assist in increasing the dietary calcium intake of older people. In addition to the usual dairy based food sources, vitamin D supplements are likely to be required for older people with reduced mobility and access to sunlight.

Is Closed Manipulative Reduction and Percutaneous Kirschner Wiring of Supracondylar Humeral Fracture in Children as Day-Care Surgery a Safe Procedure ?

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Ashok R Nayak

2013-07-01

Full Text Available INTRODUCTION: Supracondylar fracture of the humerus is a common injury in children. It accounts for 60% of fractures around the elbow children. If the fracture is not treated properly it may give rise to many complications like malunion, Volkmann’s ischemic contracture, nerve injury, arterial injury, skin slough, heterotopic bone formation , and stiffness of elbow. The management of displaced supracondylar fracture of the elbow is one of the most difficult of the many fractures seen in children. The purpose of the study was to evaluate the anatomical and functional results of treatment of supracondylar fractures of humerus with closed reduction and percutaneous ‘K’ wire fixation as a day care procedure and record associated complications, thus decreasing the cost of treating these fractures and hospitalization. METHODS: Fifty displaced closed extension type supracondylar fractures (Gartland’s type III of the humerus in children were treated by closed reduction and percutaneous fixation with Kirschner wires. All the patients selected for this study had been treated in a day care unit and were discharged in the same evening and followed up at 3 and 6 weeks and 3 months. Open fractures, fractures with neurovascular complications and children older than 15 yrs were excluded. The final results were evaluated by Flynn’s criteria. RESULTS: The majority (72%, of the patients had fracture displaced posteomedially, Fourty one of the fifty patients had satisfactory results. The majority of the patients were male, and the average age was 8-9 years. CONCLUSION: Percutaneous fixation of supracondylar humerus done as a day care procedure is an acceptable modality of treatment and reduces the duration of hospital stay for the patient.

Methodological comparison of marginal structural model, time-varying Cox regression, and propensity score methods: the example of antidepressant use and the risk of hip fracture.

Science.gov (United States)

Ali, M Sanni; Groenwold, Rolf H H; Belitser, Svetlana V; Souverein, Patrick C; Martín, Elisa; Gatto, Nicolle M; Huerta, Consuelo; Gardarsdottir, Helga; Roes, Kit C B; Hoes, Arno W; de Boer, Antonius; Klungel, Olaf H

2016-03-01

Observational studies including time-varying treatments are prone to confounding. We compared time-varying Cox regression analysis, propensity score (PS) methods, and marginal structural models (MSMs) in a study of antidepressant [selective serotonin reuptake inhibitors (SSRIs)] use and the risk of hip fracture. A cohort of patients with a first prescription for antidepressants (SSRI or tricyclic antidepressants) was extracted from the Dutch Mondriaan and Spanish Base de datos para la Investigación Farmacoepidemiológica en Atención Primaria (BIFAP) general practice databases for the period 2001-2009. The net (total) effect of SSRI versus no SSRI on the risk of hip fracture was estimated using time-varying Cox regression, stratification and covariate adjustment using the PS, and MSM. In MSM, censoring was accounted for by inverse probability of censoring weights. The crude hazard ratio (HR) of SSRI use versus no SSRI use on hip fracture was 1.75 (95%CI: 1.12, 2.72) in Mondriaan and 2.09 (1.89, 2.32) in BIFAP. After confounding adjustment using time-varying Cox regression, stratification, and covariate adjustment using the PS, HRs increased in Mondriaan [2.59 (1.63, 4.12), 2.64 (1.63, 4.25), and 2.82 (1.63, 4.25), respectively] and decreased in BIFAP [1.56 (1.40, 1.73), 1.54 (1.39, 1.71), and 1.61 (1.45, 1.78), respectively]. MSMs with stabilized weights yielded HR 2.15 (1.30, 3.55) in Mondriaan and 1.63 (1.28, 2.07) in BIFAP when accounting for censoring and 2.13 (1.32, 3.45) in Mondriaan and 1.66 (1.30, 2.12) in BIFAP without accounting for censoring. In this empirical study, differences between the different methods to control for time-dependent confounding were small. The observed differences in treatment effect estimates between the databases are likely attributable to different confounding information in the datasets, illustrating that adequate information on (time-varying) confounding is crucial to prevent bias. Copyright © 2016 John Wiley & Sons, Ltd.

A pilot study of the marginal adaptation and surface morphology of glass-cermet cements.

Science.gov (United States)

Chu, C H; King, N M; Lee, A M; Yiu, C K; Wei, S H

1996-07-01

This study investigated changes in the marginal adaptation and surface morphology of Ketac-Silver and Chelon-Silver glass-current cements over time. Dispersalloy amalgam was used as a control. Contralateral pairs of carious primary molars were restored with the test materials and amalgam. Clinical evaluations were scheduled at 12, 18, and 24 months after placement. Gold-plated replicas of the restorations were observed with scanning electron microscopy. Fractures and cracks in the surface of the Dispersalloy and Chelon-Silver increased the surface roughness; however, the damage was superficial and self-limiting in the Dispersalloy restorations, while in Chelon-Silver the fractures caused the material to break down in layers. A substantial quantity of pores, usually smaller than 50 microns in diameter, were observed throughout the surface of the Chelon-Silver restorations. The pores in the surface of Ketac-Silver were fewer and smaller. The incidence of cavomarginal breakdown increased with time. Chelon-Silver restorations had a higher rate of cavomarginal breakdown than did Ketac-Silver and Dispersalloy restorations up to 18 months. However, there was no statistically significant difference in the marginal adaptation of the three groups at 24 months.

Possible origin, nature, extent and tectomic position of joints and fracture in salt formations

International Nuclear Information System (INIS)

Weiss, H.M.

1984-01-01

The evaluation of about 500 bibliographic references for the safe ultimate storage in salt leds to the following results: fractures in rock salt and potash salt are formed in all types of storage, fractures are less numerous in a vertical storage than in a horizontal storage, nevertheless fissures are found in salt fomations containing liquids or gas undergoing rock pressures, fractures can be created during salt formation. Datation of formations by geologic methods and K-Ar method are considered. Deep formations (about 300m) are liquid and gas-tight, if homogenous and non perturbated. In all German permian formations are found indications of brine accumulation along fractures and tectonic zones

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

Science.gov (United States)

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

2010-07-01

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

Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study

Science.gov (United States)

2010-01-01

Background Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA) fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This study was conducted to determine whether MA fall training would be safe for persons with osteoporosis extrapolated from the data of young adults and using stringent safety criteria. Methods Young adults performed sideways and forward MA falls from a kneeling position on both a judo mat and a mattress as well as from a standing position on a mattress. Hip impact forces and kinematic data were collected. For each condition, the highest hip impact force was compared with two safety criteria based on the femoral fracture load and the use of a hip protector. Results The highest hip impact force during the various fall conditions ranged between 1426 N and 3132 N. Sideways falls from a kneeling and standing position met the safety criteria if performed on the mattress (max 1426 N and 2012 N, respectively) but not if the falls from a kneeling position were performed on the judo mat (max 2219 N). Forward falls only met the safety criteria if performed from a kneeling position on the mattress (max 2006 N). Hence, forward falls from kneeling position on a judo mat (max 2474 N) and forward falls from standing position on the mattress (max 3132 N) did not meet both safety criteria. Conclusions Based on the data of young adults and safety criteria, the MA fall training was expected to be safe for persons with osteoporosis if appropriate safety measures are taken: during the training persons with osteoporosis should wear hip protectors that could attenuate the maximum hip impact force by at least 65%, perform the fall exercises on a thick mattress, and avoid forward fall exercises from a standing position. Hence, a modified MA fall training might be useful to reduce hip fracture risk in persons with

Could martial arts fall training be safe for persons with osteoporosis?: a feasibility study

Directory of Open Access Journals (Sweden)

Smulders Ellen

2010-04-01

Full Text Available Abstract Background Osteoporosis is a well-established risk factor for fall-related hip fractures. Training fall arrest strategies, such as martial arts (MA fall techniques, might be useful to prevent hip fractures in persons with osteoporosis, provided that the training itself is safe. This study was conducted to determine whether MA fall training would be safe for persons with osteoporosis extrapolated from the data of young adults and using stringent safety criteria. Methods Young adults performed sideways and forward MA falls from a kneeling position on both a judo mat and a mattress as well as from a standing position on a mattress. Hip impact forces and kinematic data were collected. For each condition, the highest hip impact force was compared with two safety criteria based on the femoral fracture load and the use of a hip protector. Results The highest hip impact force during the various fall conditions ranged between 1426 N and 3132 N. Sideways falls from a kneeling and standing position met the safety criteria if performed on the mattress (max 1426 N and 2012 N, respectively but not if the falls from a kneeling position were performed on the judo mat (max 2219 N. Forward falls only met the safety criteria if performed from a kneeling position on the mattress (max 2006 N. Hence, forward falls from kneeling position on a judo mat (max 2474 N and forward falls from standing position on the mattress (max 3132 N did not meet both safety criteria. Conclusions Based on the data of young adults and safety criteria, the MA fall training was expected to be safe for persons with osteoporosis if appropriate safety measures are taken: during the training persons with osteoporosis should wear hip protectors that could attenuate the maximum hip impact force by at least 65%, perform the fall exercises on a thick mattress, and avoid forward fall exercises from a standing position. Hence, a modified MA fall training might be useful to reduce hip

Comparison of design margin for core shroud in between design and construction code and fitness-for-service code

International Nuclear Information System (INIS)

Dozaki, Koji

2007-01-01

Structural design methods for core shroud of BWR are specified in JSME Design and Construction Code, like ASME Boiler and Pressure Vessel Code Sec. III, as a part of core support structure. Design margins are defined according to combination of the structural design method selected and service limit considered. Basically, those margins in JSME Code were determined after ASME Sec. III. Designers can select so-called twice-slope method for core shroud design among those design methods. On the other hand, flaw evaluation rules have been established for core shroud in JSME Fitness-for-Service Code. Twice-slope method is also adopted for fracture evaluation in that code even when the core shroud contains a flaw. Design margin was determined as structural factors separately from Design and Construction Code. As a natural consequence, there is a difference in those design margins between the two codes. In this paper, it is shown that the design margin in Fitness-for-Service Code is conservative by experimental evidences. Comparison of design margins between the two codes is discussed. (author)

Vitamin D status, bone mineral density and mental health in young Australian women: the Safe-D study

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Emma T. Callegari

2015-11-01

Full Text Available Background. Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study. Design and methods. Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. Expected impact. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life.

Preliminary analysis of force-torque measurements for robot-assisted fracture surgery.

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

2015-08-01

Our group at Bristol Robotics Laboratory has been working on a new robotic system for fracture surgery that has been previously reported [1]. The robotic system is being developed for distal femur fractures and features a robot that manipulates the small fracture fragments through small percutaneous incisions and a robot that re-aligns the long bones. The robots controller design relies on accurate and bounded force and position parameters for which we require real surgical data. This paper reports preliminary findings of forces and torques applied during bone and soft tissue manipulation in typical orthopaedic surgery procedures. Using customised orthopaedic surgical tools we have collected data from a range of orthopaedic surgical procedures at Bristol Royal Infirmary, UK. Maximum forces and torques encountered during fracture manipulation which involved proximal femur and soft tissue distraction around it and reduction of neck of femur fractures have been recorded and further analysed in conjunction with accompanying image recordings. Using this data we are establishing a set of technical requirements for creating safe and dynamically stable minimally invasive robot-assisted fracture surgery (RAFS) systems.

Multiphase flow models for hydraulic fracturing technology

Science.gov (United States)

Osiptsov, Andrei A.

2017-10-01

drift-flux approaches. The derivation of the drift-flux model from conservation olaws is criticall revisited in order to define the list of underlying assumptions and to mark the applicability margins of the model. All these fundamental problems share the same technological application (hydraulic fracturing) and the same method of research, namely, the multi-fluid approach to multiphase flow modeling and the consistent use of asymptotic methods. Multi-fluid models are then discussed in comparison with semi-empirical (often postulated) models widely used in the industry.

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

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Mohammad R. Sobhan

2016-10-01

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

Magmatic development of the outer Vøring Margin

Science.gov (United States)

Breivik, Asbjorn; Faleide, Jan Inge; Mjelde, Rolf; Flueh, Ernst; Murai, Yoshio

2013-04-01

The Vøring Plateau off mid-Norway is a volcanic passive margin, located north of the East Jan Mayen Fracture Zone (EJMFZ). Large volumes of magmatic rocks were emplaced during Early Eocene margin formation. In 2003, an ocean bottom seismometer survey was acquired on the Vøring and Lofoten margins. One profile crosses from the Vøring Plateau to the Vøring Spur, an oceanic plateau north of the EJMFZ. The P-wave data were modeled by ray-tracing in a 2D velocity model of the crust. The process behind the excess magmatism can be estimated by comparing seismic velocity (VP) with igneous thickness (H). This profile and two other profiles farther north show a positive H-VP correlation, consistent with a hot mantle reservoir of finite extent under the margin at breakup. However, during the first two million years, magma production appears to be augmented by a secondary process. By 51-51.5 Ma melting may be caused by elevated mantle temperature alone. Seismic stratigraphy around the Vøring Spur shows at least two inversion events, with the main episode tentatively in the Upper Miocene, apparently through igneous growth to create the up to 15 km crustal thickness. The H-VP correlation of the spur is low, indicating constant and moderate-degree mantle melting not tied to the breakup magmatism. The admittance function between bathymetry and free-air gravity shows that the high is near local isostatic equilibrium, discounting that compressional flexure at the EJMFZ shaped the high. We also find no evidence for the proposed Early Eocene triple junction in the area.

The current situation and related problems of percutaneous vertebroplasty in clinical treatment of osteoporosis vertebral compression fracture

International Nuclear Information System (INIS)

Wang Luchang; Wu Chungen; Cheng Yongde

2011-01-01

As an effective, safe and less-invasive technique in interventional radiology, percutaneous vertebroplasty has satisfactory therapeutic results with fewer complications in treating osteoporosis vertebral compression fracture. This paper aims to make a comprehensive review of the current situation and related problems of percutaneous vertebroplasty in clinical treatment of osteoporosis vertebral compression fracture. (authors)

Geometrical properties of tension-induced fractures in granite

International Nuclear Information System (INIS)

Sato, Hisashi; Sawada, Atsushi; Yasuhara, Hideaki

2011-03-01

Considering a safe, long-term sequestration of energy byproducts such as high level radioactive wastes, it is of significant importance to well-constrain the hydraulic and transport behavior of targeted permeants within fractured rocks. Specifically, fluid flow within low-permeability crystalline rock masses (e.g., granite) is often dominated by transport in through-cutting fractures, and thus careful considerations are needed on the behavior. There are three planes along that granites fail most easily under tension, and those may be identified as the rift, grain, and hardway planes. This anisotropic fabric may be attributed to preferentially oriented microcrack sets contained within intact rock. In this research, geometrical properties of tension-induced fractures are evaluated as listed below; (1) Creation of tension-induced fractures considering the anisotropy clarified by elastic wave measurements. (2) Evaluation of geometrical properties in those fractures characterized by the anisotropy. In the item (1), the three planes of rift, grain and hardway were identified by measuring elastic wave. In the item (2), JRC, variogram, fractal dimension and distributions of elevations in the fracture surfaces were evaluated using digitized data of the fracture surfaces measured via a laser profilometry. Results show that rift planes are less rougher than the other planes of grain and hardway, and grain planes are generically rougher than the other planes of rift and hardway. It was also confirmed that the fracture shape anisotropy was correlated with the direction of the slit which constructed during tensile tests. On the other hand, the tendency peculiar to the direction of slit and granites fail about the estimated aperture distribution from fracture shape was not seen. (author)

Colorado Basin Structure and Rifting, Argentine passive margin

Science.gov (United States)

Autin, Julia; Scheck-Wenderoth, Magdalena; Loegering, Markus; Anka, Zahie; Vallejo, Eduardo; Rodriguez, Jorge; Marchal, Denis; Reichert, Christian; di Primio, Rolando

2010-05-01

The Argentine margin presents a strong segmentation with considerable strike-slip movements along the fracture zones. We focus on the volcanic segment (between the Salado and Colorado transfer zones), which is characterized by seaward dipping reflectors (SDR) all along the ocean-continent transition [e.g. Franke et al., 2006; Gladczenko et al., 1997; Hinz et al., 1999]. The segment is structured by E-W trending basins, which differs from the South African margin basins and cannot be explained by classical models of rifting. Thus the study of the relationship between the basins and the Argentine margin itself will allow the understanding of their contemporary development. Moreover the comparison of the conjugate margins suggests a particular evolution of rifting and break-up. We firstly focus on the Colorado Basin, which is thought to be the conjugate of the well studied Orange Basin [Hirsch et al., 2009] at the South African margin [e.g. Franke et al., 2006]. This work presents results of a combined approach using seismic interpretation and structural, isostatic and thermal modelling highlighting the structure of the crust. The seismic interpretation shows two rift-related discordances: one intra syn-rift and the break-up unconformity. The overlying sediments of the sag phase are less deformed (no sedimentary wedges) and accumulated before the generation of oceanic crust. The axis of the Colorado Basin trends E-W in the western part, where the deepest pre-rift series are preserved. In contrast, the basin axis turns to a NW-SE direction in its eastern part, where mainly post-rift sediments accumulated. The most distal part reaches the margin slope and opens into the oceanic basin. The general basin direction is almost orthogonal to the present-day margin trend. The most frequent hypothesis explaining this geometry is that the Colorado Basin is an aborted rift resulting from a previous RRR triple junction [e.g. Franke et al., 2002]. The structural interpretation

Electrical Conductivity Distributions in Discrete Fluid-Filled Fractures

Science.gov (United States)

James, S. C.; Ahmmed, B.; Knox, H. A.; Johnson, T.; Dunbar, J. A.

2017-12-01

It is commonly asserted that hydraulic fracturing enhances permeability by generating new fractures in the reservoir. Furthermore, it is assumed that in the fractured system predominant flow occurs in these newly formed and pre-existing fractures. Among the phenomenology that remains enigmatic are fluid distributions inside fractures. Therefore, determining fluid distribution and their associated temporal and spatial evolution in fractures is critical for safe and efficient hydraulic fracturing. Previous studies have used both forward modeling and inversion of electrical data to show that a geologic system consisting of fluid filled fractures has a conductivity distribution, where fractures act as electrically conductive bodies when the fluids are more conductive than the host material. We will use electrical inversion for estimating electrical conductivity distribution within multiple fractures from synthetic and measured data. Specifically, we will use data and well geometries from an experiment performed at Blue Canyon Dome in Socorro, NM, which was used as a study site for subsurface technology, engineering, and research (SubTER) funded by DOE. This project used a central borehole for energetically stimulating the system and four monitoring boreholes, emplaced in the cardinal directions. The electrical data taken during this project used 16 temporary electrodes deployed in the stimulation borehole and 64 permanent electrodes in the monitoring wells (16 each). We present results derived using E4D from scenarios with two discrete fractures, thereby discovering the electric potential response of both spatially and temporarily variant fluid distribution and the resolution of fluid and fracture boundaries. These two fractures have dimensions of 3m × 0.01m × 7m and are separated by 1m. These results can be used to develop stimulation and flow tests at the meso-scale that will be important for model validation. Sandia National Laboratories is a multi

Geophysical signatures of a fracture controlled U-mineralisation: a case study from Mulapalle area, Cuddapah district, Andhra Pradesh

International Nuclear Information System (INIS)

Rao, R.L.N.; Sethuram, S.; Rao, B.N.; Tiku, K.L.; Ram, Subhash

2000-01-01

Geophysical methods have been extensively used for delineation of structural features such as fractures and shear zones which often control and host economic mineralisation. Numerous fractures hosting uranium mineralisation and confined to younger intrusives and leucogranites occur within basement gneissic complex on the southwestern margin of the Mesoproterozoic Cuddapah basin. The geophysical signatures of one such mineralised fracture zone near Mulapalle are discussed. Mineralised fractures are mostly confined to a zone of cataclastic rocks characterised by widely varying magnetic character with respect to the surroundings. A strong redox barrier associated with the mineralisation is revealed by self-potential data. The mineralised zone is also indicated by a higher order resistivity attributable to the enrichment of silica in the fracture zone. (author)

Brittle fracture tests at low temperature for transport cask materials

International Nuclear Information System (INIS)

Kosaki, Akio; Ito, Chihiro; Arai, Taku; Saegusa, Toshiari

1993-01-01

The IAEA Regulations for the Safe Transport of Radioactive Material were revised in 1985, and brittle fracture assessment at low temperature for transport packages are now required. This report discusses the applicability of the actual method for brittle fracture assessment of type-B transport cask materials used in JAPAN. The necessity of brittle fracture assessment at low temperature was estimated for each material of type-B transport casks used in Japan and the applicability was investigated. Dynamic fracture toughness values, K Id (J Id ), and RT NDT values of Low-Mn Carbon Steels, that are SA 350 Gr.LF1 Modify and SA 516 Gr.70 material which used in type-B transport cask body, were also obtained to check whether or not an easier and conventional test method, that prescribed in ASME CODE SECTION III, can be substituted for the dynamic fracture test method. And for bolt materials, which include 1.8Ni-0.8Cr-0.3Mo Carbon Steel and type 630 H Stainless Steel, toughness data were obtained for reference. (J.P.N.)

Influence of Cavity Margin Design and Restorative Material on Marginal Quality and Seal of Extended Class II Resin Composite Restorations In Vitro.

Science.gov (United States)

Soliman, Sebastian; Preidl, Reinhard; Karl, Sabine; Hofmann, Norbert; Krastl, Gabriel; Klaiber, Bernd

2016-01-01

To investigate the influence of three cavity designs on the marginal seal of large Class II cavities restored with low-shrinkage resin composite limited to the enamel. One hundred twenty (120) intact human molars were randomly divided into 12 groups, with three different cavity designs: 1. undermined enamel, 2. box-shaped, and 3. proximal bevel. The teeth were restored with 1. an extra-low shrinkage (ELS) composite free of diluent monomers, 2. microhybrid composite (Herculite XRV), 3. nanohybrid composite (Filtek Supreme XTE), and 4. silorane-based composite (Filtek Silorane). After artificial aging by thermocycling and storage in physiological saline, epoxy resin replicas were prepared. To determine the integrity of the restorations' approximal margins, two methods were sequentially employed: 1. replicas were made of the 120 specimens and examined using SEM, and 2. the same 120 specimens were immersed in AgNO3 solution, and the dye penetration depth was observed with a light microscope. Statistical analysis was performed using the Kruskal-Wallis and the Dunn-Bonferroni tests. After bevel preparation, SEM observations showed that restorations did not exhibit a higher percentage of continuous margin (SEM-analysis; p>0.05), but more leakage was found than with the other cavity designs (pcomposite restorations and is no longer recommended. However, undermined enamel should be removed to prevent enamel fractures.

Thoracic Pneumorrhachis in Patient with Lumbar Fractures; a Case Report

Directory of Open Access Journals (Sweden)

Amir Ghafarzad

2014-03-01

Full Text Available 800x600 Pneumorrhachis as a relatively rare condition may be an indication of substantial intra-spinal column injury. Here we report a 39-year-old man was admitted because of low back pain and dyspenea after locating between motor vehicle and wall three days before admission. On arrival, physical exams and vital signs were normal. Computed tomography (CT scan showed bilateral pleural effusion, fracture of ribs number 8, 9 and 10 in lower left side of thorax, fracture of vertebra in L2-L4, and air bubbles in upper thoracic spinal canal.  Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Calibri","sans-serif"; mso-bidi-font-family:Arial;}

Sandia National Laboratories cask drop test programme: a demonstration of fracture mechanics principles for the prevention of brittle fracture

International Nuclear Information System (INIS)

McConnell, P.; Sorenson, K.B.

1995-01-01

Sandia National Laboratories recently completed a cask drop test programme. The aims of the programme were (1) to demonstrate the applicability of a fracture mechanics-based methodology for ensuring cask integrity, and (2) to assess the viability of using a ferritic materials for cask containment. The programme consisted of four phases: (i) materials characterisation; (ii) non-destructive examination of the cask; (iii) finite element analyses of the drop events; and (iv) a series of drop tests of a ductile iron cask. The first three phases of the programme provided information for fracture mechanics analyses and predictions for the drop test phase. The drop tests were nominally based upon the IAEA 9 m drop height hypothetical accident scenario although one drop test was from 18 m. All tests were performed in the side drop orientation at a temperature of -29 o C. A circumferential, mid-axis flaw was introduced into the cask body for each drop test. Flaw depth ranged from 19 to 76 mm. Steel saddles were welded to the side wall of the cask to enhance the stresses imposed upon the cask in the region of the introduced flaw. The programme demonstrated the applicability of a fracture mechanics methodology for predicting the conditions under which brittle fracture may occur and thereby the utility of fracture mechanics design for ensuring cask structural integrity by ensuring an appropriate margin of safety. Positive assessments of ductile iron for cask containment and the quality of the casting process for producing ductile iron casks were made. The results of this programme have provided data to support IAEA efforts to develop brittle fracture acceptance criteria for cask containment. (author)

Establishing seismic design criteria to achieve an acceptable seismic margin

International Nuclear Information System (INIS)

Kennedy, R.P.

1997-01-01

In order to develop a risk based seismic design criteria the following four issues must be addressed: (1) What target annual probability of seismic induced unacceptable performance is acceptable? (2). What minimum seismic margin is acceptable? (3) Given the decisions made under Issues 1 and 2, at what annual frequency of exceedance should the Safe Shutdown Earthquake ground motion be defined? (4) What seismic design criteria should be established to reasonably achieve the seismic margin defined under Issue 2? The first issue is purely a policy decision and is not addressed in this paper. Each of the other three issues are addressed. Issues 2 and 3 are integrally tied together so that a very large number of possible combinations of responses to these two issues can be used to achieve the target goal defined under Issue 1. Section 2 lays out a combined approach to these two issues and presents three potentially attractive combined resolutions of these two issues which reasonably achieves the target goal. The remainder of the paper discusses an approach which can be used to develop seismic design criteria aimed at achieving the desired seismic margin defined in resolution of Issue 2. Suggestions for revising existing seismic design criteria to more consistently achieve the desired seismic margin are presented

Immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures: is it safe enough?

Science.gov (United States)

Acker, A; Perry, Z H; Blum, S; Shaked, G; Korngreen, A

2018-04-01

The purpose of this study was to compare the results of immediate and delayed percutaneous sacroiliac screws surgery for unstable pelvic fractures, regarding technical results and complication rate. Retrospective study. The study was conducted at the Soroka University Medical center, Beer Sheva, Israel, which is a level 1 trauma Center. 108 patients with unstable pelvic injuries were operated by the orthopedic department at the Soroka University Medical Center between the years 1999-2010. A retrospective analysis found 50 patients with immediate surgery and 58 patients with delayed surgery. Preoperative and postoperative imaging were analyzed and data was collected regarding complications. All patients were operated on by using the same technique-percutaneous fixation of sacroiliac joint with cannulated screws. The study's primary outcome measure was the safety and quality of the early operation in comparison with the late operation. A total of 156 sacroiliac screws were inserted. No differences were found between the immediate and delayed treatment groups regarding technical outcome measures (P value = 0.44) and complication rate (P value = 0.42). The current study demonstrated that immediate percutaneous sacroiliac screw insertion for unstable pelvic fractures produced equally good technical results, in comparison with the conventional delayed operation, without additional complications.

Endoscope-Assisted Transoral Fixation of Mandibular Condyle Fractures: Submandibular Versus Transoral Endoscopic Approach.

Science.gov (United States)

Hwang, Na-Hyun; Lee, Yoon-Hwan; You, Hi-Jin; Yoon, Eul-Sik; Kim, Deok-Woo

2016-07-01

In recent years, endoscope-assisted transoral approach for condylar fracture treatment has attracted much attention. However, the surgical approach is technically challenging: the procedure requires specialized instruments and the surgeons experience a steep learning curve. During the transoral endoscopic (TE) approach several instruments are positioned through a narrow oral incision making endoscope maneuvering very difficult. For this reason, the authors changed the entry port of the endoscope from transoral to submandibular area through a small stab incision. The aim of this study is to assess the advantage of using the submandibular endoscopic intraoral approach (SEI).The SEI approach requires intraoral incision for fracture reduction and fixation, and 4 mm size submandibular stab incision for endoscope and traction wires. Fifteen patients with condyle neck and subcondyle fractures were operated under the submandibular approach and 15 patients with the same diagnosis were operated under the standard TE approach.The SEI approach allowed clear visualization of the posterior margin of the ramus and condyle, and the visual axis was parallel to the condyle ramus unit. The TE approach clearly shows the anterior margin of the condyle and the sigmoid notch. The surgical time of the SEI group was 128 minutes and the TE group was 120 minutes (P >0.05). All patients in the TE endoscope group were fixated with the trocar system, but only 2 lower neck fracture patients in the SEI group required a trocar. The other 13 subcondyle fractures were fixated with an angulated screw driver (P <0.05). There were no differences in complication and surgical outcomes.The submandibular endoscopic approach has an advantage of having more space with good visualization, and facilitated the use of an angulated screw driver.

Regulatory controls and slurry fracture injection

International Nuclear Information System (INIS)

Dusseault, M. B.; Bilak, R. A.

1997-01-01

The technological and regulatory framework necessary for the safe operation of solid waste disposal using slurry fracture injection (SFI) in Saskatchewan and Alberta was studied. Seven current SFI sites were used as the source of experience. Regular audits of volumes, continuous pressure recording, careful deformation monitoring and analysis, and repeated evaluation of reservoir properties were considered to be the essential features. In the case of toxic wastes, microseismic monitoring and regular well interference or tracer tests might be additional measures used to increase confidence in the containment method. Given the recent introduction of SFI technology, guarding against over-regulation was recommended to allow SFI to operate under the most effective operating conditions, and to preserve its attractiveness as an environmentally attractive and safe waste disposal alternative. 5 refs., 3 tabs., 4 figs

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

Draft fracture mechanics code case for American Society of Mechanical Engineers NUPACK rules

International Nuclear Information System (INIS)

McConnell, P.; Sorenson, K.; Nickell, R.; Saegusa, T.

2004-01-01

The containment boundaries of most spent-fuel casks certified for use in the United States by the Nuclear Regulatory Commission are constructed with stainless steel, a material that is ductile in an engineering sense at all temperatures and for which, therefore, fracture mechanics principles are not relevant for the containment application. Ferritic materials may fail in a nonductile manner at sufficiently low temperatures, so fracture mechanics principles may be applied to preclude nonductile fracture. Because of the need to transport and store spent nuclear fuel safely in all types of climatic conditions, these vessels have regulatory lowest service temperatures that range down to -40 C (-40 F) for transport application. Such low service temperatures represent a severe challenge in terms of fracture toughness to many ferritic materials. Linear-elastic and elastic-plastic fracture mechanics principles provide a methodology for evaluating ferritic materials under such conditions

Considerations of the manner of accounting for fast fracture risk in the design of PWR vessels

International Nuclear Information System (INIS)

Pellissier-Tanon, A.; Grandemange, J.M.

1986-01-01

The French approach to the prevention of fast fracture in PWR vessels is to consider it as a whole and to choose the most convenient way to meet this general goal from an economic and technical point of view. According to this approach, there are no specific limits imposed on such factors as end of life RTsub(NDT) or neutron fluence, which are taken as criteria in other countries. The RCCM design and construction code specifications on chemical content and RTsub(NDT) for beltline and non-irradiated parts establish a sound basis for safety. However, for the most critical parts, the existence of large margins with respect to fast fracture is demonstrated by analysis for all second, third and fourth category design transients. To this aim, the RCCM code needs to demonstrate specified safety margins, depending on the transient category, for reference defects defined in kind and size, in order to bound realistically any defects which have a chance of occurring in the part during manufacture. This approach, which enables the disclosure of the influence of all significant design factors on fracture risk, ensures the most consistent way to improve design safety. (author)

Considerations of the manner of accounting for fast fracture risk in the design of PWR vessels

Energy Technology Data Exchange (ETDEWEB)

1986-01-01

The French approach to the prevention of fast fracture in PWR vessels is to consider it as a whole and to choose the most convenient way to meet this general goal from an economic and technical point of view. According to this approach, there are no specific limits imposed on such factors as end of life RTsub(NDT) or neutron fluence, which are taken as criteria in other countries. The RCCM design and construction code specifications on chemical content and RTsub(NDT) for beltline and non-irradiated parts establish a sound basis for safety. However, for the most critical parts, the existence of large margins with respect to fast fracture is demonstrated by analysis for all second, third and fourth category design transients. To this aim, the RCCM code needs to demonstrate specified safety margins, depending on the transient category, for reference defects defined in kind and size, in order to bound realistically any defects which have a chance of occurring in the part during manufacture. This approach, which enables the disclosure of the influence of all significant design factors on fracture risk, ensures the most consistent way to improve design safety.

Biodegradable fixation of mandibular fractures in children: stability and early results.

Science.gov (United States)

Yerit, Kaan C; Hainich, Sibylle; Enislidis, Georg; Turhani, Dritan; Klug, Clemens; Wittwer, Gert; Ockher, Michael; Undt, Gerhard; Kermer, Christian; Watzinger, Franz; Ewers, Rolf

2005-07-01

The aim of this study was to assess the safety and efficiency of biodegradable self-reinforced (SR-PLDLA) bone plates and screws in open reduction and internal fixation of mandible fractures in children. Thirteen patients (5 female, 8 male; mean age 12 years, range 5-16 years) were operated on various fractures of the mandible (2 symphyseal, 6 parasymphyseal, 4 body, 3 angle, 1 ramus, 2 condylar fractures). The mean follow-up time was 26.4 months (range 10.9-43.4 months). Intermaxillary fixation was applied in cases with concomitant condylar fractures up to 3 weeks. Primary healing of the fractured mandible was observed in all patients. Postoperative complications were minor and transient. The outcome of the operations was not endangered. Adverse tissue reactions to the implants, malocclusion, and growth restrictions did not occur during the observation period. Pediatric patients benefit from the advantages of resorbable materials, especially from faster mobilization and the avoidance of secondary removal operations. Based on these preliminary results, self-reinforced fixation devices are safe and efficient in the treatment of pediatric mandible fractures. However, further clinical investigations are necessary to evaluate the long-term reliability.

Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible?

Science.gov (United States)

Concha, Juan M; Sandoval, Alejandro; Streubel, Philipp N

2010-12-01

Minimally invasive plate osteosynthesis (MIPO) has been advocated as a safe approach to humeral shaft fracture management. We evaluated the reproducibility of this technique in a regional hospital. Thirty-five patients underwent MIPO of humerus shaft fractures. Fifteen patients had an open fracture, six a preoperative radial nerve palsy, and nine a concomitant thoracic, musculoskeletal or vascular injury. At an average 12-month follow-up, 91% of fractures healed after a mean of 12 weeks (range, 8-16). Two infections occurred. Final alignment averaged 4° of varus (range, 5° of valgus to 20° of varus). Active elbow ROM averaged 114° (range, 60-135°) and was less than 100° in nine elbows. Five of six preoperative radial nerve injuries recovered spontaneously. Healing and infection rates in this study are consistent with those reported in the literature. Lower elbow ROM and higher fracture angulation at healing were nevertheless found. MIPO is technically demanding and requires adequate intraoperative imaging and surgical experience in order to obtain adequate fracture alignment. Brachialis muscle scarring and inadequate postoperative rehabilitation may be involved in limited elbow range of motion.

Asymmetric rifting, breakup and magmatism across conjugate margin pairs: insights from Newfoundland to Ireland

Science.gov (United States)

Peace, Alexander L.; Welford, J. Kim; Foulger, Gillian R.; McCaffrey, Ken J. W.

2017-04-01

Continental extension, subsequent rifting and eventual breakup result in the development of passive margins with transitional crust between extended continental crust and newly created oceanic crust. Globally, passive margins are typically classified as either magma-rich or magma-poor. Despite this simple classification, magma-poor margins like the West Orphan Basin, offshore Newfoundland, do exhibit some evidence of localized magmatism, as magmatism to some extent invariably accompanies all continental breakup. For example, on the Newfoundland margin, a small volcanic province has been interpreted near the termination of the Charlie Gibbs Fracture Zone, whereas on the conjugate Irish margin within the Rockall Basin, magmatism appears to be more widespread and has been documented both in the north and in the south. The broader region over which volcanism has been identified on the Irish margin is suggestive of magmatic asymmetry across this conjugate margin pair and this may have direct implications for the mechanisms governing the nature of rifting and breakup. Possible causes of the magmatic asymmetry include asymmetric rifting (simple shear), post-breakup thermal anomalies in the mantle, or pre-existing compositional zones in the crust that predispose one of the margins to more melting than its conjugate. A greater understanding of the mechanisms leading to conjugate margin asymmetry will enhance our fundamental understanding of rifting processes and will also reduce hydrocarbon exploration risk by better characterizing the structural and thermal evolution of hydrocarbon bearing basins on magma-poor margins where evidence of localized magmatism exists. Here, the latest results of a conjugate margin study of the Newfoundland-Ireland pair utilizing seismic interpretation integrated with other geological and geophysical datasets are presented. Our analysis has begun to reveal the nature and timing of rift-related magmatism and the degree to which magmatic asymmetry

An Alternative Method of Intermaxillary Fixation for Simple Pediatric Mandible Fractures.

Science.gov (United States)

Farber, Scott J; Nguyen, Dennis C; Harvey, Alan A; Patel, Kamlesh B

2016-03-01

Mandibular fractures represent a substantial portion of facial fractures in the pediatric population. Pediatric mandibles differ from their adult counterparts in the presence of mixed dentition. Avoidance of injury to developing tooth follicles is critical. Simple mandibular fractures can be treated with intermaxillary fixation (IMF) using arch bars or bone screws. This report describes an alternative to these methods using silk sutures and an algorithm to assist in treating simple mandibular fractures in the pediatric population. A retrospective chart review was performed and the records of 1 surgeon were examined. Pediatric patients who underwent treatment for a mandibular fracture in the operating room from 2011 to 2015 were identified using Common Procedural Terminology codes. Data collected included age, gender, type of fracture, type of treatment used, duration of fixation, and presence of complications. Five patients with a mean age of 6.8 years at presentation were identified. Fracture types were unilateral fractures of the condylar neck (n = 3), bilateral fractures of the condylar head (n = 1), and a unilateral fracture of the condylar head with an associated parasymphyseal fracture (n = 1). IMF was performed in 4 patients using silk sutures, and bone screw fixation was performed in the other patient. No post-treatment complications or malocclusion were reported. Average duration of IMF was 18.5 days. An algorithm is presented to assist in the treatment of pediatric mandibular fractures. Silk suture fixation is a viable and safe alternative to arch bars or bone screws for routine mandibular fractures. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Unstable femoral neck fractures in children - A new treatment option

Directory of Open Access Journals (Sweden)

Pruthi K

2006-01-01

Full Text Available Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.

Assessment of the fracture toughness of irradiated stainless steel for BWR core shrouds

International Nuclear Information System (INIS)

Carter, R.G.; Gamble, R.M.

2002-01-01

Data from previously performed experiments were collected and evaluated to determine the relationship between fracture toughness and neutron fluence for conditions representative of BWR core shrouds. This relationship together with EPFM (elastic-plastic fracture mechanics) analysis methods similar to those in Appendix K of Section XI of the ASME Code were used to compute margin against failure as a function of neutron fluence for postulated cracks in BWR core shrouds. The results indicate that EPFM analyses can be used for flaw evaluation of core shrouds at fluence levels less than 3.10 21 n/cm 2 (E > 1 MeV). At fluence levels equal to or greater than 3.10 21 n/cm 2 , LEFM (linear-elastic fracture mechanics) analyses should be used with K Ic = 55 MPa-(m) 0.5 . (authors)

Another fractured neck of femur: do we need a lateral X-ray?

Science.gov (United States)

Almazedi, B; Smith, C D; Morgan, D; Thomas, G; Pereira, G

2011-05-01

This study aimed to define the role of the lateral X-ray in the assessment and treatment planning of proximal femoral fractures. Occult fractures were not included. Radiographs from 359 consecutive patients with proximal femoral fractures admitted to our emergency department over a 12 month period were divided into anteroposterior (AP) views and lateral views. Three blinded reviewers independently assessed the radiographs, first AP views alone then AP plus lateral views, noting the fracture classification for each radiograph. These assessments were then compared with the intra-operative diagnosis, which was used as the gold standard. A 2 × 2 contingency square table was created and Pearson's χ(2) test was used for statistical analysis. The rate of correct classification by the reviewers was improved by the assessment of the lateral X-ray in addition to the AP view for intracapsular fractures (pview in intracapsular fractures was the detection of displacement where the fracture appeared undisplaced on the initial AP view. This study provides statistical evidence that one view is adequate and safe for the majority of hip fractures. The lateral radiograph should not be performed routinely in order to make considerable savings in money and time and to avoid unnecessary patient discomfort.

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.

Development of ductile cast iron for spent fuel cask applications using fracture mechanics principles

International Nuclear Information System (INIS)

Ray, K.K.; Tiwari, S.; Hemlata Kumari; Mamta Kumari; Kumar, Hemant; Albert, S.K.; Bhaduri, A.K.

2016-01-01

The structure-property relations of ductile cast irons (DCIs) with varying Cu content and ~1 wt.% Ni has been investigated with an emphasis on examining their fracture toughness property towards the development of suitable materials for large volume containers for transport of spent fuel. The detailed microstructural characteristics, hardness, tensile and fracture toughness properties of three DCIs were assessed in as-cast and annealed conditions. Fracture toughness values were determined using both ball indentation (K BI ) and J-integral (KJ Ic ) test. The obtained results assist to infer that: (i) the amount of pearlite and nodule count increases with increased amount of Cu, (ii) the hardness and strength values increases whereas fracture toughness values marginally decreases with increased Cu content, and (iii) the magnitudes of K BI estimated using a proposed analysis are in good agreement with KJ Ic values for the as-cast materials. (author)

An IGRT margin concept for pelvic lymph nodes in high-risk prostate cancer

International Nuclear Information System (INIS)

Groher, M.; Kopp, P.; Deutschmann, H.; Sedlmayer, F.; Wolf, Frank; Drerup, M.

2017-01-01

Gold-marker-based image-guided radiation therapy (IGRT) of the prostate allows to correct for inter- and intrafraction motion and therefore to safely reduce margins for the prostate planning target volume (PTV). However, pelvic PTVs, when coadministered in a single plan (registered to gold markers [GM]), require reassessment of the margin concept since prostate movement is independent from the pelvic bony anatomy to which the lymphatics are usually referenced to. We have therefore revisited prostate translational movement relative to the bony anatomy to obtain adequate margins for the pelvic PTVs compensating mismatch resulting from referencing pelvic target volumes to GMs in the prostate. Prostate movement was analyzed in a set of 28 patients (25 fractions each, totaling in 684 fractions) and the required margins calculated for the pelvic PTVs according to Van Herk's margin formula M = 2.5 Σ + 1.64 (σ ' -σ p ). The overall mean prostate movement relative to bony anatomy was 0.9 ± 3.1, 0.6 ± 3.4, and 0.0 ± 0.7 mm in anterior/posterior (A/P), inferior/superior (I/S) and left/right (L/R) direction, respectively. Calculated margins to compensate for the resulting mismatch to bony anatomy were 9/9/2 mm in A/P, I/S, and L/R direction and 10/11/6 mm if an additional residual error of 2 mm was assumed. GM-based IGRT for pelvic PTVs is feasible if margins are adapted accordingly. Margins could be reduced further if systematic errors which are introduced during the planning CT were eliminated. (orig.) [de

Dynamic plate osteosynthesis for fracture stabilization: how to do it

Directory of Open Access Journals (Sweden)

Juerg Sonderegger

2010-01-01

Full Text Available Plate osteosynthesis is one treatment option for the stabilization of long bones. It is widely accepted to achieve bone healing with a dynamic and biological fixation where the perfusion of the bone is left intact and micromotion at the fracture gap is allowed. The indications for a dynamic plate osteosynthesis include distal tibial and femoral fractures, some midshaft fractures, and adolescent tibial and femoral fractures with not fully closed growth plates. Although many lower limb shaft fractures are managed successfully with intramedullary nails, there are some important advantages of open-reduction-and-plate fixation: the risk of malalignment, anterior knee pain, or nonunion seems to be lower. The surgeon performing a plate osteosynthesis has the possibility to influence fixation strength and micromotion at the fracture gap. Long plates and oblique screws at the plate ends increase fixation strength. However, the number of screws does influence stiffness and stability. Lag screws and screws close to the fracture site reduce micromotion dramatically. Dynamic plate osteosynthesis can be achieved by applying some simple rules: long plates with only a few screws should be used. Oblique screws at the plate ends increase the pullout strength. Two or three holes at the fracture site should be omitted. Lag screws, especially through the plate, must be avoided whenever possible. Compression is not required. Locking plates are recommended only in fractures close to the joint. When respecting these basic concepts, dynamic plate osteosynthesis is a safe procedure with a high healing and a low complication rate. 

Kyphoplasty for severe osteoporotic vertebral compression fractures

International Nuclear Information System (INIS)

Bao Zhaohua; Wang Genlin; Yang Huilin; Meng Bin; Chen Kangwu; Jiang Weimin

2010-01-01

Objective: To evaluate the clininal efficacy of kyphoplasty for severe osteoporotic vertebral compression fractures. Methods: Forty-five patients with severe osteoporotic compressive fractures were treated by kyphoplasty from Jan 2005 to Jan 2009. The compressive rate of the fractured vertebral bodies was more than 75%. According to the morphology of the vertebral compression fracture bodies the unilateral or bilateral balloon kyphoplasty were selected. The anterior vertebral height was measured on a standing lateral radiograph at pre-operative, post-operative (one day after operation) and final follow-up time. A visual analog scale(VAS) and the Oswestry disability index (ODI) were chosen to evaluate pain status and functional activity. Results: The mean follow-up was for 21.7 months (in range from 18 to 48 months). The anterior vertebral body height of fracture vertebra was restored from preoperative (18.7 ± 3.1)% to postoperative (51.4 ± 2.3)%, the follow-up period (50.2 ± 2.7)%. There was a significant improvement between preoperative and postoperative values (P 0.05). The VAS was 8.1 ± 1.4 at preoperative, 2.6 ± 0.9 at postoperative, 2.1 ± 0.5 at final follow-up time; and the ODI was preoperative 91.1 ± 2.3, postoperative 30.7 ± 7.1, follow-up period 26.1 ± 5.1. There was statistically significant improvement in the VAS and ODI in the post-operative assessment compared with the pre-operative assessment (P 0.05). Asymptomatic cement leakage occurred in three cases. New vertebral fracture occurred in one case. Conclusion: The study suggests that balloon kyphoplasty is a safe and effective procedure in the treatment of severe osteoporotic vertebral compression fractures. (authors)

Origins of saline fluids at convergent margins

Science.gov (United States)

Martin, Jonathan B.; Kastner, Miriam; Egeberg, Per Kr.

The compositions of pore and venting fluids at convergent margins differ from seawater values, reflecting mixing and diagenesis. Most significantly, the concentration of Cl-, assumed to be a conservative ion, differs from its seawater value. Chloride concentrations could be elevated by four processes, although two, the formation of gas hydrate and ion filtration by clay membranes, are insignificant in forming saline fluids at convergent margins. During the formation of gas hydrate, the resulting Cl--rich fluids, estimated to contain an average excess of ˜140 mM Cl- over seawater value, probably would be flushed from the sediment when the pore fluids vent to seawater. Ion filtration by clay membranes requires compaction pressures typical of >2 km burial depths. Even at these depths, the efficiency of ion filtration will be negligible because (1) fluids will flow through fractures, thereby bypassing clay membranes, (2) concentrations of clay minerals are diluted by other phases, and (3) during burial, smectite converts to illite, which has little capacity for ion filtration. A third process, mixing with subaerially evaporated seawater, elevates Cl- concentrations to 1043 mM in forearc basins along the Peru margin. Evaporation of seawater, however, will be important only in limited geographic regions that are characterized by enclosed basins, arid climates, and permeable sediments. At the New Hebrides and Izu-Bonin margins, Cl- concentrations are elevated to a maximum of 1241 mM. The process responsible for this increase is the alteration of volcanic ash to hydrous clay and zeolite minerals. Mass balance calculations, based on the decrease in δ18O values to -9.5‰ (SMOW), suggest that the Cl- concentrations could increase solely from the formation of smectite in a closed system. The diagenesis of volcanic ash also alters the concentrations of most dissolved species in addition to Cl-. Depending on the volume of this altered fluid, it could influence seawater

Inherently safe high temperature gas-cooled reactor

International Nuclear Information System (INIS)

Yamada, Masao; Hayakawa, Hitoshi

1987-01-01

It is recognized in general that High Temperature Gas-cooled Reactors have remarkable characteristics in inherent safety and it is well known that credits of the time margin have been admitted for accident evaluation in the licensing of the currently operating prototype HTGRs (300 MWe class). Recently, more inherently safe HTGRs are being developed in various countries and drawing attention on their possibility for urban siting. The inherent safety characteristics of these HTRs differ each other depending on their design philosophy and on the features of the components/structures which constitute the plant. At first, the specific features/characteristics of the elemental components/structures of the HTRs are explained one by one and then the overall safety features/characteristics of these HTR plants are explained in connection with their design philosophy and combination of the elemental features. Taking the KWU/Interatom Modular Reactor System as an example, the particular design philosophy and safety characteristics of the inherently safe HTR are explained with a result of preliminary evaluation on the possibility of siting close to densely populated area. (author)

The disposal of intermediate-level radioactive liquid waste by hydraulic fracturing process

International Nuclear Information System (INIS)

Chen Ruilin; Zhou Hanchen; Gao Yuzhu; Qiao Wen; Wang Wentao

1993-01-01

The hydraulic fracturing process is characterized by combination of the treatment with the disposal of ILLW (intermediate-level liquid waste). It is of cement solidification in deep geology stratum. First of all, it is necessary to select a suitable disposal site with detailed information on geology and hydrogeology. The process has such advantages as simple, low cost, large capacity of disposal, safe and reliable in technology. It is an attractive process of ILLW. Since 1980's, the research and the concept design of the hydraulic fracturing process have been initiated for disposal of ILLW. It is demonstrated by the field tests. The authors considered that the geological structure near Sichuan Nuclear Fuel Plant fits the disposal of ILLW by the hydraulic fracturing process

The disposal of intermediate-level radioactive liquid waste by hydraulic fracturing process

Energy Technology Data Exchange (ETDEWEB)

Ruilin, Chen; Hanchen, Zhou; Yuzhu, Gao; Wen, Qiao; Wentao, Wang [Beijing Inst. of Nuclear Engineering (China)

1994-12-31

The hydraulic fracturing process is characterized by combination of the treatment with the disposal of ILLW (intermediate-level liquid waste). It is of cement solidification in deep geology stratum. First of all, it is necessary to select a suitable disposal site with detailed information on geology and hydrogeology. The process has such advantages as simple, low cost, large capacity of disposal, safe and reliable in technology. It is an attractive process of ILLW. Since 1980`s, the research and the concept design of the hydraulic fracturing process have been initiated for disposal of ILLW. It is demonstrated by the field tests. The authors considered that the geological structure near Sichuan Nuclear Fuel Plant fits the disposal of ILLW by the hydraulic fracturing process.

Recommendations for the application of fracture toughness data for structural integrity assessments

International Nuclear Information System (INIS)

Wallin, K.

1993-01-01

Large scale testing for the purpose of fracture mechanics verification is essentially directed towards the validation of the transferability of material data obtained with small specimens. Unfortunately the results are sometimes controversial, insinuating that the transferability is imprecise at the very least. However, it seems that in many cases the controversy is due to an improper application of the small specimen data. Present testing standards do not give any recommendations for the correct application of fracture toughness data and yet this is a crucial point for successful structural integrity assessment and fracture mechanics verification. In this presentation the topic concerning recommendations is addressed, focusing on the application of brittle (cleavage type) fracture data. Simple guidelines for obtaining optimum open-quotes best-close quotes and open-quotes safe-close quotes estimates of the behavior of the actual structure based on small specimen data are presented. 51 refs., 16 figs., 1 tab

Probabilistic fracture mechanics analysis for the life extension estimate of the high flux isotope reactor vessel

International Nuclear Information System (INIS)

Chang, S.J.

1997-01-01

The state of the vessel steel embrittlement as a result of neutron irradiation can be measured by its increase in the nil ductility temperature (NDT). This temperature is sometimes referred to as the brittle-ductile transition temperature (DBT) for fracture. The life extension of the High Flux Isotope Reactor (HFIR) vessel is calculated by using the method of fracture mechanics. A new method of fracture probability calculation is presented in this paper. The fracture probability as a result of the hydrostatic pressure test (hydrotest) is used to determine the life of the vessel. The hydrotest is performed in order to determine a safe vessel static pressure. It is then followed by using fracture mechanics to project the safe reactor operation time from the time of the satisfactory hydrostatic test. The life extension calculation provides the following information on the remaining life of the reactor as a function of the NDT increase: (1) the life of the vessel is determined by the probability of vessel fracture as a result of hydrotest at several hydrotest pressures and vessel embrittlement conditions, (2) the hydrotest time interval vs the NDT increase rate, and (3) the hydrotest pressure vs the NDT increase rate. It is understood that the use of a complete range of uncertainties of the NDT increase is equivalent to the entire range of radiation damage that can be experienced by the vessel steel. From the numerical values for the probabilities of the vessel fracture as a result of hydrotest, it is estimated that the reactor vessel life can be extended up to 50 EFPY (100 MW) with the minimum vessel operating temperature equal to 85 degrees F

Limited Blood Transfusions Are Safe in Orthopaedic Trauma Patients.

Science.gov (United States)

Dolenc, Andrea J; Morris, William Z; Como, John J; Wagner, Karl G; Vallier, Heather A

2016-12-01

Controversy exists over association of blood transfusions with complications. The purpose was to assess effects of limited transfusions on complication rates and hospital course. Level 1 trauma center. Three hundred seventy-one consecutive patients with Injury Severity Score ≥16 underwent fixation of fractures of spine (n = 111), pelvis (n = 72), acetabulum (n = 57), and/or femur (n = 179). Those receiving >3 units of packed red blood cell were excluded. Fracture type, associated injuries, treatment details, ventilation time, complications, and hospital stay were prospectively recorded. Ninety-eight patients with 107 fractures received limited transfusion, and 119 patients with 123 fractures were not transfused. The groups did not differ in age, fracture types, time to fixation, or associated injuries. Lowest hematocrit was lower in the transfused group (22.8 vs. 30.0, P < 0.0001). Surgical duration (3:23 vs. 2:28) and estimated blood loss (462 vs. 211 mL) were higher in transfused patients (all P < 0.003). Pulmonary complications occurred in 12% of transfused and 4% of nontransfused, (P = 0.10). Mean days of mechanical ventilation (2.51 vs. 0.45), intensive care unit days (4.5 vs. 1.5) and total hospital stay (8.8 vs. 5.7) were higher in transfused patients (all P ≤ 0.006). After multivariate analysis, limited transfusion was associated with increased hospital and intensive care unit stays and mechanical ventilation time, but not with complications. Patients receiving ≤3 units of packed red blood cell had lower hematocrit and greater surgical burden, but no difference in complications versus the nontransfused group. Limited blood transfusions are likely safe, excepting a possible association with longer mechanical ventilation times and hospital stays. Therapeutic level III. See Instructions for Authors for a complete description of levels of evidence.

Effect of Margin Designs on the Marginal Adaptation of Zirconia Copings.

Science.gov (United States)

Habib, Syed Rashid; Al Ajmi, Mohammed Ginan; Al Dhafyan, Mohammed; Jomah, Abdulrehman; Abualsaud, Haytham; Almashali, Mazen

2017-09-01

The aim of this in vitro study was to investigate the effect of Shoulder versus Chamfer margin design on the marginal adaptation of zirconia (Zr) copings. 40 extracted molar teeth were mounted in resin and prepared for zirconia crowns with two margin preparation designs (20=Shoulder and 20=Chamfer). The copings were manufactured by Cercon® (DeguDent GmbH, Germany) using the CAD/CAM system for each tooth. They were tried on each tooth, cemented, thermocycled, re-embedded in resin and were subsequently cross sectioned centrally into two equal mesial and distal halves. They were examined under electron microscope at 200 X magnification and the measurements were recorded at 5 predetermined points in micrometers (µm). The o verall mean marginal gap for the two groups was found to be 206.98+42.78µm with Shoulder margin design (Marginal Gap=199.50+40.72µm) having better adaptation compared to Chamfer (Marginal Gap=214.46+44.85µm). The independent-samples t-test showed a statistically non-significant difference (p=.113) between the means of marginal gap for Shoulder and Chamfer margin designs and the measurements were recorded at 5 predetermined points for the two groups. The Chamfer margin design appeared to offer the same adaptation results as the Shoulder margin design.

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.

Transhepatic Hilar Approach for Perihilar Cholangiocarcinoma: Significance of Early Judgment of Resectability and Safe Vascular Reconstruction.

Science.gov (United States)

Kuriyama, Naohisa; Isaji, Shuji; Tanemura, Akihiro; Iizawa, Yusuke; Kato, Hiroyuki; Murata, Yasuhiro; Azumi, Yoshinori; Kishiwada, Masashi; Mizuno, Shugo; Usui, Masanobu; Sakurai, Hiroyuki

2017-03-01

In the most common surgical procedure for perihilar cholangiocarcinoma, the margin status of the proximal bile duct is determined at the final step. Our procedure, the transhepatic hilar approach, confirms a cancer-negative margin status of the proximal bile duct first. We first performed a partial hepatic parenchymal transection to expose the hilar plate, and then transected the proximal bile duct to confirm margin status. Then, divisions of the hepatic artery and portal vein of the future resected liver are performed, followed by the residual hepatic parenchymal transection. The transhepatic hilar approach offers a wide surgical field for safe resection and reconstruction of the portal vein in the middle of the hepatectomy. We reviewed 23 patients with perihilar cholangiocarcinoma who underwent major hepatectomy using our procedure from 2011 to 2015. A combined vascular resection and reconstruction was carried out in 14 patients (60.9%). R0 resection was achieved in 17 patients (73.9%), and the overall 3-year survival rate was 52.9% (median survival time 52.4 months). The transhepatic hilar approach is useful and practicable regardless of local tumor extension, enabling us to determine tumor resectability and perform safe resection and reconstruction of the portal vein early in the operation.

Counterspaces for Women of Color in STEM Higher Education: Marginal and Central Spaces for Persistence and Success

Science.gov (United States)

Ong, Maria; Smith, Janet M.; Ko, Lily T.

2018-01-01

Counterspaces in science, technology, engineering, and mathematics (STEM) are often considered "safe spaces" at the margins for groups outside the mainstream of STEM education. The prevailing culture and structural manifestations in STEM have traditionally privileged norms of success that favor competitive, individualistic, and solitary…

Application of biodegradable plates for treating pediatric mandibular fractures.

Science.gov (United States)

An, Jingang; Jia, Pengcheng; Zhang, Yi; Gong, Xi; Han, Xiaodong; He, Yang

2015-05-01

We assessed the clinical results of a biodegradable plate system for the internal fixation of mandibular fractures in children, and observed the imaging features of fracture healing and bone changes around the biodegradable plates and screws during follow-up. We enrolled 39 patients (22 male, 17 female, average age 4 years 10 months) with different mandibular fractures. We used 2.0-mm resorbable plates to repair the fractures. Postoperative follow-up ranged from 6 months to 5 years; average follow-up was 1 year 2 months. The outcome measures identified and assessed included facial symmetry, mouth opening, occlusal relationship, infection, nonunion, malunion, and plate dehiscence. We fixed 42 fractures with 43 resorbable plates; the fracture site of one patient (aged 11 years 3 months) was fixed with two plates. Two patients developed small fistulas at the intraoral incision 2 months after surgery; the fistulas healed after 1 month without special treatment. In the other patients, the incision healed well, there was facial symmetry, mouth opening was >35 mm, and occlusion was good. Follow-up computed tomography examination data were available for 20 cases, and revealed different degrees of radiolucency indicating that osteolysis had occurred. Radiolucency was observed around the resorbable plates 1 month after the surgery. The extent and depth of the radiolucent region were obvious within 1 year of surgery. In the second year, there were obvious repairs, with the bony defect areas becoming shallower. After 2 years, the bony defect areas had almost disappeared. Biodegradable fixation devices are safe and efficient for treating pediatric mandibular fractures. Osteolysis commonly follows biodegradable fixation of pediatric mandibular fractures, and has no adverse effect on fracture healing. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Superficial Dorsal Venous Rupture of the Penis: False Penile Fracture That Needs to be Treated as a True Urologic Emergency.

Science.gov (United States)

Truong, Hong; Ferenczi, Basil; Cleary, Ryan; Healy, Kelly A

2016-11-01

A 38-year-old man with history of repaired penile fracture presented with rapid detumescence, penile pain, and ecchymosis during vaginal sexual intercourse concerning for recurrent fracture. Surgical exploration revealed ruptured superficial dorsal vein of the penis, which was subsequently ligated. Patients with traumatic penile vascular injuries often present with clinical features indistinguishable from a true penile fracture. Gradual detumescence and an absence of characteristic popping sound may indicate a vascular injury but they cannot safely rule out a true penile fracture. Both true and false penile fractures require emergent surgical exploration and repair to prevent long-term complications. Copyright © 2016 Elsevier Inc. All rights reserved.

Efficacy and Safety of Interlocked Intramedullary Nailing for Open Fracture Shaft of Tibia

International Nuclear Information System (INIS)

Ahmad, N.; Awan, A. S.; Sultan, S.; Saifullah, K.; Afridi, S. A.; Afridi, S. K.; Lodhi, F. S.

2016-01-01

Background: Due to increasing population and changing human habits the number of accidents and high energy trauma is rising. Management of open fracture tibia is a complex problem and is a challenge for both orthopaedic and plastic surgeons. The study was carried out to ascertain the efficacy and safety of interlocked intra-medullary nailing for open shaft tibial fractures in patients presenting at or after 24 hr of injury. Methods: In this descriptive case series, over a period of 6 moths, 163 consecutive cases of open fracture of tibial shaft were reviewed in terms of clinical profile, time of presentation, and gender distribution. Results: In this study mean age was 30±0.02 years. Males comprised 85 percent of study population while 15 percent were females. Gustilo-I type fracture and Gustilo-II type fracture was diagnosed in 90 percent and 10 percent patients respectively. Thirty three percent patients had wound infection while fracture union was found in 15 percent cases. Moreover interlocked intramedullary nailing for open fracture shaft of tibia was safe in 80 percent patients while this procedure was effective in 85 percent. Conclusion: Un-reamed, interlocked intra-medullary nailing may be considered as a suitable option for treatment of open fractures of tibia. (author)

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.

The pediatric mandible: II. Management of traumatic injury or fracture.

Science.gov (United States)

Smartt, James M; Low, David W; Bartlett, Scott P

2005-08-01

After studying this article, the participant should be able to: 1. Describe the changing epidemiology of mandibular fractures in children and adolescents. 2. Discuss the appropriate use of internal fixation in the treatment of pediatric mandibular fractures. 3. Describe the difficulties posed by the deciduous dentition in the use of interdental wiring. 4. Understand reasons why techniques specific to adult fractures may not be applicable to the growing mandible. 5. Understand the etiology and epidemiology of pediatric mandibular fractures. 6. Understand the reasons for conservative (closed) versus aggressive (open) treatment of mandibular injury. Fractures of the pediatric mandible are complicated by the anatomic complexity of the developing mandible, particularly by the presence of tooth buds and the eruption of deciduous and permanent teeth. Traditional methods of fracture reduction and fixation employed in adults have little applicability in the pediatric population. The authors describe the surgical techniques that have been used at their institution and those that can be used safely in the pediatric setting. In most cases, "conservative" management is the preferred option, especially in the treatment of condylar fractures. In cases requiring surgical intervention, interdental wiring, drop wires in combination with circummandibular wires, and acrylic splints are suited well to specific phases of dental maturation. Open reduction and internal fixation using monocortical screws and microplates or resorbable plates and screws are acceptable techniques in the pediatric patient, but they require special safeguards. Algorithms are presented to simplify management of these complicated injuries.

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

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

Hydrodynamic dispersion in a single fracture: final report on CRNL experiment

International Nuclear Information System (INIS)

Lever, D.A.; Evans, G.V.; Novakowski, K.S.; Raven, K.G.

1988-01-01

One of the options under consideration for the safe long-term disposal of radioactive waste is deep burial in stable fractured rock formations. The most probable way by which radionuclides from the waste could return to the biosphere is by leaching and dissolution of the waste-form, and then water-borne transport by the ground water. In-situ tracer experiments are an important element in developing an understanding of the physical processes that determine the migration of radionuclides through the rock. Unfortunately, there are few field studies presented in the literature to date, which corroborate existing laboratory studies and provide data for theoretical models of transport through fractured rock. The objective of this study was to design and conduct a tracer experiment in which a single fracture was isolated and tested under advective flow conditions with a conservative tracer. During the summer of 1983 a joint AECL-CEC field test was carried out at the Chalk River test site in Canada. Two experiments were conducted, using 82 Br as the conservative tracer, on a discrete fracture identified by hydraulic interference tests at approximately 100 m depth in moderately-fractured monzonitic gneiss. The selected fracture intersects two boreholes in a relatively horizontal attitude over a distance of about 10 m

Reduction of Zygomatic Fractures Using the Carroll-Girard T-bar Screw.

Science.gov (United States)

Baek, Ji Eun; Chung, Chan Min; Hong, In Pyo

2012-09-01

Zygomatic fractures are the second most common facial bone fractures encountered and treated by plastic surgeons. Stable fixation of fractured fragments after adequate exposure is critical for ensuring three-dimensional anatomic reduction. Between January 2008 and December 2010, 17 patients with zygomatic fractures were admitted to our hospital; there were 15 male and 2 female patients. The average age of the patients was 41 years (range, 19 to 75 years). We exposed the inferior orbital rim and zygomatic complex through a lateral brow, intraoral, and subciliary incisions, which allowed for visualization of the bone, and then the fractured parts were corrected using the Carroll-Girard T-bar screw. Postoperative complications such as malar asymmetry, diplopia, enophthalmos, and postoperative infection were not observed. Lower eyelid retraction and temporary ectropion occurred in 1 of the 17 patients. Functional and cosmetic results were excellent in nearly all of the cases. In this report, we describe using the Carroll-Girard T-bar screw for the reduction of zygomatic fractures. Because this instrument is easy to use and can rotate to any direction and vector, it can be used to correct displaced zygomatic bone more accurately and safely than other devices, without leaving facial scars.

OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

Directory of Open Access Journals (Sweden)

Lokesh

2016-05-01

(22% 4 patients for which secondary surgery with bone grafting procedure was done after 4 months. According to AOFAS, 7 we scored the functional outcome of the patients after 5 months of injury. We had 23% of excellent result, 30.4% good and 46% fair with plate. CONCLUSION Locking anatomical plates are a boon and have started a new era in orthopaedic surgery in fixation with articular fractures. But due to lack of locking plate principle it is again cumbersome. Locking plates give relative stability for fracture and need as much as possible anatomical reduction of articular margins unlike in nail where we can do dynamisation if fracture going for delayed union in locking plates is not possible, hence doing as much as possible fracture alignment and then stabilising the fracture with screws is recommended.

The Rovuma Transform Margin: the enigmatic continent-ocean boundary of East Africa

Science.gov (United States)

Phethean, Jordan; Kalnins, Lara; van Hunen, Jeroen; McCaffrey, Ken; Davies, Richard

2017-04-01

The N-S trending Davie Fracture Zone (DFZ) is often assumed to form the continent-ocean transform margin (COTM) of the Western Somali Basin. However, multiple plate tectonic reconstructions favour a pre-breakup location for Madagascar that crosses the DFZ, incompatible with its interpretation as the COTM (e.g., Lottes & Rowley, 1990; Reeves, 2014; Phethean et al., 2016). For the first time, we have identified classic COTM features in seismic reflection data from the Southern Rovuma Basin, to the west and inboard of the DFZ. These suggest a NNW trend to the margin, consistent with the tectonic reconstructions. 2D gravity models, with the seabed and top basement constrained by seismic data, are used to investigate the Moho structure across the Rovuma margin and are best fit using steep 'transform style' geometries, confirming the nature of the margin. We thus model generic COTM geometries elsewhere along the East African and Madagascan transform margins to locate best-fitting positions for these conjugate COTMs. This analysis confirms that the COTMs follow a NNW trend along the Rovuma Basin and Southern Madagascar, respectively, and allows a restoration of the conjugate COTMs. This restoration is used alongside geological maps and satellite imagery from Madagascar and East Africa to refine early plate motions and further constrain the precise origin of Madagascar within Gondwana. Our refined plate tectonic model independently predicts major observations made from seismic reflection and gravity data across the basin, including: regions of major transpression/transtension along the DFZ, merging of fracture zones to form the DFZ, oceanic crust on either side of the DFZ and within the Tanzania coastal basin, and the location of an abandoned MOR within the Tanzania coastal basin. We believe that this study finally provides conclusive evidence that Madagascar originated from within the Tanzania Coastal Basin, inboard of the DFZ, after some 30 years of debate regarding this

Application of Master Curve fracture toughness for reactor pressure vessel integrity assessment in the USA

International Nuclear Information System (INIS)

Server, William; Rosinski, Stan; Lott, Randy; Kim, Charles; Weakland, Dennis

2002-01-01

The Master Curve fracture toughness approach has been used in the USA for better defining the transition temperature fracture toughness of irradiated reactor pressure vessel (RPV) steels for end-of-life (EOL) and EOL extension (EOLE) time periods. The first application was for the Kewaunee plant in which the life-limiting material was a circumferential weld metal. Fracture toughness testing of this weld metal corresponding to EOL and beyond EOLE was used to reassess the PTS screening value, RT PTS , and to develop new operating pressure-temperature curves. The NRC has approved this application using a shift-based methodology and higher safety margins than those proposed by the utility and its contractors. Beaver Valley Unit 1, a First Energy nuclear plant, has performed similar fracture toughness testing, but none of the testing has been conducted at EOL or EOLE at this time. Therefore, extrapolation of the life-limiting plate data to higher fluences is necessary, and the projections will be checked in the next decade by Master Curve fracture toughness testing of all of the Beaver Valley Unit 1 beltline materials (three plates and three welds) at fluences near or greater than EOLE. A supplemental surveillance capsule has been installed in the sister plant, Beaver Valley Unit 2, which has the capability of achieving a higher lead factor while operating under essentially the same environment. The Beaver Valley Unit 1 evaluation has been submitted to the NRC. This paper reviews the shift-based approach taken for the Beaver Valley Unit 1 RPV and presents the use of the RT T 0 methodology (which evolved out of the Master Curve testing and endorsed through two ASME Code Cases). The applied margin accounts for uncertainties in the various material parameters. Discussion of a direct measurement of RT T 0 approach, as originally submitted for the Kewaunee case, is also presented

Marginal integrity of resin composite restorations restored with PPD initiatorcontaining resin composite cured by QTH, monowave and polywave LED units.

Science.gov (United States)

Bortolotto, Tissiana; Betancourt, Francisco; Krejci, Ivo

2016-12-01

This study evaluated the influence of curing devices on marginal adaptation of cavities restored with self-etching adhesive containing CQ and PPD initiators and hybrid composite. Twenty-four class V (3 groups, n=8) with margins located on enamel and dentin were restored with Clearfil S3 Bond and Clearfil APX PLT, light-cured with a monowave LED, multiwave LED and halogen light-curing unit (LCU). Marginal adaptation was evaluated with SEM before/after thermo-mechanical loading (TML). On enamel, significantly lower % continuous margins (74.5±12.6) were found in group cured by multiwave LED when compared to monowave LED (87.6±9.5) and halogen LCU (94.4±9.1). The presence of enamel and composite fractures was significantly higher in the group light-cured with multiwave LED, probably due to an increased materials' friability resulted from an improved degree of cure. The clinician should aware that due to a distinct activation of both initiators, marginal quality may be influenced on the long-term.

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.

Various types of reported seismic margins and their uses

International Nuclear Information System (INIS)

Kennedy, R.P.

1985-01-01

Nuclear power plant structures and safety-related systems have been generally designed conservatively for a safe shutdown earthquake (SSE) and more conservatively for a smaller operating basis earthquake (OBE). Depending upon the relative conservatism of the design criteria, either the SSE or the OBE will control the design. In recent years, increasing knowledge in the geoscience field has led to a better understanding that, although highly unlikely, it is possible for the nuclear power plant to be subjected to earthquake ground motion greater than the ground motion for which the plant was designed. For this reason, interest has developed in demonstrating that nuclear plant structures and safety-related systems can safely withstand earthquake ground motion larger than their design earthquake ground motions (SSE and OBE). Within this paper, this larger-than-design earthquake ground motion will be called the seismic margin earthquake (SME) to distinguish it from the design earthquakes. The goal is to determine the performance of already-designed structures, components, and systems when subjected to the SME. Different and generally more liberal criteria should be used when evaluating the performance of structures, components and systems for the SME than were used in design. Retrofit, and redesign, should only be contemplated if one cannot show a seismic margin greater than unity for the SME using these more liberal criteria. In other words, the SME is not a design earthquake. It is not a replacement for the SSE and generally has nothing to do with design. The SME is a performance-check earthquake

Tranexamic Acid Safely Reduced Blood Loss in Hemi- and Total Hip Arthroplasty for Acute Femoral Neck Fracture: A Randomized Clinical Trial.

Science.gov (United States)

Watts, Chad D; Houdek, Matthew T; Sems, S Andrew; Cross, William W; Pagnano, Mark W

2017-07-01

We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). Prospective, double-blinded, randomized controlled trial. Level 1 Academic Trauma Center. One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients). In the TXA group, patients received 2 doses of 15 mg/kg intravenous TXA dissolved in 100 mL of saline, each administered over 10 minutes; 1 dose just before incision, and the second at wound closure. In the placebo group, 100 mL of saline solution was administered in a similar fashion. Perioperative care was otherwise standardized including conservative transfusion criteria. Our primary outcome was to determine the proportion of patients who underwent blood transfusion during hospitalization. Secondary outcomes were calculated blood loss, number of units transfused during hospitalization, and incidence of adverse events at 30 and 90 days including thromboembolic event, wound complications, reoperation, hospital readmission, and all-cause mortality. TXA reduced mean incidence of transfusion by 305 mL (P = 0.0005). There was a trend toward decreased transfusion rate in the TXA group (17% vs. 26%, P = 0.22). TXA was safe with no differences in adverse events at 30 and 90 days. This randomized clinical trial found that TXA administration safely reduced blood loss with a tendency for decreased transfusion rate and total blood product consumption for patients undergoing hip arthroplasty for acute FNF. More studies are needed to further ascertain the role of TXA in the management of patients with FNF. Therapeutic Level I. See Instructions for Authors

Project margins of advanced reactor design WWER-500

International Nuclear Information System (INIS)

Rogov, M.F.; Birukov, G.I.; Ershov, V.G.; Volkov, B.E.

1994-01-01

Project criteria for design of advanced WWER-500 reactor within design conditions are compared to the requirements of the Russian regulatory guides. Normal operation limits, safe operation limits for main anticipated operational occurrences and design limits accepted for design basis accidents are considered as in preliminary safety report. It is shown that the basic design criteria in the design of WWER-500 for the anticipated operational occurrences and for design basis accidents are more severe than required in the following regulatory guides General Safety Regulations for Nuclear Power Plants and Nuclear Safety Rules for Reactors of Nuclear Power Plants. This provides certain margins from safety point of view

Magmatic development of the outer Vøring margin from seismic data

Science.gov (United States)

Breivik, Asbjørn; Faleide, Jan Inge; Mjelde, Rolf; Flueh, Ernst; Murai, Yoshio

2014-09-01

The Vøring Plateau off mid-Norway is a volcanic passive margin, located north of the East Jan Mayen Fracture Zone (EJMFZ). Large volumes of magmatic rocks were emplaced during Early Eocene margin formation. In 2003, an ocean bottom seismometer survey was acquired over the margin. One profile crosses from the Vøring Plateau to the Vøring Spur, a bathymetric high north of the EJMFZ. The P wave data were ray traced into a 2-D crustal velocity model. The velocity structure of the Vøring Spur indicates up to 15 km igneous crustal thickness. Magmatic processes can be estimated by comparing seismic velocity (VP) with igneous thickness (H). This and two other profiles show a positive H-VP correlation at the Vøring Plateau, consistent with elevated mantle temperature at breakup. However, during the first 2 Ma magma production was augmented by a secondary process, possibly small-scale convection. From ˜51.5 Ma excess melting may be caused by elevated mantle temperature alone. Seismic stratigraphy around the Vøring Spur shows that it was created by at least two uplift events, with the main episode close to the Miocene/Pliocene boundary. Low H-VP correlation of the spur is consistent with renewed igneous growth by constant, moderate-degree mantle melting, not related to the breakup magmatism. The admittance function between bathymetry and free-air gravity shows that the high is near local isostatic equilibrium, precluding that compressional flexure at the EJMFZ uplifted the high. We find a proposed Eocene triple junction model for the margin to be inconsistent with observations.

Intraocular pressure variations during zygomatic fracture reduction and fixation: a clinical study.

LENUS (Irish Health Repository)

Murray, Dylan J

2012-02-03

BACKGROUND: The reduction of midface fractures has been associated with the rare but devastating complication of blindness. An increase in intraocular pressure is important in the mechanism of blindness in this setting. In this study, the authors assessed the intraocular pressure in patients who underwent zygomatic fracture reduction (with or without fixation). METHODS: Using applanation tonometry, 29 patients underwent intraocular pressure measurements before, during, and after fracture fixation. The contralateral pressures were measured and used as the control. RESULTS: There were 29 patients with a mean age of 35 years, and the mean time to surgery was 5 days. Preoperatively, all patients had normal intraocular pressures and normal visual acuity. All patients underwent a Gillies lift and 18 patients required open reduction and fixation of the frontozygomatic suture (n = 4) or the infraorbital margin (n = 2), and the remainder (n = 12) required fixation of both points. There was no statistically significant increase in the intraocular pressures following the reduction of uncomplicated zygomatic fractures. Statistically significant pressure reductions were noted immediately after reduction and fixation. CONCLUSIONS: The surgical reduction of uncomplicated zygomatic fractures has no adverse effect on the intraocular pressure. It is the authors\\' opinion that adjunctive measures to reduce the pressures are unnecessary.

Occipital condyle fracture and ligament injury: imaging by CT

International Nuclear Information System (INIS)

Bloom, A.I.; Neeman, Z.; Floman, Y.; Gomori, J.; Bar-Ziv, J.

1996-01-01

The true incidence of fracture of the occipital condyles is unknown. It may be associated with instability at the craniocervical joint. CT is the modality of choice for the demonstration of these fractures, but its use for imaging of the associated ligament injury has not been reported. In order to demonstrate normal anatomy, occipital condyle fracture and ligament injury, and to estimate the incidence of this lesion, 21 children and young adults with high-energy blunt craniocervical injury were examined prospectively. Thin-slice, axial, contiguous, CT was performed from the base of C2 to above the foramen magnum. Bone and soft tissue windows and coronal, sagittal, and curvilinear 2D reconstructions were performed. Five occipital condyle fractures were identified in four patients (19 %), with demonstration of alar ligament injury in two cases and local hematoma in one. In four, artifacts or rotation precluded assessment of ligaments. In all remaining cases normal bone and ligament anatomy was demonstrated. Fracture of the occipital condyles following craniocervical injury is not uncommon in children and young adults. Normal bone and ligament anatomy and pathology can be safely and clearly demonstrated in seriously injured patients and others using this CT technique. Increased awareness of this entity and a low threshold for performing CT should avoid the potentially serious consequences of a missed diagnosis. (orig.). With 8 figs., 2 tabs

Comparison of safety margins for leak-before-break assessment of 500 MWe PHWR straight pipes: using contemporary techniques

International Nuclear Information System (INIS)

Rastogi, Rohit; Bhasin, Vivek; Kushwaha, H.S.

1998-01-01

The Leak Before Break (LBB) analysis of Primary Heat Transport (PHT) Piping of 500 MWe Indian PHWR is being performed using different well established techniques like R6 method (Nuclear Electric UK) and J-Tearing based methods (USNRC). These methods show that PHT piping has required safety margins and can be qualified for LBB. These analysis also showed that the piping has high fracture toughness and plastic collapse is the dominant mode of failure. To enhance the confidence in the results obtained from the above methods, further studies were done on the PHT piping. Procedures which predicted margins against plastic collapse were used. The analysis procedures used were Modified Limit Load Method, MPA Method (both from Germany), Moments Method (from Italy) and the Z-Factor method given in ASME Boiler and Pressure Vessel Code. The safety margins obtained from these analysis satisfied the LBB requirements. A table was generated which compared the safety margins obtained using all the above mentioned procedures. This report presents the results of this study. (author)

Miocene uplift of the NE Greenland margin linked to plate tectonics: Seismic evidence from the Greenland Fracture Zone, NE Atlantic

DEFF Research Database (Denmark)

Døssing Andreasen, Arne; Japsen, Peter; Watts, Anthony B.

2016-01-01

Tectonic models predict that, following breakup, rift margins undergo only decaying thermal subsidence during their post-rift evolution. However, post-breakup stratigraphy beneath the NE Atlantic shelves shows evidence of regional-scale unconformities, commonly cited as outer margin responses to ...... by plate tectonic forces, induced perhaps by a change in the Iceland plume (a hot pulse) and/or by changes in intra-plate stresses related to global tectonics.......Tectonic models predict that, following breakup, rift margins undergo only decaying thermal subsidence during their post-rift evolution. However, post-breakup stratigraphy beneath the NE Atlantic shelves shows evidence of regional-scale unconformities, commonly cited as outer margin responses...... backstripping. We explain the thermo-mechanical coupling and the deposition of contourites by the formation of a continuous plate boundary along the Mohns and Knipovich ridges, leading to an accelerated widening of the Fram Strait. We demonstrate that the IMU event is linked to onset of uplift and massive shelf...

Esthetic rehabilitation of complicated crown fractures utilizing rapid orthodontic extrusion and two different restoration modalities.

Science.gov (United States)

Milardovic Ortolan, Sladana; Strujic, Mihovil; Aurer, Andrej; Viskic, Josko; Bergman, Lana; Mehulic, Ketij

2012-01-01

This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth. How to cite this article: Ortolan SM, Strujic M, Aurer A, Viskic J, Bergman L, Mehulic K. Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities. Int J Clin Pediatr Dent 2012;5(1):64-67.

Balloon kyphoplasty for aged osteoporotic vertebral compressive fractures using domestic instruments

International Nuclear Information System (INIS)

Sun Gang; Jin Peng; Yi Yuhai; Xie Zhiyong; Zhang Xuping; Zhang Kangli

2006-01-01

Objective: To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful osteoporosis vertebral compressive fractures using instruments made in China. Methods: 10 cases of painful osteoporotic vertebral compressive fractures, involved 11 vertebrae. Under X-ray fluoroscopy monitoring, the inflatable balloon were inserted into the fractured vertebral body via transpedicular route bilaterally. The balloon was inflated with injected contrast agent to restore vertebral height and form a cavity within vertebral body. The cavity was then filled with bone cement in toothpaste state period. The postoperative symptoms and the radiographic findings of vertebral height recovery were observed. Results: Balloon kyphoplasty was successful in all 10 cases with dramatic pain relief within 48 hours after the procedure without clinical complications. The height restoration of vertebral body was satisfactory with correction of kyphosis up to 6 degree-24 degree. Leakage of a small quantity of bone cement occurred at only the anterior border of the vertebral body. Conclusions: Kyphoplasty using domestic instruments for painful osteoporotic vertebral compressive fractures was effective and safe. (authors)

Safe sex

Science.gov (United States)

... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

Short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx: Description of the injury and a technique for repair.

Science.gov (United States)

Wright, I M; Minshall, G J

2018-01-01

Chip fractures of the dorsoproximal articular margin of the proximal phalanx are common injuries in racehorses. Large fractures can extend distal to the joint capsule insertion and have been described as dorsal frontal fractures. To report the location and morphology of short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx and describe a technique for repair under arthroscopic and radiographic guidance. Single centre retrospective case study. Case records of horses with frontal plane fractures restricted to the dorsoproximal epiphysis and metaphysis of the proximal phalanx referred to Newmarket Equine Hospital were retrieved, images reviewed and lesion morphology described. A technique for repair and the results obtained are reported. A total of 22 fractures in 21 horses commencing at the proximal articular surface exited the dorsal cortex of the proximal phalanx distal to the metacarpophalangeal/metatarsophalangeal joint capsule in 17 hind- and five forelimbs. All were in Thoroughbred racehorses. In 16 cases these were acute racing or training injuries; 20 fractures were medial, one lateral and one was midline. All were repaired with a single lag screw using arthroscopic and radiographically determined landmarks. A total of 16 horses raced after surgery with performance data similar to their preinjury levels. The study demonstrates substantial morphological similarities between individual lesions supporting a common pathophysiology, but does not identify precise causation. There are no cases managed differently that might permit assessment of the comparative efficacy of the treatment described. Short frontal plane fractures involving the dorsoproximal margin of the proximal phalanx that exit the bone distal to the metacarpophalangeal/metatarsophalangeal joint capsule have substantial morphological similarities, are amenable to minimally invasive repair and carry a good prognosis for return to training and racing. �

Folding and fracturing of rock adjacent to salt diapirs

Science.gov (United States)

Rowan, Mark G.

2017-04-01

When John Ramsay wrote his groundbreaking book in 1967, deformation around salt diapirs was not something he covered. At the time, most geologists considered diapirs to form due to density inversion, rising through thick overlying strata due to buoyancy. In doing so, salt was thought to shove aside the younger rocks, shearing and fracturing them in drag folds and supposedly producing "salt gouge". Even after it was realized that the majority of diapirs spend most of their history growing at or just beneath the surface, the relative rise of salt and sinking of minibasins were (and are) still thought by many to be accommodated in part by shear and fracturing of rocks in a collar zone around the salt. There are two arguments against this model. The first is mechanical: whereas halite behaves as a viscous fluid, even young sediment deforms as a brittle material with layer anisotropy. Thus, the salt-sediment interface is the outer margin of an intrasalt shear zone caused by viscous drag against the diapir margin. The velocity of salt flow decreases dramatically toward the edge of the diapir, so that the outermost salt effectively doesn't move. Hence, no shear or fracturing is expected in surrounding strata. The second and more important argument is that empirical field data do not support the idea of drag folds and associated deformation. Certainly, strata are typically folded and thinned adjacent to diapirs. However, stratal upturn is generated by monoclinal drape folding of the diapir roof over the edge of the rising salt, and thinning is caused by deposition onto the bathymetric highs formed by the diapirs, often supplemented by roof erosion and slumping. Halokinetic sequences observed in numerous salt basins (e.g., Paradox Basin, La Popa Basin, Spanish Pyrenees, Sivas Basin, Zagros Mountains, Kuqa Basin) contain no diapir-parallel shear zones and minimal thinning and fracturing caused by diapir rise. Even megaflaps, in which strata extend for kilometers up the sides

Assessment of trochanteric osteotomy fragment union after acetabular fracture surgery.

Science.gov (United States)

Dubina, Andrew G; Wickramaratne, Niluka; O'Toole, Robert V; Manson, Theodore T

2017-02-01

Trochanteric osteotomies are performed in conjunction with standard approaches to improve surgical exposure during open reduction and internal fixation (ORIF) of acetabular fractures. The literature on total hip arthroplasty reports nonunion rates as high as 30% associated with trochanteric osteotomies; however, few data exist regarding the outcomes of trochanteric osteotomies for acetabular fracture surgery. Our hypotheses were 1) patients receiving trochanteric osteotomies during ORIF of acetabular fractures have a low rate of nonunion of the osteotomy fragment, and 2) hip abduction precautions are not necessary with digastric type osteotomies. A retrospective review was conducted to identify patients with acetabular fractures between July 2002 and June 2010 (n=734 fractures) who required trochanteric osteotomies (n=64, 9% of fractures). Forty-seven met inclusion criteria of adequate follow-up (>56days). No excluded patient experienced a complication. Fractures were classified using the Letournel-Judet classification system. Only seven (20%) of 35 patients who received digastric osteotomies had hip abduction precautions applied during the postoperative period. All study patients were shown to have radiographic union at the trochanteric osteotomy site (100% union rate, n=47). Hip abduction precautions intended to protect the osteotomy site and reduce the risk of nonunion and fixation failure were infrequently applied to patients with digastric osteotomies (20%) in this cohort. Multiple protective factors against nonunion were present in this study population compared with previous arthroplasty studies from other institutions. Trochanteric osteotomies are not associated with a significant nonunion rate, and digastric osteotomies might be safely managed without hip abduction precautions. Copyright © 2016. Published by Elsevier Ltd.

Matthew and marginality

Directory of Open Access Journals (Sweden)

Denis C. Duling

1995-12-01

Full Text Available This article explores marginality theory as it was first proposed in  the social sciences, that is related to persons caught between two competing cultures (Park; Stonequist, and, then, as it was developed in sociology as related to the poor (Germani and in anthropology as it was related to involuntary marginality and voluntary marginality (Victor Turner. It then examines a (normative scheme' in antiquity that creates involuntary marginality at the macrosocial level, namely, Lenski's social stratification model in an agrarian society, and indicates how Matthean language might fit with a sample inventory  of socioreligious roles. Next, it examines some (normative schemes' in  antiquity for voluntary margi-nality at the microsocial level, namely, groups, and examines how the Matthean gospel would fit based on indications of factions and leaders. The article ,shows that the author of the Gospel of Matthew has an ideology of (voluntary marginality', but his gospel includes some hope for (involuntary  marginals' in  the  real world, though it is somewhat tempered. It also suggests that the writer of the Gospel is a (marginal man', especially in the sense defined by the early theorists (Park; Stone-quist.

Calcaneal Fractures and Böhler’s Angle

Directory of Open Access Journals (Sweden)

Lindsey Spiegelman

2017-01-01

Full Text Available History of present illness: 40-year-old male presents to the emergency department after falling off a ladder. He was repairing a window when he fell, landing on the ground 12 feet below. The patient landed onto his feet bilaterally and then fell backwards onto his buttocks. On arrival, the patient had bilateral foot pain. He denied any back pain, headache, or loss of consciousness. Significant findings: The right ankle lateral radiograph shows a comminuted, non-displaced fracture of the posterior calcaneus (red arrow in addition to fracture fragments along the heel pad margin (blue arrow. The left ankle lateral radiograph shows a displaced, comminuted fracture of the mid to posterior calcaneus with extension into the subtalar joint posteriorly (purple arrow. There is subcutaneous air seen anteriorly to the tibiotalar joint space (green arrow in addition to a joint effusion. Of note, the Böhler’s angle in the left x-ray is 16 degrees which is consistent with a fracture (see red annotation showing Böhler’s angle. Discussion: Calcaneal fractures occur typically in adults who have undergone significant axial load on their feet secondary to a fall from high height.2,3 There are two broad types of calcaneal fractures: intraarticular and extraarticular.2 The intraarticular fractures are colloquially referred to as a “Lover’s Fracture” as they have been known to occur in those jumping out of a tall window to escape the wrath of a lover’s spouse.1 Calcaneal fractures are best diagnosed with a CT scan or with lateral x-ray by measuring Böhler’s angle.2,3 This is the angle formed by the intersection of two lines demonstrated on a normal lateral ankle radiograph. The first line is drawn between the superior aspect of the anterior process of the calcaneus (point A and the superior edge of the posterior articular facet (point B. The second line is drawn between the superior aspect of the posterior calcaneal tuberosity (point C and point B.2

Lessons from Semmelweis:A Social Epidemiologic Update On Safe Motherhood

Directory of Open Access Journals (Sweden)

Julie Cwikel

2008-01-01

Full Text Available In this historical review, Ignaz Semmelweis's study of handwashing to prevent puerperal fever is described and used as a benchmark from which to identify salient issues that are informative to today's women’s health activists working for Safe Motherhood. The epidemiology of contemporary excess maternal mortality is reviewed. Using the conceptual framework of social epidemiology, the paper addresses four issues that were problematic in Semmelweis’ era. New tools in public health are presented that can help to solve critical, still challenging problems to reduce excess maternal mortality, nosocomial infections, and puerperal fever at childbirth: 1 progress in behavioral methods to promote health behavior change, 2 the introduction of participatory action research, 3 the diffusion of evidence-based public health practice and 4 understanding how politics and health interact and present challenges when trying to meet public health goals. Social exclusion and marginality are still key issues in determining who has access to safe motherhood and who risks her life in maternity. Applied social epidemiology allows practitioners to make effective use of the already accumulated evidence and translate it into effective public health practice to promote safe motherhood around the world.

Lumbar posterior marginal intra-osseous cartilaginous node

Energy Technology Data Exchange (ETDEWEB)

Laredo, J.D.; Bard, M.; Chretien, J.; Kahn, M.F.

1986-03-01

This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed.

Lumbar posterior marginal intra-osseous cartilaginous node

International Nuclear Information System (INIS)

Laredo, J.D.; Bard, M.; Chretien, J.; Kahn, M.F.

1986-01-01

This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed. (orig.)

Too Fit To Fracture: outcomes of a Delphi consensus process on physical activity and exercise recommendations for adults with osteoporosis with or without vertebral fractures.

Science.gov (United States)

Giangregorio, L M; McGill, S; Wark, J D; Laprade, J; Heinonen, A; Ashe, M C; MacIntyre, N J; Cheung, A M; Shipp, K; Keller, H; Jain, R; Papaioannou, A

2015-03-01

lbs, no twisting), but for those with vertebral fracture, especially in the presence of pain, multiple fractures, or hyperkyphosis, the risks of many activities may outweigh the benefits-physical therapist consultation is recommended. Examples of spine-sparing techniques and exercise prescription elements are provided. Our recommendations guide health care providers on assessment, exercise prescription, and safe movement for individuals with osteoporosis.

Hollow Mill for Extraction of Stripped Titanium Screws: An Easy, Quick, and Safe Technique

OpenAIRE

Gupta, Ravi; Singh, Harpreet; Singh, Amit; Garg, Sudhir

2014-01-01

Removal of jammed titanium screws can be difficult due to the problem of stripping of the hexagonal heads of the screws. We present a technique of extraction of stripped screws with the use of a standard 4.5 mm stainless steel hollow mill in a patient of peri-implant fracture of the radius fixed with a titanium locking plate 2 years back. The technique is quick, safe, and cost effective.

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.

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

Seismic investigation on the Littoral Faults Zone in the northern continental margin of South China Sea

Science.gov (United States)

Sun, J.; Xu, H.; Xia, S.; Cao, J.; Wan, K.

2017-12-01

The continental margin of the northern South China Sea (SCS) had experienced continuous evolution from an active continental margin in the late Mesozoic to a passive continental margin in the Cenozoic. The 1200km-long Littoral Faults Zone (LFZ) off the mainland South China was suggested to represent one of the sub-plate boundaries and play a key role during the evolution. Besides, four devastating earthquakes with magnitude over 7 and another 11 destructive events with M>6 were documented to have occurred along the LFZ. However, its approximity to the shoreline, the shallow water depth, and the heavy fishing activities make it hard to conduct a marine seismic investigation. As a result, understandings about the LFZ before 2000 were relatively poor and mostly descriptive. After two experiments of joint onshore-offshore wide-angle seismic surveys in the 1st decade of this century, several cruses aiming to unveil the deep structure of the LFZ were performed in the past few years, with five joint onshore-offshore wide-angle seismic survey profiles completed. Each of these profiles is perpendicular to the shoreline, with four to five seismometers of campaign mode deployed on the landside and over ten Ocean Bottom Seismometers (OBSs) spacing at 20km deployed on the seaside. Meanwhile, multi-channel seismic (MCS) data along these profiles were obtained simultaneously. Based on these data, velocity models from both forward modeling and inversion were obtained. According to these models, the LFZ was imaged to be a low-velocity fractured zone dipping to the SSE-SE at a high-angle and cutting through the thinned continental crust at some locations. Width of the fractured zone varies from 6km to more than 10km from site to site. With these results, it is suggested that the LFZ accommodates the stresses from both the east side, where the Eurasia/Philippine Sea plate converging and mountain building is ongoing, and the west side, where a strike-slip between the Indochina

Subbrow Approach as a Minimally Invasive Reduction Technique in the Management of Frontal Sinus Fractures

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Yewon Lee

2014-11-01

Full Text Available BackgroundFrontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures.MethodsBetween March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws.ResultsContour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed.ConclusionsThe subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

Global burden of trauma: Need for effective fracture therapies

Directory of Open Access Journals (Sweden)

Mathew George

2009-01-01

Full Text Available Orthopedic trauma care and fracture management have advanced significantly over the last 50 years. New developments in the biology and biomechanics of the musculoskeletal system, fixation devices, and soft tissue management have greatly influenced our ability to care for musculoskeletal injuries. Many therapies and treatment modalities have the potential to transform future orthopedic treatment by decreasing invasive procedures and providing shorter healing times. Promising results in experimental models have led to an increase in clinical application of these therapies in human subjects. However, for many modalities, precise clinical indications, timing, dosage, and mode of action still need to be clearly defined. In order to further develop fracture management strategies, predict outcomes and improve clinical application of newer technologies, further research studies are needed. Together with evolving new therapies, the strategies to improve fracture care should focus on cost effectiveness. This is a great opportunity for the global orthopedic community, in association with other stakeholders, to address the many barriers to the delivery of safe, timely, and effective care for patients with musculoskeletal injuries in developing countries.

Treatment of high-energy pilon fractures using the ILIZAROV treatment.

Science.gov (United States)

Osman, Walid; Alaya, Zeineb; Kaziz, Hamdi; Hassini, Lassad; Braiki, Meriem; Naouar, Nader; Ben Ayeche, Mohamed Laaziz

2017-01-01

to their preinjury profession. The ILIZAROV technique is a safe and a very effective treatment for severe pilon fractures with minimum complications and good healing results.

Some problems of geologic relations between the Amazon craton and east margins fold belts

International Nuclear Information System (INIS)

Almeida, F.F.M. de

1986-01-01

This paper deals with some geologic problems related to the limits between the Amazon craton and the fold belts developed at its margins during the Precambrian. These limits are diversified but clearly recognized. To the north, the Araguaia-Tocantins fold belt, of presumed Middle Proterozoic age, is separated from the cratonic block by a deep marginal fracture zone permeated by mafic and ultramafic rocks. The geologic, magmatic and aeromagnetic characteristics of this zone point out the presence of deep faults, supposed to be of Middle Proterozoic age. The southern Paraguay fold belt constitutes and accurated zone of linear structures supposed to be of Late Proterozoic development. Despite the great increase of knowledge during the last ten years many tectonic, stratigraphic and geochronologic problems remain unsolved. The aim of this paper is to point out some of these problems and suggest specific studies to solve them. (author)

Ore-controlling mechanism of carbonaceous-siliceous-pelitic rock type uranium deposits with down-faulted red basins in the southeast continental margin of Yangtze plate

International Nuclear Information System (INIS)

Zhang Zilong; Qi Fucheng; He Zhongbo; Li Zhixing; Wang Wenquan; Yu Jinshui

2012-01-01

One of the important ore-concentrated areas of carbonaceous-siliceous-pelitic rock type uranium deposits is the Southeast continental margin of Yangtze plate. Sedimentary-exogenously transformed type and sedimentary- hydrothermal superimposed transformed type uranium deposits are always distributed at or near the edge of down-faulted red ba sins. In this paper, the distributions of the deposits are analyzed with the relation to down-faulted red basins. The connective effect and ore-controlling mechanism are proposed of carbonaceous-siliceous-pelitic rock type uranium deposits with marginal fractures of red basins. (authors)

Reverse Less Invasive Stabilization System (LISS) Plating for Proximal Femur Fractures in Poliomyelitis Survivors: A Report of Two Cases.

Science.gov (United States)

Yao, Chen; Jin, Dongxu; Zhang, Changqing

2017-11-15

BACKGROUND Poliomyelitis is a neuromuscular disease which causes muscle atrophy, skeletal deformities, and disabilities. Treatment of hip fractures on polio-affect limbs is unique and difficult, since routine fixation methods like nailing may not be suitable due to abnormal skeletal structures. CASE REPORT We report one femoral neck fracture and one subtrochanteric fracture in polio survivors successfully treated with reverse less invasive stabilization system (LISS) plating technique. Both fractures were on polio-affected limbs with significant skeletal deformities and low bone density. A contralateral femoral LISS plate was applied upside down to the proximal femur as an internal fixator after indirect or direct reduction. Both patients had uneventful bone union and good functional recovery. CONCLUSIONS Reverse LISS plating is a safe and effective technique to treat hip fractures with skeletal deformities caused by poliomyelitis.

HEALING OF ARTICULAR AND PERIARTICULAR METACARPAL AND PHALANGEAL FRACTURES

Directory of Open Access Journals (Sweden)

Aleksandar Kruščić

2003-12-01

ligamentotaxis were without significant slides, the fragments healing in good position. End functional results were satisfactory. We had only one decubitus, which healed per primam after reshaping of the splint.Conclusions. The application of local analgesia and ligamentotaxis represents a simple and safe method of treatment. It allows individual biomechanical neutralization of the pathologic activity of kinetic energy vectors on the fracture. Repositioning and physiological positioning of the hand in Softcast plaster is simple, there is no need to hospitalize the patient for surgery. This makes the method less costly as well. There are less fracture slides, and repairs due to decubitus are simpler as there is no need for total immobilization removal. Therefore ligamentotaxis is the method of choice.

Agreement between physicians' and nurses' clinical decisions for the management of the fracture liaison service (4iFLS): the Lucky Bone™ program.

Science.gov (United States)

Senay, A; Delisle, J; Raynauld, J P; Morin, S N; Fernandes, J C

2016-04-01

We determined if nurses can manage osteoporotic fractures in a fracture liaison service by asking a rheumatologist and an internist to assess their clinical decisions. Experts agreed on more than 94 % of all nurses' actions for 525 fragility fracture patients, showing that their management is efficient and safe. A major care gap exists in the investigation of bone fragility and initiation of treatment for individuals who have sustained a fragility fracture. The implementation of a fracture liaison service (FLS) managed by nurses could be the key in resolving this problem. The aim of this project was to obtain agreement between physicians' and nurses' clinical decisions and evaluate if the algorithm of care is efficient and reliable for the management of a FLS. Clinical decisions of nurses for 525 subjects in a fracture liaison service between 2010 and 2013 were assessed by two independent physicians with expertise in osteoporosis treatment. Nurses succeeded in identifying all patients at risk and needed to refer 27 % of patients to an MD. Thereby, they managed autonomously 73 % of fragility fracture patients. No needless referrals were made according to assessing physicians. Agreement between each evaluator and nurses was of >97 %. Physicians' decisions were the same in >96 %, and Gwet AC11 coefficient was of >0.960 (almost perfect level of agreement). All major comorbidities were adequately managed. High agreement between nurses' and physicians' clinical decisions indicate that the independent management by nurses of a fracture liaison service is safe and should strongly be recommended in the care of patients with a fragility fracture. This kind of intervention could help resolve the existing care gap in bone fragility care as well as the societal economic burden associated with prevention and treatment of fragility fractures.

Attritional rupture of extensor pollicis longus: a rare complication following elastic stable intramedullary nailing of a paediatric radial fracture.

LENUS (Irish Health Repository)

Sproule, James A

2011-01-01

Elastic stable intramedullary nail fixation has become established as an acceptable method of treatment for diaphyseal fractures of both forearm bones in the paediatric population. It is considered safe, minimally invasive and does not compromise physeal growth. We report a case of delayed rupture of extensor pollicis longus due to attrition over the sharp edges of a protruding nail end after elastic stable intramedullary nailing of a paediatric radial diaphyseal fracture.

Treatment outcomes of intertrochanteric femur fractures treated with DLT™ nail

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Mehmet Arıcan

2015-12-01

Full Text Available Objective: Intramedullary nails frequently use in proximal femur fractures. In this study, 49 patients with intertrochanteric fractures were evaluated clinical and radiological results treated with dyna locking trochanteric (DLT™ nail retrospectively. Methods: Twenty-two (44.9% patients were male and 27 (55.1% patients were female. Mean age was 74.29±1.98 (28-99 years and Followed up for a mean of 14.35±3.43 (9-24 months. Thirty-seven (75.6% of the fractures resulted from simple falls while 6 (12.2% caused from traffic accidents and 6 (12.2% fall down from height. There were 24 (49.0% left and 25 (51.0% right lower extremities fractured. According to Orthopaedic Trauma Association classification system; 21 (42.9%, 21 (42.9% and 7 (14.2% fractures were classified as 31A1, 31A2, and 31A3 respectively. One (2.0% patient had claviculae fracture, 3 (6.1% patients had radius distal fracture and 1 (2.0% patient had total knee arthroplasty. After surgery, X-ray was used for radiological results and functional outcomes were evaluated according to the Harris hip scoring system. Results: The average waiting time for the surgery was 2.02±0.18 (1-7 days and hospitalization time was 6.23±0.29 (4-15 days. Mean fracture healing time was 11.74±1.82 (8-15 weeks. Three patients had screw cut-out in the follow-up time and performed hemiarthroplasty. The average Harris hip score was 88.02±1.21 (42-97 points and included 29 (59.2% excellent cases, 17 (34.7% good and 3 (6.1% poor. Conclusion: DLT ™ nail is a safe and successful method because of low complication rates, and capability of detection.

Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day

Energy Technology Data Exchange (ETDEWEB)

Cho, Yong Soo; Back, Chang Hee; Lee, Kyung Rae; Shin, Yun Hack; Whang, Yeong Seop; Jeong, Ku Young [Yeosu Baek Hospital, Yeosu (Korea, Republic of); Chung, Soo Hyun [NamWon Medical Center, NamWon (Korea, Republic of); Whang, Cheol Mog [Konyang University Hospital, Daejeon (Korea, Republic of)

2007-04-15

We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries.

Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day

International Nuclear Information System (INIS)

Cho, Yong Soo; Back, Chang Hee; Lee, Kyung Rae; Shin, Yun Hack; Whang, Yeong Seop; Jeong, Ku Young; Chung, Soo Hyun; Whang, Cheol Mog

2007-01-01

We wished to compare the ability of ultrasonography and radiography performed on the same day to detect rib fractures in minor chest injuries. Two hundred and fifteen patients with minor chest injuries were selected. Radiography and ultrasonography were performed on the same day with these patients. Chest wall pain was the only presenting symptom. Two radiologists performed ultrasonography. Fractures were identified by a disruption of the anterior margin of the rib and costal cartilage. The incidence and location of fractures and complications revealed by radiography and ultrasonography were compared. Radiographs revealed the presence of 70 rib fractures in 50 (23%) of 215 patients and ultrasonography revealed the presence of 203 rib fractures in 133 (62%) of 215 patients. Ultrasonography uniquely identified 133 rib fractures in 83 patients. Ultrasonography identified a 2.9 fold increase in the number of fractures in a 2.6 fold number of subjects as compared to radiography. Of the 203 sonographically detected fractures, 201 were located in the rib, one was located at the costochondral junction, and one in the costal cartilage. There were no complications seen by either radiography or ultrasonography. Ultrasonography reveals more fractures than those that may be overlooked on radiography for minor chest injuries

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

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

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

Marginal and happy? The need for uniqueness predicts the adjustment of marginal immigrants.

Science.gov (United States)

Debrosse, Régine; de la Sablonnière, Roxane; Rossignac-Milon, Maya

2015-12-01

Marginalization is often presented as the strategy associated with the worst adjustment for immigrants. This study identifies a critical variable that buffers marginal immigrants from the negative effects of marginalization on adjustment: The need for uniqueness. In three studies, we surveyed immigrants recruited on university campuses (n = 119, n = 116) and in the field (n = 61). Among marginal immigrants, a higher need for uniqueness predicted higher self-esteem (Study 1), affect (Study 2), and life satisfaction (Study 3), and marginally higher happiness (Study 2) and self-esteem (Study 3). No relationship between the need for uniqueness and adjustment was found among non-marginal immigrants. The adaptive value of the need for uniqueness for marginal immigrants is discussed. © 2015 The British Psychological Society.

Use of Titanium Elastic Nails in the Adult Diaphyseal Humerus Fractures

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Upadhyay AS

2017-07-01

Full Text Available INTRODUCTION: Humerus shaft fractures in adults can be managed conservatively with functional braces or operatively with plate osteosynthesis or with intramedullary nailing. Conventionally humerus intramedullary nailing is done either using humerus interlocking nails or Enders nails. In this study we analyse the outcome of humerus shaft fractures (upper and middle third managed with closed ante- grade intramedullary titanium elastic nailing in terms of union rates, union time, functional results and complications. MATERIALS AND METHODS: A retrospective analysis of 25 patients treated with ante-grade intramedullary titanium elastic nailing was done during the period of August 2014 to June 2016 at our tertiary care centre. Skeletally mature patients with closed and acute fractures of the upper and middle shaft humerus of both sexes were included in the study. RESULTS: Twenty-five (100% fractures united with an average consolidation time of 14.98 weeks (10-32 weeks, and no fractures ended in non-union. Nail impingement was seen in two (8%, shoulder stiffness in one (4%. Functional results were excellent in 22 (88%, moderate in two (8% and poor in one (4%. There were 17 males and eight females with an average age of 39.08 years (range: 18-65 years. The average duration of hospital stay was 3.84±2.30 days. CONCLUSION: Closed ante-grade intramedullary titanium elastic nailing offers a safe and reliable method of fixing fractures of upper humeral shaft in adults. This method provides early fracture union, high union rates and less complications, in addition to early rehabilitation and reduces the hospital stay.

Adequacy of Current Equivalent Margins Analysis (EMA) Guidance, Data and Methodologies for 60+ Years of Operation

International Nuclear Information System (INIS)

Server, W.; Hardin, T.; Cipolla, R.; Hall, B.

2015-01-01

In order to assure the structural integrity of reactor pressure vessels (RPVs), the fracture toughness of the ferritic steels used to fabricate the RPV must be shown to be adequate during their entire operating life, including extended license life. The Charpy V-notch (CVN) impact test has been used in the nuclear industry since it uses a small test specimen that can be irradiated in surveillance programs and provides an indirect way of assessing the fracture toughness of RPV steels. The effects of embrittlement typically are characterized by changes to the average Charpy curves measured before and after irradiation: shift of the 30 ft-lb (41 J) index temperature, and decrease in the CVN upper shelf energy (USE). Requirements in the USA for the USE of RPV belt-line materials are codified in Title 10, Code of Federal Regulations, Part 50 (10 CFR 50), Appendix G. Before irradiation, USE in the transverse (T-L) orientation for base materials and crack extension in the welding direction for weld materials must be greater than or equal to 75 ft-lb (102 J), and it is not to become less than 50 ft-lb (68 J) due to radiation embrittlement throughout the license of the RPV. If the projected USE of any RPV belt-line steel falls below 50 ft-lb (68 J), the projected value must be demonstrated to provide a margin of safety against ductile fracture equivalent to that required by Appendix G of the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code, Section XI. The analytical evaluation method used is called an equivalent margin analysis (EMA). This paper reviews the current status of EMAs and recommends improvements and clarifications that can be made to meet the needs of extended license life to 80 years. Focus is placed on analytical methodology, material property needs and proper implementation. (authors)

Development of Numerical Analysis Techniques Based on Damage Mechanics and Fracture Mechanics

International Nuclear Information System (INIS)

Chang, Yoon Suk; Lee, Dock Jin; Choi, Shin Beom; Kim, Sun Hye; Cho, Doo Ho; Lee, Hyun Boo

2010-04-01

The scatter of measured fracture toughness data and transferability problems among different crack configurations as well as geometry and loading conditions are major obstacles for application of fracture mechanics. To address these issues, recently, concerns on the local approach employing reliable micro-mechanical damage models are being increased again in connection with a progress of computational technology. In the present research, as part of development of fracture mechanical evaluation model for material degradation of reactor pressure boundary, several investigations on fracture behaviors were carried out. Especially, a numerical scheme to determine key parameters consisting both cleavage and ductile fracture estimate models was changed efficiently by incorporating a genetic algorithm. Also, with regard to the well-known master curve, newly reported methods such as bimodal master curve, randomly inhomogeneous master curve and single point estimation were reviewed to deal with homogeneous and inhomogeneous material characteristics. A series of preliminary finite element analyses was conducted to examine the element size effect on micro-mechanical models. Then, a new thickness correction equation was derived from parametric three-dimensional numerical simulations, which was founded on the current test standard, ASTM E1921, but could lead to get more realistic fracture toughness values. As a result, promising modified master curves as well as fracture toughness diagrams to convert data between pre-cracked V-notched and compact tension specimens were generated. Moreover, a user-subroutine in relation to GTN(Gurson-Tvergaard-Needleman) model was made by adopting Hill's 48 yield potential theory. By applying GTN model combined with the subroutine to small punch specimens, the effect of inhomogeneous properties on fracture behaviors of miniature specimens was confirmed. Therefore, it is anticipated that the aforementioned enhanced research results can be utilized

[Treatment strategy and planning for pilon fractures].

Science.gov (United States)

Mittlmeier, Thomas; Wichelhaus, Alice

2017-08-01

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

Extended drop testing with precracked DCI-casks and evaluations on safety against brittle fracture

International Nuclear Information System (INIS)

Wieser, K.E.; Frenz, H.; Gogolin, B.

1993-01-01

This paper is a summary of a research study as part of comparable efforts in Japan, France and the USA aimed at developing principles, procedures and material data for the brittle fracture safe design of thickwalled shipping containers made from ductile cast iron (DCI) and other material susceptible - in principle - to nonductile failure. Furthermore, the application of fracture mechanics was to be qualified as an alternative method, relative to the experimental approach applied in previous licensing procedures in Germany and to be demonstrated by subjecting a full-size precracked prototype to drop tests. (J.P.N.)

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.

Effectiveness of Minimally Invasive Plate Osteosynthesis (MIPO on Comminuted Tibial or Femoral Fractures

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Ali Andalib

2017-09-01

Full Text Available Background: Comminuted fractures happen frequently due to traumas. Fixation without opening the fracture site,known as minimally invasive plate osteosynthesis (MIPO, has recently become prevalent. This study has beendesigned to assess the outcomes of this treatment for tibial and femoral comminuted fractures.Methods: A total of 60 patients with comminuted femoral or tibial fractures were operated with MIPO method in thiscross-sectional study at Alzahra university hospital in 2015. Eleven patients were excluded due to lack of adequatefollow-ups. Patients’data including union time; infection in the fractured site; hip and knee range of motion; and anymalunion or deformities like limb length discrepancy were collected after the surgery in every session.Results: Among 32 femoral and 17 tibial fractures, union was completed in48 patients, while only one patient withfemoral fracture had nonunion. The mean union time was 18.57±2.42 weeks. Femur fractures healed faster than tibia(17.76±2.36 compared to 19±2.37 weeks, respectively, P=0.09. None of the patients suffered from infections or fistula.The range of motion in hip and knee remained intact in approximately all patients. Malunion happened in 3 patients; 100internal rotation in 1 patient; and 1cm limb shortening in 2 patients.Conclusion: According to the result of this study, MIPO is a simple and effective method of fixation with a high rateof union as well as minimal complications for comminuted fractures of long bones. Infection is rare, and malunion orany deformity is infrequent. MIPO appears to be a promising and safe treatment alternative for comminuted fractures.

The use of small (2.7 mm) screws for arthroscopically guided repair of carpal chip fractures.

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Wright, I M; Smith, M R W

2011-05-01

Removal of large chip fractures of the carpal bones and the osteochondral deficits that result, have been associated with a worse prognosis than removal of small fragments in similar locations. Reducing the articular defects by repair of large osteochondral fragments may have advantages over removal. Horses with osteochondral chip fractures that were of sufficient size and infrastructure to be repaired with small (2.7 mm diameter) AO/ASIF cortex screws were identified and repair effected by arthroscopically guided internal fixation. Thirty-three horses underwent surgery to repair 35 fractures of the dorsodistal radial carpal bone (n = 25), the dorsal margin of the radial facet of the third carpal bone (n = 9) and the intermediate facet of the distal radius (n = 1). There were no surgical complications and fractures healed satisfactorily in 26 of 28 horses and 23 horses returned to racing performance. Arthroscopically guided repair of carpal chip fractures with small diameter cortex screws is technically feasible and experiences with 33 cases suggest that this may have advantages over fragment removal in managing such cases. Surgeons treating horses with large chip fractures of the carpal bones should consider arthroscopically guided internal fixation as an alternative to removal. © 2010 EVJ Ltd.

Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty

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Tzanakakis George

2009-11-01

Full Text Available Abstract Background In oncologic patients with metastatic spinal disease, the ideal treatment should be well tolerated, relieve the pain, and preserve or restore the neurological function. The combination of fluoroscopic guided radiofrequency ablation (RFA and kyphoplasty may fulfill these criteria. Methods We describe three pathological vertebral fractures treated with a combination of fluoroscopic guided RFA and kyphoplasty in one session: a 62-year-old man suffering from a painful L4 pathological fracture due to a plasmocytoma, a 68-year-old man with a T12 pathological fracture from metastatic hepatocellular carcinoma, and a 71-year-old man with a Th12 and L1 pathological fracture from multiple myeloma. Results The choice of patients was carried out according to the classification of Tomita. Visual analog score (VAS and Oswestry disability index (ODI were used for the evaluation of the functional outcomes. The treatment was successful in all patients and no complications were reported. The mean follow-up was 6 months. Marked pain relief and functional restoration was observed. Conclusion In our experience the treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty is safe and effective for immediate pain relief in painful spinal lesions in neurologically intact patients.

Acute vertebral fracture: differentiation of malignant and benign causes by diffusion weighted magnetic resonance imaging

International Nuclear Information System (INIS)

Mubarak, F.; Akhtar, W.

2011-01-01

Objective: To evaluate the sensitivity, specificity and accuracy of diffusion weighted (DWI) magnetic resonance imaging (MRI) in the diagnosis and differentiation between benign (osteoporotic/infectious) and malignant vertebral compression fractures in comparison with histology findings and clinical follow up. Methods: The study was conducted at the Radiology Department, Aga Khan University Hospital (AKUH) Karachi. It was a one year cross-sectional study from 01/01/2009 to 01/01/2010. Forty patients with sixty three vertebral compression fractures were included. Diffusion-weighted sequences and apparent diffusion coefficient (ADC) images on a 1.5 T MR scanner were obtained in all patients to identify the vertebral compression fracture along with benign and malignant causes. Imaging findings were compared with histopathologic results and clinical follow-up. Results: Diffusion-weighted MR imaging found to have, 92% sensitivity, 90% specificity and accuracy of 85% in differentiation of benign and malignant vertebral compression fracture while PPV and NPV were 78 % and 90% respectively. Conclusion: Diffusion weighted magnetic resonance imaging offers a safe, accurate and non invasive modality to differentiate between the benign and malignant vertebral compression fracture. (author)

Acetabular Fracture

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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

Percutaneous vertebroplasty for multi-level osteoporotic vertebral compression fractures

International Nuclear Information System (INIS)

Wang Gefang; Cheng Yongde; Wu Chungen; Zhang Ji; Gu Yifeng; Li Minghua

2008-01-01

Objective: To prospectively evaluate the clinical efficiency and safety of patients receiving percutaneous vertebroplasty due to multi-level osteoporotic vertebral compression fractures. Methods: A retrospective study was conducted to review eighty-six osteoporotic vertebral compression fracture patients including 23 with three and more levels of vertebroplasty. The outcome was considered carefully by pre and postoperatively the Visual Analogue Scale (VAS)for pain relief, the Oswestry Disability Index (ODI)for the improvement activity of daily life and also the accompanied imaging information. Results: All procedures were performed successfully. Three patients had a transient high blood pressure and dyspnea, and recovered after sublingual nitroglycerin. The VAS and ODI improved from a mean preoperative score of 8.58±1.12 and 81.43 ±12.54 to a mean postoperative score of 3.03±0.98 and 31.04±11.11 one day afterward. Asymptomatic cement leakage rate was 17.8% with no major complications occurred during operation or post-operation. Five patients had new symptomatic vertebral fracture (s) during follow-up in one year. Conclusions: Vertebroplasty with cement to treat multi-level osteoporotic vertebral compression fractures in the elderly is safe and effective, providing immediate and long-term pain relief with improvement in quality of life. Due to the risk of fat embolism, the limitation of three per session must be kept strictly. (authors)

Proximal humeral fractures: the role of calcium sulphate augmentation and extended deltoid splitting approach in internal fixation using locking plates.

Science.gov (United States)

Somasundaram, K; Huber, C P; Babu, V; Zadeh, H

2013-04-01

injury. Four patients had a longer recovery period due to stiffness, associated wrist fracture and elbow dislocation. The CaSO4 bone substitute was replaced by normal appearing trabecular bone texture at an average of 6 months in all patients. In our experience, we have found the use of locking plates, calcium sulphate bone substitute and tuberosity repair with high-strength sutures to be a safe and reliable method of internal fixation for complex proximal humeral fractures and fracture-dislocations. Furthermore, we have also found the use of the extended deltoid-splitting approach to be safe and to provide excellent exposure facilitating accurate reduction for fixation of the fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations. Copyright © 2012 Elsevier Ltd. All rights reserved.

Classification of fractures of the distal r[ius - Comparative evaluation of spiral CT images and X-rays

International Nuclear Information System (INIS)

Roehnert, W.; Nitzsche, H.; Franck, W.M.; Amlang, M.

1998-01-01

Within the framework of a prospective study 35 patients with fractures of the distal r[ius safely diagnosed to require surgery have been [ditionally scanned by spiral CT. For more exact diagnostic evaluation of the joint surfaces and the fractures, multiplane reconstructions have been m[e to enhance the information obtained from the primary, axial tomographic images. Two experts independently performed classification on the basis of the X-rays and the CT scans, applying the AO scheme and the method of Frykman. Classifications according to the AO scheme were found to agree for only 28.6 % of the patients, which means that 57.1 % of the fractures shown by the X-rays were more or less underassessed. Classification according to Frykman's method revealed fewer deviations and agreement in 51.4 % of the cases. Biplanar r[iography continues to be considered as the standard method for examination of distal r[ius fractures, but it is recommended to perform spiral CT scans for evaluation of more complex distal r[ius fractures because these may require different therapies according to fracture types. (orig./CB) [de

Minimally invasive surgical treatment for unstable fractures of the proximal phalanx: intramedullary screw

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Marcio Aurélio Aita

2016-02-01

Full Text Available ABSTRACT OBJECTIVE: To analyze the clinical-functional parameters and quality of life of patients undergoing minimally invasive surgical treatment for extra-articular fractures of the proximal phalanx, using an intramedullary screw (Acutrak(r. METHODS: Between January 2011 and September 2014, a prospective study was conducted on 41 patients (48 fingers with unstable extra-articular fractures of the proximal phalanx, who underwent minimally invasive surgical treatment using an intramedullary screw (Acutrak(r. These patients were evaluated 12 months after the surgery by means of the DASH quality-of-life questionnaire, VAS pain scale, measurement of range of motion (ROM, in degrees and radiographic assessment. RESULTS: All the patients achieved adequate reduction and consolidation of their fractures. There were statistically significant improvements in quality of life on the DASH scale, pain on the VAS scale and range of motion. CONCLUSION: The minimally invasive technique for treating unstable extra-articular fractures of the proximal phalanx using an intramedullary screw (Acutrak(r is effective and safe, and it presents satisfactory clinical-functional results.

Radially converging tracer test in a low-angle fracture zone at the Finnsjoen site, central Sweden. The fracture zone project - phase 3

International Nuclear Information System (INIS)

Gustafsson, E.; Nordqvist, R.

1993-10-01

The performance and results of a radially converging tracer test in a low-angle major fracture zone in crystalline rock are described. The extensive, about 100 m thick, zone 2 was encountered by means of borehole investigations at depths ranging from 100 to 250 metres at the Finnsjon site, central eastern Sweden. The zone studied (zone 2) consists of highly conductive, metre thick interconnected minor shear and fracture zones (sub-zones) with low conductive rock in between. The objective of the tracer test was primarily to determine flow and transport characteristics in a major fracture zone. Secondly new equipment, experimental design and methods of interpretation were developed, tested and improved. The converging flow field was created by pumping in a central borehole from a packed-off interval enclosing the whole thickness of zone 2. Tracer breakthrough was registered from all nine injection points, with first arrivals ranging from 24 to 3200 hours. Evaluated flow and transport parameters included; flow porosity, dispersivity, flow wetted surface, fracture aperture and hydraulic conductivity in fracture flow paths. Directional variations were found in the flow and transport parameters determined, which is concluded to be due to heterogeneity and/or anisotropy. This conditions is more pronounced at depth in zone 2. The results from the tracer test also clearly show that the upper boundary of zone 2 is highly conductive and consistent over hundreds of metres. Within zone 2, and between upper and lower margins, interconnected discrete minor shear and fracture zones (sub-zones) constitute flow paths of considerable variable residence times. The dispersion within the sub-zones of zone 2, expressed as Peclet numbers ranged from 16 to 40. Flow porosity was determined to be 0.001-0.05 in the upper sub-zone and 0.01-0.1 in the intermediate and lower ones and flow wetted surface area per volume of rock was calculated to be within 1-92 m 2 /m 3 . 68 refs, 61 figs, 40 tabs

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.

CT-guided percutaneous screw fixation plus cementoplasty in the treatment of painful bone metastases with fractures or a high risk of pathological fracture

Energy Technology Data Exchange (ETDEWEB)

Pusceddu, Claudio; Ballicu, Nicola; Fele, Rosa Maria; Sotgia, Barbara; Melis, Luca [Oncological Hospital ' ' A. Businco' ' , Regional Referral Center for Oncologic Diseases, Division of Interventional Radiology, Department of Oncological Radiology, Cagliari (Italy); Fancellu, Alessandro [University of Sassari, Department of Clinical and Experimental Medicine, Sassari (Italy)

2017-04-15

To evaluate the feasibility and effectiveness of computed tomography (CT)-guided percutaneous screw fixation plus cementoplasty (PSFPC), for either treatment of painful metastatic fractures or prevention of pathological fractures, in patients who are not candidates for surgical stabilization. Twenty-seven patients with 34 metastatic bone lesions underwent CT-guided PSFPC. Bone metastases were located in the vertebral column, femur, and pelvis. The primary end point was the evaluation of feasibility and complications of the procedure, in addition to the length of hospital stay. Pain severity was estimated before treatment and 1 and 6 months after the procedure using the visual analog scale (VAS). Functional outcome was assessed by improved patient walking ability. All sessions were completed and well tolerated. There were no complications related to either incorrect positioning of the screws during bone fixation or leakage of cement. All patients were able to walk within 6 h after the procedure and the average length of hospital stay was 2 days. The mean VAS score decreased from 7.1 (range, 4-9) before treatment to 1.6 (range, 0-6), 1 month after treatment, and to 1.4 (range 0-6) 6 months after treatment. Neither loosening of the screws nor additional bone fractures occurred during a median follow-up of 6 months. Our results suggest that PSFPC might be a safe and effective procedure that allows the stabilization of the fracture and the prevention of pathological fractures with significant pain relief and good recovery of walking ability, although further studies are required to confirm this preliminary experience. (orig.)

Delayed pneumothorax complicating minor rib fracture after chest trauma.

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Lu, Ming-Shian; Huang, Yao-Kuang; Liu, Yun-Hen; Liu, Hui-Ping; Kao, Chiung-Lun

2008-06-01

Pneumothorax (PTX) after trauma is a preventable cause of death. Drainage procedures such as chest tube insertion have been traditionally advocated to prevent fatal tension PTX. We evaluated the safety of close observation in patients with delayed PTX complicating rib fracture after minor chest trauma. Adult patients (>18 years) with a diagnosis of chest trauma and 3 or fewer fractured ribs were reviewed. Case patients were divided according to age, location and number of fractured ribs, mechanism of trauma, and initial pulmonary complication after thoracic trauma for comparative analysis. There were 207 male (70.2%) and 88 female (29.8%) patients whose ages ranged from 18 to 93 years (median, 55 years). The mechanisms of trauma were a motor vehicle accident in 207 patients, falls in 66, pedestrian injury in 10, and assaults in 14. Ninety-five patients sustained 1 rib fracture, 95 had 2 rib fractures, and 105 suffered 3 rib fractures. Right-sided injury occurred in 164 cases, left-sided injury did in 127, and bilateral injury did in 4. The most frequent location of rib fractures was from the fourth rib to the ninth rib. The initial pulmonary complications after trauma were PTX in 16 patients, hemothorax in 43, pneumohemothorax in 14, lung contusion in 75, and isolated subcutaneous emphysema (SubcEmph) in 33. Thirty percent of the patients (n = 5/16) who presented with traumatic PTX were observed safely without drainage. Delayed PTX was recorded in 16 patients, occurring mostly during the first 2 days of their admission. Associated extrathoracic injury was recorded in 189 patients. The mean hospital stay of the patients was 7.66 days. Longer hospital stay was related to increasing number of fractured ribs, need for thoracic drainage, and the presence of associated extrathoracic injury. The mortality rate for the entire group was 2%. The presence of SubcEmph was the only risk factor associated with the development of delayed PTX. Patients sustaining blunt chest

77 FR 36273 - Public Meeting on Draft Permitting Guidance for Oil and Gas Hydraulic Fracturing Activities Using...

Science.gov (United States)

2012-06-18

... duration and well closure; area of review; information submitted with the permit application; and... Fracturing Activities Using Diesel Fuels--Draft: Underground Injection Control Program Guidance 84.'' The... permits under the Safe Drinking Water Act to ensure protection of underground sources of drinking water...

Fracture Toughness Evaluation of Kori-1 RPV Beltline Weld for a Long-Term Operation

International Nuclear Information System (INIS)

Lee, Bong-Sang; Kim, Min-Chul; Ahn, Sang-Bok; Kim, Byung-Chul; Hong, Jun-Hwa

2007-01-01

Irradiation embrittlement of RPV (reactor pressure vessel) material is the most important aging issue for a long-term operation of nuclear power plants. KORI unit 1, which is the first PWR in Korea, is approaching its initial licensing life of 30 years. In order to operate the reactor for another 10 years and more, it should be demonstrated that the irradiation embrittlement of the reactor will be adequately managed by ensuring that the fracture toughness properties have a certain level of the safety margin. The current regulation requires Charpy V-notch impact data through conventional surveillance tests. It is based on the assumption that Charpy impact test results are well correlated with the fracture toughness properties of many engineering steels. However, Charpy V-notch impact data may not be adequate to estimate the fracture toughness of certain materials, such as Linde 80 welds. During the last decade, a tremendous number of fracture toughness data on many RPV steels have been produced in accordance with the new standard test method, the so-called master curve method. ASTM E1921 represents a revolutionary advance in characterizing fracture toughness of RPV steels, since it permits establishing the ductile to brittle transition portion of the fracture toughness curve with direct measurements on a relatively small number of relatively small specimens, such as pre-cracked Charpy specimens. Actual fracture toughness data from many different RPV steels revealed that the Charpy test estimations are generally conservative with the exception of a few cases. Recent regulation codes in USA permit the master curve fracture toughness methodology in evaluating an irradiation embrittlement of commercial nuclear reactor vessels

Increasing the production efficiency and reducing the environmental impacts of hydraulic fracturing

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Viswanathan, H. S.

2016-12-01

Shale gas is an unconventional fossil energy resource profoundly impacting US energy independence and is projected to last for at least 100 years. Production of methane and other hydrocarbons from low permeability shale involves hydraulic fracturing of rock, establishing fracture connectivity, and multiphase fluid-flow and reaction processes all of which are poorly understood. The result is inefficient extraction with many environmental concerns. A science-based capability is required to quantify the governing mesoscale fluid-solid interactions, including microstructural control of fracture patterns and the interaction of engineered fluids with hydrocarbon flow. These interactions depend on coupled thermo-hydro-mechanical-chemical (THMC) processes over scales from microns to tens of meters. Determining the key mechanisms in subsurface THMC systems has been impeded due to the lack of sophisticated experimental methods to measure fracture aperture and connectivity, multiphase permeability, and chemical exchange capacities at the high temperature, pressure, and stresses present in the subsurface. In this study, we developed and prototyped the microfluidic and triaxial core flood experiments required to reveal the fundamental dynamics of fracture-fluid interactions. The goal is transformation of hydraulic fracturing from present ad hoc approaches to science-based strategies while safely enhancing production. Specifically, we have demonstrated an integrated experimental/modeling approach that allows for a comprehensive characterization of fluid-solid interactions and develop models that can be used to determine the reservoir operating conditions necessary to gain a degree of control over fracture generation, fluid flow, and interfacial processes over a range of subsurface conditions.

Biomechanical study in vitro on the use of self-designed external fixator in diaphyseal III metacarpal fractures in horses.

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Turek, B; Potyński, A; Wajler, C; Szara, T; Czopowicz, M; Drewnowska, O

2015-01-01

Diaphyseal fractures of the III metacarpal bone represent 22% of all fractures of the long bones in horses. Treatment of such cases is difficult. The most popular solution used in these types of fractures is two plates applied directly to the bone surface, but they are not applicable on contaminated and infected fractures. External fixators are quite commonly used in human medicine, although in veterinary practice there is no typical stabilizer designed for the treatment of diaphyseal fractures of the III metacarpal bone so far. In this study, an external semicircular fixator of our own design was used and in vitro strength tests were conducted to determine the maximum force which would lead to the destruction of non-fractured bone and fractured bone treated with the stabilizer. On the basis of the strength tests, we can conclude that the stabilizer can be strong enough to allow the horse to stand up after surgery. It also has many favorable features which make it easy to assemble and to take care of a wound, while being safe enough for the animal at the same time.

Type 2 Diabetes and Metformin Influence on Fracture Healing in an Experimental Rat Model.

Science.gov (United States)

La Fontaine, Javier; Chen, Chris; Hunt, Nathan; Jude, Edward; Lavery, Lawrence

2016-01-01

Persons with diabetes have a greater incidence of fractures compared with persons without diabetes. However, very little published information is available concerning the deleterious effect of late-stage diabetes on osseous structure and bone healing. The purpose of the present study was to evaluate the role of diabetes on fracture healing in a rat femur repair model. Thirty-six lean and diabetic Zucker rats were subdivided into 3 groups: (1) 12 lean rats as the control group; (2) 12 diabetic rats without blood glucose control (DM group); and (3) 12 diabetic rats treated with 300 mg/kg metformin to reduce the blood glucose levels (DM + Met group). Radiographs were taken every week to determine the incidence of bone repair and delayed union. All the rats were killed at 6 weeks after surgery. In both the sham-operated and the fractured and repaired femurs, significant decreases in the fracture-load/weight and marginal decreases in the fracture-load between the lean and DM groups were found. Metformin treatment significantly reduced the blood glucose and body weight 12 days postoperatively. Furthermore, a decrease in the fracture-load and fracture-load/weight in the repaired femurs was found in the DM + Met group. Diabetes impairs bone fracture healing. Metformin treatment reduces the blood glucose and body weight but had an adverse effect on fracture repair in diabetic rats. Further investigations are needed to reveal the mechanisms responsible for the effects of type 2 diabetes mellitus on bone and bone quality and the effect of medications such as metformin might have in diabetic bone in the presence of neuropathy and vascular disease. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Stabilization of Flail Chest and Fractured Sternum by Minimally Invasive Repair of Pectus Excavatum

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Akku?, Murat; Utkusava?, Ayfer; Han?z?, Murat; Kaya, Mehmet; Bakir, Ihsan

2015-01-01

We report a 55-year-old male patient with a massive flail chest that required chest stabilization by minimally invasive repair of pectus excavatum (MIRPE) employing a Nuss bar. Surgical stabilization of severe flail chest and fractured sternum with Nuss bar by MIRPE is a safe and useful treatment modality in properly selected patients.

Effective management of bone fractures with the IlluminOss® photodynamic bone stabilization system: initial clinical experience from the European Union registry

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Thomas Gausepohl

2017-02-01

Full Text Available The IlluminOss® system (IS uses a light-curable polymer contained within an inflatable balloon catheter, forming a patient customized intramedullary implant. A registry was established in Germany and The Netherlands to prospectively collect technical and clinical outcomes in patients treated with IS for fractures of the phalange, metacarpal, radius, ulna, distal radius, fibula, clavicle and/or olecranon. Humeral, femoral, tibial and pelvic fractures were included under compassionate use. Procedural success included successful placement of the device at the target fracture site and achievement of fracture stabilization. Clinical and radiographic assessments were made postoperatively through 12 months. One hundred thirty two patients (149 fractures were enrolled with most fractures (85% resulting from low-energy trauma. Simple fractures predominated (47% followed by complex (23% and wedge (16% fractures. Procedural success was achieved in all patients and no implants required removal or revision. Normal range of motion was realized in 87% of fractures. Radiographically, there was substantial cortical bridging, total dissolution of the fracture line, and complete fracture healing. Across a variety of fracture types, the IS provides a safe and effective approach for rapid healing and functional recovery.

Fracture toughness of zirconia ceramic crowns made by feather-edge tooth preparation design

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Mirković Nemanja

2012-01-01

Full Text Available Background/Aim. Fracture toughness determines functional crown strenght and prevents damages on ceramics during mastication. There is a lack of relevant literature data about fracture toughness of crowns made by feather-edge preparation. Mechanical testing of ceramic samples is supposed to show if feather-edge tooth preparation is a successful method for making ceramic crowns without any risk of reduction of their mechanical properties. This research was done to establish effects of feather-edge tooth preparation on fracture toughness of single zirconia ceramic crowns. Methods. The research was performed as an experimental study. Sixty (60 ceramic crowns were made on non-carious extracted human premolars. Thirty (30 crowns were made on the basis of feather-edge preparation (experimental group I. The group II included 30 crowns made on 1 mm rounded shoulder. Crowns fabrication was executed on a copy mill production system “Zirkonzahn” (Zirkonzahn GMBH, Gais, Germany. The spherical compression test was used to determine fracture toughness, using 6 mm diameter ceramic ball. Fracture load for damaging ceramic crown was recorded on a universal testing machine - Zwick, type 1464, with the speed of 0.05 mm/min. Results. The results of this research introduced significant differences between fracture toughness of ceramic samples in every examined group. However, fracture toughness of crowns from both group was above 2 000 N, what was double beyond a recommended value. The mean value of fracture toughness in the feather-edge group was 2 090 N, and in shoulder group it was 2 214 N. Conclusion. This research showed a high fracture toughness of zirconia crowns made on feather-edge preparation. The examined crowns showed a fracture resistance at a sufficient distance in relation to the minimum values of functional loads. Further research of functional loads of these crown is necessary, as well as research of marginal adaptation of cemented crowns and

Kyphoplasty for osteoporotic fractures with spinal canal compromise

International Nuclear Information System (INIS)

Gan Minfeng; Yang Huilin; Zou Jun; Wang Genlin; Mei Xin; Zhou Feng; Chen Liang; Jiang Weimin

2010-01-01

Objective: To explore the feasibility and clinical outcome of kyphoplasty in the treatment of osteoporotic fractures with canal compromise. Methods: A total of 16 patients with osteoporotic fractures with canal compromise without neurological deficit were attempted to be treated by kyphoplasty. During kyphoplasty, modified techniques including staged bone cement injection and dynamic fluoroscopic monitoring were used. Pain was measured using the self-reporting Visual Analogue pain Scale (VAS) preoperatively, postoperatively and in the final follow-up. Disability was measured using the Oswestry Disability questionnaire (ODI) preoperatively, postoperatively and in the final follow-up. The height of the compromised vertebral body, the kyphotic angle and the spinal canal compromise were measured preoperatively, postoperatively and in the final follow-up. Results: Operations were completed smoothly, with the exception of one patient with less cement leakage but without clinical symptom occurred. Relief of pain was achieved after kyphoplasty. The mean VAS score of these patients decreased from 8.1 ± 1.2 pre-operatively to 2.7 ± 0.6 post-operatively (P 0.05). In the final follow-up, the spinal canal compromise was (14.4 ± 3.1)%. Conclusion: Kyphoplasty is a relatively safe and effective method for the treatment of osteoporotic fractures with canal compromise without neurological deficit. (authors)

Low cost continuous femoral nerve block for relief of acute severe cancer related pain due to pathological fracture femur

Directory of Open Access Journals (Sweden)

Rachel Cherian Koshy

2010-01-01

Full Text Available Pathological fractures in cancer patient cause severe pain that is difficult to control pharmacologically. Even with good pain relief at rest, breakthrough and incident pain can be unmanageable. Continuous regional nerve blocks have a definite role in controlling such intractable pain. We describe two such cases where severe pain was adequately relieved in the acute phase. Continuous femoral nerve block was used as an efficient, cheap and safe method of pain relief for two of our patients with pathological fracture femur. This method was proved to be quite efficient in decreasing the fracture-related pain and improving the level of well being.

Regional gravity and magnetic surveys along southern margin of Indravati basin, Central India - a guide to unconformity related uranium mineralisation

International Nuclear Information System (INIS)

Patra, I.; Ramesh Babu, V.; Chaturvedi, A.K.; Sreenivas, R.; Chari, M.N.; Dash, J.K.; Roy, M.K.

2009-01-01

Geophysical methods play vital role at various stages in mineral exploration programme particularly in case of buried deposits. The unconformity related uranium deposits owing to their concealed nature are explored by geophysical methods as an indirect tool. Regional ground gravity and magnetic surveys have been conducted to decipher the basin configuration, presence of fault/ fractures and basic activity. These structural features may form favorable criteria for mineralisation. Qualitative and quantitative interpretation of the gravity and magnetic data along the southern margin of Mesoproterozoic Indravati basin has been correlated with ground follow up geological investigation. There exists a good correlation between interpreted faults, fracture zones and mafic activity from the magnetic and gravity surveys with available borehole data in the area. Further, 2D models generated from magnetic data have paved the way for planning boreholes and thereby reorienting the sub-surface exploration programme. Evidence of alteration and fracturing intercepted from the borehole correlates well with the low gravity and magnetic. Hence, gravity and magnetic surveys can be effectively utilized in delineating basement configuration and to estimate sediment thickness besides deciphering post sedimentary fault/fractures which are favorable factors for unconformity related uranium mineralisation. (author)

Outcome of CT-guided vertebroplasty in outpatients with severe vertebral compression fractures

International Nuclear Information System (INIS)

Braun, Markus; Gevargez, Athour; Lange, Silke; Leeuwen, Peter van; Groenemeyer, Dietrich H.W.

2008-01-01

To determine the safety and efficacy of computed tomography (CT)/fluoroscopy-guided percutaneous vertebroplasty (PVP) for the treatment of painful severe osteoporotic compression fractures. In 26 patients with osteoporotic severe and non-severe compression fractures experiencing pain, 55 PVP were performed. Pain relief and improvement of function were estimated using the Visual Analog Scale (VAS), Pain Disability Index (PDI) and Hannover functional ability questionnaire (FFbH) at follow-up examinations at a median of 3 (1-31) days and 6.5 (1-18) months after PVP. Pain relief (VAS and PDI) was significant at first and second follow-up. The improvement of function (FFbH) was statistically significant at the second follow-up. Severity of the compression fractures did not influence these results. There were no clinical complications and no patient required follow-up surgery. PVP is a safe and effective treatment of pain even in severe osteoporotic vertebral body compression fractures. The advantages of CT-guidance in combination with fluoroscopy technique are a minimally invasive precise procedure with high visualization and with low risk, performed cost effective on out patient basis in local anesthesia, leading to an early recovery of individual independence. (orig.)

Efficacy and safety of rivaroxaban versus low-molecular-weight heparin therapy in patients with lower limb fractures.

Science.gov (United States)

Long, Anhua; Zhang, Lihai; Zhang, Yingze; Jiang, Baoguo; Mao, Zhi; Li, Hongda; Zhang, Shanbao; Xie, Zongyan; Tang, Peifu

2014-10-01

Thromboprophylaxis with rivaroxaban has proved effective and safe in patients undergoing hip and knee replacement surgery. As it is unclear whether it is also effective and safe in fracture patients, the aim of the present study was to evaluate the efficacy and safety of rivaroxaban in patients with lower limb fractures. We performed a retrospective cohort study of 2,050 consecutive patients treated for lower limb fractures at our trauma center, comparing rates of venous thromboembolism (VTE), bleeding and surgical complications, and the length of hospital stay for 608 patients who received rivaroxaban and 717 who received a low-molecular-weight heparin (LMWH). Rates of symptomatic VTE were 4.9 and 8.6% in the rivaroxaban and LMWH groups, respectively (p = 0.008), and distal VTE rates were 1.8 and 5.7%, respectively (p = 0.036). The incidence of major bleeding events in the rivaroxaban group was also lower than in the LMWH group (0.2 vs 0.6%), but the difference between the groups was not statistically significant. The mean length of hospital stay was significantly shorter in the rivaroxaban group (12.2 vs 13.1 days, respectively; p = 0.016). This retrospective cohort study is the first report documenting the efficacy and safety of rivaroxaban in patients with lower extremity fractures. In comparison with LMWH, rivaroxaban reduced the incidence of VTE by 45% without increasing the risk of bleeding. However, prospective, randomized controlled trials comparing rivaroxaban and LMWH are needed to confirm our findings.

Long-term cumulative survival and mechanical complications of single-tooth Ankylos Implants: focus on the abutment neck fractures.

Science.gov (United States)

Shim, Hye Won; Yang, Byoung-Eun

2015-12-01

To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth Ankylos® implants. This was a retrospective clinical study that analyzed 450 single Ankylos® implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all Pabutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

Ballistic fractures: indirect fracture to bone.

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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.

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

Open versus closed reduction: diacapitular fractures of the mandibular condyle.

Science.gov (United States)

Chrcanovic, Bruno Ramos

2012-09-01

The purpose of the study was to review the literature regarding the evolution of current thoughts on management of diacapitular fractures (DFs) of the mandibular condyle. An electronic search in PubMed was undertaken in March 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included studies reporting clinical series of DFs, including both animal and human studies, without date or language restrictions. The search strategy initially yielded 108 references. Twenty-eight studies were identified without repetition within the selection criteria. Additional hand-searching of the reference lists of selected studies yielded three additional papers. The current indications for open reduction and internal fixation (ORIF) of DFs described in the literature are: (a) fractures affecting the lateral condyle with reduction of mandibular height; (b) fractures in which the proximal fragment dislocates laterally out of the glenoid fossa, which cannot be reduced by closed or open treatment of another part of the mandibular fracture. The indications for conservative treatment are: (a) fractures that do not shorten the condylar height (a fracture with displacement of the medial parts of the condyle); (b) undisplaced fractures; (c) comminution of the condylar head, when the bony fragments are too small for stable fixation; and (d) fractures in children. As the temporomandibular joint disk plays an important role as a barrier preventing ankylosis, it is important to reposition the disk (if displaced/dislocated) during the surgical treatment of DFs. The lateral pterygoid muscle should never be stripped from the medially displaced fragment because its desinsertion disrupts circulation to the medial bony fragment, and also because this muscle helps to restore the muscle function after surgery. ORIF of selected DFs improves prognosis by anatomical bone and soft tissue recovery when combined with physical

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.)

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

Technology which led to the westinghouse inherently safe liquid metal reactor

International Nuclear Information System (INIS)

Schmidt, J.E.; Coffield, R.D.; Doncals, R.A.; Kalinowski, J.E.; Markley, R.A.

1985-01-01

The Fast Flux Test Facility (FFTF) and the Clinch River Breeder Reactor programs resulted in an understanding of liquid metal reactor behavior that is being used to design inherent safety capability into liquid metal reactors. Technological advances give the same beneficial operating characteristics of conventional liquid metal reactors, however, the addition of inherently safe design features precludes the initiation of hypothetical core disruptive accidents. These innovative features permit inherent safety capability to be demonstrated with more than adequate margins. Also, the variety of inherent safety features provides the designers with options in selecting inherent design features for a specific reactor application

"We call ourselves marginalized"

DEFF Research Database (Denmark)

Jørgensen, Nanna Jordt

2014-01-01

of the people we refer to as marginalized. In this paper, I discuss how young secondary school graduates from a pastoralist community in Kenya use and negotiate indigeneity, marginal identity, and experiences of marginalization in social navigations aimed at broadening their current and future opportunities. I...

Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography

Energy Technology Data Exchange (ETDEWEB)

Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko [Tokyo Women' s Medical Coll. (Japan). Daini Hospital

2002-03-01

With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29{+-}5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15{+-}2 deg laterally from the midline of the incisors, and 24{+-}4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9{+-}4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31{+-}5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper

Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography

International Nuclear Information System (INIS)

Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko

2002-01-01

With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29±5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15±2 deg laterally from the midline of the incisors, and 24±4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9±4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31±5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper posterior

Pre-bent elastic stable intramedullary nail fixation for distal radial shaft fractures in children.

Science.gov (United States)

Ge, Yi-hua; Wang, Zhi-gang; Cai, Hai-qing; Yang, Jie; Xu, Yun-lan; Li, Yu-chan; Zhang, Yu-chen; Chen, Bo-chang

2010-08-01

To investigate the functional and radiographic outcomes of pre-bent elastic stable intramedullary nail in treatment of distal radial shaft fractures in children. From January 2006 to December 2008, 18 children with distal radial shaft fracture were treated by close reduction and internal fixation with a pre-bent elastic stable intramedullary nail. The age range was from 5 years to 15 years, with an average of 9 years and 8 months. The minimum follow-up was 12 months. All fractures maintained good alignment postoperatively, and 94.4% (17/18) of the patients regained a full range of rotation of the forearm. One patient has limitation of rotation to less than 10°, this had improved by final follow-up. Complications included soft tissue irritation at the site of nail insertion in one patient and transient scar hypersensitivity in another. Fixation with a pre-bent elastic stable intramedullary nail is an effective, safe and convenient method for treating distal radial shaft fractures in children. © 2010 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

Application of individually performed titanium mesh in infraorbital wall fracture reconstruction

Directory of Open Access Journals (Sweden)

Kai-Jian Sun

2016-04-01

Full Text Available AIM:To discuss the application effect of individually performed titanium mesh in infraorbital wall fracture reconstruction. METHODS:Sixty-seven patients(67 eyesdiagnosed as infraorbital fracture from January 2011 to February 2014 were performed reconstruction with individually performed titanium mesh. The recovery of incision, visual acuity, eyeball mobility, diplopia and proptosis were monitored by post-operation follow-up which lasted for 1a. RESULTS:No infection, titanium mesh transposition, prolapse, deformities, exclusion or ectropion were occurred in the follow-up period. The eyeball embole was less than 2mm by bilateral proptosis contrast. The diplopia in 5 eyes were disappeared in 4 and approved in one. The eyeball descent in 2 cases was disappeared. The visual acuity was the same compared with pre-operation. The rate of disappeared diplopia at primary position was 93% and improved significantly in the other 3 patients. The rate of disappeared diplopia at peripheral visual field was 86% and improved significantly in the other 2 patients.CONCLUSION:The reconstruction effect of individually performed titanium mesh in infraorbital wall fracture was satisfied and safe.

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.

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.

People's experiences of suffering a lower limb fracture and undergoing surgery.

Science.gov (United States)

Forsberg, Angelica; Söderberg, Siv; Engström, Åsa

2014-01-01

To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge. There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery - from injury to recovery. A qualitative approach was used. Interviews with nine participants were subjected to thematic content analysis. One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended. Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, 'from realising the seriousness of the injury to regaining autonomy'. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process. © 2013 John Wiley & Sons Ltd.

Open reduction and internal fixation of patellar fractures with tension band wiring through cannulated screws.

Science.gov (United States)

Malik, Mudasir; Halwai, Manzoor Ahmad

2014-10-01

The purpose of this study was to evaluate effectiveness and safety of a relatively new technique of open reduction and internal fixation of displaced transverse patellar fractures with tension band wiring (TBW) through parallel cannulated compression screws. A total of 30 patients with displaced transverse patellar fracture were enrolled in this prospective study. Of the 30 patients, 20 patients had trauma due to fall, 5 due to road traffic accident, 2 due to fall of heavy object on the knee, 2 due to forced flexion of knee, and 1 had fracture due to being beaten. All 30 patients were treated with vertical skin exposure, fracture open reduction, and internal fixation by anterior TBW through 4.0 mm cannulated screws. The postoperative rehabilitation protocol was standardized. The patients were followed postsurgery to evaluate time required for radiographic bone union, knee joint range of motion (ROM), loss of fracture reduction, material failure, and the overall functional result of knee using Bostman scoring. All the fractures healed radiologically, at an average time of 10.7 weeks (range, 8-12 weeks). The average ROM arc was 129.7 degrees (range, 115-140 degrees). No patient had loss of fracture reduction, implant migration, or material failure. The average Bostman score was 28.6 out of 30. Anterior TBW through cannulated screws for displaced transverse fractures is safe and effective alternative treatment. Good functional results and recovery can be expected. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Study of healing process and prognosis of medial femoral neck fracture evaluated by bone scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Suzuki, K [Yokohama City Univ. (Japan). Faculty of Medicine

1981-02-01

As to healing process and prognosis of femoral neck fracture, radionuclide bone scintigraphy using sup(99m)Tc phosphorus compound was performed and the following results were obtained. 1. In cases of osteosynthesis, scintigraphical study showed a certain serial pattern until fracture was uneventfully healed. 2. On the other hand, in cases with non-union or late segmental collapse of the head, scintigraphy revealed defect at superolateral or central area in the head. This finding could be already noted prior to roentgenographical evaluation. 3. In the study of radionuclide uptake count on the femoral head of resected specimen, the higher value was observed in the area along medial fracture edge to medial margin of the head. Histological study showed feature of increased new bone formation at the area of higher radionuclide uptake. Vascular supply through the bone marrow of the neck and superior retinacular artery was thought to play an important role for the new bone formation. 4. From the aforementioned results, sup(99m)Tc phosphorus compound scintigraphy was considered as one of the quite useful methods for early diagnosis of complications after femoral neck fracture.

Marginal Matter

Science.gov (United States)

van Hecke, Martin

2013-03-01

All around us, things are falling apart. The foam on our cappuccinos appears solid, but gentle stirring irreversibly changes its shape. Skin, a biological fiber network, is firm when you pinch it, but soft under light touch. Sand mimics a solid when we walk on the beach but a liquid when we pour it out of our shoes. Crucially, a marginal point separates the rigid or jammed state from the mechanical vacuum (freely flowing) state - at their marginal points, soft materials are neither solid nor liquid. Here I will show how the marginal point gives birth to a third sector of soft matter physics: intrinsically nonlinear mechanics. I will illustrate this with shock waves in weakly compressed granular media, the nonlinear rheology of foams, and the nonlinear mechanics of weakly connected elastic networks.

Paediatric tibial shaft fractures treated by open reduction and stabilization with monolateral external fixation.

Science.gov (United States)

Simon, A-L; Apostolou, N; Vidal, C; Ferrero, E; Mazda, K; Ilharreborde, B

2018-02-01

Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed. Inclusion criteria included skeletal immaturity and closed and open Gustilo I fractures caused by a direct impact. Patients were seen until two years postoperatively. Demographics, mechanism of injury, surgical data and complications were recorded. Anteroposterior and lateral side radiographs were performed at each visit. Full-limb 3D reconstructions using biplanar stereroradiography was performed for final limb length and alignment measures. A total of 45 patients (mean age 9.7 years ± 0.5) were included. In all, 17 were Gustilo I fractures, with no difference between open and closed fractures for any data. Mean time to full weight bearing was 18.2 days ± 0.7. After 15 days, 39 patients returned to school. Hardware removal (mean time to union 15.6 weeks ± 0.8) was performed during consultation under analgesic gas. There were no cases of nonunion. No fracture healed with > 10° of angulation (mean 5.1° ± 0.4°). Leg-length discrepancy > 10 mm was found for six patients. This procedure can be a safe and simple surgical treatment for children with tibial shaft fractures. Few complications and early return to school were reported, with the limitations of non-comparative study. IV.

Volcaniclastic dykes tell on fracturing, explosive eruption and lateral collapse at Stromboli volcano (Italy)

Science.gov (United States)

Vezzoli, Luigina; Corazzato, Claudia

2016-05-01

In the upper part of the Stromboli volcano, in the Le Croci and Bastimento areas, two dyke-like bodies of volcanic breccia up to two-metre thick crosscut and intrude the products of Vancori and Neostromboli volcanoes. We describe the lithofacies association of these unusual volcaniclastic dykes, interpret the setting of dyke-forming fractures and the emplacement mechanism of internal deposits, and discuss their probable relationships with the explosive eruption and major lateral collapse events that occurred at the end of the Neostromboli period. The dyke volcaniclastic deposits contain juvenile magmatic fragments (pyroclasts) suggesting a primary volcanic origin. Their petrographic characteristics are coincident with the Neostromboli products. The architecture of the infilling deposits comprises symmetrically-nested volcaniclastic units, separated by sub-vertical boundaries, which are parallel to the dyke margins. The volcanic units are composed of distinctive lithofacies. The more external facies is composed of fine and coarse ash showing sub-vertical laminations, parallel to the contact wall. The central facies comprises stratified, lithic-rich breccia and lapilli-tuff, whose stratification is sub-horizontal and convolute, discordant to the dyke margins. Only at Le Croci dyke, the final unit shows a massive tuff-breccia facies. The volcaniclastic dykes experienced a polyphasic geological evolution comprising three stages. The first phase consisted in fracturing, explosive intrusion related to magma rising and upward injection of magmatic fluids and pyroclasts. The second phase recorded the dilation of fractures and their role as pyroclastic conduits in an explosive eruption possibly coeval with the lateral collapse of the Neostromboli lava cone. Finally, in the third phase, the immediately post-eruption mass-flow remobilization of pyroclastic deposits took place on the volcano slopes.

Laparoscopic omentoplasty to support anastomotic urethroplasty in complex and redo pelvic fracture urethral defects.

Science.gov (United States)

Kulkarni, Sanjay B; Barbagli, Guido; Joshi, Pankaj M; Hunter, Craig; Shahrour, Walid; Kulkarni, Jyotsna; Sansalone, Salvatore; Lazzeri, Massimo

2015-05-01

To test the hypothesis that a new surgical technique using elaborated perineal anastomotic urethroplasty combined with laparoscopic omentoplasty for patients with complex and prior failed pelvic fracture urethral defect repair was feasible, safe, and effective. We performed a prospective, observational, stage 2a study to observe treatment outcomes of combined perineal and laparoscopic approach for urethroplasty in patients with pelvic fracture urethral defect at a single center in Pune, India, between January 2012 and February 2013. Complex and redo patients with pelvic fracture urethral defect occurring after pelvic fracture urethral injury were included in the study. Anterior urethral strictures were excluded. The primary study outcome was the success rate of the surgical technique, and the secondary outcome was to evaluate feasibility and safety of the procedure. The clinical outcome was considered a failure when any postoperative instrumentation was needed. Fifteen male patients with a median age of 19 years were included in the study. Seven patients were adolescents (12-18 years) and 8 patients (53.3%) were adults (19-49 years). The mean number of prior urethroplasties was 1.8 (range, 1-3). All patients underwent elaborated bulbomembranous anastomosis using a perineal approach with inferior pubectomy combined with laparoscopic mobilization of the omentum into the perineum to envelope the anastomosis and to fill the perineal dead space. Of 15 patients, 14 (93.3%) were successful and 1 (6.6%) failed. One adolescent boy 14 years old developed a recurrent stricture 2 months after the procedure and was managed using internal urethrotomy. Median follow-up was 18 months (range, 13-24 months). Combining a laparoscopic omentoplasty to a membranobulbar anastomosis for complex and redo pelvic fracture urethral injury is successful, feasible, safe, and with minimal additional morbidity to the patient. The technique has the advantage of a perineal incision and the ability

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.

Marginalization of the Youth

DEFF Research Database (Denmark)

Jensen, Niels Rosendal

2009-01-01

The article is based on a key note speach in Bielefeld on the subject "welfare state and marginalized youth", focusing upon the high ambition of expanding schooling in Denmark from 9 to 12 years. The unintended effect may be a new kind of marginalization.......The article is based on a key note speach in Bielefeld on the subject "welfare state and marginalized youth", focusing upon the high ambition of expanding schooling in Denmark from 9 to 12 years. The unintended effect may be a new kind of marginalization....

A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

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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.

Convexity and Marginal Vectors

NARCIS (Netherlands)

van Velzen, S.; Hamers, H.J.M.; Norde, H.W.

2002-01-01

In this paper we construct sets of marginal vectors of a TU game with the property that if the marginal vectors from these sets are core elements, then the game is convex.This approach leads to new upperbounds on the number of marginal vectors needed to characterize convexity.An other result is that

76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

Science.gov (United States)

2011-03-08

... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free Schools; Safe Schools/Healthy Students Program; Catalog of Federal Domestic Assistance (CFDA) Numbers: 84... priorities, requirements, and definitions under the Safe Schools/Healthy Students (SS/HS) program. Since...

Clinical efficacy of open reduction and semirigid internal fixation in management of displaced pediatric mandibular fractures: A series of 10 cases and surgical guidelines

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Samir Joshi

2015-01-01

Full Text Available Aim: To evaluate the efficacy of open reduction and semirigid internal fixation in the management of displaced pediatric mandibular fractures. Method: Ten patients with displaced mandibular fractures treated with 1.5 mm four holed titanium mini-plate and 4 mm screws which were removed within four month after surgery. Results: All cases showed satisfactory bone healing without any growth disturbance. Conclusion: Open reduction and rigid internal fixation (ORIF with 1.5 mm titanium mini- plates and 4 mm screws is a reliable and safe method in treatment of displaced paediatric mandibular fractures.

Clinical efficacy of open reduction and semirigid internal fixation in management of displaced pediatric mandibular fractures: a series of 10 cases and surgical guidelines.

Science.gov (United States)

Joshi, Samir; Kshirsagar, Rajesh; Mishra, Akshay; Shah, Rahul

2015-01-01

To evaluate the efficacy of open reduction and semirigid internal fixation in the management of displaced pediatric mandibular fractures. Ten patients with displaced mandibular fractures treated with 1.5 mm four holed titanium mini-plate and 4 mm screws which were removed within four month after surgery. All cases showed satisfactory bone healing without any growth disturbance. Open reduction and rigid internal fixation (ORIF) with 1.5 mm titanium mini- plates and 4 mm screws is a reliable and safe method in treatment of displaced paediatric mandibular fractures.

Fracture toughness requirements of reactor vessel material in evaluation of the safety analysis report of nuclear power plants

International Nuclear Information System (INIS)

Widia Lastana Istanto

2011-01-01

Fracture toughness requirements of reactor vessel material that must be met by applicants for nuclear power plants construction permit has been investigated in this paper. The fracture toughness should be described in the Safety Analysis Reports (SARs) document that will be evaluated by the Nuclear Energy Regulatory Agency (BAPETEN). Because BAPETEN does not have a regulations or standards/codes regarding the material used for the reactor vessel, especially in the fracture toughness requirements, then the acceptance criteria that applied to evaluate the fracture toughness of reactor vessel material refers to the regulations/provisions from the countries that have been experienced in the operation of nuclear power plants, such as from the United States, Japan and Korea. Regulations and standards used are 10 CFR Part 50, ASME and ASTM. Fracture toughness of reactor vessel materials are evaluated to ensure compliance of the requirements and provisions of the Regulatory Body and the applicable standards, such as ASME or ASTM, in order to assure a reliability and integrity of the reactor vessels as well as providing an adequate safety margin during the operation, testing, maintenance, and postulated accident conditions over the reactor vessel lifetime. (author)

Safety margins of operating reactors. Analysis of uncertainties and implications for decision making

International Nuclear Information System (INIS)

2003-01-01

Maintaining safety in the design and operation of nuclear power plants (NPPs) is a very important task under the conditions of a challenging environment, affected by the deregulated electricity market and implementation of risk informed regulations. In Member States, advanced computer codes are widely used as safety analysis tools in the framework of licensing of new NPP projects, safety upgrading programmes of existing NPPs, periodic safety reviews, renewal of operating licences, use of the safety margins for reactor power uprating, better utilization of nuclear fuel and higher operational flexibility, for justification of lifetime extensions, development of new emergency operating procedures, analysis of operational events, and development of accident management programmes. The issue of inadequate quality of safety analysis is becoming important due to a general tendency to use advanced tools for better establishment and utilization of safety margins, while the existence of such margins assure that NPPs operate safely in all modes of operation and at all times. The most important safety margins relate to physical barriers against release of radioactive material, such as fuel matrix and fuel cladding, reactor coolant system boundary, and the containment. Typically, safety margins are determined with use of computational tools for safety analysis. Advanced best estimate computer codes are suggested e.g. in the IAEA Safety Guide on Safety Assessment and Verification for Nuclear Power Plants to be used for current safety analysis. Such computer codes require their careful application to avoid unjustified reduction in robustness of the reactor safety. The issue of uncertainties in safety analyses and their impact on evaluation of safety margins is addressed in a number of IAEA guidance documents, in particular in the Safety Report on Accident Analysis for Nuclear Power Plants. It is also discussed in various technical meetings and workshops devoted to this area. The

Contributions to knowledge of the continental margin of Uruguay. Uruguayan continental margin: Physiographic and seismic analysis

International Nuclear Information System (INIS)

Preciozzi, F

2014-01-01

This work is about the kind of continental margins such as a )Atlantic type passive margins which can be hard or soft b) An active or Pacific margins that because of the very frequent earthquakes develop a morphology dominated by tectonic processes. The Uruguayan continental margin belongs to a soft Atlantic margin

Fixing soft margins

NARCIS (Netherlands)

P. Kofman (Paul); A. Vaal, de (Albert); C.G. de Vries (Casper)

1993-01-01

textabstractNon-parametric tolerance limits are employed to calculate soft margins such as advocated in Williamson's target zone proposal. In particular, the tradeoff between softness and zone width is quantified. This may be helpful in choosing appropriate margins. Furthermore, it offers

Indirect reduction technique using a distraction support in minimally invasive percutaneous plate osteosynthesis of tibial shaft fractures.

Science.gov (United States)

Dong, Wen-Wei; Shi, Zeng-Yuan; Liu, Zheng-Xin; Mao, Hai-Jiao

2016-12-01

To describe an indirect reduction technique during minimally invasive percutaneous plate osteosynthesis (MIPPO) of tibial shaft fractures with the use of a distraction support. Between March 2011 and October 2014, 52 patients with a mean age of 48 years (16-72 years) sustaining tibial shaft fractures were included. All the patients underwent MIPPO for the fractures using a distraction support prior to insertion of the plate. Fracture angular deformity was assessed by goni- ometer measurement on preoperative and postoperative images. Preoperative radiographs revealed a mean of 7.6°(1.2°-28°) angulation in coronal plane and a mean of 6.8°(0.5°-19°) angulation in sagittal plane. Postoperative anteroposterior and lateral radio- graphs showed a mean of 0.8°(0°-4.0°) and 0.6°(0°-3.6°) of varus/valgus and apex anterior/posterior angulation, respectively. No intraoperative or postoperative complications were noted. This study suggests that the distraction support during MIPPO of tibial shaft fractures is an effective and safe method with no associated complications.

SOCIAL MARGINALIZATION AND HEALTH

Directory of Open Access Journals (Sweden)

Marjana Bogdanović

2007-04-01

Full Text Available The 20th century was characterized by special improvement in health. The aim of WHO’s policy EQUITY IN HEALTH is to enable equal accessibility and equal high quality of health care for all citizens. More or less some social groups have stayed out of many social systems even out of health care system in the condition of social marginalization. Phenomenon of social marginalization is characterized by dynamics. Marginalized persons have lack of control over their life and available resources. Social marginalization stands for a stroke on health and makes the health status worse. Low socio-economic level dramatically influences people’s health status, therefore, poverty and illness work together. Characteristic marginalized groups are: Roma people, people with AIDS, prisoners, persons with development disorders, persons with mental health disorders, refugees, homosexual people, delinquents, prostitutes, drug consumers, homeless…There is a mutual responsibility of community and marginalized individuals in trying to resolve the problem. Health and other problems could be solved only by multisector approach to well-designed programs.

Pickering seismic safety margin

International Nuclear Information System (INIS)

Ghobarah, A.; Heidebrecht, A.C.; Tso, W.K.

1992-06-01

A study was conducted to recommend a methodology for the seismic safety margin review of existing Canadian CANDU nuclear generating stations such as Pickering A. The purpose of the seismic safety margin review is to determine whether the nuclear plant has sufficient seismic safety margin over its design basis to assure plant safety. In this review process, it is possible to identify the weak links which might limit the seismic performance of critical structures, systems and components. The proposed methodology is a modification the EPRI (Electric Power Research Institute) approach. The methodology includes: the characterization of the site margin earthquake, the definition of the performance criteria for the elements of a success path, and the determination of the seismic withstand capacity. It is proposed that the margin earthquake be established on the basis of using historical records and the regional seismo-tectonic and site specific evaluations. The ability of the components and systems to withstand the margin earthquake is determined by database comparisons, inspection, analysis or testing. An implementation plan for the application of the methodology to the Pickering A NGS is prepared

Er:YAG Laser and Fractured Incisor Restorations: An In Vitro Study

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C. Fornaini

2012-01-01

Full Text Available Introduction. The aim of this study was to analyse the effects of an Er:YAG laser on enamel and dentine in cases of dental restorations involving fractured teeth, utilizing the dental fragment. Materials and Methods. Seventy-two freshly extracted bovine incisors were fractured at the coronal level by using a hammer applied with a standardized method, and the fragment was reattached by using three different methods: Er:YAG laser, orthophosphoric acid, and laser plus acid. The different groups were evaluated by a test realized with the dynamometer to know the force required to successfully detach the reattached fragment and by a microinfiltration test by using a 0.5% methylene blue solution followed by the optic microscope observation. Results. The compression test showed only a slight difference between the three groups, without any statistical significance. The infiltration test used to evaluate the marginal seal between the fracture fragment and the tooth demonstrated that etching with Er:YAG laser alone or in combination with orthophosphoric acid gives better results than orthophosphoric acid alone, with a highly significant statistical result. Discussion. Reattaching a tooth fragment represents a clinically proven methodology, in terms of achieving resistance to detachment, and the aim of this work was to demonstrate the advantages of Er:YAG laser on this procedure. Conclusion. This “in vitro” study confirms that Er:YAG laser can be employed in dental traumatology to restore frontal teeth after coronal fracture.

Fracture of the styloid process associated with the mandible fracture

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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.

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

Considerations on the manner to account for fast fracture risk in the design of PWR vessels

International Nuclear Information System (INIS)

Pellisier-Tanon, A.; Grandemange, J.M.

1985-08-01

The way followed in France for analyzing fast fracture resistance of PWR primary components is the one of a deterministic analysis with safety coefficients imposed in the fracture criteria. The study of margins towards fast fracture of the 900 MWe program vessels undertaken in 1982 includes parametric evaluations of the influence of essential variables. It has stimulated further thoughts on the level of safety to fix in the analysis methodology, on the orientations for the choice of safety factors and on the manner to introduce them in the analysis. A first chapter tries to characterize the French approach in comparison to those of other countries. A second chapter examines the manner according to which safety factors can be introduced in the deterministic analysis. It presents the principle for a logical approach accounting for the interdependency of all factors and variables. It establishes criteria for the selection of defect kind and size for the computation

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.

Ligamentotaxis for complex calcaneal fractures using Joshi′s external stabilization system

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Singh Ajai

2008-01-01

Full Text Available Background: Controversies exist in the literature regarding the management of complex fractures of the calcaneum. We evaluated a series of complex fractures of the calcaneum managed by ligamentotaxis using Joshi′s external stabilization system (JESS for its efficacy. Materials and Methods: Forty-five patients having complex (comminuted, intra-articular fracture with compromised soft tissue condition fractures of the calcaneum, who were treated by external fixator (JESS based on the principle of ligamentotaxis. The gradual distraction was done to bring the articular margins together to maintain both alpha and beta angles to near normal range. Thirteen (28.9% patients underwent additional corticocancellous bone grafting with elevation of posterior facet. All patients were evaluated for their functional outcomes by American Orthopedic Foot and Ankle society (AOFAS Score for the ankle and hind foot. Mean duration of follow-up was 20.5 months. Results: Forty-two (93.4% of our patients did well with the ligamentotaxis. On evaluating final outcomes by AOFAS, approximately 71% of cases showed good results. Eleven patients (24.4% complained of persistent heel pain in the long-term follow-up. Out of these, eight (17.8% patients were those who had severe comminution with almost total loss of calcaneal height. The origin of heel pain was not the subtalar joint in all of these patients. On long-term follow-up none of these patients suffered from such severe pain so as to compel them to change the nature of their activity. Conclusion: We conclude that ligamentotaxis by JESS provides a viable and user-friendly alternative method of management of these complex calcaneal fractures.

Chance Fracture Secondary to a Healed Kyphotic Compression Osteoporotic Fracture

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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.

Elastic-plastic fracture mechanics for nuclear pressure vessels: a preliminary appraisal

International Nuclear Information System (INIS)

Hahn, G.T.; Broek, D.; Marschall, C.W.; Rosenfield, A.R.; Rybicki, E.F.; Schmueser, D.W.; Stonesifer, R.B.; Kanninen, M.F.

1978-01-01

A research program directed at assessing the margin of safety of flawed nuclear pressure vessels near and beyond general yielding is described. The program has the general objective of developing an elastic-plastic fracture mechanics methodology. The approach is based on the use of finite element models together with experimental results to identify criteria appropriate for the onset of crack extension and for stable crack growth. A number of criteria beyond the conventional LEFM R curve are being evaluated. These include the critical values of the J-integral, its derivative, the crack tip opening angle, the average crack opening angle, a generalized energy release rate, its components and a crack tip force. The optimum fracture criterion for nuclear vessels is being determined by systematic measurements of load extension curves, strain distribution, crack opening displacement, stable crack growth and instability on 'toughness scaled' model materials. Computations have been performed for center cracked panels of a model material (2219-T87 aluminium) for full shear failure. (author)

Indian Ocean margins

Digital Repository Service at National Institute of Oceanography (India)

Naqvi, S.W.A

in the latter two areas. Some of these fluxes are expected to be substantial in the case of Indonesian continental margins and probably also across the eastern coasts of Africa not covered in this chapter. However, a dearth of information makes these margins...

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 ...

Fracture Resistance of Zirconia Restorations with a Modified Framework Design

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sakineh Nikzadjamnani

2017-12-01

Full Text Available Objectives: Chipping is one of the concerns related to zirconia crowns. The reasons of chipping have not been completely understood. This in-vitro study aimed to assess the effect of coping design on the fracture resistance of all-ceramic single crowns with zirconia frameworks. Materials and Methods: Two types of zirconia copings were designed (n=12: (1 a standard coping (SC with a 0.5mm uniform thickness and (2 a modified coping (MC consisted of a lingual margin of 1mm thickness and 2mm height connected to a proximal strut of 4mm height and a 0.3mm-wide facial collar. After veneer porcelain firing, the crowns were cemented to metal dies. Afterwards, a static vertical load was applied until failure. The modes of failure were determined. Data were calculated and statistically analyzed by independent samples T-test. P<0.05 was considered statistically significant.Results: The mean and standard deviation (SD of the final fracture resistance equaled to 3519.42±1154.96 N and 3570.01±1224.33 N in SC and MC groups, respectively; the difference was not statistically significant (P=0.9. Also, the mean and SD of the initial fracture resistance equaled to 3345.34±1190.93 N and 3471.52±1228.93 N in SC and MC groups, respectively (P=0.8. Most of the specimens in both groups showed the mixed failure mode. Conclusions: Based on the results, the modified core design may not significantly improve the fracture resistance.

Intramedullary nailing of clavicular midshaft fractures in adults using titanium elastic nail.

Science.gov (United States)

Chen, Qing-Yu; Kou, Dong-Quan; Cheng, Xiao-Jie; Zhang, Wei; Wang, Wei; Lin, Zhang-Qin; Cheng, Shao-Wen; Shen, Yue; Ying, Xiao-Zhou; Peng, Lei; Lv, Chuan-Zhu

2011-01-01

Studies showed elastic stable intramedullary nailing (ESIN) of displaced midclavicular fractures has excellent outcomes, as well as high complication rates and specific problems. The aim was to discuss ESIN of midshaft clavicular fractures. Totally 60 eligible patients (aged 18-63 years) were randomized to either ESIN group or non-operative group between January 2007 and May 2008. Clavicular shortening was measured after trauma and osseous consolidation. Radiographic union and complications were assessed. Function analysis including Constant shoulder scores and disabilities of the arm, shoulder and hand (DASH) scores were performed after a 15-month follow-up. ESIN led to a signifcantly shorter time to union, especially for simple fractures. In ESIN group, all patients got fracture union, of which 5 cases had medial skin irritation and 1 patient needed revision surgery because of implant failure. In the nonoperative group, there were 3 nonunion cases and 2 symptomatic malunions developed requiring corrective osteotomy. At 15 months after intramedullary stabilization, patients in the ESIN group were more satisfied with the appearance of the shoulder and overall outcome, and they benefited a lot from the great improvement of post-traumatic clavicular shortening. Furthermore, DASH scores were lower and Constant scores were significantly higher in contrast to the non-operative group. ESIN is a safe minimally invasive surgical technique with lower complication rate, faster return to daily activities, excellent cosmetic and better functional results, restoration of clavicular length for treating mid-shaft clavicular fractures, resulting in high overall satisfaction, which can be regard as an alternative to plate fixation or nonoperative treatment of mid-shaft clavicular fractures.

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.

Marginal kidney donor

Directory of Open Access Journals (Sweden)

Ganesh Gopalakrishnan

2007-01-01

Full Text Available Renal transplantation is the treatment of choice for a medically eligible patient with end stage renal disease. The number of renal transplants has increased rapidly over the last two decades. However, the demand for organs has increased even more. This disparity between the availability of organs and waitlisted patients for transplants has forced many transplant centers across the world to use marginal kidneys and donors. We performed a Medline search to establish the current status of marginal kidney donors in the world. Transplant programs using marginal deceased renal grafts is well established. The focus is now on efforts to improve their results. Utilization of non-heart-beating donors is still in a plateau phase and comprises a minor percentage of deceased donations. The main concern is primary non-function of the renal graft apart from legal and ethical issues. Transplants with living donors outnumbered cadaveric transplants at many centers in the last decade. There has been an increased use of marginal living kidney donors with some acceptable medical risks. Our primary concern is the safety of the living donor. There is not enough scientific data available to quantify the risks involved for such donation. The definition of marginal living donor is still not clear and there are no uniform recommendations. The decision must be tailored to each donor who in turn should be actively involved at all levels of the decision-making process. In the current circumstances, our responsibility is very crucial in making decisions for either accepting or rejecting a marginal living donor.

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...

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.

Pelvic fracture and injury to the lower urinary tract.

Science.gov (United States)

Spirnak, J P

1988-10-01

The presence of a urologic injury must be considered in all patients with pelvic fracture. Uroradiographic evaluation starting with retrograde urethrography is indicated in all male patients with concomitant gross hematuria, bloody urethral discharge, scrotal or perineal ecchymosis, a nonpalpable prostate on rectal examination, or an inability to urinate. If the urethra is normal, a catheter may be passed, and in the presence of gross hematuria, a cystogram must be performed. Female patients rarely suffer urethral lacerations. The urethra is examined, and a Foley catheter may be passed without a urethrogram. The immediate management of associated urologic injuries continues to evolve and evoke controversy. Selected cases of extraperitoneal bladder perforation may be safely managed solely by catheter drainage. Intraperitoneal perforations require surgical exploration and repair. Urethral disruption (partial or complete) may be safely managed by primary cystostomy drainage with management of potential complications (stricture, impotence, incontinence) in 4 to 6 months.

Open reduction and internal fixation of intra-articular fractures of the mandibular condyle: our first experiences.

Science.gov (United States)

Vesnaver, Ales

2008-10-01

Treatment of intra-articular fractures of the mandibular condyle head is conservative at most institutions dealing with facial fractures. Recently, reports had been published about benefits of surgical treatment in these fractures. From July 2004 until the end of June 2006, 13 patients with 16 displaced intra-articular fractures of the mandibular condyle were treated with open reduction and internal fixation at the Department of Oral and Maxillofacial Surgery in Ljubljana, Slovenia, using the preauricular approach and the lag screw technique. Twelve of the 13 patients could open their mouths for 40 mm or more, and 10 had a deflection of the chin of less than 2 mm upon maximal opening. None of the patients experienced pain upon rest, palpation, or chewing. Occlusion was not noted as altered in any of the cases, neither subjectively, nor on examination. There were no cases of postoperative weakness of the temporal branch of the facial nerve. Surgical treatment of intra-articular condyle fractures using the preauricular approach achieves a good exposure and enables proper reduction. Stable fixation of fractured bony fragments can be achieved using the lag screw technique. Another benefit of open exposure is revision and repair of TMJ soft tissues. With the appropriate surgical technique, the surgical procedure is safe and leads to good results.

HAEMATOMA BLOCK- AN EFFECTIVE ALTERNATIVE TO GENERAL ANAESTHESIA FOR REDUCTION OF DISTAL RADIUS FRACTURES

Directory of Open Access Journals (Sweden)

Prabhati Rani Mishra

2016-12-01

Full Text Available BACKGROUND Most common fracture in elderly patients is distal radius fracture. The most common method of management is closed reduction and immobilisation. The aim of the study is to compare the analgesic effects of haematoma block and general anaesthesia for closed reduction of distal fracture of radius. MATERIALS AND METHODS A prospective randomised controlled study was carried out among 100 patients of age group between 15-70 years of either sex who had fracture distal radius between 2015-2016. The patients having multiple fractures, pathological fractures or suffering from any organic diseases were excluded from the study. After taking informed written consent, the patients were randomised into two equal groups. In group A, reduction of fracture was done following administration of IV propofol and in group B after infiltration with 2% lignocaine into fracture haematoma site. Pain score was compared by VAS before, during and after manipulation in both the groups. Time taken from presentation at emergency department to reduction and discharge from hospital was also compared. Statistical analysis was done by applying SPSS software. RESULTS 100 patients of mean age 42.5 years, male: female 43:57 with fracture distal radius were studied. Mean time from admission to fracture reduction in group A was 2.64±0.93 hours and in group B 0.90±0.45 hours (P=0.0001. Discharge time from hospital after reduction of fracture in group A was 4.24±0.94 hours and in group B 0.75±0.2 hours (P=0.0001. VAS during reduction in group A was 0 and in group B 0.98±0.8 (P=0.0001. 10 minutes after reduction VAS in group A was 2.28±0.24 and group B 0.72±0.45 (P=0.0001. CONCLUSION For closed reduction of distal radius fracture, haematoma block with lignocaine is safe and effective alternative to intravenous general anaesthesia with propofol.

Safety Characterization of the Technological Development Plant at Hontomín. Risk Structures: 1. Faults and Fractures

International Nuclear Information System (INIS)

Recreo, F.; Hurtado, A.; Eguilior, S.

2015-01-01

The safe storage of CO2 requires ensuring seal integrity during the time the CO2 will remain in a supercritical state before dissolving as an aqueous phase, CO2-aq. Geological structures such as faults and fractures that affect storage and seal formations can play an important role in the behaviour of the CO2 plume depending on whether the fracture acts as a barrier to the movement of CO2 or as a preferent conduit. As a consequence, a CO2 geological storage affected by faults or fractures represents a higher degree of uncertainty and its complexity will also be greater for the estimation of the dynamic properties of the flow of CO2 than a not fractured reservoir, increasing uncertainties in assessing both performance and safety In this report an analysis is made on the role that faults and fractures can play on the storage formation flow conditions and on the effects on the behaviour of injected CO2, considering different types of fractures in relation to the fracture inclination angle with the plume flow direction and the fracture conductivity, and presents a simplified model of fracture behaviour in a CO2 storage formation which could be mplemented in the safety assessment probabilistic model that CIUDEN is developing in the framework of the ALM/10/017 project. Finally, an application at the Hontomín site is tested based on the current available geological and geophysical information

Fixing a fractured arthrodesed hip with rapid prototype templating and minimal invasive plate osteosynthesis

Directory of Open Access Journals (Sweden)

Christian Fang

2015-12-01

Full Text Available CASE:: We present an elderly lady with an intertrochanteric fracture of a previously fused hip. A 3D printed model of her pelvis and femur was used for implant templating before surgery. Minimal invasive fixation was performed with a spanning reversed distal femur locking plate without the need for removal of the previous implant. Multiple long locking screws were placed in the supra-acetabular region. The patient had union in 4 months, return to function and no complication. Conclusion:: The technique allowed us to optimize implant selection and insert screws safely at difficult trajectories using minimal invasive surgery. Keywords: Hip fusion, Fracture, Plating, Minimal invasive, 3D printing

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.

On the interfacial fracture of porcelain/zirconia and graded zirconia dental structures.

Science.gov (United States)

Chai, Herzl; Lee, James J-W; Mieleszko, Adam J; Chu, Stephen J; Zhang, Yu

2014-08-01

Porcelain fused to zirconia (PFZ) restorations are widely used in prosthetic dentistry. However, their susceptibility to fracture remains a practical problem. The failure of PFZ prostheses often involves crack initiation and growth in the porcelain, which may be followed by fracture along the porcelain/zirconia (P/Z) interface. In this work, we characterized the process of fracture in two PFZ systems, as well as a newly developed graded glass-zirconia structure with emphases placed on resistance to interfacial cracking. Thin porcelain layers were fused onto Y-TZP plates with or without the presence of a glass binder. The specimens were loaded in a four-point-bending fixture with the thin porcelain veneer in tension, simulating the lower portion of the connectors and marginal areas of a fixed dental prosthesis (FDP) during occlusal loading. The evolution of damage was observed by a video camera. The fracture was characterized by unstable growth of cracks perpendicular to the P/Z interface (channel cracks) in the porcelain layer, which was followed by stable cracking along the P/Z interface. The interfacial fracture energy GC was determined by a finite-element analysis taking into account stress-shielding effects due to the presence of adjacent channel cracks. The resulting GC was considerably less than commonly reported values for similar systems. Fracture in the graded Y-TZP samples occurred via a single channel crack at a much greater stress than for PFZ. No delamination between the residual glass layer and graded zirconia occurred in any of the tests. Combined with its enhanced resistance to edge chipping and good esthetic quality, graded Y-TZP emerges as a viable material concept for dental restorations. Copyright © 2014 Acta Materialia Inc. All rights reserved.

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

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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.

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.

Cool and Safe: Multiplicity in Safe Innovation at Unilever

Science.gov (United States)

Penders, Bart

2011-01-01

This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

[The use of Piezosurgery osteotomy in treatment of long-standing maxillary fractures: report of 12 consecutive patients].

Science.gov (United States)

Guo, Zhao-Zhong; Liu, Xue; Li, Yan; Deng, Yan-Fang; Wang, Yang

2007-02-01

To evaluate the clinical applicability of Piezosurgery osteotomy: a new safe technique in managing long standing maxillary fractures. 12 patients with long-standing maxillary fractures were surgically treated using Le Fort I osteotomy. During operation, Piezosurgery osteotomy was used for bone cutting and splitting. After repositioning, the bone segments were rigidly fixed with micro Ti-plate, Ti-mesh. All the patients were followed up for 6 to 12 months, and the functional and esthetic results were evaluated. Ultrasonic microvibrations allow accurate bone cutting without oscillating injuries to the soft tissue. All the wounds healed primarily without complications. The postoperative occlusion and appearance were satisfactory. Maximal recovery of mastication and appearance can be achieved by using Piezosurgery osteotomy with fixation materials such as Ti-plates and Ti-meshes in selected patients with long-standing maxillary fractures.

Role of multiple cusps in tooth fracture.

Science.gov (United States)

Barani, Amir; Bush, Mark B; Lawn, Brian R

2014-07-01

The role of multiple cusps in the biomechanics of human molar tooth fracture is analysed. A model with four cusps at the bite surface replaces the single dome structure used in previous simulations. Extended finite element modelling, with provision to embed longitudinal cracks into the enamel walls, enables full analysis of crack propagation from initial extension to final failure. The cracks propagate longitudinally around the enamel side walls from starter cracks placed either at the top surface (radial cracks) or from the tooth base (margin cracks). A feature of the crack evolution is its stability, meaning that extension occurs steadily with increasing applied force. Predictions from the model are validated by comparison with experimental data from earlier publications, in which crack development was followed in situ during occlusal loading of extracted human molars. The results show substantial increase in critical forces to produce longitudinal fractures with number of cuspal contacts, indicating a capacity for an individual tooth to spread the load during mastication. It is argued that explicit critical force equations derived in previous studies remain valid, at the least as a means for comparing the capacity for teeth of different dimensions to sustain high bite forces. Copyright © 2014 Elsevier Ltd. All rights reserved.

Elastic, plastic, fracture analysis of masonry arches: A multi-span bridge case study

Science.gov (United States)

Lacidogna, Giuseppe; Accornero, Federico

2018-01-01

In this work a comparison is presented between elastic, plastic, and fracture analysis of the monumental arch bridge of Porta Napoli, Taranto (Italy). By means of a FEM model and applying the Mery's Method, the behavior of the curved structure under service loads is verified, while considering the Safe Theorem approach byHeyman, the ultimate carrying capacity of the structure is investigated. Moreover, by using Fracture Mechanics concepts, the damage process which takes place when the conditions assessed through linear elastic analysis are no longer valid, and before the set-in of the conditions established by means of the plastic limit analysis, is numerically analyzed. The study of these transitions returns an accurate and effective whole service life assessment of the Porta Napoli masonry arch bridge.

THE INFLUENCE OF SCREW TYPE, ALLOY AND CYLINDER POSITION ON THE MARGINAL FIT OF IMPLANT FRAMEWORKS BEFORE AND AFTER LASER WELDING

OpenAIRE

Castilio, Daniela; Pedreira, Ana Paula Ribeiro do Vale; Rossetti, Paulo Henrique Orlato; Rossetti, Leylha Maria Nunes; Bonachela, Wellington Cardoso

2006-01-01

Misfit at the abutment-prosthetic cylinder interface can cause loss of preload, leading to loosening or fracture of gold and titanium screws. OBJECTIVES: To evaluate the influence of screw type, alloy, and cylinder position on marginal fit of implant frameworks before and after laser welding. METHODS: After Estheticone-like abutments were screwed to the implants, thirty plastic prosthetic cylinders were mounted and waxed-up to fifteen cylindrical bars. Each specimen had three interconnected p...

Comparison of Early and Delayed Open Reduction and Internal Fixation for Treating Closed Tibial Pilon Fractures.

Science.gov (United States)

Tang, Xin; Liu, Lei; Tu, Chong-qi; Li, Jian; Li, Qi; Pei, Fu-xing

2014-07-01

The timing of surgery for osteosynthesis of type C pilon (AO/OTA) fractures remains controversial. The aim of this study was to determine the outcome of early and delayed open reduction and internal fixation (ORIF) for treating closed type C pilon fractures. Forty-six patients with closed type C pilon fractures matched according to age, gender, soft tissue conditions, and fracture pattern were divided into group A (early group: underwent surgery within 36 hours of the injury) or group B (delayed group: underwent surgery 10 days to 3 weeks postinjury after the soft tissue swelling subsided). In the delayed group, 9 patients were treated first by temporary external fixation. All the closed fractures were managed by ORIF with locking plates. At follow-up, the clinical and radiographic results were retrospectively analyzed. The mean follow-up time was 25.8 months (range, 14 to 48 months) in group A and 26.0 months (range, 15 to 44 months) in group B. There was no significant difference (P > .05) between the 2 groups regarding the rate of soft tissue complication, the rate of fracture union, and the final functional score. The patients in group A had a significantly shorter mean time to fracture union (21.5 ± 4.0 weeks vs 23.3 ± 3.7 weeks, P fractures can be safe and effective, with similar rates of wound complication, fracture union, and final good functional recovery but shorter operative time, union time, and hospital stay. These results favorably compare with delayed ORIF treatment. Level III, retrospective comparative study. © The Author(s) 2014.

Percutaneous Kirschner wire (K-wire) fixation for humerus shaft fractures in children: A treatment concept.

Science.gov (United States)

Sahu, Ramji Lal

2013-09-01

Fractures of the humeral shaft are uncommon, representing less than 10 percent of all fractures in children. Humeral shaft fractures in children can be treated by immobilisation alone. A small number of fractures are unable to be reduced adequately or maintained in adequate alignment, and these should be treated surgically. In the present study, Kirschner wires (K-wire) were used to achieve a closed intramedullary fixation of humeral shaft fractures. The objective of this study was to evaluate the efficacy of intramedullary K-wires for the treatment of humeral shaft fracture in children. This prospective study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from June 2005 to June 2010. Sixty-eight children with a mean age of 7.7 years (range, 2-14 years) were recruited from Emergency and out patient department having closed fracture of humerus shaft. All patients were operated under general anaesthesia. All patients were followed for 12 months. Out of 68 patients, 64 patients underwent union in 42-70 days with a mean of 56 days. Complications found in four patients who had insignificant delayed union which were united next 3 weeks. Intramedullary K-wires were removed after an average of 5 months without any complications. The results were excellent in 94.11% and good in 5% children. This technique is simple, quick to perform, safe and reliable and avoids prolonged hospitalization with good results and is economical.

The effect of offset on fracture permeability of rocks from the Southern Andes Volcanic Zone, Chile

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Pérez-Flores, P.; Wang, G.; Mitchell, T. M.; Meredith, P. G.; Nara, Y.; Sarkar, V.; Cembrano, J.

2017-11-01

The Southern Andes Volcanic Zone (SVZ) represents one of the largest undeveloped geothermal provinces in the world. Development of the geothermal potential requires a detailed understanding of fluid transport properties of its main lithologies. The permeability of SVZ rocks is altered by the presence of fracture damage zones produced by the Liquiñe-Ofqui Fault System (LOFS) and the Andean Transverse Faults (ATF). We have therefore measured the permeability of four representative lithologies from the volcanic basement in this area: crystalline tuff, andesitic dike, altered andesite and granodiorite. For comparative purposes, we have also measured the permeability of samples of Seljadalur basalt, an Icelandic rock with widely studied and reported hydraulic properties. Specifically, we present the results of a systematic study of the effect of fractures and fracture offsets on permeability as a function of increasing effective pressure. Baseline measurements on intact samples of SVZ rocks show that the granodiorite has a permeability (10-18 m2), two orders of magnitude higher than that of the volcanic rocks (10-20 m2). The presence of throughgoing mated macro-fractures increases permeability by between four and six orders of magnitude, with the highest permeability recorded for the crystalline tuff. Increasing fracture offset to produce unmated fractures results in large increases in permeability up to some characteristic value of offset, beyond which permeability changes only marginally. The increase in permeability with offset appears to depend on fracture roughness and aperture, and these are different for each lithology. Overall, fractured SVZ rocks with finite offsets record permeability values consistent with those commonly found in geothermal reservoirs (>10-16 m2), which potentially allow convective/advective flow to develop. Hence, our results demonstrate that the fracture damage zones developed within the SVZ produce permeable regions, especially within the

On marginal regeneration

NARCIS (Netherlands)

Stein, H.N.

1991-01-01

On applying the marginal regeneration concept to the drainage of free liquid films, problems are encountered: the films do not show a "neck" of minimum thickness at the film/border transition; and the causes of the direction dependence of the marginal regeneration are unclear. Both problems can be

Understanding the occupational and organizational boundaries to safe hospital discharge.

Science.gov (United States)

Waring, Justin; Marshall, Fiona; Bishop, Simon

2015-01-01

Safe hospital discharge relies upon communication and coordination across multiple occupational and organizational boundaries. Our aim was to understand how these boundaries can exacerbate health system complexity and represent latent sociocultural threats to safe discharge. An ethnographic study was conducted in two local health and social care systems (health economies) in England, focusing on two clinical areas: stroke and hip fracture patients. Data collection involved 345 hours of observations and 220 semi-structured interviews with health and social care professionals, patients and their lay carers. Hospital discharge involves a dynamic network of interactions between heterogeneous health and social care actors, each characterized by divergent ways of organizing discharge activities; cultures of collaboration and interaction and understanding of what discharge involves and how it contributes to patient recovery. These interrelated dimensions elaborate the occupational and organisational boundaries that can influence communication and coordination in hospital discharge. Hospital discharge relies upon the coordination of multiple actors working across occupational and organizational boundaries. Attention to the sociocultural boundaries that influence communication and coordination can help inform interventions that might support enhanced discharge safety. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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)

Paediatric tibial shaft fractures treated by open reduction and stabilization with monolateral external fixation

Science.gov (United States)

Simon, A.-L.; Apostolou, N.; Vidal, C.; Ferrero, E.; Mazda, K.; Ilharreborde, B.

2018-01-01

Abstract Purpose Elastic stable intramedullary nailing is increasingly used for surgical treatment of tibial shaft fractures, but frequently requires immobilization and delayed full weight-bearing. Therefore, external fixation remains interesting. The aim was to report clinico-radiological outcomes of monolateral external fixation for displaced and unstable tibial shaft fractures in children. Methods All tibial fractures consecutively treated by monolateral external fixation between 2008 and 2013 were followed. Inclusion criteria included skeletal immaturity and closed and open Gustilo I fractures caused by a direct impact. Patients were seen until two years postoperatively. Demographics, mechanism of injury, surgical data and complications were recorded. Anteroposterior and lateral side radiographs were performed at each visit. Full-limb 3D reconstructions using biplanar stereroradiography was performed for final limb length and alignment measures. Results A total of 45 patients (mean age 9.7 years ± 0.5) were included. In all, 17 were Gustilo I fractures, with no difference between open and closed fractures for any data. Mean time to full weight bearing was 18.2 days ± 0.7. After 15 days, 39 patients returned to school. Hardware removal (mean time to union 15.6 weeks ± 0.8) was performed during consultation under analgesic gas. There were no cases of nonunion. No fracture healed with > 10° of angulation (mean 5.1° ± 0.4°). Leg-length discrepancy > 10 mm was found for six patients. Conclusions This procedure can be a safe and simple surgical treatment for children with tibial shaft fractures. Few complications and early return to school were reported, with the limitations of non-comparative study. Level of Evidence IV PMID:29456750

Management of anticoagulation in hip fractures: A pragmatic approach.

Science.gov (United States)

Yassa, Rafik; Khalfaoui, Mahdi Yacine; Hujazi, Ihab; Sevenoaks, Hannah; Dunkow, Paul

2017-09-01

Hip fractures are common and increasing with an ageing population. In the United Kingdom, the national guidelines recommend operative intervention within 36 hours of diagnosis. However, long-term anticoagulant treatment is frequently encountered in these patients which can delay surgical intervention. Despite this, there are no set national standards for management of drug-induced coagulopathy pre-operatively in the context of hip fractures.The aim of this study was to evaluate the management protocols available in the current literature for the commonly encountered coagulopathy-inducing agents.We reviewed the current literature, identified the reversal agents used in coagulopathy management and assessed the evidence to determine the optimal timing, doses and routes of administration.Warfarin and other vitamin K antagonists (VKA) can be reversed effectively using vitamin K with a dose in the range of 2 mg to 10 mg intravenously to correct coagulopathy.The role of fresh frozen plasma is not clear from the current evidence while prothrombin complex remains a reliable and safe method for immediate reversal of VKA-induced coagulopathy in hip fracture surgery or failed vitamin K treatment reversal.The literature suggests that surgery should not be delayed in patients on classical antiplatelet medications (aspirin or clopidogrel), but spinal or regional anaesthetic methods should be avoided for the latter. However, evidence regarding the use of more novel antiplatelet medications (e.g. ticagrelor) and direct oral anticoagulants remains a largely unexplored area in the context of hip fracture surgery. We suggest treatment protocols based on best available evidence and guidance from allied specialties.Hip fracture surgery presents a common management dilemma where semi-urgent surgery is required. In this article, we advocate an evidence-based algorithm as a guide for managing these anticoagulated patients. Cite this article: EFORT Open Rev 2017;2:394-402. DOI: 10.1302/2058-5241.2.160083.

Clinical outcome after surgical treatment of transitional fractures of the distal tibia in children

DEFF Research Database (Denmark)

Strohm, P C; Hauschild, O; Reising, K

2011-01-01

of follow-up none of the children were impaired in activities of daily living and there were no restrictions in sporting activity. All patients sco- red good or excellent results on the AO Foot and Ankle Score. DISCUSSION: Surgical stabilization can be recommended as a safe and effective treatment strategy...... 6 to 72) months to assess functional out come (using the AO Foot and Ankle Score). RESULTS: Nine girls and 15 boys were included in the study with the girls being younger on average (12.4 ± 0.9 vs. 14.3 ± 1.1 years, p = 0.00013). Two-plane fractures were present in 4 cases, 15 and 5 children...... sustained tri-plane I and II fractures, respectively. Median preoperative fracture displacement was measured at 4 mm (range 3 to 11 mm). Traumatic supination of the ankle joint during sports activities was the predominant injury mechanism (18/24 cases) followed by bicycle or motorbike accidents (6...

A Green's function method for two-dimensional reactive solute transport in a parallel fracture-matrix system

Science.gov (United States)

Chen, Kewei; Zhan, Hongbin

2018-06-01

The reactive solute transport in a single fracture bounded by upper and lower matrixes is a classical problem that captures the dominant factors affecting transport behavior beyond pore scale. A parallel fracture-matrix system which considers the interaction among multiple paralleled fractures is an extension to a single fracture-matrix system. The existing analytical or semi-analytical solution for solute transport in a parallel fracture-matrix simplifies the problem to various degrees, such as neglecting the transverse dispersion in the fracture and/or the longitudinal diffusion in the matrix. The difficulty of solving the full two-dimensional (2-D) problem lies in the calculation of the mass exchange between the fracture and matrix. In this study, we propose an innovative Green's function approach to address the 2-D reactive solute transport in a parallel fracture-matrix system. The flux at the interface is calculated numerically. It is found that the transverse dispersion in the fracture can be safely neglected due to the small scale of fracture aperture. However, neglecting the longitudinal matrix diffusion would overestimate the concentration profile near the solute entrance face and underestimate the concentration profile at the far side. The error caused by neglecting the longitudinal matrix diffusion decreases with increasing Peclet number. The longitudinal matrix diffusion does not have obvious influence on the concentration profile in long-term. The developed model is applied to a non-aqueous-phase-liquid (DNAPL) contamination field case in New Haven Arkose of Connecticut in USA to estimate the Trichloroethylene (TCE) behavior over 40 years. The ratio of TCE mass stored in the matrix and the injected TCE mass increases above 90% in less than 10 years.

Emergency department management of pain and anxiety related to orthopedic fracture care: a guide to analgesic techniques and procedural sedation in children.

Science.gov (United States)

Kennedy, Robert M; Luhmann, Jan D; Luhmann, Scott J

2004-01-01

Orthopedic fractures and joint dislocations are among the most painful pediatric emergencies. Safe and effective management of fracture-related pain and anxiety in the emergency department reduces patient distress during initial evaluation and often allows definitive management of the fracture. No consensus exists on which pharmacologic regimens for procedural sedation/analgesia are safest and most effective. For some children, control of fracture pain is the primary goal, whereas for others, relief from anxiety is an additionally important objective. Furthermore, strategies for the management of fracture pain may vary by fracture location and patient characteristics; thus, no single regimen is likely to provide the best means of analgesia and anxiolysis for all patients. Effective analgesia can be provided by local or regional anesthesia, such as hematoma, Bier, or nerve blocks. Alternatively, induction of deep sedation with analgesic agents such as ketamine or fentanyl, often combined with sedative-anxiolytic agents such as midazolam, may be used to manage distress associated with fracture reduction. A combination of local anesthesia with moderate sedation, for example nitrous oxide, is another attractive option.

Computed tomography fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures

International Nuclear Information System (INIS)

Iguchi, Toshihiro; Ogawa, Ken-Ichi; Doi, Takeshi; Munetomo, Kazuo; Miyasho, Koji; Hiraki, Takao; Kanazawa, Susumu; Ozaki, Toshifumi

2010-01-01

The purpose of this study was to evaluate retrospectively the safety and effectiveness of the computed tomography (CT) fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures. Six patients (four women and two men; mean age 55.8 years; range 35-77 years) with unstable posterior pelvic fractures underwent iliosacral screw placement under CT fluoroscopy guidance between November 2007 and August 2008. Unstable pelvic ring injury (AO types B and C) was the indication for this procedure. In all the six patients except one, CT fluoroscopy-guided placement had been technically successful. In one patient, a second screw had been inserted, with a tilt to the caudal site, and slightly advanced into the extrasacral body; afterward, it could be exchanged safely for a shorter screw. Five patients and one patient underwent placement of two screws and one screw, respectively. The mean duration of the procedure was 15.0 min (range 9-30 min) per screw; the duration was 12.3 min and 18.2 min for the first and second screws, respectively. No complications requiring treatment occurred during or after the procedure. The mean clinical and radiologic follow-up period was 14 months (range 6-21 months). All pelvic injuries had healed satisfactorily, without complication, and all patients are now doing well clinically and can walk. CT fluoroscopy-guided placement of iliosacral screws is a safe and effective treatment in patients with unstable posterior pelvic fractures. (orig.)

Indigenous women's voices: marginalization and health.

Science.gov (United States)

Dodgson, Joan E; Struthers, Roxanne

2005-10-01

Marginalization may affect health care delivery. Ways in which indigenous women experienced marginalization were examined. Data from 57 indigenous women (18 to 65 years) were analyzed for themes. Three themes emerged: historical trauma as lived marginalization, biculturalism experienced as marginalization, and interacting within a complex health care system. Experienced marginalization reflected participants' unique perspective and were congruent with previous research. It is necessary for health care providers to assess the detrimental impact of marginalization on the health status of individuals and/or communities.

Is Daily Low-Dose Aspirin Safe to Take Following Laparoscopic Roux-en-Y Gastric Bypass for Obesity Surgery?

Science.gov (United States)

Kang, Xian; Hong, Dennis; Anvari, Mehran; Tiboni, Maria; Amin, Nalin; Gmora, Scott

2017-05-01

Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is a safe and effective procedure for patients with severe obesity. One potential complication of LRYGB is the development of marginal ulcers (MUs). Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to significantly increase the likelihood of developing marginal ulcers after surgery. However, the risk associated with low-dose aspirin consumption is not well defined. We examined the impact of daily low-dose aspirin (81 mg) on the development of marginal ulcers following LRYGB. A retrospective cohort design studied patients undergoing LRYGB surgery, between January 2009 and January 2013, at a single, high-volume bariatric center in Ontario, Canada. The marginal ulcer rate of patients taking low-dose aspirin after surgery was compared to that of the control patients who did not take any NSAID. Diagnosis of MU was confirmed by upper endoscopy in patients presenting with symptoms and a history indicative of marginal ulceration. A chi-square test of independence was performed to examine the difference in marginal ulcer rates. A total of 1016 patients underwent LRYGB. Patients taking aspirin were more likely to be male, older, and have diabetes than patients not taking NSAIDs. Of the 1016 patients, 145 (14.3%) took low-dose aspirin following LRYGB and the rest did not (n = 871, 85.7%). The incidence of marginal ulceration was not significantly different between the two treatment groups (12/145, 8.3% versus 90/871, 10.3%; p = 0.45). Patients treated with LRYGB at our institution were not at increased risk of marginal ulcer formation when taking low-dose aspirin after surgery.

Intramedullary nailing of clavicular midshaft fractures in adults using titanium elastic nail

Directory of Open Access Journals (Sweden)

CHEN Qing-yv

2012-02-01

Full Text Available 【Abstract】 Objective: Studies showed elastic stable intramedullary nailing (ESIN of displaced midclavicular fractures has excellent outcomes, as well as high complication rates and specific problems. The aim was to discuss ESIN of midshaft clavicular fractures. Methods: Totally 60 eligible patients (aged 18-63 years were randomized to either ESIN group or non-operative group between January 2007 and May 2008. Clavicular shortening was measured after trauma and osseous consolidation. Radiographic union and complications were assessed. Function analysis including Constant shoulder scores and disabilities of the arm, shoulder and hand (DASH scores were performed after a 15-month follow-up. Results: ESIN led to a signifcantly shorter time to union, especially for simple fractures. In ESIN group, all patients got fracture union, of which 5 cases had medial skin irritation and 1 patient needed revision surgery because of implant failure. In the nonoperative group, there were 3 nonunion cases and 2 symptomatic malunions developed requiring corrective osteotomy. At 15 months after intramedullary stabilization, patients in the ESIN group were more satisfied with the appearance of the shoulder and overall outcome, and they benefited a lot from the great improvement of post-traumatic clavicular shortening. Furthermore, DASH scores were lower and Constant scores were significantly higher in contrast to the non-operative group. Conclusion: ESIN is a safe minimally invasive surgical technique with lower complication rate, faster return to daily activities, excellent cosmetic and better functional results, restoration of clavicular length for treating mid-shaft clavicular fractures, resulting in high overall satisfaction, which can be regard as an alternative to plate fixation or nonoperative treatment of mid-shaft clavicular fractures. Key words: Clavicle; Fracture fixation intramedu- llary; Outcome assessment

Mechanical and mathematical models of multi-stage horizontal fracturing strings and their application

Directory of Open Access Journals (Sweden)

Zhanghua Lian

2015-03-01

Full Text Available Multi-stage SRV fracturing in horizontal wells is a new technology developed at home and abroad in recent years to effectively develop shale gas or low-permeability reservoirs, but on the other hand makes the mechanical environment of fracturing strings more complicated at the same time. In view of this, based on the loading features of tubing strings during the multi-stage fracturing of a horizontal well, mechanical models were established for three working cases of multiple packer setting, open differential-pressure sliding sleeve, and open ball-injection sliding sleeve under a hold-down packer. Moreover, mathematical models were respectively built for the above three cases. According to the Lame formula and Von Mises stress calculation formula for the thick-walled cylinder in the theory of elastic mechanics, a mathematical model was also established to calculate the equivalent stress for tubing string safety evaluation when the fracturing string was under the combined action of inner pressure, external squeezing force and axial stress, and another mathematical model was built for the mechanical strength and safety evaluation of multi-stage fracturing strings. In addition, a practical software was developed for the mechanical safety evaluation of horizontal well multi-stage fracturing strings according to the mathematical model developed for the mechanical calculation of the multi-packer string in horizontal wells. The research results were applied and verified in a gas well of Tahe Oilfield in the Tarim Basin with excellent effects, providing a theoretical basis and a simple and reliable technical means for optimal design and safety evaluation of safe operational parameters of multi-stage fracturing strings in horizontal wells.

Refining margins and prospects

International Nuclear Information System (INIS)

Baudouin, C.; Favennec, J.P.

1997-01-01

Refining margins throughout the world have remained low in 1996. In Europe, in spite of an improvement, particularly during the last few weeks, they are still not high enough to finance new investments. Although the demand for petroleum products is increasing, experts are still sceptical about any rapid recovery due to prevailing overcapacity and to continuing capacity growth. After a historical review of margins and an analysis of margins by regions, we analyse refining over-capacities in Europe and the unbalances between production and demand. Then we discuss the current situation concerning barriers to the rationalization, agreements between oil companies, and the consequences on the future of refining capacities and margins. (author)

Safety margins in deterministic safety analysis

International Nuclear Information System (INIS)

Viktorov, A.

2011-01-01

The concept of safety margins has acquired certain prominence in the attempts to demonstrate quantitatively the level of the nuclear power plant safety by means of deterministic analysis, especially when considering impacts from plant ageing and discovery issues. A number of international or industry publications exist that discuss various applications and interpretations of safety margins. The objective of this presentation is to bring together and examine in some detail, from the regulatory point of view, the safety margins that relate to deterministic safety analysis. In this paper, definitions of various safety margins are presented and discussed along with the regulatory expectations for them. Interrelationships of analysis input and output parameters with corresponding limits are explored. It is shown that the overall safety margin is composed of several components each having different origins and potential uses; in particular, margins associated with analysis output parameters are contrasted with margins linked to the analysis input. While these are separate, it is possible to influence output margins through the analysis input, and analysis method. Preserving safety margins is tantamount to maintaining safety. At the same time, efficiency of operation requires optimization of safety margins taking into account various technical and regulatory considerations. For this, basic definitions and rules for safety margins must be first established. (author)

Estimations of durability of fracture mineral buffers in the Olkiluoto bedrock

International Nuclear Information System (INIS)

Luukkonen, A.

2006-12-01

This study attempts to make scenarios for the geochemical effects that the underground excavations in the Olkiluoto bedrock have on naturally occurring fracture mineral buffers. The excavations of underground research facilities and final repository galleries probably cause steep hydraulic gradients in some bedrock fractures. These gradients likely draw surficial waters within the fracture network and activate weathering processes deeper in rock fractures than in the natural undisturbed conditions. The present studies concentrate on the meteoric infiltration in a single rock fracture, and on the selected set of minerals believed to be significant buffers against pH/redox variations in groundwater. The modelling considers the possibility that the infiltrating meteoric water is soil water rich in dissolved inorganic carbon. Calcite, pyrite, quartz, amorphous silica, cordierite, hornblende, albite, K-feldspar, kaolinite, and illite are taken into account as reacting minerals. Simulations are done by varying the flow rate of water from 1 L/h to 100 L/h. The effects of mineral reactions onto porosity and permeability values are monitored as well. In the present study, however, the changes in physical properties of the fracture channel do not affect the flow rate of water. Furthermore, calculations also describe how cation exchange affects the studied fracture channel system. The simulations coupling the hydraulic flow and water-rock interaction were done with TOUGHREACT V1.0 code and with the EQ3/6-database implemented in the code. In part, the simulations were evaluation of the code capabilities, and verification of results to earlier PHREEQC-2 simulation results. The calculation results confirm the assumption that principal buffer against pH changes is calcite. All silicate reactions, with considered reactive surface areas, are by comparison of marginal importance. The only redox buffer in the calculations is pyrite, and consequently significant amounts of oxygen runs

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

Marginal Models for Categorial Data

NARCIS (Netherlands)

Bergsma, W.P.; Rudas, T.

2002-01-01

Statistical models defined by imposing restrictions on marginal distributions of contingency tables have received considerable attention recently. This paper introduces a general definition of marginal log-linear parameters and describes conditions for a marginal log-linear parameter to be a smooth

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 ...

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.

French approach on the definition of reference defects to be considered for fracture mechanics analyses at design state

Energy Technology Data Exchange (ETDEWEB)

Grandemange, J M; Pellissier-Tanon, A [Societe Franco-Americaine de Constructions Atomiques (FRAMATOME), 92 - Paris-La-Defense (France)

1988-12-31

This document describes the french approach for verifying fracture resistance of PWR primary components. Three reference defects have been defined, namely the envelope defect, the exceptional defect and the conventional defect. It appears that a precise estimation of the available margins may be obtained by analyzing a set of reference defects representative of the flaws likely to exist in the components. (TEC). 5 refs.

The number of displaced rib fractures is more predictive for complications in chest trauma patients.

Science.gov (United States)

Chien, Chih-Ying; Chen, Yu-Hsien; Han, Shih-Tsung; Blaney, Gerald N; Huang, Ting-Shuo; Chen, Kuan-Fu

2017-02-28

, three or more rib fracture or any displacement were found to be the most sensitive risk factor for chest complications, independent of other risk factors or severity index. The number of displaced rib fractures could be a strong predictor for developing pulmonary complications. For patients with fewer than three rib fractures without rib displacement and initial lung or other organ injuries, outpatient management could be safe and efficient.

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....

Digital Margins : How spatially and socially marginalized communities deal with digital exclusion

NARCIS (Netherlands)

Salemink, Koen

2016-01-01

The increasing importance of the Internet as a means of communication has transformed economies and societies. For spatially and socially marginalized communities, this transformation has resulted in digital exclusion and further marginalization. This book presents a study of two kinds of

Implications of power uprates on safety margins of nuclear power plants. Report of a technical meeting

International Nuclear Information System (INIS)

2004-09-01

The safety of nuclear power plants (NPPs) is based on the defence in depth concept, which relies on successive physical barriers (fuel matrix, cladding, primary system pressure boundary and containment) and other provisions to control radioactive materials and on multiple levels of protection against damage to these barriers. Deterministic safety analysis is an important tool for conforming the adequacy and efficiency of provisions within the defence in depth concept and is used to predict the response of an NPP in predetermined operational states. This type of safety analysis applies a specific set of rules and specific acceptance criteria. Deterministic analysis is typically focused on neutronic, thermohydraulic, radiological and structural aspects, which are often analysed with different computational tools. The advanced computational tools developed for deterministic safety analysis are used for better establishment and utilization of licensing margins or safety margins in consideration of analysis results. At the same time, the existence of such margins ensures that NPPs operate safely in all modes of operation and at all times. To properly assess and address the existing margins and to be able to take advantage of unnecessary conservatisms, state of the art analytical tools intended for safety assessment have been developed. Progress made in the development and application of modern codes for safety analysis and better understanding of phenomena involved in plant design and operation enable the analysts to determine safety margins in consideration of analysis results (licensing margins) with higher precision. There is a general tendency for utilities to take advantage of unnecessarily large conservatisms in safety analyses and to utilize them for reactor power uprates, better utilization of nuclear fuel, higher operational flexibility and for justification of lifetime extension. The present publication sets forth the results of a Technical Meeting on the

Vertebral Artery Caught in the Fracture Gap after Traumatic C2/3 Spondylolisthesis

Directory of Open Access Journals (Sweden)

Ralf Henkelmann

2017-01-01

Full Text Available Background Context. Patient with a C2 fracture and entrapment of the right vertebral artery in the fracture gap. Purpose. Presentation of a case with follow-up until end of treatment. Study Design. Case report. Methods. A 25-year-old woman was brought into our emergency room after falling while riding a horse. She complained of pain in the cervical spine. Clinical examinations showed local tenderness at the upper cervical spine and painful impairment of the mobility of the neck, with no signs of neurological impairment. Radiological diagnostics revealed a traumatic C2/3 spondylolisthesis. A computer tomography (CT angiographic scan showed a dislocation of the right vertebral artery into the fracture gap without injury to the artery. Open reduction and osteosynthesis were considered of too high risk. Therefore, we conducted fracture treatment with closed reduction and halo fixation. After removal of the halo fixator, the patient was given a soft cervical collar and was advised to rest for additional 6 weeks before beginning gradual activity. Results. Conventional follow-up revealed osseous consolidation and a CT angiographic scan showed consistent blood flow to the artery. Conclusion. Halo fixation was a safe and effective therapy strategy in the case of vertebral artery entrapment after traumatic C2 spondylolisthesis.

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.

Risk of Fractures and Falls during and after 5-α Reductase Inhibitor Use: A Nationwide Cohort Study.

Science.gov (United States)

Robinson, David; Garmo, Hans; Stattin, Pär; Michaëlsson, Karl

2015-01-01

Lower urinary tract symptoms are common among older men and 5-α reductase inhibitors (5-ARI) are a group of drugs recommended in treating these symptoms. The effect on prostate volume is mediated by a reduction in dihydrotestosterone; however, this reduction is counterbalanced by a 25% rise in serum testosterone levels. Therefore, 5-ARI use might have systemic effects and differentially affect bone mineral density, muscular mass and strength, as well as falls, all of which are major determinants of fractures in older men. We conducted a nationwide cohort study of all Swedish men who used 5-ARI by comparing their risk of hip fracture, any type of fracture and of falls with matched control men randomly selected from the population and unexposed to 5-ARI. During 1 417 673 person-years of follow-up, 10 418 men had a hip fracture, 19 570 any type of fracture and 46 755 a fall requiring hospital care. Compared with unexposed men, current users of 5-ARI had an adjusted hazard ratio (HR) of 0.96 (95% CI 0.91-1.02) for hip fracture, an HR of 0.94 (95% CI 0.90-0.98) for all fracture and an HR of 0.99 (95% CI 0.96-1.02) for falls. Former users had an increased risk of hip fractures (HR 1.10, 95% CI 1.01-1.19). 5-ARI is safe from a bone health perspective with an unaltered risk of fractures and falls during periods of use. After discontinuation of 5-ARI, there is a modest increase in the rate of fractures and falls.

Risk of Fractures and Falls during and after 5-α Reductase Inhibitor Use: A Nationwide Cohort Study.

Directory of Open Access Journals (Sweden)

David Robinson

Full Text Available Lower urinary tract symptoms are common among older men and 5-α reductase inhibitors (5-ARI are a group of drugs recommended in treating these symptoms. The effect on prostate volume is mediated by a reduction in dihydrotestosterone; however, this reduction is counterbalanced by a 25% rise in serum testosterone levels. Therefore, 5-ARI use might have systemic effects and differentially affect bone mineral density, muscular mass and strength, as well as falls, all of which are major determinants of fractures in older men.We conducted a nationwide cohort study of all Swedish men who used 5-ARI by comparing their risk of hip fracture, any type of fracture and of falls with matched control men randomly selected from the population and unexposed to 5-ARI.During 1 417 673 person-years of follow-up, 10 418 men had a hip fracture, 19 570 any type of fracture and 46 755 a fall requiring hospital care. Compared with unexposed men, current users of 5-ARI had an adjusted hazard ratio (HR of 0.96 (95% CI 0.91-1.02 for hip fracture, an HR of 0.94 (95% CI 0.90-0.98 for all fracture and an HR of 0.99 (95% CI 0.96-1.02 for falls. Former users had an increased risk of hip fractures (HR 1.10, 95% CI 1.01-1.19.5-ARI is safe from a bone health perspective with an unaltered risk of fractures and falls during periods of use. After discontinuation of 5-ARI, there is a modest increase in the rate of fractures and falls.

Informing practice regarding marginalization: the application of the Koci Marginality Index.

Science.gov (United States)

Koci, Anne Floyd; McFarlane, Judith; Nava, Angeles; Gilroy, Heidi; Maddoux, John

2012-12-01

The 49th World Health Assembly of the World Health Organization (WHO) declared violence as the leading worldwide public health problem with a focus on the increase in the incidence of injuries to women. Violence against women is an international epidemic with specific instruments required to measure the impact on women's functioning. This article describes the application of the Koci Marginality Index (KMI), a 5-item scale to measure marginality, to the baseline data of a seven-year prospective study of 300 abused women: 150 first time users of a shelter and 150 first time applicants for a protection order from the justice system. Validity and reliability of the Koci Marginality Index and its usefulness for best clinical practice and for policy decisions for abused women's health are discussed. The 49th World Health Assembly of the World Health Organization (WHO) declared violence as the leading worldwide public health problem and focused on the increase in the incidence of injuries to women (Krug et al., 2002 ). Violence against women in the form of intimate partner violence (IPV) is costly in terms of dollars and health. In the United States in 2003, estimated costs of IPV approached $8.3 billion (Centers for Disease Control and Prevention [CDC], 2011). Outcomes related to severity of IPV vary but in 2003 victims suffering severe IPV lost nearly 8 million days of paid work, and greater than 5 million days of household productivity annually (CDC, 2011). Besides the evident financial cost of IPV, research confirms that exposure to IPV impacts a woman's health immediately and in the long-term (Breiding, Black, & Ryan, 2008 ; Campbell, 2002 ; CDC, 2011). Such sequela adversely affect the health of women and may increase their marginalization, a concept akin to isolation that may further increase negative effects on health outcomes. Immigrant women are at high risk for IPV (Erez, 2002 ) and those without documentation are at higher risk for marginalization (Montalvo

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.

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.

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.

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.

The SafeCOP ECSEL Project: Safe Cooperating Cyber-Physical Systems Using Wireless Communication

DEFF Research Database (Denmark)

Pop, Paul; Scholle, Detlef; Hansson, Hans

2016-01-01

This paper presents an overview of the ECSEL project entitled "Safe Cooperating Cyber-Physical Systems using Wireless Communication" (SafeCOP), which runs during the period 2016 -- 2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

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

The anterior interhemispheric approach: a safe and effective approach to anterior skull base lesions.

Science.gov (United States)

Mielke, Dorothee; Mayfrank, Lothar; Psychogios, Marios Nikos; Rohde, Veit

2014-04-01

Many approaches to the anterior skull base have been reported. Frequently used are the pterional, the unilateral or bilateral frontobasal, the supraorbital and the frontolateral approach. Recently, endoscopic transnasal approaches have become more popular. The benefits of each approach has to be weighted against its complications and limitations. The aim of this study was to investigate if the anterior interhemispheric approach (AIA) could be a safe and effective alternative approach to tumorous and non-tumorous lesions of the anterior skull base. We screened the operative records of all patients with an anterior skull base lesion undergoing transcranial surgery. We have used the AIA in 61 patients. These were exclusively patients with either olfactory groove meningioma (OGM) (n = 43), ethmoidal dural arteriovenous fistula (dAVF) ( n = 6) or frontobasal fractures of the anterior midline with cerebrospinal fluid (CSF) leakage ( n = 12). Patient records were evaluated concerning accessibility of the lesion, realization of surgical aims (complete tumor removal, dAVF obliteration, closure of the dural tear), and approach related complications. The use of the AIA exclusively in OGMs, ethmoidal dAVFs and midline frontobasal fractures indicated that we considered lateralized frontobasal lesions not suitable to be treated successfully. If restricted to these three pathologies, the AIA is highly effective and safe. The surgical aim (complete tumor removal, complete dAVF occlusion, no rhinorrhea) was achieved in all patients. The complication rate was 11.5 % (wound infection (n = 2; 3.2 %), contusion of the genu of the corpus callosum, subdural hygroma, epileptic seizure, anosmia and asymptomatic bleed into the tumor cavity (n = 1 each). Only the contusion of the corpus callosum was directly related to the approach (1.6 %). Olfaction, if present before surgery, was preserved in all patients, except one (1.6 %). The AIA is an effective and a safe approach

Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study.

Science.gov (United States)

Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid

2014-09-01

Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Ultrasound Diagnosis of Either an Occult or Missed Fracture of an Extremity in Pediatric-Aged Children

Energy Technology Data Exchange (ETDEWEB)

Cho, Kil Ho [Yeungnam University, Daegu (Korea, Republic of); Lee, Sung Moon [Keimyung University Dongsan Hospital, Daegu (Korea, Republic of); Lee, Young Hwan [Daegu Catholic University, Daegu (Korea, Republic of); Suh, Kyung Jin [Dongkuk University, Kyungju (Korea, Republic of)

2010-02-15

To report and assess the usefulness of ultrasound (US) findings for occult fractures of growing bones. For six years, US scans were performed in children younger than 15 years who were referred with trauma-related local pain and swelling of the extremities. As a routine US examination, the soft tissue, bones, and adjacent joints were examined in the area of discomfort, in addition to the asymptomatic contralateral extremity for comparison. Twenty-five occult fractures in 25 children (age range, five months-15 years; average age, 7.7 years) were confirmed by initial and follow-up radiograms, additional imaging studies, and clinical observation longer than three weeks. The most common site of occult fractures was the elbow (n = 9, 36%), followed by the knee (n = 7, 28%), ischium (n = 4, 16%), distal fibula (n = 3, 12%), proximal femur (n = 1, 4%), and humeral shaft (n = 1, 4%). On the retrograde review of the routine radiographs, 13 out of the 25 cases showed no bone abnormalities except for various soft tissue swelling. For the US findings, cortical discontinuity (direct sign of a fracture) was clearly visualized in 23 cases (92%) and was questionable in two (8%). As auxiliary US findings (indirect signs of a fracture), step-off deformities, tiny avulsed bone fragments, double-line appearance of cortical margins, and diffuse irregularity of the bone surfaces were identified. Performing US for soft tissue and bone surfaces with pain and swelling, with or without trauma history in the extremities, is important for diagnosing occult or missed fractures of immature bones in pediatric-aged children.

Finite element analysis to determine the stress distribution, displacement and safety factor on a microplate for the fractured jaw case

Science.gov (United States)

Pratama, Juan; Mahardika, Muslim

2018-03-01

Microplate is a connecting plate that can be used for jaw bone fixation. In the last two decades, microplate has been used so many times to help reconstruction of fractured jaw bone which is called mandibular bone or mandible bone. The plate is used to provide stable fixation of the fractured bone tissue during healing and reconstruction process. In this study Finite Element Analysis was used to predict the stress concentration and distribution on a microplate, displacement on the microplate and also to determine the safety factor of the microplate based on maximum allowable stress value, and finally to ascertain whether microplate is safe to use or not. The microplate was produced from punching process using titanium grade 1 (pure titanium) as material with a thickness of 500 µm. The results of the research indicated that the microplate was safe to use according to the maximum stress around the hole, displacement around the hole and also the safety factor of the microplate.

Fracture mechanics assessment of surface and sub-surface cracks in the RPV under non-symmetric PTS loading

Energy Technology Data Exchange (ETDEWEB)

Keim, E; Shoepper, A; Fricke, S [Siemens AG Unternehmensbereich KWU, Erlangen (Germany)

1997-09-01

One of the most severe loading conditions of a reactor pressure vessel (rpv) under operation is the loss of coolant accident (LOCA) condition. Cold water is injected through nozzles in the downcomer of the rpv, while the internal pressure may remain at a high level. Complex thermal hydraulic situations occur and the fluid and downcomer temperatures as well as the fluid to wall heat transfer coefficient at the inner surface are highly non-linear. Due to this non-symmetric conditions, the problem is investigated by three-dimensional non-linear finite element analyses, which allow for an accurate assessment of the postulated flaws. Transient heat transfer analyses are carried out to analyze the effect of non-symmetrical cooling of the inner surface of the pressure vessel. In a following uncoupled stress analysis the thermal shock effects for different types of defects, surface flaws and sub-surface flaws are investigated for linear elastic and elastic-plastic material behaviour. The obtained fracture parameters are calculated along the crack fronts. By a fast fracture analysis the fracture parameters at different positions along the crack front are compared to the material resistance. Safety margins are pointed out in an assessment diagram of the fracture parameters and the fracture resistance versus the transient temperature at the crack tip position. (author). 4 refs, 10 figs.

Surgical treatment of rib fracture nonunion: A single center experience.

Science.gov (United States)

de Jong, M B; Houwert, R M; van Heerde, S; de Steenwinkel, M; Hietbrink, F; Leenen, L P H

2018-03-01

In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. A single centre retrospective cohort study was performed at a level 1 trauma centre. Symptomatic rib nonunion was defined as a severe persistent localized pain associated with the nonunion of one or more rib fractures on a chest CT scan at least 3 months after the initial trauma. Patients after initial operative treatment of rib fractures were excluded. Nineteen patients (11 men, 8 women), with symptomatic nonunions were included. Fourteen patients were referred from other hospitals and 8 patients received treatment from a pain medicine specialist. The mean follow-up was 36 months. No in-hospital complications were observed. In 2 patients, new fractures adjacent to the implant, without new trauma were observed. Furthermore 3 patients requested implant removal with a persistent nonunion in one patient. There was a mean follow-up of 36 months, the majority of patients (n = 13) were satisfied with the results of their surgical treatment and all patients experienced a reduction in the number of complaints. Persisting pain was a common complaint. Three patients reporting severe pain used opioid analgesics on a daily or weekly basis. Only 1 patient needed ongoing treatment by a pain medicine specialist. Surgical fixation of symptomatic rib nonunion is a safe and feasible procedure, with a low perioperative complication rate, and might be beneficial in selected symptomatic patients in the future. In our study, although the majority of patients were satisfied and the pain level subjectively decreases, complaints of persistent pain were common. Copyright © 2018 Elsevier Ltd. All rights reserved.

A STUDY OF SURGICAL MANAGEMENT OF DISTAL FEMORAL FRACTURES BY DISTAL FEMORAL LOCKING COMPRESSION PLATE OSTEOSYNTHESIS

Directory of Open Access Journals (Sweden)

Dema Rajaiah

2016-08-01

Full Text Available AIMS AND OBJECTIVES To study the fractures of distal end of femur and the mechanism of injury in distal end femur fractures, the advantages and disadvantages of open reduction and internal fixation of distal end femur fractures by distal femoral locking compression plate osteosynthesis and to analyse the outcome in terms of range of Knee motion, time to union, and limb shortening. RESULTS The mean age of patient is 44 years, 85% are males, road traffic accidents account for majority (80%, right side involved in 70%, Muller’s type C fracture is common, good range of movements is seen 90% of cases and union occurred in 95% in 5 months. The results were assessed using Neer’s score, seven (35% patients had excellent results, eight (40% patients had good results, four (20% patients had fair results and one (5% patient had poor result. CONCLUSION From our study, we conclude that DF-LCP is a safe and reliable implant and has shown excellent to satisfactory results in majority of intra-articular fractures (AO type C. Fixation with locking compression plate showed more effectiveness in severely osteoporotic bones, shorter operative stay, faster recovery, faster union rates and excellent functional outcome.

Development of assessment methods for transport and storage containers with higher content of metallic recycling material

International Nuclear Information System (INIS)

Zencker, U.; Qiao Linan; Droste, B.

2004-01-01

The mechanical behaviour of transport and storage containers made of ductile cast iron melted with higher content of metallic recycling material from decommissioning and dismantling of nuclear installations is investigated. With drop tests of cubic container-like models, the influence of different real targets on the stresses in the cask body and the fracture behaviour is examined. A test stand foundation is suggested, which can be manufactured simply and improves the reproducibility of the test results strongly. The test objects are partially equipped with artificial cracklike defects. Dynamic fracture mechanics analyses of these defects were performed by means of finite element calculations to uncover safety margins. Numerous test results show depending on the requirements that containers for final disposal can be built by means of a ductile cast iron with fracture toughness more than half under the lower bound value for the licensed material qualities yet. The application limits of the material are determined also by the opportunities of the safety assessment methods. This project supports the application of brittle fracture safe transport and storage packages for radioactive materials as recommended in App. VI of the Advisory Material for the IAEA Regulations for the Safe Transport of Radioactive Material (IAEA No. TS-G-1.1)

Development of assessment methods for transport and storage containers with higher content of metallic recycling material

Energy Technology Data Exchange (ETDEWEB)

Zencker, U.; Qiao Linan; Droste, B. [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin (Germany)

2004-07-01

The mechanical behaviour of transport and storage containers made of ductile cast iron melted with higher content of metallic recycling material from decommissioning and dismantling of nuclear installations is investigated. With drop tests of cubic container-like models, the influence of different real targets on the stresses in the cask body and the fracture behaviour is examined. A test stand foundation is suggested, which can be manufactured simply and improves the reproducibility of the test results strongly. The test objects are partially equipped with artificial cracklike defects. Dynamic fracture mechanics analyses of these defects were performed by means of finite element calculations to uncover safety margins. Numerous test results show depending on the requirements that containers for final disposal can be built by means of a ductile cast iron with fracture toughness more than half under the lower bound value for the licensed material qualities yet. The application limits of the material are determined also by the opportunities of the safety assessment methods. This project supports the application of brittle fracture safe transport and storage packages for radioactive materials as recommended in App. VI of the Advisory Material for the IAEA Regulations for the Safe Transport of Radioactive Material (IAEA No. TS-G-1.1).

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.

Developing person-centred practice in hip fracture care for older people.

Science.gov (United States)

Christie, Jane; Macmillan, Maureen; Currie, Colin; Matthews-Smith, Gerardine

2016-12-14

To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people.

Safe Kids Worldwide

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... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are What We Do Find Your Safe Kids Safe Kids Day Main menu Keeping All Kids Safe Safety Tips Get Involved 4 Star Charity Donate Text Burns and Scalds 4 tips ...

Respiratory gated beam delivery cannot facilitate margin reduction, unless combined with respiratory correlated image guidance

International Nuclear Information System (INIS)

Korreman, Stine S.; Juhler-Nottrup, Trine; Boyer, Arthur L.

2008-01-01

Purpose/objective: In radiotherapy of targets moving with respiration, beam gating is offered as a means of reducing the target motion. The purpose of this study is to evaluate the safe magnitude of margin reduction for respiratory gated beam delivery. Materials/methods: The study is based on data for 17 lung cancer patients in separate protocols at Rigshospitalet and Stanford Cancer Center. Respiratory curves for external optical markers and implanted fiducials were collected using equipment based on the RPM system (Varian Medical Systems). A total of 861 respiratory curves represented external measurements over 30 fraction treatment courses for 10 patients, and synchronous external/internal measurements in single sessions for seven patients. Variations in respiratory amplitude (simulated coaching) and external/internal phase shifts were simulated by perturbation with realistic values. Variations were described by medians and standard deviations (SDs) of position distributions of the markers. Gating windows (35% duty cycle) were retrospectively applied to the respiratory data for each session, mimicking the use of commercially available gating systems. Medians and SDs of gated data were compared to those of ungated data, to assess potential margin reductions. Results: External respiratory data collected over entire treatment courses showed SDs from 1.6 to 8.1 mm, the major part arising from baseline variations. The gated data had SDs from 1.5 to 7.7 mm, with a mean reduction of 0.3 mm (6%). Gated distributions were more skewed than ungated, and in a few cases a marginal miss of gated respiration would be found even if no margin reduction was applied. Regularization of breathing amplitude to simulate coaching did not alter these results significantly. Simulation of varying phase shifts between internal and external respiratory signals showed that the SDs of gated distributions were the same as for the ungated or smaller, but the median values were markedly shifted

Task Group on Safety Margins Action Plan (SMAP). Safety Margins Action Plan - Final Report

International Nuclear Information System (INIS)

Hrehor, Miroslav; Gavrilas, Mirela; Belac, Josef; Sairanen, Risto; Bruna, Giovanni; Reocreux, Michel; Touboul, Francoise; Krzykacz-Hausmann, B.; Park, Jong Seuk; Prosek, Andrej; Hortal, Javier; Sandervaag, Odbjoern; Zimmerman, Martin

2007-01-01

The international nuclear community has expressed concern that some changes in existing plants could challenge safety margins while fulfilling all the regulatory requirements. In 1998, NEA published a report by the Committee on Nuclear Regulatory Activities on Future Nuclear Regulatory Challenges. The report recognized 'Safety margins during more exacting operating modes' as a technical issue with potential regulatory impact. Examples of plant changes that can cause such exacting operating modes include power up-rates, life extension or increased fuel burnup. In addition, the community recognized that the cumulative effects of simultaneous changes in a plant could be larger than the accumulation of the individual effects of each change. In response to these concerns, CSNI constituted the safety margins action plan (SMAP) task group with the following objectives: 'To agree on a framework for integrated assessments of the changes to the overall safety of the plant as a result of simultaneous changes in plant operation / condition; To develop a CSNI document which can be used by member countries to assess the effect of plant change on the overall safety of the plant; To share information and experience.' The two approaches to safety analysis, deterministic and probabilistic, use different methods and have been developed mostly independently of each other. This makes it difficult to assure consistency between them. As the trend to use information on risk (where the term risk means results of the PSA/PRA analysis) to support regulatory decisions is growing in many countries, it is necessary to develop a method of evaluating safety margin sufficiency that is applicable to both approaches and, whenever possible, integrated in a consistent way. Chapter 2 elaborates on the traditional view of safety margins and the means by which they are currently treated in deterministic analyses. This chapter also discusses the technical basis for safety limits as they are used today

Mesozoic tectonics of the Otway Basin region: The legacy of Gondwana and the active Pacific margin: a review and ongoing research

Energy Technology Data Exchange (ETDEWEB)

Hill, K.A. [Monash Univ., Clayton, VIC (Australia). Department of Earth Sciences; Finlayson, D.M. [Australian Geological Survey Organisation, Canberra, ACT (Australia); Hill, K.C. [La Trobe Univ., Bundoora, VIC (Australia). School of Earth Sciences; Cooper, G.T. [Monash Univ., Clayton, VIC (Australia). Department of Earth Sciences

1995-12-31

Recent plate tectonic models for SE Australia and the formerly contiguous parts of Gondwana are reviewed in this paper in order to assess the Mesozoic evolution of the Otway Basin. Research around the Otway Basin is summarised to demonstrate how the application of new technology can address some of the outstanding questions regarding the Basin`s evolution on local to lithospheric scales. The geometry and geology of Australia`s southern margin are compared with Atlantic rift-drift margins to provide analogues for tectonics and hydrocarbon exploration in the Otway Basin. At least two stages of rifting were found to be evident in the Cretaceous and in the deep structure of the Otway basin. These are Early Cretaceous rifting which is manifested in numerous half-graben and accommodation zones, and Late Cretaceous rifting in the deep seismic data seaward of the Tartwaup, Timboon and Sorell fault zones. Major offsets of the spreading axis during break up, at the Tasman and Spencer Fracture Zones were probably controlled by the location of Paleozoic terrace boundaries. The Tasman Fracture System was reactivated during break-up, with considerable uplift and denudation of the Bass failed rift to the east, which controlled Otway Basin facies distribution. Paleozoic structures also had a significant effect in determining the half graben orientations within a general N-S extensional regime during early Cretaceous rifting. The late Cretaceous second stage of rifting, seaward of the Tartwaup, Timboon and Sorell fault zones, left stable failed rift margin to the north, but the attenuated lithosphere of the Otway-Sorell microplate to the south records repeated extension that led to continental separation and may be part of an Antarctic upper plate. 1 table. 16 figs., 4 photos., refs.

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

[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

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.)

Displaced humeral lateral condyle fractures in children: should we bury the pins?

Science.gov (United States)

Das De, Soumen; Bae, Donald S; Waters, Peter M

2012-09-01

The purpose of this investigation was to determine if leaving Kirschner wires exposed is more cost-effective than burying them subcutaneously after open reduction and internal fixation (ORIF) of humeral lateral condyle fractures. A retrospective cohort study of all lateral condyle fractures treated over a 10-year period at a single institution was performed. Data on surgical technique, fracture healing, and complications were analyzed, as well as treatment costs. A decision analysis model was then constructed to compare the strategies of leaving the pins exposed versus buried. Finally, sensitivity analyses were performed, assessing cost-effectiveness when infection rates and costs of treating deep infections were varied. A total of 235 children with displaced fractures were treated with ORIF using Kirschner wires. Pins were left exposed in 41 cases (17.4%) and buried in 194 cases (82.6%); the age, sex, injury mechanisms, and fracture patterns were similar in both the groups. The median time to removal of implants was shorter with exposed versus buried pins (4 vs. 6 wk, Pfracture union or loss of reduction rates. The rate of superficial infection was higher with exposed pins (9.8% vs. 3.1%), but this was not statistically significant (P=0.076). There were no deep infections with exposed pins, whereas the rate of deep infection was 0.5% with buried pins (P=1.00). Buried pins were associated with additional complications, including symptomatic implants (7.2%); pins protruding through the skin (16%); internal pin migration necessitating additional surgery (1%); and skin necrosis (1%). The decision analysis revealed that leaving pins exposed resulted in an average cost savings of $3442 per patient. This strategy remained cost-effective even when infection rates with exposed pins approached 40%. Leaving the pins exposed after ORIF of lateral condyle fractures is safe and more cost-effective than burying the pins subcutaneously. Retrospective cohort study (level III).

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.

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

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

Hip fracture - discharge

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... 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 ...

Alveolar process fractures in the permanent dentition. Part 2. The risk of healing complications in teeth involved in an alveolar process fracture.

Science.gov (United States)

Lauridsen, Eva; Gerds, Thomas; Andreasen, Jens Ove

2016-04-01

To analyze the risk of pulp canal obliteration (PCO), pulp necrosis (PN), repair-related resorption (RRR), infection-related resorption (IRR), ankylosis-related resorption (ARR), marginal bone loss (MBL), and tooth loss (TL) for teeth involved in an alveolar process fracture and to identify possible risk factors. A total of 91 patients with 223 traumatized teeth. The risks of PCO, PN, RRR, IRR, ARR, MBL, and TL were analyzed separately for teeth with immature and mature root development using Kaplan-Meier and Aalen-Johansen methods. Possible risk factors for PN (age, fracture in relation to apex, displacement, gingival injury, degree of repositioning, type of splint, duration of splinting, treatment delay, and antibiotics) were analyzed for mature teeth using Cox regression. The level of significance was 5%. Immature: No severe complications (PN, IRR, ARR, MBL, or TL) were diagnosed during follow up. Mature: Estimated risk after a 10-year follow up: PN: 56% (95% confidence interval (CI): 48.1-63.9), IRR: 2.5% (95% CI: 0-5.1), ARR: 2.1% (95% CI: 0.1-4.1), MBL: 2.4% (95% CI: 0.3-4.4), and TL: 7.8% (95% CI: 0-15.7). The following factors significantly increased the risk of PN in teeth with mature root development: fracture in relation to apex (hazard ratio (HR): 2.6 (95% CI: 0.2 - 5.7), P = 0.01), displacement in the horizontal part of the fracture >2 mm (HR: 1.8; 95% CI: 1.1-3.2, P = 0.03), incomplete repositioning (HR: 2.1 (95% CI: 1.3-3.5), P = 0.003), and age >30 years (HR: 2.3 (95% CI: 1.1-4.6), P = 0.02). The type of splint (rigid or flexible), the duration of splinting (more or less than 4 weeks), and the administration of antibiotics did not affect the risk of PN. Teeth involved in alveolar process fractures appear, apart from PN, to have a good prognosis. A conservative treatment approach is recommended. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Quantifying Discrete Fracture Network Connectivity in Hydraulic Fracturing Stimulation

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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.

Margin improvement initiatives: realistic approaches

Energy Technology Data Exchange (ETDEWEB)

Chan, P.K.; Paquette, S. [Royal Military College of Canada, Chemistry and Chemical Engineering Dept., Kingston, ON (Canada); Cunning, T.A. [Department of National Defence, Ottawa, ON (Canada); French, C.; Bonin, H.W. [Royal Military College of Canada, Chemistry and Chemical Engineering Dept., Kingston, ON (Canada); Pandey, M. [Univ. of Waterloo, Waterloo, ON (Canada); Murchie, M. [Cameco Fuel Manufacturing, Port Hope, ON (Canada)

2014-07-01

With reactor core aging, safety margins are particularly tight. Two realistic and practical approaches are proposed here to recover margins. The first project is related to the use of a small amount of neutron absorbers in CANDU Natural Uranium (NU) fuel bundles. Preliminary results indicate that the fuelling transient and subsequent reactivity peak can be lowered to improve the reactor's operating margins, with minimal impact on burnup when less than 1000 mg of absorbers is added to a fuel bundle. The second project involves the statistical analysis of fuel manufacturing data to demonstrate safety margins. Probability distributions are fitted to actual fuel manufacturing datasets provided by Cameco Fuel Manufacturing, Inc. They are used to generate input for ELESTRES and ELOCA. It is found that the fuel response distributions are far below industrial failure limits, implying that margin exists in the current fuel design. (author)

[Application of three-dimensional printing technology in treatment of internal or external ankle distal avulsed fracture].

Science.gov (United States)

Shi, Weixiang; Luo, Xiaozhong; Wu, Gang; Ding, Yong; Zhou, Xin

2018-02-01

, safe, reliable, and effective. In particular, it is an ideal treatment for avulsed fracture.

Traumatic Posterior Atlantoaxial Dislocation Without Associated Fracture but With Neurological Deficit

Science.gov (United States)

Xu, Yong; Li, Feng; Guan, Hanfeng; Xiong, Wei

2015-01-01

Abstract Posterior atlantoaxial dislocation without odontoid fracture is extremely rare and often results in fatal spinal cord injury. According to the reported literature, all cases presented mild or no neurologic deficit, with no definite relation to upper spinal cord injury. Little is reported about traumatic posterior atlantoaxial dislocation, with incomplete quadriplegia associated with a spinal cord injury. We present a case of posterior atlantoaxial dislocation without associated fracture, but with quadriplegia, and accompanying epidural hematoma and subarachnoid hemorrhage. The patient underwent gentle traction in the neutral position until repeated cranial computed tomography revealed no progression of the epidural hematoma. Thereafter, the atlantoaxial dislocation was reduced by using partial odontoidectomy via a video-assisted transcervical approach and maintained with posterior polyaxial screw-rod constructs and an autograft. Neurological status improved immediately after surgery, and the patient recovered completely after 1 year. Posterior fusion followed by closed reduction is the superior strategy for posterior atlantoaxial dislocation without odontoid fracture, according to literature. But for cases with severe neurological deficit, open reduction may be the safest choice to avoid the lethal complication of overdistraction of the spinal cord. Also, open reduction and posterior srew-rod fixation are safe and convenient strategies in dealing with traumatic posterior atlantoaxial dislocation patients with neurological deficit. PMID:26512572

Vertical Root Fracture: Preservation of the Alveolar Ridge Using Immediate Implants

Directory of Open Access Journals (Sweden)

Edmar de Oliveira Oya

2014-01-01

Full Text Available Teeth with vertical root fracture (VRF have complete or incomplete fractures that begin in the root and extend toward the occlusal surface. The most frequent causes of VRF originate from physical trauma, occlusal prematurity, inadequate endodontic treatment, and iatrogenic causes. Diagnose is difficult and delay can cause stomatognathic system problem. The purpose of this case report was to evaluate immediate implant placement after extraction of teeth with vertical root fracture. For the 1st case, the VRF in 1st left lower molar was confirmed during surgical flap and at the same time, the tooth was removed and immediate implant was placed. For the 2nd case, the VRF 1st left lower molar was confirmed during endodontic access and at the same appointment, the tooth was removed and the immediate implant is placed. Several studies have shown that immediate implants have similar success rates when compared with late implants. Consider that this approach is a safe procedure with favorable prognosis. In cases of VRF, the main factor to be considered is the presence of adequate bone support and immediate implants can preserve the vertical bone height, adding the fact that good patient compliance reduces the number of surgical interventions and promotes the functionality of stomatognathic system.

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

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

The marginal costs of greenhouse gas emissions

International Nuclear Information System (INIS)

Tol, R.S.J.

1999-01-01

Estimates of the marginal costs of greenhouse gas emissions are on important input to the decision how much society would want to spend on greenhouse gas emission reduction. Marginal cost estimates in the literature range between $5 and $25 per ton of carbon. Using similar assumptions, the FUND model finds marginal costs of $9--23/tC, depending on the discount rate. If the aggregation of impacts over countries accounts for inequalities in income distribution or for risk aversion, marginal costs would rise by about a factor of 3. Marginal costs per region are an order of magnitude smaller than global marginal costs. The ratios between the marginal costs of CO 2 and those of CH 4 and N 2 O are roughly equal to the global warming potentials of these gases. The uncertainty about the marginal costs is large and right-skewed. The expected value of the marginal costs lies about 35% above the best guess, the 95-percentile about 250%

Vitamin D Status, Bone Mineral Density and Mental Health in Young Australian Women: The Safe-D Study.

Science.gov (United States)

Callegari, Emma T; Reavley, Nicola; Garland, Suzanne M; Gorelik, Alexandra; Wark, John D

2015-11-17

Vitamin D deficiency has been associated with both poor bone health and mental ill-health. More recently, a number of studies have found individuals with depressive symptoms tend to have reduced bone mineral density. To explore the interrelationships between vitamin D status, bone mineral density and mental-ill health we are assessing a range of clinical, behavioural and lifestyle factors in young women (Part A of the Safe-D study). Part A of the Safe-D study is a cross-sectional study aiming to recruit 468 young females aged 16-25 years living in Victoria, Australia, through Facebook advertising. Participants are required to complete an extensive, online questionnaire, wear an ultra-violet dosimeter for 14 consecutive days and attend a study site visit. Outcome measures include areal bone mineral measures at the lumbar spine, total hip and whole body, as well as soft tissue composition using dual energy x-ray absorptiometry. Trabecular and cortical volumetric bone density at the tibia is measured using peripheral quantitative computed tomography. Other tests include serum 25-hydroxyvitamin D, serum biochemistry and a range of health markers. Details of mood disorder/s and depressive and anxiety symptoms are obtained by self-report. Cutaneous melanin density is measured by spectrophotometry. The findings of this cross-sectional study will have implications for health promotion in young women and for clinical care of those with vitamin D deficiency and/or mental ill-health. Optimising both vitamin D status and mental health may protect against poor bone health and fractures in later life. Significance for public healthVitamin D deficiency, depression and osteoporosis are all major public health issues. Vitamin D deficiency has been associated with both reduced bone mineral density and depressive symptoms. Moreover, cohort studies have found that subjects with depression have lower bone mineral density when compared to healthy controls. Early adulthood is a critical

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.

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.

[Medpor plus titanic mesh implant in the repair of orbital blowout fractures].

Science.gov (United States)

Han, Xiao-hui; Zhang, Jia-yu; Cai, Jian-qiu; Shi, Ming-guang

2011-05-10

To study the efficacy of porous polyethylene (Medpor) plus titanic mesh sheets in the repair of orbital blowout fractures. A total of 20 patients underwent open surgical reduction with the combined usage of Medpor and titanic mesh. And they were followed up for average period of 14.5 months (range: 9 - 18). There is no infection or extrusion of medpor and titanic mesh in follow-up periods. There was no instance of decreased visual acuity at post-operation. And all cases of enophthalmos were corrected. The post-operative protrusion degree of both eyes was almost identical at less than 2 mm. The movement of eye balls was satisfactory in all directions. Diplopia disappeared in 18 cases with a cure rate of 90%, 1 case improved and 1 case persisted. Medpor plus titanic mesh implant is a safe and effective treatment in the repair of orbital blow out fractures.

"Same Room, Safe Place".

Science.gov (United States)

Keene Woods, Nikki

2017-04-01

There are many different professional stances on safe sleep and then there is the reality of caring for a newborn. There is a debate among professionals regarding safe sleep recommendations. The continum of recommendations vary from the American Academy of Pediatrics (AAP) Safe Sleep Guidelines to the bed-sharing recommendations from the Mother-Baby Behavioral Sleep Laboratory. The lack of consistent and uniform safe sleep recommendations from health professionals has been confusing for families but has more recently raised a real professional ethical dilemma. Despite years of focused safe sleep community education and interventions, sleep-related infant deaths are on the rise in many communities. This commentary calls for a united safe sleep message from all health professionals to improve health for mothers and infants most at-risk, "Same Room, Safe Place."

An engineering methodology for fracture analyses of tough materials

International Nuclear Information System (INIS)

Shih, C.F.

1981-01-01

The paper summarizes progress made in two research programs sponsored by the Electric Power Research Institute (EPRI), to identify viable parameters for characterizing crack inititation and continued extension, and to develop an engineering/design methodology, based on these parameters, for the assessment of crack growth and instability in engineering structures which are stressed beyond the regime of applicability of linear elastic fracture mechanics. The ultimate goal in the development of such a methodology is to establish a rational basis for analyzing the effect of flaws (postulated or detected) on the safety margins of pressure boundary components of light water-cooled type nuclear steam supply systems. The methodology can also be employed for structural integrity analyses of other engineering structures. (Auth.)

A study of radiological features of healing in long bone fractures among infants less than a year

Energy Technology Data Exchange (ETDEWEB)

Warner, Christopher; Miller, Angie; Weinman, Jason; Fadell, Michael [Children' s Hospital Colorado, Department of Radiology, Aurora, CO (United States); Maguire, Sabine; Trefan, Laszlo [Cardiff University, Institute of Primary Care and Child Health, Cardiff (United Kingdom)

2017-03-15

To create a timetable for dating long bone fractures in infants aged less than 1 year using previously defined radiographic signs of fracture healing. A retrospective cross-sectional time series of long bone fractures in infants aged less than 1 year was conducted from 2006 to 2013. After exclusion criteria were applied 59 digital image series were available for review from 40 infants. Utilizing published criteria for dating fractures, the presence or absence of four pre-defined features of healing was scored: periosteal reaction, callus, bridging, and remodeling. Three radiologists independently scored radiographs with a 3-point scale, marking each feature as present, absent, or equivocal. The times in days when features were first seen, peaked (feature agreed present in >40% of images), and last seen were noted. Statistical analysis using free marginal kappa was conducted. The level of agreement among the three radiologists was high (0.64-0.85). The sequence in which the features were seen was: periosteal reaction range 7-130 (present in the majority of cases between 9 and 49 days); callus range 9-130 (present in the majority of cases between days 9-26); bridging range 15-130 (seen in the majority of cases between 15 and 67 days); remodeling range 51-247 days. This study provides a timetable of radiological features of long bone healing among young infants for the first time. Dating of incomplete long bone fractures is challenging, beyond the presence of periosteal reaction, but a consistent sequence of changes is present in complete fractures. (orig.)

Internal Fixation of Transverse Patella Fractures Using Cannulated Cancellous Screws with Anterior Tension Band Wiring

Directory of Open Access Journals (Sweden)

Khan I

2016-07-01

Full Text Available Aims: To evaluate the effectiveness and safety of anterior tension band wiring technique using two cannulated cancellous screws in patients with transverse (AO34-C1 or transverse with mildly comminuted (AO34-C2 patellar fractures. Materials and Methods: This is a prospective study of 25 patients with transverse fracture or transverse fracture with mildly comminuted patella fractures. All the patients were treated with open reduction and internal fixation using two parallel cannulated screws and 18G stainless steel wire as per the tension band principle. Results: There were eighteen males (72% and seven females (28%. The age group ranged from 24 to 58 years, with mean age of 38 years. The most common mode of injury was fall (72% followed by road traffic accident (20% and violent quadriceps contraction (8%. Transverse fracture was present in 60% and transverse fracture with mild comminution in 40% of patients. Mean time to achieve union was 10.7 weeks (range 8-12 weeks. Mean ROM at three months was 113.8 degree (90-130 and at final follow up this improved to 125.4 degrees (range 100-140. There was one case of knee stiffness and no case of implant failure was observed. Patients were evaluated using Bostman scoring, the mean score at three months being 26.04 which improved to 27.36 at the end of final follow up at one year. Conclusion: Cannulated cancellous screws with anterior tension band wiring is a safe, reliable and reproducible method in management of transverse patellar fractures, with less chances of implant failure and soft tissue irritation.

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.

Refining margins: recent trends

International Nuclear Information System (INIS)

Baudoin, C.; Favennec, J.P.

1999-01-01

Despite a business environment that was globally mediocre due primarily to the Asian crisis and to a mild winter in the northern hemisphere, the signs of improvement noted in the refining activity in 1996 were borne out in 1997. But the situation is not yet satisfactory in this sector: the low return on invested capital and the financing of environmental protection expenditure are giving cause for concern. In 1998, the drop in crude oil prices and the concomitant fall in petroleum product prices was ultimately rather favorable to margins. Two elements tended to put a damper on this relative optimism. First of all, margins continue to be extremely volatile and, secondly, the worsening of the economic and financial crisis observed during the summer made for a sharp decline in margins in all geographic regions, especially Asia. Since the beginning of 1999, refining margins are weak and utilization rates of refining capacities have decreased. (authors)

Area balance and strain in an extensional fault system: Strategies for improved oil recovery in fractured chalk, Gilbertown Field, southwestern Alabama. Annual report, March 1996--March 1997

Energy Technology Data Exchange (ETDEWEB)

Pashin, J.C.; Raymond, D.E.; Rindsberg, A.K.; Alabi, G.G.; Groshong, R.H.

1997-08-01

Gilbertown Field is the oldest oil field in Alabama and produces oil from chalk of the Upper Cretaceous Selma Group and from sandstone of the Eutaw Formation along the southern margin of the Gilbertown fault system. Most of the field has been in primary recovery since establishment, but production has declined to marginally economic levels. This investigation applies advanced geologic concepts designed to aid implementation of improved recovery programs. The Gilbertown fault system is detached at the base of Jurassic salt. The fault system began forming as a half graben and evolved in to a full graben by the Late Cretaceous. Conventional trapping mechanisms are effective in Eutaw sandstone, whereas oil in Selma chalk is trapped in faults and fault-related fractures. Burial modeling establishes that the subsidence history of the Gilbertown area is typical of extensional basins and includes a major component of sediment loading and compaction. Surface mapping and fracture analysis indicate that faults offset strata as young as Miocene and that joints may be related to regional uplift postdating fault movement. Preliminary balanced structural models of the Gilbertown fault system indicate that synsedimentary growth factors need to be incorporated into the basic equations of area balance to model strain and predict fractures in Selma and Eutaw reservoirs.

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.

Anterior glenoid rim fracture: the value of helical CT with threedimensional reconstruction and electronic humeral disarticulation

Directory of Open Access Journals (Sweden)

Heverton César de Oliveira

2003-06-01

Full Text Available Objectives: To show a new three-dimensional reconstructiontechnique based on helical computed tomography images withelectronic humeral disarticulation in anterior glenoid rim fractures,correlating the anatomic specimen with simulation of an anteriorglenoid rim fracture, as well as evaluating the extension of thefracture, the bone fragment position and distance in relation to theglenoid cavity in six patients. Methods: One scapula and onehumerus with no signs of fracture or congenital malformationswere placed in anatomical position using an adhesive tape aftersimulating an anterior glenoid rim fracture made by an osteotome.Helical CT imaging was acquired and three-dimensionalreconstructions were made based on these images, with andwithout electronic humeral disarticulation. The bone fragment waslocated, measured and its position in relation to the glenoid cavitywas assessed. Six patients with anterior glenoid rim fracture weresubmitted to CT of the shoulder using the same parameters asthose applied to the anatomic specimen. Results: In the anatomicspecimen and in all six patients the bone fragment was clearlydemonstrated; bone fragment measurements in the anatomicspecimen and in three-dimensional reconstructions wereequivalent. The fragment was better demonstrated in the imagestaken with electronic humeral disarticulation, particularly in thefrontal view of the glenoid cavity as observed in all six patients.Conclusion: We concluded that our experiment with the anatomicspecimen and the study of six patients allow us to state that thistechnique is safe and accurate to demonstrate the extension, sizeand location of the bone fragment in anterior glenoid rim fractures,and it provides essential elements for therapeutic planning.